The Electric Bath

by George M. Schweig

Case XV. Mrs. S., aet. 22, four years married. I was called to see her on October 2d, 1874. She then had a spontaneous miscarriage, the fifth since her marriage. She asked me whether nothing could be done to enable her to carry a child to full term, as both she and her husband were very desirous to have offspring. In pursuance of my directions, she presented herself at my office about ten days after I first saw her. On examination I found no organic trouble, no uterine displacement, nor any other local trouble to account for her premature confinements. Involution had progressed normally. The only deviation from the normal that I could discover about the uterus was undue paleness of the cervical portion. Her appearance was very decidedly anæmic; features pale, flabby; lips whitish blue; physical energy much depressed. She had had but very slight loss of blood on the occasion of her recent miscarriage; certainly not enough to account for her anæmic appearance. Viewing her case as one of idiopathic anæmia, I ordered her electric baths strongly impregnated with iron. In addition to this, the regimen usual in such cases, and also strychnia and phosphorus internally. She took her first bath on Oct. 14th; then one bath weekly until she had taken six baths, the last of which was administered on the 24th of November. During all this time she kept steadily improving. The anæmic appearance and symptoms gradually receded, and, soon after she had taken her last bath, I discharged her, as far as the anæmia was concerned—cured. While she was under treatment she had, by my advice, refrained entirely from sexual intercourse. Early in the spring of 1875 she called to tell that she was again pregnant, and in November, 1875, I delivered her of a healthy male child, at full term.

PARALYSES AND PARESES.

I include these under one head, because not only is their origin frequently identical, but, chiefly, because the therapeutic indications are almost always the same in both. Whatever the cause in any given case, whether cerebral, spinal or peripheral, organic or functional; whatever the treatment that may be indicated—and this should never be neglected—for the primary trouble, the direct electrical treatment of the paralysis, sub-paralysis or paresis, being purely symptomatic treatment, remains in the great majority of cases essentially the same. The objects to be aimed at are two, viz: first, a normal state of nutrition of the affected muscles; second, their normal contractility. In other words, we are to endeavor to prevent atrophy of the affected muscles, or, where this has already taken place to some extent, to restore their normal bulk; and, second, we must strive to restore the more or less impaired contractility of the paralytic or paretic muscles. Even where symptomatic treatment for these purposes is the only treatment employed in a case, we frequently meet to a great extent the indicatio morbi, by favorably influencing, either in a reflex or direct manner, the primary disease. This is true of local electrizations of the affected parts; it holds good much more strongly however of electric baths, because here, in addition to the reflex influence that we get from local applications, we have also the direct influence of the electric current on the spinal cord and posterior portion of the brain not only, but on the sympathetic system and all the important organs contained in the thoracic and abdominal cavities. The great importance of this is apparent, when we reflect that in very many if not most cases of disease of the nervous system, central or peripheral, electricity in an appropriate form is a useful therapeutic agent, and that moreover the great majority of functional paralytic disorders respond favorably to its influence. As for any harm being done by it in those rare cases where its use may be contra-indicated, I admit that such may accrue from the administration of electric baths without medical supervision; it is entirely obviated however where the baths are under the supervision of a physician, who does not, like a layman, indiscriminately admit to their use any and everybody who is willing to pay for their administration, but will carefully discriminate, and conscientiously exclude those cases in which general electrization might result injuriously. In such cases a tolerably accurate diagnosis is as a rule readily made, and will enable the physician to separate the suitable from the unsuitable cases.

As to the mode of administration of the baths in cases of the class under consideration, the use of both currents is requisite; the galvanic as a nutrient, the faradic as an excito-motor agent. Where, as is sometimes the case, faradic irritability is extinct, or so slight as to be practically unavailable, the (slowly) interrupted galvanic current must take the place of the faradic, until faradic irritability has become re-established. As to the intensity, direction, etc., of the currents, each individual case has its own laws, which must be recognized by the supervising physician.

Case XVI.—Infantile paralysis. Albert Pichl, aet. 22 months, was sent me by Dr. Lilienthal, October 3d, 1874. Had complete paralysis of right leg (of four weeks standing), with considerable atrophy of the entire leg as well as the gluteal region of the corresponding side. The temperature of the leg was much lower than that of the healthy limb. Faradic irritability was entirely extinct. The treatment was begun by galvanizations of the lower (lumbar and sacral) portion of the spinal cord, and the use of the interrupted galvanic current on the affected muscles. This was at first done daily. The contractility of the muscles gradually but slowly improved, but neither the atrophy nor temperature of the limb appeared visibly affected by the treatment. With a view to favorably influencing these conditions, I ordered him galvanic baths. He had a bath every alternate day. The result was favorable and rapid. The leg became sensibly and permanently warmer after each bath, and commenced steadily to increase in bulk. Faradic irritability soon returned. The local applications were continued several times a week for some time, and then gradually abandoned, the baths being meantime continued regularly. The boy very soon began to walk, and in December active treatment was discontinued. At that time, faradic irritability having long since become completely re-established, I caused the child’s father to purchase a faradic battery to use at home. The limb was eventually entirely restored in every respect, with the exception of a slight abduction of the foot, for which I referred the patient to Dr. Gibney. I saw the child recently; he remains well.

Case XVII.* Sub-hemiplegia from cerebral hemorrhage. Mrs. S., aet. 30, married, from the practice of Dr. Krehbiel, was sent by Dr. K. to take baths, July 3d, 1874. It was a routine case, differing in no respect from what is ordinarily witnessed as a sequence of cerebral hemorrhage. Six baths, taken at intervals of two and three days, restored almost entirely the muscular power of the affected side. The patient subsequently made a complete recovery without further treatment.

Case XVIII. Paralysis from insolation. Mr. P., proof-reader aet. about 40, had suffered for some time from sub-paraplegia, the result of insolation. He was sent to take baths in May, 1874, by his physician, Dr. Schirmer. Electro-balneological treatment in this case met with no success.

Case XIX. Lead paralysis. Mr. M., aet. about 35, painter, was referred to me for treatment May 15th, 1874, by Dr. Mohn. The extensors of one (I believe it was the right) arm were paralyzed. The characteristic blue line about the gums was clearly defined. I ordered an electric bath daily. The descending galvanic current was used for twenty minutes each bath. From half to one ounce of iodide of potassium was added to each bath. The blue line became less distinct from day to day, until, after eleven baths, it had entirely disappeared. The object for which I had ordered the baths having now been accomplished, I treated the affected muscles with the faradic current. A short course of this treatment sufficed to remove the paralysis from all but one finger (it was either the middle or ring finger), the extensors of which had probably undergone fatty degeneration.

NEURALGIÆ.

The great variety of causes that may give rise to neuralgia, precludes the possibility of any specific for this symptom. In discussing its electro-balneological treatment, I would observe a primo that I cannot, in the light of my personal experience, agree with those who claim for electrical treatment good results in a majority of cases.[16] On the other hand it cannot be denied that, either as a palliative or curative measure, electricity, employed in an appropriate form and manner, is of inestimable value in many cases, and frequently succeeds where all other remedies are of no avail. Where we know the cause of a neuralgia, it is of course comparatively easy for us to determine whether or not electricity promises to avail anything. But even where the nature of the cases appeared to indicate its use, the failures, in my hands at least, have outnumbered the successes. The brilliant results—sometimes almost instantaneous—that we obtain now and then, should not lead us into overlooking our failures. Undoubtedly the circumstance that most of the cases that have come under my observation were of a very obstinate nature, referred to me by other physicians after varied unsuccessful treatment, has much to do with the formation of my views as expressed above, and future experience may perhaps lead me to modify them.