[16] In the treatment of Neuralgia by the constant current the electrodes should be so applied as to include between them the part or nerve affected—the number of cells the highest number that can be borne without pain, i.e., the current to be distinctly but not painfully felt, both electrodes being immovable. |Electricity in Neuralgia.| Time, five to ten minutes. Frequency, as often as the attacks of pain recur. I am satisfied that in severe cases this rule of application is essential—that the influence of the current shall be maintained as much as may be in the irritable nerve during the intervals of pain. In one case under my care the patient was galvanized with benefit 27 times in the 24 hours; but in milder cases one or two applications daily will generally suffice. A weak current from two or three cells—the electrodes being applied to each temple for one or two minutes—will sometimes dissipate a severe headache. This soothing influence of the current is often useful in allaying Spasm, as, for example, in spasmodic torticollis. The current should be localized in the irritable muscles: and it is generally advisable to energetically Faradize their antagonists and to conjoin with the electrical treatment appropriate gymnastic exercises, alternating with periods of perfect rest. I may mention that the only recorded case of improvement in that remarkable condition of spasm first described by Hammond under the name of Athetosis resulted from the Voltaic current. The case was brought before the Medico-Chirurgical Society by Dr. Gowers, and is published in the 49th volume of their Transactions. The reader will find the subject of neuralgia very exhaustively considered in Dr. Anstie’s work.[17] He quotes some extremely severe cases in which the effect of Electrization was to arrest the pain in a few sittings, and to procure a remission for several days or even weeks; and I have had several cases which I believe to have been as fairly cured as an ague fit may be said to be cured by quinine. Dr. Russell Reynolds also quotes the case of a patient, a lady, who for twenty years had suffered from an extremely severe neuralgia of the ophthalmic branch of the fifth nerve, which recurred daily and from which her health had greatly suffered. It was not only relieved but removed by a single application.
[17] “Neuralgia and the Diseases that resemble it.” By Francis E. Anstie, M.D., &c. London: Macmillan and Co. 1871.
[18] Electrolysis is, of course, chiefly applicable to tumours which, from their nature or situation, are difficult or impossible to be removed by the knife; and, perhaps, also to malignant tumours; for whether or not the Voltaic current exerts a special destructive influence upon diseased germs, it seems certainly proved that there is a less frequent return of cancerous growths removed by its agency than by ordinary operative procedures or by caustics.
|Electrolysis of Tumours.|
This treatment of malignant tumours by electrolysis is yet sub judice, but the evidence in its favour has recently much accumulated, and its full and exhaustive trial by competent observers possessing the opportunities of large hospital practice ought not to be much longer delayed.|Electrolysis of Malignant Tumours.| Neftel, of New York, who is its chief advocate, contends that malignant tumours are at first entirely local, and he explains their recurrence, after removal by the knife, from the fact of the impossibility of the whole of the diseased mass being excised, as apparently healthy parts when microscopically examined show that they have already become infected. Electrolysis he considers acts not only on the tumour but also on the surrounding tissues, the current being diffused to some distance in all directions. After electrolysis he applies a mild and not painful current for from a quarter to half an hour daily to the locus morbi, and continues this for some months. In one of his cases a mammary tumour existed of the size of a small orange. Three needles, from the negative pole of thirty-five cells, were inserted for half an hour under chloroform, and the operation was repeated thrice at intervals of a week, daily external galvanization being also used. The tumour gradually became smaller, and at last disappeared, but external treatment was continued for several months. At the end of a year there had been no relapse. In another case, in which the tumour had been excised by Marion Sims, it reappeared, and was again removed by the same surgeon, and pronounced cancerous. It again reappeared and was then electrolyzed, upon three occasions, by two, three, and four needles respectively, and with a current gradually increased from ten to thirty cells. The tumour by degrees grew less, and in three months was entirely dispersed; while, when the patient died from another disease three years afterwards, there had been no recurrence.
|Aneurismal Electro-puncture.|
Electrolysis has been successfully employed in several cases of aneurism. Where pressure and ligature admit of application, it is hardly necessary to say that the preference should be given to them; but many internal aneurisms, and especially aortic aneurisms, cannot be thus treated, and in such cases the question of electro-puncture should be carefully considered, and, when called for, it should not be too long delayed. Two fine, sharp, and carefully insulated needles, one connected with each pole, should be introduced into the aneurismal sac, and the current allowed to pass for from half an hour to an hour, the needles carefully withdrawn, and their punctures covered with a bit of lint soaked in collodion or styptic colloid. Authorities are divided as to the kinds of aneurism calculated for electro-puncture, but there is no doubt than an aneurism pressing on the parietes, but not having actually perforated them, is the best adapted for this treatment, and that it is contra-indicated where the sac is of large size, or where large trunks issue from it.
[19] The following is an illustrative case:—
A lady, forty-one years of age, had suffered from right hemiplegia for eighteen months, and described her condition as having remained without improvement for the past six months. She had recovered sufficiently to walk with the aid of a stick, but the movements of the arm were very weak, especially those of the deltoid, extensors of the fingers, and individual muscles of the hand. Faradic contractility was somewhat lowered, but there was no rigidity. The muscles were carefully Faradized with a current just sufficiently strong to produce their contraction. The entire application occupied about fifteen minutes, and was made once daily. After a fortnight’s electrization she was able to raise the arm to a right angle with the body, and to use the hand to feed herself, neither of which had she been able to do before treatment.
[20] The following is an extract from Dr. Sturge’s Report of the results of treatment at the National Hospital for the Paralyzed and Epileptic:—