The galvanic current has of late been considered one of the most important agents in the treatment of these affections, but there is considerable variance among authorities as to how it should be applied. The most efficacious method is the descending current (anode on the spine and the cathode at the periphery), as this has been found to be more soothing in its effects than the reverse. The anode should be placed upon the spine over the cervical cord, and the cathode in the hand of the affected side or over the affected muscles or nerves.
A stabile current—i.e. where the poles are not moved about—is to be preferred to a labile current—i.e. where the poles are moved constantly—as this is more stimulating than the former; but if a current of proper strength is used, one that can be plainly felt when the circuit is made and broken only, the importance of the stabile over the labile does not obtain.
The treatment should not be prolonged for more than fifteen or twenty minutes, and may be repeated three times a week or every other day.
Onimus and Legros107 recommend this mode of treatment, but from a different pathological standpoint, as they consider the neurosis to be an excitability of the sensitive nerves of the muscles, and employ the descending current to allay this.
107 Loc. cit.
All sudden shocks or reversals of the current should be avoided in the treatment, although this may be necessary in using the galvanic current for diagnosis.
As the seat of the trouble in many cases is probably in the cervical cord, it is well that special treatment should be applied to this part, and for this purpose Althaus108 recommends that the anode be placed, as previously mentioned, over the cervical cord, and the cathode in the depression between the angle of the lower jaw and the sterno-cleido-mastoid muscle, which position corresponds to the superior cervical ganglion of the sympathetic. The current should be allowed to flow from three to five minutes at a time; it should be a mild one, and not be broken or increased or diminished suddenly, as vertigo may be produced. Both sides should be treated should the left hand be suffering also. A reversal of this method—i.e. cathode to spine—does little if any good, according to the same author.
108 Loc. cit.
Poore109 employs the descending stabile current of a strength just short of producing muscular contraction when the current is broken, but at the same time he employs rhythmical movements of the muscles supplied by the nerve upon which the cathode is placed during the flow of the current.