Electricity is a powerful therapeutic ageut, and well deserving a notice under the class of Excitants.
Therapeutic Action.—It acts either as a general or local excitant or stimulant, or sedative, according to the mode of application. It excites the vascular and nervous systems, accelerates the pulse, arouses the nervous susceptibilities, stimulates the muscles to involuntary contractions, and promotes the secretions.
Its employment is indicated in atonic states of the system. Paralysis of either the sensor or motor nerves, when unconnected with, or not dependent upon organic lesion of the cerebro-spinal system, are cases requiring the use of electricity. Old cases of paraplegia and hemiplegia, nervous deafness, amaurosis, paralysis of the fore-arm, occasioned by the poison of lead or of mercury, topical numbness, asphyxia, etc., are often entirely relieved or greatly benefited by its application. It should be borne in mind, however, that it can not be expected to afford much, and in general any relief, in those cases of paralysis arising from lesion of the nervous centers; in other words, it is mostly available in paralysis dependent upon functional and not upon organic lesions of the nervous system. It may be remarked that in amaurosis it is rarely of any avail. In amenorrhoea, when, from the concomitant symptoms, it may be supposed to depend upon uterine torpor, the electrical current passed through the pelvis from the sacrum to the pubes, is often followed by the most gratifying results. In loss of muscular power, attendant on chronic rheumatism, and in the stiffness and rigidity following sprains or bruises, it has rendered essential benefit.
In certain convulsive disorders, as chorea, much benefit has often been known to attend its use. Electricity has been employed to promote the absorption of tumors, and serous and synovial oysts, congestions, indurations, dropsical effusions, as in hydrocele, ascites, hydrothorax, hydrops pericardii, hydrops articuli, etc.
In applying electricity to deep-seated parts, as the uterus through the vagina, or the meatus auditorius internus, the conducting wire is made to pass through a glass or rubber tube.
Neligan remarks that the different forms of electricity may be in general indifferently applied, but says that galvanic and magnetic electricity possess the advantages of being more readily employed, of not being interfered with by the state of the atmosphere, of the effects produced being more under control, and in the facility with which they may be applied to different parts of the body; hence they are mostly used at the present day.
It rarely proves speedily beneficial; it is only by its long continued employment that benefit is to be derived. It is also necessary that the intensity of it be not too great, as over excitement from it is especially liable to prove injurious. It should be further remembered, that it is to be resorted to, as a general rule, only as an auxiliary, and not as a principal therapeutic measure.
We now employ the galvanic battery in almost all cases, using the broken or Faradic current, and the constant current. The first is employed for the ordinary purposes of an excitant, and to relieve hyperesthesia of parts. The second is used for its chemical action, influencing the nutrition of parts or even destroying them if desired.
The single element battery with Ruhmkorff coil and vibrator is the one in common use, and is represented in the market by Kidder, Drescher, Foster, and others. The constant current battery, consisting of a number of elements, is not so commonly used.
If one will take hold of the poles of a battery of this kind, he will find that the current is broken, and is very sensibly felt. One pole will give a distinctly stronger sensation than the other, and this is the positive pole, the current passing into the body; the other negative, the current passing out of the body. The poles are marked on the battery, and if the elements ore properly connected with the coil, there will be no trouble.
The first use of the battery is as a direct remedy to the skin and to the cutaneous nerves; the second is to influence a special organ or part.
This influence may be either sedative or stimulant, and it is essential to know which influence we want, and which we are getting. It has been said that the positive pole is stimulant, and the negative pule sedative, but this will not answer, and is usually wrong. It is the direction of the current as to the direction of the nerves supplying the part that we are to look at. The current passed in a direction contrary to the nervous flow is sedative; the current passed in the direction of the nervous flow is stimulant.
If we are making a general application of electricity to the skin, and want a sedative action, we apply the negative pole to the spine, and pass the positive pole over the surface. If we wish a stimulant action, the positive pole is applied to the spine, and the negative pole is passed over the surface.
This general application is one of the best uses of electricity, not only influencing excretion directly, but exerting a most favorable influence upon the innervation of the patient. Of course it is understood that the poles are embedded in a wetted sponge.
In making a local use of electricity, we must know whether a stimulant or sedative influence is required. Has the part an increased circulation? is its condition one of irritation? If so, we use the sedative current—the positive pole applied over the part, the negative pole to the spine where its nerves given off. Are the sensations those of atony or congestion—fullness, weight, dragging?—then we want the stimulant current—the negative pole applied over the part, the positive to the spine where the nerves are given off.