depending upon great increase in size of the sebaceous follicles with infiltration of the interfollicular tissues, and in one case of non-parasitic sycosis. The doctor ends a most interesting communication by stating that "the results thus far obtained, though by no means uniformly successful, are sufficiently encouraging to warrant further observation of the effect of this agent upon morbid conditions of the integument." " 1 1 Reported by Dr. H. G. Piffard, in The Doctor, August 1, 1871. CHAPTER XI. ELECTROLYSIS. Theory of Electrolysis.-Anions and Cations, etc.-Steps of Operation.-Needles and Apparatus.-Electrolysis of Aneurisms (Galvano-puncture).—Malignant, Erectile, and Serous Tumors.-Goitre.-Hydatids.-Hydrocele.—Stricture.— Galvano-therapy of Wounds and Ulcers, Nævi, etc. BEFORE we enter into the consideration of electrolysis as a therapeutical means, it may be well to briefly consider its philosophy. Electrolysis is eminently a chemical process, and may be defined as a change or division of a compound body through the catalytic agency of electricity. We call a substance capable of such analysis, an electrolyte. All substances are good electrolytes which contain water, and the quantity of water and soluble salts they contain gauges their conductibility and capacity for electric decomposition. When the positive and negative poles are immersed in a fluid, we find that the decomposed parts of the substance collect at the respective poles, and to those that are decomposed at the positive pole we give the name anions; at the negative, cations. When we decompose water, we find, for instance, that oxygen is set free at the positive pole, and hydrogen at the negative; therefore they are respectively anion and cation. The different tissues found in the body, whether they be heterologous or homologous, are capable of being disorganized by this action. I have spoken before of the phenomena exhibited when blood is submitted to this process; other fluids and substances are subject to changes also. Some writers, among them Dr. Neftel, of this city, state, and prove their assertion with cases, that malignant growths may be destroyed by an electrolyzation of their substance.' Neftel goes so far as to say that it exercises a constitutional effect in suppressing or neutralizing a cancerous diathesis; "the cancer-cells have their protoplasmatic contents so altered as to make the formation of new deposit impossible." Electrolysis may be used for the dispersion of tumors or morbid growths, or collections of serous fluid. For the operations of electrolysis we require a battery capable of producing currents of tension without too great “quantity." With quantity we get heat, and this is fatal to success. Electrolysis may be performed either by external or internal action. For the former method we may apply flat sponges or plates of metal; for internal electrolyzation we use needles. There has been so much dispute upon this point that I hesitate in recommending any particular kind. Zinc, platinum, silver, and gold, have been lauded. Dr. Keyes, in the performance of some very valuable experiments last year, tried hollow needles for aneurisms, but abandoned their use; he finally arrived at the conclusion that gold were the best. In my experience, steel needles covered with gold, and afterward insulated, were most reliable. Dr. A. D. Rockwell says: "It has been found that electrolytic action is very materially modified according to the nature of three important factors: 1. The composition of the substance decomposed. 2. The material of which the electrode is made. 3. The strength of the current employed." Under the first head we will find that some substances decompose much more readily than others; under the second, that some electrodes are better conductors of the current than others, or are more oxidizable; and, on consideration of the third, we find that a condensed current (that is, when greater resistance is offered by a small needle or conductor) will produce electrolytic effects much more quickly and effectually than when the current is diffused. The action of the current, when 1 Medical Record, September 1, 1869. 2 Baumgartner's experiments clearly prove that an electrolytic effect follows external transmission of the current. 8 New York Medical Journal, July, 1871, p. 3. 4 "Practical Electro-Therapeutics," New York Medical Journal, December, 1871, p. 577. two needles connected with the poles of a battery are thrust into a piece of animal tissue, is as follows: At the positive pole, the formation of acid will coagulate the render the parts in the vicinity tough and hard. tive, the surrounding parts are shrunken. albumen, and When the two needles are thrust into a cavity filled with blood, we have the phenomena described in a previous chapter. Litmus-paper will demonstrate the presence of acid at the positive pole, and at the negative pole the original color will be restored. Electrolytic effects may be produced in other ways, by external application. When a deposit or exudation, which is the FIG. 45. product of disease, is treated in this manner, the substance is disorganized, and the vessels dilated so that they remove the disintegrated matter. In goitre and other like diseases, in the exudations of rheumatism, etc., this process goes on till the enlargement is finally reduced. Dr. Murray has been in the habit of using FIG. 46. the needle shown in Fig. 45; while, for cases where many needles are to be inserted, several instrument-makers make the apparatus, Fig. 46. For general use, I strongly advocate a large steel gilt needle, well insulated to within a few lines of its point. When we insert two needles of this kind into a tumor, a chemical action takes place, absorption is induced, and disintegration and atrophy finally occur. We should test the strength of the battery before proceeding with the operation, and this may be done by the decomposition of a solution of iodide of potassium. The rapidity with which the evolution of free iodine occurs, will give some idea of the intensity of the current. Electrolyzation of Aneurisms-Galvano-Puncture.—Ciniselli has been the great worker in this field, and his success has been more evident than that of any other operator. In a thesis written over three years ago, I traced as faithfully as possible the history and success of this mode of treatment; since that time others in this country have taken up the subject, and have given their results to the public. Dr. Keyes, of this city, in the summer of 1871, experimented most carefully, and, after trying galvano-puncture in a case of aneurism of the abdominal aorta, came to the conclusion that, though his case was not cured, it is well to attempt this treatment in abdominal aneurisms; that in these cases peritonitis is not necessarily produced, and that the danger of the operation is inconsiderable. Dr. R. S. Lincoln,' also of New York, treated an aneurism of the arch of the aorta more successfully, and, in an article relating his case, finally says: "We have grounds for encouragement that promise a measure of success where formerly a speedy death seemed inevitable." The action of the current in the aneurismal cavity is attended by a deposition of fibrine in the neighborhood of the positive pole, and this eventually fills up the aneurismal sac. The appearance of a positive clot may be seen in Fig. 47. This fibrous structure is deposited on the sides of the sac in laminations which can be readily stripped from one another. When the aneurismal cavity is filled, this lowly-organized structure is gradually absorbed, as is the rule with the majority of false membranes and tissues found in other parts of the body. Having considered the pathology of the process, I will now speak of the operation. For some weeks before, the patient should be put upon as nearly a perfect animal'diet as is con 1 Medical Record, May 15, 1871. |