ENLARGED SPLEENS TREATED BY STATIC

ELECTRICITY.

BY ALICE B. CONDICT, M. D., PUNJAB, INDIA.

Medical literature treating of enlarged spleens, and their cure, has thus far been meager. This must necessarily be the fact: (1)because extreme cases are rarely seen in Temperate Zones; (2) the necessary time to leisurely study these cases, on the ground where they are most abundant, is seldom possible in the lives of the overburdened medical profession. There is a large field for such study on the plains of the Punjab, India. There is probably no more malaria here than in many other parts of India, but a large part of the native population are cultivators of the soil. The largest wheat fields of India are here. And of late the English Government has excavated a series of irrigation canals here, that are fed from the branches of the sacred river Ganges, which rises in the Himalayan Mountains near. The irrigation is a great boon, and greatly increases the yearly output of wheat produced, and the ability of the natives to faithfully pay taxes.

The Sutlej River that flows through these plains is a most sluggish river, and it is, no doubt, a most prolific source of the malaria-producing mosquito. In many villages near these canals, and rivers, the whole population are nightly, no doubt, exposed to the malaria-producing anopheles, for these poor people have no means of protection. In fact malaria is the bane of their lives.

The large death-rate among young children is no doubt largely due to malaria and its results.

Immunity seldom seems to be the result of the continued inoculation of the malaria parasite. But with recurrent attacks of malaria, comes the chronic state that leaves a greatly enlarged spleen, as the result. Also the cachexia peculiar to malaria patients.

There is no doubt that with each paroxysm of ague, there is for the time a greatly engorged spleen. This engorgement soon subsides in favorable cases, but when the patient is poorly fed, and at the same time is overworked (considering his bodily powers) and his attacks of malaria continue unchecked, we

have a patient who easily succumbs to the enervating effects of the malarial parasite.

We have yet to study in detail the steps of such enervation in cases when the spleen becomes so congested and enlarged as to no longer normally perform its functions. Especially is the task a difficult one, as we are at present much in the dark as to exactly what all these functions are. Therefore, I beg friendly criticism on the following statements-crude yet true, for although details as to what was the condition of the blood of these patients, what of their urine, etc., are not recorded, and not even in some cases was an opportunity given to study their daily rise of temperature as some were outdoor patients, still the results obtained were so remarkable, and the hope for future study so enticing, I beg your kindly interest, and friendly criticism of these hastily arranged notes. Most of all hoping for an interest that will encourage further information. from others who may be studying this important matter.

The ordinary native of India will pay no attention to an enlarged spleen until tenderness and pain, and anemia cause so much reduction of strength that at last the patient reluctantly turns to the medical profession. When no civilized medical assistants are at hand, the hukeen of the jungle has a variety of methods for treatment, but palliation is all that he is able to effect.

Since beginning the use of static electricity at the Memorial Hospital at the Medical School for India's Women at Ludhiana, India, it has been my pleasure to treat 53 cases of enlarged spleens, from October 1, 1906 to April, 1907. As no mild cases think it worth while to come to a doctor, the following are only representative of what most cases were as a whole.

I would also state that most of these 53 patients were cases that had been faithfully treated by the most approved methods, where medicine and outward applications are all that are available, which is most generally the situation here in India.

Case 1.-Mam-bi-bi, a little unmarried Mohammedan girl of about ten years, with a history of having had chills and fever daily, with enlarged spleen for over a year. This spleen was exceedingly tender, and as shown by the accompanying chart, extended from under the ribs, down to I 1-2 inches below the umbilical line. And toward the right of the median line. The

surface of the spleen under my hand, was smooth, bulging, and regular. The splenic outlines being well marked. The effect on the general health was pronounced anemia, with great prostration. She had been faithfully treated for four and one-half months at our Outdoor Department, by the usual remedies for malaria with enlarged spleen, with no results. To treat this

Fig. 1.-Mam bi-bi when she came under observation.

case I applied a soft metal electrode, four inches in diameter. Placing it over the splenic region, and binding it on with a wide bandage, so that it coapted closely with the surface. Then seated the patient on the insulated platform. Then connected my patient's electrode to the positive pole of the static machine, and grounded the negative pole; thus producing the Morton

wave-current.

This little patient was so sensitive that at first it was not possible to employ more than an inch spark-gap, increasing the length of the gap after giving the treatment for three or four minutes. I was always able in this case to increase the

spark-gap to three inches during the twenty minutes' treatment. This treatment began October 31, 1906. The patient responded rapidly; no medicine was given, save the mixture we know as spleen mixture, which is simply light doses of ferrum carb. With this is given frequent light doses of mag. sulph. After the third treatment there were no more chills and fever. The enlarged spleen slowly decreased in size, until by December 15 the case was discharged, entirely cured. The spleen so softened in texture as to be only distinguished by percussion and only then found well up under the ribs of left side.

Case 2.-Suba, a finely-built, large-framed Hindu man of about thirty years of age, from a distant town. As this hospital

Fig. 2.-Suba's spleen when he came under observation.

Fig. 3.-Suba's spleen when leaving our care.

is strictly a Purdah hospital (for veiled Zenana women) it is not possible to take in male patients, but this man had heard from his distant home of what we were able to do for spleens

that could not be reduced by medicine, and so he resolved to try to get the treatment as an outside patient.

This man gave a history of having had enlarged spleen for five years. He had been faithfully treated by several English surgeons and physicians during this period of five years. This was an aggravated case, as can be seen by the chart (Fig. 2). The spleen filled the whole of the left abdominal region, from under the diaphragm, to one and one-half inches below the crest of the left ilium, to across the median line, in most places one inch or one-half an inch, as shown by the chart.

The surface of this spleen under my hand was nodular, and exceedingly hard; so dense indeed as to resemble bone. The whole mass was so immovable that when the patient lay down on his back with his knees drawn up, the abdominal contents fell back into the abdominal cavity, but this spleen was so fixed, so adherent to the abdominal walls that it stood out sharply, allowing an easy mapping out of the anterior thinner border, and the sharply defined nodular anterior surface, thrown well up. There were sharp pains through the entire mass, and so much emaciation with a history of very great loss of strength. While in the past he had been able easily to carry a maund (eighty pounds), now ten pounds was too great a weight to lift.

The whole aspect of this patient induced me to decide this very probably had become a cancerous spleen. Notwithstanding my fears, however, I decided to give the Morton wave-current a trial for a few days, giving absolutely no medicines internally. What was our surprise to find the patient reporting an almost immediate relief from the sharpest of the pains, and no more fever.

After one month's treatment the spleen had reduced in size fully one-half. His strength also returned rapidly, and he declared that he was so well that a longer stay was not necessary. No amount of persuasion would induce him to remain long enough to complete the treatment, and give us the great satisfaction of making an absolute cure.

I must admit, however, that the whole aspect of this poor man had entirely changed. When he left us he had no more pain, nor tenderness over the splenic area, also the splenic texture had softened so much, that a radical change had without doubt taken place. The spleen was now quite movable