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The Medical and Surgical Reporter.

Contributions are solicited upon any subject connected with the practice of medicine or the allied sciences, and the only restrictions placed upon them are that they shall be free from personalities and given to the REPORTER erclusively. The Editor of the REPORTER is not responsiblo for any opinion expressed by contributors.

Vol. XII.

JANUARY, 1904.

• No. 1.

Original Articles.

ELECTRICITY IN THE TREATMENT OF NERVOUS DISEASES.

By C. e. Sawyer, M. D., Marion, Ohio. A paper to be valuable should be practical. A practical paper for a body of general practitioners should advance methods and indicate means which are obtainable, applicable and useful. With this end in view, in my consideration of the subject, “Electricity in the Treatment of Nervous Diseases,” I shall endeavor to deal only with such electrical treatments and such means for their employment as are within the reach of all, leaving even without mention, many of the more modern advancements along electrical lines. Therefore this paper is not intended as either exhaustive or scientific, but practical.

With my intention thus defined, I wish to preclude my argument with the assertion that after twenty years' experience in many chronic nervous cases, I am sure there is no other single remedy that does as much real good in the treatment of nervous diseases as does electricity. I would remind you that in this connection reference is made to the use of electricity intelligently applied by one who is awake to the needs of the case in point. I would again remind you that electricity in any form if not intelligently applied is more often harmful than beneficial.

In employing any means for the treatment of a disease, no matter what its character or nature, there are two fundamental principles which must ever be borne in mind. First, the operating cause in the production of the disorder; second, the individualization of the case. With these two basic principles before us we shall endeavor to show the practical utility of electricity in the treatment of nervous diseases.

In studying the complexities of nervous diseases, whether they be physical or mental, constitutional or local, functional or organic, we invariably find poor circulation, imperfect assimilation and disturbed elimination. These are the results of impaired peristaltic action and bad vaso-motor operation which in time bring on a condition of auto

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intoxication that sets into abnormal action the whole nervous mechanism in such a way as to produce disease.

Among the ever apparent manifestations of the nervous system are almost invariably a heavily coated tongue, an extremely offensive breath, with obstinate constipation, irregular and scanty urinary secretion, muddy complexion, inactive skin, quickened pulse, lowered temperature, with blood depleted and circulating poorly. It will be noted that these are especially common symptoms in neurasthenia, hysteria, hypochondriasis, melancholia, mania, apoplexy, epilepsy, chorea, paralysis agitans and various other functional, organic and spasmodic disorders.

In seeking for the cause of these symptoms in this varied class of patients, we are at once led to conclude that one of the common conditions of nervous disease and certainly one of the principal causes of their production, is a lack of complete oxygenation of the blood and the means which solves the problem of cure in these cases hinge directly upon overcoming this deficiency.

Oxygen composes about ninety per cent. of the human body. Perfect oxygenation means life, health and strength. Imperfect oxygenation means disease and disorder, and as this much needed oxygenation depends upon a good circulation and as good circulation depends on motion and action, electricity by its quick, short vibration, its tissue changing ability and its stimulating force is most effective. The blacksmith's arm, the sprinter's leg, the oarsman's heart are all evidences of the effect of rapid alternate dilatation and contraction of the parts in use. They illustrate the principle of electricity exactly, and it is my belief that it is this, and this alone, that gives to electricity its practical utility; it is essentially an exerciser, and the increased motion which it excites is favorable to the improvement of all nervous disturbances which are in any way dependent upon imperfect nutrition, poor blood supply or ptomanic absorption, and as the majority of nervous diseases arise from these causes, its field of usefulness in their treatment is infinite.

I realize fully that many failures have been charged to electricity in the treatment of nervous diseases, but investigation of these cases usually shows that the means have not been intelligently applied or that they have not been persistently employed. To illustrate how easy. error may be made, let us consider for a moment the fact that different parts of the body vibrate or contract and dilate differently. The stomach, for example, makes about sixteen contractions per minute, the intestines about twice as many, some of the large muscles of the body twice as many more, while some of the smaller muscles of the body, such as those of the inner ear, hundreds of times more. Now it is not reasonable that the same current with the same frequency of interruption should be employed in the treatment of all of these. If electricity is to be used, its interruptions should certainly be made to conform to the normal action of the part under operation, therefore if it is the desire of the operator to bring the intestinal tract to a normal action, the frequency of the interruptions of the current should be regulated to meet the number of normal contractions of the intestine. This necessitates interrupting the electric current at shorter or longer intervals, according to the needs of the case, and it is upon these facts that the selection of the current must be made in compliance with the particular requirements, we must judge which form of electricity should be used.

The human ear is only capable of appreciating three thousand vibrations per minute, so that all sounds vibrating more rapidly than this are lost. If the intestines in a condition of health are only capable of about thirty vibrations per minute, they are certainly incapable of responding in action and reaction to the regular vibrations of the faradic current, which are normally several times as rapid, therefore the necessity of individualization and special care in the method adopted.

This citation is made simply to show how electricity may be charged with failures which are due entirely to the ignorance of the operator, and to emphasize the fact that the use of any sort of a battery in the hands of anybody does not constitute an electrical treatment by any means.

Electricity has its place, its purposes, its objects and actions, and these should each be understood by the one employing them. Remembering that we are dealing in the treatment of nervous diseases with imperfect nutrition, lack of oxygenation and want of power, we should never lose sight of the fact that time is an important element and that persistency of effort is ever essential to success. The real good to be derived from electricity is by continued use at regular intervals; used otherwise, failure will follow. The reason that locomotor atixics, neurasthenics and some of the paralytics fail to derive benefit from the use of electricity is because the remedy has not been continued long enough. If persistently used, even the worst of cases will at least be benefited if not cured.

In order that we may have a fairly reasonable understanding of electricity in the treatment of nervous diseases, it may be well to consider the four principal currents and the general indications for their application, viz. : faradism, galvanism, sinusoidal and static. Each

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