make it one of the most popular galvanic, faradic and sinusoidal outfits yet offered the profession.

All of the parts, such as coils, meters, rheostats, interrupters, etc., are made detachable so that the outfit may be sold with only such attachments as may be required for the time being and later as occasion may require other attachments may be added so as to make the outfit complete in every detail. Thus at moderate expense not to exceed that paid for many cheap outfits the purchaser is enabled to obtain an apparatus that will never need to be thrown aside for something more complete.

Another novel feature used in connection with the wall plate is the use of a high tension induction coil for obtaining the sinusoidal current. The current is alternated through the primary of the coil by an alternater driven with a small motor so as to give any frequency of alterations desired, and the strength of the sinusoidal current, as applied, is governed in the same manner as the strength of the faradic current.

The wide range of and variation in the currents obtainable from this New Universal Wall Cabinet has not yet been duplicated by any other similar form of apparatus.

A NEW SPARK DIRECTOR.

To meet the necessity of always exactly localizing a static spark, the director shown in the cut has been designed.

The handle, 18 inches in length, is of hard rubber. From the extremity to the metal band to which the spark is applied on the handle, an insulated wire conducts the current between the band and the terminal.

Two terminals are provided which screw on at the extremity-one a ball and the other a disc, flat on one side and con

VH&TB.CO.N.Y

vex on the other, for adaptation to various surfaces and conditions. By making contact with a large surface, a long spark may be applied over a sensitive area, producing effects as of the wave-current discharge.

The spark effect is the same as when administered in the usual manner, and may be administered in this manner to clefts over coarse clothing and in the cavities if indicated.

The electrode is manufactured and for sale by Van Houten & Ten Broeck Co., 300 Fourth Avenue, New York.

THE "LEUCODESCENT" THERAPEUTIC LAMP WITH NEW "ADJUSTING TROLLEY.”

This device makes it possible to throw the rays of the "Leucodescent" Lamp in any desired direction by tilting the hood at any angle from vertical to horizontal, and fixing it there by a thumb-screw on a curved trolley.

The utility of this improvement will be apparent at once, in the treatment of the orifices of the body.

0

It is of great convenience, also, in applying the light externally while the patient is partly nude (trunk, for example) and sitting upon a chair.

It insures a steadier radiance than can be obtained by holding the hood with the hand, which becomes tiresome if many cases are to be treated in succession.

The Leucodescent Therapeutic Lamp is a high-power incandescent lamp (300, 400, 500 c. p.) and has been approved as a most valuable addition to the equipment of the progressive, advanced therapeutist, by some of the most conservative, practical men in the profession.

It is made by the Spear-Marshall Company, Republic Building, Chicago, and is on sale at the salesrooms of Van Houten & Ten Broeck Co., New York; Swett & Lewis Co., Boston; A. J. McKee & Co., Washington.

Advanced Therapeutics

VOL. XXIV.

JUNE, 1906.

No. 6.

CONSERVATIVE GYNECOLOGY-ITS RELATION TO

THE CONTINUOUS CURRENT.

BY MARGARET A. CLEAVES, M. D., NEW YORK.

By conservative gynecology must be understood any measure or measures which will tend to a restoration of the pelvic organs of women to normal functional activity, if not normal anatomical conditions. The two are not necessarily the same. A malposed uterus need not be a barrier to pelvic health and function, nor does a uterine fibroid always menace health and demand a surgical operation. Curettement for sterility is begging the question, for the uterine mucosa and the pelvic organs in general which are the subject of perverted nutritional conditions do not demand a destructive measure to restore them to healthful function. On the contrary, such an expenditure of energy as will tend to the production of nutritive changes without such destructive action is indicated. A gonorrheal vaginitis to be successfully combated requires a gentle expenditure of energy. Strong silver solutions, for example, are contraindicated. Gonorrheal pyosalpinx does not in all cases call for removal of infected tubes. The prolapsed vaginal walls forming cystocele and rectocele with or without perineal injury are not beyond our help. In the aged, operation is apt to be refused and, even so, is not always advisable. The retrodisplacements, the anterior flexions, modifications of the position of the normal uterine organ, are by no means beyond assistance. Uterine prolapse does not always require surgical interference. A degree of prolapse can be overcome, the symptoms relieved and the patient's life made more than tolerable. Pelvic exudates can be made to disappear almost like magic and even when fibrous bands exist which cannot be absorbed, the improved circulatory changes established result in disappearance or modification of the symptomatic evidence of the trouble. * Read before the Fifteenth Annual Meeting of the American Electro-Therapeutic Association at New York, September 20, 1905.

To hang a uterus up in midair, so to speak, as in a ventrofixation, depriving the organ of all its normal elasticity until it becomes chronically enlarged, and hangs suspended in the pelvic cavity like an inflated balloon, no matter how successful the operation, does not restore pelvic and general health-on the contrary.

Since the time of Apostoli the value of the continuous current in conservative gynecology has been recognized, and to the members of this Association the principles laid down by him need no repetition. In the hands of the especially skilied, good work even in grave pelvic cases has been and is done. But unfortunately, no matter whether skillfully used or not, this method possesses untoward features on account of the danger of exciting inflammatory conditions, pre-eisting, with their unfortunate sequelæ of exudates and adhesions. The gynecological surgeon not infrequently has the care of these cases later on, and if called upon to operate, he finds his work complicated by the presence of adhesions for which the electrical treatment receives the blame. This is not necessary, nor does it occur as frequently as formerly; still, a surgeon reported a case to me within the last few weeks. No matter what work is to be done, what obstacle is to be overcome, there is no need of using a sledge-hammer blow when the flutter of a butterfly's wing or the tap of a feather, so to speak, will suffice. There are methods of using the continuous current in the class of conditions enumerated as well as others, which are as yet too little appreciated. The work of my fellow-founder member of this Association, Dr. G. Betton Massey, has made the use of mercury at the anode with massive doses of current classic, and to him belongs the greatest credit for his continued and persistent efforts in the cataphoric sterilization of cancer. For my own part, in every suitable case I believe the preference is to be given to Dr. Massey's method in this class of cases over and above the X-ray.

My fellow-member, Dr. W. J. Herdman, admirably showed in his paper two years ago the beneficent action of anodal electrolysis in an osteosarcoma of the superior maxillary bone involving the whole of the jaw and alveolar arch on the right side, extending upwards so as to encroach upon the antrum, and inward to the median line of the jaw so as to displace the tongue to the left side, and back part of the oral cavity.

In both these instances the applications were characterized by great current density.

The action of the current upon oxidizable electrodes at the anode with mild doses in the treatment of endometritis, of fibroids, of pyosalpinx and of gonorrheal vaginitis is to be preferred in every instance to the simple polar action of the current. With the latter, no matter whether cathodal or anodal, there is a destructive action, at the cathode by reason of chemical action and at the anode by coagulation, resulting in the production of scar tissue. With mild currents this scar tissue is slight, but it exists. Not so from the action of oxidizable electrodes at the anode and the transfer of the ions of a given metal, copper, silver, zinc, zinc-mercury amalgam, as the case may be. The best interests of the patient are conserved always by avoiding the production of scar tissue, which with its imperfect circulation readily becomes a nidus for morbid conditions.

Twelve years ago it was my pleasure to present this subject to the members of this Association. In all these years this method has been my main reliance, where an invasion of the uterine cavity became necessary by reason of the existing pathology. Experience has taught me that the maximum dose of 30 milliamperes advised by Gautier as the result of his experiments, need never be exceeded in non-malignant conditions, while 20 milliamperes is oftener used. By this method the nascent ions of copper, silver, zinc, and mercury, are transferred deep into the uterine mucosa or that of the urethra, as the case may be, and the action is much more energetic and profound than can be obtained either by the polar action of the current, or by the topical application of medicaments. Experience in connection with experimental work has also taught me that too frequent repetition, even as often as the period of eight days established by Gautier, for the work of congestion, elimination and repair, does more harm than good. Experiments made upon living animals, frogs and guinea pigs, in the muscular structure of the former and the genital mucous membrane of the latter, showed extreme dilatation of the blood vessels and imperfect repair of the mucous membrane even after ten days. Two intrauterine applications in a bleeding fibroid or endometritis or a uterine hyperplasia during a menstrual cycle, can rarely be made. One is productive of greater good and should be made the middle of the menstrual month.