Read Ebook: How to Use a Galvanic Battery in Medicine and Surgery A Discourse Delivered Before the Hunterian Society Third Edition by Tibbits Herbert

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NOTE TO THE THIRD EDITION.

PRELIMINARY REMARKS.

THE DIFFERENT VARIETIES OF ELECTRICITY.

THE ACCESSORIES OF ELECTRICAL APPARATUS.

R?SUM? OF FIRST LECTURE.

GENERALIZED ELECTRIZATION. The Positive Charge. The Electric Bath. General Faradization. Central Galvanization.

LOCALIZED VOLTAIZATION AND LOCALIZED FARADIZATION. Direct Muscular Electrization. Indirect " " Different kinds of Rheophores. Importance of exactitude in administering a Constant Current.

CUTANEOUS ELECTRIZATION. The Electric Hand. Metallic Conductors. The Wire Brush.

ELECTRIZATION OF INTERNAL ORGANS. of Rectum and Muscles of Anus. of Bladder. of Uterus. of Larynx. of Male Genitals.

ELECTRIZATION OF CENTRAL ORGANS OF NERVOUS SYSTEM. of the Brain. of the Sympathetic. of the Spinal Cord. of the Retina. of the Auditory Nerve.

PRECAUTIONS TO BE OBSERVED IN ALL MEDICAL APPLICATIONS OF ELECTRICITY.

LIMITATION OF ELECTRICITY IN DIAGNOSIS.

METHOD OF TESTING FARADO-IRRITABILITY.

" VOLTAO-IRRITABILITY.

RULE FOR STRENGTH OF CURRENT.

DIAGNOSIS WHEN IRRITABILITY IS NORMAL. diminished. increased. diminished to Faradism and increased to Voltaism. of Peripheral from Central Disease. of commencing Paraplegia from Locomotor Ataxy. of Real from Feigned Disease.

ELECTRICITY AS PROOF POSITIVE OF DEATH.

LIMITATION OF ELECTRICITY AS A REMEDY.

FRANKLINIZATION. in Facial Neuralgia. in Sciatica. in Facial Spasm. in Emotional Aphonia. in Hysterical Hyperaesthesia. in Tremor.

NOTE UPON RECENT ADDITIONS TO OUR KNOWLEDGE OF THE BENEFIT OF FRANKLINIZATION IN DISEASES OF DEBILITY.

ELECTRIZATION in Neuralgia. in Fatigue Diseases. in Electrotonus. its Resolvent Effects. in Electrolysis. in Impotence. in Gout. in Rheumatic Arthritis. in Muscular Rheumatism. in General Debility. in Atrophic Paralysis. in Infantile Paralysis. in Traumatic Paralysis. in Lead Palsy. in Facial Paralysis. in Wasting Palsy. in Hemiplegia.

ELECTRIZATION as a Direct Application to the Brain. in Spinal Paraplegia. in Paraplegic Constipation. in Incontinence of Urine. in Hysterical Paralysis. in Locomotor Ataxy. in Insanity. in Diseases of Women. as an Emmenagogue. in Inertia Uteri. in Post-partum Haemorrhage. in Uterine Neuralgia. in Sterility. in Paralysis of Nerves of Special Sense.

R?SUM? OF THE GENERAL PRINCIPLES OF ELECTRO-THERAPEUTICS.

CONCLUDING REMARKS.

HOW TO USE A GALVANIC BATTERY IN MEDICINE AND SURGERY.

MR. PRESIDENT AND GENTLEMEN,

When your Council did me the honour to ask me to bring before you the subject of Electro-therapeutics, I felt that the invitation was addressed rather to the Hospital to which I am attached than to myself, seeing that to it belongs the merit of having been for some years the pioneer and outpost, so to say, in this metropolis of the scientific and methodical application of electricity to the alleviation and removal of disease; and that we are indebted to one of its distinguished physicians for a remarkable investigation into animal electricity, and the demonstration that much of what we have been accustomed to attribute to a "vital principle" may, in reality, be the effect only of electrical charge and discharge ; and to my predecessor for the discovery of the special influence of voltaic currents in certain forms of paralysis.

As it is one of our objects in our practice here to study the scope and the limits of electricity as a remedy in disease, it seemed to me not inappropriate to devote my first Lectures to electro-therapeutics; and the more so, as few medical men have a practical knowledge of the subject; and I fear that the profession generally, through lacking this practical knowledge, are to some extent responsible for the utter and astounding recklessness with which the laity--ever ready to rush in where physicians fear to tread--are prone to apply painful and dangerous electrization, not to themselves, but to their suffering friends; while it is still too common for the medical practitioner to consider that when his fiat has gone forth "let the patient be electrified," he has done all that is necessary, while the patient usually carries out this mandate by the purchase of a rotary magneto-electric machine, and by using it according to the directions of its maker, who is generally about as well fitted to teach its application in disease as is the maker of an amputating knife to operate with it!

The almost complete absence in the medical schools of the great hospitals of opportunities for an adequate study of electro-therapeutics, the importance of the subject, and the widespread attention that it is awakening throughout the profession, have also determined me to sketch as briefly as is consistent with clearness the present position of the science and practice of medical electricity, and especially of its practice.

Electricity, Gentlemen, is by no means one of those remedies that, failing to do good, is little likely to do harm. On the contrary, in injudicious hands, it is potent for evil, while the benefit to be derived from it is in exact proportion to the judgment and care with which it is administered. Moreover, the results of its employment are dependent, more than with any other therapeutic agency, upon the methods by which it is applied--methods that should be familiar, not alone to a few specialists, but to every practitioner.

In the present Lecture I shall consider instruments, their construction and management, a dry subject, but an essential one, the first requisite of a good workman being complete familiarity with his tools, lacking which he will be the victim of constantly recurring annoyances and difficulties; for although the present position of electro-therapeutics is largely due to improved methods of administration, these methods would be impossible with faulty instruments, while, on the other hand, the most perfect instruments require a certain amount of skill and care in their management, and some acquaintance with at least the mechanical details of their construction; and without this rudimentary knowledge it is also impossible to usefully compare one instrument with another.

My second Lecture will be devoted to the different methods of applying electricity, and my third and last to its uses in the diagnosis and treatment of disease.

We make use of three varieties of electricity in medicine.

FRANKLINISM.

Franklinism, sometimes of the utmost value, and far surpassing, in certain cases, any other form of electricity, has some inconveniences in its application, and has hitherto been little used but by specialists. Recent improvements in Franklinic instruments have, however, largely removed these inconveniences, and have placed at the general service of the profession a remedy of much good and still greater promise. The fundamental requisite in all Franklinic machines, consists in the rotation of a glass plate against a leathern or other rubber, and the accumulation of the resulting electricity upon a metallic receiver, insulated by a non-conducting support, usually of glass.

Discarding the primitive cylinder machine, now long since disused, we will firstly consider the plate machine in which the electricity arising from the friction of the rotating glass plate against the upper and lower cushions, is collected by two brass arms and distributed to the brass conductor, from which they branch out, and which is insulated by a glass support.

The machine should be fixed upon a firm stand that it may be quite steady during rotation, and be screwed to a heavy painted deal table, as is shown in Fig. 1.

But in the daily or frequent use of Franklinism it is essential, equally for the comfort of the operator, as for the benefit of the patient, that the most efficient apparatus should be provided. The one delineated in Fig. 3, and which I habitually use, is that known as Carr?'s, but I have modified it by having attached to it a second accumulator, or conductor . This arrangement admits of the patient receiving the charge of either positive or negative electricity--a condition said by some physicians to be of primary importance.

There are other machines, but I do not propose to weary you with their descriptions.

I use a "Bischoff's" gas engine, shown to the right hand in Fig. 3. It consists of a cylinder, surmounted by a hollow column serving as a guide to the piston. From the extremity of this column there is a very long connecting rod which acts upon the crank of the shaft of the fly-wheel and driving-pulley. When the piston ascends it draws in during four-tenths of its course a mixture of air and gas from the pipes. A little before the piston has ascended half-way a gas jet ignites the mixture. There is a slight explosion without the least effect on the sides of the cylinder, but sufficiently strong to push the piston and cause it to complete its course. In consequence of this movement the piston is raised and acts on the connecting rod, forcing it upwards and half turning the fly-wheel. On account of the speed acquired, and of the impulse given, the fly-wheel continues its course by means of the crank and connecting rod, and sends the piston to the starting-point again. Then it ascends again, taking in a fresh charge of air and gas, motion being imparted anew to the driving shaft by every revolution of the engine.

An engine of 2-man power, with an altitude from the ground to the top of the column of 4 feet, and with a fly-wheel measuring 2 feet 6 inches in diameter, is amply sufficient for every purpose. It works evenly and without noise; it is absolutely free from danger, and it is placed instantly in or out of action by merely igniting or extinguishing a single gas jet. But it is remarkable that no one seems to have suggested--even before the gas-engine era--that a "fly-wheel" with a pulley would obviate the old difficulty of the unsatisfactory rotation of the Plate machine. Going into a hair-cutter's shop I found the apparatus, figured to the left of Fig. 4, standing in the shop to work the customary "hair brushing machinery" instead of its being, as is usual, fixed upon an upper floor. I obtained one, and fitted it in the manner shown, to a Carr?'s machine. The fly-wheel is so heavy that it can be rotated by the operator without the aid of an assistant, by his giving the handle an occasional "swing round." Its momentum then keeps it revolving a sufficient number of times before the next "swing" is required, to enable him to leave it and attend to his patient. The manner in which the band from it is attached to a small wheel in rear of the Static machine is also shown in the Figure.

There will also be needed two or three lengths of brass chain, or of copper wire, and a stool about 4 feet by 2 feet, with four glass balls or legs. A stool of this size admits of a chair being placed upon it, as in Fig. 3, and it will be also useful for certain applications of voltaism, which will be mentioned later on. Four glass jars are also needed with which to insulate an ordinary couch.

In Fig. 5, improved "dischargers," and a convenient metallic connecting rod are shown.

The ball terminations of the dischargers should vary in size, for within certain limits, the larger the ball the more intense the spark; with the pointed end the spark is very small; with the discharger terminating in many small metallic points still smaller, and with a similar discharger made of wood, a luminous glow alone results, and no spark.

I shall discuss, in my third Lecture, the therapeutic values of Franklinism.

VOLTAISM OR GALVANISM.

Efficient cells are, however, but a first step to the perfection of electrical apparatus, and the mechanism by which the current is brought into use and graduated, and the general accessories of the instrument, are of at least equal importance. The instruments which I am about to describe, have been designed by myself, and may be obtained from Mr. Hawksley, Surgical Instrument Maker, Oxford Street. It is claimed for them that they place at the service of the busy practitioner a battery that with ordinary care may be kept upon his consulting-room table, always as available to his service as his stethoscope or ophthalmoscope.

Three kinds of batteries are constructed:--A Voltaic battery, with any required number of cells, from 15 to 100; a Faradaic battery; and a Combined battery, uniting both Voltaic and Faradaic currents.

When desired batteries can be constructed with this double dial , but it adds to the complexity of the instrument, and I do not myself use it.

In Fig. 9 a similar battery is shown to that just described; but the elements consist of carbon and zinc, and are lifted into and out of a bichromate solution. As it can be recharged by the owner without the necessity of sending it to the maker, it is especially suited for country and colonial practitioners.

To recapitulate. The essentials of a medical Voltaic battery are--

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