Electricity in its relations to practical medicine

Front matter

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Gift of the New Haven Medical Association

Preface To The American Edition

The belief that Dr. Moritz Meyer's Treatise on Electricity in its Eelations to Practical Medicine was the best which had yet appeared on the subject, must be my excuse for presenting it in an English dress to the Medical Profession of America and Great Britain.

I had intended adding largely to it, but attentive perusal convinced me that, by so doing, I would only enlarge the volume, without giving it a corresponding increase in value. I have, therefore, refrained from the citation of cases from my own practice, except in a few instances ; or from adding much other matter, except under the head of Infantile Paralysis, which subject, it appeared to me, had not been sufficiently considered by the author.

"William A. Hammond.

162 West 34th St., New York, June 20, 1869.

Preface To The First Edition

In the age in which we live, an age rich in superstition, but poor in belief, when now a holy robe, now a Goldberger's rheumatic-chair, now animal magnetism and somnambulism effect the most marvellous cures among the pious believers, it is not a subject of surprise if the considerate and thoughtful physician ventures upon the therapeutical application of an agent of whose real character the naturalist still knows comparatively little. Thus it is that the practitioner, and unfortunately also those physicians who devote themselves especially to the application of electricity, often have the most crude and absurd ideas of its action on the animal body. As an example, among the late products of the press, see Prof. Dr. Hassenstein's Slchere Heilung nervoser, geschtischer, rJieumatischer, iind andere Krankheiten durch die JSUctricitat iind den Magnetismus. Fourth edition. Leipsic, 1852, page 18. Prof. Hassenstein views the human body as a voltaic pile ; one portion of its electricity is latent, another is polarly active ; through the action of the latter the surface of the body is always negative, the central organs of the nervous system always positive ; a greater or

Till PREFACE TO THE FIKST EDITION.

lesser quantity of the latent electricity can be used to increase or decrease the polar electricity, and, indeed, to increase it by adding to the electricity of the surface a portion of the latent electricity. The decrease is effected by adding to the electricity of the surface a portion of the latent + electricity. It is, therefore, only necessary to know, as Hassenstein pretends to, in what diseases an increase, and in what diseases a decrease of the polar electricity is necessary, to effect the most perfect cure. Another (see Electricitat und Magnetismus als Heilmittel. Kurze Betrachtungen uber deren Anwendung im Allgemeinen, mit gleichzeitigen Hiiiblicke auf die Tendenz seines Instituts, von Dr. B. Bamberger, Berlin, 1854), who believes he has discovered in scrofula the richest and most fruitful field for the application of electricity, reasons a priori, that there, where air, light, and heat are so very efficacious, electricity cannot be other than highly beneficial. Of the correctness of this logic he has been convinced by the most brilliant successes. This view has the merit of naivete, to say the least.

These are the reasons why electricity until now has been numbered by many among those remedies which the rational physician is slow to adopt, and yet, in those cases in which it is indicated, it is one of the most admirable, one of the surest, and in some cases an incomparable remedy. It is, therefore, the duty of every physician to study the action of electricity, to become acquainted with its value in therapeutics, and to follow the improvements that are being made in the apparatus for its application in medicine, that he may be able to choose the one best adapted to the treatment of individual cases, and to test a remedy fairly and

Preface To The Itkst Edition. IX

without prejudice, which already, especially in nervous diseases, has been used with the best results, and which promises to yield an abundant harvest in a still broader domain.

Thus we have, for example, in surgery, the treatment of varix and aneurism, by electropuncture, and the removal of tumors, with the cadent platina wire, heated by the electric current. And since it has been shown that the urinary calculi are soluble by means of the electric current, is it not possible that there may be an instrument constructed by which the operation may be practised on the living subject ? Is the galvanic treatment of malignant tumors not worth an experiment ? May not the local application of electricity by Duchenne's method in orthopsedia — to which the profession is now devoting so much attention — be made useful ? Is it not possible that more may be accomplished in this direction with electricity than with gymnastics ? May not a timely application of electricity prevent many deformities, and render many a tenotomy unnecessary? And has the obstetrician such a series of reliable emmenagogues at his command, that he has no need of another which he can perfectly control, and with which he can produce at pleasure the most powerful contractions of the uterus ? All these are open questions, which it becomes every physician to assist in solving, but more especially those who hold positions in public hospitals, on account of their greater facilities. We must, however, unfortunately confess that they, thus far, particularly in Germany, have shown very little zeal in the matter.

If my own researches have not extended beyond the action of electricity in nervous diseases, I nevertheless believe

X PREFACE TO THE FIRST EDITION.

that, in giving the results of my labors publicity, I shall contribute to the solution of the general question, by giving the reader a cursory view of the field over which medical electricity is endeavoring to extend its usefulness. The anatomist and physiologist, the obstetrician, surgeon, and physician, will thus have an opportunity to test the use and importance of electricity in his particular field ; here to extend and there to circumscribe its application, to fix more special indications, and to adopt more rational and practical methods for its use.

With regard to the origin of this work, it may be stated that the author was one of the competitors for the prize offered by the Medical Society of Ghent, for 1852, " On the Efficacy of Electricity in the Treatment of Disease." True, he did not receive the first prize, which was awarded to Duchenne — who has done so much for the rational application of electricity in medicine — nevertheless, the commission deemed the author, even with such a competitor, worthy " dhme mention honorable et oVune recompense honorifique." In their detailed report (see Bulletin de la Societe de Medeoine de Gand, vol. xviii., 1852, pages 122-163), after awarding to the treatise the praise of being logically and well written, and of comprehending nearly all the points necessary to consider in solving the question, and after mentioning as defects that neither the influence which the electric current, according as it is constant or interrupted or according as it flows in different directions, exercises on the vitality of the nerve, nor the importance of electricity as an aid in forming a correct diagnosis or prognosis was sufficiently considered, they use the following language : " But notwithstanding the deficiencies to which we have adverted

PKEFACE TO THE FIRST EDITION'. XI

the work under notice is in some parts marked by great excellence. Thus, we would cite the remarks relative to the therapeutical action of electricity, the chapter which treats of the various forms of electrical apparatus, and that in which the author examines and classifies the principal affections, to the treatment of which, electricity has been applied with success. This last chapter is especially remarkable for the erudition which the author gives evidence of possessing. Finally, we must speak in equal terms of praise of the cases which are appended to the memoir, and which show that they have been noticed and recorded by a skilful practitioner."

I was at that time solicited by several persons, and particularly by the house of Hirschwald, of this city, to publish my little treatise ; but I was deterred by various considerations. On the one hand, the field over which it should extend had been so enlarged, especially by the researches of Duchenne, in the space of two years, that the book would have been old ; on the other hand, I thought it my duty not to appear before the public until I had a greater number of observations at my command. But when the Medical Society of Ghent had my treatise translated into French, and published it in their Annals for 1852, and, as the translator greatly increased the number of the defects of the contents, I saw myself compelled to alter my resolution.

Thus this volume originated, which, it is true, is only a reproduction of the Ghent treatise so far as the general contents are concerned, but which aims to remedy the defects cited by the Ghent commission, to embody the progress made during the past two years, and to record the results of my later observations. These genetic motives will suffice,

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I trust, not only to justify the existence of the work, but also to secure charitable criticism.

In conelusion, I would avail myself of this opportunity to express my hearty thanks to many of my honored colleagues for sending me such of their patients as were proper subjects for electric treatment ; also to Dr. E. du Bois-Reymond and L. Posner, for the valuable material they so generously placed at my disposition.

Dr. Moeitz Meyer.

Berlin, January, 1854.

Preface To The Second Edition

TnE hopes I entertained, on the publication of the first edition of this book, have been quickly realized ; yes, more than realized. Not only has the medical press, without exception, 6poken of the work in favorable terms, not only have authors of the hand-books that have appeared since then, in a measure, adopted my arrangement of matter, and borrowed from me no inconsiderable portion of their material, not only are there since then, in nearly all the larger German cities, thoroughly scientific physicians to be found, who devote themselves specially to the study of electro-therapeutics, but the profession generally has also recognized electricity as a remedy fully meeting the demands of certain indications. And the layman intrusts himself willingly — often with too great expectations — to a mode of treatment which, only a few years ago, he did not venture to adopt, until after the failure of every other remedy, and then only " by way of experiment." I think I shall not be accused of presumption if I ascribe, in some measure, these changes to my labors. The attention of other members of the medical profession — among them those who, as anatomists

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and physiologists, were capable of making thorough and exact researches — was directed to electro-physiology and therapeutics, and they were induced to make experiments, and publish the results of their observations in works either theoretical or practical in their character. The large number of text-books of electro-therapeutics, which, in this manner, followed one another almost without interruption, delayed the publication of the second edition until to-day, although the first edition was exhausted nearly four years ago.

Whether the contents of this edition will excuse a silence of seven years ; whether the results are commensurate with the time and labor expended ; whether the time has arrived when we can classify the paralyses, according to their location, into cerebral, spinal, nervous, and muscular; and whether I, especially, who have had comparatively few opportunities to make post-mortem examinations, should venture to make such a classification, are matters I leave to the decision of my colleagues, who have received my former labors in a manner so charitable and encouraging. I believe that I can, at least, claim to have used conscientiously such material as I have had at my disposal, to have tested the contributions of others carefully and without prejudice, and to have subjected my own observations to the most ri<nd scrutiny before giving them publicity.

A retrospective glance at the progress made in electro-therapeutics, during the last few years, is, on the whole, highly encouraging. If the hopes, to which the application of the constant current in the treatment of muscular and nervous diseases gave rise, have been only partially realized still, its readoption and recommendation by high authority

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have led to new and careful experiments, resulting, on the whole, to the advantage of electro-therapeutics. But delusion and ignorance have not spared us with their products, and if the fantastic extravagance of a Beckenstein (fitudes stir Velectricite, nouvelle meihode pour son emploi medicate. Tome premier. Paris, 1852), and of his successor, Zimple {Die.Heibungs-Electricitat in Verbindung rait Imponderabilien oils Heilmittel. Stuttgart, 1859), only excite a smile, such books as that of Dr. Dropsy (fileclro-therapie, ou application medicate practique de Velectricite basee sur de nouveaux procedes. Ouvrage presente au concours decrete par S. M. VEmpereur des Francais. Paris, 1857) put us in bad humor, because the author devoted more than ten years of his life and his best intellectual energies to an unscientific and fruitless theory, of the correctness of which he is personally convinced.

On the contrary, earnest and well-directed research has demonstrated the importance of electricity in diagnosing paralyses, which, as a consequence, are treated more successfully. The cure of neuralgia has become far more certain, and many forms of muscular contraction have found in electricity an efficient remedy. Disturbances of the secretions and excretions have, in many instances, been removed by electricity. In surgery, the galvano-caustic has secured a permanent foothold ; while the possibility of dispersing tumors by means of the galvanic current, so often questioned, is a fact established beyond further doubt. German obstetrics alone seems inexplicably indifferent to electricity. While it would servilely follow the dangerous example of a few Englishmen, who, regardless of human life, use chloroform in cases of normal parturition, it refuses to profit by the

XVI PREFACE TO THE SECOND EDITION.

verified experience of English obstetricians in producing contractions of the uterus with electricity, and by the possibility it offers of often preserving human life. Let us hope that the Corypheuses of German obstetrics will no longer hesitate to accord to electricity that place in medicine that is acknowledged to yield greater scientific and practical results than any other.

Dk. Moeitz Meter.

Berlin, December, 1860.

Preface To The Third Edition

From the publication of the second edition of this book to the present time, has proved to be another important period in the history of electro-therapeutics. The great event has been the reception of the constant current into medical practice generally. True, the founder of this mode of treatment, Robert Kemak, has, during this period, been taken from his place among the living, while valiantly contending for the correctness and the recognition of his theories. But his unexpected death and the involuntary termination of his brilliant labors led, perhaps, to a more candid examination of his assertions, and to an earlier acknowledgment of their correctness, than would have been the case had he lived. This intimation might be so construed as to mean, that either mental apathy, jealousy, or perversity, prompted the partisans of the intermitting current to oppose the constant current ; this reproach, however, may be emphatically denied. It was not the constant current as such, but the manner in which Eemak — especially at the beginning of his career as practitioner — denied that the interrupted current possessed any therapeutical value whatever, that made of natural allies unwilling opponents.

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I hope that the present volume, while it recognizes, on the one hand, the superiority of the constant current in certain directions, on the other it aids the interrupted current to recover its full and well-founded rights, of which it has of late been deprived by a sort of distinguished and unmerited distrust, and that it advances the true object of therapeutics in securing to the greatest possible number of the afflicted either a radical cure, or, at least, some relief. Then, we must not forget that the interrupted current is to-day the common property of the profession, while the constant current will, perhaps, never come into bo general use. At all events, it has thus far comparatively few advocates, and these are found only in the larger cities.

A retrospective glance at the progress made in electro-therapeutics, especially during the last few years, is in the highest degree encouraging. The possibility of the constant current acting on the brain or spinal marrow — which has been until late so generally doubted — the electrotonic action of the constant current on the living, the galvanic irritation of the sympathetic nerve, etc., have been stricken from the list of hypotheses, and elevated to places among scientific facts. In surgery, the electro - chemical action begins to attract more attention. It is now being used not only in cases of varices and aneurisms, but also hi the treatment of strictures, tumors, etc. In regard to obstetrics, we would repeat the wish expressed on a former occasion — that more extended experiments may be made by our honored colleagues, especially by those who have charge of our public hospitals.

Dr. Moritz Meter.

Berlin, March 29, 1868.

Contents

FIRST SECTION.

PAGE

Historical Sketch of the Applications of Electricity in Medicine, . 1

CHAPTER I. The Use of Electricity in Medicine, ..... 307

I. Electricity in Nervous Diseases, .... 307

180 180 192 203 209

247 254

CONTENTS.

XXI

A. Hyperesthesia — Neuralgia, .....

B. Anaesthesia, ......

D. Paralyses, .......

Cerebral Paralysis, ......

Spinal Paralysis, .....

Locomotor Ataxia, ......

Nervous and Muscular Paralysis,

Rheumatic Paralysis of the Muscles of the Eye,

Traumatic Paralysis, .....

Secondary Paralysis, .....

Lead Paralysis, ......

Asphyxia, .......

Incontinence of Urine, .....

Laryngeal Paralysis, .....

II. Electricity in Diseases depending upon Anomalies of Secretion

and Excretion, .......

A . Rheumatic Exudations, .....

/.'. Arthritic Articular Exudations, . . . .

C. Suppressed Secretions and Excretions,

CHAPTER II. The Employment of Electricity in Midwifery and Gynecology

. 452