PHYSIOLOGICAL EFFECTS.

In accordance with the plan of the present work, the remarks I shall offer under this head are by no means intended to comprise all that is known at the present day of the physiological effects of electricity in general. It was my purpose when I undertook to write these pages, to offer to the profession a book confined to one subject; not a compilation, but a volume made up almost if not wholly of original matter, chiefly, if not entirely the result of my own observations and experience. For the general physiological effects then of electricity as well as for the theories of its action, I refer those interested to the many excellent works on the subject that have appeared within the last few years. I will treat here only of the physiological effects peculiar to the electric bath.

The daily observations that I have had the opportunity of making in this respect, extending as they do over a period of upwards of two years, have not been as fruitful of results as might be expected. This is due mainly to the circumstance that but a small percentage—and these took the baths merely as a refreshing tonic—of those whom I have had the opportunity of observing, were in a condition that might be called normal. By far the greater majority were suffering from some complaint, in most instances of a neurotic or rheumatic nature, the presence of which, while it afforded admirable opportunity for observing therapeutic results, modified more or less the physiological effects of the baths, and served to deprive them of a uniformity which might to a great extent justly be looked for in healthy organisms. If, therefore, what I now contribute to the physiology of the subject is but little, it will I trust be at least found of practical utility in its applicability to the therapeutics of the subject.

Before entering into details, it is necessary in the first place to inquire in what respects electric baths differ from other methods of electrization—especially those recently introduced as “general”—that their physiological effects should merit individual consideration. They differ in two ways. One of these is self-evident. To the effects of electricity are superadded those of the warm bath. The effects of the warm bath per se are too familiar to every physician to require comment. Its effects in combination with electricity, however, may not be so generally known; and I therefore feel justified in quoting here a passage that bears directly on the subject, from a recent German work by Dr. Hartmann[4] of Wiesbaden.

From the foregoing quotation may be realized the importance which is attached to the electric current in the warm bath. And here let me ask the question: May not the remedial superiority, in many cases, of the mineral water bath over the ordinary warm bath be due mainly, if not solely, to the more abundant generation in the former of electricity? Or rather, is it not very likely that this is so? And if such is the case, it would appear evident that the mineral water bath, the electric properties of which, depending on the chemical changes going on between the gases and salts of the water on the one, and the cutaneous secretions and other constituents of the body on the other hand, are to a great extent beyond our control, must in turn be vastly inferior to a bath where the electric current is under our perfect control, and can be modified in intensity, direction and quantity to meet the individual requirements of every case. And such is the electric bath I am now describing.

The second difference between the electric bath and all other methods of applying electricity is, that the bath is the only method by means of which general electrization can be realized. In making a distinction in this respect, it becomes necessary for me to advert more especially to a method first introduced to the profession in a systematized and scientific manner by Drs. Beard and Rockwell,[6] and termed by them “General Faradization.” The undoubted good results that have been obtained from this method—for the details of which I refer the reader to the latest work of the authors[7]—have caused it to be extensively adopted by the medical profession, both here and in Europe. It is, however, not with its results that I have to do at present, but with its appellation and true nature. General faradization, so-called, consists of a series of local faradizations, administered during one and the same sÉance, until the current has alternately been made to impinge upon and traverse the entire or at least a large portion of the body. This cumulative procedure, it is true, approaches general electrization, as represented by the electric bath, more closely than any of the other local methods; yet it is not that which its name would imply, and I do not think it requires argument to make it apparent, that even this procedure differs vastly from the electric (whether galvanic or faradic) bath, where the current at one and the same time impinges directly on every peripheral nerve-end (excepting those of the head and face) and traverses every part of the body, obtaining—both as to reflex and direct effects—as a whole that which the method known as general faradization seeks to obtain by the cumulation of fractional portions.

Having thus, I trust, established the individuality of the bath as an electric method, I will without further digression proceed to the consideration of its physiological effects.

The physiological effects of the electric bath may be qualified on the one hand as either “immediate,” or “remote,” on the other as either “transient” or “permanent.” Strictly to classify these is impracticable, and I will therefore be influenced in the order of their enumeration principally by their importance in a therapeutic respect.One of the most pronounced as well as uniform, and at the same time most important, effects of the electric bath, is its property as an

HYPNOTIC.

This somniferous influence, which is to some extent exercised by local electrization, is here distinguished by its far greater constancy as well as by its greater degree of perfection. That this difference should exist, appears quite natural, when it is considered that the same topical influences which produce it in local electrizations, and which I shall presently endeavor to analyze, are here brought to bear on the entire system. The hypnotic effect is both immediate and remote, and more or less permanent. When there is an immediate inclination to sleep, which may make itself manifest during the bath or immediately after this, it is generally accompanied by a

PLEASANT SENSE OF FATIGUE,

which cannot be likened to weariness, but rather to what we feel after moderate exercise; it is only in some instances, where an individual takes his first bath, or where, for therapeutic reasons, a strong faradic current—accompanied by responsive muscular contractions—is employed, that this feeling is intensified sufficiently to become unpleasant, calling for rest and recuperation, and must here be looked upon as analogous to the effects of severe exercise. It invariably disappears after a brief rest.

Experience and good judgment will enable us moreover in almost all cases to avoid effects of this kind. The immediate inclination to sleep is much more decided as well as constant when the bath is taken late in the day, than when taken in the forenoon. When the latter is the case however, the individual will as a rule become sleepy during the afternoon, or else at an earlier hour than usual in the evening, and sleep more soundly during the night. This is the effect of one bath. A series of baths will however produce more or less marked and permanent improvement in the sleep of individuals, where this has been below the normal standard. And this is among the most invariable of the effects of the electric bath, whether galvanic or faradic.

I have formed a theory as to the rationale of this influence, which I will offer as its probable explanation. We all know that sleep is a process designed by nature for the recuperation of the system after a certain period of activity. In other words, when the various functions have been more or less exercised for their daily allotted time—say seventeen hours—the respective organs need that profound rest which we know as sleep. Now, it is pretty well conceded by physiologists, that electricity stimulates the secretory as well as excretory organs; that it furthers endosmosis and exosmosis—by its electrolytic influence in a physical, by its influence on the nervous system in a catalytic manner, in short, and by virtue of these properties, that it greatly

ENHANCES THE CHANGE OF MATTER

and incites the various organs to so great an activity as to cause them to perform in a comparatively brief space of time—say an hour, the work of several hours. The natural sequence is obvious: The want of rest—of sleep, is felt at a correspondingly earlier period. I offer this as a probable explanation of the immediate or almost immediate disposition to sleep. As to the permanent improvement in sleep, where this has been below the normal standard, it must always be due to the removal of some morbid condition, and thus belongs among therapeutic results, rather than physiological effects. It is true that in many instances of agrypnia we are unable to discover any pathological condition that would account for this symptom; but the probability is that here there is a sluggishness of some one or more of the functions, mental or physical, too obscurely manifested to be discovered by our present means of diagnosis, yet reached and rectified by a mode of electrization that traverses and permeates every portion of the body.

If this explanation of the hypnotic effect of the electric bath be not the true one, it is at least—so far as I know—the first attempt at accounting for a phenomenon that has been noticed as a result of even local applications of electricity by many observers, and about the pretty uniform occurrence of which there can be no doubt.

With respect to the effect on the

TEMPERATURE AND PULSE,

I have made a number of observations, of which I have recorded twenty-two, made on persons where both were at or nearly at the normal standard. With regard to the frequency of the pulse, the results were conflicting and by no means reliable. In the majority of cases there was an increase, immediately after the bath, ranging from four to eighteen beats per minute. In others there was no change whatever, and in a few there was an absolute diminution in frequency; this last I believe however to be a therapeutic rather than physiological effect, manifesting itself only where there is pneumogastric asthenia, and attributable directly to electric stimulation of this nerve. Thus in one instance, which occurred in the person of a physician of this city, who had an intermittent pulse, the result was as follows: Immediately before bath: pulse 70, two intermissions; at the expiration of 15 minutes, during which he was under the influence of a descending galvanic current: pulse 65, two intermissions; at the end of ten more minutes, during which he received the faradic current: pulse 65, no intermissions; ten minutes after leaving the bath: pulse 66, no intermissions. As a rule then, we may look for an immediate and more or less transient moderate increase in frequency of the pulse. As for any permanent increase or reduction of the pulse, there is none as a physiological effect. Where such an one does take place, it is by the removal of some morbid influence on the heart, and must be looked upon as a therapeutic result.

With respect to the temperature, the results were somewhat more uniform. I have found that where this is either normal or slightly below, the immediate but transient effect is to raise it from 2 to 6 tenths of a degree (Fahrenheit)—in most instances 4 tenths. In a very few cases it remained unchanged, and in one case, where before the bath the temperature was 100, at the close of the bath it was 99?. Of permanent modifications of the temperature, the same holds good that I have said of permanent changes in the pulse. It must not be forgotten that the temperature of the water is undoubtedly an important factor in modifying the temperature of the body. In almost all instances where my observations were made, the temperature of the water was below that of the body, being 95° or a little less. This, which has a tendency to lower the bodily temperature, is to some extent counterbalanced by the suppression of the insensible perspiration, so that modifications of temperature resulting from electric baths, the water of which is but few degrees below 98½°, may justly be attributed to the influence of the electric current. The importance of the electric bath as a

PHYSIOLOGICAL STIMULANT AND TONIC

cannot be overrated. I deem it superior in this respect to any other known agent. This effect manifests itself immediately by a feeling of exhilaration and unwonted vigor, remotely by an improvement—where there is a margin for such—in the performance of some or all of the physiological functions, as well as by a gradual but nevertheless marked increase in weight.Most striking among the tonic influences of the baths, are those that occur within the sphere of the digestive and sexual apparatuses. I will first consider the effects on

THE DIGESTIVE APPARATUS,

which may be subdivided into those on a) the appetite, b) digestion, absorption and assimilation, and c) alvine excretion. The improvement of the appetite under electro-balneological treatment is one of the most constant effects of this. While a series of baths will produce permanent results in this respect, an increase of the appetite, in some instances amounting to positive hunger, is a tolerably uniform and more or less immediate result of each separate bath. The permanent improvement of the appetite is relative. Not very appreciable where this is normal, it becomes most marked where the appetite has from some cause been impaired. The effect on the appetite is definite. The effects on absorption and assimilation are presumptive; but when we couple the absence of any corresponding difficulty in digesting the increased supply of food, with the increase before alluded to in the weight of the body, their assumption becomes fully justifiable. It is these combined influences that make the electric bath so valuable a remedy in almost all forms of dyspepsia.

The influence on the alvine process is if anything even more marked than that on the assimilative process. Where the action of the bowels is normal, it is not modified permanently by the electric bath, although we often have, as an immediate consequence, a cathartic effect that manifests itself as a more or less watery evacuation, either a few hours after the bath or on the succeeding day. Where the fecal process however is sluggish, the improvement resulting from the baths is very striking. I shall recur more fully to this subject under the head of constipation.

The effects on the various functions connected with digestion are due doubtless to the combined influences of stimulation of the secretions of the alimentary canal and stimulation of the muscular coats of the stomach and intestines, as well as permanent tonization of the muscularis. While the enhancement of the secretions is undoubtedly due chiefly to the electric stimulus to the secreto-motor nerves, and the increased activity of the muscular coats to a like influence transmitted to their motor nerves, I believe the permanent tonization and invigoration of the muscular fibres to be mainly attributable to the direct trophic influence of the current traversing the parts themselves; and I have no doubt that this direct influence has much to do with the stimulation of the secretions and peristalsis also. At any rate, I have never obtained from galvanization of the nervous centres, which I have practiced in a great number of cases, the striking effects on the alimentary processes which are so uniform a result of the baths.

The influence on the

SEXUAL APPARATUS

of the electric bath does not manifest itself in so striking a manner as in the case of the organs of digestion. It is true I have seen individuals whose sexual functions were normal, have stysis in the bath, but the mere cutaneous irritation of the electric current is here sufficient to account for a phenomenon which, where sexual irritability is intact, will follow any other local irritations.

If not as immediately perceptible, the stimulant and permanent tonic and invigorating influences on the sexual organs are not much less constant than the corresponding influences on digestion. Careful observation, however, of a considerable number of cases where the sexual function was more or less impaired, has convinced me that while there can be no doubt that direct influence on the innervation, tone and nutrition of the respective parts as well as the stimulus which the electric current furnishes to the seminal secretion, bear a share in the improvement that takes place, permanent beneficial results must be looked upon as chiefly the expression of improved nutrition and tonization of the system at large. I do not mean to be understood as wishing to put in negation the beneficial results that the local influence of electricity is capable of sometimes accomplishing in the sexual sphere. These results, however, are not of a physiological, but rather of a purely therapeutic nature, and are obtained there only where local morbid conditions exist. Now, in the great majority of the cases that have come under my observation, the causes of deterioration of the sexual capacity, though frequently obscure and indefinable, were certainly not local, but to be sought for in the general—most probably the nervous—system. In none but perhaps the very mildest and recent cases have I ever seen rapid results follow electrical treatment of any kind whatsoever. In support of my assertion however that in the majority of cases the sexual sphere can be influenced only through the system at large, I will state first, that I have seen cases where local electrical treatment had utterly failed to do the slightest good, respond favorably to the baths, and second, that where success was met with, it was only after persistent treatment, continued long enough to modify favorably the condition of the entire organism, and through this the objective sphere.

The stimulant and tonic effects under consideration, although shared to some extent by other methods of electrization, are here far more comprehensive and pronounced, a fact which is not surprising, when we reflect that in the electric bath not only are all the organs indirectly influenced through stimulation of the nervous centres, but each separate organ is at the same time directly acted upon by the current.

A direct sequence of the stimulant and tonic effects of the electric bath is its

SEDATIVE INFLUENCE.

This sedative effect, whereof the hypnotic effect already spoken of is the supreme manifestation, must not be associated for a moment with any idea of depression, for here we have none such. In addition to what I have already said in endeavoring to account for the hypnotic influence of the baths, I refer the reader for further information to the admirable and lucid remarks on this subject by Beard and Rockwell.[8]

The galvanic bath shares with other galvanic applications made in the cranial and upper spinal region, the effect of producing the galvanic taste, as also the flashes when the current is interrupted, showing that the

CRANIAL NERVES

come within the sphere of its influence.

A further effect peculiar to the galvanic bath is a sense of

ITCHING,

felt chiefly in the lower extremities and about the neck, and proportioned to the intensity of the current. Rather pleasant when mild or medium currents are used, under the influence of strong currents it may become so intense as to create an irresistible desire on the part of the bather to scratch especially the legs.

A negative effect of the galvanic bath, even where very intense currents are used, is the

ABSOLUTE FREEDOM FROM PAIN

throughout the entire process. I wish this to be understood of course as holding good only when currents within the ordinary limits of intensity are employed. The strongest that I have used, and on which I base my statement, was that from 48 StÖhrer or 60 Hill cells. As stronger currents are not required for therapeutic purposes, what I have asserted remains practically true as applied within these limits.

This absence of pain, which cannot be claimed for correspondingly intense local applications, is to be attributed to the diffusion of the current throughout the body and its surface, as well as through the water of the bath. The redness of the entire back after a galvanic bath, is among the proofs of this diffusion.

Freedom from pain is a characteristic likewise of the faradic bath, properly administered. When too strong a faradic current however is incautiously administered, the resulting muscular contractions are accompanied by an amount of local pain proportioned to the violence of the contractions. By keeping the faradic current within proper limits, all pain can be avoided.

With respect to

MUSCULAR CONTRACTIONS,

the effects of the electric bath may be distinguished from those obtained by other modes of faradization by their comprehensiveness. Many groups of muscles may be made simultaneously to contract by this means. The practical bearing of this on the therapeutics of pareses and paralyses, renders it an important characteristic of the bath.

The physiological effects on

THE MIND

of electric baths, is a natural result of the enhanced tone and vigor of the physical system, and keeps pace with this. Mental buoyancy and even exhilaration are among the most common sequences of electric baths. Although indirect, these results are none the less decided.

It has been my aim in the foregoing remarks to give the reader, as concisely as possible and within the limits which I set for myself in the beginning of the present chapter, a summary of the more important physiological effects of electric baths. As the isolated results of observations made in a limited field by one unaided individual, I trust the shortcomings of this chapter will be viewed indulgently. If what I have said of the physiological effects of electric baths proves the means of stimulating to further investigation more competent observers than myself, my labor, whatever its imperfections, will not have been in vain.

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