GENERAL THERAPEUTIC EFFECTS AND USES.

The therapeutic uses of a remedy are based on what we know of its physiological effects. Many—or rather most—of the therapeutic effects of this as well as of most other remedies, correspond to certain physiological effects. Those therapeutic effects whereto we find none analogous among the physiological effects, are yet the results of the physiological tendencies of the remedy, and where these tendencies do not manifest themselves as results, it is because they find no field for action in the healthy organism. When they meet with the requisite pathological conditions, these tendencies make themselves manifest in the shape of definite results, commonly known as therapeutic effects.

Nothnagel, in his classical work,[9] recognizes this theory by excluding from his book the term “therapeutic effects” altogether. Where he finds it necessary to say anything of the physiological effects of a remedy, in addition to those “on man in health,” he speaks—still under the head of “physiological effects”—of those “on man when sick.” When, setting aside its empirical employment, we come then to inquire what it is that furnishes us with the true indications for the use of a remedy, analysis of the question leads us invariably back to its physiological effects. If I have failed nevertheless to include the few effects which I am about to touch on, under the head of “physiological effects,” I have done so simply in compliance with universal usage, and as a matter of convenience for reference.

I will now, without further digression, proceed to the consideration of those effects of electric baths not yet enumerated.

As a fitting precursor to the enumeration of the therapeutic properties of the remedy under consideration, it may be well to dwell for a moment on what is among its most prominent characteristics; I have reference to its great value as a

DIAGNOSTIC.

In explanation of this, I will state that in a very large number of cases of disease of an obscure nature, and where, to be candid, the electric bath was employed empirically, or, if you please, tentatively, it has served to point out the locus morbi. The number of cases in which I have made this observation, has been sufficiently large to establish beyond a doubt the fact, that as a rule the electric current makes itself more decidedly and often even painfully felt in any part where a morbid condition exists; whether this be of an inflammatory, neuralgic, rheumatic, traumatic, congestive or other nature, the result is the same. It appears to be somewhat analogous to the “tenderness on pressure” that we find present in many of these conditions. In anÆsthesiÆ even the current makes itself conspicuous by the absence of its normal effects. The value of this will at once be recognized in connection with a method of electric application which at one and the same time acts on every portion of the body. Local electrization is accompanied by like phenomena, when we happen to strike the right spot. The superiority of the bath as a means of diagnosis is found in the circumstance that here we must touch it.

The great importance of this feature of the electric bath will at once be realized by every physician of much experience, for there can be none such who has not frequently met with subacute or chronic conditions the etiology of which was more or less obscure.

One of the most important effects in its therapeutic application of the electric bath, is its superior excellency as an

EQUALIZER OF THE CIRCULATION;

so far as I know, it is more potent, constant and comprehensive in this respect than any other agent. Where an imperfect circulation of the blood is due to irremovable organic causes, the results obtained will of course be transient only. In all other cases, however, favorable results, more or less perfect according to the nature of the case, may be reliably looked for. Both currents act very well in this respect, though on the whole I look upon the galvanic as superior to the faradic current.

As a theory of this effect of the currents I would offer the following, viz: That the galvanic current acts by stimulating the vasomotor centres and peripheral nerves, by giving tone to the mucular coats of blood vessels, and by counter-irritation. That the faradic current stimulates the vasomotor centres little, if at all, does not influence the coats of vessels, except such as are close to the skin, but tonicizes these latter more effectually than the galvanic current; that it stimulates the peripheral nerves to some extent, though far inferior in this respect to the galvanic current; but that when employed of sufficient intensity it superadds to those mentioned a strictly mechanical action, which consists in forcing static blood from the capillary into the general circulation through the medium of muscular contractions.

As a

GENERAL COUNTER-IRRITANT

the galvanic bath has few if any superiors. The degree of counter-irritation can be very nicely determined by regulating the intensity of the current. The characteristic tingling sensation of the galvanic current is felt over the entire surface, corresponding in degree of course to the intensity of the current; while the redness of the skin, bearing a like relation to the intensity of the current, is observable more especially near the electrodes, being particularly conspicuous over the entire back. Concentrated local counter-irritation can be obtained by the use of the surface board.

The counter-irritant effects of the galvanic bath, differ from those of ordinary counter-irritants in their freedom from pain, even the slight burning sensation accompanying strong currents ceasing with the application. The redness remains quite a while and the stimulus to the peripheral circulation causes the persistence for some time of a “glowing” sensation all over the body.

In the chapter on physiological effects enough has been stated to make it apparent that as a

GENERAL INVIGORANT AND TONIC

the electric bath can have few if any superiors. In the healthy organism, however, the stimulant and tonic effects of the baths are much less marked than they are where the general condition is “below par.” In health there is little or no margin for improvement. The results obtained are temporary stimulation, and a permanent invigoration which partakes more of artificial development than anything else. It is analogous to the development by gymnastic or other exercise of a previously healthy set of muscles. Where we meet with atonic conditions however, with debility, malnutrition, want of energy or general asthenia of an obscure nature, and amenable to electric influence, the tonic effects of the baths become striking and brilliant. I have observed cases where patients fairly bloomed up under their influence and acquired actually more physical strength and weighed more than before they became sick. When we consider how in such conditions as those mentioned, patients are made to swallow pills and mixtures for months or years, or, more appropriately, and if they can afford it, are sent abroad, we can realize the importance of an agent by means of which the desired end can be obtained more conveniently, certainly, economically and in a shorter time than by any other means. There is no rule without its exceptions, and I freely admit that in many instances where persons are, as the saying is, “run down,” a sojourn in some mountainous region or a course of sea-bathing, etc., would do them more good than anything else, electric baths included. The results obtained from these last are however sufficiently uniform to justify us in looking for very favorable results in every case.

In the preceding chapter I have already dwelt on the

HYPNOTIC AND SEDATIVE INFLUENCE

of the baths. It is only necessary to state here that this influence manifests itself still more decidedly in corresponding morbid conditions than in health. The greater the degree of restlessness, irritability or wakefulness, the more strikingly does the soothing and hypnotic influence of the baths—appropriately administered, of course—become apparent.

IMPROVEMENT OF NUTRITION,

as manifested by rapid increase of weight, and which I have likewise touched upon in the preceding chapter, is a reliable, constant effect of electric baths. Where previous loss of weight is due to an incurable organic disease, it is, if at all obtained, of course much less in degree, as well as transient. When due, however, as is frequently the case, to causes that are amenable to electrical influence, the increase in weight is marked, and has a tendency to be permanent.

It will be seen that the few therapeutic effects which I have here enumerated, are in reality nothing more than intensified physiological effects, there being about them nothing that might be termed specific. It may be asked in reply: why then did I devote any space to them at all? I will answer that I thought best to point out some general therapeutic USES for which electric baths may be made available, and the indications for which are furnished by so great a number of pathological conditions, that omitting special reference to them would have led to a great deal of tautology in the chapter on “special therapeutics.”Before leaving the subject of “general uses” of the baths, I will dwell for a moment on their admirable adaptability as a

PROPHYLACTIC.

Every physician is fully aware of the fact that disturbances of the circulation constitute one of the most frequent causes of disease. There are, indeed, comparatively few pathological conditions that do not bring with them congestion of some more or less important organ. A remedy then which more than any other has a tendency to equalize the circulation, and thus counteract a condition which as cause or effect, or both, is an almost universal concomitant of disease, and which in addition to this is so admirable and physiological a stimulant and tonic, can hardly be surpassed as a prophylactic by any other uncombined remedy.