_The Galvanic, Continuous or Direct Current._--In using the galvanic or
direct current the electrode must be covered with padded webbing or some
other absorbent material, the metal of the electrode never being allowed
to come in contact with the skin. The padding by retaining moisture
helps to make good contact, and also helps to guard against burning the
skin. But when a continuous current of 3 am. or more is passed for more
than 5 min. the electrodes must be raised periodically and the skin
inspected. If the current be too strong or applied for too long a time,
small blisters are raised which break and are very troublesome to heal.
Nor does the patient always feel much pain when this occurs. Also the
electrodes must be remoistened every five or six minutes, as they soon
become dry, and the skin will then be burnt. It is best to use a
solution of sodium bicarbonate. Again, the danger of burning the skin
depends on the density of the current per sq. in. of electrode, so that
a strong current through a small electrode will burn the skin, whereas
the same current through a larger electrode will produce a beneficial
effect. If the patient be immersed up to his neck in an electric bath,
much stronger currents can be passed without causing either pain or
injury, as in this case the whole area of the skin in contact with the
water acts as an electrode. In passing the current it must be remembered
that the negative electrode or kathode is the more painful of the two,
and its action more stimulating than the positive electrode or anode,
which is sedative. If a muscle be stimulated over its motor point, it
will contract with a sharp twitch and then become quiescent. With normal
muscle the KCC (kathodal closure contraction) is stronger than that
produced by the closure of the current at the anode ACC (anodal closure
contraction). And if the muscle be normal the opening contraction KOC
and AOC are not seen. When a galvanic current is passed along a nerve
its excitability is increased at the kathode and diminished at the
anode. The increased excitability at the kathode is katelectrotonus, and
the lowered excitability at the anode anelectrotonus. But since in a
patient the electrode cannot be applied directly to the nerve, the lines
of force from the electrode pass into the nerve both in an upward and
downward direction, and hence there are two poles produced by each
electrode. If the current be suddenly reversed, so that what was the
anode becomes the kathode, a stronger contraction is obtained than by
simply making and breaking the current. To avoid the four poles on the
nerve to be tested, it is found most satisfactory to have one electrode
placed at some distance, on the back or chest, not on the same limb.
Public-domain text, read in full here on John Shaqi.
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