How to Use a Galvanic Battery in Medicine and Surgery: A Discourse Delivered Before the Hunterian Society, Third EditionTibbits, Herbert
Science
How to Use a Galvanic Battery in Medicine and Surgery: A Discourse Delivered Before the Hunterian Society, Third Edition
Tibbits, Herbert
Electrotherapeutics
Indirect, or extra-muscular electrization, next claims our attention.
You will recollect that it is produced by acting upon the special
nerve trunk and its branches, instead of by placing the rheophores
upon the muscle itself. We may thus call a motor nerve into action
without affecting the cutaneous nerves, and with a minimum of power
of current, and necessarily a minimum of sensation which hardly ever
need amount to actual pain. This method is preferable, therefore, in
cases where we desire to produce muscular contraction and as little
sensation as may be, and again when the sedative influence of the
constant Voltaic current is required to be localized in any special
nerve. In its application it is convenient to place a good-sized
sponge connected with one pole upon an indifferent part of the body,
such as the sternum, and to apply a pointed conductor from the
second pole directly over the course of the nerve it is desired to
act upon. Speaking generally, these motor points as they are called
may be selected by reference to a good anatomical plate, but only
approximately, for we know that it is common to find variations
in the course of the nerves and in the mode of their distribution
among the muscles, and this being so, it is well when we propose to
act upon a motor or mixed nerve (which is not paralyzed), to make
sure that we are localizing the current in it by producing for a
moment the contraction of its muscles and then marking the spot by
touching it with a pencil of nitrate of silver. This, of course, is
only necessary where in our subsequent electrization we do not wish
muscular contraction, as in the treatment of neuralgia.[12] I will
demonstrate indirect electrization by Faradizing the median nerve in my
left forearm above the wrist, and before it passes beneath the annular
ligament of the carpus. It lies a little below the surface, between
the tendons of the flexor carpi radialis and palmaris longus. You
observe that its muscles powerfully contract and oppose the thumb to
the other fingers, at the same time abducting it. There occurs also a
slight flexure of the first phalanges of the index and middle fingers.
Professor Ziemssen in his work on Medical Electricity has published
some extremely accurate plates of the motor points of the body, and I
have grouped together the more important of them in a chart or map for
convenient reference.[13] Ziemssen’s method of procedure was to find
out experimentally the points where the application of electricity most
readily produced muscular contraction. He then marked these points with
coloured chalk, and after a sufficient number of trials with nitrate of
silver. Photographs of the parts thus marked were taken and afterwards
transferred to the wood blocks. These figures may therefore claim to be
true to Nature, although they may not be absolutely correct for every
individual. Ziemssen verified their approximate exactitude by following
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