How to Use a Galvanic Battery in Medicine and Surgery: A Discourse Delivered Before the Hunterian Society, Third EditionTibbits, Herbert
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How to Use a Galvanic Battery in Medicine and Surgery: A Discourse Delivered Before the Hunterian Society, Third Edition
Tibbits, Herbert
Electrotherapeutics
In non-atrophic paralysis--of which hemiplegia may be taken as a
type--the propriety of electrization, and especially the proper
moment for its application, requires careful consideration. In both
brain and spinal cord disease muscular electrization is not advisable
until some time after the attack, or until the muscles exhibit
signs of impairment of nutrition from disuse. As long as there is
rigidity--especially with increased reflex action--any stimulant
application of electricity is not likely to do good, and may do harm;
but in older cases--both hemiplegic and paraplegic--cases of from six
to eighteen months’ duration--the immediate benefit to be derived
from localized electrization is often remarkable, especially in those
cases where, after a partial return of voluntary movement, the patient
suddenly stops short, and for weeks or months makes no progress. As
the sequel of electrization, the hemiplegic patient able to use the
arm slightly, but not to feed himself, may regain this power, to his
infinite comfort, and the paraplegic patient, able with difficulty
to drag himself along by crutches, is enabled to walk by the aid
of a stick. Some improvement is usually soon obtained, and it is
progressive for, perhaps, two or three months, after which continued
electrization fails to increase it; but at a subsequent period--six
months afterwards--a renewed electrization may give rise to a new
improvement; but be this as it may, whenever in these old-standing
cases we see signs of impaired nutrition, it is wise to occasionally
stimulate the muscles by Faradism. We should endeavour--in the words
of the late Nestor of modern medicine, Sir Thomas Watson--“to preserve
the muscular part of the locomotive apparatus in a state of health
and readiness, until peradventure that part of the brain from which
volition proceeds having recovered its functions, or the road by which
its messages travel having been repaired, the influence of the will
shall again reach and reanimate the palsied limbs.”[19] [SN: Direct
application of Voltaic Current to Brain.] In hemiplegia the propriety
of a direct application of the constant Voltaic current to the brain
must be thoughtfully considered. In selected cases, where the clot
or softening is of limited extent, its removal may be accelerated by
a carefully localized current--two or three cells--for two or three
minutes to the injured hemisphere, followed by Voltaization of the
cervical sympathetic (so-called) for four or five minutes. After such
an application there follows--according to Althaus--“greater ease in
the head, as well as in the limbs, and if there has been pain this
is relieved.” [SN: Electricity in Spinal Paraplegia.] Similarly the
absorption of the inflammatory products may be promoted in the earlier
stages of spinal disease, by localizing the Voltaic current in the
parts affected, especially where pain is present, and we have reason
to suppose that the myelitis is circumscribed. The daily application
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