inti AHD SURGICAL CASK WUtD Bl EIECTRICm,

No. 1.-MEDIOAL CASES.The following medical cases "will serve to

illustrate certain features in electro-thera-peutics that are not yet fully recognized bythe profession, even among those who makeconsiderable use of electricity in practice. Itis possible that these reports may be read bysome who are in the habit of using both cur-rents of electricity, and who have acquiredsufficient skill to enable them to confirm ordisprove the results here claimed. Generalpractitioners have continually under ob-servation cases that the specialist sees butrarely, and if he happens to be familiarwith electrical applications, may, if he willbut take the pains, assist materially in ad-vancing the cause of electro-therapeutics.Acting on the theory that at least a part ofthe pathology of diabetes rises in the brainor spinal cord, I have treated ten cases bygalvanization. Thefirst one treated was thefollowing:—Diabetes Mellitus, Traumatic Origin, in an Aged

Patient; Rapid Relief of all the Symptoms, andApparent Arrest of the Disease under Central Gal-vanization ; Subsequent Attack of Hemiplegia.J. D., a farmer, aged 76, was referred to

me, January 30,1873, by Dr. J. H.Raymond.The patient had always been active, labori-ous, and well, until twoyears previous, whenhe fell ten feet in a barn, struck and hit onhis side. That same night came pain in thenipple, and a very profuse flow of urine.At one timehe passed as high as two quartsand three pints daily. It was ascertainedthat the urine contained sugar, and by medi-cal advice he had adopted Camplin’s diet,and under Dr, Raymond had taken carbo-nate of soda with advantage.

The symptoms at the time the patientcame to me were as follows: There washeadache, bad taste in the mouth; the urinehad a specific gravity of 1024, and he wasobliged to rise in the night to pass water;about two quarts were passed daily; there

was considerable muscular debility, so thata short walk was fatiguing.

On the theory that the disease was in thespinal cord, or at least in some part of thecentral nervous system, I began to use cen-tral galvanization, with immediate results.After the first application he began to bestronger, and after a week it was no longerneedful for him to rise at night to pass water.The specific gravity of the urine soon wentdown to 1019, at which point sugar couldstill be detected. The diet of the patient,and his general manner of life, was the sameas before. Sugar wasnever entirely expelledfrom the urine, but in strength the patientso much improved that he could walk sev-eral miles daily. The headaches were feltno more, and the bad taste was much miti-gated. He returned to his home and to hisoccupation, and was able to wT ork more orless for six months, when he was taken withhemiplegia.

Dr. Barker informs me that he has simi-larly treated a case of diabetes, and has fromtime to time examined the urine and esti-mated the quantity of urea. He has con-firmed the experience above recorded, andbesides, has shown what I do not attempt,that the quantity of urea diminished verymarkedly under the treatment.

In the following much severer case theapparent results of treatment were less de-cided ;

Diabetes Mellitus, Two and a Half Years’ Stand-ing, Apparently Caused by a Fall, Complicatedwith Various Nervous Symptoms; TemporaryBenefit from Central Galvanization.

Mrs. L., a married lady, under middle age,was sent to me, March 4tb, 1873. Two anda half years before she had a severe fall,which produced a concussion of the spine,and laid her up for a week. In a fewmonths came on excessive thirst, constipa-tion, and sugar In the urine. She had been

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through various forms of treatment, and con-1fined herself to bran-bread, and was thendrinking Bethesda water, which seemed to jdo her good. Her condition was as follows ; :

specific gravity of urine, 1049 ; six gallonspassed daily par t of the time, and when shepaid no regard to her diet. Considerablefacial neuralgia, great thirst, a feeling ofaching and stiffness in legs, with pains re- jsembling growing pains; insomnia, partly Iowing to the fact that she was obliged toget up several times during the night topass water; and tenderness of dorsal andlumbar vertebra}. Treatment by centralgalvanization faithfully used brought downthe specific gravity of the urine to 1040, butnever lower than that, enabled her to passthe entire night without rising to make wa-ter, and relieved many of her general nerv-ous symptoms, and this was. all it accom-plished.

Anosmia, loss or impairment of the senseof smell, is relieved by electricity, andsometimes permanently cured. Internal japplications are better than external appli-cations, and the galvanic current is prefer-able to the faradic.

Chronic Rhinitis, with Anosmia and Profuse Secre-tions ; Immediate Relief under Internal and Ex-ternal Galvanization.

Mr. H., a gentleman of middle life, wasreferred to me by Dr. St. John Roosa, Octo*ber sth, 1872. The patient was sufferingfrom “catarrh,” so-called, most severely;the secretion was very abundant. The an-osmia was quite profound, and the sense oftaste also was considerably affected. Thesymptoms had been worse during the pasttwo weeks. I gave treatment by internalgalvanization with a mild current, six cells,by means of the nasal electrode, the cathodeinternally. The nasal passages were sensi-tive, and only gentle currents and short ap-plication could beborne. External applica-tion also was employed, one pole on thebridge of the nose and the other in thehand. Relief followed the next day; forthe first time in tw7 o or three weeks, hecould smell fragrant substances. He con-tinued to improve under a number of appli-cations, when I lost sight of the patient.

In the above case there was not, so far asI know, any marked improvement in thedischarge or in the character of the ulcersfrom which the discharge proceeded. Thecase illustrated the fact I have often ob-

served, that the anosmia yielded long beforethe inflammation with which it is asso-ciated.

Cases of asthenopia are frequently bene-fitted by local faradization or galvanization.I long ago expressed the belief that morecould be done for asthenopia than for almostany other form of disease of the eye.Asthenopia, Nine Years’ Standing ; Temporary but

no Permanent Relief from Localized and GeneralFaradization and Central Galvanization.Miss W., aged 25, was referred to me,

December 11,1872, by Dr. E. G. Goring.Since puberty the young lady, who was of

a pronounced nervous temperament, hadsuffered from weakness of the eyes. Shecould read but little without pain. Beforethe menstrual periods she was always worse.There was ovarian tenderness, resultingprobably from congestion due to a coldtaken during the menses. This tenderness,which had existed two months, made itquite difficult for her to walk long distances,and apparently the weakness of the eyeswas aggravated thereby.

An application of localized electrizationmade her eyes feel better for a day or two.This method of treatment was continued fora month, though varied somewhat by cen-tral galvanization and general faradizationwith a view to improve her general con-dition, The improvement was not satisfac-tory; temporary, and I believe permanent,relief was gained.

There is no form of paralysis that servesso well to illustrate the differential action ofthe two currents as facial paralysis.

Facial Paralysis ofEight Side, Caused by Exposureto Cold; Permanent Eecovery under Local Gal-vanization after Failure of Faradization.Mr. E., a gentleman of middle life, was re-

ferred to me November 29,1871, by Dr. Wm.K, Brown.

The patient had been exposed, a numberof weeks before, to a cold wind while riding;there followed paralysis of the right side ofthe face. For this condition Dr. Brownhad used faradization without much effect.I found on examination that the patient

could move the muscle of the diseased sidehut slightly, and under a strong faradiccurrent there was no response. Six weakcells of the galvanic current caused readycontractions of the eorrugator superciln, theorbicularis and the zygomatiei.

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After one week of treatment, six; applica-tions, the patient could close the eye im-mediately after the application, and could ■slightly corrugate the forehead; at theangle of the mouth no movement was possi-ble. The slight improvement just after thesitting lasted, in its full extent at least, but ashort time. December 20, after sixteen ap-plications, the patient could slightly movethe angle of the mouth. January 24, afterthirty applications he was so nearly wellthat treatment was abandoned. Subse-quently I saw the patient, and he was en-tirely restored.

In the above case the faradic current alone,

even if persevered in, would probably haveaccomplished little or nothing. And yetcases of facial paralysis of a similar characterare sometimes treated by faradization andthen abandoned, and then electricity losesground in that immediateneighborhood. Iwill not say that faradizationlong continuedmay, by its mechanical effect and generalinfluence over nutrition, aid the case of aperipheral facial paralysis, even when it pro-duces no contraction ; indeed, I suspect thatit may have such an effect; but so long aswe have the galvanic current at commandit is not necessary to wait the slow action ofsuch an experimental expedient.

jSTo. 11.-SURGIOAL OASES.Epithelioma of the Face, Originating in an Old Sear,

Six Months’ Standing,Removed by a Combinationof Electrolysis of the Base and the Galvano-Can-tery.Captain I), was brought tome, April 271h,

1873, by Dr. Fessenden. The patient had atumor that appeared to be an epithelioma,about the size of a small walnut, over thezygoma. It had developed from an oldscar that had existed from childhood. Whenhe was first brought to me the tumor hadbeen in existence six months. It had beentreated by caustics but rapidly recurred. Idecided to treat the tumor by electrolysis ofthe base , combining with it the galvano-cautery, if necessary or convenient, andshorten the operation.

April 30th I operated, assisted by Dr.Fessenden, who gave the anaesthetic for tenminutes, with eighteen zinc carbon cells. Iused my long cutting needle, passing oneconnected with the positive pole under thetumor near the edge, and another long cut-ting needle connected with the negativepole, also under the tumor, and parallel tothe positive needle. The electrolytic actionwas moderately strong, and the growth wasrapidly loosened. The positive needle be-came fixed in the tissue where it was im-bedded, through the oxidization, as is alwaysthe case with the positive needle, whilearound the negative needle a yellowish foamappeared, caused by the mingling of the hy-drogen evolved with the blood. The needlewas very loose in the tissue, and I worked

it slowly to the right hand and left untilthe tumor was undermined by the electro-lytic action, and nothing removed but aportion of the skin. I completed the ope-ration by a short wire connected withByrne’s galvano-cautery battery. After thetumor was removed, I worked up the base,partly with the needles and partly by theheated galvano-cautery wire.

Both needles, positive and negative, wereplunged into the base and edge of the tumor,into healthy tissue, until all was bloodless,charred and dry. Scarcely any blood flowedduring the operation.

The patient was soon able to leave theoperating room. Cold -water dressing onlywas used. Some sloughing followed, andsatisfactory granulation. In six weeks thesore had completely healed, with a moder-ate cicatrix, and at the date of writing, Feb-ruary Ist, 1874, ten months from the time ofoperation, there are no signs of recurrence.The growth was examined microscopicallyby Dr. Ormiston, and by him pronouncedmalignant.

This method of working up the base I de-vised in 1871, and have used it on a largevariety of tumors, epithelioma, cysticgrowths and schirrus, and in different locali-ties, as the face, neck, rectum, vagina andbreast. It is, of course, indicated only inmalignant growths, by which I meangrowths that recur after removal. Benigntumors, as nsevi, certain forms of cystic tu-mors, and goitres, are best treated by the or-

6dinary method of electrolysis, that is byplunging the needles into the body of thetumor.

When the method of working up the baseis used, the body of the tumor may be re-moved by the knife, the ligature by enuclea-tion or by the galvano-cautery wire. So faras the results are concerned, it matters notwhat method of removal is used. The im-portant point is to thoroughly electrolyzethe base of the tumor and the surroundingtissue, so that the chemical changes causedby the current may reach not only the dis-eased tissues, but also those tissues that are,so to speak, passing out of the healthy intothe diseased condition.

I do not profess that this method, or anyother method of electrolysis, has any con-stitutional effects against the cancerous dia-thesis, if we are to suppose that such a dia-thesis exists. Its effect is chemical andlocal. Its chemical effects are complex, andare essentially different from the effect ofcaustics or chloride of zinc, which havebeen successfully used in these cases.

Destruction of tissue is only one of itseffects, and one which is of the least im-portance. Electricity acting on the tissuesdecomposes them, as no other force or agentcan do, and with a variety of primary andsecondary results, which can be only in partexplained.

From my present experience with thismethod of working up the base, these pro-visional conclusions seem to me justifiable.

1. Malignant growths, epithelioma, cys-tic and schirrus, when thoroughly treatedby this method, do not recur as readily aswhen treated by other methods, if indeed,they recur at all. ’ A longer time will beneeded to settle this question beyond dis-pute, for the obvious reason that after ordi-nary operations, a certain percentage ofma-lignant growths do not recur. Several ofthe cases that I have treated by this methodhad been previously operated on by theknife and ligature, and the recurrence hadbeen very rapid ; these cases I have keptwatch of since I operated on them by thismethod, and from times ranging betweenthree years and three months, and at thepresent date there has been no recurrencein any case where it was possible to thor-oughly use this method. In hopeless- casesof cancer of the vagina and rectum, where itwas impossible to use this method in itscompleteness, there have been recurrences;

but even in these cases the rapidity of thehealing has been most gratifying, and thegrowths have been kept back much longerthan where the knife and ligature were usedalone.

2. More rapid and satisfactory healing.This is observed, as I have stated, not onlyin the curable, but also in the incurablecases. In some cases, although the slough-ing is quite extensive, the cicatrix is notlarge.

3. Less probability of shock and pyemia.These two bad results of ordinary operationshave not yet occurred to me in any of mynumerous experiments with the method ofworking up the base. In the case where Iyielded my method to the knife, the patientdied of shock, and in another case, where Iyielded my method to enucleation, and ne-glected to work up the base, the patientdied of pyemia.I give these conclusions with reservation.

I am still extending the field of my re-searches, and am now treating schirrus ofthe breast by the same method; as thesetumors are almost sure to recur after ordina-ry operation, it will not take long to deter-mine whether the advantages of my methodare as great as I have suggested. The ordi-nary method of electrolysis does not accom-plish much in schirrus of the breast, exceptto relieve the pain ; but the pain can be re-lieved by simple external galvanization,without the use of galvano-puncture.

When large malignant tumors are treatedby this method, it is a saving of time to re-move the growth with a knife, unless, onaccount of feebleness of the patient, a shockmay be apprehended, and then work up thebase with my long cutting needle, or withthe harrow electrode that I have devised forthat purpose. When the growths are smalltheywill fall off by the dissolving influenceof the electrolysis, and the knife is not

I needed.The following case illustrates what can he

done for the relief even of hopeless cases ofschirrus of the breast, by external galvani-zation alone.

Scliirrus of the Left Breast, Apparently FollowingInjury; Some Subsidence and Belief of Pain Un-der Local Galvanization.Miss H., a maiden lady, about 35, residing

in Springfield, Mass., was brought to meOctober 16th, 1871, by S. J. Holley. Threeyears before she fell and struck on her left

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breast; abscess followed ; then a hard lumpappeared, then pain arose, then a tumor ofconsiderable size was manifest, that was de-clared by a good surgeon to be schirrus.This was removed ; then a tumor appearedin the right breast, subcutaneous in charac-ter. At the time she presented herself tous there was a reappearance in the leftbreast, and a subcutaneous tumor in theright, and some swelling on the breast bonebetween the breasts.

Localized galvanization of the tumors,and central galvanization to affect the nervesupply of the breasts, were used for twoweeks, with the effect of relieving the painand causing the tumor of the right breast togrow evidently smaller and softer. Thepatient soon left town, and when I nextheard from her she was very feeble. Sheprobably died of exhaustion. I had notat that time fully developed the methodof working up the base, else I might, per-haps, have tried it, although the tumor wasa recurrence.

In the following case the disease was ap-parently arrested by external treatment; atthe date of writing the patient is still toler-ably wTell.

Schirrus of Left Breast; Eight Years’ Standing;Feeling of Weight and Pressure; Relief of theUnpleasant Symptoms Under Localized Galvani-zation, Faradization and Central Galvanization.

Mrs.. M., of Philadelphia, consulted meOctober 24th, 1871. The lady was of middlelife, and the meno-pause had recently oc-curred. For eight years she had been an-noyed by a tumor that very many eminentauthorities had pronounced schirrus in theleft breast. It began with a small hardlump, and gradually but very slowly In-creased, The pain had never been very vio-lent, but there was a feeling of weakness, ofpressure and of debility in the left breast,that at times was distressing. There was acardiac difficulty which aggravated thenervous symptoms. There was also insom-nia and debility.

About a month before she consultedme there had been various signs that thetumor was on the point of making a newdeparture, and the patient was considerablyalarmed. I treated her exclusively by ex-ternal galvanization, with mild currents,about twenty-five times. The applicationswere made five or six times a week. Theuneasy sensations connected with the tumor

were relieved, and there was apparent arrestof its progress.

I have since heard from the patient, andthe tumor, though still existing, does notcause her serious trouble, although the gen-eral condition of the patient is not good.

In cases like the above, it is, of course,impossible to tell just how much the apparentarrest of the tumor is the result of the treat-ment. There are some eases that of them-selves stop at a certain stage, and are sta-tionary for years. If this patient shouldever reach that stage where operation wouldseem to be imperatively required, themethod of working up the base would beappropriate.Cystic Tumor of the BreastTreated by External Gal-

vanization and Electrolysis; Great Reduction inSize and Apparent Curs.Mrs. P., a lady of middle life, consulted

me December Sd, 1873. The patient had atumor in the left breast, of the size of a smallorange. About two months had passedsince it was first observed.

Both her family physician and anothersurgeon of eminence regarded the tumor asschirrus, and advised its removal.

The patient, I may remark, traced theorigin of the growth very directly to a

! severe bruise of the breast from striking*against a bed-post. When I first saw theease the tumor could be easily felt andgrasped between the fingers, and seemedquite hard. The nipple was but slightlyaffected, and there was no involvement ofthe glands in the axilla.

There had been little or no pain, thetumor had not extended to the skin, andthere was no discoloration ; except by ex-amination the presence of the growth wouldhardly have been suspected. The growthwas quite movable.

The patient was of a very nervous tem-perament, and had suffered much fromneuralgia. In spite of the lack of verysevere symptoms I concurred in the opinionof her previous advisers, that the tumor wasschirrus. The patient so dreaded the thoughtof the knife that she wanted to give electri-cal treatment a good trial.I began with local external galvanization

with moderate currents. After one week’streatment the tumor seemed looser, softer inportions, and a trifle smaller. Subsequenttreatment added nothing to this apparentimprovement. I therefore resolved to usegalvano-puneture.

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December 31st, I inserted two needles into 1the part of the tumor that was most super-ficial ; one needle was connected with thepositive and the other with the negativepole.

Ether spray was used by Dr. Rockwellbefore the needles were introduced,- Theneedles had not been in position more thanfive minutes when a fluid as colorless as :water began to flow out of the places wherethey were inserted, and on pressure, thequantity that came away was much in-creased, and more or less flowT ed out duringthe whole operation, which lasted fifteenminutes. IWhen the needles were withdrawn, andpressure was used, still more fluid exuded, !and the' tumor had become reduced two-thirds in size. The tumor was evidentlycystic.

January 2d and January Bth I againoperated with my long cutting needle, with-out assistance and without anaesthesia, so asto reduce the tumor to a minimum, and ifpossible cause absorption or atrophy.

At the second operation a less quantity offluid exuded, and still less at the third opera-tion. The patient left for home. I occa- jsionally hear from her, andfip to the date ofwriting the tumor has not resumed its |

original size, and does not in any way troubleher.

In the above case one of three results arepossible.

Ist. The tumor may remain comparativelysmall, causing no annoyance to the patient, jThis result I have seen in other cystic tumors i(though not in the breast), from the samemethod of treatment that was adopted in thepresent case.

2d. The tumor may again fill up withfluid, and may require a repetition of thesame treatment.

3d. It may take on the schirrus form. Itis, of course, possible that the cells of thegrowth may already be of a schirrus charac-ter. Even if it should prove to be a schirrus

grov ui it would not follow that removalwould be at once indicated.I have seen one case where a tumor of an

undoubtedly schirrus character kept almoststationary for eighteen years. It was thenremoved, and the base was worked up byelectrolysis, for the reason that it was be-coming adherent and painful. I have seenanother case of malignant cystic tumor,where early operation was advised andadopted, and although every feature in thecase was favorable for an operation, thegrowth recurred immediately, and thepatient died. The above case, I may furtherremark, is of interest to surgeons as well aselectro-therapeutists, as illustrating the ne-cessity of preliminary exploration in alldoubtful cases. None of us suspected thatthe tumor was cystic until the fact was re-vealed by galvano-puncture.If in the above ease there should ever be a

rapid and ugly recurrence of the tumor, withthreatening indications of any kind, themethod of working up the base would be in-dicated, the knife or the galvano-cauterybeing used to remove the body of thegrowth.I have here no space to discuss the rival

theories of malignant growths.* I maysimply remark that reasoning backward,from therapeutics to pathology, all myobservations thus far seem to confirm thetheory that cancer is a local disease, and ex-cited by local injury of some kind, as blows,falls, and exposure to cold. The tendency totakeon cancerous degeneration, on exposureor injury, may be constitutional and heredi-tary, but each manifestation of the disease is,for all practical purposes, local, and may,when taken in reasonable time, be cured bythorough local measures such as I have heredescribed.

* For the views of recent pathologists on thissubject see “A Lecture on the Structure of Cancer-ous Tumors,and the Mode in which Adjacent Partsare Invaded.” By 1.1, Woodward, Assistant Sur-geon U. S. A. The TonerLectures of the /Smithsonianinstitute, Washington, November, 1873.