The Galvanic Treatment of 
Fibro-Myomata. 
BY 
A. H. BUCKMASTER, M.JD., 
Assistant Surgeon to St. Peter’s Hospital; Alumnus of the Woman’s Hospital; Gynaecologist to the 
Hospital for Mental and Nervous Diseases; Fellow of the N. Y. Obstetrical Society. 
Prize Essay of the Alumni Association of the Long Island College Hospital for 1888. 
Published In The Brooklyn Medical Journal, Nov.-Dee., 1888. 
NEW YORK: 
M. J. Rooney & Co., Printers, cor. 35th Street and Broadway, 
1888. THE GALVANIC TREATMENT OF FIBRO-MYOMATA. * 
BY A. H. BUCKMASTER, M.D., 
Assistant Surgeon to St. Peter’s Hospital; Alumnus of the Woman’s Hospital; Gynaecologist to the 
Hospital for Mental and Nervous Diseases; Fellow of the N. Y. Obstetrical Society. 
Too often the profession is startled by the birth of novel therapeu- 
tic measures which are based upon clinical cases and confirmatory 
investigations, and which fail to fulfill their promises and die a speedy 
death ; fortunate indeed if the amount of mischief accomplished be 
small. The effect is to throw discredit on new things and to cause 
them to be regarded with distrust, however eminent their sponsors, 
and however complete may be the proof of their right to live. The 
professional bigotry that prevented the early recognition of Jenner’s 
great discovery is not possible to-day, but the hypercritical method in 
vogue often prevents justice being accorded to work of the highest 
order. The profession is not always to blame for slighting new meth- 
ods that promise great results. New plans of treatment claiming the 
attention of physicians by the clinical evidence adduced, the value of 
which depends largely on the honesty, experience and ability of the 
investigator, cannot be tested by experimental research in the hurry of 
an active professional life, and the doubter who follows in a perfunc- 
tory manner the directions of the enthusiast may arrive at conclusions 
more remote from the truth than the latter. It is only when scientific ex- 
perimental research goes hand in hand with clinical investigation that 
error is eliminated as much as possible and theories, if found worthy, 
are supplied with the strongest claims for consideration. In the con- 
sideration of the subject of this paper by writers in general, experi- 
mental research has been almost entirely ignored, and my desire to 
pointedly direct attention to this is the raison d'etre of this 
essay. My clinical experience in the general treatment of fibroid 
tumors of the uterus is based on the study of sixty-eight cases, in 
twelve of which the uterus was removed. If the experimental work in 
this paper accomplishes only the discontinuance of the improper term 
electrolysis, I believe that an important misconception of the treatment 
will be removed. 
* Prize essay of the Alumni Association of the Long Island College Hospital 
for 1888 2 
A. //. BUCKMASTER, M. D. 
For the perfect understanding of what follows I will give a brief 
description of fibro-myomatous tumors. They consist of bundles of 
fibrous tissue, non-striated, but rarely striated muscular fibres, blood- 
vessels, nerves and lymph spaces. They present infinite variations 
between two forms which are clinically known as the white or hard 
fibroid, and the red or soft fibroid. This difference in appearance is 
caused by the preponderance of blood-vessels and muscular tissue in 
the one case, and of white fibrous tissue in the other, indeed the latter 
variety has so poor a vascular supply that observers have rarely been 
able to inject its blood-vessels from the uterine artery. In some in- 
stances there is a distinctly cavernous structure of the vessels about 
these growths and from these receptacles comes the nourishment of the 
fibroid. I have frequently seen fibroids whose blood supply was in 
no small part derived from the adhesions which were the result of 
inflammatory action caused by the irritation of the tumor. “In rare 
cases the blood-vessels become wide and dilated, so that the tissue is 
pierced with capacious channels and cavities containing blood. In 
other instances the lymphatics are widely dilated/’* The blood-vessels 
are said byKlebsfto be somewhat peculiar. There are numerous 
capillary blood-vessels containing large nuclei, supported by a thin 
layer of fibrous structure and surrounded by muscular tissue. Between 
the sheaths of the vessels and the muscular bundles are wide spaces 
containing white blood cells. A cavernous structure thus originates 
which is not found in normal uterine tissue, and it is very probable 
that these cavities are to be regarded as lymph spaces in which the 
blood-vessels are suspended, as it were, by fine bands of connective 
tissue. On section I have found the exuding fluid to be markedly 
acid in reaction. This is probably due to the degenerative change 
that takes place during rigor mortis. From the above description it 
will readily be seen that tumors differing so widely in the proportion 
of the tissues that compose them, must respond differently to agents 
whose action depends on the predominance of one or other of their 
component parts. This may perhaps explain the conflicting results 
obtained by investigators. Clinically speaking, the uterine fibroid is a 
mass of fibroid and muscular tissue in the pelvis or abdominal cavity, 
that by its size presses upon surrounding structures ; by its weight drags 
upon contiguous organs; and by its tendency to haemorrhage causes at 
times fatal blood impoverishment. One can never predicate the symp- 
toms by the size of the tumor. Some as large as a child’s head may 
be unnoticed, while others no larger than a hen’s egg may make the 
* Gen’l. Path. Anat.,Ziegler, p. 197. 
f Handb’ch d. Path. Anatomie. GALVANIC TREATMENT OF FIBRO-MYOMATA. 
3 
life of the patient miserable. This was shown by the cases of Mrs. G. 
and Miss D. The former sought the writer’s treatment for sterility. 
She had no pelvic or abdominal symptoms, but a fibroid as large as a 
child’s head was found, and the patient was utterly unaware of its 
presence. On the other hand, Miss D. suffered excruciating pain for 
many years from an irritable bladder. She was a school teacher by 
occupation, but unable to attend to her duties. The trouble arose 
from a fibroid, the size of a very small lemon, in the anterior wall of 
her uterus. 
The distressing symptoms accompanying fibroid tumors are worthy 
of attention, because their permanent removal is in some cases tanta- 
mount to a cure, and this would be the case in the unmarried, par- 
ticularly those where matrimony was but little apt to be contemplated. 
These distressing symptoms are : 
1. Pain, (a.) From inflammatory products excited by the presence 
of the tumor. 
(A) From direct pressure on nerve trunks. 
(c.) Vesical'tenesmus* caused by tension on the neck of the blad- 
der ; this may eventually lead to cystitis. 
(d.) Rectal tenesmus. 
2. Chronic poisoning from absorption of fecal matter, the evacua- 
tion of which is interfered with by the tumor mass. 
Dr. Sir Andrew Clark, in a very interesting and instructive paper 
on the chlorosis of girls,f draws attention to the importance of fecal 
accumulation in causing this condition. The accumulated feces not 
only undergo changes in themselves, but promote changes in the 
mucous membrane with which they are in contact. As one of the 
results of these changes, both chemical and biological, there are pro- 
duced new substances, ptomaines and leucomaines, which are injurious 
to the organism. To this condition is the anaemic and cachectic ap- 
pearance of patients with fibroids often due, and if by any means we 
can lessen the size of the tumor mass great relief may thus be afforded 
in permitting the intestines to rid themselves of their dangerous con- 
tents. 
3. Haemorrhage, (a.) From fungous endometritis, which the 
writer has found to exist in almost all the cases where the uterus was 
removed for bleeding fibroid. 
(A) From passive hyperaemia. No one will dispute this cause who 
has seen the large congested os that will bleed freely even from the 
* The writer holds with Dr. T. Addis Emmet that the mere pressure of the 
fibroid tumor on the bladder very rarely, if ever, leads of itself to irritation of that 
organ. 
f British Medical Journal, 1888. 4 
A. H. BUCKMASTER, M. D. 
prick of a pin. Gusserow has called attention to the fact that the por- 
tion of tissue over the tumor may become thin and atrophied, and 
that there will be a collateral hypersemia of the remaining portion of 
mucous membrane. Rokitansky reported a case where a fatal haemor- 
rhage from a varicose vein of the bladder occurred in a patient affected 
with a fibroid. 
4. Discomfort from weight of the tumor mass. This is the only 
symptom in some cases, and may be relieved by a properly fitting 
abdominal support. 
The above symptoms are profoundly effected by the galvanic cur- 
rent. The pain is checked, and to what this cessation is due is a 
matter of conjecture. We know that an inflammatory exudate is often 
quickly absorbed under influence of the galvanism, and some have 
offered this as an explanation. The decrease in size of the fibroid 
lessens the pressure symptoms, and the cauterizing effect in the uterine 
mucous membrane places an impassable barrier between the blood- 
vessels and the cavity of the uterus. We believe that the haemastatic 
effect of the positive pole is made clear by this mechanical explana- 
tion ; iodine, the actual cautery, and other agents of this character 
would have proved themselves much more potent had the skill of the 
gentlemen using them been sufficient to have applied them thoroughly 
to the surface from which the blood passed. It is oftentimes a matter 
of the utmost difficulty to pass a sound to the end of the uterine canal 
in these cases. The life history of these tumors is very irregular, a 
large proportion of them disappearing or causing no further trouble at 
the menopause.* In those cases where the symptoms are very dis- 
tressing, and the menopause is far distant, life becomes a burden. 
Before the treatment under discussion was inaugurated, the only effective 
alternative was removal of the ovaries or of the uterus. When the 
tumor is large, Hegar’s operation is usually impracticable, becausb the 
ovaries are so bound down that hysterectomy becomes an operation 
involving less risk.f Not only are the chances of immediate recovery 
from the operation very bad—I do not think the mortality is over- 
stated at 30 per cent, even in the hands of skillful laparotomists—but 
the possible pains of a large cicatricial mass in the abdominal wall 
or peritoneal adhesions may prove greater than existed before the 
operation. | The writer has in mind two cases where life was miser- 
* Ur. T. A. Emmet, at the January meeting of the N. Y. Obst. Society, 1886, 
remarked that when preparing the statistics for his book he found about 19 per cent, 
of the cases either disappeared after the menopause or the patient ceased to suffer 
from its presence. 
f “Contributions to the Surg. Treat, of Tumors of the Abdomen,” Keith. 
| The intraperitoneal method so ably advocated by Martin has not found much 
favor in this country. GALVANIC TREATMENT OF FIBRO-MYOMATA. 
5 
able before the operation, and almost unbearable a year after it was 
performed. I will venture to say that no surgeon was ever justified, 
however good his statistics, in subjecting his patient to the risk of an 
operation in the case of a fibroid, unless the symptoms were of a marked 
character, and the conclusion that follows from this statement is that 
if galvanism will relieve the symptoms, no one is justified in doing a 
hysterectomy at the present day. This is what the conservative Dr. 
Thomas Keith,* of Edinburgh, remarks. I quote from the British 
Medical Journal: “Fortunately for those afflicted with internal tumors 
it matters but little which of the old ways of operation is the best. 
The treatment introduced by Dr. Apostoli must take 
precedence of all others. The success of this treatment is a great fact, 
and I accept, toto animo, his teachings. I do not speak without some 
experience of his practice.” He then remarks that he has treated a 
large number of patients. He concludes with this statement: “I 
would consider myself guilty of a criminal act were I to advise my 
patient to run the risk of her life—and such a risk—before having 
given a fair trial to this treatment, even were I sure that the mortality 
would not be greater” than that of my private cases. 
Dr. Apostoli, in a paper before the American Gynaecological Asso- 
ciation, said he had employed electrolysis in nearly three hundred 
cases. The uterine fibromata almost invariably diminished in size, but 
never totally disappeared. 
Dr. Skene, in a personal communication to the writer, speaks in 
the very highest terms of this treatment. The following case was nar- 
rated to me by Dr. Louis D. Mason, of this city. He sent a young 
lady suffering from a fibroid which reached above the symphysis, to 
Dr. Skene’s private sanitarium. After a few months’ treatment she 
returned home, and there seemed to be a disappearance of the growth. 
Since then she has married and is now the mother of a fine child. 
With such a success as this, we can hardly be surprised at the doctor’s 
partiality for the method. 
Dr. John Byrne, who is an authority on electrical matters, reported 
the favorable treatment of a case in the proceedings of the N. Y. 
Obstetrical Society for January, 1887. The patient, after treatment, 
suffered from a severe attack of peritonitis, but eventually recovered. 
In this case, puncture by the abdomen was practiced. 
“ The hopefulness of the treatment has always seemed to me,” says 
the great English obstetrician, Dr. W. S. Playfair,f “to be in the well- 
known clinical fact that uterine fibroids often undergo spontaneous 
absorption, as, for example, during involution following labor; and it 
* British Medical Journal, Dec. io, 1887. 
f British Medical Journal, June, 1887. 6 
A. H. BUCKMASTER, M.D. 
seems not unreasonable to suppose that we may find a means of doing 
by art what is often done by nature under conditions as yet but little 
understood, but well worthy of further study.” 
Dr. W. Woodham Webb, at the suggestion of Sir Spencer Wells, 
made a thorough investigation into the methods of Apostoli. He 
remarks that “for more than six months I have regularly attended his 
clinique, spending many hours a day questioning and examining his 
patients, noting what was done. .... The upshot of all this is 
that I am perfectly satisfied much good has been done; many women 
have been gradually, and without suffering, set up in health, who 
would under ordinary circumstances have been condemned to the 
risks of some cutting operation.” 
Mr. E. Stephenson, electrician to St. Bartholomew’s Hospital, says: 
“I have been associated in the treatment by electricity in two cases of 
fibroid tumor of the uterus, both of which improved.” 
Dr. Geo. J. Engelemann, of St. Louis, states that he has destroyed 
neoplasms, from the size of a walnut to that of a hen’s egg, in three 
sittings of five minutes each. 
Dr. W. H. Baker says: “ My experience in the application of elec- 
trolysis in the treatment of fibroid tumors of the uterus extends to 
fourteen cases, the results of which, so far as relieving the suffering 
dependent on the existence of the growth, have been highly satisfac- 
tory ; and, so far as arresting, diminishing the size of, or causing the 
entire disappearance of the growth are concerned, fairly satisfactory, 
viz.: in one case the tumor entirely disappeared; in twelve cases the 
tumor diminished one-third to one-half of its size. In one of these 
cases, however, there is now some indication of a return of the growth 
accompanied by suffering. In one case, although the suffering was 
greatly relieved by this treatment, there was little or no diminution in 
the size of the tumor.” The doctor has made no attempt to cull all 
the published cases, but mentions the views that seemed most valu- 
able. 
Dr. Marie B. Werner states that she saw Dr. Apostoli at his clinic, 
“ and the patients without exception expressed themselves much im- 
proved by the treatment.” She reports six cases, three cured, three 
benefited. 
Those who are not convinced by personal experience can hardly 
remain incredulous in the face of such evidence as that we have given, 
on the authority of men who are not only eminent on account of pro- 
fessional qualifications, but men whose honesty cannot be gainsaid.* 
* Since the above was written there has been some unfavorable testimony ; of 
fifteen patients treated, Chadwick lost two. N. Y. Med. Jour., vol. 46, p. 385. In 
the Arch, d’obst. et de Gyn. (Jan., 1888,) Dr. D’Angel Villa, a clinical assistant of GALVANIC TREATMENT OF FIBRO-MYOMATA. 
7 
Historical References.—In the Medical and Surgical Reporter of 
February 8th, 1873, appears the report of a case of fibroid tumor of 
the uterus which was treated by a strong galvanic current under the 
direction of Dr. Ephraim Cutter, of New York. Dr. Gilman Kimball 
directed the second application, and the names of those gentlemen 
have been indelibly stamped on the procedure as pioneers. Their 
attention was called to the subject by the success attending 
the treatment of a venous tumor of the neck by Dr. Lincoln,* of 
New York. The method pursued was that of puncturing the tumor 
through the vaginal wall in two places. A three-cornered needle was 
used, made of a surgeon’s director and japanned at the larger end, 
leaving a free surface of two and seven-eighths inches. While it was 
recognized that the treatment pointed out by these gentlemen was 
potent for good, a number of disastrous cases (some of whom died) 
deterred the profession generally from taking up their methods. Dr. 
Cutter reports the results of fifty cases treated, as follows : 
Series 1.—Non-arrests, Seven cases. 
Series 2.—Fatal, Four “ 
Series 3.—Arrests. Twenty-five cases. 
Series 4.—Relieved, Three “ 
Series 5.—Cured, Eleven “ 
Total, 
fifty cases. 
In 1878 Dr. N. Freeman, of Brooklyn, reported a case of galvanic 
treatment of a fibroid tumor, where a consultation of a number of 
eminent Brooklyn surgeons had decided that no surgical interference 
was justifiable. The doctor used a straight, round-pointed needle, and 
pushed it through the abdominal wall to within a short distance of a 
sail needle passed through the uterine canal into the tumor. Both 
needles were insulated within an inch of their point. Since this time, 
Dr. Freeman has used the method of abdominal puncture. His use 
of a round needle is a great advantage because less liable to be fol- 
lowed by haemorrhage (separating the tissues instead of cutting them); 
but we believe puncture through the abdominal wall should never be 
practiced. The writer has seen the surface of a fibroid covered with 
veins, some as thick as one’s thumb, and we cannot conceive it justi- 
fiable to run the risk of peritonitis by this method when a much safer 
and probably as effective a method is known. For this we are indebted 
to the indefatigable industry and ingenuity of Dr. G. Apostoli, of Paris, 
for some years a surgeon in the French army; and his attention was 
Dr. Doleris, states that the results obtained in the clinic were not satisfactory either as 
regards disappearance or marked diminution in size of the growth. He deemed the 
method a palliative one, and declares that the views he expressed are those of Dr. Doleris. 
° Lincoln, R. P., Med. Rec., Dec. 15, 1870, vol. v , No. 20. A. H. BUCKMASTER, M. D. 
directed to the subject of electrical therapeusis by Dr. Tripier. In 
1884 he presented a memoir to the Academy of Medicine, giving an 
account of his manner of treatment. He revolutionized the matter, or, 
rather, he infused into it new life by two things; one was the use of 
galvanometer, so that the current strength* could be accurately meas- 
ured ; and the other was to so diffuse the current over the abdomen, 
by means of a broad electrode of clay, that the patient was able to 
bear very powerful currents without puncture. He also made use of a 
platinum probe in the uterus. He placed the method on a scientific 
basis, and it would be much more reasonable to call it Apostoli’s 
method than the treatment of fibroids by electrolysis, which is a very 
misleading application of the term. 
In the face of these facts, we would scarcely believe that any one 
would wish to detract from the credit that belongs to Apostoli. This, 
however, is the case. Mr. Tait, as usual, claims precedence. He 
states, in regard to a certain occasion, that by using a number of ele- 
ments “of small and uniform size . . with constant replacement 
of precisely the same exciting fluid, the dosage was precise and accur- 
ate.” (?) The absurdity of this remark scarcely needs consideration. It 
simply shows that the writer was ignorant of the practical 
matters connected directly with the subject he criticises. He further 
states that he used a galvanometer with an ordinary angle- measure- 
ment, “and this told quite as much as any instrument graduated into 
amperes.” Comment is unnecessary. 
At the International Medical Congress at Copenhagen in 1884, Dr. 
Meniere, of Paris, reported six cases treated by electro-puncture in 
which there was complete amelioration of the symptoms and disap- 
pearance of the fibroid. 
Dr. George J. Engelemann read a very exhaustive paper before the 
American Gynaecological Society in 1886 on the subject of electricity 
in gynaecology. He drew attention to the importance of the definite 
size for the electrodes, and sugested that the abdominal plate or, as he 
very nicely expressed it, the dispersing electrode, should be "3% by 
4 */v , or ”4 */2 by 6*4", or "6*4 by or 10". It seems to the writer 
that this would be better expressed by stating the number of square 
inches of contact, for it is often convenient to cut the plate so that it 
will fit the abdominal wall. The importance of having a large abdom- 
inal electrode is made manifest when a patient is treated without using 
an anaesthetic; for, where a small contact causes pain, a larger one 
may be absolutely painless. To those who have not a clear conception 
of the term intensity or current strength, the following comparison 
* The term current strength ” is much preferred to the term “intensity,” which 
is almost obsolete among electricians. GALVANIC TREATMENT OF F1BRO-MYOMATA. 
9 
may be of service. We may imagine a wind of a definite velocity and 
of a definite height sweeping over the country, and the trees and herb- 
age that are swayed by its gentle pressure will thrive from the better 
circulation induced by their motion. If the same breeze is confined 
to one twentieth of the country, other conditions being equal, it will 
become a wind storm, and the corn will be thrown down and the 
branches broken off trees; but, further, if we confine the wind to a 
much less territory, we have a hurricane that uproots the trees, throws 
houses about like playthings, and leaves desolation and ruin in its 
train. Yet there is always the same amount of energy, only in case of 
the hurricane it is concentrated. So a current of the same intensity 
may blister or not be felt according as it is diffused. Intensity is 
synonymous with current strength, which is a much better term; it is 
this that is measured in amperes. A current which is much 
diffused may act as a tonic; while, if it is much concentrated, 
it may act as a caustic. The practical lesson this teaches is 
that we should be careful with a current passing through the perito- 
neum in order to reach the tumor, particularly when the patient is 
under the influence of an anaesthetic and pain ceases to be present to 
give the signal of danger referable either to the abdomen or pelvis. 
Apostoli says: “II faut que toute operation soit uterinement toler- 
able.” 
The next suggestion of importance was made by Dr. Franklin H. 
Martin, of Chicago, who indicated that two square centimetres of 
uterine electrode with a current of fifty milliamperes, or four square 
centimetres with one hundred milliamperes of current would accom- 
plish both the checking of haemorrhage and the absorption of the fibroid. 
The definite size of the exposed surface of the electrode, together with 
the definite intensity of current, is a great advance. The proportions 
given by Dr. Martin will give good results, as the writer can attest. 
Dr. Martin did more than the others in an experimental way; he 
watched the effect of the electrodes on the tissue outside of the body. 
Dr. Robert T. O’Callaghan,* in a communication to the British 
Medical Journal, refers to the frequency of diseased appendages, and 
implies that they exist in a large proportion of the cases of myoma, 
and draws the conclusion from this that the treatment is dangerous. 
This is quite contrary to the writer’s experience; but, as the doctor is 
a follower of Tait, his enthusiasm in this direction may be accounted 
for. He also calls attention to the intimate relation between these 
tumors and the menstrual function, and it is undoubtedly a fact that 
their presence is chiefly noted when this function is in operation ; but 
* British Medical Journal, July 30, 1887. 10 
A. H. BUCKA1ASTER, M. D. 
Dr. O’Callaghan draws an erroneous conclusion when he states that 
there can be no security of cure except by the arrest of the menstru- 
ation. We would call this gentleman’s attention to a not so small 
class of cases where the tumors increase after this function has entirely 
ceased. 
I wish to offer a clinical case that was observed by physicians not 
particularly interested in its treatment. Miss X., aet. 34, nurse by 
occupation, had been under general gynaecological treatment for six 
years. She first sought medical care on account of pelvic pain. She 
took at one time ergot for seven months with no results, and finally 
sought the advice of Dr. Skene because the tumor had lately been 
rapidly increasing in size. She was examined carefully by Dr. Skene, 
who made notes of the case at this time, and also by Dr. Lucy H. 
Hall when she first came under my care by the kindness of Dr. Skene. 
She has had twenty treatments, averaging from two to three weekly. 
The current used, which was as strong as she could bear with comfort, 
ranged between thirty and sixty milliamperes. The abdominal elec- 
trode consisted of a mass of moulding clay with thirty-six square 
inches of contact. The uterine electrode consisted of two square cen- 
timetres of platinum, and was the negative pole. The seances lasted 
from five to eight minutes. After the patient had undergone eighteen 
treatments she was carefully examined by Dr. Skene and Dr. Hall, 
and they both agreed that the tumor had decreased in size. The patient 
was convinced that the tumor had decreased, but stated that she had 
gained much in flesh. It is not uncommon for patients to rapidly 
gain in flesh while under this treatment. Three other cases under my 
care have shown decided improvement, the tumors growing smaller 
and the unpleasant symptoms growing less. 
It is often difficult to estimate the comparative size of the tumor 
at different periods. The distended condition of the intestines will 
cause error in the calculation, and the same tumor varies at different 
times of the menstrual period, as it is more or less engorged with 
blood. The measurements, considering the ant. superior spinous 
processes, the umbilicus, and ensiform cartilage as test points, are de- 
fective. The best method we are aware of is that followed by Dr. 
Skene. He catches up the abdominal wall and makes a careful esti- 
mate of its thickness, and then places the fingers at the sides of the 
tumor, estimating its thickness. The same approximate measurement 
is made from above and below, if possible. The importance of allow- 
ing for the abdominal wall will be appreciated when we observe how 
rapidly its thickness is affected by the general nutrition of the 
patient. GALVANIC TREATMENT OF FIBRO-MYOMATA. 
11 
HOW DOES GALVANISM AFFECT THE FIBROID? 
The use of the term electrolysis, as applied to the form of treat- 
ment considered in this essay, has been avoided because, when 
used as a distinctive application, it is misleading. There is no more 
justification for the term as applied to the treatment of fibroid 
tumors than there is for the use of the expression for the applica- 
tion of the galvanic current for the relief of a sciatica. Elec- 
tricity is conducted by the metals and only such fluids as it can 
decompose.* The tissues of the body only become conductors when 
fluid is present. The decomposition takes place only at the poles, and 
the changes that occur between them are those of atomic rearrange- 
ment. For example, if a current is applied to decompose a certain 
amount of water, as represented by—HI,O'-, HIj' O", Hi" O'" , H2VOlT' 
-J-, the first molecule is decomposed, the H1 going off as a gas to 
the negative pole. Molecule H2Olv- is also decomposed, the Oiv 
passing off as a gas at the positive pole; this would necessitate an 
entire rearrangement, so that the following condition would be pres- 
ent : H1, free and—Hj'CL, H'2" O", H^O"1, + free Oiv\ This change would 
continually take place until all the water had become decomposed. It 
makes no difference whether the molecule be a simple one like water, 
or a complicated organic combination. This rearrangement is, as far 
as we know, the only chemical change that takes place; so that the 
term electrolysis, used to indicate some peculiar disintegration that is 
not always present, is clearly misapplied; electrolysis occurs whenever 
a current is used. 
In attempting to answer the question of how galvanism affects 
fibroids, writers have indulged in idle speculations rather than at- 
tempted experimental research. The riddle is no easy one to solve, 
for the tumors vary not only in position, form, and blood supply, but 
differ widely as to their constituent parts. They differ not only among 
themselves, but the same fibroid presents marked differences at differ- 
ent times. During the menstrual period they may be enlarged and 
soft, and when it is past, relapse into their former hard condition. 
They often enlarge very markedly during pregnancy, and disappear as 
the uterus undergoes involution, as has been observed by Emmet, f 
Lorain, J Pagan, § and Hanks. || They disappear at times without any 
known reason even in young women, but this is of so rare an occur- 
* 1’ure carbon is an apparent exception to this. 
■f Emmet, Princ. and Pract. of Gyn. 
J Gazette des Hopitaux. 
§ Lambert, des Grosses de myomes. These Paris, 1880. 
|| Diseases of the Female Sexual Organs.—N. Y. Med. Jour., 83, 614. 12 
A. H. BUCKMASTER, M. D. 
rence, that it need scarcely be considered when dealing with satistics 
of their treatment. It has been claimed that the cases where this was 
noticed were cases of hard inflammatory masses, but both Schroeder* 
and Gusserowf believe that it occasionally takes place. The former 
gentleman collected thirty-nine cases, and said that in the majority of 
these “the correctness of the diagnosis may be regarded as beyond 
question.” 
In considering the cause of their disappearance both spontaneously 
and as the result of treatment, the more cautious observers ascribe it 
simply to modified nutrition, and there is but little doubt that in so 
doing they occupy an exceedingly safe standpoint. Prof. Playfair 
says that “the action of the negative galvanic current in electrolysis is 
probably simply that of a strong stimulus to absorption."The nutrition 
of the fibroid may be affected in one of several ways, or by all of them 
combined. 
1 st. By affecting the blood-vessels and absorbents. 
2d., By affecting the muscular tissue. 
3d. By affecting the nerves. 
4th. By affecting the connective tissues. 
5th. By affecting the cells directly. 
That the blood-vessels and absorbents play an important role sev- 
eral facts abundantly attest. The increase in size of many of these 
tumors during menstruation and their atrophy when the ovaries are 
removed and they are deprived of the periodical hyperaemia, attest to 
this. The ligation of the ovarian arteries when the appendages have 
been removed may in some cases have something to do with the 
decrease in size. The relation between the direct action of ergot on 
the coats of the blood-vessels and its indirect action through the mus- 
cular structure, has not been entirely determined, and another agent 
that probably acts much in the same way as ergot, has been recently 
advocated—pinus canadensis. J Gusserow states that various operative 
procedures—sponge tents, incision of the mouth of the uterus and 
intra-uterine injections, frequently cause sloughing of the fibro-myomata 
by interference with its nutrition through traumatism of the uterine 
mucous membrane. 
The effect of a current of fifty milliamperes can be well studied, by 
passing it through a portion of bared intestine of a living animal. The 
tissue between the poles becomes blanched and continues in this con- 
dition for some time after the current is broken. I have observed this 
several times, and there is undoubtedly an intense contraction of the 
* Dis. of Female Sexual Organs. 
t«Op. cit., p. 223. 
X Schmidt, N. Y. Med. Rec., Feb. 15, 1888. vessels. Another important effect of the current is its cataphoric action. 
This takes place during the passage of an electric current through a 
porous body. The fluids are transferred toward the negative pole 
about which they accumulate. This can be nicely seen in the above- 
mentioned experiment, where the tissue about the negative pole bulges 
up from its excess of fluid. The activity of the cataphoric action is 
much greater with stronger currents and with more poorly conducting 
mediums (Erb). A familiar experiment to illustrate this action, is 
made by using a vessel containing water which is separated by a porous 
partition into two compartments. If the current is passed from one 
compartment to the other, the water is seen to rise in the compartment 
in which is placed the negative pole. The removal of a large amount 
of fluid from one portion of a fibroid to another must profoundly affect 
its nutrition, and of course this influence would be more manifest in 
those tumors where the fluid portion is more markedly in excess. The 
lymph spaces in some of these tumors are enormously dilated. It will 
perhaps be demonstrated in the future that many of the blood-vessels 
and lymph spaces are destroyed by very strong currents. 
If a muscle through which the blood is circulating be exposed to 
the action of heat at 118 F., to distilled water, to acids, even of the 
weaker kind such as carbonic acid, to various chemical bodies, and to 
the effects of freezing and then thawing,* it passes into a state known 
as rigor mortis. In this condition it is devoid of irritability. It is 
strongly contracted in the direction of its length, and is less elastic ; it 
has a whitish, curdled appearance and an acid reaction. The pre- 
viously transparent muscle tubes appear opaque and flocculent, and 
their contents solid. The essential process in rigor is a contraction of 
the contents of the muscle tubes whereby they become solid. The 
analogy between rigor and the active state is very close, and it has 
been assumed that coagulation does take place when a muscle is in 
motion and that the product is rapidly disposed of, or that perhaps the 
myosin is generated with such rapidity that it has not time to pass at 
once into the state of gelatinous solution, but enters for a moment into 
the undissolved condition which does not appear under slower decom- 
position until considerable concentration (Gamgee). Recognizing the 
fact that rigor mortis can occur in muscular tissue while the circulation 
is maintained, the writer desired to ascertain if this condition was 
brought about by very strong galvanic currents. A dog was thoroughly 
anaesthetized, and a current of seventy-five milliamperes passed through 
the wall of the left ventricle, one electrode being placed in contact 
with the diaphragm and the other over, and in contact with the peri- 
cardium. A piece of the muscle that was in a direct line with the 
GALVANIC TREATMENT OF FIBRO-MYOMATA. 
13 
* Herman. Human Physiology, p. 281. 14 
A H. BUCKMASTER, M.D, 
current was excised, and a fresh section prepared. Another section of 
the ventricle outside of the direct line of current was also prepared in 
the same manner, and they were compared and the following differ- 
ences noted : In the section affected by the current the transverse striae 
were much less distinct than in the other section, seeming granular, 
and the tube seemed much more opaque. The fibres were also less 
regular.* The tendency of this experiment is toward the fact that 
there is a direct effect on the muscle cells with the seventy-five milli- 
ampere current. Whether this change be due to rigor mortis remains 
to be shown. The heart was selected for the experiment because, 
while in many respects it is classed as an involuntary muscular struc- 
ture, the striated markings of its muscle tubes render changes more 
readily discernible. How far we may compare the results obtained in 
the heart muscle with those that would exist in non-striated muscular 
fibres, of which the myomata are largely composed, is yet unknown, f 
A spontaneously coagulable substance in the non-striated muscular 
fibres under certain conditions may be assumed from the occurrence of a 
death rigor (Hermann), and the writer thinks it is not improbable that 
this is the condition found. If the death rigor occurs in any consider- 
able part of the muscle tubes of the tumor there would result a marked 
diminution of its irritability, for it is a well-known fact that the muscle 
under this condition ceases to respond to stimuli. J It is not easy to 
estimate this on the living subject, but the following experiment was 
made with this object in view, viz.: to determine if there was any dif- 
ference in the irritability of the uterus before and after treatment. As 
it is not possible for obvious reasons to observe the contractions of the 
uterus, the following indirect method was utilized. 
° This experiment was performed in the laboratory of the Long Island College 
Hospital, and I have to acknowledge the kind aid of Dr. J. M. Van Cott, Jr., Path- 
ologist to that institution. 
f The properties of the two classes of muscles are, as far as they have been inves- 
tigated, almost identical; but the respiratory and chemical changes are due to activ- 
ity and the electrical conditions; the formation of heat, etc., of smooth muscles have 
yet to be made out (Hermann). 
J Welsh made an interesting observation in this respect. “Once, in teasing out, 
in a warm room, a bit of fatty heart-muscle from one of the rabbits, I made a curious 
observation. Near the edge of the cover glass, where there was a slight current in 
the physiological salt solution, rythmical contraction was observed in a group of mus- 
cle fibres. This interesting spectacle could be watched under the microscope for ten 
minutes. These contracting fibres were filled with fatty globules, and only here and 
there, and then indistinctly, could any trace of striation be detected.”—(The Cart- 
wright Lectures on the General Path, of Fever, 1888.) This observation shows that 
under some conditions, even where the striae are not to be found, contraction can 
take place, but probably only under most favorable conditions, for very short 
periods. GALVANIC TREATMENT OF EIBRO-MYOMATA. 
15 
Contractions of the Uterus are followed by Contractions of the Vagina.— 
It is assumed that the contractions of the uterus are followed by con- 
tractions of the vagina which are in direct proportion to them. Kehrer* 
found in his experiments with rabbits, that exposure to air would give 
rise to a contraction which advanced through the whole genital canal, 
while by chemical, mechanical, electric and thermal irritation contrac- 
tions could be started at almost any point and were transmitted in one 
or the other direction, so that an increase in the vaginal pressure would 
indicate a contracted condition of the uterus. This method of indi- 
cating contractions of the uterus has been utilized by Milne Murray,f 
of Edinburgh, in his experiments on the effects of hot water on the 
uterus. The following method was adopted by the author. A rubber 
bag by which the vaginal pressure is to be determined is filled with 
water and communicates by a rubber tubing with the proximal arm of 
a U-shaped glass tube which contains mercury. The other arm of the 
glass tube is opened at the end. When any pressure is made on the 
bag the column is pushed back, and this raises the discus of the mer- 
cury in the distal arm. The variation can be read by means of a 
graduated scale. The chief sources of error in using this means of 
measurement, arise from having air mixed with the water, or having 
the tube of such thin rubber that it readily becomes distended by 
pressure. 
There are two methods of measuring the effects of stimuli on mus- 
cular contraction, one is by observing the comparative strength of the 
contraction, and the other is by ascertaining the smallest amount oj 
current that will give a contraction, and the latter method was in this 
instance adopted. The induced current with a sliding induction coil 
was used. The cell used was a constant one. The patient in position, 
the electrode was placed in the uterine canal. The bag filled with 
water was then introduced, and after waiting five or six minutes for the 
vagina to become accustomed to it, the faradic current was very gently 
turned (the other arrangements being exactly similar to those used in 
the ordinary treatment) until contractions were induced in the uterus. 
The amount of this current was carefully calculated. The constant 
current was now gradually substituted by means of a rheostat until 
sixty milliamperes was registered. In about a minute the column of 
mercury showed an increased vaginal pressure of one-sixteenth of a 
pound. 
The current was turned off very gradually, and the patient allowed 
s? “ Peristalsis of the Genital Tract.” Chadwick, Trans, of Am. Gyn. Soc., 
vol. x. 
■f Edinburgh Med. Journal, Aug. and Sept., 1886. 16 
A. H. BUCKMASTER, M.D 
to remain perfectly quiet for twenty minutes ; at the end of this time 
the slightest induced current that would give a contraction was con- 
siderably less than before the treatment.* 
Direct Irritant Effect of the Curre7it.—Does the current leave a con- 
dition which tends to induce firm uterine contraction, as hinted by Dr. 
T. Addis Emmet, when he said that he had seen diminution in size 
produced by an irritant such as a sponge tent which set up a strong 
uterine contraction, and is this diminution in size permanent? This 
assumption can only be discussed when some one has carefully studied 
the condition of the uterus several weeks before and after such treat- 
ment that is followed by favorable results. 
The precise effect of the current on the nerves of the tumor is a 
difficult matter to determine. Dr. Martin says: “I believe that elec- 
tricity powerfully concentrated as it is in this treatment in passing 
through these tissues has oftentimes some such destructive effect on 
these trophic nerves, or nerves which carry a trophic influence and 
thereby cut off the power on nutrition in the tissues.” He refers to 
“peculiar irritations of motor or other nerve trunks or their branches 
which are supposed to contain inherently or in close association trophic 
influence which will oftentimes cause progressive or rapid atrophy of 
the tissues under their control.” This theory is entirely speculative, 
and, while ingenious, can hardly be considered until we have more 
anatomical and physiological data. 
The effect of the positive pole in preventing haemorrhage is, in my 
opinion, entirely due to its caustic effect, and could be brought about 
as effectively with the galvano-cautery were it possible to so use it as 
to bake the tissue as we sometimes do outside of the body. 
The Effect 07i the Connective Tissue.—Dr. William H. Baker states it as 
his opinion, “That electrolysis establishes a process similar to that which 
occurs without the intervention of any outside agency that we are aware 
of, i. e., an interstitial inflammation of the connective tissue, and in its 
resulting cicatricial contraction the muscular fibres are so compressed that 
fatty degeneration occurs, which being absorbed the growth diminishes in 
its volume or entirely disappears.” He cites in support of this view a 
case in the practice of the late Dr. Peaslee, in which such a result fol- 
lowed the puncture of a fibroid by an aspirating needle used for diag- 
nostic purposes. We will concede that an acute inflammation of the 
connective tissue may, and sometimes does, ensue in fibroid tumors; 
but as it could readily result in the formation of abscesses, we believe it 
would be attended with great danger to the patient, and therefore not 
* Unfortunately the writer has been unable to repeat this experiment, but hopes 
that others may do so. GALVANIC TREATMENT OF FIBRO-MYOMATA. 
17 
desirable to attempt to produce. The so-called chronic interstitial 
inflammation, of which we have an analogy in the processes that take 
place in the kidney and liver, might undoubtedly in its contractile 
stage produce such a change as is supposed to have taken place in a 
case reported by Kidd, where the tumor, which reached midway be- 
tween the umbilicus and symphysis, shrank until only a small portion 
could be detected. Several gentlemen have spoken of its action upon 
cells, “cell liquefaction,” but the term is so indefinite that it reminds 
one of the so-called catalytic process of the physiologists. 
Dr. Martin, in reviewing the causes of the action of the galvanic 
current, advances the following theory, which I will give in his own 
words. This theory involves a conception that many men entertain, 
as evidenced by the distinctive application to this treatment of the term 
electrolysis, and I believe it in my power to absolutely demonstrate its 
fallacy. Dr. Martin says: “Electrolysis only occurs in that part of 
the body which is in a fluid state. While the galvanic current passing 
through a soft living tissue has not an interrupted fluid medium, it has 
practically a fluid medium divided into innumerable little compart- 
ments, each one separated from the other by a thin wall of solid. 
During the passage of the current each of these particles of solids acts 
as a positive electrode on the fluid between it and the next solid particle 
in front, and as a negative electrode upon the fluid between it and the 
solid particle behind it. Each molecule of fluid in a conducting solid, 
therefore, in the line of the galvanic current may become electrolysized.” 
He imagines a chain of innumerable compartments of tissue, in each of 
which an electrical reaction takes place. Either of the three following 
reductions would seem to prove this theory untenable: 
First.—Let us suppose that four compartments are side by side in 
a straight line, as is represented by the following diagram— 
+(+HCl, HC1—) (+HC1, HC1—) (+H20, H20—) (+NaCl, NaCl—)— 
the first two containing chloride of hydrogen, the third water, and the 
fourth chloride of sodium. If a strong current be passed through this 
line, the first two cells will be filled with chlorine and hydrogen gas, 
the third hydrogen and oxygen gas, and the fourth with chlorine gas and 
sodium. Just imagine how the tumor would balloon up immediately 
after treatment! 
Second.—The counter-current, besides the internal resistance in 
each of these little particles of tissue, would make an enormous counter- 
resistance, and would be out of all proportion to what we know must 
exist. 
Third.—If the membrane is dry and does not permit the current to 
pass, no reaction can take place; and if any moisture exists, no such 
action would take place. Further comment is unnecessary. 18 
A. //. BUCKMASTER, M.D. 
Dr. W. Woodman Webb very frankly remarks: “With regard to 
the mode of action of electricity used curatively in such cases, we must 
for a time be contented with knowing the fact that it does what we 
propose to do in a manner safe, comparatively easy, and in a reason- 
ably short space of time.” 
Experiments on Fibroid Tissue.—How the electric current brings 
about the arrest of the tumor growth and its diminution of size, has 
given rise to much speculation. The effect is produced either at the 
poles or between them, and I have studied these effects on fibroid tissue 
outside of the body. A piece of fibroid tumor about six centimetres 
square is so cut that it presents as its upper surface a smooth plane of 
white tissue with a pinkish tinge. The end of a platinum probe and 
of a piece of copper wire of about the same size are allowed to rest on 
the tissues about three centimetres apart. If now a current of twenty 
milliamperes be used, the first thing noticed will be a white froth at 
both poles, and the odor of a gas which is soon perceptible throughout 
the room. If this froth is brushed aside, there will be noticed, extend- 
ing directly from either pole, a circle of brown color,* which at the end 
of three minutes is fifteen millimetres in circumference. I have named 
these portions of changed tissue about the poles for convenience the 
positive and negative polar masses. The color is very similar to that 
of tissue that has been slowly baked by Keith’s method. At the end 
of fifteen minutes the size of the circle has not increased very much, 
but certain other changes have taken place. The periphery of the 
positive mass is depressed, leaving the sharp-cut border of the sur- 
rounding tissue. The centre of the brown patch is slightly higher than 
the surrounding structure, and slopes down symmetrically to the per- 
iphery. At the apex, where the probe has been in contact with the 
tissue, a dry, whitish appearance is observed. We make a section 
through this brown mass from above downward, and find the color is 
lighter than on the surface, and that the vertical distance is about equal 
to the horizontal surface measurement of the mass. The mass is hard 
when pricked with the point of a needle, and the reaction of the exu- 
ding fluid markedly acid. 
At the negative pole a band of tissue of a reddish brown color 
extends outward from the positive pole in about the same time and of 
about an equal distance. It is not so circular in outline, however, 
and, although there is a distinct line of demarkation between it and 
the surrounding tissues, it is not so well marked as in case of the posi- 
tive mass. The edges are also elevated slightly, sloping up toward the 
centre, which is the highest point. A vertical section from before 
* No two people to whom I have shown this experiment could agree on the 
color. GALVANIC TREATMENT OF FIBRO-MVOMATA. 
19 
backward, and from side to side, shows the mass to be semi-hemi- 
spherical. The color is a dark red, and has a jelly-like appearance. 
It is soft when pricked with a needle, and is full of fluid. If the sur- 
face of the mass is touched with litmus paper, the paper instantly turns 
a deep blue. 
After passage of the current for some time, the conductivity of both 
masses is decidedly diminished, as is shown by an attempt to pass the 
current directly through either of them. A narrow strip of tumor, one 
and one-quarter inches long, a half an inch wide, and three-quarters 
thick, was placed between the electrodes, and fifteen milliamperes of 
current indicated by the meter. The masses gradually developed from 
the ends, and continued to spread until they met. Shortly after this 
took place, the milliamperemeter ceased to register any current. A larger 
piece was used with the same current, and the conductivity became 
greatly diminished before the areas were in contact. The reactions to 
litmus paper that have been noticed were strictly confined to the polar 
masses. 
Some of the changes that take place in the polar masses have been 
mentioned. In order to determine whether they occur to any extent 
in the intermediate portions, the following experiment was made. 
Three portions of the fibroid tissue were placed in a line and the elec- 
trodes applied to the terminal pieces. As soon as the polar masses 
approached the middle piece, new terminal pieces were substituted, and 
this continued with a fifteen milliampere current for over an hour. 
The changed tissues always extended from the pole by continuity and 
no change could be noticed in the intermediate piece of fibroid. When 
the pieces were finally left the masses spread through the intermediate 
portion. No change could be detected in the intermediate portion 
before extension of the polar masses, either by the unaided eye or the 
microscope. It was also desired to know if the central portion had 
suffered any diminution in weight, so it was carefully weighed before 
and after the experiment. To guard against the error arising from the 
evaporation of water from it, a piece of about the same size was placed 
on the table near it and also carefully weighed before and after the 
experiment. By comparing the weighings, it was found that the inter- 
mediate portion sustained no loss except by the evaporation of water 
from its surface. 
These experiments show that with the use of strong currents that 
the polar masses represent considerable areas of tissue that have become 
greatly changed, and so far as they encroach upon the nutritive sup- 
plies to the tumor so far must they modify its growth. The experi- 
ments cited show that they are not unimportant factors. 
Method of Using the Current.—It may be applied in one of two 
ways. 20 
A. //. BUCKMASTER, M.D. 
First. By puncturing the tumor by one or both electrodes through 
the abdominal wall. 
Second. By the method of Apostoli; this consists in passing a power- 
ful current through the abdominal wall by means of a large disbursing 
electrode. 
Of the first method we can say but little in its favor. That it is 
attended with danger one fatal case reported by Dr. Freeman (and we 
believe that there are others that have never been reported) and the 
frequent cases where large masses slough out after the treatment will 
attest.* We have yet to hear of a case where unfortunate results followed 
the use of Apostoli’s method and where the currents used were less 
than one hundred and fifty milliamperes. If one elects to puncture 
through the abdomen, in spite of its dangers, a round pointed needle 
insulated to as near its point as the amount desired to be exposed, 
should be used. There is a decided objection to a steel needle that is 
covered by shellac as an insulating material. It may become broken, 
and if this was not noticed, its use, particularly where the patient is 
etherized, might be attended by the most serious consequences. Be- 
fore puncture the abdominal wall should be made surgically clean and 
the needle likewise. All antiseptic precautions should be scrupulously 
followed. It often requires great force to insert the needle into the 
tumor. The abdominal puncture, in the opinion of the writer, should 
not be used, because equally good results are obtained by a safer 
method. It is more dangerous than Apostoli’s method, because: 
a. The needle may introduce septic matter. 
b. If sloughing does ensue, a tract is left by which pus might find 
its way into the abdominal cavity. • 
c. If there be diseased appendages, for example, a tube filled with 
pus, this would be emptied into the abdominal cavity. 
d. If large veins are punctured, and these are sometimes present on 
the outside of the tumor as large as my thumb, (as the writer can attest 
by personal experience) serious hemorrhage may ensue. 
Apostoli's Method of Treatment.—For this treatment four things are 
necessary : a milliamperemeter to determine the strength of the cur- 
rent ; a rheostat, so that the current may be gradually increased and 
diminished; electrodes, and a battery. 
The Milliamperemeter.—This consists of a galvanic needle so ar- 
ranged that it is affected by a current passing in certain relations to it. 
The ampere is the unit, but as only a small part of the unit is used the 
instrument is graduated in one thousand parts, or a milliampere. Even 
* This criticism is also applicable to those cases where currents of excessively 
high intensity are used. GALVANIC TREATMENT OF FIBRO-MYOMATA. 
21 
approximately accurate instruments have been until recently very 
costly, but there are, however, now in the market several that are 
reliable enough for the purpose of the physician. I have used the 
milliamperemeter of Mr. John A. Barrett, and found it entirely satis- 
factory. So much has been said of the impossibility of procuring an 
instrument that was at all reliable in this country, that I took the 
trouble to determine the error in my own instrument, which is less 
than four per cent; this is sufficiently accurate for practical purposes. 
The error of a Hirschman instrument that had recently been imported 
was found to be more than this. 
By means of a shunt the instrument can be made to register up to 
two hundred and fifty milliamperes, which is a greater current than I 
believe warrantable. Dr. Playfair says that: “Apostoli’s galvano- 
meter is only graduated up to two hundred milliamperes, and he never 
exceeds this and generally works with lower intensities, at least with 
the negative pole. The action of the negative galvanic current in elec- 
trolysis is probably simply that of a strong stimulus to absorption not 
of a cautery .... the lesson to be learnt from which is prob- 
ably that very high intensities should be avoided." 
Without the shunt the resistance is one hundred and fifteen ohms, 
as I have personally measured, and with it it would be reduced to an 
insignificant amount. 
The Rheostat.—By means of this instrument introduced into the cir- 
cuit, the current can be as gradually increased or diminished as is 
desired. The principle of its construction is the insertion or with- 
drawal from the current of a definite amount of resistance. Water is 
most commonly used for the resisting body. Two plates of metal are 
so arranged that they can be brought in contact or separated under 
water at will. When in contact the whole current passes, but when 
made to separate the current is proportionately diminished. Most of 
the water rheostats have been very imperfect in action. The best that 
we are acquainted with is that invented by Mr. Bailey. It consists of 
two plates of carbon that are gradually lowered into the water. The 
writer used this rheostat for some time, and the only objection to it as 
a non-portable instrument was that water would sometimes remain 
between the plates, so that when the current was turned on the patient 
would immediately feel the effect of five or ten milliamperes. This is 
enough to cause a disagreeable shock. Its large size prevents its being 
easily carried about. 
Mr. John A. Barrett has invented a rheostat that seems to be per- 
fect. It may be used with a powerful induced current, and will increase 
it so gradually that if the electrodes be placed on the tip of the tongue 
it is impossible to say just at what time the current commences. Its 22 
A. H. BUCKMASTER, M.D. 
principle of construction is that of compressing a substance containing 
carbon in a finely divided form. The greater the pressure the less re- 
sistance offered to the passage of the current. It can be carried about 
in the coat pocket. Its minimum amount of resistance is less than fif- 
teen ohms. Three things are desirable in a good rheostat: It should 
be portable, it should allow the current to be increased and diminished 
without jerkiness, and its minimum amount of resistance should be 
small. 
Electrodes.—The electrodes are two in number, an abdominal or 
dispersing electrode and a uterine electrode. For the dispersing 
electrode we must have a broad surface that will intimately adapt itself 
to the abdominal wall. If it does not do this, the points of greatest 
contact may become blistered. Dr. Apostoli used a placque of clay, 
which was covered by a copper plate. This answers the purpose ad- 
mirably, but the wet clay soils the person and clothing of the patient 
as well as of the operator. Dr. Martin devised an electrode which con- 
sisted of an animal membrane tightly stretched over a hemisphere of 
metal, having the space between the membrane and the metal filled 
with salt water. I have never used his instrument, but some of my 
friends have discontinued its use because of its readiness to leak. Punk 
and other materials have been used, and Dr. Rockwell recommends 
simply cotton well saturated and covered by the metallic plate. Dr. 
Skene has found this sufficient. I believe this will answer the pur- 
pose if only enough cotton be used. The size of the plate is a matter 
of no little importance, and the most accurate way of desig- 
nating it is by expressing its area in square inches, and from, thirty to 
eighty square inches or more are used. By using an adjustable clip to 
the copper electrode a separate one may be cut from a roll of copper 
for each patient, at a trifling cost. 
T/ie Uterine Electrode.—This should be made of a metal that will 
not oxidize by the passage of a current, and platinum is found to be 
most serviceable. It is of the utmost importance to have the electrode 
in close contact with the walls of the uterine canal; and from what we 
read, I am inclined to believe that when a good apposition is secured 
it is rather the result of accident than of adapting a means to an end. 
Dr. Martin speaks of two sizes, one with a diameter of three and the 
other of five millimetres. I believe that there should be at least three 
sizes, one of two millimetres, one of five millimetres, and one of seven 
millimetres. The length of the platinum portion of this instrument 
should be such as to give about four square centimetres of contact when 
used with a current of a strength of fifty to one hundred milliamperes 
for five minutes. I have adopted Dr. Martin’s suggestion in this case. 
I am sure that any one who thinks it an easy matter to pass a probe GALVANIC TREATMENT OF FIBR0-MYOMATA. 
23 
through the meandering path of a uterine fibroid, has thought he 
accomplished the result when this was not so, or has had a slight ex- 
perience and that with favorable cases. Aside from the difficulties of 
passing the uterine electrode, the variations in the size of the uterine 
canal should not be forgotten, and for this reason I insist upon at least 
three sizes of electrodes. The size of the canal varies so much with 
different degrees of contraction of the uterine tissue that we rarely find 
it in the same case twice- alike. After menstruation, while the patient 
is undergoing treatment, the canal is very small; while ordinarily, the 
reverse is the case. And while I have as yet observed too few cases with 
the object of noting this condition, to speak with any degree of positive- 
ness, yet I am strongly inclined to believe, from clinical observation, that 
in the case of a fibroid rapidly increasing in size we will find after each 
menstrual period the os dilated sufficiently to introduce one or two 
fingers. I have never seen this stated, but believe it to be worthy of 
investigation. 
Platinum is a costly metal. The expense of having so many elec- 
trodes is an important factor. I went to one instrument maker who 
stated the price of the uterine electrodes after Apostoli’s model would 
be $40.00. I have overcome this difficulty, and an efficient and con- 
venient platinum electrode may be had for about $3.00. The expense 
of the instrument is mainly caused by the amount of platinum used. 
Martin proposed to overcome this by using platinum wire and winding 
it about a copper core. If the positive electrode of a current passing 
through a portion of a fibroid tumor consist of two terminal ends, one 
of platinum and the other of copper, the electrolytic action will be 
very much greater at the copper termination. If a current of ten milli- 
amperes be continued for ten minutes, and the tissue then divided, it 
will be seen that the green solution of copper has been diffused through 
the mass of tissue. This indicates the danger of having the slightest 
amount of copper exposed. To overcome the objections, and at the 
same time to utilize the economical suggestion, I make use of the fol- 
lowing expedient. An ordinary bougie is selected, of the desired 
diameter, and the butt removed. A piece of copper wire is now adapted 
to the cavity. The distal end is wround with a thin piece of platinum 
wire for the required length, and the end of the wire pushed through 
the rubber and into a hole bored into the copper; by pinching the 
copper core, it is fastened. The copper wire, which projects about an 
inch and a half from the butt, is now wound in a spiral, so that an 
effective connection is made, and we then have an effective electrode 
that meets every practical requirement. This electrode should be 
cleansed by means of a nail brush and soap and cold water. 
Dr. Skene Keith says, in regard to a flexible electrode: “We are 24 
A. //. BUCKMASTER, M.D. 
Platinum 
Wire> 
Iig. II 
%2 
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fig .3 
Copper Wire 
Conducting Cord GALVANIC TREATMENT OF FIBRO-MYOMATA. 
25 
told in Dublin that it is necessary above all to have a good knowl- 
edge of pelvic diagnosis ; yet flexible electrodes are advocated because 
they are more easy of introduction than rigid ones, and can be got into 
the cavity when a rigid one cannot. What is this but an acknowledg- 
ment of the want of the first great essential—a knowledge of the diag- 
nosis and manipulation.” We agree with what was said in Dublin, 
and disagree entirely with Dr. Keith’s supposition. We have been 
able to introduce, for example, our flexible electrode into the tortuous 
cavity of a fibroid that had been removed from the body,-where it 
would have been impossible (?) to have accomplished it with one more 
rigid; and if this is so outside of the body, where one certainly has 
all the aid that could be furnished by the most accurate diagnosis, how 
much more is it true with the living subject? 
The Battery.—It is foreign to my purpose to discuss the relative 
merits of the many different batteries in the market. A good battery 
should be constant in its action ; if it is not so, there will be marked 
variations in the current. This is apt particularly to occur when work- 
ing with high intensities, and it is caused by the decomposing fluid in 
the cell preventing its efficient action, both by covering the elements 
and causing a counter-current. I have used the Law cell with satis- 
faction ; and when I desired a current of forty milliamperes or under, 
Barrett’s fifty-cell chloride of silver battery has proved itself entirely 
competent. It is necessary to have from seventy-five to one hundred 
and fifty cells to obtain a current of very high intensity. 
For the past few months I have used a battery that I improvised. 
It is economical and effective. The ordinary wide mouth quart fruit 
jar is used. Several layers of thick pasteboard are cut so as to fit into 
the neck of the* bottle, and more pasteboard covers so cut that they 
project slightly over the side of the glass rim at the mouth of the bottle. 
These are tacked together and perforated by means of a carpenter’s 
chisel, so as to permit a carbon plate six inches by one and a half 
inches by one-quarter inch to be pushed through it. A perforated 
punch, No. ii, will make a hole that will allow the zinc element to 
pass through. The elements are submerged in a solution of chloride 
of ammonium, the connections made, and the battery is ready for use. 
To those to whom the expense of a battery is quite an object and who 
have some mechanical ability, it is not difficult to prepare, and it will 
work as well as any in the market. Its cost, if the materials are ob- 
tained at wholesale rates, is about $15 per hundred cells. 
Method of Application.—The patient is placed on a table with the 
clothes about the waist loose and so arranged that they can be readily 
pushed aside. The dispersing electrode is placed in a basin of very 
hot water and then adjusted to the abdominal wall. It is well to allow 26 
A. H. BUCKMASTER, M.D. 
it to remain for as long a time as convenient before using the current, 
for the skin becomes a very much better conductor when soaked with 
water. The resistance of the horny layer of the skin is so great that 
Erb says all others need scarcely to be considered, and from this state- 
ment it will be seen that it is important to have it well soaked, as by 
this means alone its resistance is to a great degree overcome.* 
The rheostat and milliamperemeter should now be placed in the 
circuit and the uterine electrode fastened to the rheostat. The battery 
may be short circuited for a moment, and if one is not positive as to 
which is the negative terminal, place the bare terminations in a glass 
of water, and it will be distinguished by the greater number of bub- 
bles collecting upon it. The rheostat should now be so placed that 
no current is permitted to pass. The uterine electrode may 
now be inserted. This is often the most difficult part of the 
treatment and requires the tactus erudi/us. I usually do this 
on the back, but sometimes it is necessary to turn on the side, 
and then the patient gently turned over on the back. The cur- 
rent may be gradually increased until the patient feels pain. The 
strength of current that a patient is able to bear without pain varies 
greatly. In some cases the patient will bear one hundred milliam- 
peres, while in others it is impossible to go over thirty milliamperes. 
One cause of pelvic pain is an overloaded condition of the bowels, and 
particular attention should be given to have them empty. After the 
seance it is better for the patient to lie down for a short time. When 
the treatment is used for the purpose of checking haemorrhage, the 
patient should remain in bed and keep very quiet for forty-eight hours. 
We are quite sure to have the good results obtained by a new 
method of treatment called to our attention before we learn of its 
casualties, and this is true of the subject under consideration. When 
using currents of great strength we are dealing with an agent capable 
of doing much harm, To those who are not specially familiar with 
the use of electricity it is almost impossible to conceive of a patient 
being able to bear with comfort a current, say of one hundred milliam- 
peres, that has been gradually increased, when to apply suddenly a 
* While a saline solution will overcome its resistance much more effectively than 
simple warm water, the latter is to be preferred, as may be demonstrated by the fol- 
lowing experiment: Allow a current as strong as comfortable to traverse any part 
of the body, using simple water to moisten the electrodes ; lessen the current, and, 
after moistening the electrodes with the saline solution, increase the current to its 
maximum, consistent with comfort. It will then be found that the current’s strengh 
is much less than it was with simple water; and, as it is difficult to work wffh as 
much current strength as we desire in a number of cases without anaesthesia, on 
account of the pain to the patient, the disadvantage of the saline solution is ap- 
parent. GALVANIC TREATMENT OF EIBRO-MYOMA TA. 
current of less than thirty milliamperes may occasion intense suffering. 
The ability to bear the current might not inaptly be compared to the 
case with which one can pass over the ground on an express train ; 
but the train starts very gradually and also decreases its speed gradu- 
ally. Should it attain or discontinue its maximum speed abruptly, 
serious trouble would ensue. The importance of making secure con- 
nections in order to avoid abruptly breaking the current should be 
borne in mind. Stirring the connecting cords will at times prove dis- 
agreeable, as will likewise shaking the table. Using the positive pole 
inside of the uterus may give rise to a stenosis, as occurred in a case 
that came to my notice. A nurse was permitted to give the treatment, 
and from the contracted condition of the canal it is presumed that she 
used the poles improperly. This illustrates the danger of indiscrimi- 
nate use of this method. It should never be used except by an expert. 
A current strong enough to throw a patient off a table by causing pow- 
erful muscular contractions, is one that is not to be trifled with, and a 
wet towel or any conducting substance that would switch suddenly a 
current of great strength through the heart or nervous centres, might 
prove fatal. In short, all the dangers have probably not yet illustrated 
themselves, and like any other new procedure we should be on our 
guard for danger signals. Before closing this paper, I should be un- 
grateful if I did not acknowledge the kindness of Mr. John A. Barrett, 
to whom the medical profession is greatly indebted for his inventions, 
whereby he has enabled them to utilize an agent whose usefulness, 
without his aid, would be much more restricted.