INDICATIONS FOR ELECTROLYSIS IN- ANGEIOMA 
AND GOITRE * 
By Charles R. Dickson, M.D., 
Electro-Therapist to Toronto General Hospital, Hospital for Sick Children, St. John’s Hospital for 
Women, and St. Michael’s Hospital, Toronto, Ontario. 
IT is a subject for much congratulation that electrolysis, so long misused, 
abused, and neglected, is, thanks to our improved apparatus and 
increased knowledge of fundamental principles, now allowed by the fore- 
most surgeons of the day a place on the list of measures to be relied upon 
in certain conditions. And it is greatly to the credit of the surgeon of the 
day that he is dealing with the whole subject of electro-therapy in a broad- 
minded, intelligent spirit. Four Toronto hospitals have now recognized 
departments of electro-therapy, and it is a matter of much encouragement 
to me that my best friends in the city of my adoption are the leaders in 
our noble profession. 
There are many conditions in which electrolysis is often most clearly 
indicated, and possesses many advantages over other surgical interference, 
but I shall refer to merely two. 
First, to angeioma. Here the disfigurement is frequently the chief 
reason for consultation and incentive to operation, particularly when situ- 
ated, as it so frequently is, on the face. In this location the probabilities 
of resultant scarring are much less than when other means are resorted to. 
Excision of the involved tissue is indeed, in many cases, quite useless, and 
the same applies to the cautery, scarification, and external applications, 
while the employment of injections is not free from danger. 
It is not the purport of this paper to consider the etiology, the varie- 
ties, nor yet the pathology of angeioma. Suffice it to say that electrolysis 
is applicable in the majority of cases. While it is true that cure may take 
place spontaneously, and interference is often deferred on that account, it 
is likewise true that the angeiomatous condition may spread greatly, and if 
operated upon early the result will probably be more successful, and the 
scar, if any, pale away as the child grows up. When small and super- 
ficial, and the capillary vessels chiefly at fault, a single negative needle and 
"Read at the twenty-eighth annual meeting of the Canadian Medical Association in Kingston, 
Ontario, on August 30, 1895. 2 
DICKSON : INDICATIONS FOR ELECTROLYSIS. 
mild currents may suffice to produce coagulation and blocking of the 
lumen of vessels; but when the vessels are much enlarged, it may be nec- 
essary to employ the positive to produce the characteristic contraction and 
resultant atrophy. The indifferent electrode in these cases may preferably 
be a large pad at the shoulders. 
In cases of the cavernous variety of large size, electrolysis may be 
carried to the extent of direct destruction of tissue, both poles being in 
the tumor. 
The treatment is one which I very frequently employ, but I select one 
case from my notebook which illustrates the difference between proper 
and unsuitable technique: 
On June 16, 1893, at the request of Dr. J. A. Temple, acting on the 
suggestion of Dr. Grasett, I treated a child, one year old, who had been 
subjected to six previous electrical operations with little appreciable 
benefit. The left ear was fully one-third larger than the right, and pro- 
jecting. At the back of the lobe was situated an ugly pendulous mass, 
while in front were three raised “ strawberry marks,” and a plentiful 
supply of very noticeably dilated capillaries. Chloroform having been 
administered, on careful examination I detected a spot on the back of the 
ear where, by pressure, I could lessen the circulation through the blemishes 
in front. In this I inserted a gold needle connected with the negative 
pole of the battery, while in the centre of the pendulous mass I inserted a 
similar electrode connected with the positive pole. Fifty milliamperes 
was used for seven minutes, and seventy-five milliamperes for eight 
minutes. 
That the negative needle had transfixed the supply vessel as intended 
was quite apparent, for the bubbles of hydrogen gas could be readily seen 
meandering through the dilated vessels in front and along the “ strawberry 
spots.” On turning off the current, the needles were carefully withdrawn, 
and oozing controlled by pressure with iodoform dusted pads. The sites 
of punctures were then coated with iodoform collodion, which was renewed 
subsequently as often as necessary. 
The effect in this case was steady and progressive ; the spots gradually 
paled ; the pendulous mass atrophied ; the hypertrophy of the ear became 
less apparent, and the ear less projecting. No other interference was 
necessary, and to-day, the other ear having developed with age, there is 
little difference in appearance between them, certainly not sufficient to 
constitute a deformity. 
Only one other condition will I allude to, namely, goitre. My researches, 
carried on for the past five years at the Toronto hospitals, and in my 
private practice in the treatment of the various forms of goitre by means 
of electricity, have attracted much attention, and have been most favorably DICKSON : INDICATIONS FOR ELECTROLYSIS. 
3 
received by my confreres in that city. I may remark, in passing, that during 
this time I have treated over one hundred cases of the different forms of 
this disease, but confine my remarks to cystic goitre, as my methods of 
treating it differs from the usual technique. 
The fluid is aspirated and replaced by a good electrolyte, that is, an 
easily decomposable conductor of electricity, various chemical solutions 
being used according to the indications. The aspirating needle together 
with the aforesaid electrolyte form an electrode conveying the current to 
the entire inner surface of the cavity, and through its walls also. The 
partially decomposed solution is removed on completion of the operation, 
and firm pressure kept up, with drainage if necessary. I aim to cause 
collapse and excite adhesive inflammation of the cyst wall, with atrophy, 
and in some cases secondary degeneration of the hypertrophied tissue. 
In this hope expectations are realized in the majority of cases, with very few 
exceptions ; but old, very firm fibrous tissue may resist, as it is almost 
impossible to excite any reaction whatever in it. 
A recent post-mortem on a case I had previously treated revealed the 
site of the former cyst a mass of cicatricial tissue, while the lobe had 
undergone calcareous degeneration. 
As to instruments. The lumen of my cannula permits the easy passage 
into cavities of No. 3 drainage tubing when required. The tube 
of the cannula is constructed of platinum, that it may be used with 
the positive pole if necessary, and the addition of a second stop-cock 
renders it independent of the reservoir when introducing it ; otherwise, 
this part of the apparatus is the usual Potain aspirator attachment. The 
use of chemical solutions corrodes metal parts ; therefore for the injections 
I employ a second bottle with tubes of glass leading to and from it. A 
third tube has also been introduced to facilitate the introduction of the 
solution. By another arrangement the sac may be evacuated without 
polluting this reservoir. 
Shall the general practitioner employ electrolysis ? Yes, if he possess 
the necessary apparatus ; knows how to take care of it; is endowed with 
the ability to use it skilfully ; has a minute acquaintance with its funda- 
mental laws, and can properly estimate the wonderful power of this alluring 
agent. Otherwise, a thousand times, No. 
159 Bloor Street East.