With the Compliments 
of the Author 
pGGUMUliATOI^S 
AND THEIR MEDICAL USE. 
BY 
ROBERT NEWMAN, M.D. 
RE-PRINTED FROM 
THE PHILADELPHIA MEDICAL TIMES, 
April 15, 1889. ACCUMULATORS 
AND THEIR MEDICAL USES. 
ROBERT NEWMAN, M.D. 
Synonymous terms of accumulators are stor- 
age batteries and secondary batteries, and will 
be used so in this paper. 
These names convey only a vague 
idea of the nature of these batteries, 
without really explaining their charac- 
teristics. The accumulator is a battery, 
which first must be charged with elec- 
tricity b}r a primary battery, before it 
can be used, thereby becoming a secon- 
dary battery. It is not exactly correct 
to say that the electricity is stored up ; 
but the fact is, that by changing accumu 
lators, they become reservoirs for elec- 
tric energy, which can be used at will, 
and last till the electric energy is ex- 
hausted. A secondary battery consists 
of one or a series of accumulators, each 
accumulator representing one cell. 
To make this paper more complete, 
some terms and electric units used in 
modern electricity will be explained as 
adopted at the Electric Congress in 
Paris, 1881. 
Electric Units. A Volt is the unit 
of electro-motor force, the measure for 
pressure of difference of potential. It 
is nearly equal to one cell of Daniell’s 
Battery. 2 
The Ohm is the unit of resistance, 
or rate of velocity, the standard of which 
is a column of pure mercury one square 
millimeter in cross-section, and 10G 
centimeters in length, at the tempera- 
ture of ° C. “An ampere is the unit 
of current strength or volume; the 
standard measure of the electric current. 
An ampere is equivalent to the strength 
furnished by an electro-motive force of 
one volt, passing through a resistance 
qual to one 'j 
A coulomb is the unit of quantity. 
It is equal to one unit of current am- 
pere passing in one unit of time (one 
second); or in other words a current of 
one ampere in a circuit will produce 
one coulomb in a second. 
A Watt is the unit of energy or force, 
or equal to a combined volt, and am- 
pere. 
Amp. x Volt. 
One horse power = 
746 
A Farad is the unit of capacity. It 
represents the storage of one coulomb of 
electricity in a condenser. 
A Joule is the unit of heat; it also 
represents the work done by a watt in 
a second. 
Cell. By a cell we understand the 
vessel with its contents complete with 
liquid and elements (or plates) not the 
receptacle per ee. 3 
Primary cells used for Faradic and 
galvanic batteries, vary very much in 
their composition ; but all have one char- 
acteristic 'when exhausted, the whole 
or part of the chemicals employed must 
be renewed, and sometimes the plates 
also. Types of these are the Daniell, 
Bunsen, Grove, Leclanche, etc. 
Secondary cells are such, which when 
exhausted, may be revived by simply 
passing a current through them from a 
battery of primary cells. 
For each cell we have a fluid and 
plates. Cells proper are generally made 
of glass or hard rubber. The plates 
consist of positive and negative ele- 
ments, made of some suitable sub- 
stances. 
Fluids.—The fluids used may be al- 
kaline, acid or neutral, according to the 
plates employed, and other considera- 
tions. In the present storage batteries 
the fluid consists of diluted sulphuric 
acid covering the plates to the depth 
of half an inch above the upper edges 
of the negatives. 
The theory of electric storage is that 
when water is decomposed by electroly- 
sis the gases are collected in separate 
receptacles, if the connection with the 
battery be severed, and the wires lead- 
ing to the gas tubes brought into con- 
tact, a current of electricity will flow 
through them in the reverse order to 
that of the original current, the gases 
at the same time recombining to form 4 
water. Thereby the electric energy ex- 
panded in decomposing the water is 
stored up in the gases, and recovered 
when they recombine, Oxygen accu- 
mulates at the positive pole and hydro- 
gen at the negative. The oxygen unites 
with the terminal, if composed of any 
of the baser metals, and appears in the 
combined form of an oxide instead of a 
gas. But experiment proves that elec- 
tric energy is also stored up in the 
oxide, w hen so formed, and may be re- 
covered from it.1 
Asa primitive storage of electricity 
we may look to the Leyden jar in prin- 
ciple; which, however,differs consider- 
ably from the present accumulators; 
the Leyden jar becomes charged by 
induction, the secondary battery by 
chemical acti'on. The Leyden jar, when 
used, liberates all the electricity con- 
tained in it, as one discharge, while in 
our present accumulators the electricity 
can be used in quantities to suit our 
purpose, commenced, stopped, inter- 
rupted at will instantaneously, and even 
the strength of such current can be 
regulated. 
The principle of our present accumu- 
lators wasdiscovered by Plants, 1800. A 
modification of Plante’s system was 
made by Faure in 1880, whose storage 
battery was the first exhibition of a 
1 Atkinson : The element* of electric light- 
ing. 5 
practical appliance, which promised to 
be used for different purposes. At the 
present time the best cells in use are in 
reality only improved Faure’s cells,and 
come under three heads : One has plates 
composed of lead in a spongy or gran- 
ular state ; the second has lead plates, 
or some alloy of lead, perforated with 
holes which are filled with lead com- 
pounds. The third type has lead and 
.zinc plates. All lead-plate accumula- 
tors are based on the principle of 
Plante,s invention, which represents, 
also, the type of the first class men- 
tioned. 
Plante’s system is as follows : 
Two sets of lead plates prepared with 
a view of making them porous are 
rolled into each other; at the start both 
sets are identical, and only afterwards 
become positive and negative respect- 
ively. They have luggs either cast on 
them or put on afterwards to project 
above the level of the electrolyte, so 
that the plate itself may be completely 
immersed. A strip of lead is then sol- 
dered to the luggs of all the negatives, 
and the same is done with the positives 
destined for one cell. The two sets of 
plates are pushed into one another, so 
as to form a compact block, positive 
and negative, alternately, every plate 
being insulated from the next one by 
some non-conductor, for which India- 
rubber bands are mostly used; but they 
remain joined by the lead strips de- 6 
scribed above. The block of plates is 
firmly held together and constitutes a 
section. The two poles of a primary 
battery are connected with the accumu- 
lator, and by a series of charges and 
discharges with reversible properties 
the forming takes place. For charging, 
a battery is used consisting of a series 
of Daniell’s or Bunsen elements. The 
principle is to form an oxidation 
at the positive pole, thereby converting 
the plates into a peroxide of lead and 
the positive plate will accordingly be- 
come brown, while the negative plate 
will remain gray. The battery is fully 
charged when gases are formed at the 
positive pole (brown color) and escape 
in small bubbles. If a so-charged bat- 
tery is left to itself without l>eing used 
it will deteriorate, by a reduction of 
the peroxide of lead, and it Incomes a 
sulphate of lead, which can be observed 
by the brown color at the positive pole 
changing into a yellow. The chief 
drawback to this type of accumulator 
is that frequent reversals are necessary 
to obtain a good storage capacity, and 
just when that point has been attained, 
the plates shortly fall to pieces ; that 
is the limit of the accummulator and its 
end. The objections, therefore, are 
that such batteries are troublesome, ex- 
pensive, and too heavy for portability. 
The Second Type (lead plates per- 
forated with holes which are filled with 
lead compounds) is unquestionably the 7 
most useful, and it is those which are 
most in use at the present day. 
Pasted plates are made in many 
but the object in all is to pro- 
duce an efficient support of lead for 
carrying the paste. Several companies 
prepare plates which are almost iden- 
tical. They consist of lead, or an alloy 
of lead, cast in plates full of small 
square holes, in form, with 
their bases on the surface of a plate 
minute-glass shape in section, with a 
lugg to attach the connecting strip of 
lead, when built up in sections. Now 
they use an alloy of lead to obtain a 
better plate of grid, as it is called, the 
alloy being far stronger than the lead. 
The plates intended for positives are 
pasted with red lead, or minimum, and 
sulphuric acid ; the negatives with yel- 
low lead, or litharge and sulphuric 
acid ; the latter is used to make the 
paste more coherent. 
They are now built up in sections'by 
soldering the luggs of a number of pos- 
itives to a strip of lead. The negatives 
are treated in the same way. These 
two sets of plates are pushed into one 
another, so that positive and negative 
alternate, and every plate is insulated 
from the next one. A plate of thick 
glass is then placed at each end of the 
section, and two stout rubber bands are 
made to encircle the whole, one near 
the top, and one near the bottom, of 
the section, horizontally. The number 8 
of negative plates always exceeds the 
positives by one, so that a negative is 
seen at each end; of the remaining 
plates the edges only are in sight, the 
plates being about a quarter of an inch 
apart, positive and negative alternately. 
There is no connection between the 
positives except through the leaden 
strips at the end of the luggs, this being 
left long enough to join to the next 
cell; the ends of the luggs with the 
strip always remain above the liquid of 
the cell. These remarks also apply to 
the negatives. The section is now 
ready for forming. In the foregoing 
description of the manufacture of the 
plates I have followed mostly Sir 
David Salomon’s management of accu- 
mulators. 
Many experiments have been made 
to improve the Plante’s system, and we 
find accumulators exhibited by the fol- 
lowing scientists; Meritens, Pezzers, 
Sellon & Volckmann, Changy, Kabath, 
Faure and Schulze. 
Next come the accumulators with 
only one lead plate by Arsonvals, Boett- 
cher, Sutton ; and last, the experiments 
of accumulators without lead plates by 
Houston <k Thompson, II. Aron, Yar- 
ley and Dumoncel. The latter belong 
to the third type mentioned above. 
All support plates belonging to the 
first type were founded on the princi- 
ple of the oxidation of the positive 
plates or their conversion into peroxide, 9 
so that they soon fell to pieces, which 
is the objection. The type of the sec- 
ond class differs from the first in that 
the plates are already prepared in its 
make, so that the cell is ready for im- 
mediate use. Our present useful accu- 
mulators belong to this class, and are 
all modifications and improvements of 
the Faure system. 
The importance of a reliable accumu- 
lator will be appreciated best when it 
6an be utilized in all practical appli- 
ances of electricity. It has already 
been extensively used for the following 
purposes: 
1. Electric lighting of buildings. 
2. Lighting of railway trains, street 
cars, and omnibuses. 
3. The traction of all vehicles, more 
especially street cars. 
4. The propulsion of yachts, launch- 
es and pleasure boats. 
5. The lighting of steamers. 
6. Running motors of all kinds. 
7. Telegraphy, signaling. 
8. Medical use. 
9. Electro-plating. 
10. General laboratory, etc. 
Each of these uses plays a very im- 
portant part in our domestic and public 
economy; but most interesting is 
“ Electric Lighting.” It is here that its 
functions as a reservoir of energy be- 
come utilized to the greatest advantage ; 
and after a retrospect of not so many 
3rears, in which the light for houses and 10 
our studies was a tallow candle, we can 
appreciate more fully the progress of 
an enlightened community, which has 
given us electric light as a comfort and 
a luxury. While this subject is so very 
interesting, its pursuit is not within the 
scope of this paper, and we must re- 
strict the further consideration of ac- 
cumulators to Medical Uses;” which 
are: 
1. Galvano cautery. 
2. Incandescent light for general ex- 
amination and especial illumination of 
cavities of the body. 
3. Motors, and operating induction 
coils. 
Among the many advantages of the 
accumulators are : 
A. In regard to Light. 
1. The greater superiority and stead- 
iness of the light. 
2. It does not heat the instruments, 
and its surroundings. 
3. The light is concentrated and does 
not flicker or smoke. 
4. The freedom from smoke and del- 
eterious gases. 
B. In regard to Cautery. 
5. The cleanliness in contrast with 
the acid plunge batteries, which often 
have ruined clothes, carpets and furni- 
ture. 
6. The battery is always read}' for 
use. 
7. It gives a uniform strength of 
current from beginning till the energy 11 
of electricity is completely exhausted ; 
thereby a platinum burner can be kept 
at the same intensity of heat during 
any operation ; whereas, the primary 
batteries polarized and the heat dimin- 
ished during an operation. 
8. The amount of heat desired can 
be regulated by the rheostat. 
9. The accumulators are more port- 
able than a battery filled with acid 
fluid. 
10. It saves time and work, being 
always ready; there is no necessity of 
making fluid, filling, refilling and clean- 
ing the elements. 
DISADVANTAGES. 
• 1. The constant care and use. 
2. If out of order, the cell must be 
renewed ; it cannot be repaired. 
These may be considered by some 
drawbacks ; just as well, as it needs to 
be an expert to handle the instruments. 
The accumulators must be used often, 
and it must be charged and discharged 
at certain intervals. One or a few days 
intervals will not make much differ- 
ence ; but if a charged cell will be left 
standing without being used, it may be 
found entirely useless after a certain 
time; just as well, as if the cell is left 
exhausted of energy and not charged 
again. Therefore, the general practi- 
tioner, who, perhaps, uses a galvano- 
cautery once in a month will not find 
the accumulator practical; but the ex- 12 
pert and specialist will not complain ; 
on the contrary, will find that he saves 
time and w'ork. I use the accumulators 
almost daily, and find the care needed 
not burdensome, on the contrary, pleas- 
ant, and saving time and labor in com- 
parison with the old method. All these 
disadvantages are reduced to a mini- 
mum by constant improvements which 
inventors make. 
PRINCIPAL ACCUMULATORS FOR MEDICAL 
USE. 
In America several types of batteries 
have appeared, all having as foundation 
the Plante’s system; the plates of all are 
a modification of Faure, all plates are 
in cells, filled partially with diluted sul- 
phuric acid. The difference consists in 
preparing the plates, in which the prin- 
cipal point and secret is to prepare a 
suitable alloy of lead, instead of lead 
itself. 
Here in New York we have three 
systems in use, all protected by letters 
patent, viz.: The Gibson’s, the Julien, 
and the Black Giant. The latter two 
will be considered here, and introduced 
to your special attention. I have used 
them side by side for comparison for 
some time past, and both have given so 
much satisfaction that I feel justified-in 
recommending both and showing them 
to you here in orperation. 
Is manufactured by a powerful and en- 
TIIE JULIEN ACCUMULATOR 13 
terprising company, called “ The Julien 
Electric Company,” doing business on 
a very large scale ; having the patronage 
of the Vanderbilt, Pennsylvania and 
other railroads, and also using their 
batteries as motors for railroad cars. 
The inventor is Edmond Julien, a Bel- 
gian engineer. His specific claim is that 
the grids or supporting plates are made 
of a special metallic composition which 
prevents oxidation and buckling,giving 
the battery much greater durability 
than can be obtained by the use of lead 
grids. The nature of this composition 
is a business secret, but some knowing 
ones say it consits of 94.5 lead,4.2 an- 
timony, and 1.3 mercury. In commer- 
cial circles it is known as “ L’Elec- 
trique.” The company calls it a new 
principle, that of an inoxidizable sup- 
port plate. The Julien accumulator is 
guaranteed to render efficient service 
for a period of at least two years, and 
the company considers it the most du- 
able battery. An instrument of this 
make I have used for some time, and it 
has given me perfect satisfaction. It 
consists of three cells in one case, and 
can be used for cautery as well as for 
electric light. It is charged by a series 
of ten Watson cells. The Watson cell 
is an improved gravity cell, each six by 
eight inches in size. This primary bat- 
tery is stationary below in the basement, 
and two wires running up, representing 
the positive and negative poles, respec- 14 
tively, are connected with the same 
poles of the accumulator, when the lat- 
ter wants to be charged. As a rule the 
battery is charged during one night. 
The instrument is also provided with a 
rheostat, by which the strength of the 
current may be increased or diminished 
or regulated for the work to be done. 
One charge will hold a two-candle power 
lamp in a state of incandescence for ten 
hours. I believe that this battery has 
sufficient power to do all galvanic 
cautery work for surgical purposes, 
while the use of the rheostat will 
regulate and diminish the power to 
such a degree that the smallest burner 
can be applied without the risk of melt- 
ing the platinum. I have used this ac- 
cumulator for my galvanic cautery 
sound, also for heavy work. If the 
operator is attentive and uses the 
rheostat with care, he will never melt 
the platinum and ruin his instrument, 
while he can hold the same heat for any 
length of time without any polarization. 
This and other advantages over the 
primary cautery battery have been men- 
tioned above. Another additional ad- 
vantage is that this battery can be 
arranged for quantity, as well as for in- 
tensity, by plugs inserted in the holes 
you see here. If the battery is used in 
three consecutive cells at once, heat in 
the burner used immediately gives a 
Hash to its fullest extent, which is im- 
portant for some uses, particularly in 15 
the application to the prostate with 
my galvano-cautery sound ; this is the 
intensity or volt current. On the other 
hand, if the three cells are converted 
into one cell, the heat comes gradually 
up to its fullest power, where it will re- 
main during an operation. In the latter 
case the battery is set for quantity. 
To a certain extent this battery is port- 
able, that means, one strong man can 
carry it to the place of operation, if he 
holds it “ this side up.” Its weight is 
about forty pounds. It cannot be laid 
on its side or upset, in which case the 
fluid would run out and injure the up- 
per part of the cells. 
THE BLACK GIANT ELECTRIC ACCUMULATOR 
Is the invention of Dr. Flick of Brook- 
lyn, and has come more recently to the 
notice of the public. Each cell is a 
sealed receptacle, has 8 plates, and is 
encased in an exterior of hard rubber. On 
top is a small hole in which a £ inch 
high tube is placed, which has the func- 
tion as a ventilator to allow the free 
escape of gases. This opening can be 
closed by any kind of plug or cork, 
which prevents any leakage during a 
transportation. In the middle of the 
top are two projecting arms, nickel- 
plated, which are the two poles, with 
binding posts used for storing as well 
as for discharging. The cell is round, 
inches high, 4 inches in diameter, 
with a circumference of 13 inches, 16 
and weighs 10 pounds. It can be 
used single or in combination. A 
battery of two such cells is powerful 
and sufficient for almost any surgical 
galvano-cautery operation. 
From trials made, I believe that two 
cells give nearly as much heat as three 
cells of the Julien accumulator. One 
cell, when fully charged, is equal to 
volts, and can be discharged at the 
rate of from 5 to 20 amperes, accord- 
ing to the use desired, and has a ca- 
pacity of at least 30 ampere hours. 
This battery has also a rheostat 
attached. 
The plates are made of an alloy of 
lead, the composition of which is also 
the secret of the inventor. It is a very 
neat battery and has given me entire 
satisfaction. A particular advantage, 
which would make it useful to the gen- 
eral practitioner, is that in the Black 
Giant accumulator no local action takes 
place, and there is no loss of power 
when standing unused ; and it may be 
allowed to stand many months empty 
and will readily charge again. IIow 
long it will retain its power I cannot 
say; but from experiments made myself 
I know that this accumulator was dis- 
charged and idle for nearly three 
months without losing anything in its 
power, was charged readily again and 
to-day is just as good as ever in its 
start. These accumulators are now 
manufactured in New York, and are for 17 
sale at B. Blum & Co., 5 and 7 Dey 
Street, New York, and other dealers. 
The inventor claims that the Black 
Giant excels all other accumulators in 
the following points: 
1. Its electrodes or plates are non- 
corrosive and consequently indestruc- 
tible. 
2. The composition of its plates and 
its method of manufacture prevent local 
action and consequent loss of capacity 
to receive, retain and develop a high 
tension and a great quantity of current. 
3. It is durable, reliable and con- 
stant. The plates do not enter into the 
chemical action involved in the opera- 
tion of the cell, but remain non-disin- 
tegrable conductors. 
4. Its capacity is greater in propor- 
tion to weight of cell than that of any 
other. 
5. Its mechanical construction and 
appearance is superior to any other. 
The cell does not leak, the terminals or 
plates are thoroughly protected from 
corrosion,and consequently permanent. 
f>. The cells in transportation can 
be placed in any position or upset with- 
out being injured or leaking. 
Both instruments, Julien as well 
as the Black Giant, are good prac- 
tical accumulators which I can recom- 
mend. Both claim their instruments 
are the best and most durable. Pro- 
gress is constantly made, and while we 
•discuss here the merits of each, an im- 18 
provement may greet us on awakening 
in the morning. 
In determining the degree of intensi- 
ty of a current required to heat a plati- 
num wire to a point suflicicntly hot for 
the purpose of operation with galvano- 
cautery, it is impossible to say how 
many degrees Fahrenheit are necessary, 
obviously ,sincefor some time operations, 
a wire heated to a dark red is sufficient, 
while, for others, the wire must be 
brought to a white heat, yet not carrie d 
to such a degree as to melt the wire. 
The intensity of an electric current be- 
ing measured only by electric units, it 
is but the sign of dense ignorance of 
electric laws to ask how many degrees 
Fahrenheit are necessary to produce a 
given result in electricity, because the 
thermometer is not a measure of elec- 
tric force. 
All operations can be made with the 
accumulators where galvauo- cautery 
can be used, with platinum burners or 
with the galvano-cautery ecraseur with 
platinum wire. For most operations 
of the latter kind a No. 22 wire is used; 
while a No. 20 or 24 may be indicated, 
according to the work to be done. 
II. INCANDESCENT LIOFITINO 
Is one of the most interesting appli- 
cations of the storage battery. It is 
here that its functions as a reservoir of 
energy become utilized to the greatest 
advantage. Electric illumination is 19 
carried on upon a large scale by dynamo, 
accumulator or both combined. Lights 
supplied direct from a dynamo are un- 
steady, uncertain and flickering, and the 
wires of such a current are dangerous 
to life by its large electro-motive force. 
A type of this is the Brush system, 
which flickering, unsteady lights can be 
observed in our streets, and the news- 
papers report many cases of death by 
loose wires coming in contact with a hu- 
man body. On the other hand, the 
light furnished by accumlators is per- 
fectly steady, and the current can be 
regulated with great certainty, so that 
we are enabled to use it for medical pur- 
poses. The Edison light is the type of 
this, which is used for illuminating our 
houses, and has 100 to 110 volts. The 
storage battery is, in fact, an equalizer 
and regulator to the dynamo, besides 
acting as a reservoir of accident, which 
is liable to happen with the best ma- 
chinery. It is evident that in incandes- 
cent lighting for medical instruments, 
we can use the accumulator only. 
Lighting apparatus for surgical in- 
struments do not require so much room, 
and an electric lamp can be brought 
into nearer proximity with the parts of 
a human body under examination than 
any other lamp, and it also permits the 
eye of the operator to get nearer tlie- 
point of observation, by which means a 
closer and more thorough examination 
becomes possible. By the aid of lenses, 20 
pictures can easily be enlarged, and 
finally very fine photographs of the 
cavities of the human body can be ob- 
tained. II. Fenwick, in London, has im- 
proved now his apparatus to take photo- 
graphs of the interior of the bladder. 
The best instruments of illuminating 
the cavities of the body by incandes- 
cent light are now made by ,T. Leiter, 
of Vienna. We find among his instru- 
ments the following: 
Lamp for the forehead. 
The lamp used for these instruments 
gives a light equal to from ten to twenty 
standard candles. It can be removed 
from its holder and connected with a 
handle, so as to be used as a hand 
lamp. It never becomes heated. 
Laryngoscope; can also be used for 
dental operations. 
Rhinoscope. 
Tongue-depressor. 
Gastroscope, after Mikulicz-Leiter,to 
examine the stomach. 
Speculum, with incandescent lamp. 
The lamp is carried on a spring, 
which can be clamped to any speculum. 
Leiter’s panelectroscope, for male 
and female urinary organs, ear, nose, 
oesophagus, rectum and vagina, is a uni- 
versal lighting apparatus. The same ap- 
paratus will illuminate either of the or- 
gans mentioned, if an appropriate tube 
for the purpose is attached to the end 
of the instrument. As you see here, 
on removing the metal plate and screw- 21 
ing on a mirror in its place, we have a 
laryngoscope, and in turning the same, 
it can he used for lighting up the nasal 
cavity. The differs 
from other endoscopic instruments in 
the mirror being placed behind the 
lamp, and its concavity permitting of 
concentration of the rays of light com- 
ing from the lamp upon the object. The 
operator looks over the upper edge of 
the mirrof in though the respective 
tube. The lamp stands here free, not 
encased or obstructed above, which has 
the advantage that the instrument will 
not be heated, even if the lamp is kept 
burning for hours. 
The most important novelty is 
Leiter’s improved Cystoscope. This 
excels all former apparatus by supe- 
rior workmanship and finish, has a far 
greater illuminative power, can be used 
in a bladder full of fluid, will bum 
steadily a long time and in every way 
gives the greatest security. Two instru- 
ments are made, one for examining the 
posterior part, and the other the ante- 
rior surface of the bladder, the light be- 
ing respectively on the concavity and 
convexity of the instrument. By aid of 
the cystoscope a surface of'the interior of 
the bladder of 100 to 200 millimeters 
can be very seen at once. 
The size of the tube is No. 22 French; 
but it is also made of a calibre of No. 
40, which is very useful in the exami- 
nation of the female bladder. 22 
Cystoscopes must not be left burn- 
ing for tiny length of time in the open 
air, as in that case they become heated. 
If, however, that part of the apparatus 
containing the lamp is surrounded by 
water, the cystoscope may be kept 
burning for hours before it becomes 
perceptibly heated. To be examined 
with such instruments, the bladder al- 
ways ought to contain 5 to 8 ounces 
clear water. 
I have here a phantom bladder filled 
with six ounces of water,in which I have 
placed some objects which are for your 
inspection with the cystoscope, which 
is now lighted up writh the accumulator. 
We need 3 to 4 cells to produce a bril- 
liant light, which is regulated with the 
rheostat, according to the resistance of 
the lamp. The latter is placed near 
the curve of the instrument, by which 
the light is introduced directly into the 
bladder and not by reflection through 
mirrors, as was the case with all former 
instruments. Leiter furnishes a plunge 
battery with acid and bichromate of 
potassa for the generation of the elec- 
tric current; but our demonstration 
here will prove that the accumulators 
do the work perfectly, and once adjust- 
ed give a steady light uninterruptedly 
for hours, while a plunge battery, with 
acids, necessarily will polarize and must 
constantly be readjusted. There is no 
question that the incandescent light, 
including the Mignon lamp,is an Ameri- 23 
can invention. Yet we are unable 
to procure any incandescent lamp 
made in this country that is of any 
practical value, though many are made 
here, yet all are defective in one way 
or another, some bursting without 
warning and without apparent cause 
save defective workmanship, and all 
fail to give light sufficient for the re- 
quired purpose. 
It has fallen to the hands of skillful 
instrument makers of Europe to fur- 
nish us with a lamp yielding the best 
light with a greater resistance, thereby 
making the lamp more durable and less 
liable to breakage. 
Among good lamps are some manufac- 
tured by J. Leiter in Vienna, P. Hart- 
wig,of Berlin,and K. Scliall,of London. 
Leiter furnishes with his cystoscope 
a longer tube, for deeper inspection ; 
but as he thereby alters the arrange- 
ment of the lenses, he also disturbs the 
focus, so that the point to be examined 
is not shown as distinctly as in the 
regular tube. 
We have also in the market Nitze’s 
cystoscope, which is nearly identical 
with Leiter’s. Yet Nitze’s has this 
advantage over Leiter’s that the instru- 
ment, while in the bladder, may be 
turned around so as to make examina- 
tion of posterior and anterior surfaces, 
while with Leiter’s a different instru- 
ment must be used for each examina- 
tion. Notwithstanding this disadvan- 24 
tage, many prefer Leiter’s instrument, 
myself being among those. 
The cystoscope possesses nearly the 
same disadvantage that existed in 
Desormcaux endoscope, viz.: an abrupr 
curve which is sometimes dillicult fot 
the operator and painful for the patient 
in introducing it into the bladder. Could 
the fenestrum be arranged in a gradual 
curve,like the steel sound, much disad- 
vantage would be overcome. 
The cystoscope in the present condi- 
tion can only be used in examination 
and for diagnosis. 
Could it be modified so as to enable 
the physician to make a diagnosis and 
operate at the same time, the instru- 
ment would be the ideal of perfection. 
We sincerely hope that this instrument 
may shortly be brought to this state of 
perfection. 
New York, 68 Wt«t 36th Street.