Reprinted from Codex Medicos for November, 1897. 
The Electro-Therapeutics of Rheumatism. 
By A. R. RAINEAR, A. M., M. D. 
Formerly Demonstrator of Experimental Therapeutics and Electro-Therapeutics in Jefferson 
Medical College and Hospital. 
The electro-therapeutics of rheuma- 
tism are referable more specially to 
the sub-acute and chronic forms. In- 
deed, the acute articular variety is 
retarded in its process of recovery, by 
using any form of electrical treatment. 
Included under these two classes of 
the disease, (sub-acute and chronic), 
are the muscular and arthitic and 
gouty conditions. 
However, in all rheumatic condi- 
tions, electricity as a means of treat- 
ment must be applied in two ways : 
First, constitutional; second, locally. 
In considering and selecting the proper 
form of therapeutical electrization, we 
have at our disposal really five differ- 
ent modifications or phases of current; 
each one, perhaps, showing special 
characteristic advantages and peculiar- 
ities of its own. Thus, we have Gal- 
vanism, Faradism, Static or Franklinic, 
Sinusoidal, and combining the first 
two, Galvano-Faradic. Having re- 
ported to these several styles of electri- 
cal applications, and in gathering the 
results of other specialists in electro- 
therapeutics, a complete and thorough 
test has induced me to depend apon 
the Galvanic, Faradic, Galvano-Far- 
adic, and Static forms as the most 
reliable and permanent in their actions 
on the rheumatic condition, whether it 
be exemplified in the muscles or joints. 
Quite a number of medical electric- 
ians favor the static machine, saturat- 
ing the patient on an insulated stool, 
and removing sparks up and down the 
spine. 
Much good has undoubtedly resulted 
from his plan of treatment, but the 
results seem to be not as permanent: 
great relief being experienced at the 
time, and perhaps for a few days fol- 
lowing the electrical seance, but I have 
carefully noted that often a relapse or 
return of the trouble after a month or 
two from the last application of the 
static current. 
Regardless of theories involving the 
causes of rheumatism, two important 
facts must be remembered. First, 
never treat a case of acute articular 
rheumatism with any form of elec- 
tricity. It being an acute febrile dis- 
ease, accompanied with intense pain 
and suffering, will only be aggravated 
and intensified by any form of elec- 
tricity coming in contact with the 
acutely inflamed parts. Secondly, all 
pains in the muscles and joints, and all 
paralyses or partial muscular paralyses are not rheumatic or of rheumatic 
origin. Yet pain and stiffness of 
joints, and partial atrophy of the mus- 
cles are positive attendants and condi- 
tions coexisting with sub-acute and 
chronic rheumatism. 
It will, therefore, aid the practi- 
tioner in his future prognosis for his 
patient, to be well able to diagnose his 
case as one of the sub-acute or chronic 
types of rheumatism, before referring 
him to the electro-therapeutist for 
treatment. There are some physicians 
too hasty to receive the diagnosis as 
made by the patient, where all pains 
are stated to be the evidences of pre- 
vious rheumatic attacks. 
As mentioned before, the constitu- 
tional and local methods are the only 
proper ways to use electricity. Pre- 
vious to citing some cases it would be 
well to look into some of the reasons 
for such forms of treatment. 
General or constitutional galvaniza- 
tion acts as a tonic to the entire system ; 
but decidedly so on the nervous system. 
Galvanism is the most active stimulant 
of nutrition we have, and as mal-nutri- 
tion and mal-assimilation are present 
in all these cases, the organs of di- 
gestion and absorbtion are stimulated 
to the proper performance of their 
functions. Insomnia being present in 
a number of cases, the application of 
the galvanic current to the spine, and 
specially the upper dorsal and cervical 
regions, has a tendency to cause a 
quiet and normal sleep. Irritability of 
temper is often present, where a gen- 
eral treatment has a soothing and ano- 
dyne effect on the sympathetic and 
general nervous system. 
The local treatment may be galvanic 
or faradic, or the two combined, 
galvano-faradic. The slowly inter- 
rupted faradic current, when locally 
applied to an individual muscle, 
causes a contraction, and indirectly 
such contraction means more blood 
to the part and therefore increased 
nutrition. When pain is present in 
the muscle, a galvano-faradic current 
would cause a contraction and at 
the same time producing decreased 
pain and soreness of the parts. If 
there is fluid of a pathological nature, 
or even commencing deposits, absorb- 
tion can be effected by the local appli- 
cation of the current to the joint, or 
even the inserting of metallic needles 
attached to the cathode may be resort- 
ed to where the deposits are of a com- 
mencing calcareous or urate of soda 
formation. 
Some of the few prominent local 
phenomena are as follows :- 
a. More or less pains in the various 
joints affected, and more severe on 
pressure. 
b. Difficult movements in the joints, 
due probably to the pain and weakness 
of contiguous muscles. 
c. Pains or soreness of the muscles, 
brought out by pressure. 
d. Atrophy of the muscles and di- 
minished contractility. 
e. Hydrarthrosis. 
The general treatment is about as 
follows : Where there is much mus- 
cular involvement, a primary and sec- 
ondary current from the faradic ?oil, 
of about three to five minutes dural ion, 
applied directly to the muscles. At 
first, use currents of modern strength, 
the electrodes well moistened with a 
saline solution, and the current in- creased to the maximum power of 
endurance. This to be followed by 
weak interrupted faradic primary cur- 
rents. If excessive pain be present, 
use galvanic An. of fifteen to thirty 
milliamperes. Where the joints are 
affected, galvano-faradic currents ap- 
plied immediately over the joints from 
ten to fifteen minutes' duration. La- 
bile currents following stabile applica- 
tions are usually productive of much 
good. Also, galvanism to the spine, 
An. over the origin of the nerve from 
spine, and labile applications of Ca. 
over the joint or muscles. Spinal 
galvanism with An. over the cervical 
vertebrae, and Ca. on upper section of 
sacrum, using twenty to thirty-five 
milliamperes, stabile applications from 
ten to twelve minutes. 
In the following cases reported, I 
have copied from my record book of 
treatment, and each case in its history 
will demonstrate the condition of the 
patient, and the general plan of electro- 
therapy as applied thereto. In almost 
all cases of subacute rheumatism, at 
least two sittings per week are neces- 
sary, while the chronic cases require 
daily or not less than three treatments 
weekly, and continued for some time. 
Avoid informing the chronic rheumatic 
of a month's electrical treatment as 
an infallible cure ; three to six months 
will be the nearest solution. 
In March, 1895, Mr. I. D. was 
referred to me by Dr. R. of this city, 
with the following history. Two years 
ago he was in bed for six weeks with 
inflammatory rheumatism. At that 
time all of the smaller joints in the 
body seemed to be swollen and painful. 
After getting about and working, the 
muscles at times were painful to the 
touch and aggravated by movement 
during contractions. Mr. D. says 
" that a long continued treatment with 
iron and iodide of potassium got him 
in pretty good condition." His 
greatest annoyance now is the en- 
largement of the wrist joints, which 
comes on during the late winter and 
early spring, when the air is damp 
and cold. The joints are very painful 
on pressure and in the movements of 
the hands the wrists are exceedingly 
sensitive and tender. Some of the 
extensor muscles of the right forearm 
were atrophied, and as he expressed 
himself, "full of neuralgic pains." 
The patient was placed upon the 
galvanic treatment, with an occasional 
recourse to a slowly interrupted pri- 
mary faradic current to the muscles. 
Twenty milliamperes were passed into 
these joints every day for three weeks, 
and then increased to thirty milliam- 
peres three times a week, about fifteen 
minutes at each sitting, habile cur- 
rents of galvanism were used to the 
extensors and flexors of both forearms. 
This treatment was continued for two 
months, with slight changes in the 
diet, no medicine or drugs of any kind 
being used. He has reported to me 
several times. There is no return of 
the previous trouble and an absence of 
deposits in the joints or any deformity. 
In December, 1894, Mr. W. J., 
aetat, 41, merchant, consulted me for 
a severe ' ' ache ' ' and pain in the lower 
part of the back and upper portions of 
thighs. Had two previous attacks of 
rheumatism, this region of the back 
being the most troublesome ; so bad in 
fact that he was compelled to remain in bed for some time. During the 
winter he went to Florida, where he 
got comparative relief and comfort, 
but upon his return in the spring, the 
muscles of the lower back would be- 
come sore on pressure, and at times 
interfered with proper locomotion. 
Walking aggravated the trouble. 
There was no disease of the spine or 
kidneys. Great pain was experienced 
before or upon attempted rising from 
the bed in the morning. He was com- 
pelled to neglect his business, in fact 
gave it up until through with electrical 
treatment. 
Galvanism was applied to the back, 
the An. to the upper dorsal and cerv- 
ical regions, and the Ca. over the lum- 
bar regions. Eighteen to twenty-five 
milliamperes were used daily, duration 
of twelve minutes. Later on, the 
slowly interrupted secondary faradic 
current was used over each muscle. 
When the pains had disappeared, 
gymnastic exercise of these muscles 
was ordered, and at the end of three 
months' treatment, no tender spots or 
pains were present, and no return has 
occurred. Both stabile and labile cur- 
rents were used on the back and thighs. 
Mrs. O., aetat 34, consulted me in 
February, 1896, complaining of loss 
x>f power in the left leg, following an 
attack of rheumatism. The history 
plainly shows a former attack of acute 
rheumatism. Upon examination I 
found the muscles of the calf of the 
leg and also of the thigh, very much 
wasted, somewhat cold and moist to 
the touch. Sensation was very much 
impaired. She experienced pain at all 
times in these atrophied muscles, but 
more intense when in bed and sitting 
erect for any length of time. The 
opposite limb seemed to be in a normal 
condition, rather over-developed. She 
dragged the left leg when walking, 
necessitating the use of a cane. I 
may add, that the other muscles of 
the body were in good condition, and 
unattended with pain. This woman 
was referred to me as a case of ' ' rup- 
tured blood vessel in the spinal cord." 
There were no De. R. The wasted 
muscles responded to both galvanic 
and faradic currents. Galvanism to 
the entire limb was used every day 
more as a tonic to the parts, followed 
during the same sitting with mild, 
slowly interrupted secondary faradic 
currents. At the end of t\Vo weeks 
the pain had ceased entirely ; the 
atrophied muscles had increased in 
size and contractile power, and then 
the applications were made on alter- 
nate days for three weeks longer; when 
the limb reached its normal condition, 
and has remained so up to the present 
time. Labile galvanic currents of 
twelve to twenty milliamperes were 
applied during the early treatment, 
using large electrodes covered with 
cotton. When the muscles showed im- 
provement, small electrodes were used 
in order to select the individual mus- 
cles ; an interrupted current being used. 
Other cases can be quoted, showing 
the effects of electro-therapeusis in 
this apparently intractable yet annoy- 
ing complaint; but I think that the 
above statements, together with a 
practical demonstration as shown in 
the cases mentioned, will serve toward 
a better understanding of the electro- 
therapeutics of rheumatism. 
2024 Diamond Street, Philadelphia, Pa.