ON THE APPLICATION OF THE ELECTRIC CURRENT 
IN CERTAIN CLASSES OF DISEASES. 
BY 
JOHANN I''I.IXTEH>[A.NN, Al. I)., 
Detroit, Michigan. REPRINTED FROM 
®be anb Surgeon, 
DETROIT AND ANN ARBOR. 
ON THE APPLICATION OF THE ELECTRIC CURRENT 
IN CERTAIN CLASSES OF DISEASES. 
BY 
JOHANN TTLinSTTERAIAN'TSr, TVI. T)., 
Detroit, Michigan. 
It is with some feeling of embarrassment that I come before you to-night with 
a weak attempt to make a few remarks on the application of the electrical 
current in the treatment of certain diseases. Looking through the daily news- 
papers of our land we hardly find one that does not contain an advertisement 
recommending the use of electricity for every disease. Very seldom do our 
medical journals contain articles scientifically treating of the use of electricity 
in medicine, although the advertising pages abound with recommendations of 
electrical batteries, instruments and appliances. The offices of medical men are 
more or less provided with batteries, the electric current is frequently applied, 
but reports of cases treated by electricity are seldom given. When I see the 
electric current applied, and the way in which it is done, I very often ask myself 
how is it that professional men, who are careful in administering medicine and 
who follow the strictest rules in cases of operation, become careless when they 
resort to electricity as a curative remedy. Is electricity in itself a thing that 
does not need careful study? Where is the man among you who would give to 
the people a pound of powdered opium and say that opium is a good remedy for 
stopping pain, leaving it to an unexperienced youngster to give it in any form 
and any strength? Certainly such carelessness would be criminal and negligent, 
and yet in electricity just such things are done every day. Without any knowl- 
edge of the nature of electricity or the laws which govern its different physical 
and chemical changes, without which no uniform results can be obtained, 
medical men resort to electricity. A man who wishes to apply electricity as a 
remedial agent must make himself familiar with several facts. It is necessary 
first, that he should have a good knowledge of the physics of electricity; he 
must understand what instruments are needed, the electrodes, the instruments- 
of precision, the different kinds of apparatus; he must know the laws of 
physiology, the anatomy of the parts where treatment is to be applied-topo- 
graphical, systematic anatomy, the histology, the pathology of the processes for 
which the electric current is used as a remedial agent. Without a thorough 
knowledge of all these, and without a good knowledge of general medicine the 
application of electricity is a fraud. 
The foremost and principal question is, At what strength must a current, or 
may a current, be applied, and what means do we have to measure the strength 
of the current? Two definitions must be familiar to the electro-therapeutist if 
he w'ants his actions to be governed by reasoning and calculation, namely, the 
density of the current and the meaning of the word resistance. Next in impor- 
tance to these two definitions is the question, How long may an electric current 
be employed? The question of resistance has lost some of its importance by the 2 
absolute measurement of the strength of the current, but anyone familiar with 
the subject knows that in many instances the question of resistance must be 
taken into serious consideration. Density of the current is such a very important 
factor that without it an approximate measure of the strength of a current for 
electro-therapeutic action is entirely impossible. The time has passed when an 
electro-therapeutist tried to emancipate himself from the uncertain task of 
ascertaining the intensity of the current by only mentioning the number of cells 
used or perhaps adding to his report the deflections of an unreliable galvanoscope. 
Nothing was said about the size of the electrode's resistance of the galvanoscope 
used in the case. But even to-day we will meet with reports of cases in which 
the absolute measure of the galvanometer is given without stating to what extent 
of body-surface the current was applied. What does a report amount to that 
gives only the number of milliamperes without further defining its practical 
effect? If we state a certain strength for a certain electrical application and if 
we describe its application for a certain purpose on a certain area of the body, 
we mean to say by that that the accurately measured area on the surface of the 
body has been given to a certain quantity of current as a transverse surface in 
the circuit. Or, to speak more properly, the current must enter and leave certain 
parts of the body at a certain strength and at a well defined density. The cura- 
tive effect of the electrical treatment is dependent upon the density of the 
current passing through the desired parts. According to this explanation to 
apply a weak or strong current means in the one case to bring these parts of the 
body under the influence of electrical currents which are more diffusely dis- 
tributed, in the other, under the influence of concentrated currents. If the 
transverse diameter of the part to be treated does not change, in such a case 
a weak current or a current of small density can only be produced by the 
decrease of the strength of the current; a strong current only by an increase. 
Letting D stand for density of current, I for strength of current, and T for the 
surface of the transverse section, we have the formula, D=I-i-T. Or, in case the 
cross-sections remain constant the density of the current is directly proportional 
to the strength of the current. If density is the chief factor in the curative effect 
of the current, and if this leading principle has been formed from experience 
and experiments made touching upon this point, then it follows from the 
formula, D=I-s-T, that if we desire the effect of a certain intensity of a current 
I' with a certain density D', we must take a cross-section T'. Or, in other words, 
we must apply a certain strength of current on an area of certain surface. This 
must be our first work when we apply the electrical current, to ascertain the 
density of the current to be applied by having the intensity of the current 
divided by the exact measure of the surface area. 
In cases of sciatica I should recommend two differently shaped electrodes, 
one in the form of a rectangular parallelogram and the other of oval shape with 
a surface of seventy square centimeters and a current of an intensity of four 
milliamperes. In spinal affections, treating by stations, by which I mean that 
I commence from upwards, and then select different stations below the point, at 
which I start, I always have the current flowing from the dorsal to the anterior 
surface of the trunk. In some cases I use large electrodes with surfaces of more 
than six hundred square centimeters, but keep the D of the current in the ratio 
of one to eighteen. 3 
For circumscribed cases, as for instance, myelitis transversa, which we some- 
times may be able to localize by a spot tender on pressure between the fifth and 
eighth vertebral bone {processus spinosi et transversi), or for chronic intercostal 
neuralgia over this area and in this region, one rectangular electrode in the back 
and one of oval shape in the epigastric region is found serviceable, each electrode 
measuring fifty-five square centimeters. D=I-i-T. I) = one-eighteenth=three- 
fifty-fourths v 1=three milliamperes. 
In cases of the affection of the roots of lumbar nerves, where distinct puncta 
dolorosa posteriora are found, take a broad plate, covering the lumbar vertebral 
bones, of one hundred and five square centimeters and an oval plate of one 
hundred and ten square centimeters opposite on the abdomen. Then figuring 
approximately, since one is to eighteen as six to one hundred and eight, the 
intensity of the current ought to be six milliamperes. 
For an inflamed wrist I use concave electrodes measuring thirty-five square 
centimeters and a current whose intensity is two milliamperes. In these cases 
the current flows in a transversal direction through the locus morbi. But the 
law, which we have defined, holds just as well for cases where the current flows 
in a longitudinal direction, if the poles are some distance apart, and if for this 
reason the curves of the current are able to reach lower points, before they con- 
verge again towards the poles, as for instance, in the treatment of the spine in 
longitudinal direction. In such cases a weak current is used, either ascending 
or descending; one of the poles is placed on the lumbar vertebral bones and the 
other on the neck. (If the upper electrode is applied in the neighborhood of 
the occipital bone, a decrease of strength occurs in the current). 
Every rule has its exceptions, and so has our rule of the density of the cur- 
rent. It can easily be proven that in spite of all facts favorable to the principle 
of weak currents, very often modifications become imperative on account of the 
impractical size of the transverse sections of the electrodes and the distance 
between them, not forgetting the locality of the body and the individual case of 
the disease. In order to illustrate the reason for exception to the rule, I want to 
mention a case in which we apply a current in a longitudinal direction, having 
the poles but a short distance apart, and where the curves of the current are only 
enabled to penetrate to a sufficient depth by great density, as for instance, in a 
case which we treat by applying the current in the direction from the jugulum 
to the ganglion sympathici supremum. Here we take two thick buttons, sur- 
face only ten square centimeters. Although the sympathicus reacts to the 
weakest currents, in this case where we use so exceptionally small-surfaced 
electrodes, the curves of the current are so very few, that only by the high excit- 
ability of this nerve can it become evident why the strength of the current is 
one-fourteenth instead of one-eighteenth. A similar increase in the density of 
the current takes place in spite of the opposite application of the electrodes. In 
cases of simple rheumatic affections of the joints, which have no other symp- 
toms than pain by motidn, tenderness at pressure, swelling, no color, rubor, but 
the parts covering the joints are cold, which very often has by reflex action the 
same effect on the whole extremity, either the arm or leg, D in such cases should 
be one-fourteenth, and in cases where there is little reaction, one-tenth. The 
same I) must be applied in chronic traumatic affection of the joints. In cases 
of disease of the joints, where you apply the electric current, it is necessary that a 4 
very large area be penetrated by the curves of the electric current, a surface 
larger than is necessary, when you apply electricity for affection of the medulla 
spinalis or of a circumscribed affection of a nerve. Therefore a current of con- 
siderable D on the electrodes is needed in order to furnish a sufficient quantity 
of the current to the diseased joints, in spite of the fact that the curves of the 
current distribute themselves on a larger area as soon as'they have left the 
electrodes. 
Torpid affections of the foot, knee, hand, and in all cases where adhesions' 
are liable to be formed, in which it is your aim to have hypersemia rather than 
anaemia, a current of D one-sixth should be applied, and even above this D. It 
is advisable in such cases to use the commutator. Certainly for diseases of the 
central organs our rules for density of the current are limited in the opposite 
direction. In brain treatment as a rule D=I-i-T=one-twenty-fourth; in easily 
influenced individuals D = one-twenty-eighth-one-thirtieth. In cases where appli- 
cations must be made in the neck, and sometimes in cases where the electrodes 
are applied in the superior dorsal regions in persons of cerebral anaemia, it is 
advisable to have D from one-eighteenth to one-twenty-fourth, as very often by 
the curves of stronger currents a dullness in the head is complained of, as if 
from pressure, dizziness and a feeling of fainting. 
All acute cases with symptoms of high inflammation, all recent, all erethic 
cases, as for instance, myelitis, neuritis, neuralgia, etc., are best treated by apply- 
ing the current with a density below the degree mentioned. Individual cases 
require scrutinizing inquiries and cautious trials as to the degree of density the 
patient will bear. Very often only half the average D (one-thirty-fifth) is 
sufficient, often you must apply even weaker currents. In certain functional 
disturbances with nervous irritation the application of electrical current with 
small D very often work like a charm. Hemicrania spastica, D--one-seventh, 
duration two to three minutes, using reophore plate of twenty-two square centi- 
meters, current of about two milliamperes; cathode on the angulus maxillae 
inferioris, a second reophore plate of fifty-five square centimeters on the cervical 
vertebral bone as anode. In cases of paralytic form, in order to cause a contrac- 
tion of the cerebral vessels and capillaries D on the ganglion supremum should 
be one-tenth, duration thirty to forty seconds. It is, however, always advisable 
to make the smaller electrode the anode, as it is less painful. 
For what length of time a current should be applied during one session, 
depends on the nature of the affection and personal equation of the patient to 
be treated. How often such treatment should be repeated depends on the same 
factors. But one point I always insist on, namely, that the patient, if possible, 
should rest after each treatment, even if only for a short time. 
There are many other points in connection with electrical treatment, which 
I have not touched upon in my short disclosure this evening. But for lack of 
time, and that I may not tax your patience long, I shall leave them for some 
future paper.