The Value of Electrolysis 
in the Treatment of 
Ovarian Tumors 
PAUL F. MUNDE, M. D. 
REPRINT FROM VOLUME II 
(Kjmecolonial ^Transactions 
1878 TRANSACTIONS 
OF 
The American Gynecological Society. 
VOL. I., FOR THE YEAR 1876. 
400 pages. Many illustrations. 
The Annual Address by the President, Dr. Fordyce Barker, of New 
York, and the following papers : - 
I. Etiology of Uterine Flexures, with the proper mode of treatment indicated. By 
Thomas Addis Emmet, New York. 
II. Cicatrices of the Cervix Uteri and Vagina. By Alexander J. C. Skene, M. D., New 
York. 
III. Extirpation of the Functionally Active Ovaries for the Remedy of otherwise Incur- 
able Diseases. By Robert Battey, Rome, Ga. 
IV. On Central Rupture of the Perineum. By J. Matthews Duncan, M. D., Edinburgh, 
Scotland. 
V. Viburnum Prunifolium (Black Haw); its Uses in the Treatment of the Diseases of 
Women. By Edward W. Jenks, M. D., Detroit, Mich. 
VI. An Illustration of Xenomenia. By Theophilus Parvin, M. D., Indianapolis, In- 
diana. 
VII. Relations of Pregnancy to General Pathology. By Robert Barnes, M. D., Lon- 
don, Eng. 
VIII. The Spontaneous and Artificial Destruction and Expulsion of Fibrous Tumors of 
the Uterus. By W. H. Byford, Chicago, Ill. 
IX. Case of Abdominal Pregnancy, treated by Laparotomy. By T. Gaillard Thomas, 
M. D., New York. 
X. Pneumatic Self-Replacement in Dislocations of the Gravid and Non-gravid Uterus. 
By Henry F. Campbell, M. D., Augusta, Ga. 
XL Hydrate of Chloral in Obstetrical Practice. By W. L. Richardson, M. D., Boston, 
Mass. 
XII. Labor Complicated with Uterine Fibroids and Placenta Previa. By James R. 
Chadwick, M. D., Boston, Mass. 
XIII. Latent Gonorrhea, with Regard to its Influence on Fertility in Women. By 
Emil Noeggerath, M. D., New York. 
XIV. Death from Urinemia in Certain Cases of Malignant Diseases of the Uterus. By 
Alfred Wiltshire, M. D., London, England. 
XV. Clinical Memoir on some of the Genital Lesions of Childbirth. By William Good- 
ell, M. D., Philadelphia, Pa. 
XVI. Hermaphroditism. By Lawson Tait, F. R. C. S., Birmingham, England. 
XVII. Cases of Cystic Tumors of the Abdomen and Pelvis. By George H. Bixby, 
M. D., Boston, Mass. ' 
XVIII. Case of Solid Uterus Bipartitus; both ovaries removed for the relief of epileptic 
seizures ascribed to ovarian irritation. By E. Randolph Peaslee, M. D., New York. 
XIX. The Origin and History of Calculi found in the Bladder after the Cure of Vesico- 
Vaginal Fistula by Operation. By Henry F. Campbell, Augusta, Ga. 
XX. Rare Forms of Umbilical Hernia in the Fetus. By James R. Chadwick, M. D., 
Boston, Mass. 
XXL In Memoriam Gustav Simon. By Paul F. Munde, M. D., New York. 
Price of Volume I., $5.00. 
As contributions to advanced gynecology they exceed in value anything which we have 
ever before seen collected in any one volume. - N. K Medical Record. 
This volume of Transactions is certainly superior to any book of the kind that has been 
issued by the American Press. - St. Louis Clinical Record. 
Now we have the first of, we hope, a long row of volumes which will bear comparison 
with the Transactions of European Societies. Indeed, these must look to their laurels in 
this noble emulation. - Edinburg Medical Journal. 
This volume is one of the best collections of gynecological papers that has been published 
this year. -Annales de Gynecologic. VOLUME II. 
650 pages, 12 chromo-lithographs and many other illustrations. 
Contains the following papers, with the discussions to which they gave 
rise : - 
I. Annual Address, on Medical Gynecology. By the President, Dr. Fordyce Barker, of 
New York. 
II. The Functions o£ the Anal Sphincters, so called. With two wood-cuts. By Dr 
James R. Chadwick, of Boston, Mass. 
III. Excision of the Cervix Uteri; its Indications and Methods. With one wood-cut. 
By Dr. John Byrne, of Brooklyn, N. Y. 
IV. Report on the Corpus Luteum. With twelve chromo-lithographic plates. By Dr. 
John C. Dalton, of New York. 
V. The Pathology and Treatment of Puerperal Eclampsia. By Professor Otto Spiegel- 
berg, of Breslau, Prussia. 
VI. Dilatation of the Cervix Uteri for the Arrest of Uterine Hemorrhage. By Dr. 
George H. Lyman, of Boston. 
VII. The Principles of Gynecological Surgery applied to Obstetric Operations. By 
Dr. A. J. C. Skene, of Brooklyn, N. Y. 
VIII. On the Necessity of Caution in the Employment of Chloroform during Labor. 
By Dr. William T. Lusk, of New York. 
IX. The Present Status of the Intra-Uterine Stem in the Treatment of Flexions of the 
Uterus. By Dr. Ely Van de Warker, of Syracuse, N. Y. 
X. Supplement to the report of a case of Xenomenia made at the first. Annual Meeting 
in 1876. By Dr. Theophilus Parvin, Indianapolis, Ind. 
XI. A Case of Vaginal Ovariotomy. By Dr. William Goodell, of Philadelphia, Penn. 
XII. Is there a Proper Field for Battey's Operation? By Dr. Robert Battey, of 
Rome, Ga. 
XIII. Subsulphate of Iron as an Antiseptic in the Surgery of the Pelvis. By Dr. H 
P. C. Wilson, of Baltimore, Md. 
XIV. Tetanus after Ovariotomy. By Dr. Theophilus Parvin, of Indianapolis, Ind. 
XV. Sarcoma of the Ovaries. By Dr. Washington L. Atlee, of Philadelphia, Penn. 
XVI. The Value of Electrolysis in the Treatment of Ovarian Tumors, as seen in the 
Light of Recent Experience. By Dr. Paul F. Munde, of New York. 
XVII. Congenital Absence and Accidental Atresia of the Vagina; Mode of Operation 
to Establish the Canal, and to Evacuate retained Menstrual Blood. With three wood- 
cuts. By Dr. Thomas Addis Emmet, of New York. 
XVIII. Case of Sarcoma of the Kidney in a negro child. With Heliotype. By Dr. 
W. H. Geddings, Aiken, S. C. 
XIX. The Hystero-Neuroses. By Dr. George J. Engelmann, of St. Louis, Mo. 
XX. Cases illustrating Important Points connected with Ovariotomy. By Dr. Gilman 
Kimball, of Lowell, Mass. 
XXI. The Radical Treatment of Dysmenorrhea and Sterility by Rapid Dilatation of the 
Canal of the Neck of the Uterus With one wood-cut. By Dr. Ellwood Wilson, of Phil- 
adelphia, Penn. 
XXII. Dr. Uvedale West's Views of Rotation, as illustrated by the Contrast between 
the Mechanism of Simple Occipito-Posterior Positions and those of the Bregmato-Coty- 
loid Variety. By Dr. John P. Reynolds, of Boston, Mass. 
XXIII. Vascular Tumors of the Female Urethra; with the Description of an Instru- 
ment devised to Facilitate their Removal. By Dr. A. Reeves Jackson, of Chicago, Ill. 
XXIV. Lying-in Hospitals; especially those in New York. By Dr. Henry J. Gar- 
rigues, of Brooklyn, N. Y. 
XXV. The Simpler Varieties of Perineal Laceration; their Consequences and Treat- 
ment. By Dr. Thaddeus A. Reamy, of Cincinnati, Ohio. 
XXVI. The Cyclical Theory of Menstruation. By Dr. John Goodman, of Louisville, 
Ky. 
XXVII. In Memoriam Charles E. Buckingham. With a Heliotype Portrait. By Dr. 
George H. Lyman, of Boston, Mass. 
Index of Obstetric and Gynecological Literature of all Countries, from July 1, 1876, to 
January r, 1877. 
The price of Volume II. is $6.50. The 2 volumes will be sent by mail 
or express, post-paid, for $10.00. Address, 
HOUGHTON, OSGOOD & CO., Boston. THE VALUE OF ELECTROLYSIS IN THE 
TREATMENT OF OVARIAN TUMORS. 
BY PAUL F. MUNDE, M. D., 
New *"¥vrk. 
In December, 1875, exactly one year and a half ago, Dr. 
Frederic Semeleder of Mexico electrified the professional 
world with the thrilling announcement of " No more Ova- 
riotomy,"1 and by the report of several cases of ovarian tu- 
mors cured by electrolytic treatment threatened to nullify 
the achievements of our numerous illustrious ovariotomists. 
So painless and simple, so sure and effectual was, , accord- 
ing to his account, this new method of treatment of cystic 
disease of the ovary, that it seemed almost criminal to have 
subjected so many patients to the dangerous operation of 
ovariotomy, which had attained its present low state of 
mortality only after numberless trials and sacrifices ; and 
that many began to ask themselves whether, after all, the 
consummate skill and dexterity of a Spencer Wells, a Keith, 
an Atlee, and many others, had been all in vain, and was 
destined to fall into oblivion as a mere waste of thought 
and energy, as a relic of by-gone and darker days. 
Dr. Semeleder did not profess to be the originator of this 
method. His attention was first called to it by two suc- 
cessful cases published2 by Dr. Friedrich Fieber of Vienna, 
in 1874, who himself appears to have received the incentive 
to a trial of ovarian electrolysis from a Dresden physician, 
Dr. von Ehrenstein, through a patient cured by that gen- 
tleman, whose claim to priority is again contested by Dr. 
1 Wiener Med. Presse, 52, Dec., 1875. 
2 Wiener Allg. Med. Zeitg., 1874. 
1 2 
ELECTROLYSIS OF OVARIAN TUMORS. 
Theodore Clemens of Frankfort-on-the-Main. Fieber cred- 
its Dr. I. T. Biihring with having first mentioned the 
method in the year 1848.1 
But it is not of priority that I wish to speak here. 
Whatever ground there is for the assertions of the various 
competitors will appear in the course of the following pages. 
The question of who first employed this mode of treatment 
in ovarian tumors is of very small moment in comparison 
with the determination of the exact merits of the method, 
a problem which it is my object to discuss and fathom, so 
far as the evidence of hitherto recorded experience permits. 
Hardly had Semeleder's paper reached this country and 
begun to excite the attention of our leading practitioners, 
before he himself was compelled, by the political troubles in 
Mexico, to make New York his abode for a time. His 
presence was eagerly seized upon by several of our princi- 
pal ovariotomists to test the treatment with which his name 
had rapidly become identified. A number of cases were 
placed at his disposal; the subject was discussed in various 
medical societies, and was the one theme, for the time, of 
professional conversation ; and other gentlemen, embold- 
ened by the simplicity and apparent innocuousness of the 
applications, subjected patients with ovarian tumors, which 
happened to come under their care, to the treatment. All 
was expectation, hope, and wonder. But the fates were not 
propitious. The ovarian tumors of our American women 
(at least in New York) refused to succumb to the insinua- 
ting means to which those of their Austrian and Mexican 
sisters had readily yielded. Semeleder himself was not suc- 
cessful, and but few of the other operators reported favor- 
able results. As rapidly as expectation had been raised, so 
rapidly did it fall again, and there was danger of the oppo- 
site extreme being reached, as is unfortunately so often the 
case with many of our new remedies and inventions. First 
they are proclaimed as cure-alls, and because they naturally 
fail to respond to all the demands of their supporters, they 
1 Amer. Jour. Obstet., Oct., 1876. PAUL E MUNDE. 
3 
are at once decried and summarily cast aside as worth- 
less. 
This method of electrolysis of ovarian tumors is too 
vastly important to be dropped without thorough, impar- 
tial, and painstaking consideration. Heralded as it has 
been with the convincing argument of three cured cases, 
supplemented since by several others also cured or much 
relieved, it does not seem possible that the treatment can 
be all delusion, and it certainly does not appear right or 
just to discard it without a fair trial, at all events not until 
its successes and failures have been reviewed and some 
definite conclusion drawn as to its therapeutical value. 
This, then, is the object of this communication. I shall 
not enter into a discussion of the modus operaudi of the 
galvanic current in cystic growths, how it produces the ab- 
sorption of the fluid, whether by coagulation or decomposi- 
tion of the cyst contents, or by a peculiar change in the 
cyst walls or influence on the nerve-elements supplying 
them, mysteriously called catalysis, or by what other oc- 
cult means. Electropathologists incline to the latter view. 
Semeleder believes both in decomposition and absorption 
of the contents and the catalysic change of the cyst-wall, 
destroying its power to secrete further. Fieber recom- 
mends previous evacuation of the fluid, in order that a cer- 
tain destructive process may be surely inaugurated in the 
cyst-wall, by which sooner or later the entire neoplasm is 
shriveled and destroyed. Ehrenstein calls the process " elec- 
tro-catalysis," which Dr. Beard, of New York, informs me 
is, in his opinion, the proper term. So far the authorities 
seem unable to explain the How of the method, which in- 
ability, of course, enhances the mystery and is one of the 
main arguments of the skeptics, who term obphoro-electro- 
lysis " the medicine of the ' Arabian Nights.' " But before 
proceeding to the enumeration of the individual cases, I 
deem it necessary to a correct appreciation of the latter, to 
mention the method by which electrolysis may be practised 
in the treatment of ovarian tumors, and the procedures 
adopted by the different leading operators in this branch. 4 
There are two methods of applying electrolysis: the ex- 
ternal or percutaneous (which is really no electrolysis at all), 
and the internal, by means of the introduction of one or 
more needles into the tumor. In the percutaneous method, 
both poles may be placed on the abdomen at some distance 
apart, or one pole may be held in the hand or introduced 
into the vagina, while the other is changed about on the 
abdomen, or one on the back and the other on the abdomen. 
In the internal method, one or more, generally insulated, but 
with mild currents also non-insulated, needles are thrust 
into the tumor through the abdominal walls, and the other 
or sponge-electrode is placed on an opposite spot of the 
abdomen or introduced into the vagina. This latter method 
is theoretically and practically proved to be the more effi- 
cient, although it will be seen that some of the operators 
have used both procedures alternately in the same case, and 
several cases of cure even by the external method alone 
are reported. 
Some practitioners have combined local and general 
Faradisation with the galvanolytic treatment, as they claim, 
with marked advantage. 
The batteries used for electrolysis are either composed 
of zinc and carbon, or of zinc and copper elements, and 
must be so arranged that the positive (carbon or copper) 
and negative (zinc) poles must alternate. If all the zinc 
elements are directly connected, and all the carbon or cop- 
per elements also, more heat will be generated, but less 
electrolytic power. 
I purposely abstain from dilating further on the minutiae 
and technicalities of the electrolytic process, partly because 
all these points have been quite fully discussed by Drs. 
Semeleder and Fieber, and partly because they are foreign 
to the aim of this paper, not to speak of my lack of com- 
petency to handle them as an expert. I wish to confine 
myself here simply to facts, as near as I can determine them, 
and to exclude theorizing entirely. 
The honor of inaugurating (or reviving) this new de- 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUNDE. 
5 
parture in ovarian therapeutics belongs chiefly to three 
men, - Fieber, Semeleder, Von Ehrenstein. 
Fieber, in a " report of 16,000 cases of diseases of the 
nervous system, thorax and larynx," 1 in 1874. published 
two cases of ovarian cysts cured by electrolysis, which 
first attracted Semeleder's attention. Subsequently Fie- 
ber 2 described the process employed by himself, which is 
exceedingly simple. Indeed he calls it " simple acupunc- 
ture," saying that he connects one pole with a needle 
(which pole he does not say, although I judge from fol- 
lowing remarks, the negative), and the other, which is to 
be applied to the skin, with an ordinary sponge-electrode. 
He does not mention how often the applications should be 
made, or how long, or how strong, but says that they may 
be carried out in the physician's office, although he prefers 
the safer course of choosing the patient's residence (there- 
from I judge that he used mild currents, and Semeleder so 
asserts). If the cyst contains a large quantity of fluid he 
advises that it be voided before proceeding to electrolysis, 
in order to ease the patient as rapidly as possible, and not 
to waste the current in decomposing a fluid which can 
much more readily be removed otherwise, but rather to 
confine its force directly to the cyst-walls. He also com- 
bines percutaneous electric (galvanic, I presume) applica- 
tions with the electrolysis, although he does not place much 
reliance on them, and warns against losing time with them. 
One point of importance stated by him is the different 
action on the tissues of the needle when it is connected 
with the negative or with the positive pole. With the neg- 
ative pole the flesh appears cooked, the channel of the 
needle is smooth, and the needle is easily movable in, and 
can be readily removed from it. With the positive pole, 
however, the whole needle-channel shows a grayish-black 
coloration, and the needle, corroded itself, adheres quite 
firmly to the tissue. The advisability of connecting the 
1 Wiener A llg. Med. Zeitg., 1874. 
2 Am. Jour. Obstet., loc. cit. 6 
ELECTROLYSIS OF OVARIAN TUMORS. 
needle with the positive pole in preference is, it seems to 
me, apparent when we consider how easily the fluid might 
ooze into the peritoneal cavity from, or, what is infinitely 
worse, air enter the cyst by the gaping channels of the 
negative needle-punctures. 
Semeleder, at the time of his second communication,1 
flushed as he then was with, at least, no unfavorable and 
mostly favorable results, was more bold than at a later 
period. In five of the cases reported by him then he in- 
troduced sometimes both needles into the tumor, generally 
only one, and made the applications daily, lasting from five 
to ten minutes. The current, however, was always mild, 
no anesthetic was used or needed, and the patient expe- 
rienced no noticeable inconvenience from the operation. 
He first took qare to confine the punctures to a limited 
area, fearing that they might cause adhesions which would 
be very troublesome if the failure in a cure subsequently 
necessitated ovariotomy, but when he found that no inflam- 
matory reaction followed the punctures, he extended them 
all over the tumor, and is confident that they do not pro- 
duce adhesions. Polycysts he advises, with Fieber, to be 
punctured so as to thrust the needles through as many 
cysts as possible. He states that up to that time no relapse 
had occurred, and believes that such a one could be ex- 
plained by supposing, not that the original cyst had refilled, 
but that a smaller cyst had escaped the needles and begun 
to develop. The batteries he has used are the carbon-zinc 
and copper-zinc, evolving the constant current only. In one 
case, where he feared hemorrhage, he applied both elec- 
trodes to the skin of the abdomen, or one on the abdomen 
and the other in the vagina ; in another case the nature 
of the tumor was doubtful, and it was low in the pelvis, so 
he limited himself to percutaneous applications, after run- 
ning a needle several times into the tumor. Which bat- 
tery is to be used, and which pole should be introduced by 
needle in a particular case, as well as which class of tumors 
1 N. Y. Med. Jour., June, 1876. are most favorable to electrolytic treatment, and to what ex- 
tent that treatment should and may be pushed, are all points 
to be determined by further experience. 
In a later paper,1 published after his return to Mexico, Dr. 
Semeleder gives some additional details as regards his 
modus operandi as follows : - 
i. Battery. The battery he used was a zinc and copper 
(Calland), and a zinc and carbon electrolysis instrument 
(Leiter). Any battery so arranged as to produce electro- 
chemical effects will answer; it makes no difference what 
substances the single element is made of, but there must be 
several smaller elements, and the positive pole of each ele- 
ment must be connected with the negative pole of the next 
following element, so as to form a chain. 
2. Number of cells used. His Calland battery of twelve 
elements decomposes in one minute .03 cubic centimeter 
of common water acidulated with one drop of sulphuric 
acid to the ounce, while Leiter's electrolytic battery of eight 
cells decomposes in one minute .30 cubic centimeter as 
measured by the voltameter. The electro-chemical power 
of a battery depends on the number and size of the ele- 
ments, on the quality of the exciting fluid, and on the 
extent to which the elements are brought in contact with 
the fluid. But the number and size of the elements do not 
convey an idea of the electro-chemical power developed. 
3. Strength of the current. As a rule, from eight to ten 
Calland elements. A stronger current, although satisfac- 
torily applied by others, he considers unsafe. 
4. Length of the sittings. Five minutes, as a rule, al- 
though fifteen minutes have been employed with benefit. 
5. Frequency of applications. He has employed them 
every day, even during the menstrual period, and advises 
the same, unless a special contra-indication exists. 
6. Introduction of needles. Generally he introduced only 
the needle connected with the positive pole, and thinks this 
the safest plan, as the current passes just as well through 
PAUL F. MUNDF. 
7 
1 N. Y. Med. Jour., March, 1877. 8 
the liquid when only one pole is inserted, and because the 
negative pole gives more pain and is more likely to produce 
burning and sloughing. 
7. Kind of needles, insulated or not. He thinks that the 
mildness of the currents renders insulation of the needles 
unnecessary, and uses platinum, and preferably steel nee- 
dles, of the size of a knitting-needle, pointed. One needle 
is introduced, the other pole applied to the skin with a 
sponge or metallic electrode, if the latter, separated from 
the skin by a layer of blotting-paper soaked in salt water. 
Dr. J. W. Von Ehrenstein, physician in charge of an 
electro-therapeutic institute in Dresden, has been placed 
third on the list, not because he was the last to practise the 
method, for indeed he claims precedence of all others in 
having developed the plan, but because his first two brief 
publications followed those of Fieber and Semeleder, and 
with another subsequent one contain no detailed descrip- 
tion of the method which he styles his own, but merely 
long notes of one case, and the mere mention of a number 
of others claimed to have been cured thereby. Published as 
these two communications were in a journal having compar- 
atively little circulation in this country outside of medical 
libraries, I venture to say that they have met the eyes of but 
few American physicians, and that the name of their author 
is scarcely, if at all, known on this side of the Atlantic. 
For this reason, and because the number of cases claimed 
to have been cured and benefited by him with this method 
far exceeds that reported by any other operator, and all 
operators together, do I deem it important to cite his 
experiences, meagre though the account be which he has 
thus far seen fit to give us. 
In three short notes under dates of May 3, 6, and 17, 
1876,1 Dr. Von Ehrenstein claims the priority of the electric 
treatment of ovarian dropsy discovered by him, and states 
that the case which first induced Drs. Fieber and Sem- 
eleder to adopt the method had been under his care ; 
ELECTROLYSIS OF OVARIAN TUMORS. 
1 Allg. Med. Central Ztng., 36, 37, 40, 1876. PAUL F. MUND&. 
further, that since 1871, when he discovered this treatment, 
several hundred ovarian tumors have been treated by him 
in this manner, nearly fifty of which were crtred in his es- 
tablishment, while all of the cases treated were materially 
benefited. As a reason why he has never published this 
great invention, he says that he had not considered the 
question sufficiently matured and wished to collect the 
necessary cases. But as the statements of the patients re- 
ferred to have been used as a basis of operations by several 
physicians with less successful results than those obtained 
by Dr. Semeleder, three of the cases having terminated 
fatally, he thinks it incumbent upon him to publish his 
method and cases at an early date. 
For his part he substitutes for Semeleder's peremptory 
" No more Ovariotomy," the modest question : " How far 
do our electro-therapeutical results in each individual case 
enable us to save the patient from the ordeal of ovariot- 
omy ? " A question which he would answer by saying, 
"that henceforth we possess in the science of electro-ther- 
apeutics a remedy against ovarian dropsy which by means 
of its extraordinary freedom from danger and pain, as well 
as the great probability of entire cure and the almost per- 
fect certainty of relief from all discomforts and the impend- 
ing danger to life under all circumstances, calls for a fair 
trial, before undertaking puncture or subjecting the patient 
to the chance of life or death by ovariotomy." A month 
later we therefore find in the same journal1 an article 
entitled, "Additional Explanations and Cases from my Elec- 
tric Institute, in Proof of the Efficiency and Scope of my 
Electric Treatment for the Radical Cure of Ovarian Cysts." 
In this paper Ehrenstein says that Semeleder's announce- 
ment, " No more Ovariotomy," was evidently premature, and 
repeats his opinion that the method, "even after five years' 
experience and a successful trial in hundreds of cases," is 
not yet ready for judgment; he therefore begs his readers 
not to expect as yet a detailed account of his method, 
9 
1 Ibid., 48, 49, 50, 51, June 14-24, 1876. 10 
ELECTROLYSIS OF OVARIAN TUMORS. 
giving as an excuse the haste with which he has been com- 
pelled to appear before the public, the multitude of his other 
duties, and the uncertainty as to how the profession may 
look upon the matter ; and promises to limit himself to an 
exact statement of facts, without indulging in epicritical 
speculations, and to report both his good and bad results. 
Finally, he styles his procedure as " something which is to 
him partly a knowledge, but partly also a personal potency," 
(" Das, was mir zwar halb ein Wissen, halb aber auch ein 
personliches Kbnnen ist"), which it is difficult to repro- 
duce in writing, and closes this introductory explanation 
by the assurance that "Facta loquuntur." He goes on 
to explain at some length the manner in which, the diag- 
nosis of cystovarium having been assured, the exact meas- 
urements of the abdomen are taken, an accurate control of 
the results of the treatment secured, and all errors as to the 
dimensions avoided. He marks with nitrate of silver four 
points on the abdominal surface of the patient, namely, the 
lower tip of the ensiform cartilage, the superior border of 
the symphysis pubis, and the right and left anterior supe- 
rior spinous processes of the ileum. From each and all of 
these points the distance is measured to the umbilicus, both 
rectilinear by compasses, and curvilinear, following the con- 
vex line of the abdomen by tape-measure. Taking the aver- 
age of the two measurements of each of these lines and ad- 
ding them together, a sum total is obtained expressive of the 
exact dimensions of the abdomen, a comparison of which 
with the same measurements made just prior to the next 
sitting, accurately shows the increase or decrease of the tu- 
mor. To be sure, the greater or lesser amount of ingesta 
or of fecal accumulation or flatus may affect any measure- 
ment as compared to the one preceding or following it; but 
this same objection applies with equal force to the ordinary 
measurement by tape-measure around the abdominal cir- 
cumference at different points, and measurement during 
gastric or fecal distention is readily avoided by undertaking 
it only before a meal, and by securing regular defecation. PAUL F. MUN DP. 
11 
The gradual, occasionally rapid, diminution of the cystic 
volume under electric treatment manifested by the meas- 
urements becomes a delightful and undeniable certainty 
when it goes hand in hand with an often marvelous im- 
provement in the general health and physiological life of 
the patient, when she, "as it were, becomes visibly rejuve- 
nated." 
When patients with enormous abdominal distention in- 
capacitating them from walking, with icteric, muddy com- 
plexions, without appetite or strength, anemic, suffering 
from persistent insomnia in consequence of want of exer- 
cise and terror of the inevitably impending ovariotomy, - 
when such patients, soon after beginning the course of elec- 
tricity feel their long-lost appetite returning, recover their 
normal habit of defecation, when profuse discharges of urine 
and perspiration occur without the action of diuretics and 
diaphoretics, when at his (Ehrenstein's) instance they are 
able to take calisthenic, and gradually out-door exercise, 
and thereafter enjoy a natural and refreshing sleep without 
the aid of hypnotics, and regain the functions of respira- 
tion and perspiration to their full extent; then, when they 
fully realize all these marvelous changes, they awake to 
new life, and the conviction of the wonderful effects of the 
electrolytic method forces itself with irresistible power on 
the mind of patient and physician ! 
This improvement in general health to a great extent 
invalidates the information which careful weighings of the 
patient might afford us in estimating the decrease of the 
tumor, for it was found a rule that in proportion to the di- 
minution of the tumor a corresponding increase in weight 
of the remainder of the body took place, which occasionally 
even exceeded the loss of gravity in the pathological growth. 
In this connection Ehrenstein mentions an objection to the 
ordinary method of ascertaining the weight of a body which 
applies to the whole system, namely, that only the absolute 
gravity of the patient's body is ascertained, instead of the 
specific gravity also, thus making a consumptive in the last 12 
ELECTROLYSIS OF OVARIAN TUMORS. 
stages with anasarca weigh more than he did when the dis- 
ease was still in its infancy. How to remedy this defect 
Ehrenstein says neither physicists nor mechanicians have 
been able to tell him. 
Ehrenstein then briefly tabulates eight cases of cure in 
order to show the differences between the measurements at 
the beginning and conclusion of the treatment, and then 
relates one case in extenso - all of these cases I shall 
enumerate hereafter - giving a table of the almost daily 
measurements for two months, with the difference between 
every two measurements, until the final complete cure of 
the patient. 
In the course of this case are interlarded remarks, the 
only ones I have found referring to the peculiar method 
claimed to be employed by him, which I, therefore, think it 
necessary to cite, unsatisfactory though they be. 
The table shows that frequently the diminution in size 
obtained at one electric sitting was annulled at the next. 
This he considers partly evidence of the obstinacy of the 
affection and the difficulty of conquering it, but princi- 
pally the consequence of the formation of hydrogen gas 
in the cyst through electric decomposition, which is soon 
absorbed with no other than occasional colicky symp- 
toms, but never, with his method, can produce peritonitis 
or suppuration. Whatever slight pain occurred appeared 
chiefly on the right side during walking, and was always 
referable to this cause; it never prevented the patients 
from taking out-door exercise. Occasionally the fine needle 
punctures, instead of healing spontaneously as usual within 
twenty-four hours, became superficially inflamed, but readily 
yielded to an ointment of nitrate of silver. 
The two signs which Ehrenstein hails as the " beginning 
of the end," as harbingers of approaching recovery, are, ist, 
the impressibility of the abdomen, even though it still ap- 
pear pretty well filled, which permits the palpating hand 
almost to touch the vertebral column ; and, 2d, a peculiar 
gnawing, hungry, empty sensation in the gastric region, PAUL F. MUNDS. 
a sign which he has observed only in women immediately 
after confinement. In both cases the sensation probably 
originates in the emptying of an elastic cavity, the con- 
traction of which is but slow and imperfect. 
The after treatment following the disappearance or rapid 
diminution of the cyst, when needed, consists in an abdom- 
inal supporter, strengthening abdominal inunctions, and 
chiefly in the regular employment of Faradic electricity 
and calisthenic exercise. With the promise of a speedy 
continuation in a subsequent number, this communication 
closes, and the peculiar method by which the author has 
achieved such splendid results still remains a compar- 
ative secret, for no conclusion of his paper has thus far 
appeared. In a note dated March io, 1877, Dr. Von Eh- 
renstein informs me that his "old infirmity of blindness has 
been supplemented by a distressing nervous affection which 
nearly incapacitates him from speaking, and renders him 
unable to comply with the request I had made of him to 
supply me with the details of his method and his cases. 
Should the course of treatment which he was about to un- 
dergo in Vienna prove successful, he would then gladly 
put the fruits of his large experience at my disposal for 
the propagation in the New World of the electric treatment 
of cystovarium discovered by him." 
I should have waited until receiving the rich fund of ex- 
perience thus promised me in support of the method before 
preparing this paper, had I not thought that the signs of 
the times, in New York at least, called for a speedy revival 
of the question of oophoro-electrolysis, to rescue it from the 
impending depression following Semeleder's first over-zeal- 
ous panegyric and subsequent unfortunate results, pro- 
vided such a rescue be indeed practicable. I have been 
thus explicit in detailing the paper of Von Ehrenstein, and 
shall be equally so in relating the one case carefully reported 
by him, because the marvelous results claimed by him enti- 
tle his assertions to the most marked attention, and because 
I believe the details of his treatment to be of the greatest 
importance. 
13 14 
ELECTROLYSIS OF OVARIAN TUMORS. 
I cannot but deplore his to me inexplicable hesitancy in 
detailing his method on the ground of its not yet having 
been sufficiently tried. I think the profession generally 
will agree with me that a method of treatment by which 
" several hundred ovarian tumors have been beneficially 
treated, and nearly fifty of them cured," is surely suffi- 
ciently mature and well founded to be placed before the 
profession, and that its author commits an injustice both 
towards himself and his method, and towards those af- 
flicted with cystic ovarian disease, by still longer deferring 
the full publication of his experience. 
Scarcely had Ehrenstein published his claim to the pri- 
ority of the treatment in question, before Dr. Theodor 
Clemens of Frankfort-on-the-Main indignantly repelled the 
claim, and asserted1 that he had already treated and cured 
ovarian tumors by electrolysis as early as 1859.2 On looking 
over the various articles written by Clemens on the general 
subject of electro-therapeutics extending from the above 
date, to as recent a period as the middle of the year 1875, I 
find that the method then described by him as well as the 
results claimed by him do not justify him in asserting 
either his priority to the operation of galvano-electropunc- 
ture or an equal success with Von Ehrenstein. 
His first communications treat principally of electro- 
therapeutics in general, interlarded with observations on 
the diminution of purely chronic hypertrophic ovaries by 
electricity, one electrode being placed on the abdomen, the 
other over the sacrum. Of the three cases there reported 
as cures of ovarian tumors, two are instances of this nature, 
and only one is a real polycyst of the ovary. And this one 
was not cured, as the report of the case below will show. 
He says that he uses Daniell's battery, eight to ten elements 
of which are needed before sufficient effect is produced on 
the tumor. The current is passed transversely through the 
1 Allg. Med. Central Ztng. 38, 1876. 
2 Deutsche Klinik, 1859, 5, 27; 1873, 48; 1874, 16, 28; 1875, 6, 7, 
etc. PAUL F. MUNDL. 
abdomen, the zinc pole being placed on one side, the copper 
pole on the other. Before passing the galvanic current, the 
patient was generally subjected to from four to six or twelve 
electric shocks, sent through the tumor from a battery 
peculiarly the author's own. The electrodes are round 
metal plates 4" in diameter covered with double layers of 
linen, wet in rain-water. The patient soon feels a decided 
sensation of warmth in the abdomen and of increasing light- 
ness. The cystic fluid on tapping is found changed both in 
color and constitution, becoming dark and containing larger 
quantities of albumen and tissue-detritus. 
The articles in 1873, and the succeeding years, treat of 
"electric acupuncture," but I regret again not to have been 
able to glean more than a few tangible points from a great 
mass of electro-physical speculation. Clemens uses steel 
(so called Carlsbad), but also copper, platinum, gold, and 
silver needles. The sittings last from five minutes to one 
hour ; in cases of unipolar acupuncture he has even ex- 
tended them to one hour and a half. He divides electro- 
puncture into three varieties: unipolar, when only one 
needle is introduced ; bipolar, when both poles are needle- 
armed and both are introduced ; and electrolytic, when 
certain substances, chiefly iodine, are supposed by electro- 
lytic action to be passed through the tumor. This last is 
an idea which he evidently greatly favors. He says further, 
that electric treatment differs according as it is employed in 
cystic growths or on solid tumors, the latter of which, if ab- 
sorption is to be increased, secretion diminished, or the fluid 
decomposed (on the probability of which processes he casts 
a doubt by affixing a ?), evidently will not prove amenable 
to the treatment. His idea is, that the reducing metamor- 
phosing influence of electricity, particularly the Faradic cur- 
rent, consists in the production of a commotion of atomic 
elements, of a peculiar oscillation or vibration of the mole- 
cules, which changes the intimate construction of the tumor 
and renders absorption possible. 
A thrombosis, or slight inflammation (capillary embolism, 
15 16 
always takes place at the point of insertion of the poles) 
and is generally funnel-shaped, the base of the funnel being 
towards the surface. From these thromboses starts the 
process which results in the atrophy and diminution of 
the tumor, and is evidenced by a slight depression at each 
such spot. 
In the journals at my disposal I was unable to find reports 
of any of the cases promised by him (perhaps I missed 
the numbers containing them ?), and I am therefore obliged 
to close this quotation in as unsatisfactory a manner as I did 
that of Von Ehrenstein. It is unfortunate that both of these 
gentlemen, who claim to be adepts in the science of elec- 
tro-therapeutics and inventors of the electric treatment of 
ovarian tumors, have, in all their writings, chiefly indulged 
in speculations and vague, unsupported assertions, practically 
entirely valueless, instead of giving us definite details and 
directions how to follow their example and popularize their 
great discovery. 
No more positive information do I gain from a letter from 
Dr. Clemens, dated June 3, 1877, in answer to one of in- 
quiry from me. He writes: " I have not answered your 
letter of February 8, 1877, sooner, because up to date I was 
unable to obtain from electro-therapeutists, who claim to 
have cured ovarian tumors by electricity, any details as to 
method or cases. As regards my own experience and re- 
sults, I have cured only two cases out of fourteen treated by 
me by electricity, and you will find details in my book, the 
fourth part of which is now in press.1 For a collation of 
statistical material with the purpose of deciding on the 
value of this method of treatment, it would seem to me that 
the matter is still too new and scarcely as yet above the 
dignity of mere experiment. If the results thus far obtained 
were of value, undoubtedly more would have been published 
on the subject. Whether real electrolysis, or obliteration by 
a subacute inflammatory process induced by electric action 
ELECTROLYSIS OF OVARIAN TUMORS. 
1 Theodor Clemens, Electro-therapetitical Experiences, Frankfort. 
Part iv. has not yet appeared. PAUL F. MUNDE. 
17 
on the vaso-motor system, or both, is to be produced by 
electropuncture, is still an open question, especially as his- 
tologically entirely different tumors come to us for treat- 
ment, the diagnosis of which is by no means easy. Ordinary 
ovarian cysts, ovarian dropsy, occasionally remain unchanged 
for a long while, and not unfrequently undergo retrograde 
metamorphosis ; cases of spontaneous cure even are not 
uncommon in literature. How great must therefore be the 
material and how positive the diagnosis before definite con- 
clusions can be drawn. All my experience on this subject 
is recorded in my work, a resinne of which experience I 
would gladly give you, did its extent warrant its being used 
for scientific deductions. Unfortunately this point is still 
far distant." 
This letter seems to me to afford a, probably involuntary, 
testimonium paupertatis for the practice of oophoro-electro- 
lysis, which, coming from a specialist in electro-therapeutics, 
sounds like a confession of its worthlessness. Certainly, 
a method which is beset with so many uncertainties, the 
value of which will not be definitely assured until we are 
able to diagnose the histological character of each and every 
ovarian tumor before deciding on its treatment, and the 
status of which fifty accurately reported cases do not to 
some extent assure, is too mystical and problematical ever 
to gain a firm hold in therapeutics. 
In striking contrast to the communications of Ehrenstein 
and Clemens is the one from which I am now about to 
quote. 
All the observers whose opinions I have thus far reported 
were warm advocates of the method, and whatever views of 
it might be privately entertained or expressed, no public 
approval or disapproval has manifested itself until quite 
recently,1 when Dr. Ultzmann, tutor in the University of 
Vienna, critically reviewed the subject, supported by experi- 
ments of his own, and expressed his disbelief in the efficacy 
of electricity for the cure of ovarian tumors. His paper 
1 Wiener Med. Presse, 42, 43, 44, 46, 1876. 18 
ELECTROLYSIS OF OVARIAN TUMORS. 
is of such importance, and gives, I think, so clearly and 
truly the facts as seen from the author's eminently ex- 
perimental and practical stand-point, which widely differs 
from that of the gentlemen already referred to, that I deem 
it desirable to give his arguments and deductions at some 
length. 
Ultzmann made numerous experiments with galvano- 
puncture on dead bodies, and on natural and prepared sero- 
albuminous fluids, for the purpose of ascertaining the changes 
which the galvanic current thus introduced would be likely 
to effect in the living body, the results of which experiments 
I will briefly detail as follows : - 
When both poles of a constant galvanic battery, armed 
with platinum needles, are immersed in a sero-albuminous 
fluid, and a strong current passed through them, a develop- 
ment of gas occurs at each needle, which is produced by 
the electrolytic decomposition of the water into hydrogen 
and oxygen, and is more abundant at the negative than at 
the positive pole, the negative pole chiefly attracting the 
hydrogen (or bases, alkalies), the positive pole the oxygen 
(or acid). A perfectly clear filtered fluid from a hydrocele 
will rapidly show cloudiness about the positive pole, which 
under the microscope is seen to consist of delicate flakes, 
which are easily dissolved by alkalies. This cloudiness is 
produced by the coagulation of the albuminates by the acids 
generated about the positive pole. At the negative pole 
no such cloudiness appears. 
The same alkaline and acid reaction accompanies the in- 
troduction of the needles into organic tissues, the tissue 
about the negative needle being gelatinized and solidified, 
as by caustic potash, giving an alkaline reaction, and the 
needle being loose in its canal and easily removable ; while 
at the positive pole the tissue is blackened, charred, dry, the 
slough much smaller than at the negative pole, and the 
needle adheres to the flesh. 
Having thus shown the direct effects of the galvanic cur- 
rent on organic fluids and tissues, Ultzmann goes on to describe the method employed by him in cystic tumors of 
all kinds, particularly hydrocele and ovarian cysts. 
The negative pole of a constant battery of twenty-four 
Leclanche elements, armed either with a gold or platinum 
needle, is passed into the cyst and the positive pole, in the 
shape of a large sponge, is applied to the abdominal wall. 
The needle is ten to twelve centimetres long, and of the 
thickness of an ordinary knitting-needle. The point of the 
needle is three-edged and sharp. Should the abdominal 
wall be very thick, it is best not to risk bending the needle 
by forcing it through into the cyst at once, but only to in- 
troduce it as far as it will penetrate easily, then apply the 
current and push it into the cyst only when the peculiar 
chemico-galvanocaustic circle appears around the needle ; 
the complete introduction is then always easy. The sit- 
tings last from ten to thirty minutes, and if well borne may 
be repeated every day or every other day, otherwise every 
three or four days. The strength of the current will depend 
on the susceptibility of the patient, but the stronger it is 
used the greater will be the effect. Should it at any time 
be impossible to pass the needle entirely into the cyst, then 
even the strongest current will be ineffectual in reducing the 
size of the cyst. 
Now, Ultzmann has found that these cysts, which are 
amenable to the electrolytic influence, especially hydroceles, 
are benefited and cured thereby often with astounding 
rapidity. But with ovarian cysts his experience is differ- 
ent, and he has come to the conclusion, that the albumi- 
nates in the contents of ovarian cysts are not capable of 
being so changed by electrolysis as to render them prone 
to absorption by the cyst wall ; neither does he believe that 
the secreting power of the cyst wall can be so altered by 
the galvanic current as to render it an absorbing mem- 
brane. The result of his observations is, that the effect of 
electrolysis depends chiefly on the physical and chemical 
character of the cystic contents in each individual case, 
and that only those ovarian cysts which (like hydroceles) 
PAUL F. MUND£. 
19 20 
contain a watery sero-albuminous fluid are benefited by this 
treatment. Such cysts are frequently seen in young, vigor- 
ous women ; they possess very thin walls, and are usually 
found to spring from the parovarium, that is, they are cysts 
of the broad ligament, the fluid of which consists of an 
aqueous solution of chloride of sodium and carbonate of 
soda, with small quantities of albumen, sulphates, and phos- 
phates, and are known to be cured often by simple punc- 
ture. Other cysts, with slightly more albuminous, but per- 
fectly clear fluid contents, are still benefited by electro- 
lysis. But those cysts which enclose a thick, viscid honey- 
like fluid, containing a large amount of mucin paralbumen 
and seralbumen, are entirely inappropriate for electrolytic 
treatment, and scarcely diminish under the strongest cur- 
rents. 
In those tumors, finally, the contents of which consist of 
decomposed blood or pus, the fluid appearing brownish-red 
or greenish-red, depositing a thick sediment, and showing 
microscopically large quantities of blood and pus corpuscles, 
the electrolytic procedure is positively contra-indicated 
and injurious, producing at once symptoms of peritonitis 
which may endanger the life of the patient. Such a case is 
related by Ultzmann as occurring in his own practice, and 
will be found below. 
By means of an experiment with electrolysis on the fluid 
of a hydrocele, Ultzmann satisfied himself that electrolysis 
is entirely incapable of rendering the albuminates of that 
fluid, which are ordinarily unable to pass through the sur- 
rounding membranes, capable of doing so ; further, that 
neither the water nor the salts of the fluid are alone ab- 
sorbed by the current, for the specific gravity and relative 
constitution of the fluid from the hydrocele after electroly- 
sis was exactly the same as before the treatment, although 
the hydrocele had diminished to one half its size within 
twenty-four hours after the sitting. In short, neither the 
coagulated albuminates nor the water and salts of ovarian 
cysts with seralbuminous contents are absorbed by the 
ELECTROLYSIS OF OVARIAN TUMORS. lining membrane of the cyst wall as it is, nor is the func- 
tional power of the cyst wall so changed by the influence of 
electrolysis as to permit of its absorbing these substances. 
How, then, explain the statement that certain ovarian cysts 
with clear, thin, seralbuminous contents are cured by this 
treatment ? Ultzmann offers a very ingenious, and, I think, 
plausible explanation, the idea of which was given him dur- 
ing his observations of electrolysis of hydrocele. As has 
already been stated, the needle puncture is a gaping pat- 
ent canal through which the fluid readily escapes when 
the needle is withdrawn. Should the outer opening now 
become agglutinated before the inner aperture, or be closed 
by adhesive plaster, as is usually done, the fluid will escape 
into the cellular tissue, be thence absorbed, and the hy- 
drocele cured. The same facts apply to the electrolytic cure 
of ovarian cysts. The thin cystic contents escape through 
the gaping opening into the peritoneal cavity, and being 
bland and innocuous, are gradually absorbed without ex- 
citing any reaction. This outflow of the fluid is assisted 
by the formation of hydrogen gas in the cyst. 
" We now clearly understand why electrolysis achieves 
its greatest triumphs in cysts with thin sero-albuminous 
contents ; why with thick, viscid, honey-like fluid no result 
is obtained ; and why finally with hemorrhagico-purulent 
contents peritonitic symptoms make their appearance. 
" In the first case an absorbable serous fluid, non-irrita- 
ting to the peritoneum, exudes into the peritoneal cavity - 
rapid success ; in the second case, none of the cystic con- 
tents reach the peritoneal cavity, because their thick, viscid 
consistency prevents their passing through the narrow, 
although cauterized, puncture - no result; and finally, in 
the third case, a fluid no longer indifferent, but more or 
less irritating, flows into the peritoneal cavity, and peri- 
tonitic symptoms of greater or lesser degree result - 
failure." 
Insulated platinum needles were never used by Ultzmann, 
but he believes that the punctures made by them, although 
PAUL F. MUNDE. 
21 22 
not cauterized, will still remain patent (the needles be- 
ing three-edged and thick) long enough to permit the 
escape of a portion of fluid into the peritoneal cavity. 
Ultzmann denies the statement that galvano-puncture 
does not produce adhesions of the cyst with the omentum 
or anterior abdominal wall, for in one of the cases ovarioto- 
mized by Rokitansky, Jr., which had before been electro- 
lyzed by Benedict, extensive adhesions were found, the 
situation and firmness of which corresponded perfectly 
with the seat of the punctures and the time elapsed since 
the treatment ; and it would be strange if the caustic effects 
of electro-punctures should not be followed by adhesions, 
when we consider, that the latter are often found to arise 
in consequence of simple tapping. 
But the cystic fluid is also changed by electrolysis. 
Ultzmann, in one case, after a long course, found abundant 
pus corpuscles in the fluid, which diminished gradually as 
the time increased since the electrolysis, appearing but in 
small amounts at the second tapping, after six months, and 
having entirely disappeared after twenty months. 
Ultzmann, now assuming the above-mentioned theory to 
be true, very properly asks : " Is it more advantageous or 
advisable to treat an ovarian cyst by electrolysis, or is it 
better merely to tap and empty it ? " and answers it by say- 
ing that on general principles it is always desirable to pre- 
serve to the body its most precious constituents, the albu- 
minates ; therefore, electrolysis should be preferred to tap- 
ping. But, on the other hand, the electrolytic treatment 
is efficacious only in sero-albuminous cysts, and is danger- 
ous in those with less fluid contents ; it is tedious, more or 
less painful, and, above all, sadly uncertain as to the ultimate 
result, for Ultzmann claims to have seen many patients, 
who are dismissed apparently cured after electrolytic treat- 
ment, return with their tumors as large as ever. 
The electrolytic treatment of ovarian cysts, therefore, pro- 
duces no radical cure, but consists merely in a painful pal- 
liative procedure, to which tapping is for many reasons to 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUND&. 
23 
be preferred. A patient, who before the electrolytic course, 
would probably have stood an excellent chance by ovari- 
otomy, perfected as that operation has lately been, would be 
scarcely likely to consent to the removal of her tumor 
with her whole abdomen covered with cicatricial tissue or 
sloughs from the caustic positive pole, or with probable 
adhesions of the cyst to the anterior abdominal wall or to 
the intestines. 
In view of all these facts Ultzmann arrives at the conclu- 
sions, that i, Electricity is not a radical cure for ovarian 
tumors ; 2, Electrolysis is nothing but a protracted method 
of painful puncture, by all means inferior to simple punc- 
ture with a trocar; 3, Electrolysis is likely to do more 
harm than good. 
Dr. George M. Beard, of New York, has very recently 1 
published a few "Practical Points in the Electrolytic Treat- 
ment of Cystic and Fibroid Tumors," in the course of 
which remarks he says, " that the object of using electro- 
lysis in cystic tumors is not the decomposition of the fluid 
constituents, but the stimulation of the secreting surface so 
as to prevent further secretion and aid absorption." It 
will be remembered that, while Semeleder strives to attain 
both of these objects, Ultzmann's experiments go to show 
that the fluid may be decomposed, it is true, but that it is 
thereby in no case rendered more easy of absorption, and 
that the galvanic current is incapable of influencing the 
secreting and absorbing powers of the endothelium of the 
cyst-wall. If Dr. Beard's purpose is practicable, then it 
would seem as though those tumors possessed of the great- 
est amount of secreting and absorbing surface, notably 
polycysts with numerous compartments and trabeculae, 
would be most easily influenced by electrolysis, and not the 
thin-walled unilocular cysts, claimed by Ultzmann to be the 
only ones amenable to this treatment. It will remain for 
me to show, if possible, which opinion is borne out by the 
facts, so far as known. 
1 New York Medical Record, March, 1877. ELECTROLYSIS OF OVARIAN TUMORS. 
24 
Beard further remarks that, during electrolysis of cystic 
tumors, the fluid sometimes flows out of the negative nee- 
dle puncture during, or directly after, the operation ; but 
that this discharge, and the consequent shrinkage of the 
tumor, is a temporary matter, unless something has been 
done to prevent the secreting process. 
According to Beard, " a battery composed of a small 
number of cells of moderate size is the one required in the 
electrolytic treatment of solid uterine fibroid, fibro-cystic, 
and also ovarian tumors." The actual decomposition of 
tissue, the electrolysis, is really the least important fact in 
the rationale of the so called electrolytic treatment of this 
class of tumors ; the great thing is the indirect modification 
of nutrition through the nerves. A battery in which the 
chemical action goes on feebly and slowly, such as in the 
Daniell's cell and its modifications, which affords the stim- 
ulating action of the electricity with but slight electrolysis, 
must therefore present some advantages. 
Under the head of comparative prognosis of the various 
classes of tumors by electric treatment Beard places, sec- 
ond, " Benign Cystics. Including ' weeping sinews,' hydro- 
cele, and possibly, also, small ovarian tumors," etc.; not 
a very enthusiastic recommendation, it would seem to me. 
Still, a few lines above, he says, that " ovarian tumors, if 
treated cautiously and judiciously, with proper apparatus, so 
as not to excite suppuration or cause inflammation, offer, to 
say the least, an encouraging field of experiment; and the 
probability is, that a certain proportion of cases, if taken be- 
fore too great a size is obtained, will be radically cured in 
this way. Generally, however, these cases are not seen 
early There may have been failures in the past, where 
in the future there will be partial or complete successes. 
There need be, ordinarily, no danger in electrolyzing these 
cases, provided the conditions and cautions here suggested 
are not forgotten. In this, as in other applications of elec- 
tricity, the greatest mistakes are made in overdoing the 
treatment, in attempting to concentrate everything in a 
short time, and in treating all cases alike." PAUL F. MUNDE. 
With these quotations I have exhausted the modern lit- 
erature on the subject, so far as I am able to learn. In 
order, now, to arrive at a positive conclusion as to the cura- 
tive value of the electrolytic treatment of ovarian tumors,- 
if such a conclusion, pro or con, be indeed possible at this 
period with the unfortunate lack of detail in the communi- 
cations of the man whose experience, the largest on record, 
I have above quoted, - I have thought it best to place the 
question entirely on its merits by collecting and reporting 
all the cases in which the method has been intelligently and 
fairly tried by reliable and competent observers. These 
cases I have subdivided into five classes, namely, -- 
A. Cases in which a complete cure was obtained. 
B. Cases in which decided and permanent improvement 
only was observed. 
C. Cases in which the improvement was only temporary. 
D. Cases in which electrolysis produced no perceptible 
effect whatever on the tumor. 
E. Cases in which decided injurious results accompanied 
or followed the electrolytic treatment. 
(a) Peritonitis, or other unpleasant symptoms, ending in 
recovery. 
(£) Peritonitis terminating fatally. 
A comparison of the number of cases in each of these 
five classes, with a consideration of their individual pe- 
culiarities, will, I think, give us, at least, some definite idea 
of the present position of the question. 
These cases comprise all which I have been able to col- 
lect either from the periodical literature or through the 
kindness of members of the profession, to whom I made 
known my intention personally or through the columns of 
the "New York Medical Record." To those gentlemen 
who kindly forwarded to me their unpublished cases for 
unrestricted use in this paper, and to all who have aided me 
in my labors, I herewith express my sincere thanks. 
The unpublished cases are reported in detail as given me 
by their authors ; those already printed elsewhere have been 
abbreviated as much as practicable. 
25 26 
ELECTROLYSIS OF OVARIAN TUMORS. 
A. Cases in which a Complete Cure was obtained. 
Case I. E. Cutter, Cambridge. - Bilocular cyst, thin 
walls; one insulated needle at three sittings; treatment 
continued by daily external galvanization alone. No sign 
of tumor to be detected after two months' treatment. (Un- 
published.) 
Miss L., 34 years, enlargement first noticed ten months 
ago. Suffers from dyspepsia, vaginismus, and abdominal 
pains. Nervous temperament ; weak constitution. Dys- 
menorrhea. Large fluctuating tumor extending to ensi- 
form cartilage ; distinct wave. Aspiration produced a 
greenish, sticky liquid, of saltish taste, showing, under the 
microscope, the granules of Gluge and Drysdale, epithelium 
and fat. Diagnosis unquestionable. 
February 15, 1877. Insulated needle with negative pole ; 
positive pole with zinc button on abdomen; ten cells for 
three minutes. Cutter battery excited with strong cider 
vinegar. 
February 18. Measured thirty inches around most prom- 
inent part of abdomen. Sitting as before, four minutes. 
February 21. Circumference 29". Can stand up straight, 
which she had not been able to do before. Abdomen 
wrinkled. Tympanites over upper part of tumor. Battery 
seven minutes, as before. Little pain. The battery was 
left with her with instructions to use it two hours every day 
by the percutaneous method, that is, simple application of 
two copper quadrangular electrodes to the abdomen. This 
was continued throughout the case. 
February 24. Found her quite sore; painful to cough 
over a circular area of i|" radius with the site of the 
puncture as a centre, but no objective signs of inflam- 
mation. Abdomen enlarged to 30". It was decided to 
desist from acupuncture, and to rely upon the cutaneous 
method alone. This was done till March 10, when it was 
replaced by a Hall's French C. and Z. battery with in- PAUL F. MUND A. 
27 
duced current, which decomposed water. Measured 29^". 
Tension less. 
March 21. Measured 30. Abdomen distended and 
tympanitic. Great gastric disturbance. As a relief to the 
patient's fancy, as much as for real necessity, an aspirated 
needle was introduced, and less than one pint of greenish 
fluid withdrawn, which was slightly flocculent. From the 
difficulty in finding a distinct area of dullness, and from 
the general tympanites and the small amount of fluid with- 
drawn, it was inferred that the great abdominal distention 
was due to tympanites, and that the cyst really was much 
diminished. Extract of malt, pepsin, bismuth, and strych- 
nia, chlorodyne. Faradisation continued, one to three hours 
daily. 
March 27. Much better, appetite improved; measures 
28". Much tympanitic percussion, small area of dullness, 
slight wave impulse. 
April 2. Circumference 28". Form erect. Abdomen 
tympanitic throughout; no wave nor globar tumor to be felt 
nor detected. 
April 6. Circumference 27". General health improving 
rapidly. 
April 13. Absolutely no sign of tumor to be detected; 
no wave, no dullness, no globar mass, only still slight in- 
crease in size of abdomen. Vaginismus gone, menstruation 
normal. 
May 7. Has come down to normal size ; abdomen tym- 
panitic throughout. Danced at May-day festival twice. 
Case II. E. Cutter, Cambridge, Mass. - Large uni- 
locztlar cyst. Two sittings, four and two needles, once thirty 
and once thirteen cells. Oozing from aspirated pimcture, 
slight inflammation arotmd that ptmcttire. Almost entire 
disappearance of cyst. 
Mrs. S., 24 years of age, nullipara, colored. Duration 
of present illness four years. Enormous symmetrical en- 
largement of abdomen, measuring over umbilicus and crests 
of ilia fifty-eight inches. Great weight and distention. 28 
ELECTROLYSIS OF OVARIAN TUMORS. 
The diagnosis of ovarian disease was concurred in by the 
physicians named in the preceding case. General health 
good. 
November 12, 1876. Aspiration of one pint of turbid 
fluid resembling urine, taste saltish, of ropy adhesive con- 
sistency. The microscope showed fat globules, granular 
ovarian cells of Drysdale, compound granular gorged cells 
of Gluge, and epithelium. Heat and nitric acid showed an 
abundance of albumen. When acted upon by ten cells of a 
galvanic battery, the cystic fluid showed no signs of fila- 
mentous coagulation, but the needles were simply coated 
with whitish-looking gas-bubbles. 
First application of electrolysis; Fleming and Talbot's 
carbon-zinc battery, plates 3" X f". Thirty cells were used, 
and four needles passed into the tumor, and the current 
sent through for five minutes. Two needles were intro- 
duced in the left and two in the right side. One of the 
needles was the aspirator needle, the smallest of the set, 
nickel-plated. No reaction. 
November 14. Second and last operation. The abdomen 
shining, wrinkled, and lessened in size. The puncture made 
by the aspirator needle has continuously oozed since the 
operation. Judging from the absence of tenderness over 
the abdomen and the diminished size and mobility of the 
tumor, it appeared that the fluid had not discharged into 
the peritoneal cavity. It could not be decided whether the 
diminution was entirely due to the oozing. The punctures 
made by the three insulated needles were all completely 
healed and of course did not ooze. This point is worthy of 
note and remembrance. Two needles, one on each side; 
more sensitiveness to the puncture than the first time. 
The full power of the battery, thirty cells, was connected 
but instantly broken, as it was too painful. The current 
was commenced at one cell and gradually increased to thir- 
teen, which seemed to be the limit of tolerance. Current 
passed five minutes. She walked home, as before, with 
ease. PAUL F. MUNDE. 
29 
November 18. The aspirated opening ceased to ooze. 
November 25. This closure was followed by a chill, fever, 
accelerated pulse with circumscribed tenderness, swelling 
and hardening about the aspirator puncture. Opiates and 
rest for three days relieved these symptoms and her present 
condition is as follows : Feels as well as ever ; abdomen 
puckered, like elephantiasis ; curiously wrinkled appearance 
around the puncture, with depression at the site of each 
hair. A great deal of the pendulous abdomen is fat in the 
areolar tissue. The cyst could be felt underneath the adi- 
pose to the right of the navel ; it was globar in shape and 
apparently 6" in diameter. Measure, 42," against 58" thir- 
teen days before. 
November 28. At aspirator puncture, formation of an 
abscess which discharged about one pint of pus. No cyst 
now discernible. 
December 6. Absolutely no sign of ovarian cyst. 
December 13 and 21. Adipose diminished. In dorsal 
decubitus hardish, rounded, mass, 3" in diameter, palpable 
to the right of the umbilicus. 
January 19, 1877. Tumor somewhat larger. 
February 8. Tumor hard, inelastic, apparently six inches 
in diameter. Gives no trouble. 
February 20. Gone to service as cook. Tumor not 
fluctuating ; no pain. Health good; feels entirely relieved. 
Case III. Von Ehrenstein, Dresden. - Mziltilocular 
cyst, fluid contents; forty-three, sittings in two months. 
Complete and permanent cure} 
Mrs. K., of B., admitted to Ehrenstein's electric estab- 
lishment July 23, 1873 ; discharged cured, September 27 of 
the same year. Multilocular ovarian cyst with considerable 
free ascites. No particular history, except certainty of long 
existence of tumor, which formerly increased gradually. It 
protruded chiefly on the left side, and was increasing so rap- 
idly within the year as to jeopardize digestion, respiration, 
and abdominal circulation. Solid masses or adhesions were 
1 Allg. Med. Central Zeitg., 1876. 30 
ELECTROLYSIS OF OVARIAN TUMORS. 
not discernible. The sittings began July 24th, and were 
continued without interruption till her discharge, six ap- 
plications being made in July, eighteen in August, and 
nineteen in September. The movements of the abdomen 
frequently showed a temporary increase in volume after the 
sittings, which Ehrenstein attributes to the electric forma- 
tion of hydrogen in the cyst; but also a steady diminution 
of the tumor. Occasionally colicky pains, chiefly on the 
right side, were experienced, doubtless due to the same 
cause, but there was never the least sign of peritonitis. 
A few of the needle punctures became locally inflamed, 
but were readily cured by an ointment of nitrate of silver. 
After the third sitting an unaccountable profuse diuresis 
took place accompanied by a marked decrease of the ab- 
domen. No cystic fluid escaped through the abdominal 
walls at any time, but the originally tense abdominal pari- 
etes became lax, after the third day, particularly in their 
upper portion, so as to render the formerly hidden points 
of the false ribs easily palpable, and a splashing motion 
became perceptible in the abdomen at each movement of 
the patient. These attacks of profuse micturition were 
repeated during the whole month of August, at intervals of 
twelve hours to three days, without, however, producing 
debility, because the development of a strong appetite ren- 
dered the patient better able to bear the drain on her sys- 
tem and the improved condition of the blood prevented the 
rapid refilling of the cyst by transudation of its watery 
constituents. The usual diaphoretic tendency did not ap- 
pear in this case, but on August 29, an intense itching 
of the abdominal epidermis showed itself, unaccompanied 
by an eruption, or by a change of temperature or color. 
But the dry hand or a dry warm plate of glass applied to 
the skin at once demonstrated the presence of a continuous, 
almost imperceptible, moisture, which was neither actual 
perspiration, nor transudation from a puncture, and could 
be looked upon as nothing else than so called " perspiratio 
insensibilis." The beneficial diuresis in the meanwhile having ceased, Ehrenstein restored it by a mixture of squills, 
digitalis, and oil of juniper. Soon the first signs of ap- 
proaching recovery presented themselves, namely, (i) even 
with a still quite distended abdomen, a distinct compressi- 
bility of its walls, which permitted the hand to bury itself 
in its folds and penetrate even to the vertebral column ; and 
(2), a peculiar sensation of emptiness, gnawing, similar to 
that of hunger, experienced in the abdomen ; both of these 
signs produced no doubt by the evacuation of the elastic 
cavity, the cyst. The Faradic current was now substituted 
for the constant ; the gastric pains soon subsided ; the tu- 
mor diminished in the two weeks from September 13, to 27, 
from 66.75 centimeters to 58.25 cm., whilst the whole time 
from July 24 to September 13 had been required to re- 
duce it from 75.25 cm. to 66.75 cm., the electric treatment 
being the same. September 27, patient was discharged com- 
pletely cured, has since married, and up to date of report 
(June 24, 1876), had continued perfectly well. 
PAUL F. MUNDE. 
31 
Cases. 
Name. 
Dimensions of 
Abdomen in 
Centimeters. 
Percentage of De- 
crease in Volume. 
Percentage of Change 
in Weight of Body. 
Remarks. 
On Admis- 
sion. 
At Dis- 
charge. 
IV. 
Miss M., of H., North 
Germany .... 
178.62 
89-75 
49-67 
30.75 
Complicated with rheu- 
matism. 
V. 
Mrs. L., of Ch. . . . 
no-75 
60.75 
45-15 
i-53 
Confined of a healthy 
girl fourteen months 
after cure. 
VI. 
Mrs. V., of D. . . . 
90.00 
60-75 
32-50 
1.83 
Two years after cure 
also confined of a 
girl. 
VII. 
Mrs. V. H., from Russia 
79-75 
56-37 
29.32 
11.80 
- - 
VIII. 
Mrs. T., from Russia . 
127.12 
87-50 
- 
- 
70 1-4 years of age. 
IX. 
Mrs. K., of B., in M. . 
75-25 
58-25 
22.59 
8.04 
- - 
X. 
Miss K., of P., in M. . 
109-75 
87-75 
20.04 
- 
Complicated by mi- 
tral insufficiency. 
XI. 
Miss B., of D. . . . 
77-25 
63-75 
17-49 
9-29 
" - 
Ehrenstein offers to request permission of these ladies 
to give their addresses to any physician desirous to make in- 
quiries as to the correctness of the above. 32 
Case XII. F. Fieber, Vienna. - Multilocular cyst, 
non-fluid contents; numerous sittings; reduced to size of 
small apple ; considered cured? 
Patient 32 years of age; tumor of the size of an adult 
head, irregular, nodular, extending half an inch above the 
umbilicus. Prof. Carl Braun confirmed the diagnosis of a 
multilocular ovarian cyst, with non-fluid contents, the extir- 
pation of which he considered impracticable. Electrolysis 
was performed by Professor Braun himself the first time, 
then a number of times by Fieber. Reaction very moder- 
ate. The points of insertion of the needles were changed 
constantly, and finally extended all over the surface of the 
tumor. The tumor was finally reduced to the size of a 
small apple, a fact corroborated by one of the assistants 
of Professor Braun, who had seen the tumor in its original 
size. Patient subsequently married ten years ago. 
Case XIII. F. Fieber. - Large cystic tumor; perma- 
nent recovery?' 
Lady sent by Professor Braun ; a cystic tumor of the 
ovary existing for years, considerably larger than an adult 
head, was completely removed by electrolysis, the last 
puncture having been made a year previous to the report- 
ing of the case. The tumor as such had entirely disap- 
peared, leaving only a funicular remnant, and some dullness 
on percussion. Further particulars are not given. 
Case XIV. F. Semeleder, Mexico.- Large cyst, thin 
walls. Five months treatment, almost daily. Complete cure. 
Young lady, unmarried, 18 years of age; tumor noticed 
for several years ; latterly rapid increase. Tumor reached 
three centimeters above the umbilicus, dull on percussion ; 
walls of tumor apparently thin, but it was very tense, fluctua- 
tion therefore not perceptible. Circumference 2" below um- 
bilicus, 96 centimeters. Treatment commenced April 29, 
1875, and continued nearly daily, even during menstruation, 
to July 26. Then the abdomen measured 92 centimeters 
ELECTROLYSIS OF OVARIAN TUMORS. 
1 Wiener Med. Presse, 1874. 
3 Wiener Med. Presse, 1874. PAUL F. MUND^. 
11 The treatment was continued in Puebla, and over two 
months more were required to make the cure complete." 
Case XV. F. Semeleder. - Unilocular cyst; reduced 
to the size of an orange in six weeks. Perfect recovery. 
Married lady, 24 years of age, two children ; for two years 
past had noticed tumor in left side of abdomen. When 
first seen tumor was of the size of the head of a child ten 
years of age, and quite soft. The diagnosis of ovarian cyst 
had been made and confirmed by several physicians. Treat- 
ment was commenced May 27, 1875, and continued till 
July 5, when the tumor was reduced to the size of an 
orange, and perfectly hard, and the patient returned home 
perfectly well. 
Case XVI. F. Semeleder.-Large, probably multiloc- 
tdar tumor; so much reduced after six weeks' daily treat- 
ment as to render continuance of treatment unnecessary. 
Dimensions not stated. 
Patient 40 years. Cyst of left ovary extending to the 
ribs on the left, to the umbilicus on the right side ; quite 
soft. Length of time of growth could not be ascertained. 
After daily treatment for six weeks the tumor was so much 
reduced that it seemed unnecessary to continue it. 
Case XVII. F. Semeleder.- Thin-walled, probably 
unilocular cyst; eight weeks' treatment; cyst so shrunken as 
to be no longer recognizable. 
Patient 38 years, married; soft, fluctuating tumor acci- 
dentally discovered on the left side of the abdomen, extend- 
ing to within two fingers' breadth of the umbilicus. Walls 
thin. Eight weeks' treatment during summer, 1875 5 cyst 
reduced to a small solid mass not recognizable as the re- 
mains of an ovarian cyst. 
Case XVIII. F. Semeleder. - Cyst with thick walls, 
and contents ; size of large cocoanut. Reduced to size of an 
egg, solid, after four weeks' treatment. Complete czire. 
Patient 45 years, one child twenty-four years before. 
Nervous hysterical temperament. In November, 1875, a 
tumor of the size of a cocoanut was discovered occupying 
33 the left side of the abdomen, quite low down. It had a 
dense feel, with obscure fluctuation. Diagnosis not quite 
certain, but the impression was that it was an ovarian cyst, 
with thick walls and thickish contents. Although the diag- 
nosis was uncertain, by express desire of the patient, elec- 
trolytic treatment was commenced, which up to Dr. Sem- 
eleder's departure from Mexico, had produced no results. 
The treatment was continued by Dr. Schmidtlein, who in 
May, 1876, reported to Dr. Semeleder that the liquid had 
been completely absorbed, and the cyst reduced to a hard 
lump of the size of an egg. Time of treatment four weeks. 
Case XIX. Dr. Plym S. Hayes, Chicago. - Multilocular 
sero-cystic tumor. Fottr sittings ; once, two needles, three times 
only one needle, always negative. General galvanization. 
Disappearance of left lobe of cyst in six weeks ; accidental 
rupture of right lobe. Complete disappearance of both lobes. 
Cure} Sequel: Return of tumor, or new tumor, two years 
later. Disputed points. Ovariotomy; small, solid tumor 
found. Death. 
Miss S., a medical practitioner, aged 40. Tumor first 
noticed about December 1, 1873 ; the patient can trace 
three distinct lobes. General health formerly good, but 
failing since discovery of tumor, which then was of the size 
of an orange. 
March 11, 1874. The abdomen was as large as that of 
a woman five months pregnant, the tumor extending i|" 
above the umbilicus, the three lobes distinctly palpable. 
For two weeks prior to this the patient had used the electro- 
thermal bath and the Faradic current had been passed 
through the tumor frequently, a treatment by which the 
general health of the patient was improved, and the tumor 
somewhat diminished in size. 
March 13. Electro-puncture commenced, Dr. A. Reeves 
Jackson introducing the needles, one of which was insu- 
lated, the other non-insulated, and both connected with the 
negative pole; the insulated needle was passed into the 
34 
ELECTROLYSIS OF OVARIAN TUMORS. 
1 Chicago Med. Jour.., September, 1874. PAUL F. MUND A. 
right, the non-insulated into the left cyst. The positive 
electrode, a moist sponge, was placed over the right sacro- 
iliac articulation. The current of twenty-one Hill ele- 
ments (with a galvanometer and rheostat in an accessory 
circuit, with a resistance of 2,100 B. A. units, and that of 
the galvanometer coil in this circuit) was applied for three 
minutes, and the nine elements added, and the whole thirty 
given for twelve minutes longer. The skin became whit- 
ened and raised around the uninsulated needle, but re- 
mained unchanged around the insulated one. A few drops 
of clear, serous fluid exuded on the withdrawal of the insu- 
lated needle. For two days and three nights following the 
operation there was marked diuresis and diaphoresis; no 
pain. 
March 14. Electrical treatment; feet in warm water in 
which positive electrode was placed, while the negative 
sponge electrode was applied over the abdomen for five 
minutes with a current of twenty-one elements. Then the 
negative was placed in the foot-bath, and the positive held 
in the hands for ten minutes. This treatment was repeated 
on the following afternoon. 
MarcJi 21. Since March 16 she is able to dispense with 
the lunch between her regular meals made necessary by the 
former rapid growth of the tumor. Left the city for three 
days. 
March 23. One insulated needle in right cyst, thirty 
elements for twelve minutes. Again marked diuresis and 
diaphoresis for two days. 
April 9. Insulated needle into left cyst, thirty elements, 
fifteen minutes. No diuresis, but gentle perspiration for 
some time. 
April 18. Fourth and last operation. Insulated needle 
into right cyst, thirty elements, fifteen minutes. Distinct 
fluctuation in right lobe, left lobe scarcely distinguishable. 
April 24. Has just ceased menstruating ; tumor appears 
as large as before last operation. 
April 26. The tumor has diminished much in size. 
35 36 
ELECTROLYSIS OE OTA RIA M TUMORS. 
April 29. Examination by Dr. Jackson : " The left cyst 
could not be found." While using considerable force in 
trying to ascertain size and position of the much-diminished 
right cyst, it was ruptured with an audible sound. Fol- 
lowing the rupture there was dullness of percussion at the 
most dependent portion of the abdomen. No systemic dis- 
turbance followed the rupture. 
May 1. More urine voided during the last two days than 
usual. No tumor to be detected, but the ovary somewhat 
enlarged. 
June 20. No tumor; right ovary displaced to the left 
and somewhat enlarged ; no fluctuation and whole abdomen 
tympanitic. Menstruation regular, general health excel- 
lent. The electro-thermal bath was used during the inter- 
vals between the operations as a constitutional tonic. 
July 21. No cysts to be found when examined by Dr. 
Jackson. 
Dr. Hayes concludes : " We consider that the operation 
is attended with no more danger than is the introduction of 
the needle of an aspirator." 
There is, however, a sequel to this case, one account of 
which I find in a small work by Dr. Justin Hayes, entitled 
"The Electro-Thermal Bath," Chicago, 1877, p. 88, seq. 
March 31, 1876, nearly two years after the cure above 
reported, the patient again presented herself with a new 
enlargement of the abdomen. This Dr. Hayes diagnosed 
as free ascites, not being able to detect the least sign of a 
tumor. The electro-thermal bath and diuretics taken for 
two months produced no appreciable change ; on the con- 
trary, she then began rapidly to increase. Several other 
physicians saw the case and detected a sero-cystic ovarian 
tumor, which diagnosis was confirmed by the microscopic 
examination of the fluid by a competent microscopist, who 
found ovarian cells in the fluid. This proof, generally con- 
sidered tolerably conclusive of the presence of an ovarian 
cyst, did not convince Dr. Hayes of the incorrectness of his 
diagnosis of simple ascites, for he explained the presence of PAUL F. MUND^. 
37 
the corpuscles by assuming that they escaped into the ab- 
dominal cavity when the galvano-puncture was used, or when 
the small cyst burst, or at a later period from some relic of 
the old cyst. In this view the patient is said to have coin- 
cided. Notwithstanding, the diagnosis of ovarian tumor 
was persisted in, and a radical operation proposed and ac- 
cepted. As Dr. Hayes puts it, " The result was a formi- 
dable operation for ascites, without finding an ovarian cyst; 
also cauterization of the right ovary, and the removal of the 
left ovary, which measured when spread out on paper and 
outlined i|" by 2|", and showed marks of disease." The 
patient died December 6, eleven days after the operation, 
and before her death demanded an autopsy, which revealed 
extensive wasting of the omentum, and inflammation of 
the peritoneum, also fatty degeneration of the kidneys. 
Nothing is said of the finding at the autopsy of relics of 
the multilocular ovarian tumor supposed to have been cured, 
of which one would expect to see traces, nor is a reason 
given for the rather unusual proceeding of cauterizing and 
returning the right ovary. That there are two sides to this 
question, and that the reproach of an error in diagnosis 
made against the physicians last in charge of the case is 
unfounded, would appear from the following letters from 
these gentlemen, and from Dr. Wm. H. Byford, of Chicago, 
to whose kindness I owe what seem to be the facts in the 
case. As the case has been repeatedly quoted as an in- 
stance of cure by electrolysis, and thus fraudulent capital 
unintentionally made for that treatment, I think it impor- 
tant to publish these letters verbatim, finding it impractica- 
ble to give their full import by abstracts. 
Ottawa, Illinois, May 28, 1877. 
Prof. Wm. H. Byford, - 
Dear Doctor, - By request of Dr. John E. Owens, of Chi- 
cago, I write you to give you our reasons why we diag- 
nosed Miss P. A. S.'s case, one of ovarian tumor. For a 
more minute history in the earlier stages of her case I refer 38 
you to the "Chicago Medical Journal," of September, 1874, 
where you will find a report of the case as made by Dr. 
P. S. Hayes of your city. You will please note that some 
of the details I do not report as he does ; he may be right 
and I wrong. I depend upon what Miss Shotwell told me 
at a time more distant from the inception of her disease 
than his report, therefore I say he would be more likely to 
be right than her report to me ; still I report it as it came 
to me. 
Miss P. A. S., by profession a physician, her age would 
have been forty-three on January 4th, 1877. On the morn- 
ing of December 1, 1873, before rising, she. discovered in 
the lower part of the left lumbar region a tumor the size of 
a fist. Her menstruation commenced between the years of 
thirteen and fourteen, and continued regular up to the time 
of the discovery of the tumor. She had been troubled with 
leucorrhea more or less for the preceding fourteen years. 
From the 1st of December, 1873, to about the middle of 
February, 1874, she watched the steady growth of the tu- 
mor, at which time (middle of February, 1874) she went to 
Chicago, and placed herself under the care of Dr. Hayes. 
She remained under his charge until the following August, 
when she returned to her home, and again resumed the 
practice of her profession, thinking at that time that she 
was quite well. For the treatment as reported by Dr. Hayes, 
see " Chicago Medical Journal" of September, 1874. On the 
1st of April, 1876, she again returned to Chicago, and con- 
sulted Dr. Hayes, and was treated by him until about the 
1st of June. Miss Shotwell called on me about the middle 
of June; at that time I did not examine her. Some ten 
days later Dr. R. F. Dyer, of our city, examined her and pro- 
nounced her disease an ovarian tumor. On the same day 
that she was examined by Dr. Dyer, Dr. James H. Campfield 
of our city also examined her, who agreed with Dr. Dyer 
that she had an ovarian tumor. About the 1st of July I 
called on Miss Shotwell at her home, not then being aware 
that Drs. Dyer and Campfield had examined her. I first 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. mundL. 
39 
examined her sitting up ; found increased size about waist, 
six and a half inches more than her ordinary measurement 
when well. The tumor at this time rose about two inches 
above the umbilicus, and measured nearly one inch more at 
umbilicus on the left side than on the right, that is to say, 
measuring from the spinous process of the vertebra on a 
level with the umbilicus to the linea alba. I found as above 
stated that the left side was one inch larger than the right 
side; and the tumor thus far more on the left than right 
side. While in this position percussion gave a dull sound 
all over the region of the tumor, and resonant sound around 
its borders. There was no tenderness of the abdomen at 
this time, and the abdominal walls glided freely over the tu- 
mor. She was but little emaciated, and showed no constitu- 
tional symptoms. Her catamenia had been regular, yet she 
thought, perhaps not quite so profuse as in times past. I 
now examined her lying down (and here let me say that up 
to this time she did not believe her trouble was ovarian), and 
found the dullness in the same place whether she turned to 
the left or right side, or lying on her back; there may have 
been a little change of area of dullness when she changed 
her position, but slight ; percussion now gave the wave, 
clear and distinct throughout the tumor, yet to get fluctua- 
tion clearly you had to press with some force on the ab- 
dominal walls to reach the cyst on her right side from the 
wave passing all through the tumor. I diagnosed a uniloc- 
ular tumor springing from the left ovary. The patient grew 
rapidly from this time until the twentieth day of August, 
when in company with Dr. Dyer we tapped her. In tapping 
we used a rather small needle of an aspirator, and through 
this drew thirteen pounds of a straw-colored fluid, which, 
upon being heated, formed a solid coagulum of a grayish- 
white color. The patient was tapped lying on her right 
side. Dr. Dyer passed the trocar through the abdominal 
walls after first making an incision through the skin. After 
passing the trocar through the walls there seemed to be 
a stratum of fluid, but pushing the trocar a little further, 40 
ELECTROL YS/S OF O VARTAN TUMORS. 
ke came in contact with the tumor, pierced it, and drew 
off the contents until he had taken away the above thir- 
teen pounds. I held the trocar in position while he pumped 
the fluid away, and I observed the tumor contracting as he 
proceeded to draw the fluid, until all at once the point 
of the trocar slipped out of the tumor, partly owing to the 
tumor shrinking away from the trocar, and partly to a 
slight retraction of the trocar. The trocar still remained 
within the abdomen. We discussed the question whether 
we should again thrust the trocar through the walls of the 
tumor, and withdraw more of the fluid, as there was a good 
deal left. The patient complained that she was somewhat 
exhausted, so we concluded to desist from further attempts 
at this time. I am more particular about the details of this 
tapping, as settling the question, whether there was a cyst 
at this time, as at the operation for a radical cure we found 
no cyst enclosing the fluid. About four ounces of this 
fluid were sent to Dr. John E. Owens, of Chicago, and 
submitted by him to Dr. Danforth for examination, who 
made a microscopical examination, and diagnosed ovarian 
tumor. After tapping, the patient gained in flesh, and was 
in good spirits. We found in about two weeks her size 
to be again slowly increasing, which continued until the 
24th day of November, the day of the operation for a rad- 
ical cure. I enclose Dr. Dyer's note to me, in answer to a 
note I addressed him, asking him why he pronounced Miss 
P. A. Shotwell's case a cystic ovarian tumor. I have this 
moment received a letter from Dr. Owens, in which he 
makes some extracts from a book published by Dr. Hayes. 
I shall take occasion to answer said book in detail. I am, 
dear sir, Your most obedient servant, 
J. C. Hatheway. 
Dr. J. C. Hatheway :- 
Dear Sir, - You ask me to state why I pronounced 
Miss P. A. Shotwell's case one of cystic ovarian tumor. 
In June, 1877, I was called to examine her. I first di- PAUL F MUNDE. 
rected her to urinate, then placed her in a complete horizontal 
position. I first observed a prominence of the abdomen, 
which, upon percussion, gave a dull sound. Then by a bi- 
manual examination I could clasp a tumor and move it; then 
by turning patient on side but little change of bowels took 
place ; then by a vaginal examination with right hand, with 
the left applied externally, I could feel a tumor about the 
size of a child's head (somewhat larger) ; and as there was 
a distinct fluctuation, and no history of heart, liver, or kid- 
ney disease, no cancerous cachexia, I had no hesitancy in 
pronouncing the case one of cystic ovarian disease. There 
were other symptoms, which I have not enumerated here, 
that assisted me in making my diagnosis. 
I am, truly yours, R. F. Dyer. 
Ottawa, May 28, 1877. 
41 
117 Twenty-first Street, Chicago, May 19, 1877. 
Wm. H. Byford, M. D.: - 
My dear Doctor, - According to promise I send you the 
chief points in the Shotwell case. The earlier history of 
the case will be found in the "Chicago Medical Journal," 
September, 1874. The patient, on the morning of December 
1, 1873, discovered in left lumbar region a tumor the size 
of the fist; menstruation was regular to date of discovery of 
the tumor, which steadily enlarged till the middle of Feb- 
ruary, 1874, when she placed herself under the care of Dr. 
P. S. Hayes, of this city, and remained under his care until 
the following August. Under the impression that she was 
well she returned to her home, and resumed the practice of 
her profession. In April, 1876, she returned to Chicago, and 
was again treated by Dr. Hayes until June 1st. About June 
10th she was examined by Dr. Dyer, of Ottawa, who diag- 
nosed ovarian tumor. Dr. Hatheway, of the same city, who 
was at the time not aware that Dr. Dyer had examined the 
case, called upon the patient about July 1st, and discovered 
a tumor, the superior limit of which was on a line two inches 
above the umbilicus ; the abdominal walls glided freely over ELECTROLYSIS OF OVARIAN TUMORS. 
42 
the tumor ; the tumor enlarged rapidly until August 20, 
when she was tapped, thirteen pounds being withdrawn. 
Dr. Hatheway, in charge of the case, observed the tumor 
diminishing as the fluid was withdrawn, until suddenly the 
point of the trocar slipped out of the tumor. There was a 
free discharge of fluid during the subsequent twenty-four 
hours. Three or four ounces of fluid were sent to me for 
examination. I submitted it to Dr. I. N. Danforth, who fur- 
nished the annexed report. After the tapping the patient 
gained in flesh and spirits, but in two weeks she again found 
that she was slowly filling up as before, and so continued 
to fill until November 24, 1876, the day that I performed 
ovariotomy upon her. Menstruation had been quite regular, 
though somewhat more scanty, during the last few months. 
On November 27, assisted by Drs. Hatheway, Campfield, 
Stout, and Dyer, I removed the tumor. The patient died 
December 6, of peritonitis. Upon opening the abdomen 
(at the time of the operation) a large quantity of serous fluid 
was poured out from the cavity of the abdomen ; no tumor 
was at this moment discovered ; the incision through the 
abdominal walls was four inches long. I soon began a 
search for the ovaries. The right was first found rough and 
firm ; well down behind the uterus was a fibro-cystic mass 
attached by a pedicle. This mass was the degenerated left 
ovary. The parietal peritoneum, at the time of the oper- 
ation, was red, thickened and velvety. Recent lymph 
was removed from its surface in two localities. 
Respectfully yours, Jno. E. Owens. 
Chicago. May 26, 1877. 
Prof. J. E. Owens, M. D. : - 
My dear Doctor, - With reference to the specimen of 
fluid purporting to be ovarian which you sent me for exam- 
ination a long time since, I have to say that I quite dis- 
tinctly remember finding the " gorged granules" or large 
granular corpuscles described by Eichwald, Drysdale, and 
others, and generally regarded as diagnostic of ovarian dis- PAUL F. MUNDF. 
43 
ease. I reported to you at the time that if the presence of 
these peculiar cells was proof of the existence of an ovarian 
cyst, then the case in question could be nothing else. 
Yours, etc., I. N. Danforth. 
125 State St., Chicago, June 4, 1877. 
Dr. Paul F. Munde : - 
Dear Doctor, - While in Boston I mailed to your address 
the papers of the gentlemen who had charge of Dr. Hayes' 
patient with ovarian tumor. I have every confidence in their 
capacity as observers, and veracity as physicians. I saw the 
tumor removed by Dr. Owens. It was about three inches 
in diameter, quite solid in consistence, containing several 
sacs from the size of a walnut to that of a shot. There was 
another, empty of its contents, and with an opening that 
would admit two fingers. The edges of the opening in the 
empty sac were thin, as though the orifice had existed for 
some time before the operation. The empty cyst would 
have contained an ounce of fluid. 
This, so far as I can judge, is about all the information, 
in addition to the papers I sent you, essential to your un- 
derstanding of the sequel to the case. 
I am, as ever, yours, etc., W. H. Byford. 
It will thus be seen conclusively that there certainly was 
an ovarian tumor present in August, 1876, two years after 
the reported cure, when the patient was tapped, the walls 
of which tumor were shrunken and collapsed when the 
abdomen was opened three months later. Whether this 
cyst was simply a refilling of the one claimed by Dr. Hayes 
to have been cured by electrolysis, or whether it was an 
entirely new cyst developed since the cure of the original 
tumor, can scarcely be determined. The shadow of doubt 
thrown on the result of this case by these conflicting state- 
ments to a great extent invalidates its use as an instance of 
cure by electrolysis. A permanent cure it certainly was not. 
Having, however, been published as such, I leave it in this 44 
ELECTROLYSIS OF OFARIAM TUMORS. 
category, where I had placed it before the sequel became 
known to me. 
Case XX. Dr. R. W. Macdonnell, Montreal, Can.- 
Two applications; gradual disappearance of tumor; entire 
cure, confirmed nine months later. (Unpublished.) 
Circumference of abdomen thirty-four inches ; after two 
applications it had diminished to twenty-eight and a half 
inches. The operation was performed on August 29, 1876, 
first by application of sponges alone, the next day by one 
sponge and one needle. A Daniell's battery of six cells 
was used. The patient was seen a short time ago, and no 
trace of the tumor could be detected. 
I am indebted for these brief notes to Dr. Macdonnell 
himself, who proposes to publish the case in extenso here- 
after. 
Case XXI. Dr. J. T. Everett, Sterling, Ill. - Three 
sittings ; twenty cells ; one negative needle. Complete cure. 
No trace of tumor found three years later. (Unpublished.) 
Mrs. A. M., seen September 3, 1872, aged 32. Multi- 
para, anemic, strong specific symptoms. Detected cyst of 
right ovary of three years' growth. Circumference at hips 
36", umbilicus 42", ensiform cartilage 32". 
Three insulated silver needles were introduced six inches 
into the cyst, and attached to the negative pole of a twenty- 
cell zinc and copper battery ; the positive pole was placed 
over the sacro-lumbar articulation, and the current passed 
through for five minutes. 
September 8. Umbilical diameter 36". Treatment re- 
peated. 
September 15. Umbilical diameter 28". Treatment re- 
peated. From this time the patient gradually regained her 
normal health, and was lost sight of for three years, when 
she was again examined, and no trace of the tumor found. 
Case XXII. J. T. Everett.-Medium sized ttimor; 
fifteen sittings, thirty cells, one needle, once a week. Entire 
disappearance of tumor. (Unpublished.) PAUL F. MUNDF. 
May io, 1873, saw Mrs. F. H., aged 26 ; good general 
health. Found ovarian tumor involving the left ovary, of 
the size of an adult head. A silver needle was introduced 
4" into the sac, and a twenty-cell current passed through it 
for five minutes, as in the preceding case. These sittings 
were repeated once a week until fifteen had been given, 
when the tumor had entirely disappeared. It has never re- 
turned ; the patient has since given birth to a child, and is 
now in perfect health. 
Case XXIII. J. T. Everett. - Very large tumor; three 
platinum needles to negative pole ; only two sittings on the 
same day, of together fifty minutes; thirty cells. Rapid 
decrease of tumor ; entire disappearance in a year. (Un- 
published.) 
Mrs. S. W., aged 42 ; multipara, formerly of robust health, 
but now presenting the facial cachexia common to ovarian 
tumors. She had noticed the growth for four years. De- 
cember 8, 1873, umbilical circumference 49". Inserted 
three platinum needles seven inches into the cyst, and 
passed a thirty-cell current, the same as in the two pre- 
vious cases, for twenty minutes. The patient was then al- 
lowed to rest one hour, and then the doctor having to return 
to the city, the current was again given for thirty minutes 
more. The patient made a rapid improvement; the tumor 
decreased until the umbilical diameter reached 30", and the 
general health improved exceedingly. The doctor was in- 
formed that at the expiration of one year the enlargement 
had entirely disappeared. 
Case XXIV. Dr. St. Clair, of Rossville, Staten 
Island, has cured a case of ovarian tumor by electrolysis, 
so I am informed, but his absence on a prolonged journey, 
for his health, has prevented my obtaining the particulars. 
Case XXV. Dr. Frommhold, Buda-Pest, is reported by 
Semeleder as having cured an ovarian tumor by electroly- 
sis, and another by external Faradisation, which will be 
separately mentioned hereafter. I have not been able to 
obtain particulars of these cases. 
45 46 
ELECTROLYSIS OF OVARIAN TUMORS. 
B. Cases in which Decided and Permanent Improve- 
ment ONLY WAS OBSERVED. 
Case I. Dr. L. Bopp, New York. - Multilocular cyst 
of enormous size. One needle every other day for two months. 
Marked reduction in size, and particularly decided improve- 
ment in general health and strength. Still under treatment. 
(Unpublished.) 
Mrs. Osten, 44 years of age. October, 1874, to April, 
1876, tapped eleven times ; eight to eighteen pounds of dif- 
ferent colored fluid being removed each time. Last para- 
centesis, April, 1876. Electrolytic treatment was begun 
October 17, 1876. Stbhrer's battery, twelve to fourteen 
elements used at each sitting for eight to ten minutes. 
General health very poor; hardly able to leave her bed. 
Measurement about umbilicus at tenth sitting 44", Octo- 
ber 29. 
November cy Fourteenth sitting, circumference 42". 
December 6. Twenty-seventh sitting, circumference 41". 
General health being much improved, and patient able to go 
to work as a seamstress (sewing on the machine even), the 
treatment was interrupted until March 5, 1877, and then 
resumed, a sitting being given every third day. No inflam- 
matory reaction whatever was experienced at any time. 
The treatment is still being continued, but the improve- 
ment thus far is so marked (so the patient assured me her- 
self), as to warrant the case being recorded in this class.1 
Case II. Dr. R. Hesse, Brooklyn.- Unilocular cyst; 
three sittings, two needles; tumor diminished in one week 
from 35" to 27" in circzimference. Apparently permanent 
result? 
Patient first seen in October, 1874, and diagnosis of 
ovarian cyst made, which was confirmed by Dr. Noegger- 
1 February, 1878, the patient died, the tumor having again increased 
after the cessation of the treatment. The diagnosis was verified at 
the autopsy. 
2 Am. Jour. Obstet., January, 1877. PAUL F. MUNDE. 
ath. Patient, aged 43 years, noticed enlargement three 
years ago. Circumference at umbilicus about 29". Again 
seen October, 1876. Circumference of abdomen now 35". 
General health failing. 
November 11, 1876. One needle connected with nega- 
tive pole introduced into the tumor. Drescher's zinc and 
carbon battery; positive electrode was introduced into the 
vagina, touching the os uteri. The current used gave a 
direct shock to the tongue and decomposed water. Pain 
not great. Sitting ten minutes. 
November 13. Circumference 3" less, namely 32" ; ab- 
dominal walls flaccid. Patient was able, for the first time in 
four years, to bend her body forward. Two needles (one 
platinized) with negative pole this time, fifteen minutes. 
November 15. Circumference decreased to 29". Abdom- 
inal walls flabby, similar to those after confinement. In- 
tended to insert three needles, but not being able to define 
the boundary of the tumor clearly, introduced only two, 
fifteen minutes. Next day, circumference 27". Patient had 
abundant micturition after each sitting. 
November 30. Circumference still 27". The cyst doubt- 
less still contains fluid, but as the boundary of the cyst is 
so indistinct and the patient feels no inconvenience what- 
ever, further treatment is indefinitely postponed until the 
cyst shall refill. 
December 13. Cyst the same, but somewhat harder. 
December 30. Continues well. 
May 25, 1877. No reappearance of tumor. In good 
health. 
Case III. F. Semeleder, Mexico. - Multilocular tu- 
mor ; forty sittings ; complete absorption of liquid contents ; 
treatment discontinued on account of difficult introduction of 
needles. 
Patient 28 years of age, married, five children. Since 
last confinement, one and a half years ago, had noticed en- 
largement of abdomen. General health fair; beginning 
emaciation and anemia. Tumor soft, fluctuating, walls 
47 48 
thin, extending two inches above the umbilicus. Three 
hard lumps were discernible in the tumor. Treatment 
commenced toward the end of November, 1875, and con- 
tinued till Dr. Semeleder's departure, February 15, 1876, 
being suspended only during menstruation, five days every 
month. At the latter date the tumor had shrunk to the 
level of the umbilicus. 
In May, 1876, Dr. Schmidtlein, of Mexico, in whose care 
the patient had been left, and who continued the treatment, 
reported that the liquid contents of the tumor had been en- 
tirely absorbed, and that the last five or six times the intro- 
duction of the needle had been quite difficult, because of 
the reduction of the tumor. The number of sittings was 
forty. . 
ELECTROLYSIS OF OVARIAN TUMORS. 
C. Cases in which the Improvement was only 
Temporary. 
Case I. Dr. H. O. Marcy, Cambridge, Mass.-Mul- 
tilocular cyst; twenty-two sittings ; first decided diminution, 
then increase of Utmor, probably by growth of new cysts. 
(Unpublished.) 
" Mrs. H., aged 27, married two years, never pregnant. 
She first noticed a slight enlargement in left iliac region in 
May, 1875. Two years previous she was injured by a child 
falling on her side when in bed, and was sore and lame for a 
month. General health good, menses regular, without pain. 
First seen January 10, 1876. Tumor was then of the size 
of a small cocoa-nut, movable, fluctuating, and distinctly out- 
lined by conjoined manipulation. Diagnosis, ovarian cyst. 
" January, 1877. Commenced treatment by electrolysis. 
Galvano-Faradic Company, N. Y., battery of sixteen cells. 
Positive needle introduced, negative applied by sponge elec- 
trode ; time usually about ten minutes ; fourteen cells. 
Entire number of applications twenty-two, every second or 
third day. 
" After ten or twelve sittings, always at the house of pa- 
tient, the tumor had decidedly diminished, was much firmer, and was probably half the original size, when it was about 
the size of the uterus at the fifth month of pregnancy, 
reaching to the umbilicus or above. Treatment was omit- 
ted for three weeks, when the tumor was found perceptibly 
larger, and had increased by the growth of a new cyst to 
the right of the older and larger one, which still felt hard 
and firm. Treatment continued till about April i, when 
the needle entered with difficulty. The tumor was hard 
and firm to the feel, without fluctuation anywhere, and had 
diminished to-the size of a large cocoanut. I felt that the 
patient was probably cured. 
" April 29, 1877. Condition again changed. The tumor 
has slowly enlarged; is, at least a portion of it, quite firm, 
and yet there is' an elastic, fluctuating feel on bimanual ex- 
amination. I am disposed to think the enlargement due 
to the growth of new cysts, and that the firm feel of the 
anterior lower portion is due to the contracted cysts oper- 
ated on. This case is at least instructive, and may teach 
the reason of success in some cases, and of signal failure in 
others. It would seem to illustrate that which from theo- 
retical reasoning would appear to be most probable, i. e., 
that a single cyst would give the best results, while in a 
multilocular cyst it would be difficult so to change the 
growth as to prevent further development." 
Case II. Dr. Joseph Schnetter, New York. - Mzilti- 
locular cyst; twenty-five sittings. Temporary decrease; then 
rapid and extreme increase, necessitating tapping by the as- 
pirator. Decomposition of cyst contents ; death from rupture 
of the cyst. (Unpublished.) 
Mrs. M. N. was delivered of her first child October 1, 
1876. Was then in the care of Dr. A. Assenheimer, and 
seen by Dr. Schnetter in consultation October 7, when all the 
signs of a large cystic tumor of the right ovary were found. 
Tapped October 30, and about four and a half gallons of 
dirty, brownish, viscid fluid evacuated. The collapse of the 
tumor was only partial, about one third of the original mass 
remaining as a solid mass on the right side. Unmistakable 
PAUL F. MUNDF. 
49 50 
signs of intimate and extensive adhesions. The cyst filled 
up again in two or three weeks to nearly the former size, 
and electrolysis was decided upon. This was applied by 
Dr. Assenheimer several times at the patient's residence, 
and during January and February, 1877, by Dr. Schnetter 
in his office, twenty-five sittings being held altogether. 
The application was at no time followed by any symptoms 
of inflammation. For a time the tumor remained station- 
ary, then a marked decrease in its size was noticeable. 
(Dr. Schnetter at that time expressed himself to me as 
highly pleased with the treatment, and expecting great 
things from it.) But suddenly, towards the end of February, 
the tumor again increased rapidly to such a degree as to ren- 
der relief by tapping imperative, which was done by aspira- 
tion on February 21, the liquid removed being very much 
the same as that withdrawn at the first tapping. The solid 
part of the tumor was found neither increased nor dimin- 
ished in size, although the electrolysis had been equally 
applied to it. No symptoms of inflammation followed the 
operation. 
March 3. Dr. Schnetter was sent for and discovered a 
development of gas in the cyst, and advised the transfer of 
the patient to the German Hospital for the performance of 
the radical operation. During the drive through Central 
Park, March 5, symptoms of rupture of the cyst suddenly 
made their appearance, and the patient arrived at the hos- 
pital in a moribund condition, where she died on the follow- 
ing day. The autopsy was not permitted. It is to be re- 
marked that electrolysis was not performed after the last 
tapping on February 21, and that the inflammation of the 
cyst and decomposition of its contents cannot be ascribed 
to the electrolytic treatment." 
Case III. E. Cutter, Cambridge.- Unilocular cyst; 
eight sittings, extending over three months. Reduction of 
tumor zmtil a fluctuation wave could no longer be detected. 
Great relief from pain. Considered a perfect cure. Relapse 
after fozir months. 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUNDP. 
Mrs. Read, aged 40 years, three children. Nervous tem- 
perament. Duration of present illness twelve months. 
Pretty constant pain in abdomen. The diagnosis of ova- 
rian cyst was confirmed by Drs. T. G. Thomas, Kimball, 
and several others. 
October 29, 1876. Dr. F. Semeleder introduced one gold 
plated needle into the cyst through the abdominal walls, 
and connected it with the carbons of the battery above men- 
tioned. A sponge electrode was connected with the zincs 
and applied to the other side. Ten cells, three minutes. 
The patient at once returned to her home, three miles dis- 
tant. 
November 12. Immediately after sitting was taken with 
menses, which passed off painless and crampless, the first 
immunity of the kind she had had for years. Cyst reduced 
at least one third its size. Operation repeated with a Kid- 
der insulated needle. 
November 25. Tumor less than one half its original size. 
Much prostration and nervous disturbance. Applied two 
needles of Cutter's battery, ten cells. 
November 28. Still prostrated, although she does house- 
work. Cutter's battery, ten cells ; two needles, five minutes. 
December 6. General health improved ; tumor about the 
same. States that each of the previous operations was fol- 
lowed by pain and tenderness, lasting some time. Battery 
as at last sitting. Suffered all night from pain after this 
operation. Menstruating, but owing to distance of resi- 
dence application not postponed. 
December 13. Tumor evidently smaller and firmer. Two 
needles, unusual resistance ; current three minutes. Menses 
suddenly stopped by last application. 
December 21. Application repeated. 
January 19, 1877. Cyst smaller and denser. Battery 
applied as before, for the last time. 
March 28. No wave or distinct tumor to be felt. Palpation 
masked by fecal accumulations. General condition good. 
P. S. Under date June 2, Dr. Cutter writes that he is 
51 52 
ELECTROLYSIS OF OVARIAN TUMORS. 
informed by Dr. Wheeler, the attending physician, that there 
are again signs of fluid in the cyst, and that he is reapply- 
ing the battery. 
Case IV. Ultzmann, Vienna.1-Patient treated by 
electrolysis and dismissed cured. Tumor refilled ; repeated 
tappings. Condition same as before electrolytic treatment. 
D. Cases in which Electrolysis produced no Per- 
ceptible Effect whatever on the Tumor. 
Case I. E. Cutter, Cambridge. - Multilocular cyst 
with thick walls. Six sittings in five weeks; both poles 
inserted as needles. No change whatever. (Unpublished.) 
Mrs. M. E. Murray, 31 years of age. Tumor first no- 
ticed six years ago. General health good. Circumference 
36-4 inches at umbilicus. Electrolytic treatment under Dr. 
Cutter's direction by Dr. C. C. Pike, of Peabody, Mass., com- 
menced February 20, 1877. Ten cells of Cutter's galvanic 
C. and Z. battery for three to eight minutes ; two needles, 
one positive, one negative. Considerable pain and soreness 
in abdomen, but no serious trouble. Five additional sittings 
of a like strength were held at intervals of about one week 
up to March 20 ; no appreciable effect was produced, the 
tumor being of exactly the same size as before treatment. 
Dr. Cutter informs me that he intends pursuing the per- 
cutaneous method in this case. 
Case II. Dr. Frank W. Rockwell, Brooklyn, N. Y.- 
Two sittings ; no effect whatever. Patient refused to continue 
treatment and demanded ovariotomy, which was successfully 
performed. (Unpublished.) 
But two sittings were held, the Bartlett battery made by 
the N. Y. Galvano-Faradic Co. being used. The negative 
pole was thrust into the cyst (a monocyst), and the positive 
electrode applied externally. The strength of the current at 
the first sitting was twelve elements ; at the second eighteen 
elements ; the length of each sitting ten minutes. A bright 
erythematous blush followed the second operation, occur- 
1 Loc. cit. ring over the spots where the positive pole had rested, and 
lasting some hours. Not finding any relief from these two 
applications, the patient refused to continue the treatment 
and demanded the removal of the tumor. This was per- 
formed April 23, 1877, with perfect success. 
No traces of the punctures made by the needle March 1 
and 4 could be detected on the cyst wall. 
Of' course this case can scarcely be considered a fair test 
of the electrolytic treatment, but it is quoted as an in- 
stance where ovariotomy followed the treatment. 
Case III. Paul F. Munde, New York. - Patient four- 
teen years old, unilocular cyst ; twenty sittings, positive nee- 
dle only, every other day, five to twenty minutes. No change 
in tumor whatever. Slight increase at date. (Unpublished.) 
S. K., fourteen years of age ; never menstruated ; gen- 
eral health fair, but gradually becoming weaker and paler 
during the past year. Tumor first noticed some nine 
months before she came under observation, since which time 
it has grown slowly to its present size. During the last 
three months it has grown somewhat more rapidly, and a 
great deal of pain has been experienced, particularly in the 
right iliac region. 
I saw her first in September, 1876, and decided that the 
tumor was probably ovarian. The patient was seen at this 
time also by Drs. E. J. Messemer, to whose courtesy I am 
indebted for the case, C. Williams, and Mary Putnam-Jacobi, 
who withdrew a clear, yellowish fluid from the cyst by the 
hypodermic syringe, which, on being examined under the 
microscope, showed granular corpuscles and epithelial cells. 
The patient was lost sight of for several months, and when 
she returned towards the end of December the tumor was 
found to have grown rapidly during the interval, and the 
patient to have become more feeble and markedly cachectic. 
December 27. I repeated the hypodermic removal of 
fluid, which was found by Dr. M. D. Mann to contain the 
same microscopic ingredients as those already detected, but 
no ovarian corpuscles. It was a clear, viscid fluid, consist- 
PAUL F. MUNDE. 
53 54 
ELECTROLYSIS OF OVARIAN TUMORS. 
ing mainly of albumen, and there was no question in the 
minds of Drs. Semeleder, Tauszky, and Mann, who also ex- 
amined her, that the tumor was an ovarian cyst, probably 
unilocular, with large dense masses on the right side. The 
size of the cyst was about that of the uterus in the eighth 
month of pregnancy, reaching nearly up to the ensiform 
process, and unusually prominent through the slender fig- 
ure of the scarcely developed girl. 
December 29. The measurements were : - 
Circumference at umbilicus ...... 29I" 
Circumference midway between umbilicus and symphysis 29^" 
Distance from symphysis to ensiform process . . . 14" 
The skin was tense, the tumor being evidently contigu- 
ous to the parietal peritoneum. Greater enlargement on 
right side, from which ovary the tumor probably sprang. 
Per vaginam, hymen, uterus slightly retroverted, tumor 
fluctuating in anterior cul-de-sac. 
Dr. Semeleder, to whom I applied for advice as regards 
the electrolytic treatment, gave me the following directions, 
which I followed closely, except as regards strength of cur- 
rent and length of sittings. " I advise you to use for elec- 
trolysis of ovarian cysts a current which can be borne 
without pain when both poles are applied to the tongue ; 
four elements of your battery (N. Y. Galvano-Faradic Co., 
sixteen cells). The sittings five minutes each. If well 
borne, every day; otherwise, every other day, continuing 
for four to six weeks. Only the positive pole should be in- 
serted, the negative applied to the abdomen over the tumor 
with a sponge electrode or one of metal with blotting paper 
wet in salt water placed between it and the skin." 
January 2, 1877. Electrolysis was commenced in my 
office in the presence of Drs. Tauszky and Mann, Dr. 
Semeleder having already left the city. The current used, 
four elements, decomposed salt water readily. An insu- 
lated steel needle was introduced, and the current applied 
for five minutes. Slight pain. The application was followed PAUL F. MUNDI'. 
55 
by more copious micturition than usual, and produced no 
reaction. Sittings continued every other day. At the 
sixth sitting the patient stated voluntarily that the former 
severe pain in the right side had entirely left her within a 
few clays. 
February 5. Fourteenth sitting. Dimensions same as 
always, but appearance of abdomen changed ; it is flatter, 
more equally distended ; instead of being higher on the right 
side, as formerly, there is now a marked protrusion in the 
left lower angle of the abdomen. The tumor now extends 
up to the diaphragm, and seems to have been lifted out of 
the pelvis, being no longer accessible to the finger in the 
vagina. It appears, as it were, more compact, more dis- 
tinct from the other viscera, and movable in the abdominal 
cavity. The patient complained of having suffered a great 
deal of pain in the left side after the last application, and 
had noticed the peculiar change in the configuration of her 
abdomen. I thought we were on the verge of a decided 
change in the tumor, precursory of its diminution. The 
increased cachectic appearance of the patient, her unusually 
sunken eyes and hollow cheeks, show the constitutional 
participation in the local change, whatever that was. Her 
pulse and temperature, however, were normal, and there 
was no pain in the abdomen. 
February 7. Tumor the same, only more solid in its 
feel, and a fluctuating spot for the insertion of the needle 
less easy to determine. 
February 10. The tumor has regained nearly its original 
shape and outline, and distinct fluctuation has again become 
discernible. For the sake of ascertaining whether any 
change had taken place in the fluid, I drew off another 
hypodermic syringe-full of clear, light brown liquid, which 
was found to be precisely the same as before the treat- 
ment. 
March 6. Twentieth and last sitting. The number of 
elements used, and the length of the sittings had been gradu- 
ally increased, until, during the last three sittings, fourteen to 56 
ELECTROLYSIS OF OVARIAN TUMORS. 
sixteen elements were used for fifteen to twenty minutes, 
causing some pain. No change whatever had taken place 
either in the dimensions, shape, or configuration of the tu- 
mor, and the only benefit that the patient seemed to have 
derived during or from the electrolytic treatment was the 
absence of pain in the abdomen, from which she had for- 
merly suffered, and a slight improvement in her general 
health, which was probably largely due to a persistent course 
of tonics. No peritonitic symptoms had appeared at any 
time, neither did adhesions appear to have formed between 
the peritoneum and the tumor. 
May 1. Dimensions slightly increased. 
Circumference at umbilicus 30I" 
From symphysis to ensiform process .... 14I" 
General health excellent. 
May 22. Tumor again somewhat enlarged. Umbilical 
circumference 31I". 
General health not so good ; complexion more pallid than 
at last visit. No inconvenience from the tumor, however, 
except its weight. Therefore the radical operation was 
postponed until a rapid increase of the tumor or urgent 
symptoms should require it. 
Now, while for a time the growth of the tumor in this 
case seems to have been arrested by the electrolysis, and the 
freedom from pain and improvement in general health may 
fairly be attributed to some extent to that treatment, still 
it is evident that even that slight improvement was but 
temporary, and that the tumor is again slowly but surely 
growing. The entire absence of the positively curative in- 
fluence of the electrolytic treatment in this instance, be- 
sides, induces me to include the case under the negative 
class.1 
Cases IV. and V. Benedikt, Vienna. - Large tumors, 
1 March 4, 1878. Tumor considerably enlarged ; circumference at 
umbilicus ss" ; patient complains of slowly increasing debility. Ova- 
riotomy advised without further delay. PAUL F. MUNDF. 
57 
thick, viscid fluid. Frequent electrolysis, entirely ineffectual. 
Ovariotomy by Carl Von Rokitansky, Jr., successful. In 
one case adhesions of cyst to abdominal wall corresponding 
to acupunctures, of fresh origin. Had never been tapped.1 
Case VI. Dr. J. T. Everett, of Stirling, Ill., writes me 
that he is performing electrolysis on an ovarian tumor with 
an entirely negative result. It is more dense than his other 
successful cases. 
E. Cases in which decided Injurious Results accom- 
panied OR FOLLOWED THE ELECTROLYTIC TREATMENT. 
(al) Peritonitis or other Unpleasant Symptoms ending in 
Recovery. 
Case I. Thomas - Semeleder, New York. - Multiloc- 
ular cyst, three sittings ; local inflammatory symptoms ; elec- 
trolysis discontinued. Ovariotomy, removal of both ovaries. 
Recovery. No adhesions. (Unpublished.) 
Miss K. G., aged 26, was admitted to the Woman's Hos- 
pital, New York city, service of Dr. T. G. Thomas, in No- 
vember, 1876. 
Menstruated at 14. First noticed in May, 1876, that she 
was increasing in size; did not notice that either side en- 
larged more than the other. Has at no time had pain. 
General health excellent, has lost no flesh, never having 
been stout. Appetite good ; bowels regular. No history 
of peritonitis. 
Physical Examination. Uterus 2|" deep ; position nor- 
mal. No sense of fluctuation in vagina. Abdomen occu- 
pied by a cystic tumor; distinct fluctuation about median 
line, but the wave is not transmitted from side to side. 
November 30. Electrolysis (Semeleder) ; fine platinum 
needle connected with positive pole of battery being inserted 
into tumor about three inches to the left of median line, 
two inches below umbilicus. A sponge attached to the 
negative pole being placed on the right side the current was 
1 Ultzmann, loc. cit. 58 
allowed to pass for five minutes. No pain or disagreeable 
symptoms were experienced either before or after the oper- 
ation. 
December 2. Operation repeated. After operation, meas- 
urements ; no appreciable change. 
December 7. Operation repeated, ten minutes ; patient 
complained very much of burning pain during the passage 
of the current; pain continued through the night. 
December 8. Patient still complains of sharp pain at 
place of puncture. Temperature, 99.50 ; pulse 90. Mag- 
endie's solution M. viii. for the pain. 
December cy Considerable redness remains about point 
of last puncture. 
December 13. Measured waist 35" ; L. A. S. S. I. to um- 
bilicus 8|"; R. A. S. S. I. to umbilicus 8" ; P. to U. 9" ; U. 
to E. P. 7". 
January 2, 1877. It being considered dangerous to con- 
tinue electrolysis, ovariotomy was proposed and accepted, 
but deferred till after next menstrual period. The patient 
left the hospital. 
January 22. Operation at her house by Dr. Thomas, it 
being considered unadvisable to operate in the hospital, 
owing to its hygienic condition at the time. Both ovaries 
removed. Recovery. 
No adhesions were present, and neither the peritoneum 
nor the wall of the cyst showed signs of the electrolytic 
punctures, or traces of recent inflammation. 
Case II. Thomas - Semeleder, New York. - Small 
ovarian cyst; seven sittings; no change whatever. Dis- 
charged. Two weeks later returned with local pain and 
tenderness ; fever ; cyst much enlarged. Lost sight of; termi- 
nation unknown. (Unpublished.) 
E. H., Hamilton, Ontario. 30 years. Married. One 
child. Two miscarriages. 
Three years ago had pains in the left side, always com- 
ing at irregular intervals. Never noticed any enlargement 
till a year ago, when a surgeon called her attention to it. 
ELECTROLYSIS OF OVARIAN TUMORS. Since that time her left side has slowly but steadily in- 
creased in size. Frontal headache almost constant. Appe- 
tite good. Bowels generally regular. 
Physical Examination. Small ovarian cyst in left hypo- 
gastrium. Measurements: - 
PAUL F. MUNDE. 
59 
Girth 32^ 
L. A. S. S. I. to umbilicus . . . 6|" 
R. " " " " .... 7|" 
Ensiform cartilage to umbilicus . . 6|" 
December 9, 1876. Electrolysis employed. Current 
passing ten minutes, causing but little pain and no incon- 
venience afterwards. 
December 11. Electrolysis repeated, but was discon- 
tinued after six minutes, owing to some defect in the bat- 
tery, which caused the current to intermit and give pain. 
December 13. Electrolysis repeated, current passed six 
minutes. 
December 17. Electrolysis six minutes. 
December 23. Period came on after last operation, and 
electrolysis was not repeated till to-day ; current passed ten 
minutes. Measurement shows no diminution of tumor. 
December 26. Electrolysis ten minutes. 
December 30. Electrolysis ten minutes. 
January 14, 1877. No change in tumor; patient dis- 
charged unimproved. 
About January 25, returned, saying that she had suf- 
fered a great deal since her discharge from abdominal pain 
and fever. The abdomen was found enlarged and tender. 
The cyst, which formerly was about the size of an infant's 
head, had grown to the size of the head of an adult, and 
was tender to the touch. Pulse and temperature were both 
higher than normal. Although told to remain in the hos- 
pital, she left saying she would call again in a few days, but 
has not been heard from since. 
Case III. Ultzmann, Vienna.1- Repeated electrolysis, 
continual diminution and refilling of cyst. After a pause 
1 Loc. cit. 60 
ELECTROLYSIS OR OTA RIAN TUMORS. 
of several months electrolysis recommenced. Acute pain and 
peritonitic symptoms probably cattsed by needle striking old 
adhesions. 
Patient was treated by electrolysis, by Ultzmann and 
others, always with diminution of the tumor, which regu- 
larly filled up again, however. After a pause of several 
months electrolysis was recommenced. Immediately after 
passing the needle into the cyst, the patient experienced 
a severe drawing abdominal pain, which increased so much 
with even the weakest current and spread to the rectum 
and bladder, that the needle was withdrawn after five min- 
utes. Abdominal colic, rectal and vesical tenesmus fol- 
lowed in rapid succession, and the patient was put to bed 
with some difficulty, where she remained a week. Ultz- 
mann explains these symptoms by the suggestion that the 
needle happened to strike old adhesions dating from former 
electro-punctures, and caused contractions of the adherent 
parts, and thus the severe pain. 
Case IV. Ultzmann, Vienna.1 - One sitting, mild cur- 
rent, ten minutes. After thirty hours peritonitis and persist- 
ent bilious vomiting persisting for a week. Patient's life 
saved only by paracentesis. Fluid removed contained blood 
and pus. Recovery. 
Mrs. H., aged 45 years, large ovarian tumor of several 
years'standing. General health good, but emaciated. Ap- 
petite good, no fever, hopeful and bright of disposition. 
Desired electrolysis. One platinum needle attached to the 
negative pole was inserted, and the positive pole placed on 
the abdomen. The sitting was painless, and lasted only ten 
minutes, ten to twelve elements being used. The same 
evening the tumor was apparently somewhat smaller and 
softer. Thirty hours after the sitting, the patient had a 
sudden chill; peritonitis set in, with bilious vomiting, which 
latter persisted for a week, and rendered the condition of 
the patient very precarious. Prof. Carl Braun was then 
called in consultation, and advised immediate tapping. This 
1 Loc. cit. PAUL F. MUNDS. 
was done, and ten litres of thin, chocolate-colored fluid evac- 
uated, which, under the microscope, showed blood and some 
pus corpuscles. The vomiting soon ceased, and the patient 
improved and recovered ; a fortunate termination, ascribed 
by Ultzmann entirely to the timely tapping. Electrolysis 
was of course not resumed.1 
61 
(bi) Peritonitis, terminating, fatally. 
Case I. Semeleder, New York.- Polycyst. Five sit- 
tings in tzvo weeks. Speedy peritonitis, rapidly terminating 
fatally. Supptiration of cyst-contents. Needle punctures 
visible, and fresh adhesions around them. 
Miss P., aged 44, always menstruated regularly, but suf- 
fered from dysmenorrhea and menorrhagia. In August, 
1875, she first noticed a rapidly increasing enlargement of 
the abdomen, chiefly on the right side. In August, 1876, 
she had an attack of acute abdominal pain, accompanied by 
a marked change in the tumor, one portion of it becoming 
hard and the other soft. She soon after entered the New 
York Woman's Hospital, service of Dr. T. G. Thomas, who 
recommended her to Dr. Semeleder for electrolytic treat- 
ment, the tumor not being considered favorable for opera- 
tion. Electrolysis was performed by Dr. Semeleder five 
times in two weeks, " the patient growing much weaker with 
each application ; notwithstanding which, daily visits were 
urged by the electrician." This quotation, as well as the 
above and subsequent details, are taken from a history of 
the case, published by Dr. Arthur T. Hills, of New York, 
a homeopathic practitioner, in the " Homeopathic Times " 
for March, 1877, into whose care the patient then fell, dis- 
appearing entirely from Dr. Semeleder's observation. The 
1 An additional case of peritonitis after a single electropuncture 
occurred in the practice of Dr. Rudolph Tauszky, of New York, 
during the fall of 1877. The patient gradually developed suppura- 
tion of the cyst and septicemia, and died during ovariotomy, which 
was performed by Dr. Peaslee as a last resort, and was very difficult, 
owing to the numerous adhesions. 62 
ELECTROLYSIS OF OVARIAN TUMORS. 
substance of Dr. Hills' remarks is as follows: November 
io, he was called in haste to see the patient, and found 
her in high fever, pulse 130, hot, burning skin, labored res- 
piration. The needle punctures were plainly visible on the 
abdomen, which was not tender, however. The same even- 
ing severe excruciating abdominal pains and vomiting came 
on ; she was very pale ; the pulse small and wiry, great 
dyspnoea. Hot fomentations, etc., were ordered. Early the 
next morning Dr. Hills was awakened with a message that 
Miss P. was dying. On arriving at the house he found that 
she had just expired. 
Autopsy. Free ascites. The needle punctures were 
plainly visible on the peritoneal surface, and fresh inflam- 
matory deposits were present around them. The tumor 
contained a fluid resembling that found in the peritoneal 
cavity, and also a cheesy substance, which, under the mi- 
croscope, showed an abundance of pus corpuscles. A fi- 
brous tumor was attached to the fundus uteri externally, 
and a polypus internally. 
It should be noted that the time between the cessation of 
the electrolytic treatment and the date of the discovery of 
peritonitis November 10, is not stated, neither what pole, 
and how many needles were introduced. Still, there can 
be no question that the fatal peritonitis and the adhesions 
were caused by the electrolytic punctures, the evidences of 
which I myself have distinctly seen on the specimen. 
Case II. Semeleder, New York.1-Enormous imiltiloc- 
1 New York Med. Jour., March, 1877. In the Homeopathic Times, 
for March, 1877, while looking for the case above reported, which I had 
been informed was there printed, I accidentally came across the report 
of an Ovarian Timor with Autopsy, by Mrs. J. G. Brinkman, M. D., 
in which electrolysis was followed by peritonitis and death, which as 
regards measurements and various particulars, so closely resembles 
the case briefly mentioned by Dr. Semeleder in the New York Med. 
Jour., beginning with " I lost a patient from peritonitis," that I have 
no doubt whatever of its being the same case, and therefore report it 
as such, having besides other good reasons for feeling sure of the 
identity of the two cases. I make the report full, copying it almost 63 
PAUL F. MUNDE. 
ular tumor, two tappings during treatment; thirteen electric 
sittings, five to ten minutes each within twenty-seven days; 
patient weaker after each sitting. Stcdden collapse and death 
on the day of the last sitting. Fresh adhesions and extensive 
suppuration of cyst contents. 
Mrs. Dr. A., a homeopathic practitioner, aged over 50 
years. Multilocular ovarian tumor measuring 52^" at um- 
bilicus and extending far above it. Growth of tumor rapid ; 
general health fair ; able to attend to daily duties up to date 
of first operation. 
November 17, 1876. First electric sitting five minutes; 
needle attached to positive pole, opposite pole placed on ab- 
domen. The immense size of the tumor called for para- 
centesis ; forty-five pounds of clear, amber-colored fluid were 
removed, which reduced the tumor one half. 
Nights restless after sitting ; patient perfectly helpless ; 
great distress, faintness, and soreness in the abdominal 
organs. Cough. Urine increased in quantity only for the 
first few days. No appetite. 
November 20. Slight improvement in general condition, 
temperature 103, pulse 112. 
November 21. Sat up half an hour; temperature 100, 
pulse 100. 
November 22. Electricity applied for ten minutes 10 a. m„ 
pulse 104, temperature 102 ; 5 p. m., pulse 102, temperature 
103.5. 
November 23. Less distress on motion ; 10 a. m., pulse 
100, temperature 102 ; 5 p. m., pulse 100, temperature 103. 
November 24. Much distress through night, abdomen 
distended, much pain; 10 a. m., pulse 112, temperature 
102.5 > 5 p- M-> pulse 120 ; temperature 103.5. 
November 25. Stronger; electricity applied for ten 
minutes. 
verbatim, because it probably is entirely new to the regular profession, 
and also, because the daily notes of pulse, temperature, and general 
condition are necessary to a proper appreciation of the progress of 
the case. 64 
November 26. Removed by tapping 30 pounds of syrup- 
like fluid. Sleep very poor to date. 
November 27. Slept all day ; 10 a. m., pulse 102, temper- 
ature 101 ; 5 p. m., pulse 96; temperature 102.5. 
November 28. Tumor measured 42" over umbilicus. 
Electricity for ten minutes. Sleep restless, with moaning 
and talking; 6 p. m., pulse 104, temperature, 102. 
November 29. Great distress and soreness in abdomen ; 
10 a. m., pulse 92, temperature 101 ; 5 p. m. pulse 96, tem- 
perature 103. 
November 30. Both needles inserted into the sac for ten 
minutes ; patient in half stupor all day. 
December 1. Same stupid condition. Five p. m., pulse 
100, temperature 103.5. 
December 2. Same half-sleepy condition. Slight suppu- 
ration from punctures of November 30, and skin deep red 
over circumscribed portions, abdomen not specially sensi- 
tive to pressure. Five p. m., pulse 116, temperature 103.5. 
December 3. Weak and exhausted. 
December 4. Electricity applied ten minutes ; complained 
afterwards that contents of tumor seemed like burning hot 
water. 
December 5. Same burning heat in tumor ; pulse 104, 
temperature 102.5. 
December 6. Appetite improved ; electricity six minutes. 
December J. Electricity ten minutes. Three p. m., great 
distress, pain, chill, face sunken and anxious, lasting about 
two hours. 
December 8. Electricity ten minutes ; patient quiet, 
pulse 104. 
December 9. Electricity five minutes ; urine scanty and 
dark. 
December 10. Weak, but comfortable. Electricity five 
minutes ; pulse 100. 
December 11. Weak and nervous. 
December 12. Electricity ten minutes; pulse 108. 
December 13. The same. Electricity ten minutes. At 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUND A. 
65 
2 p. M., sudden distress and pain in bowels ; chill, vomiting, 
loose stools. At 5 p. m., pulse 130, very weak ; 8 p. m. pro- 
fuse perspiration, coldness of surface. Patient died at 3 
A. M. 
Autopsy showed peritonitis, which Semeleder thinks had 
evidently started from the point where once only (Novem- 
ber 30) he had inserted both needles, and passed a cur- 
rent capable of decomposing .15 cubic centimeters of acid- 
ulated water per minute. The point of insertion of the 
negative needle was marked by a slough in diameter; at 
the positive pole there was merely a dry, burnt spot a little 
larger than the needle. Around several of the needle-punc- 
tures there were slight fresh adhesions ; at the spot of the 
first tapping there was a patch of cicatricial tissue in 
diameter. The tumor was' composed of eleven cysts, with 
liquid or gelatinous contents. There was extensive suppu- 
ration of the cyst. 
From the above report it must certainly seem that in- 
flammatory reaction followed very soon after the first elec- 
trolytic sitting and tapping, not alone after the introduction 
of both needles, as Dr. Semeleder supposes. Whether the 
electrolysis or the tapping gave the first incentive to inflam- 
mation and suppuration of the cyst is a question open to 
discussion. At all events the danger occasionally attending 
electro-puncture is sufficiently illustrated by this case. 
Case HI. Alexander J. C. Skene, Brooklyn. - Mono- 
cyst. One sitting ; two negative needles, twelve cells for five 
minutes. Thirty hours later peritonitis, which continued for 
eleven days and then subsided, but the patient never recovered 
her strength, and died on the twenty-third day. (Unpub- 
lished.) 
Mrs. N., aged 47 ; four children, youngest eleven years 
old, since birth of which her health has not been good. 
Five years ago attack of menorrhagia returning for sev- 
eral menstrual periods. About that time she noticed a 
tumor in the left inguinal region which has been grow- 
ing ever since. Menses now regular (August 23, 1876). 66 
ELECTROLYSIS OF OVARIAN TUMORS. 
Last winter she had what was called inflammation of the 
lungs, but no doubt was pleurisy. Now she has fluid in left 
pleural cavity. Pulse 118, temperature 102.5. Diagnosis: 
Large ovarian cyst and old pleuritis. 
December 13. Pleuritis has subsided and patient is 
stronger, but not in a condition for ovariotomy. Circum- 
ference at umbilicus 4O|". From pubes to ensiform carti- 
lage 2O|". Two needles were introduced into the cyst and 
connected with the negative pole, the positive electrode 
being introduced into the vagina ; twelve cells of Drescher's 
battery were used for fifteen minutes. A coffee-colored 
fluid escaped from the openings when the needles were 
withdrawn. Slight pain in the vagina at first, and then at 
needles. Fluid easily decomposed outside of the body. 
December 14. Thirty hours after the operation, chill at 
3 p. m., followed by fever and vomiting. 
December 15. 5I p. m. signs of peritonitis, pulse 120, 
temperature 102.5. 
December 16. Pulse 120, temperature 101. 
December 17. Pulse 102, temperature 100.5. Das had 
diarrhea and vomiting ever since 15th, which continued 
until 23d. 
December 18. Pulse 100, temperature 100.5. 
December 19. Pulse 106, temperature 99.5. Quinine 
first two days and continued throughout. 
December 20. Pulse 134, temperature 99.75. 
December 21. Pulse 104, temperature ico. Diarrhea 
less. 
December 22. Diarrhea worse, pulse 100, temperature 
100. 
December 23. Better; pulse 100, temperature 98.5. 
December 25. Better ; diarrhea and vomiting stopped, 
pulse 100, temperature 100. 
The acute symptoms subsided, but the patient continued 
to lose strength and died on the 6th of January, 1877, 
twenty-three days after the operation. Tumor unchanged 
in size. " I am satisfied " (says Dr. Skene) " that the oper- 
ation caused the peritonitis which hastened her death." 67 
Case IV. Dr. George Ross, Montreal.-Multilocular 
tremor. BotJi needles introduced; twenty-four sittings, each 
attended with some tympanites, but followed by general im- 
provement and marked decrease of tumor. Then sudden 
enormous tympanites relieved only by repeated aspiration of 
a large quantity of sulphureted hydrogen gas. Rapid col- 
lapse and death. Autopsy shows cavity of cyst communicat- 
ing with peritoneal sac, by recent needle puncture, also large 
hemorrhagic effusion into smaller cyst, rupture of this into 
peritoneal cavity. (Unpublished.) 
" C. L., 38, a large, healthy-looking Irish woman. Has 
been five years married ; no children or miscarriages; 
menstruation always regular. About the month of June, 
1876, began to notice her abdomen commencing to enlarge, 
but could not definitely say at one side more than the other. 
From this time she found her appetite failing, and began to 
suffer from occasional attacks of vomiting. The abdominal 
enlargement continued to increase and the sickness to be 
more frequent, when she was admitted into the Montreal 
General Hospital, under my care, October 7, 1876. 
On admission complained much of a pain in the left side 
of the abdomen which has been present for a month past, 
accompanied by frequent sick stomach. There is consid- 
erable dyspnea, patient being seldom able to lie down in 
bed. The bowels are obstinately constipated and the 
tongue furred. Considerable frequency of micturition, the 
urine being scanty and painful in evacuation. 
The abdomen is found to be occupied by a large tumor 
possessing all the usual characteristics of a multilocular 
ovarian cyst. Girth at the umbilicus forty-three inches. 
From anterior-superior spine to umbilicus on right side 
ten inches, on left side eleven inches. Fluctuation is 
most distinct upon the right side, where also the surface of 
the tumor is smooth, whereas upon the left and above, 
irregular projections of small cysts are distinctly to be felt, 
and the whole mass seems more solid. The skin can be 
freely moved over every part of the tumor. (Patient is 
PAUL F. MUNDE. 68 
ELECTROL YS/S OF OFARZAM TUMORS. 
stout and there is a very large quantity of subcutaneous 
adipose tissue.) Two days after admission she began to 
suffer from a thrombus of the right femoral vein accom- 
panied by fever, rapid pulse, frequent vomiting, great pain, 
and considerable swelling in the right leg. This, under 
treatment, subsided in about seven days, and was succeeded 
by a repetition of the same trouble in the left leg. Meantime 
the abdomen was slowly increasing, and the distress aug- 
menting, pains in various parts of the abdomen, anorexia, 
vomiting, etc. I therefore, on 22d October, tapped the 
tumor with the aspirator-needle and drew off thirteen and 
a half pints of very dark brown, somewhat viscid fluid. 
The umbilical girth before tapping was forty-three and a 
half inches ; after tapping thirty-seven and a half inches. 
The large mass of smaller cysts could now be distinctly felt 
inclining rather to the left side of the abdomen, and com- 
posed of an irregular aggregation of rounded lumps of va- 
rious sizes. The relief, of course, was great ; the stomach 
could retain food, the pains disappeared, the bowels acted 
and the appetite returned. Shortly after she underwent a 
second severe repetition of the phlegmasia in the legs, pre- 
viously described, during which time it was not thought 
advisable to pursue any other treatment. 
On 30th of November, her condition generally being 
tolerably satisfactory, the application of electrolysis was 
begun. Girth at this time thirty-eight inches. The battery 
used was one containing six cells of the character of 
Daniells ', viz., zinc and copper, with dilute sulphuric acid, 
and solution of sulphate of copper. Tested beforehand by 
plunging the needles attached to the poles into a glass of 
water slightly acidulated with sulphuric acid, decomposition 
of the water was seen to be rapidly effected, bubbles of gas 
being given off in a continuous stream. The electrodes were 
long steel gilt needles which were passed deeply into the 
tumor, one on either side. The current was then passed 
for ten minutes. Considerable burning pain at the nega- 
tive pole was felt. Clear evidence of electrolytic action PAUL E MUNDE. 
69 
upon the contained fluid was obtained by percussion, an 
area of several inches in circumference at the upper part of 
the tumor being found to emit a clear amphoric note, 
whereas, of course, previously, it was perfectly dull. There 
was a good deal of corrosion of the needles, but very much 
more on the negative than on the positive. For some days 
the punctured spots remained tender, and the negative one 
became somewhat hard and red. On 5th December, a 
second sitting of similar duration was given with a repeti- 
tion of the same phenomena, and on the 9th December the 
girth is noted at forty inches, but at the same time the 
general feelings of the patient were much improved. The 
electricity would seem also to affect the bowels, as on each 
succeeding day they are unusually relaxed. Applications 
were made on the nth and 18th December without further 
result. At this time, owing to very free menstruation, the 
treatment was suspended until 3d January, 1877, when it was 
resumed and continued regularly as described, three times 
a week, until 12th March, there having thus been twenty- 
four sittings in all. During this time the abdominal girth 
had been steadily diminishing until from forty inches it had 
fallen to thirty-five and one half inches, a less circumfer- 
ence than was obtained after tapping the main cyst. The 
abdominal walls were of course correspondingly lax, and the 
remaining mass could be explored in every direction. The 
improvement in the general condition of the patient was 
also very marked. She was free from pain, and quite cheer- 
ful. Could eat, drink, and sleep well, and gained much in 
strength. This was her condition on the morning of the 
15th March, the last application having been on the 12th 
March. Seen by the house-surgeon at 9 a. m. She was 
quite comfortable and ready to have a sitting that day. 
Very shortly after this, however, she observed that her ab- 
domen was rapidly swelling, so much so as soon to become 
very painful. Dr. Cline, the house-surgeon, saw her at 11 
a. m., and found the abdomen much distended and tym- 
panitic. He therefore ordered turpentine epithems and an 70 
ELECTROLYSIS OF OVARIAN TUMORS. 
enema of the same. This gave no relief, and by afternoon 
she was suffering much distress and frequently vomiting. 
The tympanites having now enormously increased, a me- 
dium-sized aspirator needle was introduced, which gave 
vent to a quantity of gas distinctly smelling of sulphurated 
hydrogen. Some relief followed. I saw her at 9 p. m. 
Found the patient sitting up with great dyspnea and 
rapid breathing, quick, small, shabby pulse, blue extremities, 
which were also cold, frequent vomiting. A larger needle 
was again introduced, giving escape to a copious flow of 
the same sulphurated hydrogen gas. Some hypodermic 
morphia was administered. She continued to sink, and 
died on the morning of the 16th March. I was fortunate 
in being able to secure an autopsy, from the record of which 
I take the following extract concerning the condition of the 
parts within the abdomen : " On opening the abdomen a 
small quantity of fetid gas escaped from the peritoneal cav- 
ity, and a large quantity of the same from a small puncture 
which had been made in the front of the sac during life. 
About seventy-five ounces of a turbid sanguineous fluid were 
removed. The sac of an ovarian tumor fills up the whole 
of the front part of the abdomen. The anterior wall of the 
same is of a dark red color, and scattered over with small 
extravasations. It is adherent above to the great omentum, 
which is pushed up. On the anterior surface the tumor is 
attached to the peritoneum over an area about two inches 
in diameter, to the right of the umbilicus, and over another 
similar but rather smaller spot on the left side, and at both 
these points the membrane is very much thickened. At 
the upper part of the tumor is a large, solid mass, attached 
to the mesocolon. On separating this from its attach- 
ments, which are not strong, the parts about are seen to be 
infiltrated with b'ood, and on close inspection a large por- 
tion of the solid mass is seen to be hemorrhagic. The 
hemorrhage has apparently taken place into the semi-solid 
cysts, which, becoming distended, have ruptured, permitting 
the blood to escape into the peritoneal cavity. About one PAUL F. MUND A. 
71 
hundred and fifty ounces of a dirty brownish fluid were re- 
moved from the sac. The lining membrane is dark in 
color and to the touch emphysematous." 
Case V. Dr. George Ross, Montreal. - Unilocular 
tumor; about twenty-one sittings; no marked benefit. Re- 
peated tappings during treatment. After last sitting local 
peritonitis at seat of puncture, and general collapse, appar- 
ently general subacute peritonitis. Ovariotomy; death; 
Firm, dense adhesions, at sites of needle-punctures. (Un- 
published.) 
" M. L., aged 24, was admitted into the Montreal General 
Hospital on the 13th October, 1876, with a large abdomi- 
nal tumor. She is a small, slim, French-Canadian girl, un- 
married. Has always been delicate, and has long suffered 
from dyspeptic symptoms. Menstruated since 14, but 
never very regularly, and has even passed as much as six 
months. Last winter first noticed a lump in the left side 
as large as the closed fist. It rapidly increased, and for re- 
lief she has been tapped four times by the local surgeon, 
at intervals of about two months. She says about two pail- 
fuls of yellow fluid were drawn off on each occasion. At 
present she is able to move about pretty well, but has occa- 
sional attacks of dyspnea, and complains of pain in the 
back and difficult micturition. This patient has a very thin, 
wasted look, and says she has become very thin and very 
weak since the commencement of her illness. The abdomen 
is pretty uniformly distended by a smooth-walled tumor 
through which the sense of fluctuation is peculiarly distinct 
in every direction. Girth at umbilicus thirty-seven and one 
half inches. 
On the 19th October, treatment by electrolysis was com- 
menced, the mode of procedure being exactly the same as 
that detailed in the case of C. L., that is, repeated every 
third day. On the 22d the girth is noted at thirty-nine 
inches; on the 29th, forty inches; November 8, thirty- 
eight inches; November 14, thirty-six inches; November 
19, thirty-four inches. With the view now, to shorten the 72 
treatment if possible, I determined, after the next sitting, 
to tap and remove the remaining contents of the cyst. 
Accordingly, on November 28, having applied the elec- 
tricity for ten minutes as usual, I introduced an ordinary 
aspirator needle and drew off six pints of fluid. It was 
yellow, transparent, and viscid, like strained honey. Girth 
after tapping thirty inches; November 30, thirty-three 
inches ; December 2, thirty-two inches. From this time 
the tumor increased pretty rapidly in size, and the ab- 
domen became tense in spite of the continuance of the 
electricity as before. December 19, thirty-six and a half 
inches ; December 21, thirty-seven and a half inches. On 
the morning following the application on this day she com- 
plained of severe pain near the puncture on the right side, 
fever, and headache ; the pulse rose to 120, the temperature 
to 1030 F. There was considerable tenderness around the 
part complained of, which was clearly the seat of local 
peritonitis. Ordered three leeches, followed by linseed 
poultices and one quarter grain morphia every four hours. 
Under this treatment the local symptoms were soon re- 
lieved, but the temperature and pulse continued high, and 
the fluid rapidly increased in amount, producing great ten- 
sion, with shining of the abdominal walls, with much pain, 
dyspnea and exhaustion. 
I was therefore obliged, through urgency of the symp- 
toms, to tap again on December 30, when fourteen and a 
half pints of similar fluid were removed. Even after this 
her condition remained unsatisfactory, abdominal pain, 
vomiting, a weak and rapid pulse, etc. By January 9, 
1877, the fluid had all re-collected, and she measured forty 
inches. Great dyspnea, she could retain no food, and evi- 
dently would soon die of exhaustion. In this desperate state 
of things I determined to give my patient the chance of 
ovariotomy. Having held a consultation of my colleagues 
in which they concurred in the propriety of the operation, I 
proceeded to the removal of the tumor by gastrotomy on 
January 10. I need not describe the operation, the only 
ELECTROLYSIS OF OVARIAN TUMORS. point calling for special mention being the,very firm and 
thick adhesions on both sides of the tumor at the seats 
where the punctures had been practised. These were unu- 
sually tough, and could only be torn through with great diffi- 
culty. There were no intestinal or other adhesions of any 
moment. The galvanic cautery was used to arrest hemor- 
rhage from all the smaller points. All instruments and 
sponges were carefully carbolized. The patient never rallied 
fully from the operation, though most carefully nursed, 
and died quietly at 7 a. m., the following day. 
The autopsy showed abundant signs of recent lymph from 
peritonitis, - raw surfaces corresponding with the situation 
of the needle punctures." 
Case VI. Dr. Emil Fliess,1 New York. - Large multi- 
locular tumor; general health poor. Aboztt tzventy-five sit- 
tings, the first sittings follozjued by fainting-fits and great 
prostration. Considerable decrease of the tzimor and general 
improvement. Last sitting only external galvanization ; 
same day peritonitis. Death. No autopsy. 
Patient aged 30, married, three children. Tumor noticed 
two years previously. General health poor. Circumference 
at umbilicus ninety-eight centimeters ; distance from sym- 
physis to ensiform cartilage, 46.5 centimeters. Abdomen 
very much distended. 
Treatment by electrolysis was commenced November 21, 
1868, and continued every second or third day until Jan- 
uary 9, 1869. The first puncture was very painful, and was 
followed by a fainting-fit ; current eighteen elements, eight 
minutes. The pain caused by the electro-punctures re- 
quired the application of wet cloths at home after every 
sitting, at first from six to eight, later, only from one to 
two hours. 
November 23. Yesterday less pain, but several fainting- 
fits ; circumference of abdomen diminished two centime- 
ters. Second electric sitting, fifteen minutes, followed by 
severe fainting-fit. 
PAUL F. MU ND A. 
73 
1 N. Y. Med. Jour.., Jan. 1877. 74 
November 25. Abdomen one centimeter more than last 
time. Much pain. Third sitting, eighteen minutes, no 
fainting-fit. 
November 25 to 29. Diarrhea and copious micturition ; 
great debility, but sleep improved. After the fourth sit- 
ting, the application was always made for thirty minutes, 
the strength of forty elements being gradually reached and 
continued, without inconvenience to the patient. The ab- 
domen became more and more flabby and the skin soft and 
rugous, the sensation of fullness was to a great extent re- 
lieved, the general health improved, the fainting-fits disap- 
peared, and the patient appeared in a fair way to be rid of 
her tumor. 
The fourteenth, sixteenth, eighteenth, and twentieth sit- 
tings consisted merely in the external application of the 
galvanic current, from which the benefit seemed to be about 
the same as from the galvano-puncture. 
January 9, 1869. The circumference of the abdomen at 
the umbilicus was found to have decreased from ninety- 
eight to eighty-three centimeters. The upper margin of 
the tumor could be felt as a distinct ledge, about four centi- 
meters above the umbilicus, but losing itself laterally. 
January 9. The patient came to Dr. Fliess' office feeling 
exceedingly well and in good spirits. Galvanism was ap- 
plied externally, and she returned home partly on foot and 
partly by the stage. After feeling well the whole day, she 
was suddenly attacked by a fainting-fit, followed by a chill, 
severe pain in abdomen, chiefly in left side, great abdominal 
distention, fever, and great prostration. There was fluctu- 
ation over a greater surface than before, and the abdomen 
was very tender to the touch. The latter symptoms im- 
proved somewhat, but the strength failed, and on January 
14 stercoraceous vomiting came on, which continued till 
her death on the 18th. An autopsy could not be obtained. 
It should be mentioned that the negative needle was not 
introduced directly through the skin, but that a steel trocar 
and canula were first introduced, then the trocar withdrawn 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUN DE. 
and a wire, insulated almost to the end, passed through it 
into the fluid. What the cause of the fatal peritonitis was 
is a matter of question ; but Dr. Fliess, while recommending 
the method for further trial, advises the precaution of un- 
dertaking it either in the patient's house or in a hospital. 
The fact that the peritonitis followed immediately after the 
last galvanic sitting will certainly give color to the supposi- 
tion that the electricity, even though it was merely applied 
externally, was the exciting cause. 
Cases VIL, VIII., IX., are merely mentioned by Dr. 
von Ehrenstein (see above), and referred to here as authen- 
tic on the authority of that gentleman. Particulars are un- 
known. 
Although the passage of a galvanic current through an 
organic substance merely by placing a sponge or other flat 
electrode on each side of that substance, external galvaniza- 
tion, cannot properly be called electrolysis (Beard and Rock- 
well 1 say, that when this term is " applied to any electrical 
operation, it is understood that electrolytic action was the 
leading effect sought for, and that it was obtained by nee- 
dles, or at least by some form of metallic electrode more 
or less pointed at the extremity"), still, for the purpose 
of completeness, I will report a few cases of treatment of 
ovarian cysts by so called " external electrolysis," which is 
generally supposed to be entirely innocuous, but will be 
seen to be followed occasionally by peritonitic symptoms, 
as well as electro-puncture. 
75 
Cases of Ovarian Tumors treated by External 
Electrolysis. 
(a) Cure. 
Case I. Dr. Francesco Dichiara, Professor of Sur- 
gery in Palermo, Italy.2 - Cystovarizcm ; great constitutional 
debility. Some three hundred sittings ; reduction of tumor 
1 Med. and Surg. Electricity, 1875, p. 699. 
8 Dell' Uso della Corrente Ellettrica, etc., Palermo, 1875. 76 
ELECTROLYSIS OF OVARIAN TUMORS. 
to the size of a hen's egg. Restoration of patient to complete 
health. 
M. R., aged 46, a nun in the convent of Santa Chiara 
in Palermo ; of nervous, lymphatic temperament, and feeble 
constitution. Seen in December, 1873. General health 
poot, much emaciated. An immovable, fluctuating tumor 
in left side of abdomen, reaching up to the umbilicus and 
extending to the right side. Free fluid in the abdominal 
cavity. Diagnosis of ovarian cyst was concurred in by 
Prof. Antonio Longo. 
About January 1, 1874, the first electric sitting was held, 
the galvanic current being passed for ten minutes through 
the tumor, one electrode being placed on the latter, the 
other on the lumbar region. This first application was well 
borne, and after a few additional sittings, which were pro- 
tracted to twenty minutes, expressed herself as feeling 
lighter, better able to walk, and as improving in digestion. 
These sittings were continued every day, excepting during 
the menstrual epochs, until December, 1874, being gradu- 
ally prolonged to one hour's duration. The second men- 
strual period after the commencement of the treatment 
passed with much less local and constitutional trouble, diar- 
rhea and pain, than usual. During March the ascitic fluid 
was diminished one half, and in May it had almost entirely 
disappeared. The cyst then also began to diminish and 
become movable; in June this diminution in size was still 
more marked, and in July the tumor was reduced to two 
thirds of its primitive volume. At the same time the gen- 
eral health of the patient had improved wonderfully, her 
appetite was good, she slept well, began to gain flesh and 
strength, her menstrual period was almost painless, and the 
amount of blood much diminished. Towards the end of 
December the tumor had decreased to a mere remnant of 
the size of a hen's egg, and the patient was in perfect 
health. The number of cells and the battery used are not 
stated. 
Case II. Dr. Frommhold, of Buda-Pesth, is reported PAUL F. MUNDF. 
by Semeleder,1 who gained his information from Benedikt's 
" Nervenpathologie und Therapie," 1874, to have cured an 
ovarian cyst by the external application of the Faradaic 
current. I was unable to find in the work of Benedikt re- 
ferred to any mention of this case, and Frommhold's work 
on "Electrotherapeutics," published in 1874, was not ac- 
cessible to me. The older edition of 1865, I think, con- 
tained no mention of the use of electrolysis in any shape 
in ovarian tumors. 
Case III. E. Cutter, Cambridge.- Case I. under A., 
" Cures by Electropuncture," Miss L., perhaps belongs here ; 
at least Dr. Cutter himself wrote me, that in his opinion the 
favorable result would have been obtained with the same 
certainty if the few electropunctures had not been made, 
but the treatment had been entirely external. 
77 
(f) Improved. 
Case I. Dichiara.2 - Daily sittings for four weeks ; 
great diminution in tumor and ascites. Treatment stopped 
on account of complicating malignant disease of uterus. 
Mrs. M. O. was first seen in 1873, when a tumor of the 
size of a lemon was found in the left iliac fossa, which was 
diagnosed as an ovarian cyst. In June, 1874, several phy- 
sicians again saw the patient and found the tumor enlarged 
to the size of a fetal head at term. Soon an ascitic devel- 
opment greatly enlarged the abdomen. 
September 29, 1874. Circumference of abdomen 96 cen- 
timeters. Commenced the continuous current adminis- 
tered as above, and continued in daily sittings of half an 
hour and more. Soon the ascitic fluid commenced to di- 
minish, the tumor gradually became more easily palpable, 
softer, flabbier, and November 1, more than two thirds of 
the fluid had been absorbed ; still the general condition did 
not improve, the emaciation increased, and it was thought 
1 TV. Y. Medical Journal, June, 1876. 
2 Loc. cit. 78 
ELECTROLYSIS OF OVARIAN TUMORS. 
that some other disease must be present. A vaginal exam- 
ination revealed malignant disease of the uterus, with which 
that of the ovary was probably connected. Galvanic treat- 
ment was, therefore, given up. 
(c) Negative. 
Case I. Th. Clemens, Frankfort. - Daily sittings; 
currents six to twelve cells Daniell for twenty days. Then 
necessary to tap, ttimor not decreased. At forty-eighth 
sitting still the same ; necessary to tap again. After a 
walk, peritonitis. Recovering when repotted)- 
Mrs. L., 32 years of age; tumor had been growing for 
eight years. Had been tapped twelve times, a large quan- 
tity of albuminous fluid having been removed each time. 
General health good. At the first sitting six electric shocks 
were sent through the tumor, then the current from six 
cells of Daniell's galvanic battery used, one electrode being 
on one, the other on the opposite side of the abdomen. At 
the second sitting ten cells were employed for fifteen min- 
utes. Daily sittings were held, and the current gradually 
increased to twelve cells. After twenty days the fluid had 
increased largely in quantity, and on the thirty-sixth day it 
became necessary to tap. A large amount of brownish fluid 
was removed, which created surprise, as it has always been 
perfectly clear in color. On examination it was found to 
contain a large amount of albumen, fibrine, and abundant 
tissue detritus. The original hard nodules of the tumor 
had become soft, and the whole tumor had descended in the 
pelvis. Electrolysis continued daily. 
After forty-eight sittings it was found necessary to tap the 
tumor again, and the same dark fluid was removed. One 
week later the patient took a long walk, was seized with 
fever and violent abdominal pain (peritonitis), from which 
she had not yet recovered. 
1 Loc. cit., Wiener Med. Presse, 1869. PAUL F. MUNDF. 
We thus have in 
79 
Class A. Cure . . . . . . >25 cases. 
" B. Permanent improvement ... 3 " 
" C. Temporary " .... 4 " 
" D. Negative result 6 " 
u (a. Peritonitis, recovery . . . 4 " 
' (b. Peritonitis, death .... 9 " 
Making a total of fifty-one cases of ovarian tumors reported 
as having been treated by electrolysis. 
Of these it appears that nineteen, or 37.25 per cent, de- 
rived no benefit whatever from the treatment, not counting 
the four cases in which the improvement was not perma- 
nent ; in thirteen, or 25.4 per cent, decidedly injurious effects 
were directly produced by the electrolysis, in consequence 
of which nine of these, or 17.6 per cent, of the whole fifty- 
one, died. 
Of the whole fifty-one cases, twenty-eight (giving Dr. 
Hayes' case the benefit of the doubt), or about 55 per cent., 
are reported as cured or permanently improved. In only 
twenty-six of the fifty-one cases is the anatomical character 
of the tumor mentioned, as follows : - 
Unilocular. 
Multilocular. 
A.. Cured 
5 
5 
B. Improved . . . 
i 
2 
C. Temporarily improved .... 
- 
2 
D. Negative . . 
I 
3 
( a. Peritonitis, recovery . 
I 
I 
E. Injurious j Peritonitis, death . . 
2 
4 
It thus appears that of the nine fatal cases four, or nearly 
one half, occurred in multilocular tumors, while of the ten 
cases reported as cured, in which the nature of the tumor 
is given, five were unilocular growths, and five polycysts. 
It is unfortunate that the character of the tumor is not 
mentioned at least in the majority of the cases, for the 
present figures do not permit the formation of any definite 80 
conclusions. While it does not, on the face of these in- 
complete returns, appear that electrolysis in multilocular 
tumors is more likely to entail injurious consequences than 
when practised on monocysts, on the other hand the latter 
do not seem more amenable to the electrolytic treatment, as 
Ultzmann from practical observation and theoretical rea- 
soning had supposed. Were his supposition of cure by con- 
tinual oozing into the peritoneal cavity through the needle 
punctures correct, a much larger proportion of monocysts 
would be reported cured, and I must in this respect concur 
in the opinion of Dr. Beard above quoted, an opinion shared 
also by Dr. Cutter who, in a private letter to me, referring to 
the oozing in Case II., under A. "Cured," says : " It is not 
desirable to force conclusions, but no such results as were 
obtained in this case follow mere tapping, therefore the cure 
could not come from the oozing. The uninsulation of the 
aspirator needle prevented contraction of the tissues through 
which it passed. The other needle being insulated gave no 
trouble." Besides, the cure in such cases could be only 
temporary, for the cyst would refill as soon as the needle 
punctures became closed. 
In this connection it may be well to state that the battery 
chiefly used by Dr. Cutter is so constructed as to produce 
mainly a caustic, and but very slight electrolytic effect, 
and the question might, therefore, very properly be raised# 
whether the cases reported by him were really treated by 
electrolysis at all. Still, this is a question open for discus- 
sion, for, as above stated, Beard - certainly a competent 
authority in electro-therapeutics - says that electrolysis is 
really the least important factor in the rationale of so called 
electrolytic treatment; the great desideratum is the indirect 
modification of nutrition through the nerves. And why 
would not the electro-cautery, as applied to the tumor by 
means of needles thrust into its substance, be likely to in- 
fluence or shock the nerves to a change of nutrition ? How- 
ever, so far as this paper is concerned, this question is of 
little importance; for only two of Dr. Cutter's cases were 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUNOZ. 
81 
cured, and one of these chiefly by the aid of external gal- 
vanization ; the third was temporarily improved, and the 
fourth did not respond to the galvanic punctures in any 
way whatever. 
Of course, as Beard and Rockwell say in their book (p. 
739), referring to the claim that electrolysis and external 
galvanization have dispersed ovarian tumors, " The diffi- 
culty of diagnosing ovarian tumors diminishes not a little 
the value of this claim ; " and the unbelievers in the method 
have contended that many of the cured cases were simply 
errors in diagnosis and no ovarian tumors at all, but merely 
ascites, flatulence, or adipose development. But we are 
certainly not justified in doubting the diagnosis of the gen- 
tlemen whose cases I have reported, many of them men of 
acknowledged eminence in the profession, well fitted to 
judge of these matters ; and are therefore obliged to accept 
them unconditionally, and try to reconcile our a priori rea- 
soning to the facts, not vice versa. 
That a number of ovarian tumors have been entirely 
cured (whether permanently will always remain doubtful, so 
long as the patient continues to live) by electrolytic treat- 
ment is beyond question, even though we admit the uncer- 
tainty of one or the other diagnosis. The question for us 
to decide, it seems to me, is whether the benefits of the 
method sufficiently counterbalance its acknowledged and 
proven dangers, and the continual uncertainty of its sup- 
posed successes. Obphoro-electrolysis was designed by its 
originators and advocates to supplant ovariotomy. Let us 
see whether its results will bear comparison with those of 
the latter operation. 
I have shown that about 55 per cent, of the cases of elec- 
trolysis reported above were cures. 
Spencer Wells reports 1 that of two hundred and ninety- 
six ovariotomies performed by him in the Samaritan Hos- 
pital during the last nine years, two hundred and thirty, or 
77.71 per cent., recovered. Of fifty-five ovariotomies per- 
1 British Medical Journal, March 3, 1877. 82 
ELECTROLYSIS OF OVARIAN TUMORS. 
formed in the same hospital during 1876, five, or somewhat 
over 9 per cent., died, leaving the enormous percentage of 
ninety-one recoveries.1 The former percentage Wells trusts 
to increase by operating only on antiseptic principles, un- 
der which plan the first twenty-seven cases of his ninth 
hundred all recovered. 
According to Graily Hewitt,2 between 70 and 80 per cent, 
of the ovariotomies by the more experienced operators of 
the present day recover ; a percentage far surpassed, as just 
shown, by some of the recent results of Spencer Wells, 
Keith, and several others. When we consider that out of 
every one hundred patients with progressive ovarian disease, 
ninety are sure to die within two years, if none but pallia- 
tive measures are adopted,3 and when we take into ac- 
count that ovariotomy radically cures the patients so far as 
disease of that ovary alone is concerned, while after elec- 
trolysis the danger of a relapse always hovers over, patient 
and physician, no matter how complete the cure may appar- 
ently have been at the time the treatment was discontinued, 
then it seems as though we are scarcely justified in tempo- 
rizing and trifling with our patient for months, when a swift, 
sure, and generally certain cure is at our disposal. 
That the dangers of electrolysis, simple though the pro- 
cedure may appear and actually is, should not be underrated, 
is proved by the occurrence of nine deaths in fifty-one re- 
corded cases, a percentage of 17.6 ; larger by 8 per cent, 
than that of Spencer Wells in about the same number of 
ovariotomies. 
The cases quoted in this paper show that electrolysis, 
when employed against ovarian tumors, may, even with all 
proper precautions, produce decomposition and suppuration 
of the cyst contents, great exhaustion and depression, peri- 
tonitis and death. I am informed on reliable authority (not 
1 Abstract in Boston Medical and Surgical Journal, February 24, 
1877- 
2 Dis. of Women, 1872. 
8 Ibid., p. 638. PAUL F. MUNDE. 
83 
by the operator himself), that in one of the above cases the 
intestine was punctured by the electrolytic needle, and that 
death actually followed this accident, although after so long 
a period of time as to lead me to exclude the case from the 
class E. b, under which it otherwise would have belonged. 
Add to these data, the length of time required for a thorough 
trial of the electrolytic treatment, a time often so precious 
as not to bear wasting in case the treatment proves ineffec- 
tual; further, the diminished chance of success from ova- 
riotomy, when the patient's strength has been allowed to 
depreciate during the vain electric course, and when, per- 
chance, adhesions have formed about the numerous needle- 
punctures (as occurred in four of the cases reported) ; and 
finally, the unavoidable, constant uncertainty of the perma- 
nence of the cure, so long as the least remnant of the dis- 
eased ovary remains, and the distrust with which many 
of our leading Gynecologists have begun to look on the 
method is scarcely to be wondered at. We thus find not 
only men who, like Semeleder, Skene, Fliess, and Ross, 
have been so unfortunate as to lose patients by it, but 
others, who have had favorable results, like Cutter and 
Macdonnell, sharing this distrust. 
Dr. Cutter writes me: " There is danger in this oper- 
ation ; " and attributes the deaths which have occurred to the 
use of uninsulated needles. He states his intention of con- 
tinuing his observations with external galvanization. This 
remark applies entirely to ovarian tumors, not to uterine 
fibroids, in which the pathological conditions are totally 
different, and where greater risks are allowable to secure 
proportionate results. 
Dr. R. W. Macdonnell, of Montreal, who has had one 
successful case, writes under date of April 30, 1877, to Dr. 
Cutter (to whose kindness I owe these extracts): " I think 
it would be a risk to allow the patient to use the battery 
for more than ten minutes, as the evolution of the gases 
might distend and perhaps burst a thin cyst, and then the 
escaped fluid would cause peritonitis. In an experiment,! 84 
made upon an ox-bladder almost filled with an imitation of 
ovarian fluid (z. e., whites of twenty eggs, salt and warm 
water), after electricity was employed for fifteen minutes, 
the upper part of the bladder became much distended with 
the gases, and tympanitic. We saw the gases ascending 
on both needles, and the coagulation of the albumen also. 
On opening the bladder the albumen presented the appear- 
ance of the white of a boiled egg. 
"In one of the cases in the hospital the upper part of the 
tumor became increased and tympanitic the day after elec- 
trolysis was employed. 
" We must proceed cautiously, for I confess my first 
ideas of the harmless nature of the process have been sadly 
shaken by the results of Semeleder's cases, as well as the 
results in the hospital." 
Again, in a later letter to Dr. Cutter : " The details have to 
be worked out yet. I shall, I think, dispense with needles, 
and apply the electricity over two large surfaces with sponges 
externally. It may take a longer time, but it will be free 
from danger. I intend using two or three separate batter- 
ies at the same time, so as to cover the tumor with five or 
six sponges, all working at the same time." 
Finally, in a letter to me, dated May 3, 1877, Dr. Mac- 
donnell says: " Electrolysis is not the simple thing that 
Semeleder's first papers would lead one to suppose. There 
is a great deal about it to which he does not even allude. 
In future I shall not use needles, and will confine the treat- 
ment to the application of wet sponges." 
While on the point of summing up the evidence above 
collected, and drawing whatever conclusions the facts would 
appear to warrant, I received the following letter from Dr. 
Von Ehrenstein, in answer to a final request from me for 
figures and positive statements. I give it verbatim, as I 
think its interest and importance demands : - 
ELECTROLYSIS OF OVARIAN TUMORS. PAUL F. MUNDE. 
85 
Vienna, May 7, 1877. 
Dr. Paul F. Munde, New York: - 
My dear Colleague, - Your esteemed favor has only just 
reached me here, where I am spending a few weeks for the 
restoration of my health. First let me thank you for your 
sympathy with my physical condition. I hope to return to 
Dresden by the middle of this month and to be able to re- 
sume practice during the coming summer. It is impossi- 
ble for me to answer your questions otherwise at present, 
in the absence of my notes, than from memory and conse- 
quently only approximately, but what I have to communi- 
cate may be briefly summed up as follows : The sum total 
of all female abdominal tumors treated by me with electric- 
ity, but not always by electrolysis only, amounts to four 
hundred and fifty-six ; of these about three hundred were 
cases of ovarian dropsy, two hundred and twenty of which 
being tumors with liquid contents, and of these all were 
cured, with the single exception only, of one patient who 
left before the completion of the treatment. In some of 
these cured cases, say, in thirty or forty, after two to five 
years the tumors returned, but were invariably removed 
again when the treatment was administered in my establish- 
ment ; one case of return, on the other hand, treated by a 
North-German physician with electrolysis only, without re- 
gard to my method, terminated fatally under his care. 
Twice I have been gratified by the intelligence that pa- 
tients who had been permanently cured of ovarian tumors 
by me had borne children two or three years later, which 
were stronger than those of which they had been previously 
delivered. 
Of the other cases those particularly took a less favorable 
course which had previously been frequently tapped, or in 
which solid masses projected like islands into the liquid 
contents. In this connection I will mention a cystosar- 
coma, the owner of which while under my treatment died 
of an accidentally acquired intercurrent pneumonia. The 
sarcoma was found at the autopsy to weigh fully thirty kilo- 86 
grammes (sixty pounds). Besides, a large number of cases 
of easily recognizable carcinoma of the ovary and other ab- 
dominal organs, and others in which the malignancy of the 
affection was not discovered until the autopsy, presented 
themselves for treatment, all of which terminated fatally in 
spite of the electric treatment, although even then the pain 
and dimensions were diminished thereby ; in general, how- 
ever, the electricity appeared rather to hasten the end, al- 
though no trace of suppuration or other traumatic inflam- 
mation ever followed the therapeutic measures or was visible 
at the autopsy. 
In conclusion, I particularly desire to caution the profes- 
sion against the decidedly false imitation of my method, 
according to which several German .physicians introduce 
both poles armed with needles into the tumor at once, while 
I principially insert only the cathode or positive pole, and 
am especially careful to prevent any absorptive fever by 
blood-purifying remedies particularly the sulphite of mag- 
nesium or magnesia sulphurosa (not the sulphate of mag- 
nesia). 
I shall be happy to be of service to you with further 
information should you desire it, and request, in case you 
publish any of these notes, that a copy be sent me to Dres- 
den. Yours very respectfully, 
Dr. Med. Von Ehrenstein. 
ELECTROLYSIS OF OVARIAN TUMORS. 
At first sight it would appear, as indeed it did to me, 
that this letter completely changes the figures and statistics 
collected and reported by me in this paper, making the pre- 
ponderance of successes (say two hundred and twenty, at 
least) so great as to throw the paltry few unfavorable re- 
sults (nine) entirely into the shade. But a moment's re- 
flection will show that this is not the case. My paper is 
based entirely on the individual cases and the special 
methods which have either already been published or were 
directly communicated to me by their authors. All these 
cases are enumerated with more or less detail, and in each PAUL F. MUND^. 
87 
the manner of application of the electrolytic method is dis- 
tinctly stated. On these only, therefore, can I base my 
conclusions, and so long as Dr. Von Ehrenstein does not 
favor us with a detailed account of his method in all its in- 
tricacies, and with positive and complete figures and histo- 
ries of his cases, so long will it be impossible to give his 
method the credit to which I trust it is justly entitled, or 
make his cases available for statistical research. 
I therefore believe myself fully justified in adhering to 
the conclusions which the facts developed in this paper 
appear to warrant me in drawing, as follows: - 
i. Unquestionably a number of cases of ovarian tumors, 
reported on reliable authority, have been completely cured 
or permanently improved by electrolysis ; out of fifty-one 
cases twenty-eight, or about fifty-five per cent. If only one 
case were cured by this treatment, it would suffice to estab- 
lish the possibility of such a cure ; that principle is there- 
fore secured. 
2. It is equally unquestionable, however, that in a num- 
ber of cases the electrolysis was followed by dangerous (thir- 
teen, or 25.4 per cent.) and even fatal results (nine of these 
thirteen, or 17.6 per cent, of the whole fifty-one). 
3. Further, six cases out of fifty-one received neither 
benefit nor injury from the treatment, and four were only 
temporarily improved ; total ten, or 19.6 per cent. 
We thus have a total of twenty-three cases, or forty-five 
per cent, in which the electrolytic treatment failed to ac- 
complish the object for which it was administered. 
4. The lack of accurate reports of the anatomical charac- 
ter of the cyst in the cases collected prevents any definite 
conclusion as to whether monocysts or polycysts are more 
or less amenable to electrolysis or unfavorably affected by it. 
It would seem, however, that the tumors most likely to be 
benefited by electrolysis are small monocysts, and polycysts 
with thin walls and fluid contents, and absence of large, 
solid masses. 
5. How the cures were effected is a matter still open to investigation, probably by some occult, as yet unexplained, 
influence on the secreting and absorbing powers of the 
nerves and vessels supplying the cyst walls ; certainly not, 
as a rule, however, by the oozing into the peritoneal cavity 
of the cyst contents through the galvanic needle punctures. 
6. Notwithstanding these undoubted cures, the percent- 
age of successes of obphoro-electrolysis (55 percent.) com- 
pares unfavorably with that of ovariotomy (70 to 80 per 
cent. ; Spencer Wells 78 per cent., in 1876 as high as 91 per 
cent.) ; and so also do the deaths by electrolysis (17.6 per 
cent.), nearly equal those following ovariotomy in recent 
years (20 to 30 per cent.; 22 per cent.) and far exceed those 
occurring in the last series of fifty-five cases of Spencer 
Wells (five, or 9 per cent.). 
This unfavorable proportion is intensified by the length, 
and often loss, of time involved in the electrolytic course, by 
the consequent increased debility of the patient and the 
diminished chance of success for ovariotomy when more or 
less extensive adhesions have been produced by the needle 
punctures, and finally, by the uncertainty as to the perma- 
nence of the cure after electrolysis, a doubt naturally inad- 
missible after the radical operation. 
7. Judging partly from these statistics, and partly from 
general considerations, it would seem that electrolysis can 
in no wise supplant ovariotomy, and that the cases in which 
it would appear justifiable to subject the patients to the 
tedious and protracted course of galvano-puncture usually 
indispensable to the attainment of any results, good or evil, 
narrow themselves down to two classes: 1, Small mono- 
cysts in which the discomforts are so slight as to render the 
more serious radical operation as yet uncalled for, and in 
which it seems fair to give the patient a - in such tumors - 
probably innocuous chance of a cure by milder means ; and 
2, particularly, large unilocular or multilocular tumors', in 
which the presence of extensive adhesions, especially in the 
pelvis, renders ovariotomy impracticable, and in which and 
palliative procedure is desirable and admissible, so long as 
88 
ELECTROLYSIS OF OVARIAN TUMORS. 89 
it affords the patient a hope of relief and temporary prolon- 
gation of life. 
To try electrical experiments with patients whose tumors 
and constitutions are in every way prepared for the radical 
operation looks very much like trifling with their lives. 
8. While this is the verdict forced upon us by experience, 
as regards electrolysis proper, there is one method of electri- 
cal treatment which, at least, is almost innocuous, and may 
therefore be employed if the condition of the patient per- 
mits the delay. This is external galvanization or Faradiza- 
tion, by both of which methods cures of ovarian tumors are 
reported by reliable authorities. The mixed treatment by 
electrolysis and external electrization has been followed by 
some operators as more safe than the former alone, and 
more efficacious than the latter, and by it, I believe, the 
majority of cures claimed by Von Ehrenstein were ob- 
tained. 
9. In conclusion, I feel it my duty to say that, in spite 
of the above figures and deductions, correct though they 
be, I do not feel justified in positively considering this 
question decided adversely, so long as the marvelous results 
claimed by Von Ehrenstein are not disproved or shown to 
be fallacious. In simple justice to himself, to his method, 
and to suffering humanity, Ehrenstein should without delay 
publish, not only the details of his method, but also histories 
of all his cases, and this I hope to induce him to do before 
the close of the present year. 
PAUL F. MUNDE. 
Note. Notwithstanding my earnest appeal, not a word has been 
heard from Dr. Von Ehrenstein up to date of going to press, March 
15, 1878. Can it be, as I am informed by excellent authority in Ger- 
many, that he is a visionary and his successes all delusion ? I leave 
the profession to judge for themselves. P. F. M.