A Farther Study of Anodal 
Diffusion as a Thera- 
peutic Agent 
BY 
FREDERICK PETERSON, M.D. 
ATTENDING PHYSICIAN TO THE NEW YORK HOSPITAL FOR NERVOUS DISEASES 
Reprinted from the Medical Record, January 31, 1891 
NEW YORK 
TROW'S PRINTING AND BOOKBINDING CO. 
201-213 East Twelfth Street 
1891 A Farther Study of Anodal Diffu- 
sion as a Therapeutic Agent.1 
By FREDERICK PETERSON, M.D., 
ATTENDING PHYSICIAN TO THE NEW YORK HOSPITAL FOR NERVOUS DISEASES. 
Reprinted from the Medical Record, January 31, 1891 
In a paper read before the Section on Theory and Prac- 
tice of the New York Academy of Medicine, in Febru- 
ary, 1889, I called attention to the therapeutic value of 
the cataphoretic power of electricity, to which power I 
gave the name anodal diffusion.8 The ability of a gal- 
vanic current, in flowing from the positive to the nega- 
tive pole, to seemingly carry substances with it even 
through a membrane, or through the skin, has been af- 
firmed by some, but even to this day, denied by other 
authorities. 
Dr. B. W. Richardson first drew attention to what he 
termed voltaic narcotism in two articles in the Medical 
Times and Gazette, in 1859. He produced local anaes- 
thesia with solutions of morphia, aconite, and chloroform, 
but the storm of opposition aroused over Europe made 
him subsequently abandon what was an actual discovery. 
1 Read before the Northwestern Medical and Surgical Society of 
New York, December 17, 1890. 
9 New York Medical Journal, April 27, 1889. 2 
H. Munk killed rabbits by placing a solution of strych- 
nia upon the anode, and applying it to the skin of the 
animals for a few minutes with moderate currents. Qui- 
nine and potassium iodide had also, many years ago, 
been experimentally introduced by cataphoresis, and 
quickly detected in the urine.1 
Nothing further was published until 1886, when Wag- 
ner3 printed a short note expressing a belief that anaes- 
thesia might be produced by the use of cocaine on the 
anode. He made no experiments. 
In the same year Adamkiewicz3 introduced his diffu- 
sion electrode and described his experiments and suc- 
cesses with chloroform in the production of anaesthesia 
and the relief of pain. 
The conclusions of Adamkiewicz were attacked by 
Paschkis and Wagner,4 who claimed that the contact of 
the chloroform with the skin was sufficient to produce 
the anaesthesia, and that the galvanic current had nothing 
to do with it for the resistance of chloroform was so great 
that it could not conduct at all. 
Lumbroso and Matteini6 employed chloroform the 
same year with ordinary electrodes for the relief of neu- 
ralgia. 
Dr. Corning,' of this city, produced anaesthesia with a 
five per cent, solution of cocaine on the anode after prick- 
ing the skin with needles. This was also in 1886. 
Dr. Reynolds,7 of Chicago, published, in 1887, an arti. 
cle upon the use of cocaine in two to twenty per cent- 
solutions with the anode in his dermatological practice 
for small cutaneous operations and for the electrolysis of 
hair roots. He also used voltaic narcotism in one case 
1 Landois and Sterling's Physiology, page 489. 
2 Wien. Med. Presse, 1886, page 212. 
8 Neurolog. Centralb., vol. v., pp. 219-497. 
* Ibid., vol. v., page 413. 
8 Sulla cataforesi elettrica. La riforma medica, July and November, 
8 New York Medical Journal, November 6, 18S6. 
' Journal of the American Medical Association, August 20, 1887. 3 
of tooth-extraction, as had been done by Richardson just 
thirty years before. Owing to the publication of Dr. 
Reynolds's paper in the journal mentioned, it escaped 
my notice altogether, and was not included in the list of 
authorities given in my first paper. I am under obliga- 
tion to Dr. R. H. M. Dawbarn for kindly calling my at- 
tention to it. Although Wagner and Corning had sepa- 
rately written about cocaine cataphoresis before Reynolds, 
they had not given it as great practical application as the 
latter. 
When I took up the subject of anodal diffusion in the 
winter of 1888 and 1889, the bulk of information at my 
command was limited and uncertain. There was so 
much controversy on every point, so much diversity of 
opinion, that even the existence of the cataphoretic power 
of electricity seemed to be as yet not scientifically proven. 
I therefore made some hundred experiments upon myself 
and patients, the most important of which were detailed 
in my first paper already referred to. 
The results of previous experiments may be summed 
up as follows : 
The current alone does not produce anaesthesia at 
either pole, although the anode has a transitory soothing 
effect over painful foci. 
A watery solution of cocaine applied to the skin is not 
absorbed, does not produce anaesthesia, except, perhaps, 
after an indefinitely long period. The same is true of 
chloroform and of an alcoholic solution of aconitia. 
A watery solution of cocaine is diffused through the 
skin and subcutaneous tissues by the anode, but not by 
the cathode. This is true of chloroform, aconit'a, strych- 
nia, potassium iodide, corrosive sublimate, tincture of 
iodine, and other medicaments. 
The anaesthesia produced by a ten to twenty per cent, 
solution of cocaine on the anode is sufficient for small 
operations and affords distinct relief for from four to 
eleven hours in cases of severe neuralgias in superficial 
nerves and without constitutional effects. 4 
The Adamkiewicz electrode is absolutely worthless, 
since it is so stupidly constructed that the current does 
not pass through the fluid contained within it but through 
its circular metallic rim. 
Chloroform, recommended by Adamkiewicz, and by 
Lumbroso, and Matteini, should only be used for cata- 
phoretic purposes when, in addition to producing a local 
anaesthesia it is desired to counter-irritate, for it causes a 
disagreeable dermatitis of a week's duration, as I have 
had reason to learn by experiment upon myself. It does 
induce a deep analgesia beneath the anode, but it also 
vesicates. 
Up to February, 1889, I had employed anodal diffu- 
sion of solutions of cocaine and aconitia, separately or 
mingled, in two severe cases of chronic supra-orbital neu- 
ralgia, selected for me as crucial tests by Dr. Seguin; in 
one case of double trigeminal neuralgia; in one case of 
inferior maxillary neuralgia ; in one case of locomotor 
ataxia for the relief of dorsal neuralgic pains. The suc- 
cess of the measure in all of these cases was undisputed. 
It gave hours of relief from excruciating pain, and with- 
out constitutional effects of any kind. Nothing was 
claimed for it as a curative procedure, but it certainly 
proved to be a more than efficient substitute in these 
cases for morphine, which, as we too well know, is so 
prone to exact for its hours of solace lifetimes of wreck 
and ruin. 
Since the publication of my paper other articles which 
serve to show the growing recognition of the value of 
the method have emanated from various sources. Dr. 
Cagney,1 of London, reported his experience in the use 
of cataphoresis before the Harveian Society, November 
7, 1889. He employed iodine and a saturated solution 
of potassium iodide with the anode for labyrinthine 
oeafness, lead palsy, small tumors of the skin and mu- 
cous membranes; for syphilitic and other throat affec- 
1 British Medical Journal, November 16, 1889. 5 
tions; for chronic pharyngitis ; for nodes and gummata, 
tubercular ulcers, mucous patches and papular syphilides; 
for indolent ulcers, lupus, acute and strumous glands. In 
the discussion upon Dr. Cagney's paper, Mr. Juler stated 
that he had found the method useful in tobacco ambly- 
opia. 
In the same month, Drs. Gartner and Ehrmann 1 made 
a communication to the Imperial-Royal Society of Physi- 
cians, of Vienna, in reference to the cataphoretic use of 
corrosive sublimate. Dr. Gartner's electric bath tub was 
employed, from four to six grammes of mercuric bichlo- 
ride being dissolved in the water of the bath. A current 
strength of 100 milliamperes was passed through the per- 
son experimented upon for fifteen or twenty minutes, and 
subsequently mercury was found in the urine in as large a 
quantity as 1.3 milligr. There were traces of the metal 
in the urine for from four to six days after the bath. 
Some time ago Boccolari and Manzieri2 announced 
their intention to study the effects of electric cataphore- 
sis in connection with mineral baths, but I have been able 
to find no published record of the results of their studies 
in this direction. They have published, however, their 
use of anodal diffusion of drugs in parasitic affections of 
hair roots. 
Woodbury3 described in May, 1890, his successful em- 
ployment of the anode with a solution of iodide of lithium 
in a case with a syphilitic cutaneous neoplasm. 
Shoemaker 4 has also written upon the uses of cata- 
phoresis in certain skin diseases. 
Dr. A. Barth 6 describes cocaine cataphoresis as em- 
ployed by him in a number of operations upon the tym- 
panum and external auditory meatus, finding a ten per 
' Wiener Med. Blatter, November 28, 1889. 
2 Internal. Klin Rundschau, September 2, 1888. 
3 Philadelphia Medical News, June 21, 1890. 
4 Sajous' Annual, 1890. 
5 New York Archives of Otology, April-July, 1890, New York, pp. 
100-101. 6 
cent, solution on cotton connected with the anode very 
successful. 
At the International Congress held at Berlin in August, 
1890, Dr. Bayles, of Orange, N. J., read a communi- 
cation from Mr. Edison, the inventor, upon the medical 
employment of cataphoresis. The transactions of the 
Congress not yet having been published, I am indebted to 
my friend, Mr. A. E. Kennelly, Chief Electrician of the 
Edison Laboratory, for the following brief synopsis of 
Mr. Edison's experiments : 
" The first trials were purely physical. With a current 
of twenty milliamperes, lithium chloride was forced 
through a septum of animal membrane by electrical en- 
dosmose. 
li The second series of trials was upon the person of a 
healthy young laborer, who dipped one hand in a solution 
of common salt, and the other in a five per cent, solution 
of lithium chloride in water, for two hours daily for ten 
days. His urine examined before the test showed no 
more than mere traces of lithium. His urine collected 
during that period exhibited distinct presence of lithium- 
five milliamperes. 
" The third trial was upon the pdrson of an old man 
suffering from acute and chronic uric-acid concretions. 
He was in an advanced stage of the ailment, and most of 
his joints were affected ; the joints between the phalanges 
were almost obliterated. He immersed one hand in lithium 
chloride solution, the other in common salt solution, while 
a current from the one hundred and twenty volt electric- 
light circuit was employed through resistance to pass 
through his body. Measurements of the hand in the lithium 
chloride solution showed after some twenty-five hours of 
total application, a distinct reduction of bulk. There 
was also considerable relief from pain, and the general 
condition of the patient was ameliorated. The current 
strength in his case was twenty millliamperes (four times 
more than the previous healthy subject could stand with 
convenience)." 7 
Mr. Kennelly also calls my attention to a pretty experi- 
ment recently described by Dr. Ehrmann to demonstrate 
the cataphoretic power of the anode : 
Take two similar glass vessels, with zinc electrodes at 
the bottom, and filled with a very weak solution of methyl 
blue. Insert the hands, one in each, and cause ten to 
twenty milliamperes to pass for five to ten minutes. The 
hand in the anode vessel will be covered with blue spots. 
The earlier criticisms of medical men that there was no 
such thing as the anodal diffusion of drugs must in the 
face of such accumulating evidence be entirely silenced. 
It is only one and a half years ago since, in the discus- 
sion of my paper, some who took part manifested entire 
incredulity. The far more vital criticism, however, that 
accuracy of dosage was impossible by this method of 
medication has been until now unanswered. The hollow 
electrode of Munk with clay bottom, of Adamkiewicz with 
carbon bottom, and of myself with a membranous bottom, 
each has failed to determine properly the quantity of the 
medicament employed. But this is now no longer a 
valid argument against anodal diffusion, since by the 
means I have of late employed, exact dosage is simplicity 
itself.1 It is only essential to possess a flat metal 
electrode, preferably but not necessarily of platinum 
(platinum is now almost as costly as gold) or tin. A 
nickel plated surface will answer. This may be made of 
any size, round or square, convex or concave. A piece 
of tissue or filtering paper or linen is cut to fit over the 
metal surface. Upon it is placed, drop by drop, the solu- 
tion of any drug to be used, and the electrode is then 
applied to the skin. There is then a thin capillary layer 
of the medicament in the paper disk between the electrode 
and the skin, and the quantity of the drug is known. The 
electrode made for me by Messrs. White & Bartlett, of 
this city, is round, flat, two or three centimetres in diameter, 
and is provided with a narrow, soft rubber rim at its edge, 
1 New York Medical Journal, November 15, 1890. 8 
which, by its close approximation to the skin, prevents any 
loss of the solution by evaporation. In order to have 
drugs ready for use at any time, disks of paper to fit the 
electrode may be charged with aqueous or alcoholic 
solutions, and then allowed to dry, a drop or two of 
menstruum being added when they are to be used. Otto 
Boeddiker, Pharmacist, 954 Sixth Avenue, of this city, is 
prepared to furnish anyone with medicated cataphoretic 
disks to fit the electrode, and has made for me satisfactory 
disks of menthol, cocaine, helleborin, strychnine, iodol, 
corrosive sublimate, aconitine, potassium iodide, imido- 
succinate of mercury, and the chloride and benzoate of 
lithium. 
As regards the current strength to be employed one 
must be guided by the patient's feelings. Anywhere 
from five to twenty milliamperes may be used for from 
five to fifteen minutes. The stronger the current the 
shorter the duration of the stance. If one has no 
galvanometer he may use ten to thirty or more cells of any 
battery, Grenet, Leclanche, or chloride of silver. 
Anodal Diffusion of Drugs.-The indications for the 
application of the method of anodal diffusion of drugs 
may be summarized as follows : 
To Produce Local Ancesthesia for Neuralgias, Superficial 
Pains, and Cutaneous Operations.-With an additional ex- 
perience of nearly two years in the frequent treatment of 
neuralgias of superficial nerves with ten to twenty per 
cent, solution of cocaine on the anode, I can only reiterate 
my conviction that it is the best means we have for relief 
of the pain without constitutional effects. I have had no 
experience of the method in surgery, but I quote the 
following from a letter received from Dr. R. H. M. 
Dawbarn, June 10, 1889, which will merely serve as an 
instance of the successful employment of voltaic 
narcotism in a small operation : 
" I have recently, since reading your article, tried this 
method upon a child's hand, requiring suture of a severed 
tendon. The injury was an old one, and there was no 9 
wound before I made my incision. The anaesthesia from 
ten per cent, cocaine upon the anode, continued with my 
chloride of silver battery (twelve cells) for ten minutes, 
was very satisfactory." 
I have experimented with other local anaesthetics. 
Aconitia produces a deep analgesia, but it is accompanied 
with severe smarting around the edges of the anaesthe- 
tized area. A combination of cocaine with the aconitia 
prevents this hyperaesthesia. I was led by a note on hel- 
leborin 1 in a medical journal to make use of this alka- 
loid as a local anaesthetic. Three or four drops of a 
one per cent, solution of helleborin on the anode have 
brought about much more gratifying results than cocaine, 
a deeper and more lasting anaesthesia, and I have never 
noted constitutional effects. The latter need not be 
feared now that dosage has become accurate. At the 
same time I should advise caution in the employment of 
so powerful an alkaloid. 
Both onabain and strophanthin 2 (Arnaud's, not 
Merck's) are strong local anaesthetics, and may be used 
with the anode in doses of of a grain or more. 
One or two. drops of chloroform on a tissue-paper disk 
placed upon the anode will bring about a deep analgesia 
in a very short time, but will, be followed later by vesica- 
tion. When it is desirable to first anaesthetize and then 
counter-irritate, chloroform cataphoresis may be advis- 
able, and will prove useful in some neuralgias. 
A mild solution of carbolic acid may also be employed 
as a local anaesthetic and analgesic. 
For Topical Medication in various Local Lesions, such 
as Tumors, Rheumatic, Gouty, and other Swellings, various 
Skin Diseases, Syphilides, etc.-For such cutaneous disor- 
ders as are commonly treated by painting with iodine, the 
use of some of the iodine preparations, such as potassium, 
sodium, or lithium iodide, iodol, or diluted tincture of io- 
dine upon the anode is indicated. 
1 Venturini and Gasparini. Brit. Med. Journ., August 4, 1888. 
a Fortschritte der Medicine, February 1, 1890. 10 
For rheumatic and gouty swellings, solutions of the 
chloride, benzoate, or citrate of lithium, all very soluble 
salts, should be employed with the anode. Among mer- 
curial remedies the imidosuccinate and bichloride of 
mercury are well adapted for cataphoretic purposes. 
The rhinologist and laryngologist will find the method 
particularly adapted to the treatment of many difficulties 
of the upper air-passages which may require the applica- 
tion of anaesthetics, astringents, or antiseptics. 
For Electro cataphoretic Baths for General Purposes.- 
There would seem to be considerable usefulness in the 
method as applied to mineral baths. Although Gartner 
has been at great pains to invent a particular kind of 
bath-tub with two compartments for electrical purposes, 
it is not essential to have any such arrangement. By 
making an ordinary bath the anode, the hands may 
close the circuit by grasping a cathode suspended just 
above the bath. Thus almost the whole surface of the 
body may be subjected to the anodal diffusion of the 
therapeutic agent dissolved in the bath. Outside of tonic, 
stimulating, and alterative, such as are found in health re- 
sorts, cataphoretic baths of iodide of potash might prove 
useful in cases of lead poisoning, etc. 
The Use of Cataphoresis for Diagnostic Purposes.-In the 
discussion which followed the reading of my first paper 
upon this subject, Dr. Starr called attention to the pos- 
sible usefulness of cocaine cataphoresis in diagnosis. Thus 
if a pain were complained of, for instance in some part of 
the trigeminus, it should disappear under this treatment. 
If it did not, the lesion could be localized further back, 
or it might lead to the conclusion that it was a hysterical 
pain. I had myself an interesting example of its useful- 
ness for this purpose some time ago. I was called in 
consultation to see a lady who had been suffering for 
months with a rather superficial but excruciating pain in 
the knee following slight trauma. The knee was swollen 
from blistering, the limb was rigid, the patient sleepless 
from pain and anxious to have the leg amputated. The 11 
spot upon which I placed the anode with cocaine was so 
hyperaesthetic that the slightest touch made her wince 
with pain. Her eyes being closed, I stuck a pin in the 
part after a few minutes, which she did not notice. When 
she opened her eyes, the electrode having been removed, 
I touched the anaesthetic part with my finger, and she 
winced with pain the same as before. Although the limb 
was, I believe, subsequently amputated, my diagnosis of 
a hysterical knee-joint was amply corroborated by micro- 
scopical examination. 
In view of all the facts which I have adduced in this 
brief paper, there can be no doubt that the anodal diffu- 
sion of drugs is destined to far wider application than it 
has as yet enjoyed, and that the general practitioner and 
the specialist alike will find the procedure increasingly 
useful as a practical therapeutic measure. To close with 
a quotation from an editorial in the New York Medical 
Journal, December 28, 1889, it is a method that " opens a 
way not otherwise attainable for influencing tissue metab- 
olism and for changing morbid nutritive processes by 
sending the drugs into direct and immediate contact with 
diseased parts through a force which in itself must greatly 
enhance their active medicinal properties."