NEW THOUGHTS ON Medical Electricity.
The Reader is desired to correct the following ERRATA with his Pen.
P. 7 l. 22,
for
she was
read
she then was: l. 24,
for
perswaded
read
persuaded
P. 15, l. 4,
after the Word
Limbs,
add
&c.
P. 18, l. 3,
after the Word
contracted
add
Fibres
P. 27, l. 21,
for
Tensions
read
Tension
P. 30. l. 3,
for
Colds
read
Cold — l. 10 & 11,
for
in a Palsy
read
in this Kind of Palsy
P. 34, l. 26,
for
it's Accord
read
it's own Accord
There are a few Mistakes in the Punctuation, which the Reader will be kind enough to correct according to his Discretion.
NEW THOUGHTS ON Medical Electricity. OR, An ATTEMPT to DISCOVER THE REAL USES OF ELECTRICITY in MEDICINE. In Two LETTERS to a FRIEND.
Quaere Fugam Morbi.
HOR.
SEVENOAKS: Printed by THO. CLOUT Jun. Sold by S. A. CUMBERLEGE, Successor to Mr. J. HINTON. Pater-nostre-row, LONDON. 1782.
[Price One Shilling.]
PREFACE.
A S the Author of the following Letters professes not to write for Honor or Profit, but entirely for the Benefit of Mankind, it cannot reasonably be expected that he should take vast Pains, or spend much Time, in embellishing his Performance with Elegance and Ornament. His Aim is not to be entertaining, but useful. —It is almost certain that his Pamphlet cannot be long lived, because if the few Hints therein contained shall not be thought worthy of Consideration, it will immediately sink into Obscurity; if otherwise, they will soon be taken up, improved, enlarged, and given to the World in a more finished Dress by some abler Pen. If therefore he has not always expressed himself like a Surgeon or Anatomist, or if there be any other Defects in his Performance, he trusts these will not be deemed sufficient Reasons for condemning it: as he has doubtless a Right to be judged, not from the Accuracy of his Style, but from the Importance of his Subject, and the Originality and Truth of his Observations,
New Thoughts ON MEDICAL ELECTRICITY.
DEAR SIR,
Feb.
27, 1781.
H AVING lately met with as remarkable a Case in Medical Electricity, as perhaps has yet appeared in the World, I give myself the Pleasure of sending you an Account of it.
In the Month of
June,
1779, a young Person had the Misfortune to break her right Arm; which, as it was only a simple Fracture was easily reduced. But unhappily the Bandage being made too tight, the Arm was soon invaded with a very severe Pain, which in about twenty-four Hours became intolerable. A Surgeon happening to pass by the House in which the Patient then was, was called in, who immediately cut open the Bandage; when great Part of the Arm appeared to be in a gangrenous State, and a Mortification had actually begun at the Elbow. These Symptoms however were without much Difficulty overcome by proper Applications, and the Cure of the Fracture went on very well; but from that Time the Use of the Arm was lost. About three Months after this, the whole Arm and Hand began to waste, and gradually became an Object too full of Distress, to be beheld without exciting the Emotions of Surprise and Compassion. A large and hard Knob was formed on the
Fore-part
of the Arm, a little above the Bend of the Elbow; and another on the
Hinder-side,
near the upper Head of the Shoulder-Bone. The Fracture itself was near the Middle of the Bone. The whole Arm was so weak, that when it hung by her Side, she was not able to raise it without the Assistance of the other: and when supported in an horizontal Posture, the Wrist fell as in a Palsy. The Fingers were drawn backwards to such a Degree, that the Heads of the Finger-bones were forced out of the Sockets, where they join to the Palm of the Hand. At the same Time the other Joints of all the Fingers were contracted forwards, so that the Hand could not be opened or shut; and according to her own Expression,
looked more like a Bird's Claw than a Hand.
Both the Hand and Arm were almost void of Sensation, except of an obtuse Pain at Times with a pricking Numbness, and so emaciated as to become a meer Skeleton. Every Application of Baths, Liniments, Fomentations, Cataplasms, &c. &c. was tried without the least Appearance of Success; but it was observed that those of the astringent Kind, seemed to be most injurious: and the Calamity was much heightened by the melancholy Prospect of it's growing continually worse; to which was added, the Mortification of the Patient's being assured, that if she did not find Relief in a very little Time, she would have a compleatly withered Arm. In this deplorable Situation she remained at the Beginning of
March,
1780; when the Surgeon under whose Care she was, advised her to try the Effect of ELECTRICITY: adding, that he was thoroughly perswaded, that nothing within the Practice of Surgery could possibly be of any Service to her. On this she went to
London,
and after consulting several Surgeons (some of whom very earnestly recommended it, and others as earnestly dissuaded her from it,) at length determined to put herself under the Direction of Mr. LONG, of
Little Compton Street, Soho;
an experienced Practitioner, who has made Medical Electricity great Part of his Study and Employment for many Years. This Gentleman candidly told her, that her Case appeared so bad, that he could not give her any great Hopes of Success; that she might try if she pleased,
but if she should receive Benefit, it would be next to a Miracle.
Willing to try, though in a Manner without Hope, about the latter End of the same Month, she began to enter on a Course. At first the Operation was carried on very gently, as by drawing the electric Stream, small Sparks, and slight Shocks, which were attended with no visible Alteration. The Operator then proceeded to electrify more sharply, after which she soon began to find some small Signs of Relief. Thus she went on for about six Months, continuing to be electrified every Day, Sundays excepted. The Method in general was, to draw Sparks with a large and powerful Machine on one Day, and to give strong Shocks another Day; both which were continued as long as the Patient could well endure it. I cannot determine how strong the Shocks were, but by the Patient's own Description, some of them might be from a three-pint or two-quart Jar full charged. Sometimes the Number of Shocks amounted to one hundred and fifty, and even to two hundred, so insensible was the Arm at that Time. They were however sufficient in Number and Strength, to make the whole Limb swell exceedingly. The Effect was, a slow Improvement of the Sensation, Use, and Strength of the Limb; insomuch; that by
Michaelmas,
1780, her Condition was become quite happy, in Comparison of what it had been. She could now lift the Arm without Assistance, move the Elbow and Wrist, and had some Power of moving the Fingers. The Heads of the Finger-bones were reduced into their Sockets; but the Hand remained about half open; without the Ability of extending or clenching the Fingers. The fleshy Parts of the Arm were visibly increased in Bulk, as were those of the Hand, though in a less Degree. At this Time her Affairs calling her into the Country, the Electrification was discontinued until about the Middle of
January,
1781; when the Patient came into my Neighbourhood on a Visit to a Relation, and being within a convenient Distance of my House, an Opportunity presented itself for carrying on the Operation; which I have endeavoured to perform, in the same Manner as it was practised in
London,
as near as I can collect from the Patient's Account. It is now about six Weeks since I began, and I have the Satisfaction of perceiving the Arm, and especially the Hand, improved in a Degree that has exceeded my warmest Expectation. The Power of clenching and extending the Fingers is wonderfully increased, and the whole Limb better covered with Flesh. About a Week ago, the Muscles on the Back of the Arm were (upon moving the Fingers) observed, for the first Time, to work under the Skin; and she now began to make a feeble Use of her Needle, to lace her Stays, and dress her Head: and remains in a pleasing Expectation of receiving further Benefit, from the Continuation of the same Means that have hitherto been so successfully applied.
From the aforementioned Appearances (particularly the Wasting of the Limb) may we not conclude, that not only the Muscles and Tendons of the
Os Humeri,
but also the great Nerve itself was injured; especially if it be considered that the Patient is a Person of a very slender Make; her Arms being so exceeding small, that it would require no violent Pressure to injure every Muscle, Tendon, and Nerve between the Skin and the Bone? There was undoubtedly a violent Tension of the Muscles and Tendons, if not of the great Nerve itself, to which Electricity seems to be a Remedy peculiarly adapted. For my own Part, I never could perceive any great Benefit arising from it, unless there was Reason to suspect something of this Kind: and in Cases of this Nature, I do not recollect a single Instance in all my Practice, where it sailed in affording more or less Relief. In a slight Burn or Scald, it is well known there is a Tension on the Skin; and I will venture to say, that Electricity properly applied will afford more immediate Ease to the Pain occasioned thereby, than any thing contained in the whole Materia Medica.
I am, Sir, &c.
FROM the Date of the foregoing Letter, till past the Middle of April following, the Patient, whose Case is related therein, continued the Electrification, with little or no Alteration to the afflicted Limb; the Weather being all that Time very dry, and the Wind North, or North-east. But about the
21st,
or
22nd,
the Weather becoming of a Sudden remarkably mild and soft, as remarkable and sudden a Change was experienced by her, which exceedingly flattered our Hopes: the Numbness and pricking Sensation, which had never ceased from the Time the Misfortune happened, was now entirely gone off: but as the fine mild Weather did not last long, and the Wind returned into the North-east, the disagreeable Numbness returned with it; and has ever since continued in a greater or less Degree, in proportion as the Air has been more or less cold, sharp, or dry.
It is further observable, that the Limb during that Season, and at Times ever since, has been more painful than when the Calamity was at the Worst: for from
Christmas,
1779, till
March,
1781, notwithstanding the great Improvements made in the Summer of 1780, so great was its Insensibility, that all Kinds of Weather were alike to it: at the same Time the Patient began to be more shy of the electric Stroke, which obliged us to diminish the Strength and Number of the Shocks. At the latter End of
June,
1781, a free Perspiration first appeared on the Hand and Fingers; and the Skin, which had hitherto wore a very shining Polish, began to look more like that of the other Hand. On the
7th
of
July,
we were agreeably surprised on discovering the Fingers to have a much greater Power of Extension than usual; since which Time, nothing has happened that requires particular Description. It is sufficient to say in general, that the Limb continues improving in all Respects; that these Improvements are seldom observed to be regularly gradual, but appear mostly on a sudden; and after such long Intervals, that we more than once began to despair of farther Success: and that the Progress of the Cure is always very much advanced or retarded by good or bad Weather.
That the Powers of Nature alone were not sufficient to work such wonderful Alterations, as I have described, appears very plain from the State of the Arm between
Michaelmas,
1780, and the Middle of
January,
1781; in which Space of Time, the Patient declares she did not perceive the Arm grow better or worse, during the Omission of Electricity. That Omission therefore seems to be a very fortunate Circumstance, as it enables us to determine, with a great Degree of certainty, the vast Importance of Electricity in Medicine.
AT the latter End of the last Summer, the Writer of the preceding Letter had an Opportunity of seeing his Friend, to whom it was addressed; when the Conversation turning on Medical Electricity, furnished some Hints that occasioned a second Letter, as follows.
LETTER II.
DEAR SIR,
Jan.
10, 1782.
O UR last Conversation, which turned chiefly on the different, and opposite Success of Electricity on contracted Limbs, has to me been a Subject of much Consideration: and I am not without Hope that such seemingly various Effects may be accounted for, without imputing any uncertainty to the Operation itself.
We are to observe, that a Limb or Joint may become contracted from opposite Causes: either from a
real Injury,
or
morbid Contraction
of a Muscle, or from the
mere Relaxation
of its Antagonist. The Consideration of this Difference you well know to be of the utmost Importance in Practice; and it often requires great Skill and Attention to make the Distinction. If a Muscle or Tendon be relaxed in any great Degree, its Antagonist may, by its own natural contractile Power, shrink in such a Manner, as to give the Limb a srightful Appearance: and if this should be mistaken for a Tension or unnatural Contraction, the Treatment will consequently be a perverse one: and instead of Relief, the Patient will most probably find his Malady increased. Hence we may see why the same Method of Treatment shall sometimes succeed, and sometimes fail, in Cases apparently the same: and also why Complaints seemingly different, shall often yield to the very same Medicines: and hence may arise that Uncertainty of Success so frequently attributed to Electricity by those who are no Friends to it. Electricity as well as other Medicines, may be used contrary to the true Intention of Cure. There is however one happy Circumstance attending it, viz. That if it should happen to be used improperly (unless in a very imprudent Manner,) there is not so much Danger in it as may be imagined. A fair Proof of this, is that noted Case, mentioned by divers Writers, of a Girl who had a Palsy in her right Arm, which was twice increased by electric Shocks, and as often restored to the State in which it was before Electrification. Now if we consider Electricity as a Relaxer of the Solids; we may, I presume, reasonably enough conclude the true State of that Case to be this. The first Complaint was a Relaxation, consequently the Electricity was ill applied. Yet notwithstanding, as the Accounts declare, the Shocks were pretty fevere, it did but a temporary Damage; for the Fibres, although much injured before, had Elasticity sufficient to recover their former debilitated State. Whence we may infer, that in Cases of Uncertainty, a moderate Degree of Electricity may, nay sometimes ought to be applied, were it only to find out, whether the Distortion arose from an
unnatural Tension
of one Muscle, or
an unnatural Distension of another.
Hence also appears a Reason why, even in Cases wherein Electricity is properly applied, it can afford but a temporary Relief: as in Persons whose Fibres are become habitually rigid, from the several Causes of Time, Heats, Colds, Labour, Strains, hard Drinking, &c. &c. In such Subjects, nothing more than a temporary Relief can reasonably be expected; because the dry, impervious Fibres will inevitably return to their rigid State, for Want of that vital Warmth, and lubricating Moisture which are necessary to preserve their Flexibility. But in young and healthy Persons, the contracted shall be restored to their due Tone (provided the Injury be not too great,) of which there are many authentic Proofs. And it has often happened, that when the Injury has been too great to admit of a perfect Cure, a partial one has been obtained, which never relapsed; and this after the most approved Remedies had been tried in vain. From all which I infer, that where there is already too great a Relaxation of the Solids, Electricity is at best but useless.
Experience proves Electricity to be a great Promoter of the purulent Discharge in Issues, Blisters, &c. which Discharge arises from the Relaxation of the Mouths of the cuticular Vessels, after the Tension is destroyed: for otherwise, they discharge only a thin watery Humour, or rather no Moisture at all. From whence it is plain, that Electricity ought not to be administred in Fluxes proceeding from Weakness, except (as sometimes happens) there be a Tension on the injured Vessels. Mr. CAVALLO observes, that before Fluxes discover any Signs of Amendment from Electricity, they appear to be increased.
BUT perhaps you will say, "If Electricity be so efficacious in destroying Tensions as is pretended, it should seem to be a probable Means of Cure for ardent Fevers, Pleurisies, inflammatory Rheumatisms, and such Kind of Disorders, in which there is a manifest Tension on the Vessels."—But it ought to be considered, that in such Cases as these, there is something more than
bare Tension;
there is a
latent Cause
which produces and continues the Tension, and counteracts the Operation of the Electricity. Electricity will soon remove the Tension and Pain attending a slight Burn or Scald: here the Cause of the Tension and Pain, i. e. the Fire or scalding Liquor, has already ceased to act upon the affected Part; and the Cause being taken away, the Effect is soon made to cease. On the other Hand, it can give little or no Relief in Bites or Stings of venemous Animals, so long as the Cause of the Tension and Pain, i. e. the injected Poison, remains. Indeed I cannot say, what a long continued Use of Electricity might bring about, by relaxing the Capillaries and promoting Perspiration, or the impeded Circulation: or how far it may contribute to dissolve the Viscidities of the Blood and Humours: but as such tedious Operations are, in these Cases, hardly practicable, on account of the Pain, Weakness, and Impatience of the Sick, it seems to be scarce worth our While to consider much about it. My humble Opinion is, that such Attempts would serve only to bring a very valuable Acquisition in Medicine into Disrepute.
In old callous Ulcers, Electricity is said to have proved efficacious: in such, I presume, as were owing to too tight and continued Bandages, or other Mismanagement, rather than a bad Habit of Body. But for the Reasons given before, I would not wish a Practitioner to risk the Credit of his Art, by applying it to such as arise from a Malignity of the Humours.
It is also said to be a good Remedy for sore Throats; and I verily believe it may: but it must be for such as spring from some recent Cause, (such as sudden Gold, &c.) which may bring on a Tension, that may be removed before the Humours become vitiated.
In like Manner, perhaps, it may be of wonderful Service in preventing the excruciating Pains of the Rheumatism; I mean of the true, acute, inflammatory, rheumatic Fever; a Distemper which seems to have it's Beginning in the Solids; viz. a Tension caused by sudden Cold, especially after the Body has been much heated.—It has been observed by Men of great Skill, that this is a Disorder that seldom or never attacks any but those who are otherwise sound and healthy. And for my own Part, I doubt not, but that whoever is afflicted with it, might (if he paid due Attention) tell when, and how he contracted it. Supposing this to be true, it is highly probable that, could the Tension of the Fibres be removed before the Blood and Humours become inflamed, the Disease would be eradicated while in Embryo: for a little Experience might be sufficient to convince any one, of the great Power Electricity has to take off that Rigidity, so commonly felt after violent Exercise in a cold Air.
So great a Stress has of late been laid on drawing or throwing the electric Stream with Points, that Shocks, and even Sparks, have been almost laid aside as useless or dangerous. There are certainly many Cases in which gentle Methods are highly proper, and the rougher Kinds of Treatment both painful and dangerous: as when the affected Part is very tender, such as an Eye, Ear, &c. also, if the Tension be slight, or easily removable, it is unnecessary to torment the Patient with strong Shocks, or even Sparks. But when the Tension is obstinate, and not situated in a tender Part, the Degree of Electricity ought to be proportioned thereto, as far as the Patient can bear it. There are certainly many Cases, in which the very gentle Kinds of Electricity would signify little or nothing. I have often relieved very slight Burns or Scalds, by only drawing the Stream; but I had lately an Opportunity of observing that Method fail in a Scald that was somewhat severe: I drew the Stream a long Time to no Purpose; at length I proceeded to draw Sparks which soon had the desired Effect. This Scald was so great, that a Blister arose before the Person who received it, could come to the Machine, although the Accident happened in the House. Electricity in this Case, effected no other Cure than relieving the Pain: the Blister was healed as other Blisters usually are.
A Person who lives in a neighbouring Parish, about a Year ago, broke his Leg, and was confined to his Bed eleven Weeks. The Fracture being a bad one, he was obliged to lie all that Time, in one Posture; the Consequence of which was, an
Anchylosis
at the Knee of the same Leg; which continued for many Weeks after he left his Bed, without the least perceiveable Alteration. As soon as he was able to ride, he was brought to me, and electrified twice every Day for a Fortnight. The Method I used was to draw Sparks, and give four or five moderate Shocks: i. e. from a pint Vial about one-third charged. The Success answered our Expectation; every Operation being attended with a visible Improvement, except one, wherein I purposely omitted the Shocks for the Sake of Experiment. At the End of the Fortnight, the Knee, which was at first nearly straight, was become so flexible, that he could bring the Sole of his Foot to the Ground, while sitting in a common Chair. He has been with me three Times since, and not without more of less Improvement according to the State of the Weather, which I always found to be of great Importance towards a Cure. But the
Grand Proof
of the great Expediency, and even Necessity, of strong Shocks in obstinate Tensions of the larger Nerves and Tendons, was exhibited in the Case of the contracted Arm, of which I have already given you an Account.
IT has been said by an eminent Physician, a Friend to Medical Electricity, That he never knew the Cure advance, after the Patient had undergone six or seven Times of Trial. With Submission, I think, that either the Patients were not proper Subjects for Electrification; or that the Electrification was not sufficiently continued.
If the Rigidity, Tension, &c. be too stubborn to admit of a perfect Cure on the forementioned Number of Trials, the Practitioner may almost depend upon it, that he will not observe any farther Improvement for a considerable Time; nay in some Cases for many Weeks. Of this I have already produced a remarkable Instance in the Patient, who is the Subject of my first Letter, and of whom I then took Notice, that the Improvements did by no Means proceed in a regular Manner, but by sudden Fits or Starts. And indeed I must acknowledge, that had it not been for the Patient's amazing Perseverance, which I sometimes took for Obstinacy, the Affair had been long ago given up. Something like this I have observed in another Case, but that already related is sufficient. And here I desire Leave to recommend one Thing to your serious Attention; viz. To consider whether, under such Circumstances, it be better to continue, the Electrification constantly as a Preparative towards a farther Improvement: or, when it is found that the Part will suffer no greater Degree of Distension for the Present, to let it rest a While, that Nature may have Time to supply the new-stretched Fibres with Nourishment, and sit them for Distension again. This is an Object of great Importance; for if (as I am most inclined to believe) the Omission be no Hindrance to the Progress of the Cure, it will be happy for those Patients whose Occupations and Circumstances, will not allow of a long and constant Attendance, as well as for those of all Degrees, who will in a great Measure be freed from suffering perpetually, a disagreeable Sensation.
From the foregoing Considerations we may discover the Reason why, even in Cases to which Electricity is well adapted, it is more difficult to perfect a Cure, than to begin it; for at the first Application, when the Fibres are in the most stiff and rigid State, the inflating or distending Power of the Electricity will have the greatest Influence upon them; the Effects of which will naturally decrease, in proportion as the Fibres grow pliable: because through their new-acquired Elasticity, they will become capable of eluding the Force. A Smith, with a Stroke of his great Hammer or Sledge, can, without much Difficulty, bend or break a stiff iron Bar of considerable Size; but if the Bar be first made elastic, it will, in Proportion to the Degree of it's Elasticity, require a greater Degree of Violence to produce the same Effect. Thus we may easily account for an Observation made by the Generality of Electricians; viz.
That Electricity, if not unreasonbly applied, never injures an healthy Fibre:
and also why it is injurious to such, as through Weakness or Laxity, have lost the Power of recovering their Tone. And hence we may conclude, that the farther the Cure of a Contraction, Tension, &c. is advanced, the more slow will be it's future Progress; and consequently that the electric Force ought under such Circumstances, (provided the Patient's Constitution will bear it) to be rather increased than diminished. But as the Patient's Sensibility always increases as the Fibres become more elastic, it will, in many Cases, require a large Share of Resolution and Perseverance to perfect the Cure, or even to make any considerable Advances towards rendering it compleat.
'THE Reason why some Sprains receive much Benefit from Electrization, and others none at all, but rather Injury, is, because some are attended with Tensions, others with Relaxation. Hence a Reason why the Cold Bath, and other Bracers, will Sometimes do much Good, and at other Times great Mischief.—One Evening, about a Year and a Half ago, the Servant Boy, who then lived with me, happened to sprain his Wrist: the Cure was attempted by Pumping, which was continued till the Wrist was greatly swelled, with much Inflammation and Pain. As soon as I was informed of the Accident, I caused the Pumping to cease, and directed the Hand and Wrist to be bathed in warm Water. After the Pain and Inflammation were, by these Means, somewhat abated, I electrified with Sparks and Shocks, which soon reduced the Swelling much more, and the Pain was now become very tolerable. The next Morning the Warm Bath and Electricity were repeated, and the Cure perfected. Here indeed I lost a fine Opportunity of trying the Efficacy of Electricity alone; but I was, at that Time, hardly got into this Train of Thinking. It however serves to shew; that Electricity and the Warm Bath belong to the same Class; and that they may be successfully used together. —I have also known Electricity fail of curing a Sprain. —A Person, wringing some Cloaths out of the Water, sprained her Hand in such a Manner, that on the Back of it there arose a small Swelling, the same as is usually called, the Springing or Starting of a Tendon. It was soft, and without Pain or Inflammation; this was several Times electrified without Success; but was soon after cured by the Cold Bath and a Bandage.
Hence we may venture to conclude, that to Nervous Cases in general, Electricity does not seem to be well adapted. So far indeed as weak Fibres are sometimes liable to Tension, as well as strong ones, it will (if judiciously administered) be attended with great Probability of Success. But whoever expects Electricity to strengthen a weak Habit, will most certainly be deceived.
The Degree of Electricity, proper to be administered at a Time, should be determined by the Degree of Obstinacy in the Tension, Contraction, &c. — the Strength, Weakness or Tenderness of the Part affected—the Age, Strength, Constitution, &c. of the Patient, considered together; as in the Administration of other Medicines.
From what has been advanced, the following Quaere will naturally arise,—"If Electricity be indeed injurious to Weakness or Laxity, how comes it to be of Service in a Palsy, the very Definition of which is,
A lax Immobility of a Muscle?"
ANSW. Though a Palsy be a lax Immobility of a
Muscle,
it frequently arises from Causes which astringe the
Nerves;
as Colds, astringent Aliments or Medicines, Ligatures, &c. whence the Muscles become lax and collapsed, and lose the Power of Motion, from the Defect of the Influx of the vital Spirit into them; so that it is not the
relaxed Muscle,
but the
astringed Nerve
that is the immediate Object of Cure or Relief in a Palsy; because from the Nerves, the Muscles derive their Power of Motion. If the Palsy proceed from Laxity or Debility of the Nervous System, doubtless Electricity will be so far from Restoring the Patient's Strength, that it will rather increase his Calamity.
CONCERNING the Use of Electrometers, and the nice Distinction between metal and wooden Points, which at Present are considered as of great Importance, my Opinion is, that they are more curious than useful. I am very sensible, that Electricity imprudently applied may do much Harm; but the very severe Manner in which many Patients have been treated, without any fatal Consequence, sufficiently proves, that it is not necessary to dispense it like a strong chymical Preparation, of which Half a Grain too much may endanger Life. The Case being once hit on, he must be but an indifferent Practitioner; who cannot charge his Jar within the Bounds of Discretion, according to Circumstances, be the Jar of whatever Size it may. He may take Care to begin with Moderation, and increase till he has found the Degree that will answer his Intention; and when he has once discovered it, he may (if he has any tolerable Degree of Judgment) keep near enough to it to answer any good Purpose. Moreover, the Apparatus of an Electrometer, Wires, &c. added to the Conductor, will cause so great a Waste of the Electricity, as to render the Operation extremely tedious; especially, if the Globe or Cylinder be small, and a large Number of Shocks are required at a Time; which often happens in obstinate Tensions of the larger Nerves or Tendons. Add to this the disagreeable Situation of the Patient, waiting with Terror for the Stroke, which happens sooner or later, according as the Jar may acquire it's Charge; and that will be in proportion to the Number of Wires and other Incumbrances; and as those Incumbrances are more or less loaded with Dust, Damps, &c. My present Method of giving the Shock is this:—I take the Jar (a pint Vial in general) in my right Hand, and a metal Rod in my left, and having a Wire (not a Chain) of any convenient Length, form the Circuit by grasping one End of the Wire with the Rod, and the other End with the Jar. Being thus prepared, I charge the Jar to what Height I judge proper; which may be done with certainty sufficient: then pressing the Rod against that Part of the Body which Occasion may require, and advancing the Ball of the Jar to any other proper Part, I direct the Shock at Pleasure. But if I suspect Danger of a Shock to myself, from any Cause, that may turn the Force of the Electricity by Way of the Ground or Floor, as thick Cloaths, a paralytick Limb, the bare Earth, a brick or damp Floor; I insulate the Patient, or mount the Stool myself, which gives perfect Security. Sometimes I fasten one End of a Chain to one Part of the Patient, and connecting the other End with the charged Vial, in one Hand only, give the Shock without Fear. By this Means, at least Two-thirds of the Labour and Wear, attending the Use of Electrometers and Wires, are saved; which is of no small Importance to those who practice much. With respect to Points, I could never discover but that metal Points would answer every Purpose, for which Points may be required: because they may be made to operate in any Degree, that can possibly be procured by those made of Wood; and to exceed them either in Mildness or Sharpness. They are also more certain in their Operation, not being liable to grow moist or dry. The Operator may be furnished with as many as he pleases; but in this, as in Shocks or Sparks, he must be directed by the Feelings of his Patient, on whom he may rely, that he will not willingly bear enough to do himself any great Harm.
For a Proof of the relaxing Power of Electricity, take the Account of two Men killed by Lightning at
Eastbourn,
in
Sussex, Sep.
17th, 1780; whose Bodies, after they had been dead two Days, were as pliable as when alive. See
Univ. Mag.
for
Nov.
1781; where the same is transcribed from the
Philos. Transact.
Vol. LXXI.
MR. FERGUSON, in his Introduction to Electricity, says,
"I have often drawn Sparks from Chilblains, and have always found they were cured thereby."
I have often done the same, but never found it succeed. Were it certain, that Chilblains were curable by Electricity
alone,
it might furnish an Argument that would be fatal to my chief Position, viz.
That Electricity is peculiarly adapted to the Removal of Rigidity, Tension, &c. but pernicious in Cases of Laxity.
Now I presume, Chilblains are allowed to be the Effect of
Blood stagnated in relaxed Vessels;
few being subject to them except Children, and Persons of lax Habits. But perhaps it may be possible to give some Account for the Mistake;—It was that Gentleman's Method, (and a very proper One it is in all Cases, where an electrical Operation is performed,) to order the electrified Part to be kept very warm: and this alone was sufficient for the Cure of the Chilblains, and that in a little Time too. Now an Objection starts of it's Accord,—"If Electricity be indeed a good Remedy for Tensions, it should, according to the Rule laid down by myself, be a likely Means of Cure for the Complaint of which we are speaking, wherein there is a manifest Tension, as appears by the Inflammation and Hardness of the Part affected."—That there is such Tension I readily admit; yet still insist on it, that Electricity alone is not sufficient for the Cure. For unless it could strengthen the Part, alter the Habit, or remove the astringing Cold along with the Tension, there is nothing to prevent it's immediate Return: whereas a good warm Flannel, a double Pair of worsted Stockings, or whatever else may preserve the Part in sufficient Warmth, will seldom or never fail of answering every Purpose.
ELECTRICITY has been known to cure Blindness and Deafness; but it is acknowledged, that it has much more frequently disappointed the Expectation. This affords no Argument for the Uncertainty of it's Effects, but rather the Contrary; for let it be but considered, that though the Diseases of the Eyes and Ears are sometimes attended with a Tension, yet much the greatest Part of them arise from Laxity.
CONCERNING the Cure of Agues, I must acknowledge my Opinion to be, at present, unsettled for want of Experience. That such Cures have been effected by Electricity is affirmed by Writers of Credit, and therefore is not to be questioned. But being thoroughly persuaded, that Electricity operates directly contrary to such Medicines as are in general Esteem for the Cure of Agues, as the Peruvian Bark, and divers other Astringents; I find it difficult to suppose how it should be attended with Success, unless Agues may be allowed to proceed from two very different Causes: and indeed the Body appears to be both astringed and relaxed, at different Periods in the same Intermittent. Perhaps then, the good Effects of the Electricity might be owing to a fortunate Application of it in Point of Time; what that Point of Time may be, I cannot say, but if there be any Ground for the Conjecture, I should think it might be easily determined by one who has the Advantage of frequent Practice. Mr. CAVALLO, in his Medical Electricity, thinks it should be,
a little before the Fit is expected,
which may perhaps answer the Expectation, by Removing the Tension before it begins to shew itself. Perhaps also it may Sometimes succeed at the End of the Fit, when, notwithstanding the apparent Relaxation of the Solids, there may be some small Remains of a Tension, that may give Birth to another Fit.—Early in the Spring of 1781. many Persons in my Neighbourhood, were attacked with a Fever resembling a Tertian; which was very obstinate, baffling, for a long Time, all the Endeavours of the Faculty. One of my Family being seized with it, I embraced the Opportunity of trying Electricity; and at a Time when I thought the Fits were become pretty regular, passed two or three very slight Shocks, through the Sides and Stomach, those being the Parts in which the Patient complained of a troublesome Pain. After this the Fit went off so very light, that I was much pleased, and began to look on Electricity as a Specific for an Ague, consequently did not fail to repeat it at the next Return; but how great was my Disappointment, when I observed that Fit to be attended with Symptoms more than ordinary severe; I then desisted for Fear of Mischief: For instead of believing Electricity to be a Specific for an Ague, I now began to consider it in the Light of certain boasted Medicines for the Gout, serving only to avert the Paroxysm for a While, which will be sure to come at last, and make the greater Havock.
It must be acknowledged however, that this was not a perfect Ague, for upon a more exact Observation, I could plainly discern, that, between the Paroxysms, the Fever did not entirely subside. But the Case may be offered in Support of the Opinion before laid down, viz. That Electricity does not seem to be a good Remedy for Continual Fevers, and Disorders where a morbid Cause is supposed to lie concealed: for unless it has a Power of expelling the morbific Matter from the Blood, the Complaint must remain; and I do not know, that Experience has shewn it to have any such Power. It has indeed been found to cause a very sudden Translation of Pain, from a Limb or Joint, to the Stomach or Bowels, and back again: but surely such sudden Translations are not always to be effected without Danger, especially where there is a great Malignity of the Humours: and one fatal Accident might do infinite Prejudice, both to the Professor and his Art.
There have been many Instances of Agues cured by such Accidents as have caused great Surprise; thus Electricity may stand a good Chance to succeed; for it is certainly surprising enough, especially to those who are unacquainted with it; but curing by Accident does not prove it fitted for any particular Purpose. Were it once established in regular Practice, it would be a Benefit to Mankind; but while it is used at Random, it cannot be deemed better than a
Quack Medicine,
the Effects of which, whether good or bad depend on Accident.
If any Electrification were proper in Inflammatory Fevers, and others proceeding from a morbific Cause, it seems to be the Simple, which is equally distributed throughout the whole Habit, and creates the least Disturbance. But as the most gentle Electrification will quicken the Circulation, and increase Perspiration, whether Increase of Circulation can be of any Service at a Time when the Velocity of the Blood is already too great; or Promotion of Perspiration produce any great Good, while the Blood and Humours are too clammy and viscid, and robbed of their fluid Parts, must with me remain a Question till it be proved, that it is also a good Divider and Dissolver of the Viscidities, and suited to bring the Disease to a happy Crisis; or to effect a Cure by expelling the latent Cause at once. Till this be proved, I must repeat it, I cannot place any Confidence in Electricity for the Cure of inflammatory Fevers; much less in putrid Fevers, where the Solids have already lost too much of their Cohesion.
In Fevers of the Nervous Kind there seems to be as little Reason to expect Relief: nevertheless it often happens that in Fevers merely nervous, the Nerves and Tendons are terribly affected with Tensions, Spasms, Contractions, &c. therefore (as I before hinted concerning nervous Cases in general) in that respect it may prove of wonderful Service; provided it be used no farther than to answer the Intention of Removing such Spasms, &c. and nothing more ought to be expected from it. In such Cases it frequently happens that the Patient appears to receive surprising Relief at first, but on frequent Repetitions finds it disagree with him. But for such Rigidities, Contractions, &c. as frequently remain after severe Fevers, Inflammations, Rheumatisms, and such like, it is most certainly an admirable Remedy; and very little Experience is sufficient to prove it.
ELECTRICITY has been said to cure a Dropsy. — Without repeating what has been said, concerning Palsies, Agues, &c. it may be sufficient to observe—That large Draughts of cold Liquors taken by Persons much heated with Exercise, are, by Physicians, enumerated among the principal Causes of a Dropsy: if then Electricity be, as is here affirmed, an efficacious Remedy in Tensions, &c. it will follow, that where such a Cause has preceded, while the Disease is recent, and before the Waters become viscid, it may prove one of the best Remedies that ever was introduced into Practice: because as CAVALLO says in Med. Elect. Page 7,
"It seems to act even within those Parts of the Body which, especially when diseased, are mostly out of the Reach of other Remedies."
As on the Contrary, when the Disease arises in a languid and worn-out Constitution, it will bid fair to hasten the Patient's Departure.
FROM what has been advanced it is easy to infer,
1st.
That the most immediate Effect, to be expected from Electricity, administered in the medical Way, is, the Removal of Tension, Rigidity, Spasm, &c.
2ndly.
That the best Chance for Success is, when the primary Cause is removed. If a burning Coal be laid on the Hand, no Benefit is to be expected from Electricity untill the Coal be taken away, and then it will remove the secondary Cause of the Pain, i. e. the Tension. Nevertheless, in Cases where the primary Cause acts with less Rigour, it may, perhaps, be of Service in Relieving or Mitigating the Pain, at least from Time to Time, untill the primary Cause shall cease. Thus in some Fevers, the Convulsions and Pain may probably be rendered tolerable while the Fever is running it's Course; but this being Conjecture only, I shall not dwell on it, but leave it to your Consideration and Experience: only this I have to say, that in the imperfect Ague abovementioned, and a few other feverish Cases that have fallen within my Observations, it did not seem to be attended with great Success.
3dly.
That in Cases of Laxity it is generally pernicious, but under some Circumstances may (if managed with Prudence) be applied with great Advantage.
From whence it will follow, that Sometimes it ought to be accompanied with such Assistants, as seem best adapted to promote the Intention, whether Astringents, Corroborants, Discutients, Laxitives, Emollients, &c. &c.
AFTER the strictest Enquiries I have been able to make, as well as from my own Experience, it appears to me, that simple Electrification, drawing or throwing the Stream, Sparks and Shocks of all Degrees, differ only in the Power and Strength of their Operation: they all
relax and render pliable.
And yet the milder Kinds may relieve a Malady, which the more powerful would increase. We know that mild Astringents, mild Purgatives, &c. are frequently of the greatest Service, at Times when strong Ones would do great Mischief: not because they differ in Quality, but because the Patient's Constitution cannot bear them all alike. The Peruvian Bark, given in small Doses, often proves a salutary Bracer to the Bowels; but if dispensed in too large Quantities, has a contrary Effect. Thus, I presume, it is with Electricity: strong Shocks may, by over-acting their Part, increase a Palsy they were intended to relieve. Suppose, for Instance, a large Nerve leading to a Limb, from some injurious Cause, to be astringed, the Consequence will be, that the Muscles of that Limb will become paralytic: if now that Nerve can by any Means be so far relaxed, as to recover it's exact due Tone, the whole Limb will be restored to Health. But if the Nerve by a too powerful Application of the very same Means, be
over relaxed,
the Muscles will be still paralytic in proportion to the Degree of that
over Relaxation.
Hence the Limb may be cured, or made worse, by a skilful or unskilful Application of the same Means: and thus an electric Stroke may either relieve a Palsy, or increase it.
But although the mildest Operations in Electricity may, many Times, be of the greatest Service; yet I could wish every Practitioner, in this infant State of the Science, to be very cautious, that he does not impute to the Mildness of his Operations, the Credit of Cures towards which Electricity never afforded the smallest Assistance. This is of immense Importance to the Practice in general; for so long as Men remain under Mistakes, or Uncertainties, concerning the real Effects of Medicines, it will be impossible for them ever to arrive at any regular Method of proceeding. Let us suppose a Limb to be weakened from a Luxation, and to be free from Tension, (this, I trust you will grant, is no wild Supposition,) and that strong Shocks are repeated to no Purpose, or rather to the Patient's Prejudice. Suppose also, that the Operator, perceiving this severe Treatment to be more injurious than useful, should omit the Shocks and have recourse to Sparking, or drawing the Stream; this, though a perverse Treatment likewise, may not be powerful enough to prevent the relaxed Fibres recovering their Tone, by their own elastic Power. Here kind Nature performs the Cure of a Malady that was begun by Misfortune, increased by Mismanagement, and at last is, by Mistake, imputed to one particular Species of Electricity, which, in Truth, did not in the least contribute towards it: and the Use of Shocks is condemned, as generally if not universally prejudicial, only because they were injudiciously applied.
Although I insist so much on Shocks, and the frequent Expediency of strong Ones, I do not at present make use of any thing more powerful than an Apothecary's Pint Vial, and that very seldom full charged; by which you may judge that I am far enough from recommending desperate, or dangerous Experiments: Experience has however demonstrated that, on proper Occasions, double, treble, and even four Times that Force may be advised with great Safety and advantage.
What Alteration Electricity may make in the Blood and Humours, I do not pretend to determine; that I never perceived any, I can with Truth declare. From the surprising Power it has of hastening the Fluids through the Orifices of the Vessels, and consequently of very much increasing Perspiration, it must, I conjecture, leave the Blood somewhat more dry than it was before the Operation; but I could never observe, or indeed hear of any Proof of it's attenuating Qualities. On the Solids it's Influence is unquestionably very great: It is most certainly a Relaxer and Remover of Rigidity, &c. and frequently in a most astonishing Manner. I am therefore thoroughly perswaded, that if medical Philosophers had attended to this single Circumstance; it had, long before this Time, been brought into regular Practice: and many miserable Objects might have received the Benefit of a Relief, which the whole Faculty, armed with the most powerful Medicines, were not able to afford.
How, or by what Means, the Removal of Tensions, &c. is performed, I will not undertake to account. There is no Necessity to search into, analyze, or explain the Nature of Electricity: perhaps it is more than the most ingenious Man will ever be able to do. It is sufficient for our Purpose, if Electricity be found to produce
certain regular Effects;
and he who knows what those Effects are, may apply it with as much Certainty and Success, as if he understood the whole Theory of Effluvia and subtle Mediums; and could descant, in the most learned Manner, on the Arcana of Nature: however from several very common Experiments in Electricity, it appears to act by a wonderful Kind of
Inflation,
which forces the Particles of Bodies, both solid and fluid, either suddenly or gradually, into, or towards a Separation. Hence you may easily guess the Reason why the Particles of all Fluids, and particularly the Globules of the Blood, are carried through Tubes and Vessels with an increased Velocity. And perhaps Mr. CAVALLO, in his ingenious Essay on Medical Electricity,
Page 17.
is very near the Point, where he says,
"Admitting Dr. FRANKLIN's Hypothesis of Electricity; we see that it is not the Direction of the electric Fluid that determines the Fluids of the Body one Way or the other; but that the Effects usually observed upon the Body when electrized, must be owing to the Irritation or DILATATION occasioned by the Action of that Fluid."
I am, Sir, &c.
FINIS.