Although the favorable influence of electricity, even percutaneously applied, is quite evident in numerous affections of the stomach and intestines, it, however, remains questionable whether any of the produced electricity penetrates to the stomach. The main currents undoubtedly go through the skin and muscles, and if any of them reach the stomach, they must be very weak. But surely we might expect to attain better and more successful results by the application of electricity directly to the stomach. In his celebrated book on "Electrotherapy" Erb1 says: "The first maxim to observe is the treatment in loco morbi, i.e., the application of electricity to the morbid part itself. . . . There is no doubt that it is best, in the great majority of cases, to operate directly on the diseased spot".

Pepper2 had a patient with dilatation of the stomach, in whom the abdominal walls were so thin that the spontaneous peristalsis of the stomach could be perceived. On this patient he showed that electricity, percutaneously applied, never produced any peristaltic movements of the stomach. Pepper then continues as follows: "The difficulty of compelling a current, no matter what may be its strength, to penetrate through various layers of tissue of different consistence and anatomical character is well known." Speaking of the percutaneous electricity of the stomach. Kussmaul3 remarks: "The therapeutic results obtained by Fuerst-ner and others in cases with dilatations of the stomach do not prove that by means of the current a direct peristalsis of the stomach was induced, but could be attributed to the favorable influence of the contractions of the abdominal walls." All the sentences mentioned plead for applying electricity to the stomach directly, and not percutaneously, if possible.

1 Erb: "Handbuch der Electmtherapie," p. 279

2 Pepper: Philadelphia Medical Times May. 1871. p. 274.

3 Kussmaul: Arch. f. Psvch. und Nerv., 1877. viii., p 205.

Canstatt1 first proposed to combat dilatations of the stomach by direct electrization, introducing one electrode into the oesophagus and putting the other in the stomach region. Duchenne2 was the first who made use of this method.

Kussmaul's Method

Very soon afterward, in 1877, Kussmaul3 began to practise the direct electrization of the stomach. The electrode used for the purpose consisted of a stomach tube, through which ran a copper wire ending in an olive point and fastened to the cut-off end of the tube. In several patients with dilatation of the stomach Kussmaul introduced this electrode into the stomach, the other (ordinary) electrode being held in the hand. In applying electricity in this way contractions of the abdominal muscles on the left side appeared, and in one patient, with thin abdominal walls, contractions of the stomach were visible on applying weaker electric currents.

Later on Balduino Bocci,4 in 1881, experimenting on animals, was persuaded "that the indirect faradization of the stomach through the abdominal walls produces in the stomach, even when applied in a very energetic way, phenomena of very little importance, and of a dubious curative effect." As the direct faradization of the stomach, on the other hand, showed all the above-mentioned physiological effects, Bocci recommended anew the use of the direct electrization of the stomach for therapeutic purposes. Bocci used for this end an electrode like that of Kussmaul.

1 Canstatt: Cited from Kussmaul. l. c.

2 Duchetme: Cited from Kussmaul, l. c.

3 Kussmaul: L. c.

4 Bocci: Lo Sperimentale, June, 188l.

Bardet's Method

Great progress in the direct electrization of the stomach was made in 1884 by G. Bar-det.1 The direct contact of the lower metal piece of the electrode with the inner wall of the stomach irritates only a small spot, and this very intensely, whereas the larger part of the stomach receives but very little of the electricity produced; in consequence thereof the galvanic current could not be applied, because by the usual method it would not be possible to avoid lesions of the mucous membrane of the stomach. In order to overcome these drawbacks Bardet constructed his stomach electrode in such a way that the metal piece running through the tube was shorter than the tube, and did not touch its windows. By tilling the stomach with water the electric circuit between the stomach wall and the lower metal piece of the elertrode was established. In this way the electricity was (lis-tributed over the whole surface touched by the water. By means of this electrode Bardet treated three cases of dilatation of the stomach, and one case of obstinate vomiting, with the galvanic current (15 to 25 milliam-peres) and obtained splendid results. Most authors who employed the direct electrization of the stomach have, until recently, generally used Bardet's electrode.

Charles G. Stockton's1 stomach electrode does not differ very much from that of Bardet).

1 Bardet: Bull. Gen. de Therap.. 1884. tuine 106. p. 529.

Although the high value of the direct electrization of the stomach is self-evident, this method did nut enter much into practice, because the tube surrounding the electrode had to be kept in the throat during the whole electric session (about ten minutes) and inconvenienced the patient to such a degree that the procedure could be carried out only in people accustomed to lavage of the stomach, and even by them it was disagreeably felt. That is the reason why von Ziemssen 2 rejected direct electrization of the stomach as being too straining and exhausting.