2. To the Skin

If static electricity is employed for exciting the skin, it is necessary that it should be of feeble intensity, as it would otherwise penetrate the deeper tissues. The dynamic form is preferable; care being taken to have the surface of the excitors quite dry, so as to confine the influence to the skin. But the electricity of induction, the faradism of M. Duchenne, is here specially advantageous, when mere excitation without organic disturbance of the surface is wanted; as it never, like galvanism, produces severe inflammation or cauterization. If, however, a powerful revulsive effect is desired, for the relief of chronic internal affections, galvanism is preferable.

An excitor containing the moist sponge having been applied to one point of the surface, the other excitor, quite dry, is to be held by the operator, and, after the skin has been thoroughly dried by rubbing upon it lycopodium or other absorbent powder, is to be passed rapidly over the part; or cylindrical or olive-shaped dry excitors may be moved from point to point over the skin. Sometimes advantage may accrue from using the wire brush (Fig. 3, page 509) as an excitor, which may be moved over, or struck lightly on the surface. M. Duchenne calls this latter process fustigation. The wires may also, in certain cases, be kept in contact with the skin; but this cannot be long borne, in consequence of the violent pain produced. The latter mode of electrization he calls electric moxa, as having, I presume, the powerful irritant and revulsive influence of that agent, without its organic results. It is applicable only when there is great cutaneous insensibility, or it is desired to promote the dispersion of white swellings, and other chronic tumours or tumefactions.

The application of the electrified hand of the operator, under the influence of an intense current, excites lively sensation in the face, but is insufficient for other parts of the body. The rounded metallic excitors act powerfully on the face, even with a slight intensity of current, and sufficiently on the skin of the trunk and other parts of the body, except that of the hands and the soles of the feet. For the last-mentioned parts the wire brush must be used, which has three times the power of the blunt excitors. The inner and middle parts, however, of the soles of the feet have more susceptibility.

No single therapeutic agency is so efficacious in exciting cutaneous sensibility as "faradisation." It may be graduated to any required degree of impression, from a slight tingling to the most violent pain; the excitement in its higher grades is not exceeded by that of a burn, yet no disorganization takes place, not even so much as vesication; it may be carried rapidly over the whole surface of the body; and the pain subsides instantly, and almost completely, when the operation ceases.

To Internal Organs. Most of these may be reached either directly by the excitors, or through the nerves which supply them.

In affections of the rectum, one of the metallic olive-shaped excitors, upon a stem insulated by a covering of caoutchouc, may be introduced into the bowel, while the other is carried from point to point about the anus. If the sphincters are debilitated or paralyzed, the excitor may be brought into apposition with them; if the muscular coat of the rectum, it should be passed successively over the whole inner surface of the bowel. Constipation, incontinence of the feces, and prolapsus of the rectum may often be advantageously treated in this way. In the same manner the hypogastric plexus posterior to the rectum may bo excited.

The bladder and rectum are but slightly sensitive to pain from the electric impression. The latter, therefore, may be resorted to in operating on the former, an excitor being introduced into both; but care must always be taken, in using instruments for the purpose, that the stem should be completely insulated. The vesical excitor may be carried over the whole surface of the bladder. Should the rectum be too irritable for the purpose, the two excitors may be introduced through a double caoutchouc canula into the bladder; the instrument being so contrived that the excitors should not be allowed to meet. The bladder, however, should bo quite emptied of urine, as this fluid would otherwise serve to connect the poles.

The uterus may be operated on by a somewhat similarly contrived double instrument. This organ also has but little sensitiveness unless in pregnancy.

The pharynx may be entered by an olive-shaped excitor, properly supported, which may be passed along the posterior part, while the other pole is applied to the nape of the neck. It is necessary to avoid the lateral portions of the pharynx, for fear of injuriously exciting the pneumogastric, glosso-pharyngeal, and accessory nerve of Willis, which are in this vicinity.

In complaints of the larynx, as aphonia, one of the excitors may be passed down the pharynx below the posterior part of the larynx, while the other is applied, moistened, to the external parts answering to the crico-thyroid muscle. The inner excitor is then to be brought forward against the larynx, and passed upwards and downwards.

The stomach, liver, lungs, and heart cannot be acted on directly, but may be reached through the pneumogastric nerve. By making the application to the lower portion of the oesophagus, which may be done by the introduction of a suitable instrument, insulated by a caoutchouc covering, except at its extremity, and placing the other excitor at the pit of the stomach, the influence may be directed to the stomach and liver. If the upper part of the nerve is acted on by applying the pharyngeal excitor to the upper and lateral part of the pharynx, and the second to the nape of the neck, all the viscera mentioned will be put under the electric influence. But these operations require much caution, as the vital organs concerned might be unduly and dangerously affected; and M. Duchenne relates a case, in which a patient fainted under the second of the operations just mentioned, and, upon recovery, stated that he had experienced a feeling of suffocation, and indescribable precordial sensations. On a repetition of the operation, with intermissions of a second, the patient did not faint, but had the same precordial sensation each time.