This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol2", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
The continued current from a galvanic pile or battery, with large plates, is capable of producing a high degree of heat more rapidly, perhaps, than any other agency; bringing, for example, a platinum wire to a white heat almost instantaneously when it connects the poles. By interrupting the connection, the heating effect may be made to cease as rapidly as it was produced. it is obvious that such a power is capable of being very efficaciously employed for surgical purposes; whenever, in fact, it may be desirable to bring immediately to bear upon any accessible part of the body a cauterizing heat, limited in its application, sustainable for any length of time at the pleasure of the operator, and ceasing immediately at his will. it is simply by the heat developed, and through no peculiar influence, that the galvanic current acts; so that we may properly rank this agency among the means of employing heat as an escharotic.
Though the idea of applying galvanism to the purposes of a caustic appears to have occurred as early as the year 1836, if not earlier, yet it was not till 1843 that the conception was carried practically into effect. in the latter year, Herder, of Vienna, at the suggestion of Prof. Stein-heil, of Munich, used the galvanic current for cauterizing the pulp of the teeth; and the same thing was soon afterwards done by M. Louyet, of Belgium. Somewhat later, a Russian surgeon, by the name of Gustavus Crussell, gave greater extension to the measure, employing it for the removal of tumours, and for other surgical purposes. The new mode of cauterization was afterwards resorted to by various operators, both dentists and surgeons, in England and Franco; but to Professor Middel-dorpff, of Munich, is due the credit of having introduced the measure more fully to general notice, and given an ample account of the purposes it is capable of fulfilling, and the various methods of using it most advantageously. Space can here be afforded only for a general sketch of the subject; for details, I must be content with referring to the published statements of Middeldorpff.*
For producing the requisite galvanic current, Middeldorpff prefers the battery of Grove, next to this Sturgeon's, and next Daniell's. The cauterizing instrument is generally a platinum wire, with various accessaries for its convenient application. For certain purposes a piece of platinum foil may be preferred. These, heated to whiteness by the passage of the current through them, at the moment of the connection of the poles, cauterize the part with which they come in contact more or less extensively, according to the continuance of the process; and all the advantageous effects follow which are to be obtained by means of the actual cautery. By the use of the wire fistulous passages may be brought to a healing condition, fistulas laid open, strictures of the natural passages removed, abscesses opened, tumours, especially those with footstalks, extirpated, the neck of the uterus cauterized, the effects of a seton obtained, etc. By means of the plate of platinum foil, surfaces more or less extensive may be superficially cauterized, as in the fauces, vagina, rectum, etc.
The special advantages of this method of cauterization are 1. its rapidity and energy; 2. the exact limitation of its effects; 3. the facility which it offers of operating on deep-seated parts; 4. the comparatively slight mental disturbance, the instrument being introduced cold, and heated by an invisible agency; 5. the production of healthy granulations; and 6. the absence of hemorrhage.
The galvanic cauterization, as above considered, is effected by means of the heat developed; and the resulting eschar has of course the nature of a burn. M. Ciniselli, of Cremona, has brought into notice a modification of the galvanic cauterization, in which the effect is produced by the corrosive powers of chemical agents developed in the process. When an imperfect conductor is placed between the poles of a battery of sufficient power, the body is decomposed; acids seek the positive electrode, alkalies the negative. if the electrodes be insusceptible to the influence of those agents, they then act on the intervening tissues, producing an eschar precisely limited to the points of contact of the poles or electrodes. The effect takes place equally in the living and dead body, and is purely physical. The end is obtained wholly without the intervention of heat. M. Ciniselli recommends for this purpose the following galvanic arrangement. An electro-motor apparatus should be used, "with a current of great tension, and of as feeble intensity as possible; that is, a pile formed of a great number of elements of small extent." The electrodes should be of one or two metals, which are not attacked by the products of the electrolysis; should be bright and polished, and should be put into immediate contact with the tissues, at two distinct points. Lastly, the tissues acted on should be sufficiently moist to favour the chemical action. (Arch. Gén., Janv. 1866, p. 19.)
* An excellent abstract of Prof. Middeldorpff's paper, by Dr. Axenfeld, is contained in the Archives Générales for August, October, and December, 1855 (5e sér., vi. pp. 145, 444, and 706); and the reader will also find a notice of its contents, with figures of the instruments employed, by Dr. A. Coolidge, in the Boston Medical and Surgical Journal for November 22d, 1855, page 842. Becquerel's work on the Applications of Electricity to Medical and Surgical Therapeutics, published in Paris in 1857 (p. 320), contains also a tolerably full account of this method of cauterizing.
Therapeutic Applications. One of the best therapeutic applications of galvanic cauterization is to the suppression of hemorrhage from deep-seated parts, which cannot be conveniently reached by the ordinary actual cautery; as from the fauces, the deeper parts of the pharynx, the frontal and maxillary sinuses when open, the nostrils, the rectum, uterus, and vagina. it is also effectual in the hemorrhage from leech-bites.
In neuralgia, seated in various parts of the body, it has been found serviceable by being brought to bear immediately upon the diseased nerve; as, for example, sometimes in facial neuralgia by destroying the nerves of decayed teeth. Palsy has been benefited by the stimulus extended to the affected muscle by the cauterization over it. The measure has proved effectual in checking gangrene, and frequently in changing the diseased condition of ulcers, and disposing them to heal. it may be used for removing cancerous and other tumours which cannot be conveniently reached in any other mode; for curing fistulas by changing the character of their diseased surface, or laying them open; for removing obstinate strictures of the urethra; for destroying erectile tumours; for extirpating polypi from the nostrils, pharynx, larynx, oesophagus, uterus, and vagina; and finally for amputation, as of the penis, and the limbs of infants.