GENERAL CONSIDERATIONS AND DESCRIPTION OF APPARATUS.
A glance at any one of the standard treatises on the diseases of women proves how little the worth of this agent has been appreciated, for where reference is made to it at all it is largely for the purpose of summarily dismissing it in favor of other therapeutic methods apparently more active and necessitating the expenditure of less time. Doubtless, also, many gynecologists have been deterred from the use of electricity owing to the belief that its application necessitated a thorough knowledge of the physics of the agent, and for this study they have neither had the time nor the inclination. We believe, however, that, given a knowledge of the first principles of electrical phenomena, the practitioner is in a position to use the agent intelligently and to obtain good results, although we would not he understood as underestimating the value of closer study in leading to more scientific application.
French observers have contributed much of value to the subject of the electro-therapeutics of the female sexual organs. Tripier has intelli gently worked in this direction, and in particular Apostoli of Paris, to whop indeed belongs much of the credit for laying the foundation of what may be termed with justice new methods of applying electricity to the female sexual organs, methods which promise to prove valuable ad juncts to our routine measures of treatment of many of the inflammatory and non-inflammatory diseases of women. German and English writers on gynecology are as yet content to leave electricity largely unnoticed, but in this country numerous observers are beginning to report their results, and many a quiet worker is satisfying himself that there is value in what has been so long neglected, the full measure of which the near future will with certainty determine. The time is not ripe as yet for great enthusiasm; the road is only being marked out; much of the old will have to be thrown aside, and much rather startling in its novelty will have to be accepted; but, if we mistake not the signs of the time, the scientific use of electricity is going to curtail to a considerable extent the sphere of usefulness of many an agent, such as the intrauterine ap plicator for instance, and abdominal section in case of certain inflamma tory affections of the pelvic organs will grow as markedly infrequent in the future as it has rather alarmingly increased in the past.
In order to attain this end or even to approximate it, it is essential that the gynecologist shall approach the study of electricity from a far different route from that followed liy the neurologist. The latter resorts to electricity for diagnostic and for prognostic as well as for therapeutic purposes. He deals mainly with the effect of the agent on nerves and with the reaction of muscle. In his hands the fluid is ordinarily dis seminated over wide tracts and surfaces. His electrical tests must be delicate even as is the tissue with which he is chiefly occupied. He must work indirectly, so to speak, in order to reach the organs he would treat, and he must above all avoid strong currents in the instances in which the relatively sound nerve tissue is at all implicated. The gynecologist, on the other hand, does not resort to electricity for the formation of his diagnosis. It is not with him a question of the determination of nerve force or of muscle reaction. The organs which he aims at subjecting to the electric current are closely grouped together in the pelvis, and it is here that the current is localized. He deals chiefly with perverted local nutrition, with local congestion or its consequences. His know ledge, hence, of the physics of electricity need not be so exhaustive as that of the neurologist. Sufficient for him if he knows the peculiar properties of the forms of electricity at his disposal, if he constantly bears in mind the different action of the poles, and then, having made his diagnosis, all that is necessary is the intelligent application of the special property which in the given case seems called for. In short, if he wishes to stimulate, to congest, he must know which current and which pole will do this, and similarly where he aims at sedation, absorp tion, cauterization, or local anesthesiation.