Although wo are simply on the verge of the development of a now era in the application of electricity to the diseases of women, and although the possibilities in this direction cannot as yet be distinctly formulated, still the elementary principles on which this application depends are established, and the aim in the following pages is to tersely state these principles, and to point out their application to the diseases of women. Knowledge of these principles is essential in order that electricity when it is used at all may be used with proper understanding, and not blindly and with disappointment as has been the case in the past, and is still largely so to-day in the hands of many who occasionally endeavor to re inforce time-honored routine methods by electricity.
The contributions to the special electro-therapeutics of the diseases of women are largely scattered in medical journals and in special mono graphs. While endeavoring to do justice to all it is but fair to state that in the elaboration of these pages we have in particular utilized the writ ings of Apostoli, of Paris, and of Engelmann, of St. Louis, who may fairly claim to be the pioneers in the direction of systematizing the rational use of electricity in the diseases of women, and who, above all, teach us the extent to which it is justifiable to utilize the incalculable power of the agent when localized in the pelvis, and yet not inflict damage on our patients. Our purpose, then, is to gather our knowledge within a convenient compass, stating such deductions as appear at present justi fiable without attempt at dogmatism, for the time is hardly ripe as yet. for positive statement except in connection with certain conditions, and enthusiasm must still be greatly tempered. The obtainable results are sometimes, true enough, little short of marvellous, but again, as yet, they are often disappointing.
It must be apparent to every gynecologist, and to the general practi tioner in the habit of treating the diseases of the female pelvic organs, that our routine methods are often slow in action, are frequently nugatory as regards cure, and, exceptionally true enough where requisite precau tions are taken, carry with them considerable risk to the patient. The tendency of to-day, indeed, is to limit the sphere of applicability of many of these methods, in particular applications to the interior of the uterus, and purely vaginal medication is in the hands of many being largely substituted. By vaginal medication is understood chiefly the use of the dry or wet tampon, the aim of which is, ordinarily, the relief of pelvic congestion, and the equalization of the peri- and the uterine circulation, both of which aims are accomplished mainly through the support given to the uterus and its adnexa. Support by the tampon, depletion by glycerin, improvement of nutrition by one or another agent applied to the vaginal vault, such are the routine non-surgical methods favored to-day by many of the leaders in the specialty. There can be no question but that the intra-uterine applicator and the pessary are far less frequently resorted to than was the case only a few years ago, and the reason is that in the hands of many these agents very often disappoint well-grounded expecta tions, even as they frequently fall far short of effecting a cure. What we
seek is an adjuvant method which will yield speedier results and more permanent if not always lasting ones; and the wonder is that, in view of the favorable data derivable from a study of what electricity accomplishes in other departments of medicine, this agent has not, until quite recent date, begun to be systematically used in gynecology. It improves nutri tion elsewhere, it stimulates, it allays pain, it causes absorption in other regions of the body, and it surely hence would not be irrational to claim these same properties for it when applied to the pelvic organs, even if the experience of as yet only a limited number of observers had not amply proved the vast superiority of this agent alone or when associated with routine methods over these methods apart from resort to electricity. The teachings of Tripier, Apostoli, Mund(, Engelmann, and others, are gradually gaining acceptance, and the day is not far distant when elec tricity will become a very prominent factor in the relief and the cure of morbid changes in the female sexual organs. A vast advance has already been made towards the attainment of more general recognition of the value of this agent in routine gynecological practice, since it has been proved that its intelligent and satisfactory use requires scarcely more time than many of our routine methods, for thereby an often-expressed objec tion has been overthrown. Assuming then, and in this we are to-day justified, that electricity, as applied to the female sexual organs, is safe, easy of application, painless practically, and often curative, its general acceptance can no longer be deferred. Every gynecologist must learn how to use the agent in accordance with the developing methods of the present, if he would not be left far behind in the race for successful results.
The varieties of electricity of value in the routine treatment of the diseases of the female genital organs are the galvanic and the faradic, and these varieties with the essential apparatus we will describe in turn with sufficient explicitness, we trust, to enable the reader unfamiliar with elec trical appliances and properties to understandingly utilize them in his practice. For exhaustive detail and theoretical amplification we are forced to refer to works which treat of the physics of the subject. Static electricity we will not refer to, since we are considering purely routine local methods which come within the sphere of the gynecologist, and since, furthermore, however valuable this variety of electricity be to the neurologist, data in regard to its value in the diseases of women are not at our disposal.
The gynecologist should possess the following apparatus: A galvanic battery, a milliampilrerneter, a faradic battery, a set of electrodes for external and internal applications, a rheostat.