:?:-x-Nv ■ HARVARD MEDICAL LIBRARY RONTGEN THE LLOYD E. HAWES COLLECTION IN THE HISTORY OF RADIOLOGY ^Harvard Medical Library in the Francis A. Countwav Library of Medicine Boston veritatem per MedicijsTAM QUyERAMUs Digitized by the Internet Archive in 2011 with funding from Open Knowledge Commons and Harvard Medical School http://www.archive.org/details/highfrequencycurOOstro HIGH-FREQUENCY CURRENTS HIGH-FREQUENCY CURRENTS BY FREDERICK FINCH STRONG, M.D. Instructor in Electro-Therapeutics at Tuft 's College Medical School, Boston. WITH 183 ILLUSTRATIONS IN THE TEXT NEW YORK REBMAN COMPANY 1123 BROADWAY Copyright, 1908, by REBMAN COMPANY New York Entered at Stationers' Hall, London, England, 1908 A 11 rights reserved Printed in America PREFACE In all ages of which we have any authentic knowledge, and among all races, there have existed Philosophers, Investigators or Students of the Occult, who have in divers forms, and many languages, repeatedly averred that the Universe — both visible and invisible — exemplified varied expressions of a single prin- ciple— Vibration. During the last two centuries we have abandoned the theoretical and hypothetical science of the Ancients, and have gradually built up a coherent fabric by logical deductions from actual study of the facts and phenomena of the objective world. Up to a few decades ago, the various truths postulated by science had not fully conformed to a con- dition of "harmonious correlated Unity," which theoretically should be the case according to Herbert Spencer. The Chemical Elements were apparently distinct, unalterable, and bore no mathematical relation to each other. Seventy or more varieties of solid indivisible atoms formed the basis of the material uni- verse, and behind these was a hypothetical "Ether" of abso- lutely unknown nature. Matter was called "dead," or "living," according to the reflected phenomena, and an apparently bound- less gulf existed between the two. Science was becoming more and more complex when the advance guards of a new era appeared, headed by Clerk Maxwell with his "Electro-magnetic Theory of Light," and Mendelejeff with his "Periodic Law of the Elements," and rapidly followed by Crookes, Tesla, Curie, Becquerel, Hertz and J. J. Thompson, whose labors and re- searches have focused in the greatest discovery of any age — The Electron Theory. Although recent and revolutionary, this hypothesis has met with instant and eager acceptance on the part of the leading scientists throughout the world. In the bright light which it throws on the phenomena of the universe, much that was dark and undefined has become lucid and coher- vi PREFACE ent. All sciences have become united by invisible links, and we have for the first time in the history of the world a complete, harmonious system of natural philosophy, by which all facts of nature, however diverse, may be co-related and traced to a common origin. And the crowning postulate of this wonderful new system is identical with the most ancient theory of the universe which history records. In other words science in- forms us that all natural phenomena result from Vibration in a medium of a primitive nature, which appears to be nothing more nor less than Electricity. All forms of Force, from the attraction of the Sun for the Earth to the vital phenomena of the Human Organism, are fundamentally Electrical Vibrations. The "High-frequency Currents" are Electrical Vibrations artificially produced, which bear a certain relation to the cur- rents which traverse the nerves in the maintenance of life in the human body. Being Vibrations, rather than flowing streams of Electrical particles, the High-frequency Currents penetrate glass as readily as a sound wave would traverse a plate of metal, and pass through the human organism without producing the slightest sensation. The discovery and application of High-frequency Currents has resulted mainly from the work of two American Scientists, Tesla and Elihu Thomson. Tesla first recognized the won- derful therapeutic possibilities of High-frequency Currents and prophesied that they would ultimately supersede the older systems based upon the therapeutic use of Drugs ; clinical results recorded during the past five years go far to confirm the accuracy of Testa's prophecy. Although a greater part of the literature of High-frequency Therapeutics ascribes the development of these currents for the treatment of disease to ,d' £rsonval and Oudin, it is, la fact of record that the subject was developed independently by the present writer on distinctly different lines. Whereas d'Arson- val's work was solely with Low Potential Currents, while Oudin 's High-potential effects were of Mono-polar character and there- fore limited to the treatment of local conditions — the writer from the very first employed the Bipolar High-potential Cur- rents of Tesla, and it is due to this fact that the System of Tech- PREFACE Vll nic developed by him for the therapeutic application of Tesla Currents possesses so much wider a field of usefulness and produces so many more distinct physiological effects than the methods developed by Oudin and d'Arsonval. For the past decade the writer has been continuously engaged in a clinical and laboratory study of the various types of High-frequency Currents; hundreds of cases have been treated, and many im- portant facts recorded, which are given to the profession for the first time in the present volume. At the request of a number of his colleagues the present writer has not only gone into minute details in connection with the physical laws and methods of using the various apparatus herein described, but has compiled a concise Elementary Text- book containing the Essentials of the entire subject of Electro- therapeutics. This little book, which is a pocket-edition, should be carefully studied as a preliminary introduction to the present volume. In conclusion, the writer desires to acknowledge his indebt- edness for the help which he has obtained from the works of Freund, Belot, Guilleminot and Chisholm Williams. He also extends his hearty thanks for the collaboration and valuable assistance accorded him by Dr. H. G. Piffard, Professor Elihu Thomson, Dr. J. P. Sutherland and Professor Northrop. Valu- able clinical information has been received from a number of physicians, for which due acknowledgment will be made in the Treatise on the Therapeutic results of High-frequency Treatment, which the writer purposes to compile during the next two years, as a more or less necessary sequel or comple- ment to the present volume. TABLE OF CONTENTS CHAPTER I PAGE Historical and Introduction ...... 1 CHAPTER II Electrons and Vibration ...... 18 Table of Waves of Radiant Energy . . . .24 CHAPTER III Electro-Physics, from the Standpoint of the Electron Theory 30 Magnetism . . . . . . . . .33 CHAPTER IV Electro-Physics {continued) The Nature and Generation of Alternating Currents . . 36 CHAPTER V Physical Factors Involved in the Generation of High- Frequency Currents ...... 46 CHAPTER VI European Types of High-Frequency Apparatus . . 58 CHAPTER VII The Development of American High-Frequency Thera- peutics Earlier Forms of Alternating Current Apparatus . . 88 TABLE OF CONTENTS CHAPTER VIII PAGE Modern High-Frequency Apparatus op the American Type Tesla-Thomson Coils . . . . . - 106 CHAPTER IX Modern American High-Frequency Apparatus, for "Direct Current" Use . . . . . .114 CHAPTER X Analysis and Comparison of High-Frequency Currents of Different Forms of Apparatus . . . 124 CHAPTER XI The Phenomena and Physical Properties of High- Frequency Currents (^4.) Phenomena of Induction (B) Electro-Static Phenomena (C) Electro-Dynamic Phenomena (D) Resonance Effects . . 132 . 133 . 135 . 142 . 146 CHAPTER XII The Measurement of High-Frequency Currents . . 149 CHAPTER XIII Technic for the Therapeutic Application of High- Frequency Currents ...... 155 CHAPTER XIV Therapeutic Technic {continued) The Resonator Discharge . . . . . .161 CHAPTER XV Therapeutic Technic (continued) Methods for the Application of Tesla Currents . .166 TABLE OF CONTENTS XI CHAPTER XVI PAGE Therapeutic Technic {continued) Treatment by Means of Glass " Vacuum Electrodes" . . 175 (A) Monopolar Direct Application 185 (B) Monopolar Indirect Application 186 (C) Bipolar Direct Application 186 (D) Bipolar Multi-Frequency Treatment 187 CHAPTER XVII The High-Frequency Current for the Production of the X-Ray .190 CHAPTER XVIII The Generation of the Ultra-Violet Ray by High- Frequency Currents . . . . . .201 CHAPTER XIX The Generation of Ozone by the High-Frequency Current ..... ... 205 CHAPTER XX A Review of Modern Therapeutic Methods . . 209 CHAPTER XXI Physiological Action of Oscillatory Currents . .216 CHAPTER XXII The Therapeutic Action of High-Frequency Currents 226 (A) D'Arsonval Currents ...... 227 (B) Currents of Very High Potential with Relatively Low Amperage ........ 229 1. Monopolar Treatment . . ... 230 2. Bipolar Application or Tesla Technic . . . 238 3. Multi-Frequency Modalities ..... 242 4. Hyperstatic Technic ...... 247 Xll TABLE OF CONTENTS CHAPTER XXIII PAGE High-Frequency Currents in the Treatment of Diseases of Nutrition ........ 249 (A) Diseases of the Digestive System .... 250 (B) Diseases of the Blood and Heart .... 253 (C) Diseases of the Respiratory Tract .... 255 Pulmonary Tuberculosis ..... 257 (D) Diseases Involving Deranged Metabolism . . . 268 (E) Diseases of the Excretory Apparatus . . . 270 CHAPTER XXIV ThE Treatment of Diseases of the Nervous System by High-Frequency Currents ..... 272 CHAPTER XXV Infectious and Malignant Diseases 275 CHAPTER XXVI Special Uses for Currents of High Frequency INDEX 280 285 LIST OF ILLUSTRATIONS 1. Arrangement of Ley den Jars for Producing Alternating Currents of Great Frequency. (D'Arsonval-Hertz.) . 5 2. D'Arsonval Auto-Conduction Cage; Upright Form. (Piffard's.) 6 3. D'Arsonval Auto-Condensation Couch. (Williams.) . 7 4. Miniature Tesla Apparatus. (E. Ducretet.) . . 7 5. Diagram of Oudin-D'Arsonval High-frequency Appar- atus ......... 8 6. Small " Tesla," or " Secondary" Coil for Use with Pri- mary Solenoid ....... 8 7. D'Arsonval Bipolar High-tension Coil. (Williams.) . 9 8. Diagram of Solenoid and Resonator. (Freund.) . . 10 9. Oudin Resonator. (Williams.) . . . . .11 10. Bipolar Resonator of O'Farril . . . . .11 11. Rochefort's Bipolar Resonator. (Guilleminot.) . .11 12. Piffard's "Hyperstatic Transformer" . . . .12 13. The Author's Air-gap Condenser Terminals . . 16 14. A System of Technic for the Therapeutic Use of High-frequency Currents . . . . .17 15. Schematic Diagram Showing Spontaneous Degenera- tion of Atoms ....... 22 16. Magnetism Induced in Iron Bar by Current in Coil of Wire . . . 33 17. Diagram Indicating Wave Length and Frequency of Known Forms of Radiant Energy . . . .35 18. Hydraulic Analogue of " Continuous Current" Circuit . 36 19. Hydraulic Analogue of " Alternating Current " Circuit . 37 20. "Graphic Tracing" of Alternating (Sinusoidal) Current 37 21. Magnetic-electric Induction. (Williams.) . 22. Diagram of Simple "Magneto", Generating an Alter nating Current ...... 23. ) ' [-Leyden Jar, or Condenser 24 40 40 43 xiv LIST OF ILLUSTRATIONS FIGURE PAGE 25. Plate Condenser with Inductance Coil and Discharging Circuit 44 26. Diagram Showing Analogy Between Falling Water and a Current of Electricity. (Williams.) . . .47 27. Plate I. D'Arsonval Circuit and Hydraulic Analogue . 48 27. Plate II. Tesla-Thomson Circuit and Hydraulic Ana- logue ......... 49 28. Bursting and He-formation of Elastic Skin on Boiling Molasses ........ 51 29. Bursting and Re-formation of Elastic Skin on Boiling Molasses ........ 51 30. Sir Oliver Lodge's Hydraulic Analogue . . .54 31. Electrolytic Interrupter of Wehnelt. (Williams.) . 58 32. Noden Valve, or Rectifier. (Williams.) . . .59 33. Ruhmkorff Induction Coil. (Watson, London.) . . 60 34. Ruhmkorff Induction Coil, Shown Diagrammatically. (Williams.) 61 35. Mercury Jet Interrupter. (Isenthal & Co.) . . 62 36. Dipper Mercury Interrupter . . . . .63 37. Mackenzie-Davidson Interrupter . . . .63 38. Wehnelt Interrupter. (Williams.) . . . .64 39. Oudin-Dean Resonator. (Williams.) . . .65 40. Resonator of Lebailly and O'Farril . . . .67 41. Rochefort's Bipolar Resonator. (Freund.) . . 67 42. Upright Solenoid on Cabinet. (Williams.) . . 68 43. Isenthal-Oudin Resonator . . . . . 69 44. Gaiffe's Oil Condenser and Heavy Solenoid . . .71 45. Gaiffe's Bipolar Resonator . . . . .72 46. Condenser. (From Belot.) . . . . .73 47. Liquid Resistances. (From Belot.) . . . .74 48. Arrangement of Valves, Tube and Meter. (From Belot.) 75 49. Transformer. (From Belot.) . . . . .76 50. General Diagram. (From Belot.) . . . .77 51. Top Shelf of Cabinet. (From Belot.) . 78 52. Lower Shelf of Cabinet. (From Belot.) . . .78 53. Springs and Contact Plate. (From Belot.) . . 79 54. Regulating Apparatus Arrangement of Transformer. (From Belot.) ....... 80 55. Isenthal's Complete High-frequency Apparatus. (Williams.) ....... 81 LIST OF ILLUSTRATIONS XV 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. Resonator and Condensers (small model). (Williams.) 82 Diagram of the Author's Original Type of High-fre- quency Apparatus; "The Strong-Ovington Coil" "The Knott" High-frequency Coil, Working Part Im- mersed in Oil ....... Diagram of the Author's Apparatus, Adapted for the Generation of Heavy D'Arsonval Currents, as well as those of the High-potential ("Tesla") Type . Kinraide Coil; Alternating Type Diagram of Kinraide Coil Showing Relation of Spirals Tesla-Thomson High-frequency Apparatus Piffard's "Hyperstatic Transformer" Brown High-frequency Coil Campbell High-frequency Coil . Kinraide Coil with Improved Spark-gap Cyclone Coil. (Portable form.) Spark-gap of Jackson Coil High-frequency Spark-gap The Author's "Special Hercules" Coil Jackson Coil with Separate Secondaries The Author's "Ajax Coil" The "Ajax Special Coil" Theater Plug The Author's New Graduated Spark-gap, for Ajax Coils 110 The Author's "Hercules" High-frequency Apparatus 111 The Author's Improved Rotary Spark-gap Rotary Converter, Excited by a 110-Volt Direct Cur- rent, and Generating an Alternating Current of 80 Volts Scheidel-W'estern Coil for Exciting High-frequency Apparatus ...... " Scheidel- Western " High-frequency Apparatus " Inducto-resonator " Involving Induction, as well as Resonance . "Meyrowitz" High-frequency Apparatus . The "Cole Coil" for X-Ray and High-frequency Gene ration ....... The Hercules "Universal" The Author's Improved Electrolytic Interrupter The High-frequency Discharge . 83 84 85 88 89 90 92 94 95 96 98 102 102 103 104 107 108 109 112 115 116 117 117 118 119 121 122 125 Xvi LIST OF ILLUSTRATIONS FIGURE PAGE 87. Graphic Tracings of High-frequency Currents . . 125 88. Arrangement for the Production of Oudin-D'Arsonval Currents .....••• 126 89. Arrangement for the Production of Tesla-Thomson Cur- rents ......-•• 127 90. Graphic Representations of Various Currents . . 128 91. Lamp Lighted by the Current "Backed Up" by the Impedance of the Heavy Copper Arch Attached to the D'Arsonval Solenoid ..... 134 92. Incandescent Lamps lit by Currents Induced in Closed Circuits 134 93. Geissler Tube Illuminated on the "Electrical Aura" or "Vibratory Field" Surrounding a Patient, con- nected to a Terminal of a Tesla Coil . . . 135 94. Beautiful Efhuve from the Points of a Skeleton Star . 136 95. Illuminated Sign, Formed by the Effluve Given from a Fine Wire . . . ..-.'■ • • • 137 96. Terminals of the Author's Apparatus Arranged to Show the "Arc" Discharge ..... 137 97. Primary Condenser Discharges per Second . . 138 98. Appearance of Rapidly Revolving Narrow Geissler Tube Connected to Terminal of "Ajax Coil" . . 139 99. "Pseudo-Static Spark" from the Author's Hercules Machine 140 100. Resonator Discharge from Terminal of Tesla Coil . 142 101. Flow of a High-frequency Current Through a Wire to an Insulated Metal Plate .... 144 102. The Author's Apparatus for Demonstrating the Elec- tro-dynamic Phenomena of High-frequency Currents 145 103. Autograph of a Pair of Artery Forceps Laid Upon a Sensitive Plate . . . . . . .147 104. Hot Wire Milliampere Meter for Measuring the Inten- sity or Volume of Currents of High-frequency . 150 105. Lamp Bulb Hand-Electrode ..... 151 106. The Author's Photometric Mil-ammeter . . . 152 107. Professor Flemming's Direct Reading Cymometer." (Marconi Wireless Telegraph Co.) . . . 153 108. Direct Treatment by Current from D'Arsonval Sole- noid Applied to Patient, Through Sponge-covered Electrodes . . . . . . . .156 LIST OF ILLUSTRATIONS XV11 FIGURE PAGE 109. Auto-conduction Cage — Horizontal Form . . . 156 110. Piffard's Improved Auto-Conduction Cage. Vertical Form ........ 157 111. Small Cages for Treatment of Arm, Leg, etc. . . 158 112. Condenser Couch. (Williams.) . . . .158 113. Piffard's " Cushion Spiral" 159 114. Piffard's "Condenser Chair" 160 115. Effluve Electrodes 163 116. "High-frequency Cautery" ..... 164 117. Tesla-Effluve 168 118. "Pseudo-static Spark" Treatment . . . .169 119. High-frequency "Motor- Wave Current" . . .170 120. The Author's Mechanism for Superimposing a Low- frequency, Sinusoidal Wave Upon a Tesla Current 171 121. High-frequency Motor-Impulse Current. (Pseudo- Faradic.) 172 122. Theoretical Tracing of Current Obtained by the Use of the Author's Mechanical Device . . . 173 123. Theoretical Tracing of Current Obtained by the Use of the Author's Mechanical Device . . . 173 124. The Author's Technic for Vacuum Electrodes. "Tesla Vacuum Treatment" ...... 176 125. Doctor Snow's set of Vacuum Electrodes . . 180 126. Double-walled Vacuum Electrodes . . . . 181 127. The Author's Technic for the Use of Glass Condenser Electrodes 182 128. The Author's Regulating Handle for Vacuum or Con- denser Electrodes . . . . . .182 129. Herschell's Regulating Handle and Rectal Electrode. (Williams.) 182 130. Ebonite Spinal Electrode. (Williams.) . . .183 131. Condenser Electrode; "Low Red Vacuum Type" . 184 132. Vacuum Condenser Electrode with Cupping Device . 184 133. Monopolar Direct Technic ..... 185 134. Monopolar Indirect Technic ..... 185 135. Bipolar Direct Application of Vacuum Electrodes . 186 136. Friedlander's Vacuum Condenser Chair . . . 187 137. The Author's set of Condenser Electrodes . . 188 138. Method of Taking a "Skiagraph" . . . .193 139. X-Ray Tube with Solid Metal Anode . . .194 wiii LIST OF ILLUSTRATIONS FICURE PAGE 140. "Water-cooled" X-Ray tube 194 141. Vacuum Regulators for X-Ray Tubes . . . 195 142. Self-regulating X-Ray Tube 196 143. Types of "High-frequency X-Ray Tubes" . . 197 144. Thomson Double Focus X-Ray Tube . . .198 145. Single Focus Tube for H. F. Currents; with Hollow Metal Cone Under Anode 198 146. Single Focus Tube for H. F. Currents (Double Bulb Type) 199 147. Latest X-Ray Tube for Either Direct or Alternating- Currents ....'.-.. 200 148. Diagram of Finsen's Arc Lamp. (Guilleminot.) . 201 149. Piffard's Spark-gap Lamp ..... 202 150. Strong's Ultra-violet Lamp for Use with "Ajax" or "Hercules" Coils 202 151. Strong's Apparatus for the Treatment of Pulmonary Tuberculosis ....... 206 152. Apparatus for Generating Galvanic and Faradic Currents from Battery Cells or Edison 110- Volt "Direct" Circuit 217 153. Diagram of Static Electrification . . . .218 154. "Static Breeze." (Diagram.) 218 155. Diagram of Static Spark Treatment . . .219 156. Diagram of Static Induced Current . . .219 157. Diagram of Static Wave Current .... 220 158. D'Arsonval Auto-conduction Cage Operated from the Author's "Hercules" Coil 228 159. Diagram of "Labile" Method for Solenoid Currents . 228 160. Sponge-covered Electrodes for "Labile D'Arsonvaliza- tion" 229 161. Piffard's Small Spiral with Condensers; for Use with Ruhmkorff Coil 230 162. Vacuum Electrode Covered with Chamois Skin . 233 163. Ultra-violet Vacuum Lamp with Quartz Lens . . 234 164. Indirect Vacuum Treatment 235 165. Rhythmic Effluve Treatment for General Stimulation . 239 166. "Motor Impulse" Treatment 240 167. The Author's Technic for Vacuum Electrodes . . 240 168. The Author's Treatment for Diseases of the Uterus . 241 169. Double Vacuum Treatment ..... 242 LIST OF ILLUSTRATIONS XIX FIGURE PAGE 170. Double Effluvation from the Author's Apparatus . 242 171. European Outfit for Double Effluvation, by Means of Two Resonators ....... 243 172. The Author's " Condenser Effluve " Treatment . . 244 173. Tracing Giving a Conventional Idea of the Nature of the Author's High-frequency Wave Current . . 245 174. Graphic Tracing Giving Theoretical Idea of the Au- thor's Motor Impulse Current .... 246 175. Graphic Tracing Giving Theoretical Idea of "Pseudo- faradic" Current ...... 246 176. Piffard's Technic for his "Trans-resonator Effluve" . 247 177. Piffard's Electrode for Obtaining his "Trans-resonator Effluve" 247 178. Diagram of the Author's Treatment for Diseases of the Intestinal Canal . . . . . .251 179. The Author's Treatment for Chronic Constipation and for Chronic Colitis ..... 252 180. Tubulated Vacuum Electrode for Inhalation Treat- ment ......... 257 181. The Author's Portable High-frequency Apparatus Operated by Current from its Own Battery . 276 182. The Author's Localizing Effluve Electrode for Treat- ing Ulcers and Septic Areas .... 277 183. Vacuum Electrodes for Treatment of Pyrrhoea Alveo- laris .282 HIGH-FREQUENCY CURRENTS HIGH-FREQUENCY CURRENTS CHAPTER I HISTOEICAL AND INTRODUCTORY The gradual waning and ultimate extinction of the vital spark at the close of a long and healthy life must be regarded as a phenomenon quite as natural as that of birth, but we must admit that at the present day a great majority of the deaths are abnormal and premature, resulting from the adverse influences of disease and unhygienic environment. That the race will ultimately reach a stage of advancement in which physical health will be the rule and death by disease a rare event, we have reason to hope and believe from the results of hygienic education and public sanitation which have been introduced during the past few decades and which have already greatly increased the average length of life. The study of pathology and bacteriology has resulted in Antitoxic methods for the pre- vention of many formidable diseases. Surgery has become a science through the same means, while the advent of Antitoxic serum marks the first strictly scientific use of a chemical sub- stance as a curative agent. Almost all the drugs of the Materia Medica have been used in a more or less empirical manner. The study of the fundamental processes of cell action and vital chemistry has resulted in a more rational selection and prepa- ration of food and has evolved the modern science of Dietetics. Finally, after exhausting all the resources of complex indirect methods of treatment, the medical profession have begun to study the therapeutic action of the fundamental forces of nature. Prior to the last decade, physical therapeutic agents com- prising the X-Ray, Ultra Violet Ray, Light and Sound Waves, Mechanical Vibration, Scientific Nerve Massage and the various l 2 HIGH-FREQUENCY CURRENTS forms of electricity were used in a desultory and unscientific manner, being absolutely ignored by a large majority of the profession. It was the advent of the Roentgen Ray which formed the entering wedge for the introduction of physical methods into therapeutics by bringing the physician into touch and familiarizing him with apparatus for the generation of electricity of much higher potential than formerly used in elec- tro-therapeutics. A physician using a Static machine for X-Ray purposes would naturally desire to know the technic whereby the various currents obtainable from his apparatus could be applied to therapeutics. Similarly at the present time, the pur- chaser of a Ruhmkorff Coil for radiography naturally investi- gates the methods of oVArsonval and Oudin, of which he can avail himself at a small expense by the addition of a "Resona- tor" to his coil. The modern High-frequency apparatus of the Tesla-Thomson type, as employed by the present writer, has been an important factor in the development of physical thera- peutics, although designed originally for radiographic use. Prior to Roentgen's discovery, the use of electricity as a thera- peutic agent, was confined to the employment of Faradism and Galvanism by a very small percentage of the profession, the currents being as a rule seldom used except as adjuvants to some older and more conventional method of treatment. A few enthusiastic specialists, however, carried on investigations in electro-physiology and pathology and laid the foundation of our modern scientific use of electricity for the treatment of disease. The Induction Coil, invented by Faraday in 1831, was greatly improved as a therapeutic agent by Dubois-Reymond, Triplier, and Apostoli. The convenience of the Faradic battery, its portability, and the wonder and mystery that surrounded it in the eyes of illiterate persons, led to its adoption by many quacks and irregular practitioners, whose extravagant and unwarranted claims resulted in the ostracism of electro-thera- peutics by many of the more conservative members of the profession. Galvani's discovery (in 1790) of the response of a frog's muscle to electrical stimulation, supplemented by Volta's development of the "Voltaic Pile" (in 1800), gave us the Galvanic Current, HISTORICAL AND INTRODUCTORY 3 which has been scientifically developed into a valuable thera- peutic agent by Remak, Rockwell, Apostoli, and others. Its principal value lies in its power to dissolve cicatricial and redundant tissues and to drive remedial agents directly into the body. The Static Machine, which was originally employed for therapeutic purposes by Benjamin Franklin, had reached a very perfect stage of development when Roentgen's discovery was given to the world. In 1881 Dr. Wm. James Morton of New York published a report describing a new substitute for the Faradic Current, derived from the Static Machine by the use of Leyden Jars, in series with the patient. This u Static Induced Current," although in reality not of an oscillatory nature, was the prototype of our modern High-frequency Currents, and is of interest inasmuch as it marks the first use of condenser dis- charges in the treatment of disease. The discharge of the Leyden Jar or Condenser (invented in 1775 by Professor Musschen- broek) was studied in 1842 by Professor Henry of this country, who demonstrated its oscillatory nature. In 1847 Von Helm- holtz made a similar statement, which was definitely proven by the experiments of Doctor Feddersen of Denmark in 1850 by the use of the rotating mirror. The spark from the Jar was in this manner shown to consist of a series of oscillations, whose period was estimated at not less than one one-millionth of a second. In 1886, Professor Heinrich Hertz published his epoch-making discovery of Electrical Waves, which was supplemented by the work of Sir Oliver Lodge in 1887. Hertz's " Resonator" con- sisted of two polished metal spheres on the outer end of two metal rods, which terminated in small brass balls separated by a gap of fifteen millimeters. The rods were connected with the terminals of an induction coil, and the sparks between the small spheres were found to set up radiating Electrical Waves, capable of inducing sparks across a minute break in a brass wire circle suspended near the coil. The size of the circle and wire had to be very carefully determined, as the waves caused no sparks unless the circle was " tuned" to respond to a vibration of the same frequency as that of the waves. This apparatus forms the basis of modern Wireless Telegraphy as well as our apparatus for the production of High-frequency Currents. 4 HIGH-FREQUENCY CURRENTS The peculiar physiological properties of alternating currents of High-frequency were noticed some years prior to the discovery of their remarkable physical peculiarities. In experimenting with the great Spotteswoode Coil, Ward, in 1879, found that when a frequency of 8,000 interruptions per second was attained, acci- dental shocks were much less severe than with a lower rate of interruption. Rowland, some years later found that High- frequency Currents obtained from the Leyden Jar discharge could be passed through the body with little discomfort. While Joubert, in 1889, found that a nerve-muscle preparation from a frog's leg did not respond to a rapid oscillatory current. The development of High-frequency Currents from a physical stand- point has resulted mainly from the independent investigations of two American scientists — Prof. Elihu Thomson and Nicola Tesla. In a lecture before the Royal Society of Engineers in 1891, Tesla demonstrated his wonderful discoveries in High- frequency Currents by a series of brilliant experiments. This lecture has been published in book form and was for many years the only obtainable work on this subject. At the World's Fair in 1893, Prof. Elihu Thomson exhibited his giant High-frequency Coil which produced a flaming arc of over six feet in length. Up to within a few years this was by far, the largest induction coil in the world. Despite its tremendous power, the current from this coil could be passed through the body with but little discomfort. The therapeutic development of High-frequency Currents generated in accordance with the methods of Tesla and Thomson has been almost exclusively the work of the present writer and was begun in 1895. In 1893, Professor d'Arsonval of Paris published a report of his experiments with High-frequency currents obtained from the apparatus of Hertz and Sir Oliver Lodge. He had been engaged for some years in studying the physiological effects of Sinusoidal Currents of high and low frequencies, and had noticed that the phenomenon of muscular excitation decreased progressively as the frequency was increased. His experiments are reviewed in detail in a succeeding chapter. He first used the apparatus of Hertz, 1891, obtaining a current of considerable strength and a fre- quency so high that their passage through the body was attended HISTORICAL AND INTRODUCTORY 5 with no sensation whatever. The apparatus which he era- ployed is illustrated diagrammatically in Fig. 1. The Leyden Jars (A-A') are connected to the terminals of a powerful Static Machine or Ruhmkorff Coil ; their outer coatings (B-B') are con- nected to the ends of a coil of heavy copper wire (C-C'). The number of turns in this coil depend upon the size and capacity of the Leyden Jars, in other words, the inductance of the coil must be attuned to the capacity of the Jars or Condensers. (See chapter on Physics.) This produces electrical resonance be- tween the Jars and the Coil, so that when a spark passes between A and A', several hundreds of thousands of electrical oscillations Fig. 1. — Arrangement of Leyden Jars for Producing Alternating Currents of Great Frequency. (D'Arsonval-Hertz.) will pass through the coil. By connecting a wire to the termi- nals (C-C') of the coil (which is called the " Solenoid of d'Arson- val"), these oscillations can be conducted to an external circuit. When the latter is formed of two persons (D-D') holding be- tween them an incandescent bulb, L, the High-frequency Cur- rents formed by succeeding groups of electrical oscillations, will light the lamp to its full candle power. D'Arsonval states that he has been able to pass through his body currents of more than three amperes. Prof. Elihu Thomson has passed through his body without injury a current four or five times this amount. If the frequency of the above currents had been fifty, or a hun- dred, instead of from five hundred thousand, to a million per second, fatal results would have been instantly produced. The theories which have been advanced to account for the apparent 6 HIGH-FREQUENCY CURRENTS immunity of the animal body to powerful Currents of High- Frequency will be fully discussed in the chapter on physiology. D'Arsonval observed that painless Currents of High-Frequency could be induced in the human body without actual electrical contact. In place of the Small Solenoid, he substituted a large spiral of heavy wire wound upon a cylin- drical wooden frame- work, forming a cage in which the patient stood or reclined. (See Fig. 2.) This apparatus is used in Therapeutics under the name of the " Auto-conduction Cage of d'ArsonvaL" Another method de- vised by d'Arsonval for the application of these currents is known as "Auto-con- densation." The pa- tient is connected to one end of the Small Solenoid by a metal hand electrode, the other end of the sol- enoid being attached to a large sheet of Fig. 2. — D'Arsonval Auto-Conduction Cage; Upright Form. (Piffard's.) thin metal placed upon the couch upon which the patient reclines; a thick cushion covered with heavy sheet rubber is interposed between the plate and the patient, and may be regarded as analogous to the insulating glass of a Ley den Jar, the inner and outer coatings of which are represented respec- tively by the metal plate and the body of the patient. (See HISTORICAL AND INTRODUCTORY Fig. 3.— D'Arsonval Auto-Condensation Couch. (Williams.) Fig. 3.) The currents obtained from the various forms of d'Arsonval Solenoid, while of High-Frequency and large amper- age, are of relatively low voltage, and their Therapeutic effects are general rather than local. The wonderfully brilliant Elec- trostatic effects obtained by Tesla with his alternating currents of High-Frequency and High Potential led d'Arsonval and his colleagues to study them therapeutically. Tesla' s original High- frequency apparatus being too large and expensive, a miniature form of his outfit was employed, which was made by Ducretet Fig. 4.— Miniature Tesla Apparatus. (E. Ducretet.) HIGH-FREQUENCY CURRENTS of Paris (See Fig. 4). A current from the Ruhmkorff Coil was connected by the wires (i-i) to the inner and outer coatings of a Leyden Jar; in a discharging circuit, consisting of a coarse wire coil (A-B) in series with a short spark-gap (e), OUDIN fl!GHTHD»DJCY (HIGH P0TINT|AL> Fig. 5. — Diagram of Oudin-D'Arsonval High-Frequency Apparatus, Showing Intermediate Forms of Current. a, Batteries in "Series." b, Induction Coil, c, Vibrator or Interrupter. d, Spark-gap. e, Condensers for Leyden Jars. /, D'Arsonval " Solenoid." g, Oudin "Resonator." h, "Vacuum Electrode. the oscillations from the condenser induced in a fine wire sec- ondary coil (F), a High-frequency Current of High Potential, which discharged in the form of a flaming arc between the insu- lated terminals at (E). The two coils are concentric and are immersed in a bath of oil for insulation. Another type of appa- ratus used in d'Arsonval's original experiments is indicated diagrammatically in Fig. 5. A Tesld Coil can be used with this outfit consisting of a reel wound with very fine wire contained in a glass tube filled with oil; (See Fig. 6). By Fig. 6. — Small "Tesla," or "Secondary" Coil, for Use with Primary Solen- oid. (See Fig. 5.) slipping this tube inside the small Solenoid, the latter is made to act as the primary coil of a High-tension Transformer, the secondary or Tesla Coil being enclosed in a glass tube. A more practical form of this device is known as " d' 'ArsonvaV 's HISTORICAL AND INTRODUCTORY 9 High-tension Coil," (See Fig. 7), which is in reality a High- frequency Transformer of the Testa-Thomson type, air being used for insulating purposes instead of oil. At the present time these devices are seldom used among European specialists, their High-potential, High-frequency Currents being generally de- rived from what is known as "Oudin's Resonator"; (See Fig. 9). RKZS i Fig. 7. — D' Arson val Bipolar High-tension Coil. (Williams.) This device consists of a large fiber cylinder or tube, having a number of turns of fine insulated wire wound on a spiral upon its outer surface. The lower end of this wire is connected to the Small Solenoid of oVArsonval. As a rule the latter is incor- porated in the resonator and consists of fifteen or twenty turns of course copper wire wound upon the lower part of the cylinder, as in Fig. 9, the upper end of the solenoid being continuous with the lower end of the Resonator Coil. (See Fig. 8). It is neces- sary that a certain inductive relation exist between the solenoid 10 HIGH-FREQUENCY CURRENTS and Resonator Coils; they must be attuned, or in resonance. This tuning is usually accomplished by cutting out one or more turns of the Solenoid by means of a movable contact. (Fig. 9). To the upper end of the Resonator Coil is attached a wire which is connected to an insulated metallic electrode, which is used for applying the "Ef- fluve," or High-frequency Brush Discharge to the body of the patient. This discharge is essentially of a monopolar character and is therefore limited to the treatment of local conditions. To obtain an actual High-frequency, High-potential Current for general as well as local ef- fects, it is necessary to employ a generator of the Tesla- Thomson type. In Europe, however, these effects are usually obtained from a Bi- polar Resonator, two forms of which are shown diagrammat- ically in Figs. 10 and 11. Resonators and Solenoids re- quire a large Ruhmkorff Coil for their successful operation. The current from Static Ma- chines was regarded as of too small amperage for high- frequency purposes. In 1900, however, Dr. H. G. Piffard of New York devised a small apparatus of the Tesla type for obtaining High-frequency effects from a Static Machine. Al- though the current obtained from this apparatus was of small quantity, its potential and frequency were very high, making it especially suitable for the treatment of diseases of the skin. This is known as the "Hyperstatic Transformer," and is quite generally employed in series with the Static Machine in this Fig. 8. — Diagram of Solenoid and Resonator. (Freund.) Fig. 9. — Oudin Resonator. (Williams.) ^ALX — 0 o — XJa B E C Fig. 10. — Bipolar Resonator of O'Farril. Fig. 11. — Rochefort's Bipolar Resonator. (Guilleminot.) 12 HIGH-FREQUENCY CURRENTS country. (See Fig. 12). Piffard also demonstrated the possi- bility of obtaining efficient d'Arsonval Currents from powerful Static machines of the modern American type, and devised several instruments for the generation of these Currents. The study of High-frequency Currents of the Testa-Thom- son type in relation to therapeutics, was undertaken by the author in 1896. During the first few years of his work, he believed himself to be the pioneer in this particular field of inves- tigation, and when he finally learned of the work of d'Arsonval, Fig. 12.— Piffard's "Hyperstatic Transformer." he had independently developed a complete system of technic for the clinical application of Electrical Oscillations; had deter- mined the relative value and peculiarity of action of currents of different frequencies, and had founded at the Boston Dispen- sary, through the courtesy of Dr. Frederick Coggeshall, what was undoubtedly the first "High-frequency Clinic" in America. Despite the crudity of his home-made apparatus, the writer satisfactorily demonstrated the undoubted therapeutic value of High-frequency Currents in a great variety of diseased condi- tions, much of the work being done at the above-mentioned Clinic. HISTORICAL AND INTRODUCTORY 13 A magazine article by Testa, published in 1893, gave the writer his first idea of the nature and therapeutic possibilities of High-frequency Currents. Tesla reported his observations of the stimulating and vitalizing action of these Currents in the cases of several of his assistants, and upon his own organism. Although disclaiming any belief in the therapeutic value of the older forms of electricity then in use (Faradism, Galvanism, etc.), he professed himself as fully convinced of the important part that his High-frequency Currents of High Potential were destined to play in the Healing Art of the future. These facts were not considered at the time, as of more than passing interest, but were brought back to the writer's memory a few years later in a lecture on the X-Ray at the Massachusetts Institute of Technology, in which the methods for the generation of High- frequency Currents were explained, and demonstrated by a small coil of the Thomson type excited by the discharge of a battery of Ley den Jars charged by a Ruhmkorff Coil. There was at this time practically no literature on the subject, except a report of Testa's lecture before the Royal Society of Electrical Engineers, in 1891. Through the courtesy of Dr. J . B. Sutherland, at that time Professor of Anatomy at Boston University School of Medicine, the writer was given the use of his private laboratory for the purpose of carrying out investigations concerning Roentgen's newly discovered " X-Ray s." His first work was done with a small three-inch spark coil, laboriously wound by hand, and a small Crookes tube obtained from Queen & Co. A few weeks' experience demonstrated the inadequacy of this apparatus for X-Ray work, and the construction of an eight-inch coil was under way when the above lecture was given at the Institute of Technology. This was the real beginning of the writer's inves- tigations of High-frequency Currents, and his first u Tesla Coil" was completed simultaneously with his eight-inch Ruhmkorff. When primary batteries were used as a source of energy he found that the X-Rays from the latter coil were superior to those obtained from "the Testa" and the latter was temporarily dis- carded for X-Ray work. About this time the writer made the acquaintance of Mr. 14 HIGH-FREQUENCY CURRENTS T. B. Kinraide and witnessed at his laboratory in Jamaica Plain, a demonstration of X-Rays of such power as to render the bones of the trunk as clearly visible as those of the hand. With- out doubt, Mr. Kinraide was the first investigator to produce rays of such high power, but his methods were so expensive and complicated as to greatly restrict the field of their application. A tremendous amperage was obtained from a large bank of storage cells, the current being interrupted by a heavy Platinum Break of Mr. Kinraide's invention. A Ruhmkorff coil, rated at about eight inches, was thus operated, the secondary terminals being connected with a condenser immersed in kerosene. This in turn was provided with a discharge circuit, consisting of a Tesla-Thomson Coil (immersed in oil), in series with a spark- gap. From the secondary of the High-frequency Coil, Mr. Kinraide derived the currents which he employed to excite his Crookes tube. Some months later he invented his well-known "Kinraide Coil," which superseded his original apparatus. At the suggestion of Mr. Kinraide the writer modified his own outfit, and adapted it for use on the 104 volt, 60 cycle, alternating, Electric Light Current, obtaining results far beyond his expec- tations. The only unsatisfactory feature of this apparatus was the spark-gap, which consisted of two electric light carbons mounted on an insulated support, and separated by a short air space. An air blast spark-gap, as suggested by Prof. Elihu Thomson increased the steadiness and efficiency of the dis- charge, but greatly complicated the apparatus. At this period, the Knott Apparatus Company, of Boston, brought out their "Knott High-frequency and X-Ray Apparatus," which was provided with a simple rotary spark-gap, consisting of a large metal disk, revolving in front of a brass ball. This device, we believe, was the invention of Mr. E. Cate of the Knott Company. The writer's rotary gap, employed in the "Hercules" Coil, is an improved and perfected form of Mr. Cate's device. The Knott Coil, which is described in an ensuing chapter, was the first American High-frequency apparatus placed on the market, and for years was the only successful coil of this kind in use for X-Ray work. With the addition of the Knott spark-gap, the writer's apparatus proved very satisfactory, and was subse- HISTORICAL AND INTRODUCTORY 15 quently employed by him almost daily in X-Ray and therapeutic work. The marked relief of pain experienced by several rheu- matic patients after undergoing examinations by the X-Ray, revived in the mind of the writer the statements of Testa, regard- ing the therapeutic value of High-frequency Currents, and led to experiments which proved that it was the electricity, and not the X-Ray, which allayed the pain, thus demonstrating the cor- rectness of Testa's theory. From that time to the present, the writer has studied to per- fect apparatus for the efficient production of Therapeutic High- frequency Currents, the generation of X-Rays being regarded as of secondary importance. From the first, the writer adminis- tered the treatment by connecting the patient to the terminal of his Tesla Coil by means of a metal hand-electrode, the opposite pole being connected with the various devices for causing the discharge to play upon the affected area of the patient's body. A few accidents, in which the electrode was carried too near the body (causing a painful spark) , led to the employment of a tube of glass between the patient and the active electrode. It was but a step to substitute for the glass-covered metal electrode, a Geissler Vacuum Tube, in which the current passes through the body via the glass walls of the tube and the rarefied gas which it contains. This led to the invention of the Vacuum Electrode, a device now universally employed, but which was first devised by the writer in 1897. In 1898 the writer devised his well-known "Air Gap Con- denser Terminals," shown in Fig. 13, which illustrates the first form of the writer's High-frequency Apparatus that was intro- duced to the Medical Profession. By the use of these termi- nals, in connection with the writer's Bipolar, High-frequency, High-potential Apparatus, a number of entirely new and dis- tinct effects were obtained. In this way, the therapeutic action of Faradic, Pulsatory and Sinusoidal Currents of Low Frequency was added to the general and local effects of the High-frequenc}7 Tesla Currents. Ultimately a number of distinct methods, or "Modalities," were evolved, and in 1903, at the request of a number of physicians who were using the writer's apparatus, he published his results in the form of a small treatise entitled 16 HIGH-FREQUENCY CURRENTS "A System of Technique for the Therapeutic Use of High- frequency Currents." A chart giving a graphic outline of each of the methods described, was incorporated in the above treatise. (See Fig. 14.) About this time the writer designed his Portable Apparatus and his large "Grand Model" High-frequency Appa- ratus, styled by its manufacturers the ''Hercules Coil." During the past year a simplified, less elaborate form of this apparatus has been placed on the market, being known as the " Ajax Coil." This apparatus has met with the approval of a large number of Mh hi Fig. 13. — The Author's Air-gap Condenser Terminals. physicians, and is in general use in various parts of the country. The writer's latest apparatus is known as the " Hercules Uni- versal," inasmuch as it combines in a single apparatus, the devices of Tesla, oVArsonval and Oudin, and is provided with a large Ruhmkorjf Coil for heavy X-Ray work. When the X-Ray was first employed therapeutically, in the treatment of cutaneous diseases, the writer made a comparative study of the Static Machine, Ruhmkorff Coil, and his own Tesla Apparatus, and found that the X-Rays obtained from the latter possessed many advantages therapeutically over those generated from the other machines. Since that time he has devised a number of types of Vacuum Electrodes for combined treatment by the Tesla High-frequency Currents and X-Rays, as well as with Ultra Violet Rays, and other types of radiant energy. A complete description of the nature and use of these devices, as HISTORICAL AND INTRODUCTORY 17 well as the details of a number of types of High-frequency machines of different design and manufacture, will be given in the ensuing chapters. Fig. 14. CHAPTER II ELECTRONS AND VIBRATION All our conceptions of the external world are derived through impressions conveyed by the nerves corresponding to our five senses. These impressions are the result of vibratory forces which impinge upon the nerve ends. Difference in sensation results from the varying rate of the vibrations and from the character of the medium through which the vibrant waves travel. For example — Sound is the result of mechanically excited waves transmitted through the air or some solid or liquid substance; at about 40,000 vibrations per second sound waves become inaudible, as our auditory keyboard has a limited number of notes. We explain all natural phenomena by means of two funda- mental conceptions called Matter and Force. Matter, we define as that which occupies space or takes up room. Force or Energy is that which produces a change in the form, nature or position of matter. We assume that all forms of matter are composed of collections of extremely fine particles called Molecules. A mole- cule is the smallest portion of matter that can exist alone. Under ordinary conditions these molecules, or infinitesimal particles of matter do not touch each other, but are separated by rela- tively great spaces. This is due to the fact that molecules possess the inherent property of mutual repulsion, that is, each molecule tends to drive all other molecules as far away from itself as possible. The mutual repulsion of molecules is, how- ever, more or less neutralized by the attraction which each mole- cule possesses for other molecules in its vicinity. These par- ticles of matter are never at rest but are constantly swinging through definite orbits; it is this inherent tendency to orbital motion which causes the molecules to apparently push each other apart. 18 ELECTRONS AND VIBRATION 19 Energy may be divided into Mechanical or Molar force which produces changes in masses of matter; and Molecular force, which acts on the molecules of a mass. Heat is a form of molec- ular force which, when applied to a body, causes its molecules to swing through gradually increasing orbits, increasing the distance between each molecule and its immediate neighbors. This causes the mass of matter to enlarge, and consequently we say that a body "expands" when heated. When molecules are relatively close together, their mutual attraction is very strong, and the mass of matter would appear to us as being very hard and firm. Such a mass is called a solid body. Suppose a solid body were to be heated: the distance between the molecules would increase and their mutual attraction would gradually diminish; after a time a point is reached where this mutual attraction and repulsion just balance each other, and as a result, we have a form of matter in which the particles are so loosely held together that the slightest force is sufficient to break them apart. Matter in this condition is called a liquid. Application of heat to a liquid causes a still further increase in the distances between these molecules with a corresponding decrease in mutual attraction. At a certain point the mutual attraction is less than the repulsion and we have then a form of matter called a gas, in which the particles tend to diverge indefinitely ; consequently the volume of a gas is limited only by the size of the vessel in which it is contained. The above-mentioned property of gases is of great importance, as it has made possible the discovery of the minute entities of which, not only molecules, but their com- ponent atoms are constructed. These particles may be regarded as units of force as well as units of matter. From the latter standpoint they are called Corpuscles ; from the former, Electrons. The electron is, therefore, the structural unit of all phenomena. It is a minute charge of Negative Electricity, self-centered and integral. There is no good reason for supposing that an abso- lute, solid, material body underlies and supports this negative charge. In a free state, electrons repel each other, yet they are capable of forming alliances, uniting into groups consisting of from 800 to 200,000, each electron of which swings or vibrates through a definite orbit so that a miniature solar system is 20 HIGH-FREQUENCY CURRENTS formed, the electrons representing the planets, and being held in equilibrium by the attraction of a hypothetical central sun. These wonderful minute systems constitute the atoms of the various chemical elements, the number of electrons in a given group determining its physical and chemical properties and its atomic weight. Thus the Hydrogen atom consists of about S00 electrons and has an atomic weight of 1. Uranium has over 200,000 and an atomic weight of 239. Between these extremes lie the seventy odd groups of electrons which constitute the chemical elements. In each atom the mutually repellent electrons are held in a state of harmonious orbital motion by a centralizing atmosphere of Positive Electricity in which they are apparently suspended at equilibrium. In the solar system the planets are similarly held by the sphere of solar attraction. Imagine this sphere of attraction to still exist after the removal of the sun and we have a crude idea of the nature of the Positive Electricity which holds the Electrons together in the atom. A simple yet very instruc- tive experiment will demonstrate the universal law of harmoni- ous association, whereby the electrons are formed into atoms. Several dozen fine steel needles are magnetized from a powerful electro-magnet, so that all the points have a like positive polarity. Each needle is thrust vertically through a small disk of cork and placed in a large, shallow basin of water. The needles are held in an upright position by their floats and the mutual repulsion between the magnetism of the points above the water and that of the "eyes" beneath the water causes the needles to form a circle around the inside rim of the dish. Now, slowly lower over the center of the dish the negative pole of a bar magnet and when the lines of force radiating from it strike the periphery of the dish, the needles will slowly move toward a common center, stopping when the attraction of the overshadowing magnet just balances the mutual repulsion of the polarized floats. In this way, by employing a greater or less number of needles, a variety of beautiful geometrical figures will be formed. The exact number of needles required to produce a certain figure can be determined only by experiment. With some of these figures the addition of a needle will cause ELECTRONS AND VIBRATION 21 a dissolution of the regular arrangement, while the withdrawal of one will weaken but not destroy the integrity. Other figures respond in an exactly opposite manner. Now, these symmetrical groups are analogous to the atoms of the chemical elements, the experiment showing that stable arrangements of the floats recur at regular mathematical inter- vals, just as the atomic weights of the elements indicate the existence of a Periodic Law governing their formation. This Periodic Law was formulated by Mendelejeff some twenty years ago and laid the foundation of modern chemistry. Arranging the elements in an ascending scale, we have some seventy differ- ent forms of substance beginning with Hydrogen, with an atomic weight of 1, and ending with Uranium with an atomic weight of 239. The Uranium atom contains about 200,000 electrons and is the heaviest and most complex atom known to science. So ponderous is it, indeed, -that sooner or later it breaks down spontaneously, forming an atom of Radium (which is less heavy and less stable than Uranium) and one or more simple atoms of the light gas helium. Uranium evidently marks the limit of electronic combination. "Uranium, Thorium and Radium mark the end, not the beginning of a course of development. They signalize, we can dimly see, the point where the evolutionary design, so far pur- sued with success, ceases to be practicable. As the outcome of its execution we have the whole series of the chemical elements variously constructed of a primal stuff. And that primal stuff consisted, we are driven to believe, in a crowd of 'electrons,' almost infinite in number, incoherent in arrangement, bound- lessly diffusive in space." How were these "electrons" com- bined together to form an atom? It was not possible without the 'application of some force. It involved the doing of loork. Electrons are, no doubt, adapted for agglomeration, yet they will not agglomerate unless under compulsion. Just so much energy as a substance gives out in going to pieces was assuredly expended in putting it together. "A gram of radium, according to Professor Rutherford's indisputable statement, contains a store of power sufficient to raise 500 tons a mile high. An engine of 1,000 horse power would be kept working for three 99 HIGH-FREQUENCY CURRENTS hours to produce this small quantity of the heaviest of known metals. Whence did this power come? How and why was it directed in this particular channel?" Here we are met by the impenetrable secret of creative agency. The sketch (Fig. 15) is intended to give a graphic representa- tion of the break down of a Uranium atom. Some of the freed electrons have already re-formed into Helium atoms; the ma- Fig. 15. — Schematic Diagram Showing Spontaneous Degeneration of Atoms. I. — Uranium Atom (Ur), breaking down into the Radium Atom (Ra), and the Helium Atoms (He). II. — Radium Atom (Ra), breaking down into a Simpler Atom (Bi), (which is probably Bismuth or Lead) and the Helium Atoms (He), giving out meanwhile free Electrons (E, E, 5), (Cathode Rays) and Ether Waves of various frequencies; 1 , X-Rays; 2, Ultra-Violet Rays; 3, Light Rays; 4, Heat Rays. (Redrawn and Revised from a Sketch by Doctor Batten, in the "Archives of the Roentgen Ray.") jority of the remaining electrons ultimately unite to form a single atom which would appear much larger than the Helium atoms but slightly smaller than the original Uranium atom. Heat rays (4), Ultra violet-light rays (2), X-Rays (1), and streams of free electrons ("Cathode Rays/' 5) are differ- ent varieties of radiant energy given off in the breaking-down process. ELECTRONS AND VIBRATION 23 Almost all that we know concerning the electron has been learned through the study of the phenomena of Radium and of the electric discharge in Crookes' Vacuum tubes. ("X-Ray tubes.") We have seen how electrons unite to form the different kinds of matter. Let us now consider them as sources of force. We shall find that the different manifestations of energy are the result of vibrations or perturbations of electrons acting indi- vidually or in collected units. The most subtle and most elusive type of force is that which we call Radiant Energy, and consists of transverse waves propagated in the ether by the orbital or axial rotation of individual electrons, either free or in the atom. Phenomena involving sudden or periodic interference in the motion of electrons through solids, liquids or gases, also give rise to waves of radiant energy. The crack of a whip causes a single pulse or radiating wave in the air which impinges on the ear drum as a sudden, sharp noise; the alternate to-and-fro vibra- tion of a piano string, on the other hand, sends out a series of gradually diminishing waves which blend to form a musical note, of a pitch or frequency equal to that of the vibrating string. Single electrons moving at a high velocity, when suddenly stopped by some solid body, send out isolated "pulses" in the ether; when these pulses follow each other with great rapidity, X-Ray s are generated. It is the extremely short wave length of these impulses which enables them to penetrate solids which are opaque to slower vibrations. X-Rays may be likened to a succession of "whip-cracks" in ether, while light waves are like musical sounds in that they result from the sustained vibration of electrons swinging in their definitely determined orbits. The bright lines of the spectrum are single pitches or "tones," their wave length and frequency being determined by the rate of rotation of the electrons in the different chemical atoms. The relation between the various forms of radiant energy is indicated in the following table, which was arranged by Doctor Batten of London.* * "Archives," r904, p. 173; Dr. Geo. B. Batten: "The Revelations of Radium." 24 HIGH-FREQUENCY CURRENTS TABLE OF WAVES OF RADIANT ENERGY per second. Rate of travel through the ether: 300,000 kilometers ; 186,000 miles ] /i=To5o millimeter. MM = millimeter =2J5 inch. CM = centimeter. M = meter =39£ inches. KM = kilometer =1,000 meters = 1,093 yards. Complete Vibrations Oc- taves Wave- Lengths Observations Per Second. 56 55 ? Approximate 54 ? Probable position of X-Rays (Roentgen) 53 4,503,599,627,370,496 52 51 50 0.1/t Ultra - violet photographed in vacuo 1,125,899,906,842,624 \ / 0.28/i Photo limit of solar spectrum (Cornu) 789,000,000,000,000 ( ) 0.38/i Visual limit at violet end of spec- > 49 < trum 562,949,953,421.3121 ] 0.53/x Green light 451,000,000,000,000 1 I 0.76/i Visual limit at red end of spec- trum 281,474,976,710,656 48 47 ljU Infra-red photographic limit (Ab- ney) 70,368,744,177,664 46 45 4/1 Heat rays of splar spectrum, low- est, measured directly (Langley) 44 24/( Heating rays observed by bolo- meter 43 \ 42 41 40 39 38 J Seven octaves unobserved, now V partly occupied by probable ( position of N-Rays (Blondlot), ] 1903 37 / 47,000,000,000 36 2 MM Electric oscillations in small spheres 35 6 MM (Bose) 34 1.7 CM 33 2.6 CM Electric oscillations in small spheres (Righi) 32 3.5 CM 31 30 29 28 ELECTRONS AND VIBRATION 25 Complete Oc- Wave- Vibrations taves Lengths Observations 27 26 446 CM Electric oscillations in Hertz reso- o: nator, 70 CM diameter 10,000,000 6iJ 24 15 M Electric oscillations from 1-pint Leyden jar. 8,388,608 23 30 M Electric oscillations from fly in g- 22 bullet photographs (Boys) 21 20 19 262,144 18 1.1 KM Electric oscillations, Leyden bat- 17 tery circuit (Feddersen) 16 15 14 13 12 11 10 512 9 585 KM Electric oscillations in very large 8 7 battery circuit (Lodge) 157 1,910 KM Electric oscillations from conden- 6 5 ser I microfarad capacity Once per second 4 3 2 1 / 300,000 KM 186,000 Pendulum beating —1 \ miles Seconds —2 Once in 4.7 seconds —3 865,000 Electric oscillations from storm in miles sun —4 In this connection, the following hypothetical experiment is extremely instructive, as illustrating the relationship of vibra- tion to radiant phenomena. It is quoted from a most remarkable little book entitled " Dynamic Thought," by William Walker Atkinson. "To give one an idea of the differences produced by different rates of vibration, let us imagine a mass of iron, shaped like a great Hop,' capable of being impelled to 'spin' at a constantly 26 HIGH-FREQUENCY CURRENTS increasing rate of speed, by some mighty will. At first it is seen as a slowly spinning top, manifesting nothing but slow motion, to our senses. " Now, imagine our top spinning at a rate doubling each second. The first second the top spins at the rate of two revolutions per second. We notice no change, except that we can see the movement. The next second the revolutions are doubled to four per second. Then, doubling each second, we have, respec- tively, revolutions of eight per second, then sixteen, and then in the fifth second, thirty-two per second. Then we begin to notice a change. "When the revolutions reach thirty- two per second the fric- tion of the moving top on the air causes it to give forth a very low, deep bass note of Sound. This note is like a low, deep 'hum/ and is the lowest possible of perception by the human hearing, although it is possible that some of the lower forms of life may be conscious of still lower vibrations. "The sixth second the revolutions reach sixty-four, and the low note has grown much higher in the scale. The seventh second records a rate of 128, and the note has correspondingly increased. Then, as the seconds pass, we have successively, 256, 512, 1,024, 2,048, 4,096, 8,192, 16,384, 32,768, the latter, in the fifteenth second representing the highest note recognizable by the human ear, although it is believed that some of the lower animals may recognize sounds too acute for our sense of hearing. During this increase in revolutions from the fifth second to the' fifteenth, the sound-note has risen rapidly in the scale from the low sullen "hum," on through the notes of the musical scale, and beyond the range of instruments, until the shrillness be- comes so intense as to be almost unbearable, and finally terminat- ing in a shrill, piercing shriek like the ' squeak' of the bat, only long drawn out. "Then from the termination of the sound (by reason of the rate of vibration having become too high) silence reigns for thirty seconds — absolute silence, in spite of the rapidly increasing rate of vibrations; in fact, because of it. "When the forty-fifth second is reached, and the revolutions have attained the rate of 35,184,372,088,832 per second, our ELECTRONS AND VIBRATION 27 top begins to emit heat-rays, increasing each second. Then a little later a dull, dim glow may be noticed. Then, as the seconds fly, the dull glow manifests a deep dark-red color, such as one notices in the iron of the blacksmith's shop, soon after it begins to 'glow.' Then, on and on, as the seconds fly, the deep red grows lighter and brighter, gradually changing into orange, then into yellow, then into green, then into blue, then into indigo, then into violet, and then into the color of 'white heat.' Then this 'white heat' changes into a still more dazzling white, and then a white impossible to describe appears, so bright, clear and brilliant that the eye cannot bear the sight. Then suddenly, the intense brightness is succeeded by absolute dark- ness, and the moving top cannot be seen by the eye — and yet it moves on. The highest recorded chemical rays of light are estimated to equal a rate of vibration of 1,875,000,000,000,000 per second. The vibration of the lowest shade of red light is estimated at 450,000,000,000,000, and the highest of violet at 750,000,000,000,000 per second, so we may imagine what the highest line on the spectrum is like. "Still vibrating, our top, which has become now a mass of vaporized iron, rapidly tends toward still more ethereal forms. It has passed out from the region of light-waves, into another 'Unknown Region' of vibrations, in which region, however, exist the vibrations known to us as the 'X-Rays,' etc. It is throwing off great quantities of electrons. If we were to use a fluorescent screen we would be able to observe the phenomena of the Roentgen Rays, and similar manifestations of radiant energy. "On and on vibrates the top of what we once called Iron — cold iron, warm iron, hot iron, melted iron, gaseous iron, ethereal- ized iron, if you like. What it is like now, the imagination of man cannot conceive. Still the revolutions continue, doubling each second. What is being produced? The imagination cannot conceive of what this state of Substance, now being reached, is like. By a scientific form of poetry we might think of it as melting into Energy — pure Energy, if there were such a thing. Long since it has been resolved into its original particles — its electrons, and perhaps into the 'stuff' from which these 28 HIGH-FREQUENCY CURRENTS particles are made. But we must let the curtain drop — the wildest fancy cannot follow the dance of substance any further!" Many of the most advanced thinkers agree that the electron hypothesis confirms the assertion that Life and Intelligence not only manifest through, but actually constitute all phenomena of the universe. They believe that not only in conscious man do we find the Intelligent Life Principle, not merely in the lower plants, but in the wondrous snow crystals, the particles of the oldest rocks, the molecules and atoms of the so-called "elements" and even in the primitive world-forming unit — the Electron — we discover the fundamental qualities of Living Mind. This principle is exemplified in the electron by its Self-centered Unity, its "likes" and "dislikes," its inherent power of vibratory motion and electrical reaction, and in its ability to ally itself for offense or defense with other similar units, and in their com- pany to evolve to more complex and higher types — to the crystal, to the plant, to the animal, to the man — and beyond! The hard and fast line of demarcation between "Living" and "Dead" matter no longer exists. Up to 1820, chemists divided com- pounds into inorganic and organic, holding that the latter were obtainable only from vegetable or animal material and were formed solely through the mysterious agency of "life," They supposed it impossible to create in the laboratory from inorganic elements an organic compound, such as rose-oil or albumen; just as some present day scientists believe that an impassable barrier exists between the highest chemical crystal and the lowest form of cell life. Wohler, in 1820, performed the synthesis of urea from ammon- ium cyanate, and proved that it was possible to reproduce in the laboratory all the chemical combinations existing in living structures. Almost any day another "Wohler" may startle the world by apparently "creating" from chemical substances a low form of so-called cell life. Already Professor Loeb and Professor Mathews have come dangerously near this achievement, and they have shown that when this gap is bridged, it will be through the agency of the more subtle forms of electricity. Similarly, it will be but a question of time and experiment ere the exact electrical nature of normal vital activity will be ascer- ELECTRONS AND VIBRATION 29 tained. Refinement of apparatus will enable the physician to generate and apply to the diseased organism electrical forces of the exact voltage, wave form and frequency required to restore to the normal the organs and functions deranged by the disease in question. Electro-therapeutics, which has not even been considered worthy of a place in the curricula of a number of prominent medical colleges, will then become the most important subject in a medical education. CHAPTER III ELECTRO-PHYSICS, FROM THE STANDPOINT OF THE ELECTRON THEORY From a consideration of the previous chapter it will be readily understood that the advent of the "Electron Theory," while greatly broadening and amplifying our knowledge of the nature and causes of natural phenomena, nevertheless makes it neces- sary for a thorough revision of the laws and definitions which have been generally taught and accepted up to the present time. For example, we have been taught that electricity flows from the positive to the negative pole of a circuit, and that the electric- ity in a Positively charged body exists in a condition of increased pressure or concentration, the reverse being true in the case of a Negatively charged body. Physics has taught us that Electric- ity is an indefinable, elastic "something," equally diffused throughout all matter; and that by removing a portion of the Electricity contained in a given body, and adding it to another body, a Positive charge would be communicated to the latter; while the first mass would be left in a Negative condition. A Positively charged body was analogous to a chamber filled with compressed air; a Negatively charged body, to one filled with rarefied air. These statements have been generally regarded as correct, and have been of no little assistance to the student of electro-physics, but our recently acquired knowledge of the real nature of electricity has demonstrated the incorrectness of the above statements, as well as of many other explanations and theories promulgated in the various books on physics and electricity, which have been published within recent years. The profound, epoch-making character of the discovery and elabora- tion of the "Electron Theory," is not generally realized at the present time, except by investigators and students of pure science. It has been the writer's experience that the members 30 ELECTRO-PHYSICS 31 of the medical profession, including even a majority of the electro-therapeutic specialists, are almost entirely ignorant of the great practical significance, and the wide vista of possibilities which have been opened to us by the discovery of the "Electron Theory." In writing this book, the author has had occasion to consult a vast amount of literature relative to Electro-Thera- peutics; and has been impressed with the confusion and ambi- guity resulting from the attempt to employ the terms and defini- tions of "Nineteenth Century Electro-physics," in conjunction with the revised statements of facts deduced from the "Electron Hypothesis." Within the ensuing year many standard works on physics and chemistry will doubtless be revised and rewritten in the light of our recently acquired knowledge, but as no such textbooks are available at the present time, the writer has deemed it advisable to incorporate in the present volume the main facts of the electron hypothesis; and the elementary principles of electro-physics, as viewed from this modern stand- point. The first part of this task has been completed in the preceding chapter. The general nature of physical phenomena has been considered and the evolutionary process whereby electrons are united into groups of different sizes and arrangements — forming the atoms of the chemical elements — has been explained in detail. In order to understand the abstruse laws and principles exemplified in the production and application of High-frequency Currents, it is absolutely essential that the student obtain a clear comprehension of the fundamental processes which form the basis of all electrical phenomena, and to this end a brief summary of the simpler facts of electro-physics in the light of recent discovery, will now be given. Electrical phenomena result, primarily, from the Motion of Electrons, either in a free state, or united into groups, called Atoms. Every atom of every molecule is so constituted that it may be made to give up, or take in one or more Electrons. Atoms of Monad Elements, if basic, or metallic, readily give up a Single Electron, the remainder constituting a Positive Ion. Dyad or Triad atoms give out — respectively, two, and three electrons, when they become Ions. Acid-forming Elements do 32 HIGH-FREQUENCY CURRENTS not really give up electrons, but each atom attaches to itself an electron and in this manner becomes a Negative Ion. Chemical action results from — or consists in — the union between negative and positive Ions to form Neutral Molecules, called Salts. An Electron is a Unit charge of Negative Electricity. Neutral atoms consist of one or more thousands of electrons, held in equi- librium in a sphere of positive electricity. There is no such thing as a "positive electron"; that is, an isolated unit of posi- tive electricity, capable of existing in a free condition, as in the case of the negative electron. Positive charges, therefore, are found only in association with atoms, and the Unit of Positive Electricity is an Atom which has temporarily parted with one of its component electrons ; it is, in other words, a Positive Ion. The various forms of electrical phenomena may be classed under the following heads : (1) Magnetism. — Which results from the unequal distribution of electrons in a mass of iron or steel. (2) "Static" Effects. — Or conditions of electrical "charge," which result from the addition, or withdrawal of electrons from a neutral mass of matter. The temporary addition of electrons to such a mass renders it "negatively charged"; the withdrawal of electrons results in a "positive charge." (The attention of the student is called to the fact that these definitions are the exact reverse of those taught before the advent of the "Electron Theory.") (3) "Dynamic," or "Kinetic" Effects. — Including the various phenomena of "Electrical Currents." These may be divided into : (a) Currents flowing through solid conductors (such as copper wires), in which the electrons are passed along from atom to atom. (b) "Electrolytic" Currents which accompany chemical action in solutions, in which the charges move as "Ions" — the electrons being attached, rather than free as in (a), (c) Electrical discharges in air at ordinary pressures, "Electric Sparks," in other words, which consist of sudden, or momentary surges or discharges, in which both Ions and Electrons are pro- jected across an air space separating two conductors, (d) Electrical currents in gases at extremely low pressures; these con- sist almost wholly of Streams of Free Electrons, moving with ELECTRO-PHYSICS 33 great speed from the "Cathode" (or negative electrode) to the "Anode" (or positive electrode) of a highly exhausted glass bulb, which is called a "Crookes Tube." The "Streams of Electrons" just mentioned are called "Cathode Rays." Magnetism * Magnetism, while usually treated as an electrical phenomenon, has remained a puzzle to physicists up to the present time. The electron theory, which has done so much to dispel the con- fusion in the minds of students regarding the fundamental nature of electricity, has been of great assistance in explaining the phenomena of magnetism, and electro-magnetic induction. In a bar of pure iron, or soft steel, magnetism may be temporarily Fig. 16. — Magnetism Induced in Iron Bar by Current in Coil of Wire. induced by the passage of a current of electricity through a spiral coil of wire surrounding it. As has been stated, an electric current involves the passage of electrons through the circuit from the Negative to the Positive pole. In the wire (B' ', Fig. 16) streams of electrons are flowing around and around the soft iron bar (B) , in a gradually ascending spiral path (as indicated by the arrow). Each electron may be regarded as a Moving Magnet attracting electrons in the bar (B), which consequently move through a spiral path, in the superficial layers of the iron, cor- responding to the number of turns in the coil {B') . The streams of electrons rushing around this path, being unable to escape * Since this chapter was written discoveries have been made which show that the above theory of magnetism is not entirely correct: it should be ac- cepted, therefore, merely as an analogy or aid to the comprehension of the processes of induction. — Author. 34 HIGH-FREQUENCY CURRENTS from the bar, concentrate in the upper end (N), which in this way becomes the negative pole of a temporary or electro-magnet. The lower end (P), from which a large number of electrons have been withdrawn, would form the corresponding Positive Pole. Now, supposing the current, which is causing the concentration of Electrons in the upper end of the Bar, be suddenly interrupted, the particles in the Iron Bar will endeavor to restore equilibrium and will therefore return to their original positions by the same spiral path which they followed in the course of their upward movement. As every moving electron is a minute magnet these particles in the iron will attract the electrons in the coil of wire, causing them to move around the spiral in a direction opposite to that which they traveled in the form of an electric current, in the first stage of the experiment. In this way a second current would be set up, or "Induced," provided the electrons were free to move in the wire coil; for example, if the two ends of the coil were joined, forming a closed circuit, a temporary current of electricity would flow through this circuit simul- taneously with the return of the electrons in the bar to their original position. If a bar of hard steel be substituted for the soft iron in the above experiment, the electrons will not return after the interruption of the electric current, but will remain fixed; concentrated along spiral lines at the negative pole of the magnet; in other words, the bar will become Permanently Magnetized. The "Ether" is in some way, intimately associated with the magnetic properties of electrons. When a moving electron is suddenly stopped it acts on the ether as a stone acts upon the surface of a pool of water in which it is dropped, causing "Waves," which radiate in all directions. These waves, when produced by the sudden stoppage of a succession of electrons rapidly moving in a highly exhausted bulb, are of exceedingly short duration and of very "High-frequency" ; they are, in fact, what we know as the "X-Rays," of Roentgen. Electrons, moving or swinging in regularly defined orbits, produce waves in the ether whose frequency corresponds to the number of electronic rotations in a unit of time. Thus the electrons in the sodium atom, which move around their orbits ELECTRO-PHYSICS 35 500,000,000,000,000 times per second, give off (when in an in- candescent state, as in the flame of a Bunsen Burner) " Electro- Magnetic Radiations'7 or Waves in the Ether of exactly the same frequency, and a wave length of .65 micron.* Such rays would appear to us as orange-yellow Light, and would, in reality cor- respond to the " Delta" ("D") or "Sodium Line" of the Solar Spectrum. Other varieties of electronic vibration or rotation give rise to other forms of Ether Waves ; these vary in length and frequency, Fig. 17. — Diagram Indicating Wave Length and Frequency of Known Forms of Radiant Energy. a, Mertz Waves, b, Heat Waves, c, Light Waves, d, Ultra Violet Rays. e, Roentgen (X-) Rays. from the short, rapid "X-Rays" (before mentioned), to the ponderous waves produced by storms in the sun (see Table in Chapter II). The above, briefly stated, constitutes the "Electro-magnetic Theory of Light," first formulated and mathematically verified by Clerk Maxwell, in 1865 — years before the "Electron Theory" was dreamed of ! In the light of our present knowledge, we may classify practically all natural phenomena as, either the move- ments of electrons themselves, or, as the results of their motion in the form of waves in the ether; that is, as "Radiant Energy." * The above figures are only roughly approximate. CHAPTER IV electro-physics (continued) The Nature and Generation of Alternating Currents Imagine a circular tube of metal filled with air or some elastic fluid, and provided at one point of its circuit with a rotary pump, whereby a circulatory motion can be conveyed or im- parted to the fluid in the pipe. (See Fig. 18.) If this pump be set in motion, fluid will be drawn from point (A) and forced toward point (B), the result being a diminished pressure or partial vacuum at (A), and increased pressure at (B), which being transmitted causes a flow of the fluid in the direction of r. B vv — 'J Fig. 18. — Hydraulic Analogue of "Continuous Current" Circuit. the arrow, in an attempt to restore the disturbed equilibrium. This results in a continuous current circulating in the tube. Now, supposing, instead of the pump, we imagine the circular pipe to be joined to the extremities of an ordinary engine cylinder with a piston (C) sliding back and forth by the action of the rod (D) (Fig. 19). If the piston be pushed to the position (B'), a temporary flow will be established which will cease when the end of the cylinder has been reached by the piston. With- drawing the piston to (A') causes a temporary current through the tube in the opposite direction. Now, if the piston be 36 ELECTRO-PHYSICS 37 mechanically operated back and forth at regular intervals, a reciprocal or alternating motion is communicated to the fluid in the tube, the motion being graphically represented by the diagram (Fig. 20). Starting with the piston at {A'), as it is -m m- o Fig. 19. — Hydraulic Analogue of "Alternating Current" Circuit. forced in, the fluid moves faster and faster, the most rapid motion being at the middle of the stroke, the speed or flow gradually subsiding as the piston comes to rest at (B'). With- drawal of the piston causes a similar flow in the opposite direc- tion, which is represented in the figure by the curve below the horizontal line (the latter, called the "Abscissa," is mathemati- cally divided to indicate time units, such as seconds or minutes; the vertical line, called the "Ordinate," marks the rate of speed Fig. 20. — "Graphic tracing" of Alternating (Sinusoidal) Current. of the moving column of fluid). In electricity this method is commonly used to indicate graphically the nature of currents, the divisions of the ordinate being usually made in terms of "Volts" (i.e., in units of electrical pressure, potential, or Electro- 38 HIGH-FREQUENCY CURRENTS motive force). It is the "voltage" that forces the electricity through the wire or other material which forms its circuit and creates an electrical current. The electricity or moving stream of electrical particles, which is forced through the circuit by the voltage, is measured in terms of the electrical unit of intensity, called the "Ampere." When water is forced through the pipe (See Fig. 19), it meets with resistance due to the friction of the walls through which it flows. This resistance depends mainly upon the size and nature of the pipe ; similarly, a wire through which a stream of electricity flows offers resistance to its path, and the resistance is propor- tional to the size and length of the wire, provided the latter is composed of the same material throughout. Different substances offer different degrees of resistance to the passage of electricity per unit of length and thickness. The conductivity of bodies is therefore learned by comparing their respective resistances. The unit of resistance is called the "Ohm" and is represented by a column of mercury one millimeter in diameter and one meter long. A pressure of one Volt main- tained between the extremities of a wire of one Ohm resistance will cause a continuous flow of a current of one Ampere through the wire. Difference of potential ("Voltage") is maintained between the two ends of an electric circuit by (1) Batteries, which transform the energy stored up in the chemicals of the cell into active or Kinetic Electrical Energy; (2) by Generators,. which transform the Mechanical force into an equivalent amount of electrical energy. Under the head of "Generators" may be included (a) dynamos and magneto machines, which operate through Electro-magnetic induction and (b), Static Machines in which the electricity is generated either by friction or by Electro- static Induction. When the poles of a battery are connected by a conducting wire, a continuous, unidirectional current of electricity will flow as long as the chemical action goes on inside the cell. Such a current would be similar to the continuous flow of fluid around the pipe in Fig. 18. The size or quantity of the stream of energy flowing through the wire (expressed in "Amperes"), depends upon the difference in electrical pressure or potential between ELECTRO-PHYSICS 39 the positive and negative terminals of the battery and upon the resistance of the circuit. This is an example of "Ohm's Law," which states that the quantity or amperage (C), of a current, is equal to the voltage (E), divided by the resistance (R), expressed in Ohms. Thus when two of the three properties of an electrical circuit are known, we can readily find the third, the formula in each case being as follows: „ E -p E E=RxC L==R. K=C. The simplest Generator consists of a coil of insulated wire wound upon a soft iron core and revolving between the poles of a U-shaped or horseshoe magnet. (See Fig. 22.) The tempo- rary magnetism induced in the iron core produces radiating lines of force corresponding to a stress or strain in the surrounding ether, which, when suddenly released, produces, or induces, a momentary current in the coil of wire. In the course of its revolutions between the poles of the magnet, the transient electrical impulses flow through the coil alternately in opposite directions, forming an Alternating Current as represented by the curve (Fig. 20). The alternating current thus formed is conducted to any desired external circuit by means of two insulated rings, revolving in contact with stationary metallic brushes. All dynamos or magnetos depend upon the above principle but in the Direct- Current Dynamos, a device called a Commutator is employed, which sends all the electrical impulses out in the same direction. In order to obtain a clearer idea of the phenomena of electro- magnetic induction, it may be well to briefly review the theory of the ordinary Ruhmkorff Induction Coil. By introducing a permanent magnet into a coil, the ends of which are connected to a delicate galvanometer, a momentary impulse of electricity is induced, which is indicated by the fluctuation of the needle of the meter, and, when the magnet is withdrawn, a second impulse is indicated, opposite in direction to the first. (See Fig. 21.) The magnet may be allowed to remain in the coil indefinitely without any evidence of current. It is evidently the introduc- tion and withdrawal of the magnet which induces the current in 40 HIGH-FREQUENCY CURRENTS the coil. In other words, it is not merely the presence of lines of magnetic force, but the act of their formation or destruction which produces the inductive effect in the coil of wire. By successively introducing and withdrawing the magnet from the coil, an alternating current would be generated, the counter- Fig. 21. — Magnetic-electric Induction. (Williams.) part of the movement of the water in the tube (Fig. 19) when the piston is in operation. A more efficient manner of producing an alternating current is to rotate the coil of wire so as to present the extremities alternately to the poles of a horseshoe magnet, as described above (Fig. 21). The number of impulses or alterna- tions in a unit of time is called the frequency of an alternating current and depends, in the above generator, on the rapidity with which the coil revolves. An impulse in each direction is called a cycle and is represented thus (^). In technical parlance we indicate the frequency of a current in terms of Cycles per second or Alternations per minute. This is an accepted custom, alternations being always associated with minutes and cycles with seconds (thus a "60-cycle current" is understood to mean a current of sixty cycles per second; we could allude to the same current as one of "7,200 alternations" meaning 7,200 alterna- tions per minute). Currents are said to be of high or low frequency according to the great or small number of cycles or alternations in a unit of time. When a certain fre- quency is reached the currents manifest new and unique proper- ties which differentiate them markedly from low-frequency cur- rents. These peculiar properties are manifested both physically Fig. 22.— Diagram of Simple "Magneto," Generating an Alter- nating Current. ELECTRO-PHYSICS 41 and physiologically, the latter being the basis of their therapeutic use. High-frequency Currents were first studied from a physical standpoint by Nicola Testa and Professor Elihu Thomson (see Chapter I). Both Tesla and d'Arsonval first produced these currents by employing alternating generators operated at a high rate of speed and provided with a large number of revolving coils and an equally large number of field magnets. Electro- magnets were employed instead of permanent ones on account of their very much greater power and convenience. Tesla, in this manner, with an alternator having 300 pole pieces, revolving 5,000 times per minute, obtained currents of 10,000 alternations per second (technically a current of "5,000 cycles"). He found that the peculiar properties which become manifest at this frequency, were strikingly emphasized and augmented by raising the current to a very high potential or voltage by means of a "step-up" transformer. In speaking of a High-frequency Cur- rent in the ensuing pages it will be therefore understood that we refer to an Alternating Current of Very High-potential and Very High-frequency (generated usually by the methods of Tesla and Thomson). High-frequency Currents of low potential will be referred to as " d'Arsonval Currents'11 while the unipolar high- frequency high-potential flux, obtained from an "Oudin apparatus" connected to a "d'Arsonval Solenoid," will be denominated as a "Resonator Discharge." The currents employed to-day in High-frequency Therapeutics are of much greater frequencies than those obtained from alternating generators and are pro- duced in quite a different manner. The great number of alterna- tions is obtained by the disruptive discharge of a condenser. A "condenser" (Ley den Jar) is a device which has the property of absorbing or storing up electricity and giving it out suddenly in the form of an electric discharge, when the difference in potential between the positive and negative plates is sufficient to over- come the resistance of the external circuit. Professor Rowland of Johns Hopkins University first employed the condenser dis- charge for the production of High-frequency Currents in 1889. Two years later Tesla described his apparatus in which condenser currents were employed to obtain very high-frequency effects. The practical and economic generation of true High-frequency, 42 HIGH-FRIOQUENCY CURRENTS High-potential Currents was made possible a few months later by the invention of Professor Elihu Thomson. In Tesla's original coil the step-up transformer, from which the final High- potential Currents were obtained, was very complicated, and consisted of two concentric coils formed of many layers of gutta percha insulated wire wound over a central soft iron core, the whole being insulated with the greatest care, and hermetically sealed in a vessel of boiled-out oil, all air having been exhausted by an air pump. Professor Thomson substituted for this cumbrous device, a transformer without iron core, the ether stresses or lines of force being formed directly by the inductive action of the low-potential High-frequency Currents passing through the primary coil. The latter consisted of a single layer of coarse cotton-covered wire wound on a fiber tube slipped inside of a larger tube upon which was wound a layer of much finer wire, in which the High-potential, High-frequency Current Was induced. A simple bath of kerosene oil was found by Professor Thomson to be fully as satisfactory as the exhausted boiled-out oil of Testa. The final step in the simplification of High-frequency Apparatus was made by the present writer in 1897, who so modified the size and position of the two coils as to allow of their being imbedded in a solid insulating medium of paraffin and rosin. Hundreds of coils made from the writer's formulse are in use throughout the world, and it is almost as rare to hear of such a coil breaking down as in the case of those immersed in a bath of oil. In order to clearly understand the action of condensers in the production of High-frequency Currents, it will be necessary to study in detail the construction of the Leyden Jar, the nature of its discharge and the conditions which modify this discharge. Whether the latter is a series of elec- trical oscillations of high frequency or a simple unidirectional impulse, depends upon the resistance of the external circuit formed between the plates of the condenser or Leyden Jar (Fig. 23) . If this resistance be considerable, the electricity will cease to flow when equilibrium is established. On the other hand, if the resistance be small, the flow of electricity will not stop at the neutral point, but will act as if the stream of electrons possessed ELECTRO-PHYSICS 43 material properties and acquired momentum, thereby charging the condenser again in the opposite direction, again discharging a, Inner Coating. Fig. 23. — Leyden Jar, or Condenser. h, Outer Coating, c, Glass Jar. d, Brass Ball Terminal e, Discharging Wire. /, " Spark-gap." past the neutral point, and repeating the operation until the electrons gradually come to rest. This operation is analogous to the movement of water in a U tube (See Fig. 24) . Imagine the right hand column depressed, thereby raising the opposite ~ IN Fig, 24. — A, Water at Rest in "U" Tube. L, Normal Level. B, Displaced Water Oscillating Before Coming to Rest. C, "U" Tube with Arms Joined by Capillary Tube (d) which Prevents Oscillations in Water. column ; when released the water flows back by gravity, but its momentum carries it past its original position, and it oscillates 44 HIGH-FREQUENCY CURRENTS back and forth, the height reached by each movement being less than the preceding one, until the water gradually comes to rest. Imagine now that the two arms of the U tube be con- nected by a fine capillary tube, opposing great resistance to the flow of water; in the latter case when the water is depressed and suddenly released, the resistance of the capillary tube opposes the sudden flow of water and prevents its acquiring momentum, and it consequently slowly returns to the neutral level without any oscillatory movement. In an analogous manner the discharge of a condenser is oscillatory so long as the resistance of the external circuit is low, while with high resistance it becomes a single unidirectional flow, as above stated. Analogy is at fault, however, in one respect; according to the example of the water in the tube, the oscillations will be prolonged to the greatest extent when the walls of the tube possess the least possible resistance, that is, when the tube has the great- est size. In studying a condenser circuit, however, we have to deal with a new form of resistance called Inductance. Inductance acts only upon alternating currents. This inductance results from the flow of the alternating current through a coil; the current reacts upon itself in the convolutions of the coil, and this reaction is called Inductance. With a given coil having a certain number of convolutions wound upon a tube of certain diameter and of given size of wire, there is a certain frequency of alternations to which, instead of opposing resistance, the coil will actually in- crease the duration of the oscillations for each discharge. The frequency of the oscillations of a condenser discharge depends upon its size, technically spoken of as its "capacity"; that is, the amount of electricity which the condenser is capable of storing up at a given voltage or pressure. A definite mathemati- cal relationship exists between the capacity of a condenser and the inductance of the circuit through which it discharges, and Fig. 25. — Plate Condenser with Inductance Coil and Discharg- ing Circuit. ELECTRO-PHYSICS 45 in order to obtain High-frequency Currents under the most favorable circumstances, there must be experimentally deter- mined an attunement giving this particular relationship. To understand this action let us consider the well-known phenomenon of acoustics. A tuning fork when struck emits sound waves of a certain pitch or frequency, which rapidly diminish in amplitude and soon cease entirely. An organ pipe of a different pitch held to the vibrating fork, has little or no effect upon the sound. If, however, the pipe be attuned to the exact pitch or frequency of the fork, the sound waves are greatly increased in volume and duration. This is called the phenome- non of resonance, and the action of the organ pipe on the vibra- tions of the tuning fork is exactly analogous to that of the inductance coil on the discharge of a condenser. When the inductance and capacity of a circuit are exactly balanced or attuned one to the other we have a condition of "electrical resonance," and the coil which re-enforces the oscillations is called the Solenoid of d'Arsonval. (See Chapter I.) CHAPTER V PHYSICAL FACTORS INVOLVED IN THE GENERATION OF HIGH- FREQUENCY CURRENTS Despite the complex and diversified character of the external world, and the countless number of totally different things of which it is composed, we find by analysis and comparison that, fundamentally, Nature's processes are definite, simple and along parallel lines. The apparently abstruse principles underlying the most complex phenomena are often exemplified in the simple occurrences of everyday life. Newton pondered for years on the mystery of Gravitation, but it was the simple fall of an apple that finally led him to formulate its laws. This is an illustration of the "comparative method of study" br "study by analogy" which has been the main factor in the scientific progress of the past century. Until this method was applied to the study of electricity, it was extremely difficult for the student to compre- hend the relation and true meaning of the terms "potential," "intensity" and "resistance," and their corresponding units — the Volt, Ampere and Ohm. At the present time we explain these terms by the study of a stream of water flowing from an elevated reservoir through a pipe connected to a small water- motor. The speed of this motor is proportional to that of the water which flows through it, and depends on the degree of elevation of the reservoir. The higher the reservoir the greater the pressure of the water in the pipe and consequently the greater the speed at which the stream moves. Water flowing from a height of a hundred feet has a "pressure" or "head" of one hundred feet which would determine the velocity or force of the stream. The water encounters "resistance" due to the friction of the walls of the pipe and the inertia of the revolving wheel in the motor. A certain force or head of water flowing through a pipe having a given friction or resistance, would 46 GENERATION OF HIGH-FREQUENCY CURRENTS 47 enable the motor to perform a definite amount of mechanical work; if the resistance of the pipe be doubled by making it either twice as long, or of half its original diameter, the amount of work done by the motor would be just one-half of its previous performance, inasmuch as the amount of water flowing through it in a given time is just one-half of the original amount. Now the laws exemplified in the stream of water are practically the same as those which govern the flow of a continuous current of electricity from a source of supply — such as a dynamo — through McitQ^ofT-ccsSucc Resistance /ohm. ifoU. Rate of flow.- current i amp. Work done i JouCe„mte at which work is done I Hate. Quantity of current in I second, iCoubm, ^*^*W^^«« Fig. 26. — Diagram Showing Analogy Between Falling Water and a Current of Electricity. (Williams.) a length of wire to an electric motor. The amount of electricity, that is, the number of " Amperes," which flow through the motor in a given time are determined by the pressure or voltage of the current, and the Resistance, or "Ohms" of the wire and motor. A similar comparison has been given in a preceding chapter, but is reviewed here, for the purposes of impressing the student with the value of the method of teaching by "Analogy" or Comparison. (Fig. 26.) The water motor, pipe and reser- voir, in the above example, constitute a "Hydraulic Analogue" in which the water represents the electricity. The work done by the electric motor varies with the pressure and resistance of the circuit just as is the case with the water wheel. The 48 HIGH-FREQUENCY CURRENTS obvious advantage of this method of study lies in the familiar commonplace character of the Analogue. The various phenomena which take place in an apparatus generating High-frequency Currents are well exemplified in a c' ; (c^L-v *-* c " N9 1 J N -» / - discharge is non-oscillatory * C but if R < -v— ^ discharge is oscillatory. » C With zero resistance the oscillations would continue indefin- itely, but as every circuit must have some resistance, the oscilla- tions following each condenser discharge successively decrease in amplitude and ultimately die out altogether. The ideal condition in a Therapeutic High-frequency Apparatus involves the use of a circuit in which resistance is reduced to a minimum, and the capacity balanced by a suitable inductance. In order to obtain this condition the condenser should be charged by a relatively heavy current at a comparatively low voltage; the Spark-gap must be short, yet must be constructed so as to prevent the formation of an arc between its opposed surfaces. Under such conditions the interval between the termination of one set of oscillations and the beginning of the next, is so small as to be practically negligible, and we consequently have a true " Alternating Current of High-frequency." The writer determined the above facts several years ago, by a series of clinical tests of currents from a number of different types of High-frequency Generators, and has embodied the results in his Improved High- frequency Apparatus which he employs in his practice at the present time. In all apparatus of the d'Arsonval type, using Ruhmkorff Coils, the spark-gap has, of necessity, a very high resistance, varying from one to three inches in length; and it is evident that relatively great intervals exist between succeeding sets of oscillations. This is demonstrated experimentally by the sound at the Spark-gap, which resembles the noise of a "Watchman's rattle," while the condenser discharge of the author's apparatus emits a continuous Musical Note or Tone. Many physicians believe themselves to be using High-frequency Currents, when in reality they are employing Pulsatory Condenser GENERATION OF HIGH-FREQUENCY CURRENTS 57 discharges. The "Static Induced," and the "Static Wave Cur- rent," devised by Dr. William James Morton of New York, exemplify the above statement. These currents consist of single short pulses, separated by relatively enormous intervals ; graphi- cally represented, if the distance on the "time-line," or "ab- scissa," corresponding to the rise and fall of a single current impulse be one inch, then, the distance to the next impulse, as represented on the Abscissa, would be seventeen and one-half miles! CHAPTER VI EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS Before attempting a description of the various types of ap- paratus at present on the market, it will be necessarj^ to briefly review the different methods for the generation of High-fre- quency Currents. Apparatus of the European type, made in Fig. 31. — Electrolytic Interrupter of Wehnelt. (Williams.) accordance with the principles of d'Arsonval and Oudin are used with a Ruhmkorff Induction Coil, excited by a Continuous, Uni- directional, Incandescent Light Current. (Fig. 31.) In order to obtain the inductive impulses, an "Interrupter" must be employed ; this may be either electrolytic, or mechanical. If an 58 EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 59 Alternating Electric Light Current is to be used, a "Rectifier" or "Valve," may be employed, to cut out the alternations in one direction. (Fig. 32.) The result is a Pulsatory, Unidirectional Current which may be used with practically the same results as those obtained from the continuous current. If the Ruhmkorff Coil is used solely as -B^^^/^/N^ "V Fig. 32. — Nodon Valve, or Rectifier. (Williams.) a High-frequency Generator, the rectifying valve may be omitted, but if it is also employed for X-Ray purposes, the current must be made unidirectional. In the employment of the High-fre- quency Apparatus of the American, or Tesla-Thomson type, as introduced by the present writer, the conditions are the exact reverse from those above described. Properly speaking the typical Tesla-Thomson apparatus can be operated only on an Alternating Current ; in order to adapt a Direct Current for use in this connection, it must be first transformed into an Alternating 60 HIGH-FREQUENCY CURRENTS Current. For this purpose a machine known as a " Rotary Converter" is used. A good Rotary Converter will give out about four-fifths of the energy used to excite it, in the form of an Alternating Current of a somewhat lower voltage. No Rukmkorff Coil, or Interrupter is required for the production of the Tesla Currents, both these devices being replaced by an Alternating Current Transformer of the "step-up" type; that is one which takes in electrical energy of a certain voltage, and gives it out at a considerably higher pressure. The " Step-up" Transformer is usually permanently incorporated as a part of Fig. 33. — Ruhmkorff Induction Coil. (Watson, London.) the High-frequency Apparatus, whereas the Ruhmkorff Coil is an entirely separate and distinct instrument from the d'Arsonval solenoid and resonator. With this preliminary explanation we may pass at once to a detailed description of the various standard types of High-frequency Apparatus. We will first consider some of the more prominent forms of European apparatus. As most foreign instruments are designed for use with a Ruhmkorff Coil, a short description of the latter device uiSbj not be out of place. The illustrations (Fig. 33 and Fig. 34) show the appearance and construction of the average European Ruhmkorff Coil. When used for X-Ray or high-frequency work, however, an EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 61 electrolytic or mercury interrupter is usually substituted for the vibrating mechanical break (represented in the figure), which is used only in small portable coils operated by primary or second- ary batteries. The Condenser (E-E-E) which consists of a number of sheets of tin-foil, separated by sheets of mica or waxed paper, is unnecessary when an interrupter of the elec- trolytic type is employed. The function of the condenser is to suppress the "Extra Current" self-induced in the primary coil, ^ -N Fig. 34. — Ruhmkorff Induction Coil, Shown Diagrammatically. (Williams.) and this current is an important factor in the operation of the Electrolytic Interrupter. A variety of Ruhmkorff Coils, of differ- ent makes, are in use at the present time, their construction being practically the same except in minor details. For ordinary X-Ray or high-frequency work, coils having a spark-length of from ten to twelve inches are most generally used. It is possible to operate a High-frequency Apparatus of small size on a six- inch Ruhmkorff Coil, but for powerful effects — with the large " Double Resonator," of Dean for example, it would be necessary to employ a coil of from sixteen to twenty inches sparking capacity. Almost all up-to-date mechanical interrupters employ mercury in one form or another. One of the best known is " The Mercury Jet" Interrupter, of Isenthal & Company (See Fig. 35). 62 HIGH-FREQUENCY CURRENTS The mercury, forced through a small aperture by a pumping device, forms a fine metallic jet, which impinges against the amalgamated surface of a series of triangular blades, attached to a rapidly revolving drum. The height, or level of the mercury jet determines the relative length of the "make," and "break." By means of a rheostat in series with the motor which operates the Interrupter, a range of from one hundred and twenty, to twelve thousand interruptions per minute may be obtained. Fig. 35. — Mercury Jet Interrupter. (Isenthal & Co.) Another type of "Mercury Break" is shown in Fig. 36. A vertical plunger is given a reciprocal motion by a Motor which causes it to alternately dip and withdraw from a cup of mercury, the surface of which is covered with oil. While a number of these interrupters are in use, they are regarded as somewhat obsolete at the present time. Another very popular and efficient instrument is the "Mac- kenzie-Davidson Interrupter (See Fig. 37). It consists of a EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 63 motor, placed in an inclined position ; its shaft terminating in a slate disk, bearing two metal contacts, which dip into a dish of mercury at each half -re volution of the motor shaft. The opera- Fig. 36. — Dipper Mercury Interrupter. Fig. 37. — Mackenzie-Davidson Interrupter. tion of this device is obvious ; it is one of the best of the foreign interrupters. The conventional European type of "Electrolytic" Break is the well-known interrupter of Wehnelt — a simple form of which 64 HIGH-FREQUENCY CURRENTS is shown in Fig. 38. In a glass jar of dilute sulphuric acid are immersed a lead plate, or "Cathode," and a fine platinum wire "Anode" which projects for a fraction of an inch into the acid, through a small hole in the lower end of a long porcelain tube. The projecting part of the platinum wire is regulated by a thumbscrew in the cover of the Instrument. The passage of a direct current through this interrupter causes a film of hydrogen gas around the end of the wire, thereby breaking the circuit; as no condenser is used, the "extra" current — self-induced in the pri- mary of the Ruhmkorjf Coil — discharges in the form of a bright spark, causing a further reces- sion of the acid from the wire point. The acid almost immediately flows back in contact with the anode, and in this way "breaks," and "makes" follow each other in rapid succes- sion. In America this type of interrupter is extensively used, hav- ing been greatly im- proved and simplified during the last two years. In the European types of High- frequency Apparatus, the Ruhmkorff Coil is seldom incor- porated with the resonator and solenoid, the oscillating system being generally sold as a separate apparatus — comprising a pair of Leyden Jars, an adjustable spark-gap, and a solenoid and resonator usually wound upon the same cylinder, the various parts being assembled on a suitable table, or base. The most popular form is shown in Fig. 39, which is known as the "Oudin- Dean Resonator." This model has been extensively copied by manufacturers in all parts of the world. The resonator consists FiG. 38. — Wehnelt Interrupter. (Williams.) EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 65 of fifty or more turns of insulated copper wire, about three millimeters in diameter, wound spirally upon a wooden cylinder fifty centimeters high, and thirty centimeters ii. diameter. The following- description of the nature of the "Oudin Resona- tor" is quoted from Freund's admirable work on "Radiother- apy." "As forced resonance is more powerful in its effects than free reso- nance, the resonator was at first attached to one pole of the solenoid of high frequency ; the other pole remained free or was connected to the earth. This arrangement, how- ever, was soon modified. It was found that better effects could be produced by connecting both poles with the resonator. A subsequent modification led to the solenoid of high frequency being sup- pressed and the resonator directly connected with the external armatures of the condensers. The lowest spiral of the reso- nator was then united to one armature, while a spi- ral four to seven turns above it was connected to the other arma- ture by an adjustable clip. The resonator was thus divided into Fig. 39. — Oudin-Dean Resonator. (Williams.) 66 HIGH-FREQUENCY CURRENTS two solenoids — a lower and an upper. The lower, or primary sole- noid,"of small size, consisted of a few turns of wire intercepted between the points of attachment of the two cords leading to the external armatures. In it circulated currents of both high and medium frequency, those of high frequency alone being free to pass into the upper solenoid; for the currents of lower fre- quency were close-circuited by it. The secondary or upper solenoid was longer, and was traversed by currents of high frequency alone ; these by reason of self-induction of the circuit, attained an enormous tension. When the three essential magnitudes — capacity, self-induction and resistance — of the two solenoids were by trial proportioned to one another, the upper spirals of the resonator and its terminal were seen bathed in a lively brush discharge like to that produced by a Tesla Coil or influence machine. This effluve is made use of for therapeutic purposes, by connecting the free terminal of the resonator or one of its upper spirals with the wire leading to the electrode." Although the caliber of the wire which forms the resonator, does not appear to materially interfere with the production of these resonance effects, yet it has, according to Oudin a con- siderable influence on the physical character of the effluve and spark. A fine wire yields a spark, long, thin, sinuous and scarcely painful, with an effluve as poorly nourished; while with a wire of larger dimensions, both effluve and spark gain in force. This depends on the capacity of the wire rather than its self-induction, for every increase in capacity renders the spark more vigorous and painful. The manner in which connection was established between the poles of the primary solenoid of the resonator and the external armatures of the condensers next attracted attention. It was recognized that the nature of the arrangement that exists for this purpose largely influenced the adjustment of the two sole- noids and the regulation of the effects produced. The crude and unsatisfactory method in which the spring-clip or contact-hook is used to connect the wire from the external armature with the desired spiral soon gave place to others which allowed more perfect regulation and adjustment to be made without in any way interrupting the circuit. Ducretet and Bonnetti invented EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 67 an apparatus in which a grooved contact slip is made to revolve about a fixed resonator, and thus establish contact with the spirals; while Radiguet caused the resonator itself to rotate before the stationary contact point. Both these methods allow of a perfect graduation of effects and an easier adjustment of the solenoids to each other,, without any interruption of contact. The resonators above described, however, are only suitable J±UL-<) o-X-k Fig. 40. — Resonator of Lebailly and O'Farril. Fig. 41. — Rochefort's Bipolar Resonator. (Freund.) for producing unipolar effects. If double effluvation is to be practiced, the apparatus of Lebailly and O'Farril or that of M. Rochefort must be resorted to. (Fig. 40.) In the former, the primary solenoid is centrally situated, the external armatures being connected with two intermediate spirals. This creates two secondary solenoids which are situated one on either side of the primary and allows of bipolar applica- tions to be made by connecting the wires leading to the elec- trodes with the free outer terminals of these two solenoids." Although the apparatus is an improvement on the unipolar 68 HIGH-FREQUENCY CURRENTS resonator of Oudin, still it is not always easy to equalize the current density at the two poles, and for this reason that of M. Roche fort is preferred. In the Rochefort model {vide Fig. 41) four Leyden Jars are employed. These are divided into two batteries connected by their internal armatures with the secondary terminal of an induction transformer or spark-coil. The external armatures Fig. 42. — Upright Solenoid on Cabinet. (Williams.) are connected with two separate resonators, those of each battery being connected, the one with the lower terminal of one resona- tor, the other with the uppermost spiral of the primary solenoid of the other resonator. When carefully adjusted the density of the current traversing each of the secondary solenoids is equalized; and being of opposite sign, double effluvation can easily be practiced and the effects produced readily controlled. The position of the resonator in the apparatus of different makers calls for a few remarks. In some apparatus, as in Fig. EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 69 42, the solenoid stands upright on the cabinet enclosing the con- densers and spark-gap; in others; as in Fig. 43, it is permanently connected with the condensers; in others again the resonator is horizontally placed so as to allow its inclusion in a cabinet; and lastly, it may be inverted and fixed by its base to the bottom of the baseboard of a High-frequency Table. As there is no special advantage gained by any of these peculiar arrangements beyond the mere matter of saving space, these 70 HIGH-FREQUENCY CURRENTS eccentricities call only for a passing notice. Much more im- portant, however, is the arrangement for graduation. The crude method of regulation by the contact clip must only be mentioned to be condemned. The regulation by means of a revolving cylinder running on rubbered tires, whose movements can be graduated by the movement of a handle, is the one most to be commended. Not less worthy of mention is the resonator re- volving around a fixed contact in which adjustment is effected by revolving the solenoid by means of the insulating spokes fixed to the disk at its base. Guilleminot's Spirals. — In resonators formed of wire wound into a helix or solenoid, the energy of the electrostatic field developed by the inducing spirals is only to a very limited extent utilized in the production of induced currents. For the form of the resonator of Oudin does not permit the powerful oscillatory field, created in the vicinity of its spirals, to be employed in generating bipolar currents. Guilleminot has, how- ever, by changing the form of the resonator from a helix to a spiral been able to utilize the energy of the field in producing bipolar effects. The results of his experiments were published in 1901. His resonator is so constructed that the excitation is caused by a single turn, the outer one, which acts as the inducing spiral. (See Fig. 10.) In practice the adjustment is not made by altering the co- efficient of self-induction of the inducing spiral. This is kept constant and a subsidiary coil of thick wire, with an apparatus for regulating its self-induction, is introduced into the exciting circuit. The spiral is formed of eighteen turns of wire, 2 mm. thick, held in place by radii of catgut. The smallest circle has a diameter of 33 cm., and the largest a diameter of 83 cm. The interspaces between the successive turns increase in width toward the periphery, since here the difference of potential between successive turns is much greater. The various forms of exciter used in applying High-frequency Currents in medicine are attached to the center of the spiral." For further details regarding the construction and use of the various forms of spiral resonators the reader is referred to the EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 71 notes on instrumentation compiled by Dr. Clarence A. Wright, and published as an appendix to Freund's "Radiotherapy." For general treatment with Low-potential, High-frequency Currents of d'Arsonval when especially profound effects are desired, the powerful apparatus shown in Fig. 44 is employed. Fig. 44. — Gaiffe's Oil Condenser and Heavy Solenoid. It is manufactured by Gaiffe of Paris from the original designs of d'Arsonval, and consists of a multiple glass plate condenser, immersed in oil, provided with an adjustable spark-gap, and a solenoid consisting of twenty-one turns of copper wire. In the above apparatus we have a departure from the usual European type, in that the condenser consists of alternate plates of glass 72 HIGH-FREQUENCY CURRENTS and tin-foil, while in other forms of resonators and solenoids, Leyden Jars are employed. There are two other types of European apparatus in which plate condensers are employed — the first shown in Fig. 45, is known as "Gaiffe's Bipolar Resona- tor," and is in reality a form of the Tesla-Thomson apparatus. The solenoid is not connected with the resonator, the currents in the latter being induced by the rapidly alternating Electrostatic Field surrounding the solenoid. Discharges of High-frequency and High-potential may be obtained from either terminal of the Fig. 45. — Gaiffe's Bipolar Resonator. resonator, while true High-frequency Currents are produced when the patient is connected with both terminals. This ap- paratus is usually operated from a Ruhmkorff Coil excited by a "Direct" incandescent light current. Alternating currents which are extensively used in America and which are peculiarly adapted for exciting High-frequency Apparatus of the Tesla- Thomson type, have only recently been introduced into the different European cities. There is every indication, however, that currents of the alternating type will entirely supersede the " Direct" continuous current within a few years. Recognizing this fact, Messrs. Gaiffe of Paris have recently introduced an EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 73 extremely efficient High-frequency and X-Ray Apparatus, designed for use on the alternating current, without the necessity for interrupting or rectifying the latter. As this instrument is being very generally employed by European specialists, and as it also illustrates the differences in construction and operation between European and American High-frequency Apparatus of the u closed-circuit transformer" type, it has been deemed advisable by the author to quote the following detailed descrip- tion from Belot's work on "Radiotherapy": "This new apparatus makes it possible to utilize an ordinary alternating current, without an interrupter, either for the pro- duction of X-Rays or for High-frequency Currents. Hitherto, if we wished to employ an alternating current, we had to use a Ruhmkorff Coil — i.e., a transformer with an open magnetic circuit, supplied with a special form of interrupter. The choice of this lay between an electrolytic interrupter and a self-regulat- ing interrupter of Villard, and it is well-known how difficult it is to regulate either of these instruments. "It is true that a few years ago a transformer with closed magnetic circuit was made, and that this was used without an interrupter; but, though theoretically perfect, this apparatus rapidly deteriorated with use. M. Villard was the first to adopt this arrangement. The rapid breakdown of the end coils of the secondary was due to the reflected Hertzian waves. "To guard against these acci- dents we were obliged, even when working with High-fre- quency Currents, to employ comparatively low tensions of 15,000 to 20,000 volts. The results obtained were not satis- factory, and even then the transformers broke down. With X-Rays, where a higher tension was required, the appa- Fig. 46. — Condenser. (From Belot.) 74 HIGH-FREQUENCY CURRENTS —Liquid Resist- (From Belot.) ratus soon became useless. The trans- formers were soon abandoned, and the ordinary coils continued to be used. These are subject to the same dangers, but on account of their smaller output, they de- teriorate more slowly. Thus one of their greatest imperfections has added to their longevity. "The irregularities of the interrupter, of whatever form, render impossible even an approximate estimate of the output of the secondary. The great novelty in Gaijfe's apparatus is a pro- tective arrangement, which has already been presented to the Academie des Sciences by d'Arsonval. This absolutely prevents the breakdown of the instrument by arresting the reflected Hertzian waves. It is composed of various condensers and resistances. "Their arrangement and magnitude are determined by con- siderations of the insulation of the coils of the primary, and the nature of the High-frequency Waves which are required. "These improvements have been so successful that the instal- lation can be employed for all forms of practical work — the condensing couch, the em* uve, resonance, bipolar radiations or X-Rays. "The apparatus consists of an ordinary transformer, with closed magnetic circuit, receiving an alternating current of 110 volts, which it converts into one of 60,000 volts. "The protective arrangement is threefold. Firstly, there is a series of condensers arranged between the poles of the secondary (Con., Fig. 46). Secondly, liquid resistances are introduced into the circuit, on either side of the transformer (Resist., Fig. 47). Finally, other condensers are introduced, between the liquid resistances and the tube (C, Fig. 48). These latter are the d'Arsonval High-frequency Condensers. "They have the further advantage of insulating the operator, and thus prevent any danger from his accidentally touching one of the poles. At the same time they are a convenient method of limiting the current which passes through the tube. EUROPEAN TYPES OP HIGH-FREQUENCY APPARATUS 75 " The whole apparatus is enclosed in a glass-fronted cabinet, which obviates all danger of accident. The top is surmounted by a marble slab, to which are affixed the voltmeter and ampere- meter, for measuring the primary current, a rheostat resistance interposed in the primary current, and the terminals for the high-tension current. "The parts are so arranged that the apparatus may be used at will for high frequency or X-Rays by simply removing the Villard valves and interposing a spark-gap in their place. Fig. 48. — Arrangement of Valves, Tube and Meter. (From Belot.) " This apparatus is free from danger and easily adjusted. The current may be regulated by merely moving the handle of the rheostat. It will give much greater power than any which can possibly be required at the present time. When the apparatus of distribution has been perfected, and more power is required it will only be necessary to increase the capacity of the con- densers, which act as taps to regulate the output. The ap- paratus is, moreover, always ready for use; there is no trembler to get out of order, no mercury or petroleum to require constant 76 HIGH-FREQUENCY CURRENTS renewal, and no noise to disturb the patient and wear out the nerves of the operator. " Let us now inquire how it is adjusted for producing X-Rays. The current should pass in one direction only. As the alternating current produced by this transformer changes its polarity with each oscillation, one series of waves must be absorbed before reaching the tube. For this purpose two Villard valves Fig. 49. — Transformer. (From Belot.) (P-Pr Fig. 54) are inserted in parallel with the tube in the manner indicated by Villard himself. " The discharge through the Roentgen Tube is perfectly regular, the fluorescent screen being as steadily illuminated as when a static machine is in use. The means for complete adjustment is afforded by the rheostat in the primary circuit. "There is theoretically no limit to the power which can be obtained by the use of this apparatus. As soon as the con- struction of the tubes have been sufficiently improved, with a view to increasing the intensity of the rays, the length of 'ex- posure in radiography and the time of application in radio- EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 77 therapy will be greatly decreased. At present the intensity of the X-Rays obtainable is limited by the fear of injuring the tubes. "This installation may be arranged to obtain stereoscopic radiographs. Two Roentgen Tubes may be illuminated at the same time by using one of the two series of waves for each tube. Tromfft 73 HI- \ \ \ V -JH--, HlSISTMCe . ugmo ; ; icsmuu '. UtVIO \Y h \Y 4- i> A XV w» VTlLlStTIOtl Fig. 50. — General Diagram. (From Belot.) "An automatic shutter, whose movement synchronizes with the interruptions of the current, is required. Such a shutter has been invented by Villard. "This apparatus may be also used with a continuous current. A commutator converts the continuous into an alternating current. By this means we get rid of the interrupter and the Ruhmkorff coil, both of them very imperfect and unsatisfactory 78 HIGH-FREQUENCY CURRENTS instruments. The utilization of instruments for measurement is thus greatly facilitated. It may be objected to this form of Fig. 51.— Top Shelf of Cabinet. (From Belot.) installation that, since it is supplied by the alternating current, it will be influenced by any variation in the mains. The only possible variations, however, are changes of potential and changes in the rate of alternation. Fig. 52.— Lower Shelf of Cabinet. (From Belot.) " Neither of these ever varies by more than one per cent., and their effect is therefore negligible. This is quite otherwise if EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 79 ordinary current converters are used. These depend for their effect on synchronism with the current, and are therefore much more sensible to brief variations in the main. "This installation is equally adapted for high-frequency work. SPIN7ERHC TRE W' Fig. 53. — Springs and Contact Plate. (From Belot.) It is only necessary to remove the Villard valves and insert the spark-gap in order to adjust it for this purpose. "As we have already stated the whole of the apparatus — transformer, regulators, condensers and spark-gap — is arranged in a cabinet. Within the cabinet are the coils of the trans- former, as shown in Fig. 49. These should never be used outside the case* * Radiotherapy, by Dr. J. Belot (Rebman Company, New York) . 80 HIGH-FREQUENCY CURRENTS Volimetre ^—mmmh r^MMJLWMWULn Con. Hh " In Fig. 50, we give a general diagram of the installation, and Figs. 51 and 52 show the arrangement of the two shelves of the cabinet, with the connection of the transformer, condensers, resistances, etc. " Fig. 53 also shows the springs, X-X' , and the contact plate. The latter is attached to the door, and thus breaks the circuit s whenever it is opened. All danger from electric shocks is thus obvi- ated, since the apparatus cannot work unless the door is shut. All ~~\l_J | ifffearfrt dangerous apparatus is thus out of the way of the operator. " The safety-fuses, measuring in- struments, and regulating appara- tus are attached to a marble slab on the top of the cabinet, as shown in Fig. 54. " This new installation of Messrs. Gaiffe seems to meet all theoretical requirements. We have had many opportunities of proving both its safety and its adaptability to prac- tical conditions." In addition to those already described, a large variety of High- frequency Apparatus of the Oudin- d'Arsonval type has been placed on the market by the European manu- FiG. 54.-Regulating Apparatus, facturers. Of these may be men- Arrangement of Transformer, tioned the outfit shown in Fig. 55, made by Max Kohl of. Chemnitz, in which the Ruhmkorff Coil is conveniently located in the lower part of a handsome cabinet, the two upper compart- ments being occupied, respectively, by the coil terminals, interrupter and meters, and by the High-frequency Appara- tus proper; the latter being a small solenoid, separate from the resonator, to which it is connected by means of a spring clip and flexible wire. This outfit is the most frequently em- » Resist Resist* P P Tube * -i r EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 81 ployed form among the German specialists, while the upright type of resonator, as shown in Fig. 56, is preferred in England and France. As has been previously stated, the development of High- FiG. 55. — Isenthal's Complete High-frequency Apparatus. (Williams.) 82 HIGH-FREQUENCY CURRENTS frequency Therapeutics in America, began with the work of the present writer in 1896. During the first four years of his investi- gations, which were carried on upon entirely different lines from those followed by d'Arsonval and his. colleagues, he com- pleted the designs for the first practical Therapeutic High- frequency Apparatus introduced to the American profession. It had been used for several years in his private practice, before the widespread interest in its remarkable therapeutic effects E~ ItltPW" Fig. 56. — Resonator and Condensers (small model). (Williams.) led to its being placed upon the market. The first few machines were made from the writer's designs, and under his personal supervision, by Mr. E. L. Ovington of the Massachusetts Institute of Technology. The apparatus was subsequently manufactured by Mr. Ovington who devised several valuable improvements which increased its efficiency and lessened its liability to breakdown. It was at this time known as the " Strong-Ovington Static Induc- tion and High-frequency Apparatus." (See Fig. 57.) The only High-frequency Apparatus on the market at the time the EUROPEAN TYPES OF HIGH-FREQUENCY APPARATUS 83 author's machine made its appearance, was the "Knott Coil," mentioned in a previous chapter (see Fig. 58). This apparatus, however, was used solely for X-Ray purposes, the therapeutic possibilities of the Testa currents and the technic for their application being unknown to the profession until after the appearance of the writer's apparatus. The "Knott Apparatus" in common with all other High- frequency Coils made prior to 1899, was assembled in oil; and the impossibility of preventing the latter from oozing through the joints of the heavy oak box in which it was contained, was Rofery Spark -$&p. Fig. 57. — Diagram of the Author's Original Type of High-frequency Appa- ratus; "The Strong-Ovington Coil." one of the chief disadvantages of the apparatus. Both Testa and Thomson had stated that a liquid insulating medium was absolutely essential for High-frequency Apparatus, and that any solid substance, such as wax, or rubber, would sooner or later break down and allow the currents to pass. The great power and volume of Testa High-frequency Currents and the simple character of the generating apparatus, attracted the attention of certain European investigators shortly after the early clinical results of d'Arsonval and Oudin were published. Clinical tests were therefore made of currents generated on the Testa-Thomson principle, but their obviously great therapeutic 84 HIGH-FREQUENCY CURRENTS power was offset by several serious and apparently insurmount- able defects. The attitude of the European profession toward the Testa currents is well expressed in the following quotation from an article which appeared several years ago in a promi- nent English journal: "High-frequency Therapeutics as practised in Europe, is unknown in America, except for a few isolated attempts to apply Tesla currents for the relief of disease. These currents were thoroughly tested several years ago by European investiga- tors, who found them to be absolutely impractical for therapeutic 9 X 8 I4K=^ t-- direct alt. ^ ° . 3 o Fig. 121. — High-frequency Motor-impulse Current. ("Pseudo-faradic") five millimeters is formed. The rapid succession of muscular contractions produced in the patient by this procedure is so intense that a distance of two millimeters is as great a separation of the balls as will be practical with the majority of cases. The probable explanation of the lack of sensation attending the direct passage of the Tesla Current through the body of a patient as compared with the intense motor and sensory effects resulting from the interposition of a spark-gap in the above circuit, lies in the peculiar nature of the arc which flows across the air space. (Fig. 121.) The intense heat which this discharge produces causes an upward current of air which carries the arc with it, in- creasing the curvature of the latter until it finally breaks, to instantly re-form in its original position. Each "Break" of the arc causes a sudden rise in the potential of the patient's body, THERAPEUTIC TECHNIC 173 which as suddenly drops almost to the zero point simultaneously with the re-forming of the arc. (Fig. 123.) This method of treatment is primarily a motor stimulant, and may be employed for the same purposes as the faradic or inter- rupted galvanic current. The potential of the oscillations is J3 Fig. 122. — Theoretical Tracing of Current Obtained by the Use of the Author's Mechanical Device, shown in Fig. 120. rather low, except at the moment following the break of the arc. The writer has devised a variety of mechanical interrupters for the purpose of converting the above-described modality into a motor current of smooth and even character, the interruptions of which may be made to occur at any desired frequency. They AD- Fig. 123.— A, Theoretical Tracing of " Pseudo-f aradic " Current. B, Peri- odical Elongation and Breaking of Tesla Arc by the Upward Current of Hot Air. (Numbers in the "arcs" correspond to those in the tracing.) are simply mentioned in passing, as the work is still in the experimental stage. There is still another method by which simple or compound vibrations of low or moderate frequency may be superimposed upon the oscillatory current of a Tesla Coil. It consists in the 174 HIGH-FREQUENCY CURRENTS periodic modification of the resistance of the spark-gap in the condenser circuit, which may be accomplished by the vibration of one of the terminals of the gap, by rotating a slotted disk of mica in the path of the discharge, or by causing an intermittent pencil of some form of radiant energy to periodically ionize the air in the gap between the terminals. The writer has in this way been able to impress sound waves upon the High-frequency Current and has even produced a musical or speaking "Arc" in the secondary Tesla Circuit. As a carrier of vibration it is possible that the Tesla Current may ultimately be employed through the development of the writer's methods as a means of conveying sensory impressions to the nerve centers when the normal path has been destroyed by accident or disease. The High-frequency Current readily traverses the tissues of the body, the nerves being especially good conductors of electrical oscilla- tions; consequently in a case, for example, where the conducting mechanism of the external and middle ear has been destroyed and rendered functionless, sound waves might still be transmitted to the terminals of the auditory nerve by means of a High- frequency Current, the oscillations of which have been modified by the superimposition of the audible vibrations. The perfection of this method may lead to the successful solution of the problem of enabling a totally deaf person to hear. The writer believes that he is the first to suggest the use of High-frequency Currents as carriers of vibration, and is con- fident that his discovery will lead to important developments, not only in electro-therapeutics, but in the application of High- frequency Currents for technical and commercial purposes. CHAPTER XVI therapeutic technic (continued) Treatment by Means of Glass "Vacuum Electrodes" If the general employment of a new device by members of the medical profession may be taken as evidence of its practical value, the Vacuum Electrode may be justly regarded as the most important contribution to Electro-therapeutic Technic since the advent of the High-frequency Current. When first devised and employed by the writer in 1896, it was ridiculed as a spectacular toy by a number of physicians, many of whom now use it in their daily practice. At the present time it is almost universally employed for the administration of High-potential Currents of both the Static and High-frequency types. The use of hollow glass electrodes exhausted to a so-called "Low Vacuum" for the administration of High-frequency Cur- rents originated through certain clinical experiments conducted by the writer in the laboratory of Dr. J. P. Sutherland, who is at the present time Dean of the Boston University School of Medicine. In investigating the possibilities of the X-Ray as an aid to vision in the partially blind, the writer had connected the subject to one pole of his original Tesla Apparatus 03^ means of a metal electrode, and was trying the effect of bringing an X-Ray tube with its anode connected to the ground, in contact with the eyeballs and forehead of the subject. Flashes of light were seen or sensed at the moment of contact, and in order to determine whether this effect was due to the X-Ray, or to the High-fre- quency Discharge, the experiment was repeated using a Geissler Tube grounded through the body of the operator, in place of the X-Ray tube. The flashes of light were not produced, but a peculiarly pleasant sensation experienced by the patient led to the continued application of the tube for perhaps five minutes. At the expiration of this interval the subject of the experiment 175 176 HIGH-FREQUENCY CURRENTS suddenly announced that an intense neuralgic headache with which he was suffering when he came to the laboratory, had entirely ceased. He also stated that these headaches usually lasted from twenty-four to forty-eight hours, and that up to that time he had been absolutely unable to obtain relief, although he had tried all of the conventional methods of treatment. The writer subsequently treated this patient on several occasions and discovered that the use of the Geissler Tube as an electrode invariably relieved the headache, usually within ten minutes after beginning the treatment. It was nearly a year after this experiment before the writer was able to have constructed a series of Vacuum Electrodes Fig. 124. — The Author's Technic for Vacuum Electrodes. " Tesla Vacuum Treatment." a, Indirect Mono-polar Treatment, b, Direct Mono-polar Treatment. adapted to the treatment of different parts of the body. During this interval, however, he had fully demonstrated the value of the Vacuum Electrode by successfully treating a variety of cases with High-frequency Currents by means of an improvised elec- trode, consisting of a plain Geissler Tube with its upper terminal covered with sealing wax, and its opposite end fixed in an insulating handle. Having already invented his triple terminals, the writer administered the treatment as follows: With the disks and balls widely separated, the patient was connected with Terminal B by a metal electrode; the Geissler Tube Electrode was connected by a cord to the Dummy C (see Fig. 124). The end of the electrode was applied to the affected area, and the THERAPEUTIC TECHNIC 177 current turned on. The intensity of the local effect produced by the Vacuum Electrode was increased by pushing in the disk on the sliding rod in Terminal A , in other words by lowering the resistance of the air-gap between the disks. The latter were not permitted to be sufficiently close to allow of the formation of an arc between them. This Bipolar Vacuum Treatment pro- duces both constitutional and local effects, the latter being due not only to the High-frequency Current but to the secondary vibrations of the electrical and radiant energy generated by the passage of the current through the partial vacuum of the tube. These effects will be described in detail in the Chapters on ' ■ Electro-Physiology . ' ' The phenomena of electrical conduction in partial vacua may be experimentally studied by exhausting the air from a glass tube about twelve inches in length, provided with terminals connected to the poles of a small static machine or coil, capable of producing a spark of from two to six inches in length. A good mercury pump or compound oil pump of the "Geryk" type, will be required for this experiment. At the pressure of the atmosphere, no current will pass through the tube, the dis- tance between its terminals being double the length of the maximum spark from the coil. If the pump be now slowly operated until four-fifths of the air in the tube have been removed leaving a pressure of one-fifth of an atmosphere between the tube terminals, a faint branching brush discharge of violet color will appear in the tube. Evidently the withdrawal of air has increased the conductivity by diminishing the resistance of the tube. Again operate the pump until about one-twentieth of the original air is left. The current will now flow between the terminals in the form of a thin red line or thread. If the finger of the operator be brought near the tube, the luminous thread will be brought toward it exactly as the center of an elastic steel wire would be drawn to a powerful magnet. Now carry the exhaustion to one-fiftieth of an atmosphere and the thread of light will expand into a luminous pencil or band, while a violet aura will be seen surrounding both terminals in the tube, es- pecially the cathode. Carry the exhaustion still further, until all but one five-hundredth of the original air has been removed 178 - HIGH-FREQUENCY CURRENTS from the tube. The diameter of the luminous pencil will increase until it fills the entire tube. A number of transverse striations will be seen dividing the discharge into series of disks of light of equal thickness. The violet aura at the cathode has become more distinct and a dark space separates it from the series of disks on one hand, and from the surface of the cathode on the other. As the exhaustion proceeds from one five-hundredth to one ten-thousandth of an atmosphere, the disks become thicker and the striations fewer, and the color changes from a rose-pink to violet, blue, blue-white and finally to a dense yellowish-white. The violet aura at the anode has shrunk to a mere point, while that which surrounds the cathode has grown larger and the dark space wider. Inside this dark space the metal cathode glows as if it were red hot. From this point the further exhaustion of the tube is accomplished slowly and with great difficulty. After a considerable interval the pressure in the tube will be diminished to one fifty-thousandth of an atmosphere, and the light in the tube will have entirely ceased except for an irregular white cloud which flutters in the center. The walls of the tube, how- ever, have become luminous with a brilliant apple-green fluores- cence, and if a screen coated with barium platinum cyanide be held near the tube with a sheet of paper intervening, an area of light will appear on the screen due to the X-Rays produced by the intensely vibrating electrons in the tube. With a good pump it is possible to carry the exhaustion still further until all but one-millionth of original air has been removed from the tube. The current now meets with considerable resistance and will "back up" a spark of three or four inches in length across an adjustable air-gap parallel with the tube. The resistance of the tube is at its minimum at a pressure of one ten-thousandth of an atmosphere when not more than one-fourth inch of spark can be obtained at the parallel gap. With the final exhaustion at one-millionth, etc., there is no light whatever in the tube and only the intense fluorescence of the glass indicates the passage of the current. The X-Rays from the tube are now of greater power, penetration, and shorter wave length than in the preced- ing stage. By special methods it has been found possible to obtain a still higher degree of exhaustion, and tubes have THERAPEUTIC TECHNIC 179 actually been made with internal electrodes only one millimeter apart, which would nevertheless resist a voltage capable of producing a spark several feet in length. A perfect vacuum is therefore theoretically an absolute non-conductor of electricity. If the above experiment be performed with a Tesla High- frequency Current, instead of a Ruhmkorff or Static Current, practically the same phenomena will be produced, except that no " transverse striations" will appear, and the purple aura will present the same appearance and brilliancy at both of the internal terminals. These differences are, of course, due to the fact that the current in the tube is oscillatory rather than uni- directional. If a tube containing fluorescent minerals such as willemite, calcite, kunzite, etc., be connected to a Tesla Coil and exhausted by means of an air pump, the minerals will emit light of different colors as soon as the pressure is reduced below one five-hundredth of an atmosphere. The effect is due to the production in the tube of ether waves beyond the limits of vision, which are gen- erally spoken of as "Ultra-violet Rays." These rays would be of value therapeutically were they not prevented from reaching the surface of the body by the opacity of the glass walls of the tube. Some years ago the writer devised a vacuum electrode capable of transmitting these ultra-violet rays, through a quartz lens cemented to one end of the tube. (See Chapter on " Ultra- violet Rays.") Several years after the writer's discovery of the Vacuum Electrode, instruments of this kind were placed on the market by a New York firm. They were sold in sets including different shapes and sizes, and but little attention was given to the degree of exhaustion employed. In consequence some of the electrodes were of the "white," and some of the "Red Vacuum" type, varying in exhaustion from one-fiftieth to one ten-thousandth of an atmosphere. The disparity in the results obtained in similar cases treated by different electrodes led the writer to begin a series of experiments for the determination of the relation between the degree of exhaustion and the therapeutic effect. A description of the details and results of these experiments is given under the head ©f "Electro-Physiology." For the present 180 HIGH-FREQUENCY CURRENTS it will suffice to say that the effects of Red Vacuum Electrodes were found to be quite different from those of higher exhaustion, and that since the date of the above experiments all commercial vacuum electrodes have been made to conform to a standard "Low Red Vacuum." At the present time there are many forms and varieties of Vacuum Electrodes on the market, some of which are shown in Fig. 125. — Doctor Snow's set of Vacuum Electrodes. the accompanying illustrations. Among other ingenious im- provements which have been made since the original introduction of the Vacuum Electrodes, mention may be made of the Insulat- ing Air-jacket, for the purpose of preventing the escape of the current except at the extreme ends of the electrodes, for the treatment of internal conditions. Electrodes of this type are formed of two concentric tubes, the inner one being the real THERAPEUTIC TECHNIC 181 vacuum tube, which is prevented from discharging into the body by the annular air space surrounded by the outer tube. Several varieties of these double-walled electrodes are shown in Fig. 126. For increasing the intensity of the local effect produced by High-frequency Currents, a "Condenser Electrode" may be employed, instead of the simple Low-vacuum Electrode. The latter are usually supplied without internal electrodes, receiving the current from the brass socket at the end of an insulating handle which is made to be used interchangeably with the different electrodes in the set. (See Fig. 125.) Condenser elec- trodes on the other hand are provided with an internal terminal Fig. 126. — Double-walled Vacuum Electrodes. in the form of an aluminum rod, or disk. The space between the terminal and the inner walls of the tube may contain air at the ordinary pressure, salt solution and the other fluids, or may be exhausted to a low or high vacuum. Condenser electrodes were first employed by the present writer several weekg prior to his invention of the vacuum electrode. The fluctuations of the spark-gap in his original apparatus rendered the effluve from the Tesla Coil so irregular that great difficulty was experienced in the use of the latter modality without "sparking" the patient. Having already noticed the ease with which the Tesla Currents passed through glass and other non-conductors, the writer experimented with a sheet of thin plate glass applied to the body of the patient as a protection against "sparking" during effluve treatment. Although this 182 HIGH-FREQUENCY CURRENTS method did not prove a satisfactory substitute for the Direct Effluve Treatment, it led to the development of a new modality which is at present applied by means of the so-called " Condenser Electrode." As originally employed, the patient was connected /Vo.z Fig. 127. — The Author's Technic for the Use of Glass Condenser Electrodes. to a Tesla Terminal by means of a metal hand electrode and a metal point connected to- the opposite terminal was applied to the outer surface Of a plate of glass in contact with the upper epigastrium, a beautiful "rosette of sparks" radiated from the Fig. 128. — The Author's Regulating Handle for Vacuum or Condenser Elec- trodes. point over the glass surface, and slight Faradic effects were produced in the region near each electrode. A rather unpleasant noise is produced by the discharge, but despite this fact, the writer still employs the original technic in the treatment of Fig. 129. — HerschelPs Regulating Handle and Rectal Electrode. (Williams.) nervous dyspepsia, and other conditions involving a depletion or lack of power in the sympathetic nervous system. The first condenser electrodes constructed by the writer consisted of metal rods fixed in insulating handles, surrounded by glass THERAPEUTIC TECHNIC 183 tubes, the extremities of which were flat, rounded or bulb-shaped, adapted to different parts of the body. (See Diagram Fig. 127.) Later the metal rod was made to slide into the insulated handle, so that its free end could be pushed into actual contact with the sealed end of the glass tube or withdrawn to a distance of several inches. This construction permits the regulation of the strength of the discharge which may be varied from a slight warmth, to a stream of sparks capable of blistering the surface. The writer has in his possession his original electrode of this type, and still occasionally employs it in his practice. Fig. 130.— Ebonite Spinal Electrode. (Williams.) The above method of regulation suggested to the writer the idea for his regulating handle for vacuum or condenser electrodes. It is practically an application of the principle embodied in the writer's Triple Terminals, in which the effluve between metal disks forms a rheostat for the regulation of the current strength. An interesting fact in connection with the writer's regulating handle which is shown in Fig. 128, is the independent invention of a similar device by Doctor Herschell of London, for use in con- nection with his Rectal Electrode, which was described by its inventor in his manual of "Intragastric Technic." (See Fig. 129.) A large variety of condenser electrodes have been devised and 184 HIGH-FREQUENCY CURRENTS introduced by different authorities, some of glass filled with liquid, or granular carbon, others of ebonite vulcanized over metal rods of various shapes and sizes. (Fig. 130.) From a physical standpoint, all vacuum electrodes are con- Fig. 131. — Condenser Electrode; "Low Red Vacuum Type." denser electrodes, but custom has limited the latter term to vacuum electrodes of a special construction involving the use of an internal disk-shaped aluminum terminal. The conven- tional condenser vacuum electrode is represented in Fig. 131. Another modification is shown in Fig. 132. The same technic is employed in the therapeutic application E.Machlett&SoiuNY.C Fig. 132. — Vacuum Condenser Electrode with Cupping Device. of all varieties of condenser electrodes. This technic includes several different methods namely : (A) Monopolar Direct Application. (B) Monopolar Indirect Application. THERAPEUTIC TECHNIC 185 (0) Bipolar Direct Application. (D) Bipolar Multi-frequency Treatment. (A) Monopolar Direct Application. — -This is the simplest method for the direct application of High-frequency Currents from a resonator or from a single pole of a Testa Coil. The action is local rather than general but the effects are intense, and it is seldom necessary to apply the elec- trode for more than ten minutes at a time. The electrode fixed in an insu- lating handle is connected to the terminal of the coil by a rubber-covered conducting cord, and applied to the affected surface before turning on the current. But little sensation other than warmth is produced when the electrode is applied to the skin, but if one or more layers of clothing intervenes, a stinging, tingling feeling is experienced by the patient which increases in intensity as the clothing increases in thickness. (Fig. 133.) Skin lesions and superficial conditions usually require the direct application of the glass surface of the electrode. Diseases involving the deeper tissues, such as cellulitus, neuralgia and Fig. 133. — Monopolar Direct Technic. Fig. 134. — Monopolar Indirect Technic. rheumatism are more readily relieved by applying the electrode over the clothing or by covering the end of the electrode with cloth of any desired thickness ; woolen fabrics being best suited to this purpose. The differences in the physiological effects 18b' HIGH-FREQUENCY CURRENTS produced by these varieties in technic are discussed in detail in an ensuing chapter. (B) In the Monopolar Indirect Method, the patient is connected to the resonator or Testa Terminal by a metal plate or hand electrode and the vacuum or condenser electrode connected to the ground or held in the hand of the operator, is applied to the affected area. By this method a mild general effect is added to the local action of the electrode discharge, and the action of the latter is somewhat less intense than in the method pre- viously described. The glass electrode is applied to the surface or through clothing as in the preceding description. (Fig. 134.) (C) Bipolar Direct Application involves the use of two vacuum electrodes, each of which is connected to a terminal of the Tesla Apparatus, or, one electrode may be attached to the terminal of Fig. 135. — Bipolar Direct Application of Vacuum Electrodes. a resonator, the second electrode being connected with the ground. The first method should be used if possible, as its effects are much more intense. As a rule the electrodes must be applied directly to the surface of the body, as blistering may result if the clothing intervenes. One exception to this rule may be made in the application of currents of low amperage and very high voltage and frequency, such as are produced, for example, from the Piffard Kfyperstatic Transformer. The writer has found the bipolar method of especial value in the treatment of pulmonary tuberculosis and lobar pneumonia. (Fig. 135.) A variation of the Bipolar Technic is exemplified in the use of the vacuum condenser chair recently introduced by R. Fried- lander of Chicago. This device in addition to its spectacular and impressive appearance possesses real merit from a therapeutic standpoint, and the writer has obtained excellent results from THERAPEUTIC TECHNIC 187 its use in the treatment of functional and organic diseases of the nervous system. In the majority of these cases the patient is seated in the chair which is connected to one of the Tesla Ter- minals, and a vacuum condenser electrode connected to the other terminal, is applied over the solar plexus. The efficiency of the treatment is increased if the clothing be removed from the upper half of the patient's body. Insomnia or nervous- ness resulting from prolonged mental or physical exertion is almost invariably relieved by a High-frequency Bath by means of the vacuum chair. The latter is connected to a Tesla or resonator terminal as de- scribed in Section A, and the patient seats himself in a comfortable position and voluntarily relaxes every muscle of the body, closes the eyes and rests during a treatment of from ten to twenty minutes duration. By this method the accum- ulated waste products result- ing from a long day's work are removed from the mus- cles and superficial tissues and at the termination of the treatment the patient will be almost as rested and invigorated as from a night of refreshing sleep. In the opinion of the writer the vacuum condenser chair is a valuable if not an essential addition to the equipment of every progressive electro- therapeutist. (Fig. 136.) (D) Bipolar Multi-frequency Treatment involves a combination of the writer's Multi-frequency Treatment with the vacuum or condenser electrode. A Tesla Apparatus provided with the writer's Triple Terminals being required for the production of this modality. One of the Tesla Terminals B is connected to a metal electrode in contact with the patient's body, a vacuum Fig. 136. — Friedlander's Vacuum Condenser Chair. 188 HIGH-FREQUENCY CURRENTS electrode is connected with the "Dummy," and the current strength regulated by the length of the effluve between the two metal disks. This technic, which has already been described in a previous paragraph, produces the characteristic local effects of the vacuum electrode, the general effects of the Tesla Current, and an additional "Multi-frequency" effect on the motor nerves Fig. 137. — The Author's set of Condenser Electrodes. a, "Low Red Vacuum." b, "White Vacuum." c, "X-Ray Vacuum." and muscles which is of great value in the treatment of partial paralysis, incipient degeneration of the nerve centers, deep- seated pain, and in the removal of exudates and effusions. In common with all varieties of Multi-frequency Technic, the above method is to be avoided in cases of organic heart disease. Some months ago the writer designed a set of Condenser Elec- trodes for the application of High-frequency Currents to the treatment of local conditions. This set consists of three Con- THERAPEUTIC TECHNIC 189 denser Electrodes as shown in Fig. 137, and an Insulating Handle. Although identical in size and appearance these electrodes pro- duce entirely different effects upon the tissues and functions of the body. The first is exhausted to a "Red Vacuum," ap- proximating one five-hundredth of an atmosphere; the second, to a "White Vacuum," about one ten-thousandth of an atmos- phere, and the third, to a low "X-Ray Vacuum" about one one- hundred-thousandth of an atmosphere. The first electrode may be used in the majority of cases which are amenable to High- frequency Treatment. The distinctive effects of the low vacuum discharge being of a sedative character, relieving acute congestion and inflammation, allaying pain, and stimulating metabolism. The second electrode is adapted to the treatment of chronic and indolent conditions involving lowered vital resistance and impaired nutrition. It is of especial value in the treatment of pulmonary tuberculosis, cold abscess, varicose ulcers, psoriasis, and eczema. The third electrode combines the devitalizing and destructive effects of the X-Ray, with the vivifying stimulating action of the Tesla Currents, and is a most important improve- ment in the methods for the therapeutic application of the X-Ray to the treatment of lupus, epithelioma and other forms of malignant disease. It will be more fully described in the chapter on "High-frequency X-Ray." CHAPTER XVII THE HIGH-FREQUENCY CURRENT FOR THE PRODUCTION OF THE X-RAY The X-Ray, as originally discovered by Professor Roentgen, was obtained by the passage of a Unidirectional Current of high voltage through a Crookes Vacuum Tube exhausted to about one-millionth of an atmosphere. The peculiar emanations from the negative terminal of the tube had been already studied by Lenard who termed them the "Cathode Rays." These rays ordinarily confined to the interior of the tube, by the opacity of the glass walls, had been obtained outside of the tube by means of an aluminum window sealed over an aperture in the glass directly opposite the cathode. Aluminum being transparent to the cathode rays permitted their transmission to the outer air, where their properties could be directly studied. Among other phenomena produced by these rays, it was noticed that fluores- cent substances, such as barium-platinum cyanide became brilliantly illuminated when placed in their path. In experi- menting with a cardboard screen coated with the above chem- ical, Roentgen noted that the luminosity was produced not only near the aluminum window, but near the glass on all sides of the tube, even when the cardboard screen was interposed between the tube and the fluorescent film. In studying this effect the shadow of the operator's fingers were observed on the screen, the darker outline of the bones being clearly distinguished against the lighter shadow of the less opaque flesh. In this way the X-Rays of Roentgen were discovered and subsequent investigations by their originator demonstrated their character, properties and practical possibilities. Roentgen showed that these new radiations were an ethereal counterpart or sec- ondary product of the cathode ray, originating wherever the 190 FOR THE PRODUCTION OF THE X-RAY 191 latter rays collided with the glass walls of the tube or other resisting surfaces. The cathode rays are streams of Negative Electrons, projected at right angles from the surface of the cathode terminal of a Crookes Tube. These electrons move in straight lines through the highly exhausted space in the tube at a speed of about one hundred thousand miles per second, somewhat slower than light rays which travel at a rate of one hundred and eighty-six thousand miles per second. In other words the cathode rays would travel entirely around the earth at the equator four times in a single second, while a ray of light would perform the same journey seven and one-half times during an equal interval. Cathode rays do not travel ordinary air for any appreciable distance. In the low pressure of a Crookes Tube they move freely at a high velocity, their momentum being so great that when suddenly checked they produce incandescence, and sometimes actual melting of the thin platinum plate which forms the anode in the majority of X-Ray Tubes. They are readily deflected by a magnet, and the angle of deflection has a definite mathematical relation to the size and electrical capacity of the moving particles which constitute the stream. The tremendous importance of this fact will be recognized when it is stated that it is through the careful experimental application of the above law that the "Negative Electron" — the common unit of all expressions of matter and force— has been discovered, measured and weighed. A comparison of the nature and properties of the cathode rays with those of the X-Rays of Roentgen, will enable the reader to obtain a clear understanding of the fundamental differences between these two intimately related types of radiant energy. (A) In the first place the cathode rays consist of minute material entities, or electrical particles shot out perpendicularly from the surface of the cathode in a Crookes Tube, which come to rest or are checked by collision with the glass walls of the tube. The X-Rays on the other hand, consist of extremely short, rapid pulses in the ether, each of which originates at the point of con- tact between a single electron of the cathode stream, and the glass walls of the tube, the pulse being caused by the sudden impact of the collision. 192 HIGH-FREQUENCY CURRENTS (B) Cathode Rays readily pass through thin plates of alum- inum, but are stopped by contact with almost any other solid substance. The X-Rays penetrate all substances to a greater or less extent, the opacity of bodies of matter to the X-Rays increas- ing as a rule, in proportion to their increase in density or specific gravity. Thus, light substances such as wood, paper, aluminum or magnesium are relatively transparent, while denser materials such as iron, glass and mineral specimens are more or less opaque. There are several exceptions to the above rule, the most im- portant being the diamond, which despite its great density is almost absolutely transparent to the X-Ray, while "Paste Dia- monds," quartz, and other Imitations are relatively opaque. This has opened an important field for the practical commercial application of the X-Ray. (C) The X-Rays resemble rays of light in that they both consist of vibrations or undulations transmitted by the ether, but the X-Rays may be compared to a succession of sharp "whip cracks"; light, by a similar analogy resembling a low musical tone from one of the bass pipes of an organ. From a like standpoint, the cathode rays may be compared to a stream of rapidly moving particles of sand propelled from a nozzle by a strong current of air. Each grain of sand may be taken to represent one of the electrons which form the cathode stream. (D) Cathode rays may be deflected by a magnet, reflected, refracted or polarized. The X-Rays are unaffected by a magnet, and it is practically impossible to reflect, refract or polarize them. (E) Both the X-Rays and the cathode rays produce phos- phorescence or fluorescence in sensitive substances, discharge electroscopes by ionizing the air, and produce effects upon the film of sensitized photographic plates. The X-Rays produce cumulative effects upon the tissues of the body, destroying the trophic nerve influence and depleting the cellular vitality. This may even lead to the formation of extensive sloughing burns, from the necrosis and local death of the tissues in the path of the rays. The specific action of the cathode rays upon living tissues has not been definitely determined up to the time of writing. The modern X-Ray Tube in its simplest form is shown in Fig. 138, which represents the type designed for use in connection with FOR THE PRODUCTION OF THE X-RAY 193 the static machine. It consists of a thin bulb of Bohemian or calcium glass provided with two electrodes; the negative or cathode being a concave reflector of aluminum which is shaped so as to project the cathode rays toward a common point or focus in the center of the anode, which is a thin platinum plate set at an angle of forty-five degrees with the axis of the tube. The cathode rays in colliding with the anode are reflected at right angles and strike the wall of the tube in straight lines, radiating from the focal point, each line being continued in the space outside the tube in the form of an X-Ray. The higher the degree of ex- haustion in the tube the shorter will be the wave lengths of the X-Rays it produces, and the greater their powers of penetra- tion and frequency of vibration. In treating or examining dense or deep-seated tissues with the X-Ray, a so-caUed " Hard Tube " of a high degree of exhaustion will be required, while for the treatment of superficial condi- tions or for the examination of moderately thin structures, such «q t>iP h*nr\ fnnt nr forpnrm a a> Anode- c> Cathode, h, Hand of as tne nana, toot or torearm, a patient, P, Sensitive Plate En- "Soft Tube" exhausted to a les- ser degree, should be employed; as it produces, longer, slower rays of lesser penetration, but affording pictures showing greater contrast and definition. "Hard" tubes resist the passage of the current and require a high voltage. The current from a static machine will readily jump across an air-gap several inches in length rather than pass through the highly rarefied gas in a "hard" tube. Such tubes exhibit an intense green surface fluorescence but show absolutely no light inside the bulb. "Soft" tubes, on the other hand, show flickering patches of bluish-white light between the electrodes, in addition to the green fluorescence, and possess such a low resistance that not more than one-half inch of spark can be backed up by them. Tubes for heavy X-Ray work require currents of considerable volume in order Fig. 138.— Method of Taking a "Skigraph." Patient. P, closed in Opaque Paper Envelope. T, Table. 194 HIGH-FREQUENCY CURRENTS to generate rays of high power and intensity. This large amper- age gives rise to a great amount of heat, mainly at the focus of the cathode rays. Unless suppressed or absorbed, this heat would expend itself upon the anode, which would be rendered incandescent or perhaps actually melted, and in either event the Fig. 139.— X-Ray Tube with Solid Metal Anode. efficiency of the rays would be destroyed. Various means have been devised for obviating the undue accumulation of heat, such as the use of a solid metal-backing for the platinum anode as shown in Fig. 139, or by employing a cooling chamber filled with Fig. 140.— "Water-cooled" X-Ray tube. water in relation with the under surface of the platinum plate. (See Fig. 140.) The intense vibratory activity inside the X-Ray tube causes a gradual decrease in the number of residual air particles. These particles are either driven into the glass walls or are absorbed by FOR THE PRODUCTION OF THE X-RAY 195 the minute specks of amorphous platinum driven off from the surface of the anode by the bombarding electrons of the cathode stream. The tube in other words, changes during continued use, from a "Soft Low Vacuum" to a "Hard High Vacuum." Ulti- mately such a high degree of exhaustion is produced that it be- comes impossible to pass a current through the tube. In order to regenerate such a tube it may be refilled with air and again exhausted on a mercury pump or a small amount of gas may be admitted to the bulb by means of the vacuum regulator with which the majority of tubes are provided. Although every maker of X- Ray tubes has his special form of vacuum regulator, there are but three fundamental types \t 1st, Chemical Regulators, re- quiring external heat for the liberation of gas. 2d, Chemical Regulators oper- ated by an electric spark. • 3d, Osmotic Regulators depend- ing upon the ability of certain metals to absorb hydrogen gas when heated. Conventional examples of these three types of regulators are shown diagrammatically in Fig. 141. (A) consists of a glass tube projecting from the side of an X-Ray bulb, having an enlarged rounded extremity containing potassium chlorate or manganese dioxide which liberates oxygen gas when heated by the applica- tion of a match or spirit-lamp to the outer surface of the glass tube. (B) is similar in construction to the regulator just described except for the platinum wire, sealed into the portion of the tube containing the chemical. By allowing sparks from the coil or static machine to pass into the tube through the platinum wire, gas is liberated as in the first instance. An ingenious m Fig. 141. — Vacuum Regulators for X-Ray Tubes. A, Chemical Regulator, (Heat). B, Chemical Regulator, (Spark). C, "Osmo-regulator." 196 HIGH-FREQUENCY CURRENTS application of this type of regulator is found in the so-called "Self-regulating Tube" illustrated in Fig. 142. By means of an adjustable wire connected to the tube terminal farthest from the regulator, a spark-gap of any desired length may be formed between the point of the wire and the platinum terminal of the regulator. Suppose, for example, the wire be adjusted to form a gap of three inches. When the internal resistance of the tube becomes greater than that of the spark-gap, the current will take the path of the least resistance, passing across the gap to the opposite terminal of the tube by way of the chemical chamber of the regulator. Sparks will continue to pass until sufficient gas has been liberated to reduce the internal resistance of the Fig. 142— "Self-regulating" X-Ray Tube. tube until it again forms an easier path for the current than the circuit containing the spark-gap. By this arrangement the tube may be maintained at a constant resistance for an almost indefinite period. (C) represents a regulator of the Osmotic type which consists of an extremely small tube of metallic Palladium sealed into the side of the X-Ray bulb, the inner end of the metal tube being open, while the outer end is closed. Ordinarily the tube is protected by a cylindrical glass cap.. If the latter be removed and the flame of a spirit-lamp be applied to the closed extremity of the Palladium Tube, Hydrogen Ions from the interior of the flame will be drawn through the inter-molecular spaces of the heated metal into the exhausted X-Ray bulb. The principal advantage of this type of regulator lies in the fact that the FOR THE PRODUCTION OF THE X-RAY 197 vacuum may be reduced an indefinite number of times, while the life of a tube provided with a regulator of either of the preceding types is limited by the amount of the chemical in the end of the regulator tube. In order to use Testa Currents for the production of the X-Ray, a tube of special construction is necessary, as the oscilla- tory character of the current would soon destroy the efficiency of the ordinary tube of the unidi- rectional type. Various methods have been devised for the con- struction of High-frequency X-Ray Tubes involving three different principles : examples of tubes illus- trating these ideas are shown dia- grammatically in Fig. 143. (A) shows the construction of the tube of the so-called "Double-fo- cus" type invented by Professor Elihu Thomson. It is really a combination of two distinct tubes as will be seen by the imaginary dotted line dividing them. The oscillations in the direction of the arrow (X) produce X-Rays from the cathode and reflector in the right-hand half of the tube. The alternations in the opposite direc- tion, indicated by the arrow (Y), produce a stream of rays shown at (Y) in the left-hand side of the tube. This is the most efficient type of High-frequency X-Ray Tube as it utilizes the energy of the entire current. It is admirable for therapeutic work but is not suited for skiagraphic examinations as the two points of origin of the X-Rays cause double outlines, which destroy the clearness of definition. (B) shows a tube of the writer's design involving the same principle as the Double-focus tube but the rays, instead of being- projected in two parallel streams are separated, those from the Fig. 143.— Types of "High-fre- quency X-Ray Tubes." A, Thomson Double Focus. B, Strong Double Focus. C, Sin- gle Focus (double bulb). 198 HIGH-FREQUENCY CURRENTS oscillations in one direction, being reflected from the anterior surface of the platinum plate, while the rays from the opposite oscillations are reflected from the posterior surface of the plate. By mounting this tube in a dark box fixed in the center of a cloth screen or curtain, two independent examinations or Fig. 144. — Thomson Double Focus X-Rav Tube. treatments may be given simultaneously; the operator, for example, making a fluoroscopic examination of a fracture of the bones of the forearm, while his assistant is applying the rays for the treatment of a facial epithelioma, to a patient on the opposite side of the screen. Fig. 145. — Single Focus Tube for H. F. Currents; with Hollow Metal Cone Under Anode. (C) In tubes of the third type, the cathode rays from one set of oscillations are smothered or damped in a hollow metal cone or a closed glass bulb, while the opposite oscillations are em- ployed for the production of the X-Ray, as in the usual uni- directional type of tube. FOR THE PRODUCTION OF THE X-RAY 199 In Figs. 144, 145, 146, 147, are illustrated several commercial forms of High-frequency X-Ray Tubes, embodying the principles just described. The X-Ray has been employed for some years in more or less successful treatment of malignant growths involving the super- ficial tissues or the mucous membrane, the principle of its action being its cumulative destructive effects on the vitality of the cells. Malignant growths being of a low grade of vitality and devoid of trophic nerve supply are killed by a smaller dosage of the X-Rays than would be required to devitalize the normal tissues in the vicinity. Great difficulty has been experienced, however, in accurately gauging the length and frequency of the Fig. 146.— Single Focus Tube for H. F. Currents (Double Bulb Type). treatments, and in many cases extensive areas of ulceration and sloughing have been inadvertently produced in the healthy tissues covering, or adjacent to the malignant growth. Accidents of the above character have been practically confined to cases treated by X-Rays excited by a Rukmkorff Coil or static machine. Several years ago the writer successfully demon- strated the possibility of causing the absorption of malignant growths without injuring the healthy tissues, by a combination of the X-Ray and High-frequency Current. The patient was connected to a Tesla terminal by a metal hand-electrode and an electrode of the vacuum condenser type exhausted to an X-Ray Vacuum was connected to the opposite terminal and applied 200 HIGH-FREQUENCY CURRENTS to the surface of the body in immediate relation to the tumor. The increase in the vitality in the normal cells through the stimulation of the trophic nerves by the High-frequency Current counteracts the depleting effects of the X-Ray on the healthy Fig. 147. — Latest Type X-Ray Tube for Either Direct or Alternating Cur- rents. tissues and concentrates it upon the cells of the malignant growth. Some of the special methods devised by the writer for the treatment of deep-seated and inaccessible tumors are described in the chapter devoted to the "High-frequency Treatment of Malignant Growths." CHAPTER XVIII THE GENERATION OF THE ULTRA-VIOLET RAY BY HIGH-FREQUENCY CURRENTS Some years ago Doctor Finsen of Denmark began a series of clinical experiments for the determination of the therapeutic action of light rays. He first employed the sun's rays in his experiments, afterward substituting the light from a powerful arc lamp consuming eighty amperes, and provided with carbons containing salts of iron. He demonstrated the curative value Fig. 148. — Diagram of Finsen's Arc Lamp. (Guilleminot .) of light rays in the green, blue, violet and ultra-violet portions of the spectrum, in the treatment of lupus and superficial cancer. In order to obtain any degree of penetration he found it neces- sary to force the blood from the area of treatment by means of a quartz lens or compress. Daily treatments lasting for an hour or more were given for months or even years in order to produce the curative effects. (Fig. 148.) Only a comparatively small percentage of the rays from Finsen's Lamp were beyond the violet end of the spectrum, and these consisted of wave lengths only slightly shorter than the visible rays in the extreme violet. It is possible, however, to 201 202 HIGH-FREQUENCY CURRENTS produce ultra-violet rays of considerable volume nearly an octave higher than those obtained by Finsen. For the genera- tion of these rapid ultra-violet rays, a High-frequency Current is employed, discharging across a short spark-gap between iron electrodes. Many of the bright lines in the spectrum of iron are Fig. 149. — Piffard's Spark-gap Lamp. beyond the violet and by the rapid oscillations of the current these short rays are given greater intensity than the iron lines in the visible part of the spectrum. Rays of the above character may be obtained from a Ruhm- korff or static machine by connecting the terminals to a Piffard Fig. 150. -Strong's Ultra-violet Lamp for Use with "Ajax." or "Hercules" Coils. Spark-gap Lamp in series with a small Leyden Jar. Doctor Piffard's Lamp which is shown in Fig. 149, consists of two or more short spark-gaps between small iron balls, mounted in a hard rubber tube covered with a quartz lens. Rays of even greater intensity may be obtained from a lamp of a type designed THE GENERATION OF THE ULTRA-VIOLET RAY 203 by the author which is illustrated in Fig. 150. It consists essentially of a single adjustable spark-gap between the convex surface of a small steel ball projecting from an aperture in a circular brass terminal, and the end of a small steel rod which passes through a hole in the opposite terminal of the lamp, the upper end of the rod being held in a micrometer screw provided with a hard- rubber handle regulating the length of the spark. The lamp is covered with a metal canopy provided with a quartz lens for the transmission of the rays. The terminals of the lamp are con- nected to the discharging circuit of the condenser in the writer's High-frequency Apparatus, the ordinary spark-gap being thrown out of circuit and the small balls and disks of the Tesla Terminals being pushed into contact in order to short-circuit the High- frequency Coil. The rays are of extremely short wave length and high fre- quency. Glass, mica, celluloid and gelatin are absolutely opaque to these rays which, however, readily pass through plates of quartz, selenite or rock salt. They produce active fluorescent or phosphorescent phenomena as described below. Under cer- tain conditions they possess the power of ionizing the air, increas- ing the length of spark-discharges and discharging charged electroscopes or Leyden Jars. Applied to the exposed surface of the human body, these rays produce redness, congestion and blistering, in a single sitting of from thirty to forty minutes. They produce pain and redness in the human eye, and the operator should, therefore, wear spectacles with large glass lenses when working with the rays. The value of these rays as therapeutic agents has been demonstrated by the successful treatment of a large variety of acute and chronic skin diseases and in affections of the peripheral nerves. When employed for the latter purpose, the tissues to which the rays are to be applied should be de-hematized by the use of a solution of adrenalin, cataphorically diffused by means of the galvanic current. For experimental demonstration in lectures, etc., brilliant effects may be produced by subjecting specimens of the follow- ing substances to the ultra-violet rays from one of the above- described lamps : 204 HIGH-FREQUENCY CURRENTS Eosin (Aqueous Solution) Fluorescein " ^Esculin Quinin Bi-sulphate Cylinder Oil Willemite Calcite Fluorite Uranium Glass Didymium Glass Lead Glass Calcium Tungstate Barium Platinum Cyanide Calcium Sulphide Zinc Sulphide Diamond Selenite Crystals Aragonite = Green Fluorescence. = Yellow Green Fluorescence. = Sky-blue Fluorescence. c( it tt -- Yellow Fluorescence. = Bright Yellow Green Fluorescence. = Salmon-pink Fluorescence. = Amethyst Fluorescence. = Apple-green Fluorescence. = Dull Red Fluorescence. = Sky-blue Fluorescence. = Bright Blue Fluorescence. = Yellow Fluorescence. = Bright Blue Phosphorescence. = Yellow Phosphorescence. = White Phosphorescence. = Yellow White Phosphorescence. = Blue White Phosphorescence. An interesting effect is produced by powdering certain of the above substances and painting pictures with them, using a medium of gum-arabic solution, or silicate of soda. These pic- tures show no color when exposed to the ultra-violet rays, when a plate of glass is held over the quartz lens of the lamp, but when the glass is removed the designs at once appear in brilliant tints. CHAPTER XIX THE GENERATION OF OZONE BY THE HIGH-FREQUENCY CURRENT Ozone is a heavy gas of an extremely penetrating odor which is produced by the discharge of High-potential Currents, par- ticularly the High-frequency Type, across gaps filled with oxygen or air. From a chemical standpoint ozone is an Allo- tropic form of oxygen, containing three, instead of two atoms to the molecule. When introduced into the lungs or other mucous cavities of the body, ozOne acts as a powerful germicide and disinfectant. It destroys the toxic products of bacteria through its power as an oxidizing agent and is said to exert a tonic stimu- lant effect upon the cardiac and respiratory functions. Ozone has been highly exploited and undoubtedly greatly overestimated as a therapeutic agent, but on the other hand, it has been unjustly condemned by many physicians who have employed it in an impure condition. The principal obstacle to the therapeutic use of ozone as produced from ordinary air by the static or High-frequency Discharge is the large proportion of poisonous oxides of nitrogen which is simultaneously produced. Various means have been devised for the removal or absorption of these impurities, such as passing the ozone through tubes containing lime, or solutions of the alkalin hydrates or car- bonates. An apparatus has been placed upon the market in the last few years which is designed solely for the production and therapeutic administration of ozone derived from ordinary air. It consists of a "step-up" transformer which raises the potential of the com- mercial alternating current to about 40,000 volts. A pair of multiple tubular condensers are excited by the High-potential Current of the transformer and the air in their interior is rapidly converted into ozone by the silent discharge between the glass- 205 206 HIGH-FREQUENCY CURRENTS covered metal rods which form the condenser. A continuous current of air is forced through the condensers by means of an electric fan in the lower part of the apparatus and the ozone mixed with nitrous fumes passes through leather tubes to the inhaling masks. Just before entering the latter the mixture of gases passes through glass "U" tubes partially filled with an oily liquid, containing aromatic products combined with terpin and camphor derivatives. The makers of the apparatus place great stress upon the properties of this liquid, which they claim not only completely absorbs the nitrous products but forms a volatile, unstable compound with the ozone which breaks up in the lungs into nascent oxygen, and an active chemical germicide. These generators are employed by a considerable number of ■A (vimrcJ:lniq_tk.ii4ty Fig. 151.- (yieu/ed from abore\ -Strong's Apparatus for the Treatment of Pulmonary- Tuberculosis. physicians throughout the country, many of whom claim to have obtained remarkable results, especially in cases of pul- monary tuberculosis. Up to the present time no scientific clinical tests of this apparatus have been made by any of the recognized authorities. Pending such information no definite opinion can be given regarding the actual therapeutic possibilities of this method of treatment. The writer has recently constructed an apparatus for the treatment of pulmonary tuberculosis and other diseases of the respiratory system, which he believes to be the first device for the scientific generation of chemically pure ozone ever employed for therapeutic purposes. A diagram of this apparatus is shown in Fig. 151. It consists of a frame, provided with straps for attaching the apparatus to the thorax of the patient, supporting THE GENERATION OF OZONE 207 two vacuum condenser electrodes by a transverse rod of hard rubber. These electrodes are exhausted to a white vacuum and are adjustable, so that their action can be directed to any desired area. Ordinarily, they are symmetrically placed so as to cover the central portion of the right and left lung respectively, as shown in the figure. Each electrode is connected to a terminal of the Tesla Coil in series with an adjustable air-gap between metal disks, studded with points; each of the two gaps being enclosed by a glass cylinder provided with tight-fitting hardwood caps. Through tubulated apertures at both ends of the glass cylinder, the interior of the spark-gap chambers are connected in series so that air forced into one chamber will pass through it into the second whence it will be conducted through a glass tube to a rubber-edged inhaling mask supported on an adjustable spring arm attached to the frame of the apparatus. In adminis- tering the treatment the patient reclines at full length, the apparatus being strapped on his chest so as to bring the vacuum electrodes in contact with the body over the right and left lungs, while the mask is adjusted in light contact with the face of the patient covering the nose and mouth. The current is turned on, and the small disks in the glass cylinders are adjusted until a dense effluve, an inch or more in length is produced at each gap. Pure oxygen gas from a steel cylinder provided with a rubber bag and wash bottle is conducted through the two spark cham- bers to the inhaling mask over the face of the patient, in its passage across the gaps, a portion of the oxygen is converted into pure ozone and the mixture of the two gases is inhaled by the patient. Just before passing into the face mask, the ozonized oxygen passes through a small nebulizer by means of which the vapors of aromatic or antiseptic liquids may be simultaneously administered to the patient. The writer has obtained excellent results by the use of the compound which is supplied to the profession under the proprietary name of "Pineoleum," in con- nection with the above apparatus. As this device was con- structed by the writer something under three months ago, it is impossible to cite clinical evidence of its value in the treatment of pulmonary tuberculosis; however, the remarkably rapid improvement of the few cases which have been treated, up to 208 HIGH-FREQUENCY CURRENTS the present time, certainly warrants the writer in his belief that this method of combined treatment by therapeutic agents which have individually been widely employed in the successful treat- ment of tuberculosis, will prove to be the most efficient means yet produced for the ultimate eradication of civilization's most potent foe, the "Great White Plague." CHAPTER XX A REVIEW OF MODERN THERAPEUTIC METHODS Therapeutics in its broader sense may be denned as the science of treatment, or the art of healing the sick. Recent investiga- tions have shown that the various functions of the body result from the action of vibratory electrical forces in the nerves upon the chemical compounds which constitute the different cells and tissues. The vital functions may be classed under the following heads: 1st, Psychic functions, including the phenomena of conscious- ness, volition and reason, which result from the action of subtle physical forces, the exact nature of which is at present unknown. 2d, Special sense perception including, (a) vision, (b) hearing, (c) taste and smell (a single function manifesting through two channels) . 3d, General sensory perception which includes touch or tactile impressions, the sense or appreciation of weight, and the sense of pain (the latter being an abnormal effect). 4th, Motor functions, involving the voluntary or involuntary contraction of muscle fibers. 5th, Secretory functions, involving the elaboration or forma- tion of definite chemical compounds by groups of specialized cells. 6th, Metabolism, or vital combustion, a function inherent in each individual cell, whereby it absorbs its quota of nutriment from the blood or lymph, together with oxygen from the red corpuscles, and builds them into its own structure, transforming their potential energy into the primitive vital forces of living protoplasm. With the exception of the first and last group, the various bodily functions depend upon electrical vibrations, which they receive from the nervous system. Each function is expressed by cells or organs, which are specialized or peculiarly 209 210 HIGH-FREQUENCY CURRENTS adapted for their particular work, and which are associated with a special set or system of nerve fibers, transmitting electrical vibrations of a certain definite frequency. Thus the contractions of muscles depend upon vibrations averaging about four thousand per second, which traverse the so-called "Motor Nerves" as the result of a voluntary or uncon- scious impulse originating in the brain. The sensation of touch, on the other hand, undoubtedly results from an electrical vibra- tion between 10,000 and 15,000 per second, which traverse the sensory nerves as a result of stimulation of the nerve endings in the skin, and carry to the brain a knowledge of the location and nature of the external stimulus. The auditory nerves carry to the brain a series of sound or tone perceptions, ranging from thirty vibrations, to 40,000 per second, while the optic nerve transmits as color impressions, ether waves of radiant energy varying from 350 million-million (red light) to 750 million- million (violet light). The nature of the emanations which produce the sensations of smell and taste are at present unknown, but they are probably vibratory. It has not been definitely determined whether the electrical vibrations, traversing the optic and auditory nerves, correspond in frequency to the light rays and sound waves which respectively produce them ; this is probably the case with sound, which is the result of mechanical vibrations — while light, which results from electro-magnetic disturbances of the ether, probably induces in the optic nerve, electrical oscillations of a much lower frequency, but harmoni- cally related to the luminous rays which produce them. There are two other functions of living tissue which have not been included in the above classification — namely, a sense of heat and cold, probably transmitted through the sensory nerves; and the so-called " trophic influences," which enable the different cells of the body to resist destructive and disease-producing agencies, and to maintain a condition of health and structural integrity. This trophic influence does not result from a definite range of vibrations of a special set of nerves, but appears to be associated with the nerves in general ; thus, if a motor nerve be destroyed, gradual atrophy and degeneration will occur in the muscles corresponding to that particular nerve. Again, a A REVIEW OF MODERN THERAPEUTIC METHODS 211 destruction of the optic nerve will be followed, not merely by loss of sight, but by the wasting away of the corresponding eye- ball. Most forms of disease are the direct or indirect results of the diminution or cessation of the trophic nerve influence of an organ or group of organs. For example, as a result of overwork, lack of sleep, and improper food, the potential nervous energy of a given organism is greatly depleted; one of the first results of .this lack of energy is impaired circulation of the blood, which leads or predisposes to a chilling of the surface of the body, and a congestion and capillary stasis of the mucous membrane of the upper respiratory passages ; this is the first stage of the so-called " catching cold." The ever-present disease-producing bacteria, take advantage of the temporary absence of their hereditary foes, the leucocytes, or white corpuscles, which are the "protective police" of the bodily tissues, and which are prevented from reaching and destroying the bacteria by the stasis or congestion of the capillary blood-vessels in which they are confined, and the disease germs therefore rapidly multiply and produce poisonous toxins, which are absorbed into the tissues and produce grave disturbances in the already depleted nerve currents, thereby giving rise to various functional derangements. In a short time the trophic or vital nerve currents of the entire body are so greatly depleted that extreme prostration and even death may occur. The functions of digestion, assimilation and circulation, are seriously impaired and the source of supply is thereby cut off. The abnormal conditions resulting from the absorption of bac- terial poisons, sometimes involve the liberation in the nerves of powerful electrical vibrations of a different frequency from those to which the nerves are attuned, giving rise to serious functional manifestations. Thus the tetanus bacillus, when accidentally introduced into the blood stream through a wound, in the course of its multiplication, produces a toxin or poison, which, while extremely small in amount, and utterly insignificant from a purely chemical standpoint, possesses the power of liberating in the motor nerves, electrical vibrations of so powerful a nature as to give rise to terrific motor spasms; the muscles often being torn from their attachments by the intensity of their contractions. Still other forms of bacteria produce through 212 HIGH-FREQUENCY CURRENTS their toxins, interruptions or "short-circuiting" of the motor nerves, and paralysis results. It will be seen, therefore, that the majority of the phenomena of disease result from disturbances of the electrical equilibrium of the nervous system. The therapeutic use of drugs, which has been almost the sole resource of the medical profession in past years, involves the stimulation or suppression of different func- tions through the administration of medicines, and is so ob- viously empiric and unscientific, that the more progressive portion of the profession have grasped eagerly at every new method of healing in the hope of finding a more rational and satisfactory basis for the treatment of disease. The study of bacteriology has shown that the white corpuscles of a healthy body are capable of preventing, or limiting infectious disease, by the secretion of chemical substances, or so-called "Anti- toxins," which neutralize the poisonous products of the bacteria. When a patient recovers from an infectious disease, his restora- tion is due to the fact that the leucocytes of his blood have succeeded in forming sufficient antitoxin to neutralize the bacterial poisons ; and the disease germs, thus deprived of their principal offensive weapon, are picked up and devoured by the white blood cells, carried to the spleen, where their dead bodies are burned up, and excreted from the body. The antitoxins remain in .the blood for a considerable time and protect the patient from a second infection of the same nature. This so- called "Immunity," follows a mild attack and is as effectual as when produced by a severe infection. This forms the basis of our protective vaccination against smallpox. A more scientific application of the same principle is the antitoxin treatment for diphtheria and tetanus. The trend of modern thought in medical circles is along the lines of prophylaxis and hygiene ; that is, the study of methods for the prevention of disease and the preservation of health. We are beginning to realize the fact that the healthy organism contains within itself the elements which protect it from the encroachments of disease, and that even in cases where bacteria obtain access to such a system by the way of wounds or abrasion of the surface, their infection will be of a mild form, of short A REVIEW OF MODERN THERAPEUTIC METHODS 213 duration, and confined to a small area. Hygiene, consisting in careful attention to the laws of health, plenty of sleep, out-of- door exercise, wholesome food, bathing, etc., is now taught in all of our schools, while the large number of periodicals and magazine articles treating of various hygienic subjects, is in itself a striking evidence of the intense practical interest mani- fested by the masses in this most important evolutionary move- ment. Under the influence of public sanitation and personal hygiene, we may legitimately hope for the absolute suppression of all forms of infectious disease within a few generations. Meanwhile, however, the medical profession will be called upon to continue its present work of fighting acute and chronic mani- festations of disease in the individual, and it only remains for the physician to decide what particular method, or methods of treatment are in his opinion best suited for the purpose. The empiric use of drugs has constituted nine-tenths of the thera- peutics of the past century. The obviously unscientific character of such a system of treatment has long dissatisfied its followers. Attempts to formulate drug therapy into a science have met with but little success up to the present time. Hahnemann's Homeopathy, based upon the so-called "Law of Similars," has been heralded as the true solution of the above problem and a considerable fraction of the medical profession are followers of this system. A careful and conservative study, both from a clinical and theoretical standpoint has led the writer to the con- clusion that, while a limited number of powerful drugs act in accordance with a theoretical "Law of Similars," a much larger percentage of the various substances used as medicine absolutely refute Hahnemann's hypothesis; and unfortunately the nature of therapeutic drug action is not one which admits of solution by the present experimental methods of the scientific laboratory. The above conclusions regarding the reliability of the Homeo- pathic system apply equally well to the doctrine of "Specific Medication" as taught and applied by the so-called "Eclectic Practitioners." According to this hypothesis, for each and every disease to which the flesh is heir, Nature has conveniently and most accommodatingly provided a "specific" remedy, and it only remains for the physician to determine the particular 214 HIGH-FREQUENCY CURRENTS substances related to the different diseased conditions in order to obtain a complete and scientific system of therapeutics. The writer wishes it to be distinctly understood that he is neither condemning nor denying the curative possibilities of drugs; on the contrary, that valuable results may be obtained from remedies whether they be applied in accordance with the principles of homeopathy, eclecticism or empiricism is a truth which he has conclusively demonstrated in his own practice; but that individually or collectively these systems satisfactorily solve the problem of the treatment of disease, he most emphati- cally denies. The great objection to all these methods lies in the fact that they approach the problem of disease from the wrong stand- point. If the home of a Western pioneer be attacked by a band of hostile Indians, his first impulse would naturally be to seize his rifle and endeavor to kill the marauders ; experience, however, would have taught him the fallacy of such a course of action, and before beginning offensive operations he will do everything in his power to strengthen his defense. After barring the doors, closing his windows with heavy shutters, and placing his women and children in the cellar out of the way of stray bullets, he will then, and only then return the fire of his savage adversaries. The application of the above illustration is obvious; instead of endeavoring to kill the disease germs and to remove or suppress the symptoms produced by their toxins, by the administration of different drugs, we should use every means in our power to stimulate and assist the organism to call to its aid the different defensive and protective resources with which Nature has pro- vided it. Inasmuch as we know that the disease-producing agencies are as a rule readily overpowered and destroyed by the natural, vital and resistive forces which are present in the body of a perfectly healthy individual and which exist potentially even in weak organisms, the obviously ideal method of treating disease would be to infuse into the patient's organism artificial forces of the same physical nature as those which maintain health and destroy disease in the body of a person of normal health and vigor. This is all very true, theoretically, but is it possible in actual practice to generate and apply vitalizing A REVIEW OF MODERN THERAPEUTIC METHODS 215 forces of the above character? The ultra-conservative physician, whose practice consists of the empirical use of drugs along lines practically similar to those followed half a century ago, will reply unequivocally "No!" But the progressive practitioner of the "twentieth-century type," who is conversant with the development of Physical Therapeutics during the last decade, will answer as emphatically in the affirmative. It is not only theoretically possible to produce artificial forces similar to those which maintain health and vital activity in the normal human body, but we have produced, and are employing at the present day, therapeutic agencies, which, if not actual duplicates of the nerve vibrations through which Nature maintains health and functional activity, are at least sufficiently like these forces in that they increase vital resistance, reestablish depleted functions and assist in the elimination and suppression of disease-producing agencies. These forces comprise the Electrical Vibrations, known as "Alternating Currents of High and Low Frequency," and their etheric counterparts, namely, the various forms of Radiant Energy. CHAPTER XXI PHYSIOLOGICAL ACTION OF OSCILLATORY CURRENTS Before attempting a consideration of the effects produced by High-frequency Currents upon the functions and constitution of the bodily tissues, it may be well to briefly review the physi- ological and therapeutic action of the simpler forms of electrical energy, which have been employed in the treatment of disease. Under the latter head may be mentioned : (A) The Constant Galvanic Current. (B) Interrupted Galvanic Current. (C) The Slow Faradic Current of Low Voltage. (D) The Rapid High Tension Faradic Current. (E) The Sinusoidal Alternating Current. (F) General Electrification with the continuous High-potential Current from a Static Machine. (G) The Static Breeze. (H) The Static Brush or Spray. (/) The Static Spark. (J) The Static Induced Current. (K) The Static Wave Current. The galvanic current is continuous, of low potential and high amperage. It is obtained from a series of battery cells, or from a shunt from the Edison 110-volt Direct Current. The effects of its continuous passage through the body are mainly due to the chemical action of the products of the electrolytic dissociation of the salts dissolved in the tissues. Chlorin and other acid products are liberated at the positive electrode ; caustic soda and hydrogen gas forming at the negative pole. If the current be sufficiently strong, cauterization will be produced, a hard, red scar resulting from the action of the anode, while the tissues at the cathode are converted into a white soapy substance. The latter action is exemplified in the destruction of urethral stric- 216 PHYSIOLOGICAL ACTION OF OSCILLATORY CURRENTS 217 ture, superfluous hair, and small tumors by negative electrolysis. The physiological action of the galvanic current is sedative, hemostatic and germicidal near the anode; and stimulating, congestive and counter-irritant on the tissues in the vicinity of Fig. 152. — Apparatus for Generating Galvanic and Faradic Currents from Battery Cells or Edison 110 Volt "Direct" Circuit. the cathode. This current is also employed for the dissemination of various remedial agents through the tissues of the body. (Fig. 152.) The interrupted galvanic current and the slow low-tension Faradic current produce very similar effects upon the human organism, their action being mainly upon the muscles and motor 218 HIGH-FREQUENCY CURRENTS nerves. They are employed therapeutically as a substitute for massage, producing clonic contractions of the muscles; a form Fig. 153. — Diagram of Static Electrification. of "passive exercise" of value in cases of rheumatism, partial paralysis and muscular stiffness. The rapid High-tension Faradic Current, and the induced current obtained from small Leyden Jars connected to a static machine (D and J), are very similar in their effect upon the organism, and are employed for the relief of pain of nervous origin, such as neuralgia, sciatica, herpes zoster, etc. (Fig. 156.) Fig. 154. — "Static Breeze." (Diagram.) The sinusoidal current, by producing smooth wave-like con- tractions of the muscles, causes alternate influx, and expression PHYSIOLOGICAL ACTION OF OSCILLATORY CURRENTS 219 Fig. 155. — Diagram of Static Spark Treatment. of the blood in the tissues near the electrodes, thereby increasing local nutrition, oxidation and elimination. It has been more or less successfully em- ployed in the treatment of rheumatism and gout, and in the absorp- tion of exudates, effu- sions, etc. The general effects of static electricity are of a restful sedative char- acter, relieving insom- nia, headache, and reflex neuroses. The "breeze" and "brush" stimulate the peripheral nerves, increas- ing circulation and relieving superficial pain. (Fig. 154.) .The static spark produces profound contractions of the deep- seated muscles and is therefore of value in the treatment of rheumatic and paralytic affections, involving structures in the interior of the body which cannot be reached by the Faradic or interrupted galvanic currents. (Fig. 155.) The static wave current produces rhythmic contractions of a less pro- found, but more widely diffused character. It is of especial value in the relief of chronic inflamma- tory conditions. It is also used in the treatment of rheumatism, gout and spinal disease. (Fig. 157.) It will be noted that all of the above modalities produce effects of a stimulating character; in other words, they merely incite the different types of nerves to the liberation of vibratory energy, thereby depleting the vital resources, although temporarily increasing their activit}^. This effect may be compared to Fig. 156. — Diagram of Static Induced Current. 220 HIGH-FREQUENCY CURRENTS the action of a blast of air on the waning fire of a furnace. The intensity and energy of the combustion is temporarily increased, but at the expense of the already depleted fuel. It is easj' to put coal on the fire but it is not always easy to give back to the body the vital energy expended through the action of tonic and stimulant agencies. In sluggish or dormant conditions involving diminished cir- culation and accumulation of waste products, counter-irritant or stimulant applications will often re-establish functional activity and restore the healthy action of the body, providing the latter be well nourished and in possession of sufficient reserve energy to withstand the temporary overdraft on its resources. Fig. 157. — Diagram of Static Wave Current. Where the vitality has been already greatly depleted, however, as in the advanced stages of pulmonary tuberculosis, or in a patient just recovering from typhoid fever, the use of powerful stimulants, whether electrical or medicinal, would doubtless be attended with almost immediate fatal results. In these cases the chief resource of the physician has been to carefully husband the already depleted vitality, by rest and general relaxation, meanwhile endeavoring to recharge the body with potential energy by the aid of concentrated nutriments, given in a pre- digested form. High-frequency Currents, more especially those of the Tesla type, possess therapeutic powers which are not exhibited by any of the remedial agents known to the profession. In passing through the body of a person whose vitalitjr has been almost PHYSIOLOGICAL ACTION OF OSCILLATORY CURRENTS 221 exhausted through the encroachments of disease, these currents appear to promote circulation, increase metabolism, and more or less completely restore the general harmony between the different functions of the body, seemingly without the slightest expenditure of the scanty residue of vital energy stored up in the cells and tissues. In other words, we have in these cur- rents a means of increasing vitality without the necessity of digesting, assimilating and storing the nutritive material which ordinarily carries the potential energy which forms the single source of supply for organisms belonging to the animal kingdom. While a certain amount of nitrogenous material must be peri- odically assimilated for the repair of the worn-out cells and tissues of the human body, the larger portion of our food supply is simply a cumbersome and unscientific source of energy for the performance of the various bodily functions. Vegetables obtain their energy directly from the sun in the form of radiant heat and light, and it should therefore be quite possible for man to obtain his energy directly, provided a vibratory force could be obtained which would be capable of ready diffusion through the tissues and absorption by the nerve centers. To a certain extent, the Testa High-frequency Current possesses the above- mentioned requirement, and the next decade will probably witness the satisfactory demonstration of the ability of properly attuned electrical vibrations to take the place of the entire food supply with the exception of a small amount of proteid material for tissue repair. The physiological action of currents of high frequency is primarily exercised on the cellular chemical processes, increasing the vital combustion both in quantity and intensity, and facilitat- ing the elimination of waste products. There is an increase in vaso-motor activity and a slight rise in arterial tension; the oxidizing power of the blood is increased, a fact of great im- portance in the treatment of gouty conditions, inasmuch as it involves the conversion of the uric acid deposits into soluble urea. There is a peculiar inhibitory effect produced by High- frequency Currents upon the peripheral nerves. Local an- aesthesia may be produced in this way and the reaction of the superficial tissues to Galvanism and Faradism is sensibly dimin- 222 HIGH-FREQUENCY CURRENTS ished. The use of the High-frequency Arc for the cauterization of moles and warts involves a similar inhibitory effect which is shown by the fact that a discharge which at first causes pain soon renders the area practically anaesthetized. High-frequency Currents have been found capable of sterilizing cultures of pathogenic bacteria and of destroying the toxicity of their poisonous products. This fact explains their thera- peutic value in the local treatment of abscesses and septic ulcers by the effluve, and the successful treatment of pulmonary tuberculosis by the application of the d'Arsonval or Tesla Cur- rents through the methods of auto-conduction and auto-con- densation. Experiments on tubercular guinea pigs by Doctors Lagriffoul and Denoyes, have shown that an actual inflammation is produced upon the tubercular nodules by the High-frequency Currents, which are subsequently entirely freed from their bacilli by the phagocytic action of the leucocytes. Ever since the High-frequency Currents were first exploited for therapeutic purposes, great interest has been manifested in the peculiar immunity of the human organism to currents of this description even when their volume or amperage is several times the amount necessary to produce instant death if the frequency of the currents were low instead of high. One of the first explanations of this peculiar "paradox" was based upon the assumption that High-frequency Currents did not actually penetrate the body and were conducted entirely upon its sur- face. While this might be true in the case of the homogeneous metallic conductor, it has been demonstrated that these currents are really transmitted through all parts of the human organism, the latter being a complex structure whose tissues differ widely in their conductivity for electrical oscillations. The explanation suggested by d'Arsonval is more in accord with the facts deduced from clinical experience, than the hypothesis of surface con- ductivity above described. D'Arsonval attributes the destruc- tive effects of the Low-frequency Currents of High Amperage to the intense secondary oscillations which they excite in the different types of nerves. In the motor nerves, for example, a Low-frequency Current of one ampere would excite such intense vibrations as literally to tear the muscles from their PHYSIOLOGICAL ACTION OF OSCILLATORY CURRENTS 223 sockets. If not of sufficient amperage to destroy life or con- sciousness, the Low-frequency Currents produce intensely painful sensations through the secondary oscillations which they induce in the sensory nerves. Currents of high frequency, on the other hand, oscillate with such rapidity that no sensory or motor effects are produced, inasmuch as all electrical vibra- tions beyond 10,000 per second lie beyond the limits of the range of frequencies to which these nerves respond. While the theory of d'Arsonval satisfactorily explains the passage of High-frequency Currents of great volume through the human organism without injury to the latter, it is not in the writer's opinion the only reason for the immunity of the body. Careful investigation of the action of Low-frequency Currents in cases where death has been produced by their passage through the body have shown that in addition to the injuries resulting from the excessive vibrations induced in the various nerves, there is more or less serious destruction of the more delicate tissues, such as the axis cylinders of the nerves, which can be explained only by the resistance which these structures offer to the current and the mechanical disturbances resulting from the forcible overcoming of this resistance by the electronic streams. If a dam be built across the path of a river, the water will be held in check, and only a small amount will overflow. If the volume and force of the current be increased, and if certain portions of the dam be imperfectly constructed, the force of the stream will break down the resistance at the weak point, and in this way the entire dam may be destroyed. This homely analogy will illustrate the destruction of the nerve filaments, and the subsequent death of the entire body through the forcible passage of the streams of electrons which constitute a continuous or Low-frequency Current. In discussing the physical properties of High-frequency Currents, attention has been called to their freely flowing through non-conductors and bodies of high resistance; the absence of the usual interference phenomena having been explained by the fact that these "Currents" are in reality not currents at all, but transmitted electrical vibrations. The destructive interference phenomena, due to the passage of heavy currents through high resistance, are mere friction effects, 224 HIGH-FREQUENCY CURRENTS occasioned by the passage of matter through matter. The passage of a High-frequency Current, however, involves only the transmission of energy. A continuous or Low-frequency Current may be compared to a stream of air flowing through a tube, while the high frequency resembles sound waves trans- mitted through a similar tube. In the first instance, energy is transmitted in company with moving matter; in the latter the energy is transmitted by the vibration of stationary matter. Thin rubber diaphragms stretched across the pipe, in the first instance, would either stop the stream of air, or be ruptured and disintegrated by its forcible passage. Diaphragms of this kind would interfere scarcely, if at all, in the passage through the tube of energy in the form of sound waves. Let it be remembered, therefore, that High-frequency Currents are simply forms of vibration, and are consequently transmitted by any elastic medium, irrespective of its electrical conductivity. It is this fact which explains the immunity of the human body to the passage of High-frequency Currents of great volume. The use of High-frequency Currents for therapeutic purposes, produces remarkable curative effects, many of which can be satisfactorily explained only by the assumption that we have in these currents a rough counterfeit or substitute for the peculiar nutritive flux transmitted through the nerves to all tissues of the body to which we give the name " Trophic Influence." It is this trophic power which enables the cells to absorb their quota of nutriment from the blood, to maintain their vital resistance, and to perform their various functions. The exact manner in which the High-frequency Currents replace or regenerate the trophic influence, has not been definitely determined. That they really act in the above manner will be evident from a consideration of some of the cases cited in the chapters on "Special Therapeutics." The increase in the trophic and secretory nerve forces produced by the passage of High-fre- quency Currents is very much more intense in connection with the High-tension Currents from a Tesla Coil, than with the Low-tension Currents of aV Arsonval. The Tesla Currents also exert a more powerful action on the vaso-motor system and are therefore of the utmost value in the relief of passive con- PHYSIOLOGICAL ACTION OF OSCILLATORY CURRENTS 225 gestion, whether occurring as a result of the depletion of the forces of the sympathetic nervous system, as a symptom of organic renal or cardiac disease, or in the initial stages of the acute infectious fevers. The secretory functions of the body, involving the action of the various glandular structures in the elaboration of the differ- ent digestive ferments, etc., are strongly stimulated by the action of the currents from a Tesla Coil. In cases of nervous dyspepsia, for example, where gastric digestion is absolutely suspended, owing to the lack of the sympathetic nerve currents, which in the healthy organism, incite the glands of the gastric mucosa, to the secretion of hydrochloric acid and pepsin, the application of the Tesla Current seems to temporarily restore or replace the lacking nerve force, inasmuch as the secretion of the gastric juice almost invariably follows the direct High- frequency Treatment of the sympathetic nerve centers. In addition to the general vitalizing, invigorating, and har- monizing effect produced by the passage of the Tesla Currents through the human body, there are a number of local effects peculiar to the different methods employed in the application of the current to the affected areas. The differences in the physiological action of the various methods of treatment depend primarily upon the nature of the discharge and the peculiarities in the form, material and construction of the active electrode. As a consideration of the distinctive physiological action of the various methods for the local application of High-frequency Currents involves the discussion of the different pathological conditions amenable to treatment by the respective modalities, the writer has included both of the above subjects in the ensuing chapter on the "Therapeutic Effects of High-frequency Cur- rents." CHAPTER XXII THE THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS In studying the therapeutic action of oscillatory currents of high frequency, the modalities or methods of application may be considered in the following order : (A) Currents of relatively Low Voltage and High Amperage. Methods of production: (a) D'Arsonval Solenoid. (&) Primary Tesla Coil. (c) " Thermo-Faradic " Coil. Methods of Application: (I) Direct Treatment. (a) "Stabile" with Stationary Electrodes. (b) "Labile" with Movable Electrode. (II) Indirect Treatment. (a) Auto-Conduction with d'Arsonval "Cage." (b) Auto-Condensation with Condenser Couch. (c) Combined Treatment with the Piffard Condenser Spiral. (B) Currents of Very High Potential with Relatively Low Amperage. Methods of Production: (a) Oudin Resonator with Ruhmkorff Coil. (b) Tesla-Thomson Coil with Alternating Transformer. (c) The Piffard " Hyperstatic " with Holtz Machine. Methods of Application: (I) Monopolar Treatment, including: (a) Direct / (I) Effluve. Application \ (II) Pseudo-Static Spark, by < (III) Arc (High-frequency means / Cautery) . of \ (IV) Vacuum Electrodes. 226 THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 227 (6) Indirect Application of the same Modalities. (II) Bipolar Treatment including: (a) Tesla Emuve. (b) Tesla Spark. (c) Tesla Vacuum Treatment. (d) Double Vacuum Treatment. (e) Double Emuve Treatment. (/) Tesla Auto-Condensation with Couch. (g) Tesla Auto-Condensation with Vacuum Condenser Chair. (III) Multi-frequency Methods including : (a) "High-frequency Wave Current" by Effluve Inter- ruption. (6) "Motor Impulse Current" with Spark Interruption. (c) " Pseudo-Faradic Current" with short Arc Inter- ruption. (IV) Condenser Effluve or Piffard "Trans-Resonator Cur- rent." (A) D'Arsonval Currents The Low-potential High-frequency Currents of large volume are similar in therapeutic effects, and methods of application, whether obtained from a solenoid, primary Tesla or "Heat Coil." Their physiological action is exerted mainly upon the cellular functions and the chemical processes of the body, increasing tissue combustion, promoting osmosis, and stimulating metabolism and elimination. For this reason the d'Arsonval Currents find their principal field of usefulness in the treatment of chronic and constitutional diseases, involving derangements of nutrition, metabolism and cell growth, such as diabetes, rheumatism, gout and obesity. They are also of value in the local treatment of diseases involving progressive wasting of certain tissues or organs, such as tuberculosis, chronic bronchitis and muscular atrophy. In the first class of conditions the treatment is best adminis- tered by the indirect methods, with the cage or condenser couch. Practically the same results are produced in both methods, but it is sometimes advantageous to substitute couch treatment for 228 HIGH-FREQUENCY CURRENTS that of the cage, or vice versa, in cases where the modality first employed does not produce the desired effect. (Fig. 158.) For general diseases with local manifestations, such as rheu- matism, and gout, direct treatment should be employed with stabile application, with a large sponge-covered pad over the solar plexus, a vessel of warm salt water in which the feet are •& bq° °o- ^_^-*- ) r ) c > ( , ; ) cr " . ( v ) s. ( S \, Fig. 158. — D'Arsonval Auto-conduction Cage Operated from the Author's "Hercules" Coil." immersed forming the opposite electrode. The labile method involves the use of a stationary electrode usually consisting of a sponge-covered metal pad which should be wet with a salt solution, and placed over the spine or solar plexus, and a movable electrode consisting of a small sponge-covered disk fixed in the end of an insulating handle. (Fig. 159.) These electrodes are connec- > Fig. 159.- S, Solenoid. P, -Diagram of "Labile" Method for Solenoid Currents. Patient. E, E. Sponge-covered Electrodes, to be Kept Moving During Treatment. ted to the respective poles of the solenoid, and the small disk is moved slowly over the affected area during the entire treatment. From one to five hundred milliamperes maybe administered in the above manner, while if the small electrode was allowed to remain stationary, not over two hundred milliamperes could be adminis- tered without inflaming or blistering the skin. (Fig. 160.) This THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 229 does not apply in the case of large electrodes as described in connection with the stabile method. In addition to the general effect on metabolism, the labile method as above applied, produced local counter-irritant effects, and has given good results in relieving congestion and stasis, in sub-acute bronchitis and allied conditions. It is also useful in relieving pain in cases of sciatica, tic-doloreux and traumatic neuritis. Whether ap- plied directly or indirectly, a milliampere meter should always be placed in series with the patient in the solenoid circuit. With the condenser couch or Piffard Chair (see Fig. 114) the meter should be connected in series with the terminal to which the metal hand electrodes are attached. In the labile method, the meter should be on the same side of the circuit as the stationary sponge-covered pad. Fig. 160. — Sponge-covered Electrodes for "Labile D'Arsonvalization." For general hospital use the horizontal cage and condenser couch are best adapted, while for office treatment the Piffard Chair with special condenser cushion, or the Piffard Combined Spiral and Solenoid, will prove equally effective, and decidedly more convenient. (See Figs. 109 and 110.) (B) Currents of Very High Potential with Relatively Low Amperage The High-voltage Currents obtained from a resonator or Tesla-Thomson Coil differ from the d'Arsonval Currents in that they produce less marked effects upon the chemical processes of the cells, while more intensely stimulating the nerves of the sympathetic and vaso-motor systems, and exerting a peculiarly characteristic action on vital resistance and trophic influence. Among the European practitioners these High-potential High-frequency Currents are employed mainly in the treatment 230 HIGH-FREQUENCY CURRENTS of local conditions, being derived as a rule from an Oudin Res- onator. As the resonator currents are monopolar, they are obviously unsuited for the treatment of conditions of a diffused or general character. In America, on the other hand, High-potential High-frequency Currents are generally of a bipolar nature, and are employed in accordance with the technic originated by the author, using an apparatus of the Tesla-Thomson Type excited Fig. 161. — Piffard's Small Spiral with Condensers; for Use with Ruhmkorff Coil. by an alternating current transformer, or from a Piffard Hyper- Static Coil attached to a Holtz Machine or Ruhmkorff Coil. Owing to their bipolar origin, the Tesla Currents may be used as carriers for vibrations or waves of lower frequency. The appli- cation of this principle, as exemplified by the writer's Multi- frequency Modalities, has opened an entirely new field for the development of electro-therapeutics, and has greatly broadened and enlarged the range of usefulness of the currents of high frequency and high potential. No. 1. — Monopolar Treatment Direct local application of High-potential High-frequency Currents is administered b}' means of various types of electrodes, attached to the terminal of an Oudin Resonator or Tesla Coil. THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 231 The most familiar type of resonator treatment is the so-called effluve, consisting of a purple brush discharge of from one to twelve inches in length, obtained by the use of single or multiple metal point electrodes. (See Fig. 115.) The length of the effluve is determined by the number of turns in the solenoid, the length of the spark-gap and the strength of the exciting current. The effluve produces a sensation of warmth upon the skin to which is added a feeling as if a succession of miniature hailstones were falling upon the surface. If the distance between the electrode and the body be dimin- ished to the point where the discharge shows a tendency to change from the effluve to the spark, an almost painful sensation is produced from the bombardment of the skin by the rapidly moving ions. Continued application of the latter description produces redness, congestion and even blistering if the treatment be unduly prolonged. As a rule the effluve should not be given with the electrode at the above minimum distance, the latter being employed only in the treatment of indolent ulcers, and where it is desired to produce artificial inflammation as in psoriasis, chronic eczema, etc. In the usual effluve treatment, the electrode is held just near enough to cause an agreeable tactile sensation on the part of the patient. The effluve produces a threefold effect upon the tissues of the body, the first being due to the action of the electrical oscillations transmitted through the air-gap, and radiating through the tissues near the treated area. These oscillations relieve conges- tion, stimulate nutrition, and increase the activity of the vaso- motor system and trophic nerves. The second effect of the effluve results from the ionic bombardment of the treated surface and is of a stimulating counter-irritant nature. The third effect is due to the ozone and nitric oxides liberated by the effluve and driven by it into the superficial tissues ; the germicidal action of the effluve on septic ulcers, pyogenic infection and parasitic skin diseases is no doubt largely due to the production and diffusion of the above gases. In addition to these effects, there are other distinctive results of effluve treatment, which will require further investigation for the determination of their exact nature and 232 HIGH-FREQUENCY CURRENTS therapeutic value; they are produced by the action of the secondary ether vibrations resulting from the oscillatory dis- charge, which probably include rays in the blue, violet and ultra- violet together with heat waves and Hertzian radiations of different periodicities. The "Resonator Efnuve" is of value in the treatment of a large variety of local affections, particularly those of a septic or inflammatory type, and has given excellent results when com- bined with d'Arsonval treatment in cases of general diseases with local manifestations, especially pulmonary tuberculosis. The " Pseudo-Static Spark" and the method for its production and application have been described in a previous chapter. It is of comparatively little value when derived from the single terminal of a resonator, but may be used with good results over the spine as a substitute for the actual cautery, in the treatment of chronic ulcers with exuberant granulations and for the relief of pain in obstinate neuralgic conditions where other methods of application have failed. The "Direct Arc" from a resonator or Tesla Terminal was first employed for cautery purposes by the present writer in the removal of small superficial tumors, and as a substitute for incision in cases of carbuncle, and acute superficial abscesses. After the first few seconds, but little pain is experienced, owing to the anaesthesia produced by the discharge through inhibition of the sensory nerve currents. Virulent septic foci have been successfully sterilized and the toxins destroyed in a number of cases treated by the writer by the use of the High-frequency Arc. It is only fair to state, however, that in the majority of the above cases, an indirect arc from a Tesla Coil was employed, and it may be questioned whether the same results would have been produced if the direct arc from a resonator had been used. Direct application of the resonator discharge by means of glass electrodes, containing rarefied gases or some other con- ducting substances, produces a series of effects quite different from those obtained from the modalities above described. When the glass surface of the electrode is in direct contact with the skin, the discharge passes to the latter in an even regular manner, concentrating the oscillatory effect on the tissues immediately THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 233 under- the electrode, without producing the surface irritation which results from the bombardment of the effluve and spark. The vitalizing effect of the current on the tissues near the glass electrode is even more intense than with the effluve, as is also the action on the trophic and vaso-motor nerves, but the stimula- tion and counter-irritation resulting from effluve treatment is almost entirely lacking when glass electrodes are used. This applies more especially to electrodes of the Low Red-vacuum type. Electrodes of the latter class are more generally used in the application of High-frequency Currents than either the effluve or those which involve the use of a solid conductor sur- rounded by an insulating covering of glass or hard rubber. The last-named variety possesses no advantages over low vacuum electrodes except in cases where special stimulation of mucous cavities is desired. Even in these cases the vacu- um electrode may be /J made to produce identi- cal results by simply covering it with one or more layers of cloth or chamois leather. (Fig. Fig. 162.— Vacuum Electrode Covered with 1/2 r> s. Chamois Skin. When applied directly to the skin or mucous membrane, vacuum electrodes produce practically no sensory effect other than a slight warmth. In addition to their trophic and vaso- motor effects, they exert a sedative action upon superficial tissues which renders them of value in the relief of acute conges- tion and local inflammation. They tend to break up areas of infection by relieving stasis, promoting phagocytosis, and dis- persing exudates. Swelling and effusions of traumatic origin are promptly relieved and ecchymosis prevented by immediate application of the Red-vacuum electrode. Acute coryza, tonsilitis, acute urethritis, and cervical adenitis, all yield readily to this variety of treatment provided the electrode is employed in the incipient congestive stage, and before the tissues have become infiltrated with small round cells and leucocytes. 234 HIGH-FREQUENCY CURRENTS In more advanced stages of the above diseases, as well as in other sub-acute inflammations involving mucous cavities, elec- trodes of the "White-vacuum" type, exhausted to less than one ten-thousandth of an atmosphere, will probably produce satisfactory results. The difference between the White- and Red-vacuum electrodes, so far as their therapeutic action is concerned, depends upon the difference in frequency and wave-length between the secondary oscillations and waves of radiant energy produced by the electri- cal vibrations in their respective vacua. With the White- Fig. 163. — Ultra-violet Vacuum Lamp with Quartz Lens. vacuum electrode a considerable portion of the secondary radia- tions consist of light waves in the blue violet and low ultra-violet. (Fig. 163.) The high ultra-violet rays which are produced in the tube are absorbed by its glass walls, but by means of a device originated by the writer, these ultra-violet rays may be added to the thera- peutically active. emanations from the electrode. This is accom- plished by means of a quartz plate hermetically sealed in the end of the glass electrode, behind which is placed a disk of aluminum which is connected to the resonator terminal. By the intro- duction of mercury vapor into a tube of the above type, the ultra-violet rays may be greatly increased in intensity. Owing THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 235 to the difficulty and expense attending their construction, these electrodes have not been generally employed, but the writer has obtained excellent results from their use in the treatment of acne, eczema, sycosis and epithelioma. The use of vacuum electrodes of the customary construction and form, but exhausted to an X-Ray vacuum instead of the usual "Low Red" has been already referred to in a previous chapter. Electrodes of this type were first introduced by the writer for the treatment of malignant diseases of the skin, and mucous membrane, and have given excellent results not only in these conditions but in the treatment of chronic inflammatory affections of an indolent and atrophic type, which proved Fig. 164. — "Indirect Vacuum Treatment:" E, Resonator, or Tesla Coil Terminal. refractory to treatment by means of electrodes of the White- vacuum type. The term "Indirect Treatment" is applied to those methods of administering the discharge from an Oudin Resonator, in which the patient is directly connected to the latter by means of a metal electrode, and the current localized or drawn out of the body by means of an electrode connected with the ground or the body of the operator. (Fig. 164.) Although frequently employed with the conventional Oudin Resonator discharge, treatment by indirect application is of much greater efficiency both constitutionally and locally, when given by means of a modern Tesla Apparatus. The writer's "Ajax" Machine is especially adapted for this purpose. The effluve from a metal point electrode is seldom used in- directly; but the arc, spark and vacuum treatment are fre- quently employed in this manner. Indirect methods have the 236 HIGH-FREQUENCY CURRENTS advantage over the simpler direct application, in that the entire organism is subjected to a vibratory bath by the electric oscilla- tions while the local effects penetrate more deeply. The sec- ondary local action is less intense, however, unless the current be derived from a Tesla Coil instead of a resonator. With the former apparatus almost as powerful discharges may be obtained after the current has passed through the patient's body as those resulting from the direct application of an Oudin Resonator Current. The indirect spark produces a perceptible effect upon the motor nerves somewhat similar to that of the static spark, although the resemblance is less marked than when the bipolar or Tesla Technic is employed. It is of value in the local treat- ment of muscular and articular rheumatism, gout, neuralgia, etc. The indirect arc was employed by the writer in his first experi- ments in the use of the High-frequency Discharge for cautery purposes. The technic for its application has already been given. The direct use of the resonator arc for the same purpose as subsequently suggested by Oudin, does not seem to produce equally satisfactory results. This is probably due to the fact that the Tesla Current consists of a series of almost uninterrupted oscillations, and consequently produces more intense heating effects than the arc from the resonator. Freund enumerates a series of effects produced by the High- frequency Arc and Spark on various forms of bacteria, and areas of infection artificially produced in rabbits and guinea pigs. He gives detailed accounts of these and other experiments, which show the bactericidal and destructive effects of High-potential Discharges. As much of the evidence adduced was derived from experiments with discharges of low frequency, the writer has deemed it unnecessary to incorporate a detailed review of the above researches in the present volume. It may be remarked in passing that the skeptical attitude exhibited by Freund toward the therapeutic possibilities of High-frequency Currents is similar to that of a number of physicians, both abroad and in this country, who have taken up the study of electro-therapeutics as a result of special research and practical application of the X-Ray. Just why the Roentgen THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 237 specialist should adopt a skeptical attitude not only toward electro-therapeutics, but toward the electro-therapeutist as well, is a difficult question to answer. It is a generally accepted fact, however, and may perhaps explain the ultra-conservatism of certain well-known authorities in discussing the therapeutic possibilities of electricity. The indirect arc may be substituted for the actual cautery except in the destruction of inaccessible growths such as polypi in the nasal or uterine cavities. Indirect application of the Testa Current by means of vacuum electrodes, has been employed by the writer in the great majority of the cases in his clinics and office practice during the past ten years. He believes this method to be the most satisfactory form of High-frequency Treatment, inasmuch as it admits of the simultaneous production of vitalizing and curative effects upon a local lesion and the general system. The usual technic involves the connection of the patient to a Tesla Terminal and the application of the vacuum electrode held directly in the operator's hand, or fixed in an insulating handle connected to the ground through a steam or water pipe. In the case of patients of a highly susceptible nature who object to the slightest stimulation, the constitutional effects of the maximum current of the machine may be obtained with a minimum of local stimulation by the following modifica- tion in technic. A vacuum electrode in an insulated handle is applied to the affected area and instead of a direct ground con- nection with the electrode, a second vacuum tube is employed. The latter is held in the left hand of the operator, and after the current is turned on, the second tube is brought within sparking distance of the glass surface of the active electrode, near the point of its attachment to the insulated handle. By varying the distance between the two electrodes or by moving the tube in the left hand nearer to the part of the insulated electrode which is in contact with the body, the strength of the current may be regulated. The second electrode together with the spark-gap between the glass surfaces forms a sort of rheostat, regulating and limiting the local discharge of the current. By this method the mildest possible vacuum electrode treatment may be given, as, for example, in cases of eye trouble or in the treatment of 238 HIGH-FREQUENCY CURRENTS an acutely inflamed ear drum. This method is also of value in the treatment of an extremely nervous patient. No. 2. — Bipolar Application or Testa Technic For bipolar application, a Tesla Apparatus of the type intro- duced by the writer, having the triple terminals already described will be required. Apparatus of the same character but of different make may be used with the addition of a set of the above terminals. The following methods of application involve the production of secondary waves of relatively low frequency, superimposed, upon the rapidly oscillating Tesla Current. These Low-frequency Effects are, however, comparatively weak and do not properly belong to the group of modalities which the writer has termed " Multi-frequency Currents." The administration of the Tesla Effluve involves the direct connection of the patient to one terminal by a metal electrode held in the hand, or preferably, applied over the solar plexus, the opposite terminal of the coil being connected to a metal point or brush electrode from which the effluve is applied in the usual manner. A peculiarity of the Tesla Effluve is the wave-like sensory and motor effect obtained in the tissues near the metal electrode by successively lessening and increasing the distance between the metal points and the patient's body. Application of the latter procedure in the treatment of functional and organic disease of the nervous system, such as tabes, lateral sclerosis, progressive muscular atrophy, spinal irritation and general nervous exhaus- tion, has yielded excellent results in the writer's clinical practice. The stationary electrode should be in the form of a fairly large plate of block tin applied to the surface of the body over the solar plexus. It should be carefully adjusted so that its upper margin is separated by a distance of at least one inch from the surface immediately over the cardiac apex. The effluve electrode should be moved up and down the spine, its central point fol- lowing a spiral path as indicated in the diagram shown in Fig. 165. By reversing the position of the electrodes, and applying the effluve in a spiral path over the ascending, transverse, and descending colon, excellent results mav be obtained in the THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 239 treatment of chronic constipation, hepatic torpor and general intestinal atony. By substituting an electrode ending in a small metal ball or point for the multiple point or wire brush used with the effluve, the "Pseudo-Static," or "Tesla Spark" may be obtained. The apparatus should be adjusted to give a rather weak current, and the spark-gap should be as wide as possible without disturbing the continuity of the discharge. The spark may be directed upon the surface of the body ; may be given through the clothing ; or may be applied to disks of tin-foil placed upon the skin over the motor points. Contractions of the muscles will be produced by the last-named method, both at the point to which the spark S^<3=I EE Fig. 165. — Rhythmic Effluve Treatment for General Stimulation. T. E., Block-tin Electrode. is applied and in the tissues near the metal electrode. (It is, of course, understood that the latter electrode should be connected to the Tesla Terminal as for the application of the effluve.) The Tesla Spark combines the general effect of the Tesla Currents with a stimulating action upon the nerves and muscles, resulting from the super-imposed Low-frequency Wave. When employed with the tin-foil disks, the Tesla Spark is practically identical with the writer's "Motor Impulse Current" described in Sec- tion III. The conditions in which the Tesla Spark produces the most satisfactory results are mainly those affecting the motor nerves and muscles. They will be considered individually in the ensuing chapters. (Fig. 166.) The writer's method for the application of Tesla Currents by 240 HIGH-FREQUENCY CURRENTS means of vacuum electrodes may be carried out in two ways. 1st, by direct connection of the patient to the Tesla Terminals by a metal electrode on the one side and a vacuum electrode on the other. 2d, by connecting the vacuum electrode to the No. I H*3 o Fig. 166. — "Motor Impulse" Treatment. dummy terminal, and adjusting the intensity of the local effect by varying the length of the effluve between the two brass disks (see Fig. 167). The first modification produces such intense action near the vacuum electrode as to cause the latter Fig. 167. — The Author's Technic for Vacuum Electrodes. to grow extremely hot. For this reason the treatment must be given intermittently and for not more than one minute at a time. No effect is produced upon the motor nerves by this method, nor does it appreciably increase arterial tension. It may there- THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 241 fore be used for the relief of dropsical effusions occurring in organic or kidney disease, and in the later stages of pulmonary tuberculosis. Where the electrode is connected to the dummy, in series with the variable effluve, there is more or less of the "wave effect" produced, and this technic is therefore contra- indicated in organic heart disease, as it increases the rapidity of the pulse, and lessens the inhibitory action of the pneumogastric nerve. For the same reason this method is indicated in the treatment of diseases involving poor circulation, functional anaemia, insomnia, and dyspepsia due to depleted nerve force. For intense local action the double vacuum electrode treatment may be employed, as for example, in pulmonary tuberculosis when Fig. 168. — The Author's Treatment for Diseases of the Uterus. X, Uterine Electrode Pumped to an "X-Ray Vacuum." V, "Low Red" Vacuum Condenser Electrode Applied to Supra-pubic Region. we wish to concentrate the entire effect of the current upon the diseased lung tissues. (See Fig. 169.) An example of this technic has been described in connection with the writer's apparatus for the combined treatment of thoracic disease by the Testa Current and ozonized oxygen. The double vacuum method is also of value in the treatment of affections of the mucous cavities; for example, the writer's latest method for the treatment of cancer of the uterus involves the use of an internal vacuum electrode exhausted to an X-Ray Vacuum, connected to one Tesla Termi- nal and a bulb-shaped electrode of the vacuum condenser type applied to the surface of the body just above the pubes; the latter electrode is exhausted to a Low Red-vacuum and is con- nected to the opposite terminal of the Tesla Coil. (See Fig. 168.) 242 HIGH-FREQUENCY CURRENTS The double effluve treatment may be given in a similar manner substituting the appropriate metal points for the vacuum elec- trodes in the above technic. (Fig. 170.) In Europe the double effluve has been produced by means of two resonators connected in series as shown in Fig. 171. The effect is similar to that of the single effluve except for the greater intensity of action. A variation of the Tesla Effluve, Spark, and Vacuum Treat- Fig. 169. — Double Vacuum Treatment. ment, is obtained by connecting one Tesla Terminal to a con- denser couch or Piffard Cushion. By this method the Multi- frequency Effect obtained by the use of the metal electrode is entirely suppressed. The same method may be employed in the use of a Friedlander Vacuum Chair and is of great value in a variety of conditions more especially in skin diseases covering t=i Fig. 170. — Double Effluvation from the Author's Apparatus. large areas. The clothing should be removed from the affected part of the body during the treatment. (Fig. 172.) No. 3. — -Multi-frequency Modalities As previously stated it is possible to superimpose waves of almost any form or frequency upon the oscillatory current from a Tesla Coil. In this manner it is possible to duplicate the THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 243 characteristics and physiological effects of the interrupted galvanic, rapid faradic, sinusoidal and static wave currents. The writer has under investigation a considerable number of Multi-frequency Effects, many of which differ from any of the « 0 s H interrupted or alternating currents hitherto employed in the treatment of disease. In the present volume he has described only the Multi-frequency Modalities which can be readily pro- duced by any one who possesses a modern Tesla Apparatus and 244 HIGH-FREQUENCY CURRENTS which have proven their therapeutic value through actual clinical application in the writer's practice. The first of the Multi-frequency Modalities is the writer's "High-frequency Wave Current," which is produced by the interposition of an effluve between brass disks in series with the patient, who is connected by metal electrodes to the terminals of a Testa Coil. Before proceeding to the further discussion of this method, it may be well to caution the operator in regard to the use of the milliampere meter for the measurement of the intensity of Multi-frequency Currents. As the superimposed waves periodically interrupt or diminish the oscillatory stream to a degree corresponding to their own intensity, it follows that Fig. 172.— The Author's "Condenser Effluve" Treatment. the greater the prominence of the effects from the superimposed waves, the lower will be the volume or amperage of the High- frequency Current. For example, in the above wave current, with the patient connected with a metal hand electrode to Terminal (B) of the Tesla Coil, with a milliampere meter inter- posed, a metal electrode in the patient's other hand, being con- nected with the dummy, a High-frequency Current of the maximum amperage will pass to the patient so long as the brass disks are widely separated; but if the sliding rod in Terminal "A" be pushed in until an effluve appears between the disks, the patient, although experiencing a much stronger sensation, will be shown by the meter to be receiving a much smaller quantity of electrical energy. The only reliable factors for the measurement of a Multi-frequency Current are therefore the THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 245 length and nature of the air-gap, and the strength of the current employed to excite the step-up transformer of the High-frequency Apparatus. The wave current above described feels to the patient like an irregular Faradic effect, its therapeutic action, however, is quite different from either the Faradic or static induced. It is a profound stimulant to circulation, elimination and secretion, and is often administered by the writer for from one to three minutes at the termination of treatments by other High-frequency Modalities. An approximate idea of the real nature of the High-frequency Wave Current is given graphically in Fig. 173. The ''Motor Impulse Current," is the writer's term for the Multi-frequency modality obtained by the interposition of a pseudo-static spark in series with a patient connected to a Tesla Coil by two metallic electrodes. This method has been discussed in the preceding section, in connection with the Tesla J3 Fig. 173. — Tracing Giving a Conventional Idea of the Nature of the Author's High-frequency Wave Current. Spark Treatment. It may also be administered by separating the disks and balls in the writer's triple terminals, connecting the patient by metal electrodes to terminal (A), and to the dummy, and then gradually pushing in the rod in Terminal (B), until intermittent sparks pass between the small balls. The intense local action of this current on the motor nerves and muscles renders it of value in the treatment of partial paralysis, chronic muscular rheumatism, etc. It is graphically represented in Fig. 174. The " Pseudo-Faradic Current," obtained by the interposition of an extremely short spark-gap in the circuit of a patient con- nected to the Tesla Terminals by metallic electrodes, is physically the direct antithesis of the "Motor Impulse Current" above described. The latter consists of oscillations of great amplitude, periodically interrupted by groups of short oscillations, while 246 HIGH-FREQUENCY CURRENTS the Pseudo-Faradic consists mainly of short oscillations periodi- cally interspersed with those of much greater amplitude. (See Fig. 175.) The Pseudo-Faradic is employed in practically the same man- Fig. 174. — Graphic Tracing Giving Theoretical Idea of the Author's Motor Impulse Current. ner as a genuine Faradic or static induced current, but it possesses many advantages over the latter modalities owing to the High- AD- Fig. 175. — Graphic Tracing Giving Theoretical Idea of " Pseudo-f aradic Current. frequency oscillations which carry its motor waves. It is used as a substitute for massage, as an aid in the absorption of exud- ates resulting from fractures or sprains, and in the relief of acute rheumatism, and neuralgic pain. THERAPEUTIC ACTION OF HIGH-FREQUENCY CURRENTS 247 No. 4. — Hyper static Technic The Piffard Hyperstatic Transformer produces from its sec- ondary coil a current of very high frequency and voltage, but possessing too low an amperage to admit of its use with the same technic as that employed in connection with a Tesla Apparatus of the alternating type. AVhile it produces some effect on the general vitality, the principal value of the hyperstatic cur- rent is in the local treatment of diseases of the skin. While mild effects may be obtained by the direct application of the current from one pole of the hyperstatic (see Resona- tor Technic), the most effi- cient method of employing this apparatus is by the use of the Tesla Technic; the vacu- um or metal point electrode being attached to one termin- al, while the second terminal is connected to a metal-hand electrode, or to a metal plate which is placed upon the floor and upon which the patient stands in his stocking feet. The intensity of the Hyperstatic Current is insufficient for the pro- duction of an effluve by the usual method. For the produc- tion of this modality, a method has been devised by Piffard, Fig. 176.— Piffard's Technic for his "Trans-resonator Effluve." Fig. 177. — Piffard's Electrode for Obtaining his "Trans-resonator Effluve." which he terms the "Trans-Resonator Technic." (Fig. 176.) The patient stands upon a metal plate, as above described, the opposite pole of the hyperstatic being connected to an electrode represented in Fig. 177, which consists of a small coil or resonator terminating in a hollow metal cup with its upper edges turned in. From the interior of this cup, an effluve discharge is produced 248 HIGH-FREQUENCY CURRENTS nearly a foot in length and fully as brilliant as that produced by an Oudin Resonator, although not possessing the density and fineness of the eftluve from a modern Tesla Apparatus when employed with the condenser technic described in the preceding section. There are many minor methods for the application of High- potential High-frequency Currents, but they offer no advantage over those above described. The indirect treatment in which the current from the resonator or Tesla Terminal passes through a metal electrode into the patient's body, from which it is with- drawn through the hands of the operator, applied as in an ordinary massage treatment, seems to possess certain unique possibilities, but, inasmuch as several physicians report injurious effects by the use of this method, no definite conclusion as to its real value can be deduced at the present time. CHAPTER XXIII HIGH-FREQUENCY CURRENTS IN THE TREATMENT OF DISEASES OF NUTRITION The growth and functional activity of the body depend upon the assimilation and distribution of the energy-producing organic compounds taken in in the form of food. Foods are of three classes: First, the Proteid, or Nitrogenous materials, such as albumin, peptone, casein, and gluten, which are the "Tissue Builders," strengthening broken-down cells and replacing the minute portions of the body which are being worn away and destroyed in the course of normal functional activity. Second, the Fatty substances and Carbohydrates (the latter including starches and sugars) which furnish the body with energy, and are burned up in the cells as fuel in a furnace, the products of their combustion being water and carbon dioxide ; and third and lastly, the Inorganic Salts (the principal representative of this class being sodium chloride), which, though small in amount, are of extreme importance in maintaining the osmotic equilibrium and the electrical conductivity of the tissues and fluids of the body. In addition to these substances, the organism requires a constant supply of water, which is the common carrier and general solvent of the body, and a still more continuous supply of oxygen for the support of the combustion in the cells and tissues. The nutrition of the body therefore, is maintained through the digestive system, which breaks up and prepares the food for use, the assimilative and distributive system, including the absorbent, lymphatic and circulatory apparatus; the oxygenating system, including the respiratory functions of the lungs and the distributory action of the red blood corpuscles; the metabolizing structures, including the muscles and cellular tissues, in which the stored-up energy of the food and oxygen is liberated ; and finally, the excretory system, comprising the sweat 249 250 HIGH-FREQUENCY CURRENTS glands, kidneys and the venous blood, which collects and dis- charges from the body the waste products of combustion and vital activity. The disorders of nutrition may therefore be classified under the following heads : (A) Diseases of the Digestive System. (B) Diseases of the Blood and Heart. (C) Diseases of the Lungs. (D) Diseases involving Deranged Metabolism. (E) Diseases of the Kidneys. A. — Diseases of the Digestive System Gastric indigestion or dyspepsia may result from depleted nerve force, from catarrh of the stomach, from gout, and as a secondary sjmiptom in a large number of acute and chronic diseases. When of nervous origin it is best treated by direct application of a low vacuum condenser electrode over the solar plexus; the Tesla Technic with a block tin electrode over the dorsal spine, being the best method for the transmission of the current. Many cases of atonic dyspepsia of nervous origin attended with dilatation and loss of sleep, are frequently met with, and are usually promptly relieved by High-frequency Treatment. The writer has treated a number of cases of this description with excellent results. In several cases test meals of the " Ewald- Boas" type, consisting of a soft-boiled egg, roll and a cup of tea, were given prior to treatment and the result of analysis showed complete absence of pepsin, peptone and H CI. Twenty- four hours later the meal was repeated and followed in thirty minutes by treatment of either the Tesla Effluve or the Tesla Vacuum type, applied for ten minutes, followed by five minutes of the motor wave current with block tin electrodes over the solar plexus and dorsal spine. An hour later the gastric contents were removed and analyzed, the result being an almost com- plete peptonization of the coagulated albumen. Daily treat- ment for a month effects a radical cure in the majority of instances. IN THE TREATMENT OF DISEASES OF NUTRITION 251 Dr. Chisholm Williams has reported equally successful results in similar cases by the daily use of the resonator emuve followed by auto-condensation. Dr. George Herschell of London has devoted considerable time to the study of the High-frequency Treatment of the diseases of the digestive tract and has obtained excellent results. He employs the d'Arsonval Current ap- plied directly by means of metal electrodes in contact with the mucous membrane of the rectum and tongue respectively. Herschell found the above treatment of great value not only in nervous dyspepsia but in gas- tric ulcer, gastro-intestinal catarrh and chronic entero-colitis. (Fig. 178.) The writer has employed a similar technic, substituting the Tesla Cur- rents for those of d'Arsonval. In con- ditions of general muscular atony with obstinate constipation, the High- frequency Wave Current has given excellent results. After employing it for about five minutes with the two metal electrodes as suggested by Herschell (see above), a ten-minutes' treatment by the Tesla Efnuve, spi- rally applied over the course of the colon should be given. In connection with the above treat- ment the writer has obtained excellent results by frequently flushing the large intestine. The latter procedure may be self -administered by the patient by means of the "Internal Bath," or so-called "Cascade," of Dr. Chas. Tyrell of New York City. (See Fig. 179.) In acute inflammation of any portion of the digestive tract, direct application of the low-vacuum condenser electrode in con- tact with the abdomen will often prove efficacious. In appendicitis, which has not reached the stage of abscess formation, application Fig. 178. — Diagram of the Au- thor's Treatment for Dis- eases of the Intestinal Canal : V, Vacuum Electrode in Rec- tum. M, Metal Electrode in Mouth. 252 HIGH-FREQUENCY CURRENTS of the above electrode over the caecum, supplemented by a metal rectal electrode connected to the other terminal of the coil will often abort the attack. Hemorrhoids, if acutely inflamed and congested, are usually relieved by the use of a Red-vacuum Electrode in connection with a metal plate over the solar plexus. "Tesla Vacuum Technic." For chronic or sub-acute inflamma- tion of the rectal mucosa, such as ulcers, fissures, or fistulse, the Fig. 179. — The Author's Treatment for Chronic Constipation, and for Chronic Colitis. B, Doctor Tyrell's Cascade which Fills the Colon, C, with the Solution which is Connected to Tesla Terminal by way of Metal Plug of the Bag. E, Vacuum Condenser Electrode to be Applied to Abdomen over the Course of the Large Intestine. same technic may be employed, substituting a White-vacuum Electrode in place of the ordinary low red variety. For chronic hemorrhoids, and in reflex disturbances resulting from the undue contraction of the sphincter ani, the writer's pseudo- Faradic technic may be employed, using the ordinary rectal dilators as electrodes, increasing their size at intervals in the course of the treatments. The opposite electrode is the usual block tin plate over the solar plexus. IN THE TREATMENT OF DISEASES OF NUTRITION 253 B. — Diseases of the Blood and Heart The distribution of nutrition by the blood stream depends upon the constant circulation of the latter. Any interference with the movement of the blood results in local or general dis- turbance of cell nutrition and growth. The circulation is main- tained by two distinct mechanical systems; the heart, which is a powerful double pump of muscular fibers, which forces the blood with its load of fresh food and oxygen, through the arteries to all parts of the body; and secondly, the vaso-motor system, which collects the blood from the cells and tissues of the body and sends it with its load of waste products and gases, resulting from cell combustion, through the veins, back to the lungs and heart. The heart sends the blood out in periodic waves or pulses, its rhythmic motion being produced by a constant supply of electrical oscillations generated in the cardiac ganglia in the sympathetic nervous system ; the movements of the heart being regulated or governed by a second variety of nerve force transmitted through the pneumogastric nerve. Stimulation of the cardiac ganglia increases the strength and vigor of the pulsa- tions. If the pneumogastric nerve were paralyzed, the pulse would become more rapid and the heart would race like an engine without a governor. The vaso-motor mechanism is not confined to a single organ, but consists of thousands of little tubular pumps which surround the smaller veins, and which force the blood through the latter by a series of longitudinal waves or contractions produced by a network of conducting filaments called the vaso-motor nerves, which form a part of the sympathetic nervous system. The waves which force the blood through the veins result from the harmonious action of two sets of muscles, each of which has its special set of nerves. The first of these sets of muscles is called the vaso-dilators. The second the vaso-constrictors. Paralysis of the vaso-motor system, if complete, would cause death in a very few minutes, as the blood being unable to return to the heart would burst the walls of the capillaries and diffuse through the superficial tissues. Partial vaso-motor paralysis causes a backing up of the blood in the 254 HIGH-FREQUENCY CURRENTS smaller blood vessels, which is called Passive Congestion. In- crease in strength or frequency of the heart pulsations, causes a still more marked engorgement of the smaller arteries and capillaries, which is termed Active Congestion. Disturbance of the equilibrium between the cardiac and vaso-motor systems, may cause a concentration of the blood in the larger veins and arteries with a diminution in the contents of the remote peripheral vessels. This condition involves pallor and coldness of the sur- face of the body, with a tendency to chills, thereby lowering the vital resistance, and predisposing the tissues to bacterial infec- tion. When the latter event occurs, we say we have "caught a cold." Fully nine-tenths of our acute diseases result primarily from the above sequence of effects; the initial anaemia of the superficial tissues being in most cases due to depletion or exhaus- tion of the nervous energy of the great centers which supply the vaso-motor system. There is no agent known to the profession which produces such immediate and direct effects upon the vaso-motor system as the Testa High-frequency Current; in the condition above described, the surface anaemia and chilliness give place to a healthy warmth and glow within five minutes after the applica- tion of the Tesla Current. Even where serious disturbance of the vaso-motor system is present, such as in the initial chill of lobar pneumonia, prompt and vigorous use of the Tesla Current either by the effluve, or wave current technic, will if persistently applied, destroy the toxaemia, break up the superficial chill and fever and actually abort the disease; the patient breaking out into a profuse perspiration, and the pulmonary congestion changing its character so that a mild catarrhal inflammation replaces the virulent pneumonic infection. In secondary anaemia and chlorosis, general High-frequency Treatment is of great value in stimulating the regenerative forces to the production of new blood cells, and increasing the oxygen- carrying power of the individual corpuscles. D'Arsonval Auto- condensation with Tesla Low-vacuum Treatment over the spine and solar plexus, will usually bring about a progressive increase in the strength and activity of the vital functions. Diseases of the blood-vessels are in the- majority of cases IN THE TREATMENT OF DISEASES OF NUTRITION 255 amenable to treatment by currents of high frequency. Weak- ness in the walls of the veins or arteries except those of traumatic origin are corrected and strengthened by the Tesla Currents, which not only facilitate the access of the natural regenerative forces, such as the leucocytes and the elements of the blood and lymph, but by their stimulation of the vaso-motor system, they relieve the weakened vessels of undue pressure and tension, and facilitate the return of normal elasticity. In this manner the High-frequency Currents produce beneficial results in simple and rheumatic purpura, varicose veins, phlebitis, aneurism, and arteriosclerosis.1 General treatment by use of the vacuum chair, or Low Red-vacuum Electrode Treatment over the solar plexus with the condenser couch, are best adapted to the above condi- tions. Local treatment over the weakened vessels is not recom- mended nor should the Multi-frequency Methods be employed. In organic heart disease the Tesla Currents are often of great value in assisting nature to establish compensation ; in the later stages, when compensation has been finally destroyed by the dilatation of the affected muscle, the current may be used as a palliative treatment through its action on the vaso-motor sys- tem and its tendency to disperse dropsical effusions. The Red- vacuum Electrode should be employed by the monopolar indirect method; or better still, the vacuum condenser chair may be used instead of the metal electrode ; the local application of the vacuum tube in either of the above methods, should be over the cervical vertebrae and afterward over the solar plexus. D'Arsonval and other European authorities have reported a number of cures of organic heart disease in which beneficial results were obtained by treatment in the auto-conduction cage. C. — Diseases of the Respiratory Tract In this climate one of the most common and annoying affec- tions which the physician is called upon to relieve is the ordinary acute coryza, a catarrhal inflammation of the nasal passages, resulting from a mixed infection by pyogenic streptococci and 1 Since writing the above a number of cases of Arteriosclerosis have been reported by d'Arsonval and his colleagues, and successfully treated by auto-conduction. 256 . HIGH-FREQUENCY CURRENTS staphylococci; the primary infection, although not in itself a serious matter, so lowers the vital resistance of the entire body, particularly in the vicinity of the affected mucous surfaces, as to predispose the patient to other more serious infections, such as acute bronchitis, pneumonia, diphtheria and epidemic in- fluenza. If applied in the early stages of the attack attended with symptoms of disturbed equilibrium in the blood-vessels, such as congestion of the nasal mucosa with a profuse watery discharge, chilliness, alternating with fever, the Tesla Currents will usually give prompt relief. Tesla Vacuum Treatment with a metal electrode over tne solar plexus and a slender Red-vacuum Electrode inserted in the nostrils will promptly relieve the con- gestion and in many instances completely abort acute coryza; the treatments should not be discontinued with the disappearance of the symptoms; ten-minute treatments given at intervals of three hours so long as the acute symptoms remain should be given daily for a week after the attack has apparently subsided. The latter precaution will often save the patient from a serious secondary infection resulting from the lowered vital resistance. It is well to terminate each seance with a five-minute application of the High-frequency Wave Current applied by means of metal hand electrodes, or better still, with block tin electrodes applied respectively to the base of the brain and over the solar plexus. Treatment of the various acute diseases of the respiratory tract should be given with the above-described technic, a vacuum electrode of appropriate form and size being substituted for the nasal electrodes. In connection with his recently perfected apparatus for the treatment of pulmonary tuberculosis (See Fig. 151, Chap. XIX), the writer has devised a combined inhaler and double-vacuum electrode by means of which all varieties of acute and chronic diseases of the respiratory tract may be successfully treated. This device is shown in figure 180 ; it is made in two forms, for use in acute and chronic diseases, the first being of the Low Red-, the second of the White-Vacuum type. If desired, these electrodes may be used independently of the ozonized oxygen apparatus, the two bulb-shaped cavities being loosely filled with IN THE TREATMENT OF DISEASES OF NUTRITION 257 cotton wet with some volatile antiseptic such as pineoleum, formaldehyde, or guaiacol. This device is used in place of the single nasal electrode previously described. Pulmonary Tuberculosis Prominent authorities in all parts of the world have reported cases of pulmonary tuberculosis successfully treated by the application of High-frequency Currents. Among the European Fig. 180. — Tubulated Vacuum Electrode for Inhalation Treatment. A, Tube, or Air Channel. B, Double-end for Insertion in Nostrils. V, Vacuum Chamber. H, Stem to Fit in Insulating Handle. T, Top View. S, Side View. specialists, d'Arsonval Auto-conduction and condensation have been employed, supplemented by an effluve treatment from an Oudin Resonator applied directly over the areas of pulmonary infection. The following description is quoted from Dr. Chisholm Wil- liams' admirable little treatise, "High-frequency Currents in the Treatment of Some Diseases" (published by the Rebman Co. of New York and London) : "In July, 1901, the author read a paper on 'The Treatment of Phthisis by Electrical Currents of high frequency and high potential,' before the British Medical Association at Cheltenham, 258 HIGH-FREQUENCY CURRENTS and observed that forty-three consecutive cases were treated. There is reason to believe that the currents act in these cases in the following manner : "Firstly, on the tubercle bacilli themselves by making them pursue the same course as if they were under the X-Rays. According to the experiments of Drs. Forbes Ross and N orris Wolfenden, in their paper on the 'Effects produced in Cultures of Tubercle Bacilli by Exposure to the Influence of an X-Ray Tube' (Archives of the Roentgen Ray , August, 1900), they observe that the bacilli rapidly increase in numbers and have a tendency to form clumps, then get small in numbers and shape, and take the microscopical stains very readily, but are pale in color. They say, in conclusion, 'There is not the smallest doubt that X-Rays stimulate them to excessive overgrowth, and only affect them adversely by attenuation from overgrowth.' "In my experience much the same process goes on under the High-frequency Treatment. The tubercle bacilli, which are usually present in fair numbers, quickly begin to increase, and after a few applications are greatly increased; they soon, how- ever, form clumps and get misshapen, short, and stumpy, and generally curved, and take the stain far more readily than before. After a time they begin to decrease in numbers, and later, when the patient is obviously getting better in every .respect, they may cease entirely, and may appear in the sputum after weeks of absence. "Secondly, the effects of the currents of high frequency on the individual cells of the body. We judge this by the appetite and digestive powers increasing, and the patient's gain in weight. The general improvement of the body cells probably makes them more resistant to the inroads of the tubercle bacilli ; but whether the lowering of the tubercle's vitality, or a raising of the body- cells' resisting power, or a combination of both is at work, for our purpose matters little. In the majority of these cases the leucocytes were greatly increased in numbers during a course of the treatment. "In some cases the temperature is the first thing affected. Presuming that the daily variation has been about three degrees between the evening tide and the morning fall, either after the IN THE TREATMENT OF DISEASES OF NUTRITION 259 first application or, at most, after the third (consecutive days), the evening rise should be higher and the morning fall less. On examining the affected area, we find the physical signs at first increased; thus more coarse rales of louder and of a greater number could be found; the expectoration becomes larger in amount and the cough more frequent and easier. After a few applications generally when given locally, the patient often complains of pain or an uncomfortable feeling over the affected part. This as a rule, passes off after a couple of weeks' treat- ment, and is never severe if we pay due attention to the length of time and number of applications. A slight amount of pain over the affected area in severe cases is often noted from the general methods. "When the temperature has been raised by the treatment, the patient, of course, may feel rather worse — i.e., lassitude, and the sweats on the fall of the fever are sometimes large in amount; also during this period the body weight may decrease, or, at all events, remain stationary. I found this in many cases where the fever increased ; and in spite of the patient taking presumably a much more nutritious diet, still a slight weekly loss was ob- served. Some cases will react to the influence of the High- frequency Currents within twenty-four hours; others may take a few days. The more severe the case the more quickly does the reaction take place. However much the temperature rises, it will generally be found down to or at the patient's usual normal within forty-eight hours, so that the dose can be readily regulated, and the patient only given as much as he can com- fortably bear. When the patient can be exposed to the currents for over a half an hour daily for one week, and it is found that during the whole period the temperature remains steady at normal and subnormal, we may safely predict that the disease is, to say the least of it, arrested. With all these patients the milliampere meter registered from 150 to 250 milliamperes, seldom less; latterly an average of 350 milliamperes has been used, and the time five minutes." "The chart shown is a fairly typical temperature inasevere case. For the next three weeks it never rose over ninety degrees; for the following eight weeks it never rose over normal, and generally 260 HIGH-FREQUENCY CURRENTS subnormal; then daily observations were stopped. The weight increased one pound during the first week, lost one pound for the next two weeks, then steadily gained one to two pounds for the following eight weeks. During the fourteenth week of treatment from the commencement of 'high frequency' the patient "put on" three and one-half pounds. Her weight (in her clothes) was six stone and her height five feet one inch. During the fourteen weeks' treatment she gained one stone and four and one-fourth pounds. Two months after, with no treatment, she weighed (in clothes) seven stone thirteen pounds, which she has maintained for the last twelve months. The applications were fifty in number, and varied in dose from five to twenty minutes. After the third week twenty-minute doses were given on the average twice a week. In March, 1901, twelve months after, five applications of thirty minutes' duration, given on five consecutive days, could only raise the temperature to 99° in the evening and 98.2° in the morning. Now one finds that the average dose is ten minutes with the milliampere meter registering 300 to 400 milliamperes." "Forty cases in all were treated in London, which can at present hardly be considered as a first-class health resort, but I am strongly of opinion that the application of High-frequency Electrical Currents in sanatoria and like institutions will greatly swell the number of so-called cures. It is a remedy that should only be administered by medical men, as it needs as much care as any other therapeutic agent." "Further information of the original forty-three cases: Three have died ; of the rest, thirty-two have had no treatment of any kind whatever for over eighteen months. Eight cases had on an average two months' treatment each since that time. This year none of them have needed treatment. The majority, who were workers, are performing their usual duties. The three deaths were due to pneumonia, tuberculosis kidney, and larda- ceous disease." "Briefly, those patients received from ten to twenty minutes' auto-condensation. Eleven of the earlier cases were treated to the efrluve locally over the bared affected area, the operator's unemployed hand being placed in contact with the back of the IN THE TREATMENT OF DISEASES OF NUTRITION 261 chest; but owing to lack of time, etc., this latter method was abandoned. Other workers have experienced such good results that in some cases it would be well to employ general and local means." "Under this treatment they lost their cough and expectoration. The tubercle bacilli disappeared; but in some a few could be found months after all treatment had been stopped, yet they seemed in good health. Sometimes their sputum would be without tubercle for months, then a few would reappear for a few weeks, and then, without treatment, disappear again. The bodily weight increased in favorable cases as much as a pound a week." "When many hundreds of these phthisical patients have been subjected to this method we shall be in a position to judge of its merits and compare it with the 'open-air cure,' which at present has not shown such a good percentage of 'arrests.' In my opinion, as a valuable adjunct to a sanatorium, it should afford every material assistance, even in the more severe cases that do not usually gain admittance." Dr. H. Thielle reports a series of cases of pulmonary tuber- culosis treated with currents of high frequency and high po- tential.1 "Out of twenty-six tubercular patients treated, thirteen are cured, nine of these were hard-working laborers; four patients, who are on the road to recovery, are still under treatment; seven incurables were treated for the sake of completing his study and observations." The author concludes as follows : "The High-frequency Effluve fills the therapeutic indication demanded by clinical experience ; it has an evident action upon the chemistry of respiration ; increases the respiratory capacity ; diminishes the frequency of respiration, the production of carbon dioxide, the total amount of oxygen consumed and absorbed by the patient; as a result, raises the coefficient of oxidation and lowers the coefficient of absorption. "This action is riot temporary; it continues even after the 1 Bulletin Ofjiciel de la Societe Francaise d'Electro-Therapie, November, 1905. 262 HIGH-FREQUENCY CURRENTS cessation of the treatment. When during a course of treatment, we notice from month to month increased respiratory exchanges and a diminished respiratory capacity, we will always find the cause in the existence of one of the following complications: Coryza, catarrh (usually severe), influenza, syphilis, physical or intellectual overwork, prolonged walking, mental depression, etc. "In two cases with fibrous change (Cases 7 and 8) the respira- tory exchanges remain slightly above normal, and the treatment prolonged several months, even during one year, did not produce any change. "The High-frequency EfRuve increases the acidity of the urine, raises or lowers, depending upon the case, the products of nitrogenous combustion of the body, and arrests the excessive loss of mineral salts, which is a constant symptom of a tuber- culous state. "The modality produces the following changes in the com- position of the blood : The amount of hemoglobin and the number of red blood cells are increased, and there is usualty a decrease of white cells. The tissues being remineralized, the leucocytes obtain the mineral elements of which they are deprived in the tuberculous subject, and, therefore, regain their activity and power ; the defenders of the organism remain in fewer numbers but stronger, quality replacing quantity. The number of lymphocytes, those young cells which perform an important part in the nutrition, repair, and cicatrization of the tissues, is increased. "The general health of the patient in all stages of the dis- ease improves under the influence of the efliuve ; respiration is easier, inspiration deeper. All our patients experience a cool sensation, due to the penetration of air in the lungs, especially the one which is the most involved. This cool sensation dis- appears about the time of the fifteenth application. "The oppression and the dyspnoea disappear after fifteen or twenty seances, sometimes earlier, rarely later. "The cough is modified from the start; it diminishes pro- gressively and disappears in some of the cases during the first month, in others during the second or third month; but the IN THE TREATMENT OF DISEASES OF NUTRITION 263 coughing spells rarely occur, except at night and in the morning, sometimes after meals, and they do not last as long and are not as painful. "The effluve occasionally provokes a dry cough, even a slight dyspnoea; the cough and dyspnoea are caused by the direct ap- plication of the ozone which is liberated by the apparatus, but there is a gradual tolerance. The expectoration is easier, less frequent, less abundant, from purulent it becomes mucous and ceases, as a rule, before the end of the treatment. "The bacilli disappear sometime during the early months, sometimes at the end of the ' treatment ; we have never seen it reappear in any of our cases which were cured. Excepting temporarily in Case 2, after a severe attack of grippe, accom- panied with high fever. "We attach no importance to the quantity of bacilli found on the microscopic field,- this quantity being very variable. It is admitted that the expectoration on rising contains a larger number; after this morning expectoration which cleanses the bronchi, the following sputa contain less bacilli and often none at all. The appearance of the bacilli in the sputum is a late symptom. Tuberculosis begins the moment that the bacilli penetrate a favorable soil; this invasion is slow, insidious, and formerly escaped all our investigations; the study of the chem- istry of respiration permits us to detect tuberculosis from its inception, and even to recognize the predisposing soil ; when the enemy is known, it is easy to fight him and to render, by an appropriate treatment, the systems of those who are predisposed immune against the disease. "The sleep is better from the first night; the sweats diminish and cease when about fifteen applications have been made. "The appetite returns after the first few seances, increases after the tenth or so, and gets better and better. The digestion is good. "The strength returns and increases progressively during the course of treatment, nearly all our patients were able to continue their daily labors, a point of the utmost importance to them since they depended upon their labors for a living and often for the support of large families. 264 HIGH-FREQUENCY CURRENTS "The weight varies according to the patient; increasing very little in some; a great deal in others. Again it was subject to variations, depending upon the diet, fatigue, etc., variations which are also observed in healthy individuals. All our cured cases have maintained a weight which is greater than that before the treatment. "When the patients were weighed, they had taken no food in several hours and wore the simplest and lightest garments. "In phthisical cases, with fever, as well as those with soften- ing cavities, the effluve always increases, temporarily the respiratory capacity and diminishes the frequency of the respira- tion. The lowering of the respiratory rate occurs from the first month, but later remains stationary, differing thus from the marked gradual decrease observed in the tubercular patients, which are curable; although the treatment was extended over six months and in some instances over one year, we have not been able to restore to the normal rate the respirations, which after a lapse of time more or less prolonged, or after cessation of the treatment, begin again to rise. "The general health in the patients belonging to these various categories is good or seems good; the appetite returns, the weight increases, the strength is regained, work and exercise are easier, the night sweats disappear, the nights are good. The oppression ceases momentarily, the cough is less frequent and painful, the physical characteristics of the expectorations are modified. It is less purulent, less abundant, easier, and be- comes almost negligible. The mental condition is better; the patients are hopeful for a cure; the effluve has caused an illu- sionary cure, but not a real one, and after a varying lapse of time, the disease resumes its destructive course. "The organism is vanquished, the bacillus of Koch continues its work of destruction, and the fatal termination is only a question of time. "Without the biological examinations, these temporary improvements and apparent restorations to health, may have given us the illusion of success. "If we have not been able to have, even for one instant, the illusion of curing these patients, we have at least given them IN THE TREATMENT OF DISEASES OF NUTRITION 265 that illusion, and we have also, thanks to our modality, afforded them an immense relief, since in nearly all the oppression, cough, expectoration, sweats and weakness only reappeared much later, during the last stages of the disease." As the great majority of physicians who have employed High- frequency Currents in their practice have used the apparatus of Oudin and d'Arsonval, it is natural that most of the reported cases of tuberculosis have been treated by currents of solenoid and resonator types. Although employed in the writer's own practice for over ten years, apparatus and technic for the pro- duction and therapeutic application of the Tesla Currents have been available for general use only within the last year or two. It is obvious therefore, that any great number of clinical reports illustrating the value of Tesla Treatments are not as yet obtain- able from outside sources. From the writer's own experience however, and from a theoretical standpoint, there is every reason to believe that in the modern Tesla Apparatus we have a source of electrical modalities which not only possess all of the quali- fications which have made the resonator and solenoid currents of such great value in the treatment of tuberculosis, but which possess distinctive therapeutic advantages which cannot be duplicated by currents produced in any other manner. The general effects of auto-condensation and the local results of emuve treatment have demonstrated the importance of these methods; but in the Tesla Current applied by the writer's bipolar methods, we simultaneously produce effluve and other local effects, more intense and penetrating than the resonator discharge, and general vitalizing effects which cannot be repro- duced by the lower potential currents of d'Arsonval. It should be distinctly understood that the writer is not disparaging or questioning the therapeutic value of the latter currents; on the contrary, it is his practice to administer occasional d'Arsonval Treatments to patients undergoing Tesla Treatment for pul- monary tuberculosis. The increase in cell combustion, metabol- ism and elimination, produced by the d'Arsonval Currents are not produced in the same degree by the High-potential Tesla Currents which act more especially on the vaso-motor and trophic systems. The d'Arsonval Current obtained from the 266 HIGH-FREQUENCY CURRENTS primary coil of the modern Tesla Apparatus is really more efficient than if produced by a solenoid of the European type. The remarkable possibilities of the Tesla Treatment in pul- monary tuberculosis, even when the current is applied under the most unfavorable conditions is well illustrated in the report of a case treated by the writer some five years ago. A young man of sedentary habits, whose occupation made it necessary for him to work for the greater part of each' night, broke down completely as a result of overwork. An attack of nervous exhaustion left him with a greatly depleted vital resistance, and not unnaturally, he contracted pulmonary tuberculosis. Tem- porary rest and change of climate were of little avail and he was ultimately sent to a celebrated mountain resort noted for its open-air treatment of tuberculosis. The disease was progressing rapidly to a fatal termination when the writer was asked to administer High-frequency Treatment. A special apparatus was constructed and installed in the patient's room at the resort above-mentioned. When first seen by the writer the patient was apparently nearing the final stage of the disease. His physician, one of the principal authorities of this country on tuberculosis and its treatment, informed the writer that infection had extended to the intestinal canal, and probably to the entire organism, and stated that unless a miracle should intervene, the patient would die in from one to three months. He ex- pressed courteous but pronounced skepticism regarding the possibility of benefiting the patient by High-frequency Currents, or any other therapeutic agent, while his assistant who per- sonally attended the patient, expressed an equally marked skepticism but without the courtesy. The writer installed the apparatus, administered the first treatment, and instructed the nurse as to daily treatments which were to be given. The first effect of the current was to break up the stasis in the more healthy portion of the lung tissue, and to aid nature in throwing off the accumulated poisons; as a natural result, expectoration increased, more bacilli appeared in the sputum, night sweats became more profuse and the fever higher. The beneficence of these effects, however, were evidenced by the fact that despite the great drain on the vital energies, comparatively little reaction IN THE TREATMENT OF DISEASES OF NUTRITION 267 or prostration followed. The physician in attendance took advantage of the increase in the severity of the symptoms to inform the patient that the treatment was killing him, and after three weeks of daily treatment the administration of the current was discontinued. The elimination of the accumulated poisons gave rise to the above-mentioned symptoms which masked the real benefit produced by the treatment. On the cessation of the latter the increase in vitality and recuperative power at once manifested itself and two weeks later the patient was driven out for the first time in months. So far from admitting the results of the treatment, the patient's physician actually ascribed his improvement to the fact that the electricity had been discon- tinued; and this, despite the progressive advance of the disease during the six months prior to the writer's visit ! Four months after the above events, the patient was taken to California; apparently became completely restored to health and lived an active outdoor life for two years, at the end of which period he succumbed to pneumonia resulting from excessive exertion and exposure. Other cases of tuberculosis treated by the writer have shown progressive improvement, almost from the first application of the Tesla Currents; three cases were for the most part in the earlier stages, before secondary streptococcus infection had appeared. Technic in these was generally confined to the usual Tesla Vacuum Treatment, the glass electrode being moved over the lungs and spine, and the metal electrode applied over the solar plexus. In cases treated more recently the double-vacuum technic has been employed ; White-vacuum Electrodes of the condenser type being applied over each lung; this has been varied by the occasional use of the Tesla Effluve and d'Arsonval Auto-con- densation. The reports received from other physicians who have em- ployed the writer's apparatus and technic in the treatment of pulmonary tuberculosis, amply confirm his own conclusions regarding the importance of the Tesla Currents in the treatment of the above disease. Excellent results have been obtained in the treatment of 268 HIGH-FREQUENCY CURRENTS tubercular patients by inhalations of ozone, even from the crude product obtained from the passage of air across a High-potential Brush Discharge in a glass vessel. Great benefit has followed the use of pure oxygen in similar cases, also of aromatic oils, and volatile antiseptics administered by means of a nebulizer. The writer's recently perfected apparatus and technic for the scientific treatment of tuberculosis by a simultaneous adminis- tration of the Testa High-frequency Currents, pure ozonized oxygen, and ionized aromatic vapors, has been fully described in the Chapter on the "Therapeutic Use of Ozone."1 D. — Diseases Involving Deranged Metabolism Under the above heading may be grouped a number of general diseases of obscure origin but distinctive pathological effects. We have, for example, diabetes which involves the improper metabolism of the carbohydrates, characterized by the presence of sugar in the blood and urine ; gout , resulting from the imper- fect combustion of cell debris, and other nitrogenous waste products, characterized by the presence in the tissues of the partially oxidized, insoluble uric acid, instead of the completely oxidized soluble urea, which is produced in healthy individuals. Uric acid combines with the soda and lime of the tissues forming sharp crystals which collect in and around the joints, constituting the well-known " chalky" or " gouty" deposits. Obesity is a form of mal-nutrition in which fatty foods, instead of being oxidized and giving up their energy to the vital functions, collect in the cells of the subcutaneous areolar tissue forming the adipose layers which are commonly termed "fat." In addition to the above diseases there are many conditions in which all the metabolic processes are diminished ; these secondary conditions result from the constant drain on the vital forces in the course of acute and chronic infectious disease. The depletion of the sympathetic nervous energy causes a lack of vaso-motor power, weakened heart action and insufficient respiration. As a result we have a wasting of the tissues from a lack of nutrition and oxygen, an accumulation of waste products, causing rheuma- 1 Since the completion of this manuscript several advanced cases of tuber- culosis have been apparently cured after three months treatment by the combined High-frequency and Inhalation method above mentioned. IN THE TREATMENT OF DISEASES OF NUTRITION 269 tism in the muscles and joints, and insomnia and irritability from the deposits in the brain and nerves; chilliness of the surface of the body, with cold and numbness of the extremities are characteristic symptoms. Although differing in their general symptoms, the various diseases above-described are closely allied, in that they all result from some local or general interference with the nutritive and metabolic processes of the body. This fact alone would suggest the probable value of High-frequency Treatment in the above conditions, and clinical evidence from a variety of sources offers ample confirmation of this conclusion. The influence of the d'Arsonval Currents is beneficial in all the above diseases and daily treatment with the cage or condenser couch should be given if possible, in addition to the local application of the resonator or Tesla Currents. General treatment by the Tesla Wave Current or the Tesla Efnuve, applied over the spine and solar plexus, should be employed in the treatment of the above conditions, unless complicated by organic heart disease. Local manifestations, such as the skin lesions of diabetes, and the local pain of rheumatism and gout, require Tesla Vacuum Treatment, the electrode being applied over the clothing if acute pain be present. Gouty joints in the chronic stage are benefited by Tesla Sparks and direct application of the d'Arsonval Current. Where stiffness in either muscles or joints occur, the Pseudo- Faradic or Motor Impulse current may be used in addition to the above methods. It is to be understood that the High- frequency Treatment of the above diseases should be accom- panied by hygienic and dietetic measures, and medical treatment if desired. One great advantage of High-frequency Treatment is the absolute impossibility of its producing any effects which would interfere with the administration or action of any other form of therapeutic agent. On the contrary, the d'Arsonval and Tesla Currents, by their action on the circulation and their stimulation of vital function, actually increase the therapeutic efficiency of all varieties of medicinal agents. 270 HIGH-FREQUENCY CURRENTS E. — Diseases of the Excretory Apparatus Diseases of the bladder and kidneys result as a rule from the continued irritation of urates, uric acid, calcium oxalate and other products of deranged metabolism and incomplete tissue combustion. In addition to the above causes, diseases of the kidneys may result from inequalities in the blood pressure, occurring as secondary effects of organic heart disease, or toxic infections. When due to deranged metabolism, High-frequency Treatment, as described in the preceding section, will usually restore the kidneys to a normal condition by removal of the exciting cause. If renal congestion of an active type occurs in the course of other diseases, it may be usually relieved by Tesla Treatment with Red-vacuum Condenser Electrode, and a metal plate over the solar plexus; if fever is present it should be treated by the technic described in connection with acute infectious disease. Passive renal congestion is usually of a chronic or sub-acute type, and should be treated by the local use of a White-vacuum Condenser Electrode, with the Tesla Technic as above. In organic disease of the kidneys, with actual degeneration of the tubular epithelium, the Tesla Currents are of the greatest value. Cases of acute and chronic nephritis, both the interstitial and parenchymatous varieties, have been successfully treated in the writer's practice, by the application of the Tesla Currents to the lumbar region, the effluve and vacuum electrodes being used, each for ten minutes; followed by direct application of d'Arsonval Current by means of sponge electrodes. General treatment by the Tesla Wave Current, used alternately with d'Arsonval Auto-condensation should follow the local direct treatment just described. Renal colic may be frequently relieved, and the passage of the calculus through the ureter facilitated by pseudo-static sparks applied anteriorly or posteriorly according to the position of the stone. The Tesla Wave Current or Pseudo-Faradic are also of value in this condition, an olive-tipped electrode with insulated stem being inserted into the bladder and a block tin or metal disk electrode being applied to the lumbar region over the affected kidney. IN THE TREATMENT OF DISEASES OF NUTRITION 271 In septic infection of the urinary tract such as pyelitis, pyelo- nephrosis and cystitis, the metal olive-tipped electrode is inserted in the bladder as above, connected to the terminal of the Tesla Coil, while a White-vacuum Condenser Electrode connected to the center terminal is applied to the surface over the kidney or bladder.1 In acute cystitis of the catarrhal type, the same technic is employed substituting a Red-vacuum Electrode for the White. In acute cystitis complicating a gonorrheal urethritis, a Red-vacuum Electrode, shaped like an ordinary sound, is inserted through the urethra into the bladder, and connected to the center terminal, the Red-vacuum Condenser Electrode being connected to Terminal B and applied to the surface over the bladder. Persistent gleet may be permanently cured by frequent treatments with similar technic, but the urethral electrode should be exhausted to a white vacuum in place of the low red tube, used with acute inflammation. Urethral stricture may be relieved in many cases by the use of the Pseudo-static or Tesla Wave Current, an insulated olive- tipped electrode being in contact with the fibrous ring of the stricture, and the second electrode, consisting of a metal plate, applied over the solar plexus. Strictures of the more aggravated type are best treated by negative electrolysis with the galvanic current, each sitting being terminated by a five-minute Tesla Treatment with a Low Red-vacuum Electrode in the urethra. Functional impotence from excesses, or of nervous reflex origin yields readily to High-frequency Treatment. The current is applied in the form of the Tesla Effluve over the lumbar and sacral spine, the metal electrode being over the solar plexus. For the psychic effect on the patient, it is well to terminate each treatment with a short application of the Red-vacuum Electrode over the testicles and perineal region. 1 See " Tesla vacuum Technique." CHAPTER XXIV THE TREATMENT OF DISEASES OF THE NERVOUS SYSTEM BY HIGH-FREQUENCY CURRENTS The physiological action of the various High-frequency Modali- ties on the different types of nerves has been more or less gener- ally explained in the preceding Chapters. The d'Arsonval Current does not affect the nerves directly, but it is of value in restoring defective metabolism resulting from the depletion of the nervous energy of the body and may be used locally in connection with the Testa Currents for the purpose of re-establishing cellular growth and nutrition in cases of muscular atrophy or incipient degeneration of the nerve fibers. The general rules for the application of High-frequency Currents in diseases of the nervous system have never been definitely formulated, but the results obtained by the writer during his ten years' experience in High-frequency Therapeutics seemed to justify the following tentative conclusions : Diseases of the nervous system may be divided into certain classes, each of which corresponds to definite methods of treat- ment. For example, diseases of the motor nerves, involving loss of muscular power, are treated by White-vacuum Condenser Electrodes over the spine, and peripherally, by some variety of Multi-frequency Current; the Testa Effluve being properly included under the latter head. The second group of diseases comprises the affections of the sensory nerves, such as neuralgia, sensory paralysis, lumbago, etc., which should be treated by the effluve from a Testa Coil in connection with a condenser couch, the White-vacuum Electrode by the indirect or Testa Method, sparks of the Pseudo-static type, and labile applications of the d'Arsonval Current. In the third class we have diseases involving loss of trophic influence, including the various skin diseases of nervous origin 272 IN DISEASES OF THE NERVOUS SYSTEM 273 and constitutional tendencies, which predispose to infections such as carbuncles, boils, sties, etc. These conditions are locally benefited by the direct Effluve and indirect Vacuum treatment; also double vacuum treatment by means of a Red and White-vacuum Condenser Electrodes. The secondary local infections which result from the trophic depletion, such as carbuncles and furuncles, may be checked in their course by the use of the Testa Arc or High-frequency Cautery. In the next class we have the various types of neuritis which involve the inflammation and sometimes partial degeneration of certain nerves. These conditions should be treated by local application of the d'Arsonval Currents and by the Red-vacuum Electrode applied by the monopolar indirect method over the affected area. Paralysis, resulting from neuritis in a motor nerve, should be treated peripherally by the methods enumerated under "Motor Affections.'' Chronic neuritis with pain and loss of power in the muscles, such as sciatica, should be treated by a White-vacuum Electrode connected for the Tesla Technic and applied along the course of the nerve with intermittent contact, so as to produce sparks from one-half to one inch long, between the end of the electrode and the body. This Vacuum spark treatment has also given good results in cases of tri-facial neuralgia, torticollis, and similar affections. Multi-frequency Currents, while of use in treating muscles partially paralyzed as the result of neuritis, should never be used over the course of the inflamed nerve. The next group includes diseases involving degeneration of some portion of the spinal cord, or of the spinal nerve roots. Under this head may be mentioned locomotor ataxia, infantile paralysis, paraplegia, lateral sclerosis, etc. Peripheral affections resulting from these diseases are treated in accordance with the above rules, irrespective of their central origin. The lesions in the spine, however, are treated much in the same manner as cases of chronic neuritis. Local d'Arsonval Treatment is employed with a stable electrode over the solar plexus, and a labile electrode over the spine. Hemiplegia, paralysis agitans, and senile dementia, involve hemorrhage or degeneration in the brain, and are treated more or less success- 274 HIGH-FREQUENCY CURRENTS fully by application of Vacuum condenser electrodes usually of the White type applied to the base of the brain, or over the affected portion of the cortex. Tesla Technic is employed with a metal electrode over the solar plexus. In atrophy or degen- eration affecting the optic tract, or the medulla, the same technic is employed, but the metal electrode is placed in the mouth of the patient. Local or constitutional conditions resulting from the above diseases should be treated by the methods described under the various headings. Migraine, congestive, or nervous headaches, readily yield to treatment by the Red-vacuum elec- trode over the solar plexus. Excellent results have also been obtained in the treatment of epilepsy by the High-frequency Currents; the technic is similar to that employed in other brain affections. The next and last group of nervous diseases includes the so- called "Functional Neuroses," such as hysteria, chorea, neu- rasthenia, etc. General treatment of these conditions involves the use of a brisk Tesla Effluve over the spine, with a metal electrode over the solar plexus, occasionally reversed by using the effluve over the solar plexus and the metal electrode over the base of the spine. Local affections are treated by appropriate methods in accordance with the rules given above. General d'Arsonval Treatments with the Condenser couch should be given frequently in this class of diseases, especially when the nutrition is impaired. CHAPTER XXV INFECTIOUS AND MALIGNANT DISEASES Although it is true that the majority of users of High-frequency Currents are specialists who treat only chronic diseases, it is also true that the value of the currents in the treatment of acute infectious diseases is even greater than when they are applied to chronic conditions. The principal reason for the comparative rarity of High-frequency Treatment among general practitioners has been the cumbrous nature of the generating apparatus and its dependence upon the electric lighting service for its supply of energy. This objection no longer exists, as the writer has recently perfected a portable High-frequency Apparatus, which is independent of outside sources of current, its supply being drawn from a small storage battery of improved type, which is incorporated with the transforming apparatus in a portable case about a foot square.1 (See Fig. 181.) Despite its apparent insignificance when compared, for example, with the writer's Hercules Machine, this little instrument has thoroughly demon- strated its remarkable therapeutic possibilities. During the past year a number of these little machines have been in use being especially adapted for installation in the homes of bed- ridden patients. Their technic and adjustments are simple, and daily treatments may be given by the nurse or attendant under the instruction and occasional supervision of the physician in charge. Not only local conditions, such as diseases of the skin and septic areas, but chronic constitutional diseases, such as rheumatism, arthritis, and organic affections of the heart, have been successfully treated by this little device. Up to the present time this instrument has been constructed for the writer's use, for installation in the homes of patients, who are unable to 1 " Columbia Dry Cells," such as are commonly used in automobiles, can be employed with this machine if desired. Six of these cells will run the appa- ratus for approximately fifty treatments, at a total cost of $1.25. 275 276 HIGH-FREQUENCY CURRENTS come to his office for treatment. The apparatus has been made in the writer's private laboratory under his personal supervision. Fig. 181. — The Author's Portable High-frequency Apparatus Operated by Current from Its Own Battery. It will undoubtedly be placed upon the market, and meanwhile the writer will gladly furnish any information regarding its construction and uses* to physicians who may be interested in the subject. INFECTIOUS AND MALIGNANT DISEASES 277 Prompt Testa Treatment with the effluve applied alternately to the spine and solar plexus, followed by a general application of the High-frequency Wave Current, will actually abort many varieties of acute infectious disease if administered sufficiently early in the course of the attack. In the prodromal stage, and the period of incubation, treatments should be given twice daily. In the acute stage, with chills, fever, headache, nausea, etc., fifteen-minute treatments should be given at intervals of thirty minutes until the fever subsides, and the patient breaks out in perspiration. For the above purpose, a heavy current is usually necessary, such as that produced by the writer's Ajax, or Hercules Machine. Nevertheless, in several instances acute infections such as La Grippe, have been successfully aborted by the persistent application of currents from the little portable ap- paratus above described. Septic areas or the local lesions of infectious diseases, whether superficial or subcutaneous, readily yield to prompt treatment c MSS^ Fig, 182. — The Author's Localizing Effluve Electrode for Treating Ulcers and Septic Areas. with the Tesla Currents. Ulcerated areas should be treated with the Tesla Effluve from a fine metal brush electrode; if the mucous membrane be the seat of the lesion, the effluve may be localized by the use of a metal brush inside of an insulating glass tube, open at the end (see Fig. 182). This electrode was first employed by the writer in 1897; shortly afterward a device of almost identical construction was placed upon the market by a Paris manufacturer under the title of "Bisserie's Brush Elec- trode." Lesions which do not involve ulceration or solution of surface continuity may be treated with the Red-vacuum Electrode. This applies to almost all of the local acute diseases of the skin and mucous membrane, of bacterial or parasitic origin. The subcutaneous areas of infection, including abscess formations, in the early stage of congestion and stasis, the Red-vacuum Condenser Electrode should be employed, with the Tesla Technic; 278 HIGH-FREQUENCY CURRENTS in later stages, involving active suppuration, the White-vacuum electrodes should be employed. In severe cases of mastoid abscess with cerebral and pysemic symptoms, a vigorous thirty- minute treatment with the White-vacuum electrode applied externally, and a metal electrode in the mouth of the patient, produced an absolute dispersion of the acute manifestations, the patient sleeping naturally inside of five hours. The next day the pus was withdrawn, and although cover-glass preparations showed countless members of streptococci and staphylococci, but a few scattered colonies were obtained in a plate-culture on nutrient gelatin. Cervical adenitis and tuberculosis of the lymphatic glands have been successfully treated by the above method, which is also applicable to almost any type of sub-acute inflammation accompanied by hyperplasia. Diseases of the skin of a sub- acute or chronic character resulting from, or associated with diseases of the digestive system, or derangements of the nutrition are almost without exception amenable to High-frequency Treatment. Eczema, acne, psoriasis, alopecia, seborrhea, etc., have been repeatedly cured by well-known practitioners, most of whom have employed the direct effluve and vacuum treat- ment, in some instances supplemented by the use of the X-Ray or the Ultra-violet Ray from a Piffard Lamp. The writer has employed, in the above conditions, both Red- and White-vacuum electrodes; the latter giving the best results in chronic condi- tions, the former in lesions of the acute congestive type. The Testa Technic appears to be more efficient, than the direct monopolar treatment. In obstinate cases which do not yield to the latter methods, the X-Ray Condenser Electrode will often prove efficacious. In superficial malignant conditions as epi- thelioma, lupus, rodent ulcer, etc., the treatment with the X-Ray electrode should be supplemented by the Testa Effluve and in obstinate, refractory, conditions, by the High Ultra- violet Rays from a lamp with iron electrodes, operated by the condenser discharge from a Testa Apparatus. Malignant disease of the mucous cavities should be treated on similar lines, with electrodes exhausted to an X-Ray vacuum. Epithelioma of the cervex uteri may be successfully treated by the special double INFECTIOUS AND MALIGNANT DISEASES 279 vacuum method, recently devised by the writer, which has been described in a previous chapter. Cancer of the body of the uterus may be similarly treated, substituting an X-Ray Con- denser Electrode for the Low Red-vacuum Electrode, which is applied to the supra-pubic region. CHAPTER XXVI SPECIAL USES FOR CURRENTS OF HIGH-FREQUENCY In the preceding chapters the writer has attempted to describe the methods for the application of High-frequency Currents in the more prominent general and local diseases. Few cases have been cited illustrating the successful use of the different methods in the various types of disease, but in every instance in which the technic for the treatment of a given affection is described, corresponding cures have been affected, either in the writer's own practice or in the experience of some other recognized authority. The therapeutic use of High-frequency Currents is based upon physiological effects of such a fundamental character, and the rules for the use of the different High-frequency Modalities are so broad and simple that a detailed description of the technic of treatment of the general and local symptoms in the course of an ordinary "cold," (or acute coryza), is in reality a complete guide to the physician in the use of these currents in practically all varieties of local and general disease. The vitalizing and invigorating effects of High-frequency Treatment are necessarily beneficial in all diseased conditions; and special effects, resulting from the various modifications of technic, are secondary to the fundamental action of the High-frequency Oscillations. There are many diseases which have been effectually treated by High-frequency Currents of which no especial mention has been made in the present volume. From a consideration of the technic for the treatment of the typical examples of the different classes of diseases, herein described, the physician may obtain an intelligent idea of the methods which should be adopted in the treatment of any particular disease which has not been mentioned by the author. The use of High-frequency Currents in the various medical "Specialties," is in itself a broad subject for consideration. 280 SPECIAL USES FOR CURRENTS OF HIGH-FREQUENCY 281 Cases have been reported in which various diseases of the eye and ear have been successfully treated with High-frequency Currents; for example, trachoma, granular lids, glaucoma, cataracts, ptosis, exophoria, and incipient optic neuritis, also otitis-media, tinnitus, aural catarrh, Eustachian inflammation and stricture, and various affections of the inner ear and acoustic nerve. Similarly a fairly large treatise might be written concerning the practical uses of the High-frequency Currents in dentistry. Actual anaesthesia during extraction of teeth has been success- fully induced by the use of Tesla Currents, double vacuum electrodes being used, one against the gum, the other on the skin over the dental nerve. Pyrrhoea aveolaris has been treated with exceptional success by the Tesla Currents; a special set of vacuum electrodes has been devised for the treatment of this disease. (See Fig. 183.) The little portable apparatus designed by the writer, and described in the preceding chapter, is especially adapted for dental High-frequency work. The lack of system and coordination in the clinical reports of cases treated by High-frequency Currents, more especially those which have appeared in the various medical journals in America during the past five years, has rendered it well-nigh impossible to draw reliable conclusions in regard to the absolute and relative value of the different methods for the generation and application of High-frequency Currents in the treatment of disease. Statements appearing in the present volume regarding the therapeutic action of these currents are based mainly upon the writer's personal experience, but in no instance has he made any definite statement as to the value of any special method in relation to a particular disease unless the results of his own clinical experience had been confirmed by one or more reliable authorities. With a view to the ultimate production of a thoroughly reliable "Clinical Manual" compiled from the records of a large number of practitioners who employ High-frequency Currents in their practice, the writer has prepared a blank form (a sample of which will be found in each copy of this book), for the systematic 282 HIGH-FREQUENCY CURRENTS record of cases treated with High-frequency Currents between the present time and January, 1910. In the interests of humanity and of the profession at large, the author urgently requests every reader of this book who is a practitioner of electro-thera- peutics to record his cases on forms of this description and • • ,. . E : g Fig. 183. — Vacuum Electrodes for Treatment of Pyrrhoea Alveolaris. forward them to him in care of the publishers (The Rebman Company, New York). Extra blanks for records may be obtained on application. It is the author's intention to prepare a clini- cal manual compiled from these reports. The book will form a sort of sequel to the present volume and due acknowledgment will be made of the assistance rendered by the physicians who may have submitted clinical reports. INDEX INDEX Abscesses, treatment of, 277 Active congestion, 254 Acute coryza, 256 Adrenalin, de-hematization by, 203 Air-gap condenser terminals, 15, 138 Air pressure, effects of on discharge, 178 Air-jacket insulation for vacuum elec- trodes, 181 Ajax High-frequency Coil, 106, 108 Alternator, Tesla's High-frequency, 41 Alternating currents, 36 Alternating type, High-frequency Ap- paratus, 73, 88 Alternations, 40 Amperes, 38 Anode, 33 Analysis of High-frequency Currents, 124 Analogy, study by, 46 Analogy ' between Sound-waves and High-frequency Currents, 52 Anaemia, treatment of, 254 Anti-toxins, 212 Appendicitis, treatment of, 251 Arc, High-frequency, 138 Arc, High-frequency, effect on bacteria, 236 Arc, High-frequency, use of for cautery, 232 Arcing, prevention of, 99 Arrangement for producing Oudin- d'Arsonval Currents, 126 Arrangement for producing Tesla- Thomson Currents, 127 Arteriosclerosis, 255 Auto-condensation, 7, 158 Auto-condensation with currents from Tesla Coil, 168 Auto-conduction, 6, 157 Autograph of High-frequency Dis- charge, 147 Batteries, 38 Bipolar methods, see Tesla technic, 169 Bipolar vacuum treatment, 177 Bisserie's Electrode, 277 Bladder, diseases of, 271 Bright 's disease, 270 Brown High-frequency Coil, 94 Cages for Auto-condensation, 158 Calculation of Voltage, 91 Campbell High-frequency Coil, 95 Capacity, 142 relation to Frequency and Induc- tance, 55 Cancer of uterus, treatment of, 278 Carbuncles, 273 Cardiac ganglia, 253 Cathode rays, 190 Cautery High-frequency, 164 Cervical adenitis, 278 Chart, showing author's technic, 17 Chemical regulators for X-Ray tubes, 195 Clinical records, 281 Cloud-circuit Transformer, danger of using, 86 Cole X-Ray Coil, 119 Comparative method of study, 46 Condenser, discharge of, 41, 43 chair of Piffard, 160 couch, 158 effluve, 242 electrodes, 181 electrodes with graduated vacuum, 188 Congestion, relief of, 224 Constipation, 239 Continuous current, 38 Corpuscle, see Electron, 19 Crookes' tubes, 190 Cushion, spiral, 159 Cycle of frequency, 40 ♦ Cyclone coil, 97 Cymometer, 153 Cystitis, 271 D'Arsonval, early experiments of, 4 Auto-conduction cage of, 6 High-frequency Currents of, 41 High-frequency Currents of, direct application of, 155 High-frequency Currents of, gen- eration of, from author's appa- ratus, 85 High-frequency Currents of, tech- nic of application, 155, 228 High-frequency Currents of, thera- peutic effects of, 227 285 286 INDEX Deafness, treatment of, by High-fre- quency Currents, 281 Definition of High-frequency Current, 93 Deflection of Cathode rays by magnet, 191 Dentistry, uses of High-frequency Cur- rents in, 281 Diamond, transparency of, to X-Ray, 191 Dipper Mercury Interrupter, 63 Direct current types of High-frequency Apparatus, 114 Dosage, measurement, 149 Double Focus tube, 197 Double resonator treatment, 243 Double vacuum treatment, 186 effects of, 241 Ducretet's small Tesla apparatus, 7 "Dynamic Thought," 25 Dynamos, 39 Dyspepsia, treatment of, 225 Ebonite Spinal Electrode, 183 Effluve, 99, 141 electrodes, 163 technic, 162 effects of, 231 Electrical charges, nature of, 30 Electro-dynamic phenomena of High- frequency Currents, 142 Electrolytic break, 64 Electro-magnetic Theory of Light, see Maxwell's Theory, 35 Electrons, 19 motions of, 31, 34 speed of, 191 theory of, 20 Electro-physics, 30 Electro-static phenomena of High-fre- quency Currents, 135 Epilepsy, treatment of, 274 Ether waves, 35 European types of High-frequency Apparatus, 58 "Ewald-Boas" Test Meal, 250 "Extra current," 61 Factors determining qualities of High- frequency Currents, 125 Faradism, 2 Fever, treatment of, 277 Finsen's Light Treatment, 201 Flemming's Cymometer, 153 Fluorescence, 179, 204 Foods, classes of, 249 Formula for determining effects of resistance on condenser dis- charges, 56 Franklin, work of, 3 Frequency, 40 effect of inductance on, 55 Frequency , therapeutic effects of change of, 92. of the nerve currents, 210 Freund's experiments, 236 Friedlander's vacuum condenser chair, 187 Galvanic current, 216 Galvani's discovery, 2 Gaiffe's heavy solenoid and oil con- denser, 71 bipolar resonator, 72 "closed-circuit transformer" ap- paratus, 73 Generation of High-frequency Cur- rents, 46 Generators, 38, 39 Germicidal action of High-frequency Currents, 222 "Geryk" air-pump, 177 Glass plates, penetration of, by High- frequency Currents, 146 effects of treatment by, 233 electrodes, 175 Gleet, treatment of, 271 Gonorrheal infection, treatment of, 271 Graphic tracing of alternating current, 37 "Hard" X-Ray tubes, 193 Headache, High-frequency treatment for, 274 Heat produced by High-frequency Dis- charge, 140 Heinze X-Ray and High-frequency Apparatus, 120 Hemorrhoids, treatment of, 252 " Hercules " High-frequency Appara- tus, 107, 110, 121 Herschell's regulating handle, 182 treatment of digestive diseases 25L Hertzian waves, methods of neutraliz- ing, 74 Hertz resonator, 3 "High-frequency Wave Current," 244 cautery current, 164 currents as energy carriers, 221 transformer, construction of, 110 History of physical therapeutics, 1 Hot-wire mil-ammeter, 149 Hydraulic analogue, of continuous cur- rent, 36 alternating, 37 electrical oscillations, 43 illustrating Ohms law, 46 of d'Arsonval High-frequency Cur- rent, 48 of Tesla-Thomson High-frequency Current, 49 Hyperstatic transformer, 12, 247 Hysteria, treatment of, 274 INDEX 287 Immunity of human body to High- frequency Currents, 133 Impotence, functional, treatment of, 271 Indirect spark, technic for use of, 170 Indirect vacuum treatment, 235, 237 Inductance, 41 Induction coil, 39 Induction, phenomena of, 133 Inductive resistance, see Inductance, 41 Inducto-resonator, 117 Infectious diseases, treatment of, 275 Inhibitory effect of High-frequency Currents, 222 Insulation of Tesla Coils, 85 Insulators, penetrability of, 57, 86 Intensity, unit of, see Ampere, 38 Interrupter, Wehnelt (Electrolytic), 58 mercury jet, 61 Ionization of spark-gap, 174 Iron wire, burning of, by High-fre- quency Currents, 140 Isenthal-Kohl X-Ray and High-fre- quency Apparatus, 81 Jackson Coil, 101 frequency of, 91 spark-gap of, 102 Kinetic energy, 38 Kinraide's Coil, construction of, 89 High-frequency Spirals of, 90 relative frequency of, 91 Kinraide's early X-Ray work, 14 Knott High-frequency Apparatus, 14, 83 Labile applications, 156, 229 Lamp-bulb electrode, 151 Law of transformation, 91 Leather-covered glass electrode, 233 Lenard's cathode rays, 190 Leucocytes, function of, 210 Leyden jar, 3 Life principle, 28 Lodge's analogue, 54 Low-frequency effects from Tesla Ap- paratus, 167 Mackenzie-Davidson Interrupter, 63 Magnetic deflection of moving elec- trons, 191 Magnetic induction, 34 Magnetism, theory of, 33 Malignant disease, treatment of, 275 Maxwell's Theory of Light, 35 Measurement of High-frequency Cur- rents, 149 Mendelejeff, Periodic Law of. 21 Mercury vapor in vacuum lamp, 234 Meyrowitz High-frequency Apparatus, 118 Modern therapeutic methods, review of, 209 Molecular bombardment by effluve, 141 Monopolar treatment, 230 Morton's "Static Induced Current," 3, 57 Motor, Tesla's High-frequency, 144 -impulse Current, the author's, 172 -wave Current, the author's, 170 "Multi-frequency Currents," 167, 230, 243 Muscular affections, treatment of, 93 Negative Ions, 32 Neon tube, 154 Nephritis, 270 Nervous dyspepsia, treatment of, 225 Neuralgia, 176 Neuritis, treatment of, 273 Neuroses, functional, 273 Neutral atoms, 32 Nitrogen, oxides of, 205 Nodon valve, 59 Ohm, 38 Ohm's law, 38 Oil-insulation, 42 Opacity of bodies to ultra-violet rays, 203 Organic compounds, 28 Oscillations, electrical, 3, 40, 42 Osmotic regulator, 195 Oudin resonator, 9, 65 methods of tuning, 69 technic for use of, 161 Ozone generation of, by High-fre- quency Currents, 205 Palladium regulator for X-Ray tubes, 196 Paralysis, 273 Passive congestion, 252 Penetrability of matter by X-Rays, 192 Phenomena of High-frequency Cur- rents, 132 Phosphorescence, 204 Photometric mil-ammeter, 152 Physical properties of High-frequency Currents, 132 Physiological action of High-frequency Currents, 221 Piffard's " Hyperstatic " transformer, 12, 92 spark-gap lamp, 202 Plate condensers, 41 Pneumogastric nerve, 253 Pneumonia, treatment of, 254 Portable High-frequency Apparatus, 275 Positive Ions, 32 Potential, unit of, ee Volt, 37 288 INDEX "Pseudo-static" spark, 139, 232 -Faradic Current, 245 Pulsatory currents, 57 Quartz lens for transmitting ultra- violet rays, 179 Radiant energy, 23, 35 Radium, formation and decomposition of, 20, 22 Rectifying valve, see Nodon valve, 59 Rectum, diseases of, 252 Red vacuum, 189 Regulating handle for vacuum elec- trodes, 182 Renal congestion, 270 colic, 270 Requisites for an efficient High-fre- quency Apparatus, 99 Resistance, unit of, see "Ohm," 38 effect of, on condenser discharge, 56 Resonator, Oudin's, 41 discharge of, 41 Hertz, 3 technic, 161 Roentgen's discovery, 190 Rotary converter, 60, 115 Rowland's experiments, 4 Ruhmkorff type of High-frequency Apparatus, American forms of, 116, 119 coil, 39, 60 Rhythmic effluve treatment, 239 Scheidel-Western X-Ray and High- frequency Apparatus, 116 Self-regulating X-Ray tubes, 197 Septic areas, treatment of, 277 Single-focus X-Ray tube, 197 Sinusoidal current, 130 from Tesla Apparatus, 171 Skin diseases, High-frequency treat- ment for, 93 Sodium atom, 34 "Soft" X-Ray tubes, 193 Solenoid, of d'Arsonval, 4, 45 Sound waves, carried by High-fre- quency Current, 174 Snow's set of vacuum electrodes, 180 Spark-gap, breaking down resistance of, 51 analogy to elastic diaphragm, 50 Spark-gap, rotary, author's improved form, 112 Spark-gaps, various forms of, 97, 102 Special uses for currents of High-fre- quency, 280 Spectrum of iron, 202 Spotteswoode coil, 4 "Stabile" applications, 156, 228 Static machine, High-frequency Cur- rent derived from, 92 "Static Modalities," 216, 220 "Step-up" Transformer, 41, 60 Stricture of urethra, treatment of, 271 " Strong-Ovington " High-frequency Apparatus, 82 Superimposed waves, 167 Systems of therapeutics, 213 Table of wave lengths and frequencies, 24, 25 Technic, author's system of, 15 Technic for use of condenser electrodes, 182 Tesla, early experiments of, 4 currents, methods of applying, 166 early apparatus of, 42 ■ effluve, 168 spark, 170 technic, 238 vacuum treatment, 176 Tesla-Thomson Coils, early American form of, 88 diagram, showing construction of, 90 modern American forms of, 106 Tetanus, cause of spasms in, 211 " Theater Plug," for regulating current strength, 109 Theories of Matter and Force, 19-20 Therapeutic technic, 55 action of High-frequency Cur- rents, 226 Thermo-faradic coil, 105 current, 160 Thiele's, treatment of Tuberculosis, 261 Thomson, Professor Elihu, Giant High- frequency Current of, 4 double-focus X-Ray tube, 197 High-frequency Coil of, 41 Tracing, showing nature of High-fre- quency Wave Current, 122 Trans-resonator Technic, Piffard's, 247 electrode, Piffard's, 247 Triple terminals, the author's, 15, 138 Trophic nerve influence, 224 Tuberculosis, author's apparatus for treatment of, 206 TyrelPs "Cascade," for flushing the colon, 252 Ultra-violet lamp, the author's, 202 Ultra-violet Rays, 179 generation of by High-frequency Currents, 201 physiological effects of, 203 therapeutic effects of, 201, 203 Universal X-Ray tube, 200 Uranium, formation of radium from, 22 Urethral stricture, treatment of, 271 INDEX 289 Vagus, see Pneumogastric Nerve, 253 Vacuum condenser chair, 168 inhaler electrode, 257 regulator, 195 Vacuum electrode, discovery of, 15 original invention of, 176 treatment by use of, 175 Vaso-motor system, 253 Vibratory nature of High-frequency Currents, 52, 123, 132 Volt, 37 Volta, 2 Voltaic pile, 2 Water-cooled X-Ray tube, 194 Waves, electro-magnetic (or "Hert- zian,") 3 "White Vacuum," 179 electrode, 189 Williams', Chisholm, method of treat- ment in nervous Dyspepsia, 251 treatment of pulmonary tubercu- losis, 257 Wireless telegraphy, 3 use of High-frequency Currents in, 148 Wohler's synthesis of Urea, 28 X-Rays, discovery of, 190 from vacuum electrodes, 235 generation of, from High-fre- quency Currents, 101, 190 tubes for, with High-frequency Apparatus, 195 Yellow phosphorescence, 204 "Zone of Stasis," broken up by High- frequency Currents, 233 COUNT WAY LIBRARY OF MEDICINE QC 601 S88 RARE BOOKS DEPARTMENT mnnv ■ ■ '■■■.?■ ■. . iiitl:;:; .: Wm Wmm* '■:- ■■:::.-':"i:-:':v:"i':::.,:;:::v'.:;:;::::.; ^ r ' }^piisipiiiis i:=.; ;■!-■: li;-^:: ihr -^^r^p^i^^1:^:^ : ■!-::?::= :;: ;:" : ^ J^^^^^M: S« IS® 111 ^^^^s lilts 1111 ;;!;|: ■nhhhm stiiii ts|iiii .'■v./' - Ililiii|liIiEK::*: §111 »; liili : :':::■: ■:ii';;:; 11 '■■':' ';''":