CHAPTER VI. ELECTRICITY IN SURGERY. FOR purposes of electrolysis, the external resistance being small, the internal resistance should not be great. Stöhrer's or Grenet's cells are employed, and the current should be accurately measured. The needles should be well insulated for two-thirds of their length, the remaining one-third being gilded to prevent its solution. In the treatment of aneurism, our object is to secure, not decomposition, but coagulation of the blood. The clot formed about the anode being firmer, the needles are usually connected with this pole; their uninsulated portion is introduced completely into the sac in order to prevent diffusion of the current into the surrounding tissues, and the inflammation and sloughing which might result from such an accident. The kathode is placed at an indifferent point. The current strength should be sufficient to coagulate egg albumen in twenty to thirty minutes. Duration of sitting about thirty minutes, repeated according to results obtained. Great caution must be used in withdrawing the needles. In the treatment of nævi, our object is to induce coagulation to such an extent as will facilitate absorption without causing sloughing. Usually one needle (kathode) will suffice. Begin with a few cells and gradually increase, if necessary. In port-wine stain we destroy the skin by introducing a number of needles superficially; the new skin is pale, but the cicatrix from a galvanic eschar does not contract. Warts, moles, and single hair follicles may readily be destroyed by the kathodic needle. Malignant tumors are treated by introducing a number of needles through the base; sloughing occurs, and the resulting ulcer heals by granulation. Enlarged glands and small superficial tumors are often successfully destroyed by electrolysis. In cystic tumors both needles are introduced, with the object of acting on the lining membrane, so as to facilitate absorption. Successful results have been thus obtained in ovarian cysts, hydrocele, cystic goitre, hydatids of the liver, etc. By electrolysis, at least the growth of fibroids of the uterus can be arrested. The same means is very suc cessful in causing the death of the foetus and arrest of the growth of the cyst in extra-uterine pregnancy. A Excellent results have been obtained from electrolysis in the treatment of stricture of the urethra. large bougie with a metallic point connected with. the kathode is carried down to the stricture, while the other electrode is placed over the abdomen or perineum. Begin with 5-6 cells and gradually increase; repeat after a few days' interval, if necessary. Galvano-causty.-For galvano-caustic purposes, a special electrode handle is employed, to which may be attached the loop, the cautery dome, or the knife. Its advantages are that it can be used in localities where other means would not be applicable; that it causes no hemorrhage, and that it is followed by less pain than cutting operations. The loop is of great service in the removal of polypi of the larynx, nose, ear, uterus, and rectum, also in removal of hemorrhoids, and in amputation of tongue, penis, and cervix uteri. It should be placed in position, then brought to a dull red heat, and gradually tightened as it cuts its way through. The knife has been successfully employed for tra G |