JOSEPH E. G. WADDINGTON, M.D., C.M., DETROIT, MICH.
Somewhat recently the French have introduced into this country combination electrodes composed of quartz, enclosing a suitable quantity of mercury, and fashioned in variously applicable shapes. These electrodes are connected, by means of a conveniently adjustable handle, to the uniterminal Tesia of any high frequency apparatus, thereby acting precisely as any similarly connected vacuum or non-vacuum electrode would do, but—additionally—a powerful ultra-violet radiation is simultaneously evolved. According to the Bureau of Standards, the spectrum of these electrodes extends down to 2,500 Angstrom units, therefore being exceptionally strong in the more energetic bactericidal zone. A three to five minute exposure, depending upon the voltage strength employed, will produce an intense and lasting erythema. As the voltage on a high frequency apparatus is quite delicately controllable, it is easily possible to administer treatments, with the combination electrodes, of precisely the same duration of time as generally advised with the ordinary high frequency electrodes, averaging from five to ten minutes.
Due to the heat contemporaneously evoked, a more pronounced and lasting result is thereby produced from the accompanying ultra-violet. When administering ultra-violet with the air-cooled lamp for constitutional effect, it is rarely that one wishes to induce even a suspicion of an erythema; but when using the water-cooled for its more powerfully direct bactericidal action, an erythema, or at least an approximate erythema, dosage is quite generally indicated. These French or Gallois electrodes, therefore, both on account of their shape—with the exception of the body one—and because of their thermally accentuated ultra-violet radiation or comparatively low wave length, are exceptionally indicated for orificial treatment in precisely many of the conditions wherein the water-cooled quartz mercury arc would be otherwise so valuably indicated. Unlike their exceedingly fragile and somewhat dangerous glass congeners, these quartz combination electrodes will safely withstand practically any degree of heat, their thermal coefficiency being so low that the contacting quartz itself never becomes unduly heated during a treatment.
A particularly desirable feature of these electrodes, compared with the solid quartz applicators, is the equal amount of radiation that takes place from all sides of the electrode. For nasal treatments in particular, this feature of diffuse radiation is especially valuable; furthermore, the electrodes are light an can be conveniently and comfortably held by the patent:, in most instances, for any maximum length of time required. A non-greasy, water-soluble lubricant should be used to facilitate the introduction of all orificial electrodes, not excepting the aural one.
Acute nasal catarrh is invariably surtailed, if treated in its incipiency, by inserting the nasal electrode full length and giving each nostril a mild erythema dose for three to five minutes. This should be repeated daily. If the configuration of the nasal passage will not permit of adequate insertion, a narrow-pointed electrode may be used, but the thermal concentration of same will necessitate a proportionate decrease in current strength. Chronic nasal catarrh will usually require change of climate to insure permanent relief, but triweekly maximum radiations will at least prove helpful.
Otitis media and other deep-seated and serious aural affections naturally will demand any and every therapeutic aid available, but the pointed aural electrode, by its combined thermal and ultra-violet radiation, will adjunctly aid in relieving many of the accompanying indefinite and annoying symptoms so common to both mild as well as serious pathology of the ear. Eczema and pruritus of the aural canal, if dependent upon a suppurative otitis, will require primary attention to this latter, but, whether sequent or idiopathic, the former will always be benefited by intense radiation. Furunculosis of the auditory canal is easily amenable to heavy radiation, which will often abort an incipient case.
Blepharitis and chronic infection of the eyelids is relieved and kept in abeyance by treating with a nasal or other conveniently shaped electrode slowly brushed to and fro in contact with the edges of the closed lids. Only mild dosage should be employed, and treatments given tri-weekly.
The round, ball-shaped electrode is extremely convenient for throat treatments. For tonsillitis, intensive erythema doses should be given, being careful to press the electrode only against the tonsillar tissue, as excessive radiation upon the acutely responsive pillars will give rise to severe and unnecessary discomfort.
It is unfortunate that the rectal electrodes are not more conveniently modeled; however, the small hemorrhoidal is satisfactory for treatment of anal varicosities, but the indurated and connective tissue type of hemorrhoids will demand surgical attention. As a benign inflammatory reaction is indispensable for optimum results, mild blistering dosage, which is practically painless, is maximally indicated, but not to be repeated until all reaction has subsided, usually within a week.
The vaginal electrode, being insulated, concentrates the heat and ultra-violet radiation towards the cul-de-sac and around the os uteri, thus being indicated for tonic treatment of the immediately contiguous structures and for erosions of the os. An intracervical electrode is employed for intensive radiation in endocervicitis, and is usually thus indicated prior to direct treatment of cervical erosion.
Erythema dosage is determined by placing the electrode in the bend of the forearm, knee, or any other conveniently approximating surface, so as to more nearly duplicate a diffusive orificial contact. Ray two different areas, one for three minutes with medium or mild voltage, and the other for five minutes with milder voltage. In this manner one accurately determines (with each individual electrode), from the mildness or the intensity of erythema response and the thermal tolerance of the skin, a safe minimum and maximum intensity for radiation of the mucosa, recalling that this latter will, as a rule, safely and comfortably sustain a slightly more increased dosage than the skin. From my own experience, I would advise radiating for a possible minimum of five minutes with a mild current rather than a shorter time with greater current, as increased duration means increased high frequency application, which will proportionately care for the reduced voltage intensity of ultra-violet.
It were needless to expatiate upon the indications for and merits of ultraviolet; the high frequency vibrations, effluve, ozone and heat incident to the uniterminal Tesia current should and do accentuate the intensity and beneficial effects of the ultra-violet radiations evolved from the French combination electrodes, and consequently they are valuably indicated in the treatment: of a variety of additional conditions to those herein briefly alluded to.
The combination of electrodes is not intended to compete with the water-cooled quartz mercury arc, but do materially supplement its use. For the general practitioner who possesses a high frequency apparatus and may naturally desire or be compelled to limit his physical therapy apparatus, a few of these Gallois electrodes, which will admirably substitute for similar high frequency ones, and at the same time quite conveniently and efficiently act as ultra-violet generators, should prove of incalculable benefit.
National Eclectic Medical Association Quarterly, Vol. 19, 1927-28, was edited by Theodore Davis Adlerman, M.D.