A Working Manual of High Frequency Currents ( (c1920) )

presented to
ot tbe
\Hni\>er0ft2 of Toronto
Mrs. L, Campbell
WORKING MANUAL
OF
HIGH FREQUENCY
CURRENTS '
By NOBLE M. EBERHART, M. D., Ph. D., D. C. L.
Formerly Head of the Department of Physiologic Therapeutics,

Medical Department of Loyola University. Formerly Professor
of High Frequency, Illinois School of Electrotherapeutics.
Formerly Head of Department of Electrotherapy, Chi-
cago College of Medicine and Surgery. Formerly
Attending Physician Cook County Hospital.
Formerly Professor of Electrophysics Post
Graduate Medical School, Chicago; etc.
Member of Chicago and Illinois State Medical Societies; American
Medical Association; American Medical Editors' Associa-
tion; Victoria Institute or Philosophical Society
of Great Britain; etc.
Author of "Practical X-ray Therapy;" "Brief Guide to Vibratory

Technique," etc.
Sixth Edition; Revised and Enlarged.
CHICAGO
NEW MEDICINE PUBLISHING CO.
25 E. Washington St.
COPYRIGHT 1911, BY NOBLE M. EBERHART.
Nikola Tesla, Inventor of the Tesla Coil Courtesy "Elec-
trical Review and Western Electrician."
INTRODUCTION.
The on High Frequency Currents is not
literature
extensive and most of it is too technical for the
average physician, who is more interested in the
application of these currents than he is in the pre-
cise manner in which they are generated.

For this reason I have given comparatively little
space to the consideration of the various forms of

apparatus, other than to outline the types upon one
or another of which all of the machines are based.
VII.
Further information along this line is properly
within the sphere of the various manufacturers.
My intention has been to make this a practical
hand-book for the busy physician who wishes to use

high frequency currents and to learn how to do so
with as little ''red tape" as possible.
I have expressed my individual opinion on many
points, and sometimes this may be found at variance
with that of other authors, but it is based upon
nineteen years' practical experience involving the
daily use of High Frequency Currents and upon six-

teen years' experience in teaching the subject.
My indebtedness for data furnished is acknowl-

edged to Drs. W. B. Snow, W. H.
King, H. E. Waite,
F. de Krafft, E. A. Black, E. C. Titus, H. F.
Pitcher, S. Stevens, R. E. Farmer, and Messrs. F. H.

Swett, J. B. Wantz, Wm.
Meyer, Samuel T. Hutton,
Edwin Edwards, H. L. Kahl, F. A. Wiggin, R.
L.
and F. H. Wappler, T. B. McClintock, C. E. Ander-
son, M. Sanchez, J. E. Clapp, H. W. Young and
Wm. Stahl.
THE AUTHOR.
25 E. Washington St., Chicago.
VTII.
CONTENTS
Chapter. Page.
I. Definition of High Frequency Current;
Alternation; Cycle; Period; Oscilla-
tion; Frequency; Lighting Vacuum

Tube Not Proof of High Frequency
Current. 13
II. The Development of the Current Ley- ;
den Jars Plate Condensers Electrical

; ;
Oscillation. 22
III. Types of Apparatus; D'Arsonval Type

Tesla Transformer; Impedance; Ou-
din's Resonator; Measuring the Cur-
rent. 30
IV. Various Forms of Vacuum Tubes; Ef-

fects of Different Vacua; Insulated
Tubes; Fixed and Adjustable Socket

Handles; Spatulate Tubes. 45
IX.
Chapter. Page.
V. Physiological Action of the Current;

High Frequency Burns; Offsetting
Tendency to X-ray Burns. 60
VI. General Technique; Vacuum Tubes; Lu-

brication; Cautions; Asepsis; Stand-
ardizing Dosage ; Preparation of Pa-
tients Technique for Skin Diseases
; ;
Relief of Pain Cauterization Orificial

; ;
Technique ; Fulgura-
Cataphoresis ;
tion; Auto-Conduction; Auto-Conden-

sation ;
Portable and Home Made -
Pads; Surgings; Water Spray; Local

Auto-Condensation Indirect Sparks ; ;
Taking the Blood Pressure. 70
VII. Special Technique for Ear, Eye, Nose,

Rectum and Prostate, Scalp, Throat,
Urethra and Vagina. 136
VIII. Practical High Frequency Therapy, Dis-

eases and Symptoms Alphabetically
Arranged with Methods of Treatment. 152
x.
Chapter. Page.
IX. Ozone; Nature; Physiological Action;

Methods of Administration; Diseases
in Which It Is Indicated. 270
X. High Frequency X-ray; Its Scope and

Limitations; Resume of Skiagraphic
and Therapeutic Technique. 279
XI. Diathermy; Electro-coagulation; Ther-
mo-penetration. 290
XII. High Frequency in Dentistry. -

297
Glossary. 310
Index. 315
XI.
12 EBERHART'S MANUAL Of
Fig. 1 Large Tesla Coil.

HIGH FREQUENCY CURRENTS 13
CHAPTER ONE.
Definition of High Frequency Current; Alternation;
Cycle; Oscillation; Period; Frequency; Explana-
tion of Terms; Pulsatory Currents; Perio-
dicity; Lighting Vacuum Tube Not

Proof of High Frequency Current.
What a High Frequency Current? A high fre-

is
quency current is an alternating (oscillating) cur-

rent in which the frequency is beyond the point of
producing muscular contractions.

An Alternation is a complete reversal of the direc-
tion of a current as any one of the waves shown in
Fig. 3.
A Cycle is two alternations. It constitutes the
round or circle of the current embracing one posi-

tive and one negative wave or alternation.
Oscillation. An oscillation is a series of diminish-
ing waves which flow alternately in opposite direc-

tions, but not necessarily in the same time. Oscilla-
tory currents periodically reproduce similar series
of waves, as shown in Fig. 3. Their frequency is

14 EBERHART'S MANUAL OF
very high and is the reciprocal of period. It is com-
puted on the number of double alternations, thus

corresponding to the method employed with low fre-
quency currents.
Period is the time required for one cycle.
Frequency is the number of complete cycles oc-
curring in one second of time. It is the reciprocal
of period.
Explanation. In order to understand the fore-
going definitions it will be necessary to recall some

fundamental facts.
The direct current is one which always' acts in

one direction, that is from positive to negative, and
is graphically represented by a straight line.
The alternating current, in contrast to this, is one
in which the current is constantly changing its di-
rection or polarity, and we represent it by a waved

line (Fig. 3), the waves above the line being posi-
tive waves or alternations and those below the line
negative waves.
Let us call the line zero in volts and the crest of
the wave 110 volts. The current starts at zero,

reaches the maximum
positive voltage and then re-
verses and goes back to zero and repeats on the
Fig. 2 Portable High Frequency Coil.
negative side. This complete reversal of the cur-

rent is called an alternation and two of them make
a cycle. If we only represented two alternations
as in Fig. 4 and then made the second one return
to the starting point, as shown by the dotted line,
we would have in this case a circle, and the word

circle will keep the meaning of cycle fixed in the
mind. Alternations do not necessarily assume the
shape of a semi-circle, but may represent any form

of wave, still two of them represent the completion
of the circuit or cycle. In high frequency currents
these cycles become a succession of oscillations or
undulations as represented graphically in Fig. 3.
Frequency is a term properly belonging only to

the alternating current. We have uni-directional
currents such as those derived from induction coils,
in which the current broken up into a rapid series

is
of waves, with those which would be below the line
damped out, leaving a succession of pulsations. This

current lights up vacuum tubes and performs much
of the same work as the high frequency, but is not
a true high frequency current.
These are called pulsatory currents and in place

of the word frequency we indicate their rapidity by
the term periodicity.
To return to our explanation of the alternating
current, let us suppose that it takes one-one hun-

dred and twentieth of a second for any one of the
alternations in Fig. 3. Then two alternations or one
cycle would take two times one-one hundred and

YOUTS
no
^So \F
110
ALTERNATING,
OSCILLATING.
ONE, CYCLL.
. 4.
Fig. 3 Alternating and Oscillating Currents.

Fig. 4 Analogy Between Cycle and Circle.
18 EBERHART S MANUAL OF
twentieth, which equals one-sixtieth of a second, and

this is the period of the current illustrated. If it
takes one-sixtieth of a second for one cycle, there

will be sixty times as many in one second, and this
is the frequency.
It will be seen that if we have the period of the
current, all that is necessary is to invert the frac-
tion and we have the frequency or number of cycles.
In the illustration we have arbitrarily represented

an alternating current of 110 volts, sixty cycles,
which is the ordinary commercial alternating cur-
rent employed in electric lighting. It is a low fre-
quency current. Other low frequency currents have

25 cycles, 125 cycles, 133 cycles, etc.
Law, Medium and High Frequency Currents. If
we apply a low frequency current to a muscle we

find that the muscle contracts, and this is powerful
and may be strong enough to be painful. As we in-
crease the frequency of the current the painfulness.
decreases, but more than a single muscle tends to

contract. These are currents of medium frequency
of which the sinusoidal current is a type.
At a frequency of about 10,000 cycles these tetanic
contractions disappear and above that frequency
there is neither pain nor gross muscular contraction.
Fig. o High Frequency Coil, Giving All Modalities.

The absence of pain supposed to be due to the

is
inability of the sensory nerves to comprehend such
rapid alternations just as we have vibrations that

cannot be recognized by the auditory nerve as sound
or by the eye as light.
In these higher frequencies the contractile effect
is expended upon the individual cells making up
the tissues instead of on individual muscles. This I
call cellular message and one important reason
it is
why high frequency currents produce such a marked

benefit on nutrition and metabolism.
As the current increases in frequency and volt-
age, other peculiarities appear and it no longer re-
quires a complete metallic circuit, but is capable of

traversing long distances as ether waves, as in the
wireless telegraph. In fact, high frequency currents
are better understood as vibrations than as ordinary
currents.
From the fact that muscular contractions cease
with 10,000 cycles or oscillations, this has been taken
as the dividing line between medium and high fre-
quency currents.
As the frequency with some apparatus is esti-
mated in millions I have been advocating a higher

dividing line, say 100,000, as more in proportion,
but this would cause considerable confusion at pres-

ent and so the original nomenclature is adhered to.
Lighting of Vacuum Tube Not Proof of High Fre-
quency Current. As intimated above, exciting a

vacuum tube as from the static machine or from
Fig. 5a Prismatic Ray Type of Portable Coil,
one terminal of an induction coil is not proof of the
presence of a high frequency current. To produce

the high frequency current there must be attached
to either of the above one of the several forms of
high frequency apparatus described in Chapter III.
22 EBERHART'S MANUAL
CHAPTER TWO.
The Development of the High Frequency Current;
Ley den Jars; Plate Condensers;
Electrical Oscillation.
The Development of High Frequency Therapy.
The therapeutic value of the high frequency cur-
rent depends upon a number of physical phenomena,

some of which were known many years before the
high frequency was thought of.
In looking backward over electrical history, there
are three points that bear particularly upon the
development of high frequency therapy.

First: The invention of the Leyden jar, or an
electrical condenser secondly, the discovery of what
;
is known as electrical oscillation; and finally, its
application to the human body.

The Leyden Jar or Condenser. The Leyden jar
was discovered in 1775 by Musschenbroek, and takes
its name from the City of Leyden. It consists of a
glass jar covered on both the outside and the inside

with tin foil. (Fig. 7). These coverings only ex-
tend part way to the top of the jar. A chain from
the cover of the jar connects with the inner layer,
terminating above in a small rod with a ball tip.
This is for the purpose of charging the jar by con-

tact with the charging source or discharging it if
this knob is brought nearly or quite in contact with

a metallic conductor touching the outer layer.
The peculiarity of the Leyden jar consists in the
fact that when a charge of electricity is placed on

one of its layers, another charge of opposite polar-
ity immediately appears on the other layer of the
jar.
For instance, if the inner layer receives a positive
charge, a negative one will be found on the outer

lead foil and vice versa.
These charges will be held for some time unless
something occurs to connect the two layers and al-
low the opposite kinds of electricity to neutralize
one another.
In the Leyden jar, then, we have two charges of
electricity separated from one another by the glass,
which, although it keeps the charges from getting

to one another, does not prevent their exercising
6 High Frequency Coil, Giving All Modalities.

an attraction upon each other; or, to speak more

precisely, the one charge induces an opposite charge
on the other layer.
Fig. 7 Leyden Jars, Cylindrical Type.
A substance which separates two charges of elec-
tricity in a condenser while still permitting them to

have an influence on one another, is called a di-
Other di-electrics than glass are mica, vul-
electric.
canite, etc. The contraction of the charge on the

layer of the jar causes a crowding together or con-
densing of the electrical ions, and thereby gives rise
to the name condenser for the Leyden jar or the
other form known as the plate condenser.
26 EBERHART'S MANUAL off
In the plate condenser we have two layers of tin

foil separated by a plate of glass thus keeping up
the same relative arrangement that exists in the
Leyden jar. To make the analogy more complete,
Fig. 8 Section of Jar Fig. 9 Section of Plate

Condenser.
I have been accustomed in my classes to make use

of the illustration in Fig. 8, showing a section of a
Leyden jar and then supposing that
;
this were made
of flexible material, let us imagine that we took
hold of the ends of the section and straightened it
out when it would appear as in Fig. 9, which repre-

sents a cross section of a plate condenser.
Electrical Oscillation. When a Leyden jar or other

condenser is discharged through an air space, there
is apparently a single spark passing across the gap.
From the time of the discovery of the jar in 1775
was supposed to be the
until 1842, this case. At this
time Professor Henry announced in reality there

was a series of sparks passing back and forth be-
tween the terminals of the spark gap. This phe-

nomenon has received the name electrical oscilla-
tion. It has been compared to the action of two col-

umns of water of different heights connected at the
bottom by a pipe with a valve in it. When the valve
isopened, since water seeks its own level, the higher
column descends, and the lower column rises. As a
result of the action of gravity on the greater weight
of the higher column, instead of the column descend-

ing until level with the other column and then stop-
ping, this force carries it below until it becomes the
lower column and the other column the higher one.
and thus the two columns balance back and forth
until finally they come to rest at a level.
Another illustration may be made use of in the
pendulum, which when raised to one side and re-
leased, swings over to the opposite side nearly as far,

and so back and forth through shorter and shorter
arcs until it finally stops in the center.
Electricity, following the same principle as it
passes from a higher to a lower potential, produces

a similar oscillation.
Lodge gave an especially suitable illustration by

likening the action to the vibration of a straight
steel spring fastened at one end.
EBERHART'S MANUAL OF
Outfit.
ig 10 Large High Frequency
Fig. lOa Portable Coil.
Electrical oscillation is the keynote in the thera-
peutic application of high frequency currents, al-
though it was nearly forty years after its discovery
before anyone thought of applying the principle in

the treatment of the human body.
CHAPTER THREE.
Types of Apparatus; D'Arsonval Type; Tesla Tras-
formers; Impedance; Direct D'Arsonval Cur-
rents ;
Auto- Conduction ; Auto-Condensa-
tion; Resonator of Oudin; Tuning
Coils; Measuring the Current.
Types of Apparatus. There is no intention on the

part of the author to encumber this volume with
lengthy descriptions of apparatus. For such infor-
mation, the reader is referred to the manufacturers

of electrical outfits.
All high frequency instruments, however, are con-

structed along two principal types that of D'Ar-
sonval and that of Tesla and these should be un-
derstood by the high frequency operator, since all
machines represent one or the other or a combina-

tion of these types.
In connection or combination with them a third

instrument the resonator of Oudin is in such com-
Fig. 11. A Complete and Convenient Portable Outfit.

mon use that it also calls for special description. In
speaking of high frequency currents, to be specific,

we should always state the form of current used,
as D'Arsonval high frequency, or Tesla high fre-
quency, etc.
The D'Arsonval type of apparatus, as it is manu-

factured today, consists of a combination of the
D'Arsonval solenoid and an improved type of the
Oudin resonator. The Oudin current derived from
this type of apparatus serves to energize vacuum
electrodes, the spray electrode, the so-called ''static
spark" electrode, the portable ozone inhaler, and

also is the current which is utilized for obtaining
the "sold" fulguration spark. The D'Arsonval

solenoid is utilized for auto-condensation, auto-con-
duction and diathermy. The D'Arsonval solenoid

in this instance delivers a comparatively low poten-
tial and high milliamperage current.
The Tesla type of apparatus is designed along the

same general lines as is the D'Arsonval and has the
same wide range of usefulness, but the general char-
acteristics of the current are different in that the
Tesla type of apparatus delivers a high potential,

low milliamperage current.
If every physician employing high frequency ap-

paratus was aware of this difference it is the au-
thor's opinion that many cases of misunderstanding
and dissatisfaction would be cleared away.

In other words, the milliamperage reading of the
meter is not an indicator of the capacity or power
of the apparatus. This means that 500 milliamperes
of Tesla high frequency current is just as capable
of producing deep constitutional effects as 1,500
milliamperes on a D'Arsonval high frequency ap-

paratus.
The relative merit of the "Tesla" versus the
"D'Arsonval" apparatus more particularly as re-
gards auto-condensation and diathermy has been the
subject of numerous discussions among electro-ther-
apeutists. The thickness of the di-electric (auto-

condensation cushion) has also entered into this dis-
cussion. It has been proved that either type is
capable of producing results and in consequence

thereof the author does not feel capable of choosing
himself as the sole arbitrator in deciding which is
better. He, however, for the past three years has

been employing the Tesla type of apparatus in his
individual practice and has been deriving eminent
satisfaction from its use. He employs a cushion of
approximately three inches in thickness this size
being endorsed by the standardization committee of

the American Electro-Therapeutic Association.
As will be stated in Chapter VI the author orig-

inated the thin cushion as well as the portable thick
pad, and the method of making these different forms
is given. He bows to the ruling of the committtee
referred to above and now employs only the thicker

cushion.
The D'Arsonval Current is one of high frequency,

not very high voltage, and high amperage.
It is administered as a bi-polar method, thereby
producing constitutional effects. D'Arsonval started

with an induction coil attached to the direct cur-
rent. The terminals of the secondary coil were at-
tached to the inner layers of two Leyden jars, there-
by charging one of them positively and the other

negatively. In the circuit between these two layers
was placed an adjustable spark gap. Between the
outer layers of the jars was placed a solenoid or
coil consisting of fifteen to twenty turns of coarse
copper wire. This combination of condensers con-
necting on one side through a spark gap, and on the

other through a coil of wire, is an absolute neces-
sity in order to obtain the D'Arsonval current, and

it therefore constitutes this type. See Fig. 13.
When the positive layer of the first receives a
sufficiently high charge, it jumps across the spark
gap to neutralize the negative charge in the second
jar. Immediately the positive charge on the outer

layer of the second jar is released and passes through
the coil of wire to neutralize the negative charge on
the outer layer of the first jar, and as it passes
through this coil or solenoid, it produces a high fre-
quency current keeping in mind the fact that the
oscillationback and forth through 1he condensers

exists as described in Chapter II. The patient is
connected on that side of the condensers that dis-
charges through the coil and is really on a shunt or

switch from that part of the circuit, and the reason
the patient receives any current at all, is because
the solenoid possesses the property known as self-
inductance, which impedes the passage of the cur-
rent, allowing part of it to go through the lesser re-
sistance in the patient's circuit. The process of in-
terfering with the current as a result of the self-

inductance is called impedance.
The Tesla Transformer and Coil. Tesla started
with the alternating current, and by referring to
36 F.BER HARTS MANUAL OF
TATIENT]
COUCH OK
SOLLNOID
^
Fig. 13 Diagram of D'Arsonval Type.

our definition of high frequency currents (Chapter

I.), it is seen that all that was required was the
increasing of the frequency to a point which we
properly call high. To do this, he used as a primary,
a coarse coil of wire consisting of a few turns only,
while the secondary coil consisted of an extraordi-
nary number of turns of very fine wire the result

being that the current induced therein was of very
high tension and very high frequency. The Tesla
transformer or coil is especially adapted to the al-
ternating current. It is employed in all of the port-
able high frequency apparatus on the market. The

Tesla primary resembles the D'Arsonval current ex-
cept the amperage is less. Fig. 14 shows one method

of evolving the various currents.
Administration of the D'Arsonval Current. There

are three principal ways in which this current is
applied to the body ; first, the direct bi-polar method,

which has also' been subdivided into two or three
forms ; second, auto-conduction, and third, auto-con-
densation. In the first method, the patient is di-
rectly connected to the terminals of the apparatus.

Whether the patient holds the two electrodes, or
whether he is attached to one pole, while the other
pole is connected with an electrode in the hands of

38 KBERH API'S MANUAL
VERY MIQH i/oLTft<sE-HiQH
Fig. 14 Diagram of Tesla Type.

the operator, the method is still called direct appli-
cation. It should be borne in mind that the direct

D 'Arson val current is also known under several
other terms, such as diathermy, electro-coagulation
and thermo-penetration. See Chapter XI. Refer-
ring back for a moment to the component elements

of the D 'Arson val apparatus, it is seen that sole-
noids and condensers are fundamental parts. In
the elementary D 'Arson val type we have one set
of condensers and one solenoid. It would appear,

therefore, that the inventor said to himself: "If
one solenoid gives a current of high frequency, let
us add another solenoid and see what that will do."
Thus the second type, auto-conduction, is con-
structed, and a large solenoid is connected in the

shunt which forms the patient's circuit, and it is
made so large that the patient may be placed within
this coil or cage when it is found that as the high
frequency currents traverse the coil, other high fre-
quency currents are induced in the body of the pa-

tient. This is auto-conduction.
Auto-condensation. Again reverting to our ele-
mentary type instead of using the second solenoid,

the next arrangement was the use of an extra con-
denser, and the current passes from one terminal

into the plate of the condenser, while the other

plate was formed by the body of the patient, hence
the term auto-condensation.
Oudin's Resonator. Oudin discovered that with a
coil of wire properly tuned or adjusted to the coarse

coil or solenoid of D 'Arsonval the electrical currents
of the latter produced currents of such strength
that they might be taken from the terminal of the
larger solenoid and applied to the body. They are

of high frequency, high voltage and low amperage,
resembling the Tesla secondary. As ordinarily con-
structed, the D 'Arsonval apparatus and the res-
onator are combined in one instrument the resona-

tor proper consisting of a large coil of fine wire
placed above the coarse solenoid of the D 'Arsonval

machine. See Fig. 15.
Tuning Coils. The best results in resonance are
obtained when the coils are properly adjusted and

attuned to one another. To facilitate this the wire
that passes from one. side of the solenoid is attached
to a sliding metal finger, which may be moved up
or down on the solenoid, and thereby increase or de-
crease the number of turns of wire employed. This
permits proper adjustment of the coils at the same

time it is found that the R-reater the number of turns
HIGH rREQUENCY CURRENTS 41
included, the sharper the resulting spark, and vice
versa.
A ^
Fig. 15- Diagram of Oudin Resonator.
Measuring High Frequency Currents. High fre-

quency currents cannot be measured with an ordi-
nary meter. For D'Arsonval currents the method
customarily employed is the use of a hot wire meter.

This is really a thermostat instead of an electrical
device. It is based upon the fact that the passage
Fig. 16 Hot Wire Meter.
Fig. 16a Air-Cooled and Air-Cleaned Spark Gap.
of the high frequency current gives rise to heat
and this heat causes expansion in a platinum wire

and thereby deflects the needle in proportion. Hot
Fig. 17 Large Combined Tesla, Oudin and D'Arsonval

Type Coil.
'
44 EBKRH ART'S MANUAL OF
wire meters are faulty, but give a relative idea of
dosage when employed on the same apparatus. One

is shown in Fig. 16. Other methods of measuring
these currents areby Gaiffe and Meylon's induction
amperemeter, which "measures the repulsive force
between the original current and the current which
it induces in a coil attached to the indicator."
CHAPTER FOUR
Various Forms of Vacuum Tubes; Effects of Dif-
ferent Vacua Insulated Tubes Fixed and

; ;
Adjustable Socket Handles.
Various Forms of Tubes. The vacuum tubes used

in high frequency work have been made in almost
every conceivable form to enable them to be ap-
plied to various parts of the body. The vacuum

of these tubes varies from one-five hundredth of an
atmosphere up to that possessed by the X-ray, one
one-millionth. The color which appears in the tube
varies according to the degree of vacuum; thus a
low vacuum will produce a reddish color or glow
in the tube; one of medium or slightly above me-
dium vacuum, a blue color; and a high vacuum a
white appearance.
Strong says, "As the exhaustion proceeds from

one-five hundredth to one-ten thousandth of an at-
mosphere, the disks become thicker and the stria-
tions fewer, and the color changes from a rose-pink

to violet, blue (one one-thousandth), blue- white, and

finally to a dense yellow-white. A low X-ray
vacuum would be about one one-hundred thou-
sandth of an atmosphere."
Besides the degree of vacuum, the light is also
supposed to be influenced by the kind of gas re-

maining in the tube, and some authorities claim
that there is a direct analogy between the rapidity
of the oscillations at the spark gap and the color
of light in the tube. As the lowest number of vibra-
tions producing the color "red" is 450 billions per
second and the highest violet 750 billions, this
analogy seems improbable.

The low vacuum tubes give off more heat, while
the high ones give some chemical (ultra-violet) rays
and if very high, X-rays.
The red or red-pink vacuum, besides giving off
more heat, is sedative and useful in painful con-
ditions and in acute diseases and inflammation.
The medium, blue, or blue-white vacuum gives off
some chemical rays, and is more appropriate in
chronic conditions. It is often employed where
the white vacuum would really be indicated, as this
contains not only blue and violet, but also some
ultra-violet rays. All chronic ailments, where the
c
p i
.2
fcl
x S
i:c
E-i
Ji
I!
= CM
48 FBERHARTS MANUAL Of
Fig. 19 Portable Outfits.

Fig. 20 Tubes and Handles.
f 8 10 Jl 12 id
Fig. 21 Insulated Tubes.

vitality is impaired, skin diseases, indolent ulcers,

etc., call for the employment of the white or blue-
white tube.
Much of the foregoing is more theoretical than
it is practical and I have finally come to the conclu-

sion that a medium vacuum electrode (purple tinge)
answers all practical purposes, and this is what I
am now using.
Vacuum tubes are ordinarily made in a single
chamber, the tube fitting into the socket of a handle

that is used for all the different forms. Some tubes
have a leading-in wire and others, instead of having
a single chamber in the tube, have the vacuum di-
vided into two chambers the size of the curcumfer-

ence of the tube, connected by a small tube, possibly
the size of a small pencil, and surrounded by a cham-
ber that is not a vacuum. These latter are known
as insulated tubes.
The tubes used most frequently are shown in Fig.
20. No. 1 is the body tube, which is used also in
Ireating face and scalp. No. 2 is the rectal tube;
3, vaginal; 4, nasal; 5, urethral or aural; 6. throat.

In place of No. 1, No. 11, Fig 21 will be found
equally useful and in some instances superior on

account of the ridges around the depression en-
HIGH FREQUENCY CURRENTS
Fig. 23 Vacuum Tubes.

52 EBERHART s MANUAL,
Fig. 22 Various Types of Tubes.
abling it to be used where it would be difficult la

place the body tube.
Insulated Tubes. The advantage of the insulated
tube which I have been in the habit of calling the
Titus tube because I believe it was first designed
by Dr. Titus is that with this tube the current may

be introduced without loss into an orifice of the
body. Take a plain vacuum tube and attach to the
current and when it is lighted up, surround it with

the thumb and forefinger and it will be observed
that there no light beyond the point of contact.

is
It stands to reason, therefore, that if such a tube

were introduced, for instance into the rectum, the
point of contact with the body would draw off much
of the current and the surface within the body
would receive but little treatment. For this reason
with the insulated tube the opening of the orifice
comes in contact with the non-vacuum part of the

tube and the end of the tube where the vacuum ex-
ists thus conveys all of the current in at the desired
point.
I have been taken to task for my statement above,
on the ground that contact with the encircling finger
possesses no capacity. It simulates, however, the
conditions of certain orificial treatments and after
trying the experiment referred to, I am sure the
physician will resort to the use of insulated tubes

for rectal and other orificial work.
The principal forms of insulated tubes in use are
shown in Fig. 21. No. 7 is for the ear; 8, rectal, or
54 KBERHART'S MANUAL of
prostatic; 9, post-nasal; 10, for vagina or uterus;

11, prostatic or for general surface use ; 12, urethral
or aural; 13, nasal.
The Adjustable Socket Handle. The ordinary
holder for high frequency tubes consists of a straight
handle with a metal socket into which the tube is
received as shown in Fig. 20. This is suitable for
holding electrodes that are applied to the surfaces of

the body, but for most conditions I prefer a handle
with a movable or adjustable socket. Fig. 20.
This socket may be placed at any angle to the

handle that may be desired and with a thumb screw
made secure at the point necessary. The advan-
tage of this will be discussed in detail in Chapter
VII., when considering the special technique for va-
rious portions of the body.
The latest type of my adjustable handle is shown
in Fig. 24. It is of spring steel and accommodates
tubes of varying diameters.
Author's Spatulate Tubes. I have recently de-
signed the tubes shown in Fig. 27. They end in a
flattened spatulate extremity. In the body tube the

end is an angle with the main tube, thus making
at
it much handier to use than the regulation type of

body electrode.
Fig. 24 Author's Latest Adjustable Handle.

The vaginal, prostatic and rectal tubes are similar
in shape but are straight. They vary only in size
and are made both plain and insulated.
Fig. :i5 A Xcat Combination of High Frequency and X-l\ay.
The physician who has been using vaginal and

prostfitir. tubes will readily perceive the advantages
of the larger flat surface. Either of these tubes will
be found quite satisfaftory for surface applications.
ERERHART'S MANUAL OF
Fig. 27 Author's New Spatulate Tubes.

60 EBF,RHART'S MANUAL o?
CHAPTER FIVE.
Physiological Action of High Frequency Currents;

Burns; Offsetting Tendency to X-Ray Burns.
The physiological action of high frequency varies

with the form employed.
In the construction of the apparatus the coarse

coil or solenoid of the D'Arsoiival machine is used
as the primary coil of the Oudin resonator, and the
current from the secondary of the Tesla coil is es-
sentially the same as that from the secondary of the

resonator.
If a vacuum tube is excited by attaching to one
pole of the Tesla secondary it gives the same effect
as if coming from the top of the Oudin resonator.

With the hyper-static transformer the primary
yields a D'Arsenval current and the secondary one

similar to that of the resonator or Tesla secondary.
When vacuum tubes are applied locally there is
soon produced redness and hyperemia, with all of
the resultant benefits on nutrition.

hlGH FREQUENCY CURRENTS 61
In short, the fundamental value of high frequency

currents is their beneficial effect on all nutritive
processes. Incidental to this we have increased oxy-
genation of blood and tissues, increased leucocytosis

(and phagocytosis) ;
and increased elimination.
There is no painful sensation produced by the vac-
uum tube when held firmly in the hand, thus estab-
lishing complete electrical contact. Ordinarily there
is a sensation of heat and in some instances percep-
tible vibration. Removing (the tube produces a
spark which increases in sharpness as the tube is
drawn away, up to the full length spark it is capable

of emitting. The longest spark which may be drawn
from the tube has been my method of roughly calcu-
lating the strength of the current and the regulation
of the dosage. See Chapter VI.
General Action of Vacuum Electrode. In a gen-
eral way the action of the current when applied by
means of the glass vacuum electrode is as follows :
A mild current with tube in contact is sedative. As

the current is increased, or the electrode removed
from the surface, allowing a spark to pass, it be
comes first mildly stimulating, then strongly stim-
ulating and finally caustic or destructive. The whole
gradation of effect from sedation to cauterization
62 EEKRHART'S MANUAL otf
being essentially a question of current intensity and

length or sharpness of spark.
With this is the effect of hyperemia and the ger-
micidal action of the spark and the ozone which
it liberates.
Summary of Vacuum Tube Effects from Oudin

resonator or Tesla secondary :
1. Increase blood-supply to a given area. (Hy-

peremia.)
2. Increase oxidization and local nutrition.
3. Increase oxygenation of blood.
4. Increase intake of oxygen.
5. Increase output of carbon dioxide.
6. Increase secretions.
7. Increase elimination of waste products.
8. Liberate ozone with the resultant benefit of
more or less of this ozone being inhaled by the pa-
tient, and also probably carried directly into the
tissues.
9. Increase bodily heat, without a corresponding

rise in temperature.
10. Locally germicidal.
Mild and medium sparks stimulate or soothe
11.
according to length and character of application.

12. Strong sparks are caustic.
13. Sparks to spine increase arterial tension.

14. Promote absorption of plastic exudates or ad-
hesions.
These effects of vacuum tube applications, while

essentially local, are not absolutely so. The current
traverses thebody from the point
in all directions
of entry, but is, of course, most intense and pro-

nounced at the latter point. Prolonged applica-
tions of vacuum tubes will give systemic effects, but
these are obtained more easily by auto-condensa-

tion.
Constitutional Effects. These are derived through

auto-condensation and auto-conduction. These cur-
rents increase bodily heat, almost always showing
a rise of from one-half to one and a half degrees in
temperature during a ten-minute application.

Some attribute the effect of these currents to the
heat they develop in the tissues. In my opinion
their principal effects are due to "cellular mas-
sage." They have, therefore, a great effect upon

metabolism.
The effect of auto-condensation in producing cellu-
lar massage is appreciated when we realize that the
charge in the patient's body must return back into

the circuit and then alternate with one of opposite
64 KBERHART'S MANUAL OF
polarity; thus, first a positive and then a negative

charge is carried into the body and back again. This
produces a to-and-fro wave that acts upon every
cell in the organism. No sensation is usually per-
ceptible if perfect electrical contact with the patient
exists in the latter 's circuit.
Synopsis of Constitutional Effects :
1. Increase general metabolism.

2. Increase glandular activity.
3. Increase temperature and bodily heat.
4. Increase oxidization and hemoglobin.
5. Increase secretions.
6. Increase elimination.
7. Lower blood-pressure when hypertension ex-
ists.
8. Soothing to the nervous system.
High Frequency Burns. This is a subject which

has not been touched upon in the literature on high
frequency. There is a prevalent idea among many
operators that these currents do not and cannot
produce a burn. True, they do not cause a derma-
titis, comparable to that produced by the X-ray,
but they are still capable of causing annoying sur-
face burns.
It will be noted by the physician who is accus-

tomed to handling the excited tube with his hands
that after a time the skin, especially about the fin-
Fig. 28 Formalin Sterilizer.
ger tips, feels as if he had been handling a hot dish,

that had seared the outer skin. Also in giving
vaginal treatments, prolonged application may result
in shreds of the mucous membrane adhering to the

66 EBERH ART'S MANUAL OF
tube when it is To avoid this, I make

withdrawn.
it vacuum tube in contact
a rule never to leave a
with a mucous membrane for more than seven min-
utes at a time. Occasionally the urgency of a case
is such that I am willing to give longer treatments
and take the chance of a possible burn.
High frequency currents seem to have no cumu-

lative effect in so far as burning is concerned, and
treatment may be repeated frequently without any
apparent danger; thus, three seven-minute treat-
ments may be given in one day with intervals of
three to six hours between, without any serious
consequence when one twenty-minute treatment may
be disastrous.
High frequency burns appear immediately; there

is no interval as with the X-ray. Another use of
the high frequency in which burns may result is in
the application of the spark to a mucous membrane,

as for instance, to the lip, where care and judgment
must be used.
have seen a fairly sharp application to a "cold

I
sore" result in the formation of a large vesicle

which ruptured and poured ?fo>rth an incredible
amount of serum and was three weeks in healing.
As a sharp spark has a cauterizing effect and is
used for that purpose, it is readily inferred that the

reaction just referred to is of this nature, as even
a comparatively mild spark will influence a mucous

membrane.
Another condition in which these currents must
be used with care is about the neck or scalp, where
there is a fine, fuzzy growth of hair, as with some
forms of apparatus having considerable amperage,
enough current comes through to produce a spark
capable of setting fire to any inflammable substance.
This property of the high frequency spark may
be easily demonstrated by lighting a gas jet with
it. I have been told of one or two instances where
severe burns occurred from the spreading of the tiny
flame to the hair on the head.
I wish to specially caution against the danger of
using the high frequency spark on the scalp in con-
nection with lotions containing a high per cent of
alcohol or other readily inflammable material. Where
such lotions are employed, the high frequency spark
must be used first and the lotion applied thereafter,
or a serious accident may happen.

The same point must be kept in mind when using
the cataphoric electrode.
68 EBERHART'S MANUAL of
Offsetting Tendency to X-Ray Burns. While I
am touching on the subject of burns I wish to call
attention to a use which I have made of the high
frequency current, regarding which I have seen no

reference elsewhere. This is the use of this current
to offset some of the effects of the X-ray, and by
its use in conjunction with the latter, to enable a
larger dose of the X-ray to be administered without

a corresponding degree of danger.. A stimulating
application is used to the point of producing some
reddening of the skin.
The ultimate action of the application of the
X-ray is to cause a decreased amount of blood in
the part treated through the action of the ray in in-
creasing the cellular lining of the arterioles and

thereby producing a diminution in their caliber. It
is well known that in deep X-ray burns we have a

condition of starvation and death of tissues, result-
ing from insufficient nourishment. Now, as far as
the action of the high frequency current on the ves-

sels is concerned it is diametrically opposite. It in-
creases the blood supply to the part treated and to
this extent it tends to offset the anemia produced by

the X-ray.. Otherwise the two methods usually act
in harmony with one another in a large number of
diseases, particularly those affecting the skin, and

by combining the two, a greater amount of X-ray
may be safely used, while its action is hastened by
the complementary effect of the high frequency cur-
rent.
Fig. 28a Portable Outfit.
This must not confound the reader with the action

of strong sparks, which, as in fulguration, destroy
arterioles, or produce an endarteritis similar to that

caused by the X-ray.
CHAPTER SIX.
General Technique; Vacuum Tubes; Lubrication;
Cautions ; Asepsis Method
;
of Standardizing Dosage ;
Author's Unit for Measuring Auto- Condensation;
Preparation of Patient; Technique for Skin Dis-

eases or Surface Lesion; for Relief of Pain; Cauter-
ization; Orificial Technique; Cataphoresis ;

Bi-Polar
Tesla Technique; Selection of Most Suitable Form
of Current; Fulguration; Constitutional Treatment;
Auto-Conduction; Auto- Condensation; Portable
Pads; Home-Made Couches and Pads; D'Arsonval

"Surgings"; Water Spray; Local Auto- Condensa-
tion; Indirect Sparks; Taking the Blood Pressure;
Miscellaneous Suggestions Diathermy. ;
One author gives upwards of twenty different
methods of using high frequency currents. This is
apt to prove confusing to the ordinary user of these

currents, and I have reduced the headings under
which to discuss technique to those methods most
commonly in vogue.
Classification of Technique :
1. Vacuum tube technique. (Tube excited by

Oudin or Tesla currents.)
2. Fulguration.
3. Constitutional (auto-condensation and auto-
conduction.)
4. Diathermy. (Direct D'Arsonval; electro-co-
agulation ; thermo-penetration.)
1. VACUUM TUBE TECHNIQUE.
This involves the use of the tubes by direct con-
tact, by effleuve (fine spray) and by actual sparks,

from the mildest form to the sharp caustic forms.
It may be classified otherwise according to its use

as in (a) skin diseases, ulcers, inflammatory pro-
cesses, etc.; (b) relief of pain, as in neuralgias, etc.;
(c) orificial application.
Vacuum tubes are employed where an essentially

local effect is desired.
Lubrication of Tubes. Any of the lubricating jel-
lies, unguents or cerates may be employed on tubes

used within the urethra, vagina or rectum.
Vaseline answers very well, for, although it is a
non-conductor of ordinary electricity, the thin coat-

ing required on these tubes is absolutely no bar to
high frequency currents.
72 KBERH ART'S MANUAL OF
1. As stated in Chapter V., high frequency

currents are capable of producing annoying but
not ordinarily serious surface burns. These ef-
fects are especially quick to appear when mucous
surfaces are treated as in rectal, vaginal, urethral
or nasal applications and also in treating diseased
areas about the lips. On this account the applica-

tion should be relatively short and mild if a spark
is employed in treating within the various orifices.
Make it a general rule never to allow a vacuum tube

to remain in contact with a mucous membrane for
more than seven minutes at one treatment.
2. When the current is one of relatively high
amperage, the spark will set fire to any easily in-

flammable material. This may be illustrated by
lighting the gas with the spark, as previously re-

ferred to. On this account care must be exercised
in treating certain areas.
3. When introducing glass sounds into the male

urethra great care must be exercised not to use any
undue force and thereby break off the glass tube
within the canal. These tubes are made of strong
glass, but may be broken by unusual pressure, or
by a sudden jerk. If difficult of introduction it is
better to pass steel sounds first to a size larger than

the glass sound, as suggested in Chapter VII under

Urethral Technique.
Care of Vacuum Tubes. Asepsis. Although the
spark or effleuve from the vacuum tube is germi-
cidal in character, still it is the duty of the physi-
cian to use the utmost care and cleanliness in em-
ploying it in order to guard against any possibility

of spreading infection from one patient to another.
In other words he would better follow some defi-
nite system of sterilizing and disinfecting the tubes,

and the nearer this is to surgical asepsis the better.
Wiping off the tubes on a cloth or towel or sim-
ply rinsing in water is not enough.
Apply the test to yourself. How would you like
to be treated with a tube that had been used in

contact with a specific disease and which had re-
ceived no further cleaning than mere dipping in
water and then being wiped off with a towel that
had already done similar service an indefinite num-
ber of times ?
Let your technique be so careful and conscien-

tious that you need never blame yourself for spread-
ing contagion or infection of any kind.

This is a subject that I have not seen mentioned
in any treatises on high frequency currents.
Do not use the same tube for specific and non-
specific orificial cases. This alone will do much

toward lessening the danger of infection.
As these tubes bear heating they may be ster-
ilized by boiling, just as surgical instruments are

sterilized.
This however is not necessary as immersion in
strong antiseptic solutions will be sufficient.
A tube that is to be used in contact with a mu-

cous membrane, such, for instance, as a vaginal or
urethral electrode, should be immersed in pure car-
bolic acid or in pure crethol, benetol or lysol, be-
fore again using, if it has been in contact with the
discharge from a specific disease.
In cases, such as acne, psoriasis, eczema, neural-
gia, non-specific diseases of the urethra, rectum or

vagina, etc., it will suffice if the tube is immersed
for a few moments, or kept permanently, when not
in use, in a strong solution of any one of the three
antiseptics mentioned in the preceding paragraph.
For this purpose a glass jar, large enough to take
in the various electrodes, should be filled with a
twenty per cent solution of carbolic acid (a five
per cent solution is not enough) ;

or as its equiva-
lent, one of crethol, benetol or lysol containing a

tablespoonful of either to the pint of water.
An ideal way would be to have two jars, one con-
taining the full strength antiseptic, for the tubes
employed in infectious cases, and the other for those
used in non-contagious diseases.
Personally I prefer crethol or lysol to carbolic

acid, because equally satisfactory and not caustic if
any of the full strength liquid accidentally comes

in contact with the operator's hand.
If the tubes are immersed in the pure antiseptic

they should be thoroughly rinsed in alcohol and
water, or in water alone before using. From the
weaker solutions, water alone is necessary, but in
both cases hot water is preferable.
The conveniences of most of our modern office
buildings make the technique of sterilizing the tubes

a simple one in the large cities, but in smaller
towns the physician will find it somewhat more of
a task.
In the absence of large jars to keep the two solu-

tions in, with the tubes constantly immersed, wide-
mouthed bottles may be employed for use before

and after each treatment.
76 EBERH ART'S MANUAL Otf
By sterilizing in this manner both before and

after, the tube not only receives a double steriliza-
tion, but also if it has been taken care of immedi-
ately after use, if such a thing should happen that

it should be used again without remembering about
sterilizing it, the danger would be slight, and fur-
thermore the tube is easier sterilized immediately
after using, than it is when the secretions or dis-
charges have dried upon it.
I have spoken of using the same care that you

would with a surgical instrument, although the
danger with these tubes is not as great as with
surgical instruments for several reasons. In the

first place, they are not employed ordinarily in a
fresh wound ; secondly, the danger is in carrying
infection from one patient to another and not the

additional danger which accompanies a surgical op-
eration, of infecting the wound from the individual

as well, and finally, in the majority of the cases
treated there is practically no serious danger of in-

fection.
If one had a sufficient number of tubes it would

be desirable to keep an individual tube for each
patient, which was used for no other. Immersion

in the weaker solutions referred to above and
HIGH FPEQUENCY CURRENTS 77
rinsing, or even ordinary cleanliness would be suf-
ficient; but at the close of the course of treatments,

before the tube was used for another case it then
should receive vigorous and through sterilization,
in proportion to the danger of infection involved
in the case.
The sterilizer shown in Fig. 28 is an excellent

one. A basin of formalin solution keeps the tubes
always sterile.
Some of my readers may think I am devoting too

much space to this subject, but it is an important
one, and my early surgical training has made me a
"crank" on this point, and really, could you ever
excuse yourself if through your carelessness you
spread, say a specific infection, even in one single
instance ?
Measuring Dosage. One problem that confronts

the physician who is beginning to use the high fre-
quency is a method of measuring dosage.

is There
no meter which will measure the output of the
vacuum electrode or in other words the unipolar
current. For auto-condensation and for diathermy
the hot-wire meter is used and proves relatively
satisfactory. For the vacuum tube in order to con-
vey an idea that would apply, no matter what size

or make of apparatus might be employed, I have

made use of the length of spark which it is possible
to draw from the vacuum tube as a simple method
of giving some idea of the strength of current em-
ployed. This is a very crude method, and open to
some serious objections but will answer the pur-

pose in a general way and convey a more intelli-
gent idea than any method other than a meter.

With a definite amount of current passing through
the apparatus there is a positive point near the tube

that represents utmost sparking distance, that
its
is, the longest spark that can be drawn from that
tube, and this will remain constant as long as the

current is constant lessening the current shortens
the spark increasing it, lengthens it. Therefore,
if I say I employ for skin diseases a tube capable
of yielding a one-quarter inch or one-half inch spark,
I give to the physician a definite idea of the amount
of current I would employ in the tube.
This does not take into consideration the sharp-

ness of the spark, which must 'be adjusted in accord-
ance with individual susceptibility and the type of
machine used.
With the Tesla type of apparatus and particularly
with small machines the spark is apt to be sharper
in proportion and is designated frequently as a

"hot" spark. With these outfits it is often impos-
sible to employ a spark more than a quarter of an
inch in length. With other types a longer spark
will be tolerated and with the Oudin type of ap-
paratus we have what may be called a ''cold"
spark, and frequently one three-quarters or an inch

long may be more easily borne than a quarter-inch
"hot" spark. The cold spark is dehydratory and
the hot spark caustic. In interpreting my sugges-
tions for dosage in Chapter VIII, these facts should
be taken into consideration. Ordinarily if the dose

is given one-fourth to one-half inch the first would
be for the "hot" and the second for the "cold"
spark.
The Eberhart. Author's Unit of Measurement for
Auto- Condensation. For a long time both physi-
cians and manufacturers have felt the need of a
standard unit for measuring auto-condensation; one

that would fairly represent the auto-condensation
output of any type of machine. I believe I have

solved this problem, and have a standard of meas-
urement that will prove acceptable to the manufac-
turers of any form of apparatus. It will be found
convenient for the manufacturer to state with the
80 SBERHART'S MANUAI, OF
directions for auto-condensation that the output of

the machine is so many Eberharts per minute to
each 100 milliamperes registered on the hot-wire
meter. In this way with the dosage given as a cer-
tain number of Eberharts, it is easy to note by the
meter how many Eberharfs are passing per minute
and by noting how many times this number will go
in the total dose stated the number of minutes re-
quired for the treatment is ascertained.
There are three essential elements entering into

auto-condensation. First the pressure or potential
(voltage) ; second, the rate or meter reading (amper-

age) ;
and third, the time. When the voltage is
high the amperage is correspondingly low

r
,
and vice
versa. In a general way the effectiveness of any

machine for auto-condensation may be expressed in
terms representing the product of the voltage and
the meter reading (equivalent of amperage). Thus
50,000 volts at 500 is the same as 25,000 volts at
1,000; each representing an auto-condensation effec-

tiveness of 25,000,000.
My unit of measurement for auto-condensation

isbased on the passage of 1,000 volts at a rate of
100 milliamperes in one minute of time. This unit
I call the Eberhart and abbreviate it E.
Wehave two types of apparatus for auto-conden-

sation, the one high voltage and comparatively low
amperage the other low voltage and high amper-

age. In a general way I assume that the first rep-
resents a current of about 50,000 volts delivered at
a rate of 350 to 500 milliamperes as shown on a
hot-wire meter. The second averages 25,000 volts,
potential, and is ordinarily delivered at a rate aver-

aging 750 to 1,200 ; 1,000 being a frequent rate. Ap-
plying our unit it will be seen that 50,000 volts equal
50 E. for each 100 milliamperes meter reading, and

if the meter read 500, there would be delivered 5
times 50 or 250 E. for each minute of time, and this

would give 2,500 E. in a ten-minute treatment. With
the other machine 25,000 volts equal 25 E. per 100,
and with meter would give 10 times 25 E.
at 1,000
or 250 E. per minute, or 2,500 E. would require a

ten-minute treatment.
The manufacturer may state the voltage of his
machine, if desired, but the simpler way is to give
the number of Eberharts to each 100 milliamperes

meter reading. He should also state the average
meter reading at which .the apparatus is to be op-
erated. If he states the voltage, to compute a re-
quired dose, multiply the meter reading by the num-

ber of thousand volts, and divide this product by

100. This is the number of Eberhart units being
given per minute, and by dividing the dose as given

in Eberharts by this, we have the number of min-
utes required. Going back to our previous example :
to give 2,500 E. auto-condensation on a machine of

50,000 volts with enough current passing to raise
meter to 500, multiply number of thousand volts,
50 by meter reading 500, and product is 25,000. Di-
vide by 100, which is done by cutting off two ciphers,
and we have 250, which is the number of Eberharts
per minute 250 goes into 2,500 ten times, therefore,

it takes ten minutes to give the required dose of
2,500 E.
It will be seen that it would be much simpler if
the manufacturer stated with this machine that the

auto-condensation output was 50 Eberharts per
minute for each 100 milliamperes registered by the
meter. Then if the dose to be given is 2,500 E. and
the meter registered 500, or five times the 100 rate,
it is easy to figure then that 500 is five times 50
or 250 E. and this goes in 2,500 ten times ,therefore
it takes ten minutes to give that amount.
With the other type of machine we will say that
the output is 25 E. per miute per 100 milliamperes ;

but this machine will ordinarily be operated at about

1,000 milliamperes, or ten times 100, therefore it is
also delivering ten times 25 E. or 250 E. per min-
ute, and it will also take ten minutes to give 2,500
E. In Chapter VIII the dosage of auto-condensa-

tion will be stated in Eberharts.
It is well to rememeber that there is essentially

no danger in auto-condensation and therefore no
over-dose, so that the dosage stated may be greatly

increased if results are not obtained.
The only cases in which caution is necessary, are

those where a patient is carrying a high temperature
or where the pulse pressure is 20 or lower.
Preparation of Patient. When the surface of the
body is removing the

to be treated, the question of
clothing arises. no spark is desired, the electrode

If
must be in contact with the skin, and any clothing

covering the part must be removed.
All metal, such as chains, corset-steels, wire hair-
pins, etc., with which the tube comes in contact or

within sparking distance of, will be charged with
the current and give rise to sharp and disagreeable

sensations. If they cannot be avoided they should
be removed.
Applications to the body, calling for a mild spark,

may be given through thin underclothing, or the
patient stripped and covered with a sheet, through

which the spark is employed.
Aside from the reason spoken of above (chains,

etc.), whena sharp spark is required there is no
especial need of removing the clothing, in fact, a

definite thickness insures a definite length of spark.
When the tube sticks on the skin, dust on talcum
powder or lay over the surface a very thin cloth,

such as handkerchief. In vaginal treatments no
disrobing is necessary.
General Technique in Skin Diseases and Surface

Lesions. In applying the high frequency spark over
the surface of the body, as in acne, eczema, etc., I
employ a current of sufficient strength to produce

a spark one-quarter to three-quarters of an inch in
length. The discharge from the smaller Tesla coils

is relatively sharper than from the resonator or
larger Tesla outfits, and a shorter spark is used, as

the patient cannot tolerate quite as much current
in these instances. With a vacuum electrode ca-
pable of delivering a spark of the length given. I
do not try to make use of the full length spark, but

keep the tube in light contact with the skin, thus

giving a sufficient intensity of current, but avoiding
the pain that would result if the tube were held at
Fig. 28b Vacuum Electrode Technique.
full sparking distance from the surface. The tube

is passed rapidly back and forth over the area
treated, and this will be accomplished in the easiest
manner by holding the tube handle lightly with the
fingers, with the thumb extended along the handle.

A side to side motion with the wrist will soon be-
come a matter of habit to the operator and the tube
will pass lightly over the surface without any sud-
den jerks or elevations to cause annoying sparks.
If the skin 'is moist and the tube sticks, it may
be dusted with talcum or other dusting powder to

obviate this difficulty. Another method is to place
a thin cloth over the surface, which will enable

the tube to be used smoothly and at the same time
does not remove it far enough from the surface to
make an unpleasant spark.

Where itching is marked, the tube is raised from
the skin and as sharp a spark applied as the patient
will tolerate for a short period of time. This
quickly relieves the itching, and also quickly pro-

duces the characteristic reaction of the current
(hyperemia, etc.).
In treating epitheliomas, lupus and any chronic
ulcers, a spark is employed in the same manner, that

is, as sharp as the patient can stand, but not for
a long period, say from two to three up to occasion-
ally five minutes. Unless cauterization is sought,

the tube should be kept moving rapidly over the
surface and not allowed to expend its full effect
steadily over any minute area. At the present time

ful Duration (caustic)would be employed more fre-
quently for epithelioma and lupus.
Technique for Relief of Pain. In congestive head-
aches, neuralgias and other painful conditions, the

beneficial action of the high frequency current seems
to be largely the result of counter-irritation. There-
fore, it makes very little difference whether a sharp
spark is used with the rapidly moving tube at full

sparking distance, or whether with the same inten-
sity of current, the tube is kept in contact with the
skin. It depends upon the sensitiveness of the pa-
tient and also upon the location of the area treated.
A long sharp spark occasionally exerts a slight caus-
tic effect, and the surface will be covered with tiny
blebs, which are followed by minute scabs, making

the skin sore and uncomfortable. Unless the case
to be treated is a severe one, it is not permissible to
push the treatment to this degree.
Cauterization. If a hot spark is held steadily over

the spot for from thirty seconds, up to two or
three minutes, varying with the patient, it will have
a cauterizing effect. The reaction is severe and the
destruction of the tissue may be carried to a
marked degree. Such applications have been used

in the treatment of warts, moles, etc.
have treated epitheliomas in this manner and

I
have had them separate from the surrounding tissue

and peel out as smoothly as if cut out with a die.
It is too severe a measure, however, for the average

case. Fulguration involves the same principles, and
is preferable. The spark is derived from a metal
point and anesthesia may be employed if desired.

The technique of this will be considered in another
section.
Orificial Technique. The technique of the appli-

cation to the orifices of the body involves the use of
tubes suited to the various areas, and also involves

the question of sterilization and lubrication. In
these cases the tube is in contact with the mucous
membrane and there is no sensation to the treat-
ment except usually that of warmth. There is in
these cases greater danger of producing burns, and

the tube should seldom be left in contact for a
longer period than seven minutes at any single

treatment. (See the section on vacuum tube burns
in Chapter V.) The technique is so peculiarly that
of the special organ involved that it will be given
under its appropriate heading in Chapter VII. It

is desirable to remember that tubes should always

be inserted before the current is turned on, and the
latter turned off again before the tube is removed,

thus avoiding all pain and shock to the patient.
Cataphoresis. For cataphoresis a special electrode
is employed. See Fig. 29. The substance to be car-
ried into the tissues is in solution, and cotton gauze
or felt wet in the solution is placed in the depres-
Fig. 29 Cataphoresis Electrode.
sion on the face of the tube when the latter is placed

in contact with the desired area and the current
passes for from five to ten minutes or more as re-
quired. I caution against the use of solutions con-
taining alcohol or other inflammable substance be-

cause of the danger of setting same afire with the
current.
In one form an insulating ring prevents loss of
current and is a great improvement on the older
style of tube.
See Chapter XII for special electrodes used by

dentists.
Although strong claims have been made concern-

ing the value of high frequency currents for the
purpose of carrying substances into the tissues, I
believe they are so far inferior to the galvanic

current for use for these purposes that they are
entitled to comparatively little consideration.
The principle upon which cataphoresis depends

is the separating of the particles (ions) composing
the fluid by reason of the attraction possessed for
them by the poles of the battery ;
thus all positive
elements remain at or are drawn through the tissues

toward the negative pole, and vice versa. Now, in
using high frequency currents, which are alternat-

ing, the attraction would be first in one direction
and then .in the other, and as a result practically
nothing would be accomplished.
The claim is made that the high frequency cur-

rent drives substances into tissues by "molecular
bombardment." I maintain, however, that the cata-
phoric action of the high frequency current is too
feeble to commend it for general use, for which pur-
pose nothing takes the place of the galvanic current.

HIGH 1-REQUENCY CURRENTS 91
The use of dental electrodes for cataphoric pur-
poses has given good results. See Chapter X. It
is really an electrical diffusion, rather than true
cataphoresis.
Bi-polar Tesla Technique. Ordinarily the vacuum
tube is attached to one pole of the Tesla outfit. In
some coils the sharpness of the spark is regulated
by drawing off a certain amount of the current from
the active pole by bringing the sparking rod near

it, thus lessening the available current.
If it is desired to intensify the action of the Tesla
coil, the indifferent pole should be attached to the
patient or grounded by connecting to a gas or water

pipe.
Selection of Most Suitable Form to Use. Where
a local effect is more essential, vacuum tubes, metal
electrodes, etc., are employed, but if a systemic or

constitutional effect is desired, auto-condensation is
to be selected, or the diathermic treatment may be

used.
2. FULGURATION.
Fulguration. A long, sharp spark for escharotic
or destructive purposes was employed for a long
time by high frequency operators, but the use of a
metal electrode devised by Keating-Hart for this
purpose, which he termed fulguration, gave an un-

usual impetus to the method.
Fulguration as employed at the present time may

be considered under two forms : 1. Caustic or hot
fulguration, employed with D'Arsonval or Tesla

apparatus, and giving a hot, caustic, or cauterizing
spark. The D'Arsonval fulguration is particularly
suitable in orificial work, such as papillomata of the
bladder, etc. The Tesla is especially advantageous

in surface work, such as moles, warts and other
superficial growths.
2. Dehydratory or cold fulguration, employed

with Oudin apparatus. The destruction of tissue is
through a drying process and there is no sloughing.
There is essentially no pain, but its range is neces-
sarily limited.
Dr. W. F. Clark of Philadelphia employs a method

of cold fulguration with the static machine, to which
he has applied the term desiccation.
General Caustic Fulguration. The technique which

I employ for warts, moles and small growths is as
follows :
The fulguration electrode is attached and the cur-

rent turned on gradually, while the length of spark
Fig. 30 An OutfitCombining High Frequency with Numerous

Other Modalities, Twenty-one in All.
EBERHART'S MANUAL
I '^BHHBBBBBBHHBBB
Fig. 31 Application of Vacuum Electrode to Chest.
from the metal point (Fig. 33), is tested by bringing

the point nearly in contact with a piece of metal,
such as a coin. Without an anaesthetic it is impos- .
sible to employ one more than one-thirty-second to
one-eighth or occasionally three-sixteenths of an

inch in length. This spark is hot, and actually sears
or burns the tissue, as noted by the eye and usually

by the odor.
It is not desirable to keep this spark in steady
contact, as it is too painful, but if the point is
Fig. 32 Fulguration Electrode
Fig. 33 Fulguration Electrode.
touched to the surface and quickly brought away

beyond sparking distance, the patient is better able
to stand it, and by a series of rapid sparks produced
by a tapping motion of the point, thorough fulgura-

tion may be achieved without unbearable pain to the
patient. Ordinarily I pass around the margin of
the growth first, and then fulgurate the center. It
should be done thoroughly, and the growth will pre-

sent a brown, burned appearance. There is seldom
any hemorrhage, but usually some serous oozing. A
crust or scab forms which separates in a week or
ten days (average eight), leaving no scar. It is
well to bear in mind that if you do not get it all
off the first time you can fulgurate again, but if
you remove too much you cannot place it back

again.
For more extensive work, local or general anaes-
thesia is necessary.
It is fair to state that very satisfactory caustic
(hot) fulguration may be accomplished with small
machines.
In papillomata of the bladder, fulguration has
been particularly valuable.
Fulguration of Papillomata of Bladder. The

hot or caustic fulguration may be employed, using
wire insulated with rubber tubing, or the D 'Arsonval
method, which is bi-polar, may be used as follows:
One terminal of the apparatus is connected to the
fulguration wire, which is passed through the cysto-

scope, and the other terminal is connected to an
indifferent flat metallic electrode placed on the abdo-
men. The fulguration wire or electrode consists of a

steel wire insulated with pure gutta-percha. As this
wire is to be passed through the channel of an ordi-

nary catheterizing cystoscope it should not be larger
in gauge than No. 6 French.
The patient is prepared with green soap and water

and bichlorid, and the bladder distended with water.
After the cystoscope is introduced, the tumor is
brought in view and the fulguration wire passed

through the catheter channel of the cystoscope until
the end of the wire is in view. The wire is then
plunged into the tumor and the current turned on.

(Before introducing the wire into the cystoscope,
cut the wire so that the insulation is flush with the
end of the wire.) Just as soon as the high frequency

current is turned on, bubbles (presumably hydro-
gen) are seen emanating from the tumor. If the
tumor is small and the electrode has been placed near

the top of the tumor, an immediate blanching of the
tumor is seen. This treatment can readily be car-
ried out under the guidance of the eye, providing
the insulation of the fulguration wire is intact; un-
less the insulation is intact, a short-circuit in the
cystoscope and subsequent burning out of the cysto-

scopic lamp may result.
After allowing the current to pass into the tumor

for about twelve to fifteen seconds, the current is
shut off, the fulguration wire withdrawn and re-
applied to another part of the tumor. In large
tumors, this procedure can be repeated until many

different areas of the tumor have been treated in
one sitting. As long as five or six minutes may be

consumed in one sitting. Naturally, the duration
of each treatment will depend on the size of the
tumor. For example, in one case, one sitting con-
sisting of three 12-second applications was enough

to completely destroy a small papilloma.
As long as the intra-vesical electrode remains in
contact with the tumor no pain is experienced by

the patient. When working near the base of the
tumor, or if the electrode comes in contact with the
bladder-wall, the patient frequently complains of
pain. So that during the first fulgurations there

is no pain, whereas, toward the end of the treat-
ment, while working near the bladder in treating
the remaining tags, the patient at times complains
of pain. It is also necessary to consider the pain
incident to cystoscopy. This is variable in different
persons, so thatsome of the patients cannot tolerate

long sessions as well as others. The number of
HIGH 1'REQUENCY CURRENTS 99
treatments or sittings, as previously stated, is deter-
mined by the size of the tumor, some cases requiring

as many as six sittings.
Attention is called to the burning off of the insu-
lation near the end of the fulguration wire. After

the current has been turned on and the treatment
carried on for a little while, sometimes only ten
seconds, the insulation becomes soft, and falls off
or burns off from the end of the wire, so that it
becomes necessary to withdraw the wire and cut the

end off squarely. Unless this is done, there is dan-
ger of the bare wire causing a short-circuit in the
cystoscope.
Usually when the high frequency current is ap-
plied the tissues become white and shrivel up. Some-
times the tumor surface appears dark, as though
it were baked. Not infrequently after an applica-
tion a larger or smaller piece of the tumor adheres
to the end of the fulguration wire. At other times
these small pieces may be passed at the next urina-

tion and often they are obtained from the wash-
water. These are carefully saved and examined
microscopically.
It is suggested that papillomata should be con-
sidered malignant in all cases; that in all cases of
long standing cystitis which has persisted even in

the presence of careful treatment, or with the his-
tory of frequent relapses, papilloma should be sus-

pected, and the diagnosis confirmed or contradicted
Fig. 34 Portable Outfit.
by cystoscopy. It is the consensus of opinion that

the fulguration method is followed by remarkable
results, but as yet sufficient time has not elapsed

for us to make a definite statement as to an abso-
lute guarantee that this treatment will prevent re-
currences. (Abstracted from an original article.

"Fulguration Treatment of Bladder Tumors,'* by

Herman L. Kretschmer, M. D., of Chicago. Illinois
Medical Journal, April, 1913.
3. CONSTITUTIONAL (AUTO-CONDENSATION
AND AUTO-CONDUCTION).
Auto-conduction. In auto-conduction the patient
is placed within a large solenoid or coil, constituting
a cage. The patient is with this cage
not in contact
at any point and the high frequency currents in the
patient's body are produced by conduction.

The cages are of several types, some in perpen-
dicular form, and others in a horizontal position.
In the latter the patient is either placed on a board
which slides into the cage, or the top of the latter
is hinged like the cover of a basket. Some of the
perpendicular forms are collapsible, others are fitted

with a door, the patient standing or sitting on a
stool.
Small cages are also made into which the arm or

leg may be introduced, thus producing localized
auto-conduction effects.
The dosage is the same as with auto-condensation.

Owing to an inherent objection on the part of the
human race to being incarcerated in a cage, even
102 EBERHART s MANUAL
for a short time, this method of treatment, although

excellent in results, used comparatively little at
is
the present time; furthermore, it has no advantage

over auto-condensation.
Auto-condensation. In auto-condensation, one of

the terminals of the apparatus is attached to the
metal forming one plate of a condenser and the
Fig. 36. Fig. 37.
other to the patient, who becomes in this manner

the other condenser plate.
The patient is insulated from the metal plate by

silk floss, rubber, mica, glass, or other form of di-
electric.
In Fig. 36 is shown a cross-section of a plate

condenser. In Figure 37 the body of a woman is
substituted for the upper plate, thus showing the
principle involved in auto-condensation.
Auto-condensation is administered by means of

a couch or pad designed for the purpose and may
104 EBERH ART'S MANUAIy OF
include the whole body or be constructed to influ-

ence only a part of it.
The original couch was in a form similar to that

of a Morris chair (Fig. 38), the plates of zinc being
under the cushions on back and seat, the cushions
themselves being stuffed with the silk floss or with
Spanish moss. The plates connect with one binding

post of the apparatus, and the other is connected
to a rod from which wires run to metal handles on
each side, which are held by the patient, who re-
ceives the charge whether one or both handles are

grasped.
In that part of the circuit that is connected to the
handles a hot wire meter is placed to measure the
dosage. No other form of electrical treatment gives
so high an amperage, except diathermy, the dose
running from 150 to 1,500 milliamperes, with occa-

sional reports of the use of even a stronger dose.
It is well to remember that there are two types

of machines used in producing auto-condensation.
One has high voltage, but comparatively low amper-

age, requires a cushion at least three inches thick
and has great penetration, so that a vacuum tube
will light up within an area of several feet surround-
ing the patient. With this type the average meter

Fig. 37a Portable High Frequency, Telatherm Type.
reading to obtain satisfactory results is 350 to 500.

It isseldom necessary or desirable to secure a higher
reading. Lower readings, 150 to 200, would be used
where it was desired to influence nutrition without
particularly lowering blood-pressure.

The other type machine has comparatively low
voltage, but high amperage. It may be used with a
thin pad if desired. The meter will read 750 to 1,000
on an average, and up to 1,200 or 1,500, according

to the potential of the apparatus. Auto-condensation
is measured in Eberharts, as stated in a preceding
section in this chapter.
Fig. 38 Auto-Condensation Couch with Oudin Resonator and

Induction Coil. Original Type. Now Obsolete.
As long as the patient is in electrical contact with
the handles, that is, perfect contact, no sensation

is felt except occasionally a slight tingling or sen-
sation of warmth. Sparks may be drawn from the
patient, and these may be quite painful. In type
No. 1 a vacuum tube held in operator's hand will
Fig. 38a Portable Outfit.

draw a spark from the patient which is known as one
form of indirect spark. In general, a feeling of

warmth pervades the body after a few moments,
and the temperature is shown by the clinical ther-
mometer to be from one-half to one degree higher
than before the treatment.

The couch or cushion is connected to one terminal
of the apparatus, the patient to the other. The
static machine with hyper-static transformer does
not give a sufficient amperage for the satisfactory
operation of a couch ;
neither does the average port-
able outfit, although the latter has more amperage
than the static machine. Both of these may be useu
for charging small pads for restricted areas, and
some types of the larger portable coils I have found
capable of operating a good-sized pad, if the di-
electric is thin.
In 1903 I designed the first portable body pad,

which folded together when not in use. It con-
sisted essentially of the top of the couch and was
intended to save the space required for the latter.
About the same time Piffard produced a conden-
ser pad for the seat of an ordinary chair (Fig. 41).
It is a well-known fact that the thinner the di-
electric is, as long as it is a perfect di-eleetric, the

greater the corresponding charge that may be held

on each layer of condenser. This caused me to
sub-
stitute flexible mica for the material used in the
ordinary pad and thus produce a portable auto-con-

densation pad only half an inch thick, and capable
of being slipped under the leather cushion of the
ordinary office treatment table, converting the latter
into an auto-condensation table. At the same time
a much greater charge of electricity may be con-
densed in the patient than with the thicker pads.
Pads less than three inches thick have been con-
demned by the standardization committee of the
American Electro-therapeutic Association, therefore,
at the present time I employ only the thick cushion.
Many ingenious operators construct their own
chair or couch, and from an article of mine on this
subject in Popular Electricity, November, 1909, I

make a few excerpts:
"A glass slab, four or five feet in length,
twenty
inches wide and about one inch thick, such as is
used in a glass-topped operating table, is fitted in a
wooden frame and to the under surface is attached
a strip of zinc or of sheet lead 1/32 of an inch thick.
This strip should be about ten or twelve inches wide,
so that when placed on the lower surface of the
EBURHART'S MANUAL
Fig. 39 Portable Coil.

Fig. 40 Portable Coil.

glass it will leave a

margin of about four or five
inches between the edge of the zinc and the edge
of the glass. It should extend lengthwise to within
six inches of either end of the glass slab. The zinc
or lead plate is connected by an ordinary covered
conducting wire say, not smaller that No. 10 or 12,
to one pole of the high frequency apparatus and
Fig. 41 Condenser Cushion for Chair.
the patient connected by an ordinary metal elec-

trode to the other pole. The patient may be placed
directly on the glass, but it is preferable to place

him on a thin cushion upon the glass, for the sake
of comfort.
"
Another method is to take a wooden table long
enough for the patient to lie on and place under-

neath the table top a layer of plate glass the full
size of the top of the table with a strip of lead or
zinc attached to the under surface of this glass,
always bearing in mind that the essentials of an

auto-condensation pad are to have a di-electric with
a layer of condenser below it,and the patient at-
tached to the apparatus to form the upper layer.
Thus, an ordinary Morris chair or steamer-chair
may be used and a layer of lead or zinc fastened
underneath the back and seat of the chair, the two
strips being fastened together with metallic connec-
tions (chain or wire) and underneath the ordinary
cushion of the chair, four or five layers of rubber
are placed to serve as the di-electric, although the
cushions themselves, if they remove the body be-
yond the sparking distance of the charge on the zinc
plate, would really make the air space intervening

serve as a di-electric. This is not as satisfactory as
when the layers of rubber are placed between. The
patient thenis connected by the ordinary metallic
hand electrode and conducting cord or metallic
handles may be fastened on the arms of the chair,
the two connected by a bifurcated conducting cord
to the one pole, the zinc plates to the other.
"
Lastly, a pad may be constructed on the same
plan as the one have designed, using one or
which I
more layers of sheet mica large enough to permit

the body of the patient to rest on and making use
114 EBERH ART'S MANUAL Of
of a layer of condenser (either lead or zinc) under-

neath the mica, taking care that it does not extend
near enough to the edge of the mica to allow the
charge to leak over. On top of the mica place three

or four layers of felt or cover with leather as de-
sired. Should the mica be insufficient to prevent
some sparking through, it may be obviated by plac-
ing another thin cushion on top of this pad."
The patient is placed on the couch or pad and con-

nected to the apparatus before the current is turned
on, and then the current turned off before the pa-
tient lets go of the handles, thus avoiding all shock.
If the patient questions whether he is getting any

current or not a few sparks drawn from his body
readily convinces him.
Another form of treatment which the patient feels

to the extent of strong muscular contractions may
be made by introducing a spark-gap into the pa-

tient's circuit. This I describe in another section
as D'Arsonval surgings.
The value of auto-condensation depends upon its
remarkable effect upon general metabolism (see

Chapter V). In nearly all cases of hypertension the
blood-pressure is lowered.
Auto-condensation treatments average ten to
thirty minutes in duration (2,500 to 7,500 Eber-

harts), and should be given daily, or six times a
week at first, in nearly all cases, gradually decreas-
ing as improvement takes place. Less than three

treatments per week at the start are, in my opinion,
practically useless. Longer treatment may be given
if the physician desires.
Cautions. There is practically no danger of an

over-dose of auto-condensation, the only danger be-
ing in cases where the patient has a high tempera-
ture that will be raised still higher, where a small
dose, if any, is given, and in case of a pulse pressure
below 20. See section Taking the Blood Pressure,
and under Arterio-sclerosis, Chapter VIII. In low
pulse pressure there is danger of obliterating the
pulse by auto-condensation.
Author's D'Arsonval Surgings. I have alluded to

the fact that placing a spark-gap in the patient's
circuit causes strong muscular contractions. The
similarity between this and static ''surging" caused
me to apply the term of "D'Arsonval surging" to
this form of treatment.
I first noticed it when adusting the sliding rod

on a D 'Arsonval-Oudin resonator. This rod enables
116 EBERHART'S MANUAL OP
Fig. 42 Author's D'Arsonval Surgings. Separating the Sliding

Rod at A or Introducing a Spark-Gap Anywhere
Between A and the Patient, Produces
This Effect.
HIGH FREQUENCY CURRENTS H7
the operator to balance the current between the

coarse solenoid and the resonator, or "tune" the
coil. Doing this with the patient on the auto-con-
densation couch caused the latter to exclaim at the
resulting muscular jerks.

The effect of separating the point of this rod from
the solenoid is to introduce a spark-gap in the pa-
tient's circuit and to lower the frequency to the
point of causing gross muscular contractions. An

outline of the method is shown in Fig. 42.
It really is in line with the original experiments

of D 'Arson val, who first doubled the number of
solenoids, thus producing auto-conduction; then
doubled the condensers, as in auto-condensation;
and now this form doubles the spark-gap, the only
remaining element employed in the D'Arsonval
circuit.
High Frequency Water Spray. V. Laughter has

devised an ingenious method of connecting the high
frequency current to hydro therapeutic apparatus

in such a manner that the stream or spray of water
emerging from the latter is charged with the cur-

rent and when this strikes the body of the patient
he receives the effect of the high frequency current
as well as that of the water.
Local Auto-Condensation. The "Plate Glass

Method." Various methods have been devised for
applying auto-condensation locally over small areas.

Sheets of rubber with a pocket in which to slip a
flat lead or zinc plate are one form. A very popular
way, known as the "plate-glass" method, consists
in using as an electrode a metal point or ball and

applying the sparks through thick plate glass held
in contact with the patient's body. The glass is the
di-electric, the electrode corresponds to one plate of

a condenser, and the surface, of the body next to the
glass the other.
Indirect Sparks. If a resonator is connected di-
rectly to a patient with a metallic electrode and a

vacuum tube is then brought near the patient's body
sparks will fly from the latter to the tube. These

are called indirect sparks. See Figure 43.
Attaching the patient in a similar manner to one
pole of the Tesla coil, while the tube held by the
operator isgrounded by connecting to water pipe

or gas jet, accomplishes the same result.
Another method of deriving an indirect spark and
one with which I have been experimenting consider-
ably during the past few years is obtained from the
patient when lying on the auto-condensation pad.

Fig. 42a Local Auto-Condensation.
I use a high-voltage, low-amperage type of ma-

chine with a thick pad. Enough current is turned
on to give a meter reading of about 250 (125 E.)-
A vacuum electrode is held in the operator's hand
and the length and strength of spark tested by
touching the metal handle which the patient is
holding, before the tube is applied to the patient's
body. The current is then raised or lowered to pro-

vide a suitable intensity and length of spark, after
which the electrode is applied to the portion of the
body to be treated. The spark is drawn from the
patient's body, is disruptive in character, and is par-
ticularly suitable for various skin diseases, having

also the advantage of the patient's nutrition and
general metabolism being benfited by the auto-con-
densation which accompanies it. In other words, it
is both local and general in its effects.
Taking the Blood Pressure. As a knowledge of

the patient's blood pressure is vitally necessary to
the physician using high frequency current it is
important that he should have an instrument for

its rapid and accurate determination. The instru-
ment used for this purpose is called a sphygmomano-

meter and a number of satisfactory machines are on
the market. The diaphragm type is shown in Figs.
44 and 44b.
The mercury type is shown in Fig. 44a. Its action

depends on opposing the pressure of a column of
mercury with the pressure of the blood in an artery.
For this purpose the brachial artery, in the arm
above the elbow, is selected.
A band containing a rubber sack is fas-

cuff or
tened around the arm above the elbow, with that

part from which the rubber tube emerges lying in
front over the artery. Ordinarily the sleeve is rolled
up before the band is applied, but if the clothing

is thin this is unnecessary. A small rubber hose
runs from the cuff to the machine, which has a
U-shaped tube containing murcury, with a gauge

between. The zero mark on the scale is placed on a
level with the top of the mercury.
A rubber bulb is attached by a small tube to the
machine, and the physician holds this bulb in one

hand, while with the other he keeps a finger on the
pulse in the patient's wrist. The bulb is now com-
pressed and immediately air fills the cuff and the
column of mercury begins to rise. The operator con-
tinues to slowly inflate the cuff until the pressure
of the latter shuts off the blood in the brachial
artery and the pulse can no longer be felt at the

wrist. When this occurs the pressure of the column
of mercury has balanced the pressure of the blood
in the artery and the reading on the scale opposite
the top of the column is the patient's blood pressure.

In using the instrument it customary to force
is
the mercury a little above the point where the pulse

ceases to be felt and then wait two or three seconds

until the column settles to the point of the reap-
pearance of the pulse. By doing this one, two, or

three times an absolutely accurate reading may be
depended on.
TVOE.
Fig. 43 Indirect Sparks.
The scale reads from to 300. The normal is 120.
The numbers refer to millimeters of mercury. A

variation of 10 millimeters up or down would not
necessarily imply abnormal pressure, but 140 or
more would be presumptive of the presence of or
tendency to arteriosclerosis.
Fig. 44 Taking Blood Pressure with Diaphragm Type of
Sphygmomanometer.
Another instrument for accurately determining

blood pressure is the tycos diaphragm type of in-
trument, shown in Fig. 44 .
This is not a mercury instrument, but the read-

ings are obtained by indirect, internal pressure on
sensitivediaphragm chambers, so sensitive indeed
that every action of the heart is shown plainly by
the hand on the dial, as the hand works co-inci-
dently with the heart.
With this instrument the observer can accurately
determine complete blood pressure, by that we mean
maximal or systolic ;
minimal or diastolic, and pulse
pressure (the difference between the two). The
correct method of taking blood pressure readings
with this instrument is explained later on, and is
accomplished with either the dial or mercury type
of sphygmomanometer. It is probably well to ver-
ify or compare the diaphragm type occasionally with
another sphygmomanometer because of the possibil-
ity of its getting out of order without showing the
error on the dial itself. An error is quickly ap-
parent in the mercury type of instrument because
the mercury must balance at zero when not under
pressure.
The minimal or diastolic pressure is fully as es-
sential as the maximal or systolic, for without an
exact diastolic to subtract from the systolic we can-
not get the most important thing in blood pressure,
126 EBKRHART'S MANUAL
\.
Fig. 44b Portable Outfit with Novel X-Ray Tube for

Surface Treatment.
that is the pulse pressure, for by pulse pressure

alone can it be determined whether a pathological
condition compensated for or not.

is
The normal pulse pressure (difference between

diastolic and systolic) should be from 20 to 55 milli-
meters.
The determining of pulse pressure by those using
the high frequency current is absolutely essential,

for, as said before, by this we can tell whether a
condition is compensated for, and whether the use
of the high frequency current is indicated or con-
traindicated.
As an illustration, we will say that we have a case
with a systolic pressure of 170, and a diastolic pres-

sure of 140. This shows, by subtracting one from
the other, that the pulse pressure is 30, therefore,
normal. No matter then if the systolic be 170, for
the pulse pressure being normal shows that the
condition is compensated (or the pulse pressure
could not be normal), and, therefore, a circulatory
equilibrium is established, and in these cases any

further reduction of systolic blood pressure must be
accompanied by a corresponding decrease in dias-
tolic pressure or compensation will be interfered

with.
Of course, if the systolic was reduced to 160 and
the diastolic remained 140, compensation would still
exist, but would be at its low limit, and the patient

would probably not be as comfortable as with 165
or 170, with 140 as the diastolic. If, however, under
auto-condensation both systolic and diastolic pres-
sures decreased, if not always the same reduction,
at least without the pulse pressure going below 20,

the treatment may be persisted in until the systolic
pressure is normal.
Whenever the pulse pressure reaches 20 and stays
there, after carefully giving one to three additional

treatments auto-condensation should be abandoned.
It has been carried as far as it can be of benefit to
the patient, no matter what the systolic pressure
then may be, and I would suggest spinal sparks to
raise it slightly, that pulse pressure may be at
least 25.
Where the systolic reading is high it sometimes

happens that the pulse pressure will, when auto-con-
densation is employed, drop to 20, or even 18, but
after a few days the diastolic will reduce enough to
give an increased pulse pressure, and thereafter
both systolic and diastolic keep reducing in propor-
tion, in which case the treatment is kept up. See
further discussion and examples under Arterio-
sclerosis, Chapter VIII.
There are two methods of determining blood pres-

sure with the tycos type, which I have taken from
Dr. Cowing 's book, "Blood Pressure Technique Sim-'
plified."
First, the method of oscillation.

Place the bag over the arm with the two tubes
well under the arm and over the brachial artery.
Wrap the remainder of the sleeve around the arm
much the same as you would apply a bandage, tuck-
ing at least six inches of the sleeve under the last
fold. Then place the sphygmomanometer in one

tube and the bulb in another and you are ready for
reading. Care should be taken not to put the sleeve

on tight enough to cause any apprehensive feeling
in the patient. Place the fingers lightly over the
radial artery, and send the pressure in the cuff up
to the point where the pulse disappears or is oblit-
erated. This is the systolic or maximal reading.
It is desirable that the patient's wrist be sup-
ported from below by the palm of the doctor's hand,

while the first and second fingers lie with their tips
over the artery. Thus the weight of the hand is
prevented from shutting off the pulse too soon.

Second, the method of auscultation. This is, by
far, the most practical method of accurately deter-
mining blood pressure, as the dangers of personal
equation are greatly lessened. See Fig. 44c.
Bare the arm, adjust the sleeve well up (as above
described), place the stethoscope over the brachial
artery. Now gradually inflate the bag, and the first
and second sounds of the heart will become audible.

Increase the pressure in the bag to the point where
all sounds cease. At this point will be the exact
systolic or maximal pressure.
Having obtained this, gradually release the air by
Fig. 44c Auscultation Method.
means of the valve, and the first and second sounds

of the heart will become apparent, increasing in
volume as they approach the diastolic point, at
which point the second sound will entirely disappear.
The above method cannot be employed where
aortic insufficiency exists or where there is a dila-
tation of the vessels. These conditions being ob-
served, when the pressure is first increased on the
brachial, as soon as a slight pressure is placed on
the artery, a pistol-shot tone is heard, and will con-
tinue with but little variation throughout the ob-

servation. When this condition exists it is abso-
lutely necessary to resort to the oscillatory method.
It is also necessary to use the method by oscillation
when the pulse is feeble.
Having now accurately determined both systolic

and diastolic pressure, we compute the pulse pres-
sure.
Pulse pressure is obtained by subtracting the dias-

tolic from the systolic, for example :
Systolic pressure, 120; diastolic pressure, 90; the

difference, pulse pressure, 30, and, as previously
stated, it should not be less than 20, and would also
indicate a pathological condition as probable if
over 55 .
The diastolic blood pressure should be approxi-
mately two-thirds of the systolic and the pulse pres-

sure should be approximately one-third of the syst-
olic.
In 35,000 cases the average systolic pressure was

found to be :
Children's pressures 2-5, 80; 5-10, 90; 10-15, 100-

110.
1520 118. 4045 128.
2025 123. 4550 130.
2530 124. 5055 132.
3035 125. 5560 134.
3540 126. 6065 136.
It is well to remember that there is an ever in-
creasing hardening of the arteries as one grows

older, and a person of 65 or over can very easily
have a blood pressure of 160 and still be a com-
paratively healthy individual. At the same time if
these changes were not taking place the blood pres-
sure would remain the same, no matter what the age

of the patient might be. Female pressure is 10 mm.
lower than that of males. Any blood pressures,
however, between the ages of 21 and 50, lower than
100 or higher than 150, can safely be termed patho-
logical cases.
Leading life insurance companies now insist on

the examiner taking the blood pressure. Most of
them reject applicants whose pressure is 160 or
higher, whether any other reason is apparent or not ;
just as they do where the pulse is persistently

above 90,
An easy method of keeping the range of blood

pressure in mind, which I have employed in my
classes, is as follows:
Consider 120 the normal. At 20 above or below,

that is 140 or 100, the warning signal is out, and at
20 more either way (160 or 80) the brink of the

precipice has been reached and a pathological con-

dition, and probably a dangerous one, exists.
Low .
Normal High
80 100 120 140 160

Danger Point Warning Warning Danger Point
It has been noted that enlargement of the heart

or degeneration of the kidneys cause a comparative-
ly high blood pressure and when both are present

the pressure may be extraordinarily high, often (280-
325), or higher than is provided for on many of the

instrument scales.
An increased determination of blood to the sur-

face of the body lowers the pressure, and, con-
versely, driving the blood from the surface raises
the blood pressure.
It is important that the sphygomomanometer be

used, as in one series of 1,000 tests it was observed
that abnormal pressure existed in many cases that
a competent and experienced observer failed to de-
tect without.
In taking the systolic pressure I have occasionally

found that just as I had determined the pressure
there would be a sudden increase, running up 5 to
134 EBERHARX'S MANUAL o*
20 millimeters. This I have concluded is due to a

spasm of the artery, causing sudden contraction.
Blood Pressure in Various Diseases. Some con-
ditions in which high blood pressure is found are
arterio-sclerosis ; angina pectoris aneurysm of aorta,
;
chronic bronchitis, cirrhosis of liver, constipation,

brain tumors, dilatation of aorta, emphysema,
glycosuria, gout, hypertrophy of heart, lead poison-
ing, chills, meningitis, uremia and all kidney affec-
tions except amyloid, suppurative or tuberculous.
Low blood pressure is found in weak heart with

dilated arterioles, Addison's disease, aortic stenosis,
asthma, chlorosis, dilatation of heart, hemorrhage,

jaundice, mitral regurgitation, mitral stenosis, obes-
ity, pyrexia, trypanosomiasis, tuberculosis, etc.
Miscellaneous suggestions. When a resonator is
employed in connection with an induction coil on

the direct current and a mercury interrupter is
used, if it is difficult or impossible to secure a steady
spark in the spark-gap of the resonator, it is a sign

that the mercury in the interrupter is dirty and
needs cleaning.
With this same apparatus, the spark may be made
sharper by increasing the number of turns of wire
in use in the coarse or primary coil of a resonator.
This increases the size of the solenoid and conse-
quently its induction. This is true of any Oudin

resonator having the sliding rod to regulate the size
of the coarse coil.
When using vacuum tubes care should be exer-

cised to prevent the connecting cord from touch-
ing the patient, as annoying sparks will result. It
is almost impossible to find a cord so well insulated

that the high frequency current will not soon find
its way through.
Diathermy. The fourth division of my classifi-
cation of technique involves the methods known un-

der the several terms, electro-coagulation, thermo-
penetration, direct D'Arsonval current and dia-
thermy. The method of employment is given in

Chapter XI.
CHAPTER SEVEN.
Special Vacuum Electrode Technique for Various
Parts of the Body, Including Ear, Eye, Nose,
Rectum and Prostate, Scalp, Throat,
Urethra and Vagina.
In order to avoid unnecessary repetitions in Chap-

ter VIII,where particular diseases are considered,
the method of using vacuum electrodes in treating
various portions of the body is given herein, to-
gether with an idea of the scope of the treatment

in diseases of these 'organs.
Technique in Diseases of the Ear. In applying

the current to the ear, as in catarrhal deafness, etc.,
a small vacuum employed, plain and

electrode is in-
sulated types of which are shown in Figs. 20 and 21.
These are used most conveniently in the author's

movable socket handle, which enables the patient
to sit comfortably with the hands against the chest,
the tube placed at such an angle in the handle that

it is easily inserted into the ear and the cord con-

necting to the apparatus hangs clear of the patient.
See Fig. 45.
Fig. 45' Treating the K;u.
It is certainly a great improvement over the old

method, which required the patient to hold the
handle almost at arm's length.
138 EBERH ART'S MANUAL O*
The electrode is placed in the ear and the machine

started with a minimum of current. The strength
is then increased in accordance with the tolerance
of the patient to the point where the buzzing sound
becomes annoying, or the fine sparks become too
sharp. With the insulated tube, the sparks coming

from loose contact with the external opening are
avoided. A marked sensation of heat is noticed in
the ear, and the best method of regulating the
length of treatment is to allow the tube to remain
until this heat effect becomes a little uncomfortable,

although I would never under any ordinary circum-
stances continue the treatment longer than seven
minutes.
I designed a holder a few years ago which per-

mitted treating both ears at the same time, but for
all ordinary conditions this is scarcely necessary, as
the additional time required in treating the other
ear where both require treatment is not sufficient
to interfere seriously. The conditions of the ear in
which high frequency currents give the best results

are catarrhal deafness; earache; tinnitus aurium,
and chronic suppurative diseases (middle ear dis-
eases).
Special Technique in Treating the Eyes. For ap-

plying high frequency currents to the eye, a double
electrode is used, as shown in Fig. 46, which is in-
serted in the handle and the socket bent so that the
patient may hold the handle against the body and
Fig. 46 Double Eye Electrode.
thus steady it, and at the same time keep the elec-
trode in contact with the eyes, without taking any

chances of touching the cord connecting the elec-
trode to the high frequency apparatus. This is
shown in Fig. 47. The eyes are closed and the tube
kept in light but firm contact with the lids. The
current is turned on after the tube is adjusted and
is turned off before the electrode is removed, thus
saving the patient from any spark. The dura-
tion of the application varies from there to ten

minutes. If only one eye is affected, only one
lobe of the tube may be brought in contact with
Fig. 47 Treating the Eyes.
the eye and the other may extend out to one side
of the head, or a special single eye tube may be
used. One of the other vacuum tubes may be em-
ployed in treating the eye and kept in motion back
F.g. 47a An Outfit Specially for Eye, Kar, Nose and Throat
Treatment.
and forth over the closed lid, or held in contact with

it as preferred. This method with a fine spark has
proved very effective in blepharitis.

These currents are useful in atrophy of the optic
nerve; catarrhal conditions of the eye; absorption
of hemorrhages; inflammation of the retina, and in
connection with auto-condensation for the reduction

of the blood pressure, they have given remarkable
Fig. 48 One Form of Nasal Tube.
results in glaucoma. Blepharitis, trachoma, iritis,
paralysis of the ocular muscles, and cataract, are

other conditions in which they have been employed.
Nasal Technique. The diseases of the nose that

are specially suitable for treatment are all catarrhal
conditions, including ozena (atrophic rhinitis), co-

ryza, etc. Even in hay-fever it has proved useful.
The small nasal tube (Fig. 48 or Fig. 21, No. 13) is
introduced and the current turned on very slowly.

A mild current is all that is required and the length
of treatment varies from two or three to seven min-
utes. It makes very little difference whether the
tube is inserted in the straight or the movable

socket handle. If the upper or back part of the
nasal cavity is to be treated a tube having an insu-
lated chamber to within possibly three-quarters of
an inch or an inch of the end is preferable to the

non-insulated tube. In acute inflammatory condi-
tions the application of a vacuum electrode to the
sides of the nose, externally is advised.
Technique in Treatment of Rectum and Prostate.

In treating the rectum for fissure, hemorrhoids, ca-
tarrhal conditions etc., the insulated tube shown in
Fig. 21, No, 8, should be used. The non-insulated

tube is of much less value for diseases above the
sphincter. The rectal tube may be employed in
treating the .prostate, although the tube specially

designed for the latter purpose is the one shown in
Fig. 21, No. 1, where the depression in the tube

is supposed to be turned toward the anterior wall
of the rectum, and receive into it a portion of the
gland. My new spatulate tube used with one of the

flat toward the prostate gives a larger
surfaces
contact surface, it being doubtful whether with the
other tube the gland really ever fits into the depres-
sion. In prostatic diseases of all kinds, the high

frequency current has proved most efficacious,
144 EBERHART'S MANUAL, of
Fig. 49 Treating the Scalp.

whether used alone or in connection with some other

modality.
In treating both the rectum and the prostate,
my special technique consists in placing the patient

on one side in the Sim's position with the knees
well drawn up. The electrode is lubricated, inserted
in the movable socket handle and introduced into
the rectum. The handle is then bent upwards in
contact with the body and the patient takes hold
of the handle, thus keeping the tube in place dur-
ing the treatment. The duration of each treatment

is seven minutes, and the tube is inserted always
before turning on the current and the latter turned
off before the tube is removed. Treatment through
the rectum is very effective in posterior urethritis,
also in diseases of the bladder. Occasionally in vir-
gins it will be found desirable to treat uterine or
vaginal conditions with the high frequency electrode
in the rectum. The current penetrates surrounding
structures to a much greater extent than one would
suppose.
The special technique for itching is given in Chap*
ter VIII under Pruritus.
Scalp Treatment. In treating the scalp, the body
electrode, Fig. 49, is used. The electrode is moved

14G EBERHART'S MANUAL of
rapidly back and forth over the scalp, using a spark

of from one-quarter to three-quarters of an inch or
keeping the tube in light contact with the scalp. If

too sharp a spark is used, the scalp will be sore after
the treatment and tiny sores will be found. High
frequency currents are indicated in all diseases of
Fig. 49a Scalp Electrode.
the scalp, in falling hair, and some years ago I

made the discovery that if employed for a sufficient
length of time they are capable of restoring the color

to gray hair. This will be specially considered in
Chapter VIII. The tube shown in Fig. 21, No. 11,

is used conveniently in treating the scalp being
equally as good as the body tube, and a new tube
resembling a glass rake is now in general use.

Fig. 49a.
Throat Technique. The throat electrode is shown

in Fig. 50. Any of the other electrodes may be
used externally. In acute inflammatory conditions
of the throat the low vacuum tube is preferable.
The tube may be placed directly in contact with the
mucous membrane of the throat or a spark allowed
Fig. 50 Throat Electrode.
to pass, according to thenature of the case. Sparks

from the regular tube or from the fulguration point
have been employed to destroy follicles in pharyn-
gitis or in place of nitrate of silver cauterization,
and the fulguration point has even been used in the
removal of the tonsils.
Urethral Technique. When employing glass

sounds (Fig. 20, No. 5, or Fig. 21, No. 12) within
the male urethra, the patient is placed upon his back
on the operating table. Whether the knees are
flexed and the legs drawn up depends somewhat
upon the individual case; ordinarily the legs are
straight, but slightly separated.

The sterilized sound is lubricated and introduced

in the same manner that a steel sound would be
used, taking care, however, not to use much force,
on account of the possibility of breaking the tube.
This has happened occasionally, through a prying
or sidewise motion, or through a sudden jerk.
If the canal is too small to admit of the easy
passage of the tube, steel sounds are used first to
dilate the urethra to sufficient size.
In case stricture is present and the whole canal

cannot be dilated sufficiently to allow the glass tube
to pass the stricture, then it is introduced as far as
the stricture and the treatment given. On subse-
quent days it will be found that the stricture gradu-

ally disappears until finally the glass tube will pass
by it.
When the urethral tube has been properly insert-
ed, the socket of the holder is slipped over it, and

the handle bent back over the patient's abdomen.
The patient takes hold of it and thus steadies the
tube. In stricture he is instructed to make steady
downward pressure to keep the point of the tube
firmly in contact with the stricture. The handle is
connected to the machine and the current turned

on. In this way the patient experiences no shock.
The current is turned off before the sound is re-
moved. Duration of treatment, seven minutes.

Do not forget that the posterior urethra may be
treated almost as thoroughly and with much less
pain, by introducing a tube into the rectum.
Uterine and Vaginal Technique. High frequency
currents are suitable in all catarrhal conditions of
uterus and vagina, including leucorrhea, cervicitis,
endometritis, etc. They are extremely valuable in
specific vaginal diseases in conjunction with the

usual method. Treatment through the vagina is
also indicated in diseases of the fallopian tubes and
of the ovaries and in pelvic abscess and in adhe-
sions. Low or medium vacuum tubes should be used

in the latter diseases.
The technique which I use in applying the cur-

rent in the vagina, is as follows: The patient is
placed on her back with her feet in the stirrups

and the lubricated tube in the author's movable
socket holder is inserted, and then the handle is
bent down to touch the table and the patient 's skirts
folded over it, thus anchoring the tube and pre-
venting from slipping out. A towel is then wrap-

it
ped around the metal connection between the tube

and handle to prevent the latter from tipping side-
ways and thus giving the patient an uncomfortable

spark. The cord connecting with the generating
apparatus passes out under one leg of the patient
and care should be exercised
to see that it does not
come in contact with it, nor should it rest upon

any metal which touches the patient, for if there
be a defect in insulation a sharp current will be
communicated along the metal. After the tube is
properly adjusted the current is turned on and

allowed to pass for seven minutes, when it is turned
off before removing the tube. In very acute cases,
I have not hesitated to give two or three treatments
in aday until improvement took place. Ordinarily
from one treatment a day down to two or three
treatments a week will prove satisfactory in sub-
acute or chronic cases. The insulated vaginal tube
should be used. It is shown in Fig. 21, No. 10. The
prostatic tube also makes an excellent one for
vaginal use, and Fig 27 shows my new spatulate

tubes, which admit of contact with a larger surface.
Occasionally in treating diseases of the cervix, a
small electrode may be inserted within the canal,
taking care to insulate against contact with the
meta] speculum, if the latter is used. (An old-fash-
ioned glass one is better.) In cancer, the fulgura-
tion tube may be used through the vagina to destroy

the cancerous tissue. This may or may not require
an anaesthetic.
Fig. 50a Body Electrode Application.
One authority packs the vagina with moistened
gauze with a metal electrode in the center and

thus carries the current to all contiguous parts. The
D'Arsonal current may be used in the vagina by
this method. Direct D 'Arsonvalization is now
known as diathermy. See Chapter XI.
CHAPTER EIGHT.
Practical High Frequency Therapy, Diseases Alpha.
betically Arranged with the Technique
to Be Employed.
Explanatory. In the following pages no special
attempt has been made to distinguish between dis-
eases in which the high frequency current is the

sole treatment required and those in which it is of
temporary value or useful merely as an adjunct to

other methods therefore, including a disease in the
;
list, does not imply that the author necesarily con-

siders high frequency the only, or even the best,
treatment for it. Where he has a pronounced opin-
ion, however, he has not hesitated to express it.
To avoid frequent repetition, where auto-conden-

sation is referred to, it is given according to the
technique in Chapter VI ;
the same with fulguration,
etc. Where special regional technique is advised,
as for the prostate, vagina, etc., the directions in
Chapter VII are to be followed unless otherwise

indicated.
Where small Tesla coils are used with the vacuum

electrode, it should be remembered that the current
is sharper than that from Oudin or larger Tesla,
and shorter sparks must be used than the average
stated, or the patient will complain.
Where two spark-lengths are given, for example,
one-quarter to one-half inch, the shorter would be
for the machine giving a "hot" spark and the
longer for one giving a comparatively "cold" spark.
Bear in mind that this stating the strength of a
vacuum electrode in terms of a certain length of

spark does not necessarily mean that the tube is
held away from the surface so that a spark of that
length actually passes, but means that enough cur-

rent is passed through the electrode to make such a
spark possible. Usually the tube is kept in contact
with the skin and where it is not it is so stated in

the text.
In any of the cases calling for the spark the indi-
rect spark may be used instead of the direct. See
Chapter VI.
Where general treatment with the vacuum elec-
trode is given to take the place of auto-condensation

or auto-conduction, the treatment must be much

longer than that for a purely local effect. The aver-
age duration of local vacuum tube treatments is
from five to ten minutes; for auto-condensation or
auto-conduction, ten to thirty minutes, and for the

general tube treatment referred to, from twenty to
thirty minutes.
A number of symptoms or conditions have been
indexed for convenience as if separate diseases, such
as paralysis, constipation, pruritis, etc.
Insulated tubes are preferable in treating the

various orifices of the body. In general, limit orifi-
cial treatments to seven minutes to avoid possible

burns.
In stating dose of auto-condensation I have em-
ployed my new unit of measurement, the Eberhaii,

a full discussion of which will be found under that
heading in Chapter VI. It is based on 100 milliam-
peres meter reading per minute to each 1,000 volts
of potential.
There are two types of apparatus employed, which

I will designate as Number One and Number Two.
I wish to remain absolutely neutral on the question

of whether one type of the other is superior for auto-
condensation.
Type No. 1. High voltage, low amperage. I as-

sume that the voltage is about 50,000. This is not
official, however. The machine operates ordinarily
at an average meter reading of 350 to 500. In
using it I never try to crowd it about 500, and
usually employ it at about 400. Where a larger
dose is necessary I prefer to lengthen the time,
rather than increase the amperage. On the voltage
stated the number of Eberharts per 100 milliamperes
is 50.
Type No. 2. Low voltage, high amperage. I as-
sume, unofficially, the voltage to be about 25,000,

average meter reading 700 to 1,000. I believe the
majority of operators use it about 1,000 and here

again I prefer lengthening the time in giving a
larger dose, rather than to crowd the meter reading
to a higher point. Based on 25,000 volts, the appa-
ratus delivers 25 Eberharts to each 100 of meter
reading, and although the voltage is one-half that

of No. 1, is operated at twice t-be average meter
reading, which leaves the time of treatment the
"anie.
The following table shows how the time coincides,

the average being about ten to fifteen minutes on
either to give 2,500 E.
>. Eberharts per

Vo. 1 No. 2
able latitude in dosage is allowed, only be sure and

dose enough. The only contra-indications I con-
sider are high temperature in the patient or a pulse
pressure of 20 or less. In the first instance I would

start with about 1,000 to 1,200 E. and wait until
the third day before repeating, generally increasing

dose and frequency as patient showed toleration,
as indicated by a correspondingly smaller rise in
temperature immediately following treatment.

In the latter case if patient w as applying
r
for first
treatment, I would not employ auto-condensation at

all, but spinal sparks instead. If patient had been
under treatment for high blood pressure and pulse
pressure went to 20 or below, I would either stop
the treatment for a few days or give the small dose
(1,000 to 1,250 E.), and if it still stayed as low, I
would abandon auto-condensation, even though the

systolic blood pressure was still abnormally high.
When the blood pressure of the patient is normal
or below normal, auto-condensation generally would
be contra-indicated, but in those cases where it is
desired to use it for its effect in improving meta-

bolism, the dose should average about 1.250 Eber-
harts and should be given at a low meter reading
(200 to 250 for No. 1 ;

400 to 500 for No. 2). If this
158 EBERH ART'S MANUAL o*
is shown to materially decrease the systolic blood
pressure, each treatment should be followed by
sharp sparks to the patient's spine, for five minutes.

Abscess. To prevent the formation of an abscess,
the use of a low vacuum electrode is theoretically
indicated. The intensity of current employed should
be that capable of producing a spark of one-quarter
to three-quarters of aninch, but in employing the
tube it should be kept in contact with the skin. Use
enough current to get the effect of the heat gener-
ated. Duration of treatment ten to fifteen minutes,

repeated daily of twice a day if necessary. In those
cases where an abscess already exists the high
vacuum tube is preferable, using the same inten-
sity. Duration of treatment, seven to ten minutes.
High candle power lights are useful in connection
with high frequency.
Acne Rosacea (Red Nose). To destroy the en-
larged veins in this disease, the spark must be em-

ployed to get a cauterizing action. For -this the
best method is to use the fulguration electrode, reg-
ulating the strength of spark in accordance with the

toleration of the patient and treating from two or
three up to six or eight minutes at a sitting, accord-
ing to the amount of destruction required. A spark

from one-quarter to one-half of an inch in length

from any vacuum tube may be employed in place
of a fulguration point. With the latter, the treat-
ments should not be repeated until the effect of the
first has subsided, which will average from six to
ten days. The X-ray in connection with the high
frequency current is indicated, but I believe carbon

dioxide snow, first suggested for this purpose by
me, is superior to either, and we must not forget
the curative effect of electrolysis.
Acne Vulgaris (Pimples). One of the best fields

for the employment of high frequency is in this form
of acne. It is used preferably in conjunction with
the X-ray, and with this combination a cure should
be effected in practically every case. The vacuum
tube is used for the high frequency application,
the so-called body tube, Fig. 51, being that ordi-
narily employed, and a sufficient amount of current
passed through the apparatus to produce a spark of

one-quarter to three-quarters of an inch. The tube,
however, is not raised from the skin, but kept in
light contact with it, dusting on talcum powder if
the tube sticks to the skin, or else treating through

a single thickness of cloth, as through a handker-
chief. In place of the body tube, I have found that
Fig. 51 Body Electrode Applied to the Face.

any of the glass vacuum tubes ending in a vacuum

not less than an inch in diameter may be employed
as easily as the body tube. For instance, the pros-
tatic tube, Fig. 21, No. 11, makes an excellent elec-
trode for treatment of the face, because the edges
surrounding the depression on the surface of the

tube enable the operator to get a better contact
about the nose or other sharp angles than is possible
with the body tube. The tube is kept moving rap-
idly back and forth over the surface and is not al-
lowed to remain stationary over any point. Lately
I have made considerable use of the indirect spark
with the patient on the auto-condensation pad. If
the treatment is given in connection with the X-ray,

the duration of the high frequency treatment should
be from three to five minutes, but if given alone, a
treatment of seven to twelve minutes is indicated.
Treatments may be given three to six times a week
with the high frequency, but not more than three
seven-minute treatments per week with the X-ray.
The high frequency X-ray tube proves very satis-
factory for the treatment of acne, as little penetra-

tion is required. Where pustules are forming, I have
found it advantageous to raise the tube for fifteen
to thirty seconds and apply for that length of time

a reasonably sharp spark. This often aborts the
pustules, and even if it does not, will limit their

size. I do not approve of deep lancing of pustules
on account of the consequent scarring. When a
yellow head appears on the pustule it should be

opened with a sterilized needle, and then instead
of using pressure to evacuate the contents, the shaft
of the needle should be passed across the pustule,
which will remove all of the pus that is ready, with-
out bruising the tissues and extending the focus
of infection.
Where scars are already present there is no more

efficient application for them than a sharp spark
from the glass electrode, or a very mild spark from
the fulguration point may be employed.
Actinomycosis (Ray Fungus). In this disease the

high frequency spark employed as an adjunct to
is
the X-ray. The spark should be from one-quarter

to three-quarters of an inch in length, according to
the toleration of the patient, providing the vacuum

tube is used. If the fulguration point is employed,
a shorter spark is required. Three treatments per
week.
Adenitis, Cervical (See Tuberculosis of Glands).

Adhesions. Where pelvic or other adhesions fol-

low operations or inflammatory conditions, the high
frequency current will be useful. The vacuum tube
is employed, using an intensity capable of producing
a one-half inch spark and keeping the tube in light
contact with the abdominal wall, passing back and
forth over the area involved for from seven to ten
minutes, or use the direct spark with patient on

auto-condensation pad. In pelvic adhesions, the use
of the vacuum electrode in the vagina in connection
with the surface application will hasten results. Me-
chanical vibration is advised in connection.
Albuminuria (Nephritis; Bright 's Disease). Bene-
fit in these diseases has been obtained from the ap-
plication of high frequency currents. The best

method is the use of auto-condensation, 2,500 to
7,500 E. per day, in connection with the use of a
vacuum tube over the region of the kidneys. There
have been many reports of the disappearance of the
albumen following this method of treatment. I have
myself seen both albumen and casts disappear, but
do not wish to be understood as making the state-
ment that this treatment will cure Bright 's Disease.

That it is of sufficient value to warrant its employ-
ment, if possible, in every case, is my firm belief.
164 EBERHART'S MANUAL otf
particularly in cases where high blood pressure ex-

ists. This is always the case in chronic interstitial
nephritis, as high pressure in the renal artery is
apparently the primary cause of the disease. (See

Arteriosclerosis.) Auto-condensation in these cases
will lower the blood pressure and by relieving the
pressure in the kidney, the strain is taken off the
filtering tubules and the result is at least beneficial
even if not necessarily curative. High frequency in
this disease must be considered solely as an adjunct

to our usual routine treatment and should not be
looked upon as taking the place of these measures.
Alcoholism. Use of the vacuum tube over the
spine, solar plexus and to the extremities in connec-
tion with other means to overcome the effects of
alcoholism, has been advised by several operators.

If the blood pressure is high, the spinal application
would be contra-indicated and auto-condensation or
auto-conduction should be substituted. The latter
forms are also specially sedative where nervous ex~-
citement is present. (See Drug Addictions.)

Alopecia (Loss of Hair). Where baldness occurs
as a result of faulty nutrition, the high frequency
current naturally suggests itself as an ideal remedy.

The applications are made with the vacuum tube,
166 EBERHART'S MANUAL o*
using either the tube shown in Fig. 51 or that in Fig.

21, No. 11. Sufficient current is to be sent through
the apparatus to make it possible to draw a spark of
from one-quarter to three-quarters of an inch. A

case being treated with the spark from a portable
outfit is shown in Fig. 52. The tube is ordinarily in
light contact with the scalp, but occasionally may be
raised slightly, giving a short but rather intense
spark. It is to be kept moving about over the scalp,

for from five to ten minutes at a treatment. If too
sharp a spark is employed, the scalp will become

sore and tiny little places will appear where it has
exerted an escharotic effect. To get the best results
a daily treatment is advised, and two short treat-
ments per day would not be too much. In connec-
tion with the high frequency a few moments' use
of the vibrator is strongly advised. In Alopecia
Areata the X-ray is employed in connection with
the high frequency current using a medium or high

vacuum. The scalp is particularly sensitive to the
X-ray.
Amenorrhea. That the high frequency current
when applied through the vagina sometimes has an
emmenagogue effect has been noted by several au-
thors. I have occasionally observed the same ef-
feet although I cannot reconcile this action with the
beneficial results we obtain from the same current

in menorrhagia and metrorrhagia ;
conditions which
are precisely opposite. As the current determines
an increased amount of blood to the area treated, its
employment in absence of the menses would appear
reasonable. The technique is the use of the insu-
lated vaginal tube for seven minutes, three to six
times a week, and in connection therewith, the ap-
plication of a spark to the lower part of the spine

for from three to six minutes. Another method is to
use the bi-polar Tesla treatment with one pole over

the sacrum and the other over the tubes; two or
three times a week.
In those cases that result from anemia, the gen-
eral effect on metabolism of auto-condensation will
call for its employment, 2,500 to 7,500 E. three to
six times per week. Mechanical vibration is very
effective in amenorrhea, and should be employed in
connection. In virgins, where the menstrual func-
tion is irregular, a small tube, such as shown in Fig.
20, No. 4, may be employed, or the treatment given

through the .rectum with the insulated tube shown
in Fig. 21 No. 8. Ozone inhalations will still further
assist in those cases caused by anemia.

168 EBER HART'S MANUAL
fcJD
Anemia and Chlorosis. As high frequency cur-
rents increase the oxygenation of the blood, thereby
increasing both the reduction of oxyhemoglobin and

also the number of red corpuscles and the percent-
age of hemoglobin, their employment in anemia, es-
pecially of the chlorotic type, is quite as effective

as iron tonics, and at the same time does not inter-
fere with the joint use of the latter. The method of
administering the current is by auto-condensation.
If the blood-pressure is normal or above, give 2,500

to 7,500 E. three to six times per week. If the blood
pressure below normal give 1,000 to 1,250 E. with

is
meter reading about 250 for low amperage machines,

and 500 for high amperage outfits.
Ozone inhalations are clearly indicated and are
of the utmost value in these cases. In one of my
cases the percentage of hemoglobin increased from
thirty per cent to eighty per cent in eight weeks.
Intra-muscular injections of iron solutions are ad-
vised.
Aneurism. Auto-condensation, 2,500 to 5,000 E.,

three to six times per week gives relief, but is, of
course not curative. Under no circumstances should
the vacuum electrode be employed locally over the
aneurism.
Appendicitis, Catarrhal. In catarrhal appendi-

citis, the vacuum tube has been employed locally,
using a tube capable of emitting a one-fourth or

one-half inch spark, keeping it moving in contact
with the skin over the region of the appendix. Both

the monopolar application from the resonator or
Tesla, and the bi-polar Tesla current have been em-

ployed. In the latter case, the other pole is placed
over the lumbar region, or grounded by attachment
to gas or water pipe. It is my opinion that appendi-
citis, in any form, is a disease which high frequency
operators should not trifle with, but turn over to
their surgical friends.
Arteriosclerosis and High Blood Pressure. Arte-

riosclerosis is a disease that is of the utmost im-
portance, because it is the primary condition which
results in so many diseases of kidneys, liver, heart
and brain, which we are accustomed to classify ac-
cording to the organ more particularly affected.
Arteriosclerosis, formerly looked upon as the herit-
age of old age, now very common and greatly on

is
the increase because of our present mode of life with

its strenuous efforts to gratify ambition; its ex-
cesses and indiscretions in eating, drinking, etc. To-
day there are many men young in years whose arte-

ries are those of the octogenarian and forecast the

probability of a sudden termination of their useful-
ness.
The most prominent and persistent symptom of

arteriosclerosis is high blood pressure. The circu-
latory system may be compared to an electrical
plant, in which the heart is the central station or
dynamo and must necessarily have a pressure suffi-
cient to overcome the resistance in the circuit.
Therefore, we have the pressure decreasing in the
arteries, less in the capillaries, and still decreasing

as the veins grow larger. Thus we have the com-
plete round of the circulation, the blood following
the rule of water and of electricity and flowing from
a higher to a lower pressure. Normal pressure of
the blood in the arteries is sufficient to support a
perpendicular column of mercury of from 110 to 120
millimeters. In arteriosclerosis it sometimes in-
creases to over 300.
The disease is usually divided into the functional

and organic stages. The would be the stage
first
previous to the real hardening of the arteries and

the latter that in which structural changes actually
had occurred.
172 EBER HART'S MANUAL o*
In the functional stage there comes to be present

a contracted condition of the artery, producing
thereby increased tension and raising the blood pres-
sure. At this time this is the result of irritation
and spasm on the part of the muscular fibres and no

actual degeneration or permanent change in structure
has appeared. Thus the disease develops gradually
and without any particularly noticeable or alarm-
ing early symptoms. The theory is that toxins in the
blood first cause irritation, then contraction or
spasm of the arteries, which may be intermittent, but

becomes a more or less steady contraction, increasing
the pressure by narrowing the caliber of the artery
and finally attaining the permanent changes of the

second stage. The causes producing the original
irritation are gout, uric acid, lead poisoning, syphilis,
diabetes, excesses or abuses in eating, drinking, to-
bacco, etc. There is faulty conversion of food prod-

ucts into living cells with failure to properly elimi-
nate poisons from the system and the absorpton of
the products of imperfect intestinal digestion (auto-
intoxication).
Of the errors in diet, the most common is the con-
sumption of too much nitrogenous food, especially

red meats and substances rich in proteids. Other
causes of arteriosclerosis are worry; prolonged men-

tal or muscular strain, and the after effects of in-
fectious diseases. Although more common after the
age of forty, no period of life is exempt; cases
occurring at the ages of eight, fifteen and twenty-
eight years being on record. Whatever the treat-
ment undertaken for the disease, there must neces-

sarily be a regulation of habits to overcome the
causes stated above. The diet should be simple, all
alcoholic beverages tabooed; tobacco should be pro-

hibited or used sparingly. Milk or buttermilk are
allowed, especially the buttermilk made with lactic
acid ferments. Eed meats are to be eaten sparingly,

but plenty of vegetables are advised.
There has been a tendency on the part of many
physicians toward the partial or complete elimina-
tion of salt from the diet. The individual should
take his time, and avoid all worry, haste and excite-
ment. In addition, strict attention should be given
to personal hygiene and regular but moderate exer-
cise, baths, etc. It has been shown experimentally
that in a normal subject, the blood pressure may be
raised from five to ten millimeters by taking a cup
of beef broth. Therefore, the necessity for curtail-
ing the amount of red meat is apparent.
174 EBKRHART'S MANUAL off
One of our Chicago millionaires consulted two

celebrated German specialists, Dr. Grodel of Nau-
heim and Dr. Vogel of Ems. -The directions given
by each were almost identical, and I herewith give
the combined list:
"Two cigars daily, separately. Coffee, three-

fourths milk, or dekafa. Chocolate. No tea. No
Turkish baths. Swimming all right. Horse-back
'riding; slow horse. Slow
Automobiling all
golf.
right. No stairs; no strain; no hurry. Eat coarse

graham bread like Nauheim. Never over-eat, it
kills! No sweets. No cabbage, fresh bread or foods
causing flatulence. Champagne and wines do the
same (cause flatulence). Eat lightly and more often
if necessary."
Although high blood pressure is the rule, if the
heart is dilated and there is a tendency 'to dropsy
and congestion, there may be a low blood pressure.
In these, cases it is necessary to be sure of the pulse
pressure. (See Chapter VI under "Taking Blood
Pressure.") The most important and constant
symptom, however, is high blood pressure. In Figs.

44 and 44a the process of taking the blood pressure
is illustrated. (For the technique of taking the
blood pressure, see Chapter VI.)
The electrical treatment of arteriosclerosis is the

use of the high frequency current by auto-conduc-
tion or by auto-condensation. The preliminary dose
is 2,500 E., and it should be given daily in the begin-
ning, and less than three treatments a week at the
start are useless.
As the blood pressure approaches normal, the

treatments may be reduced to three a week, then to
twice a week, and if there is no tendency to a rise
in pressure, then once a week. A treatment every

week or two should be maintained for some time
in order to be sure of the permanency of results.
It is not enough to force the pressure down and

then suddenly abandon all treatment. It will re-
quire on an average about 40 to 50 treatments to

bring the pressure from 200 down to 140 or under,
or to the point where only one treatment a week is
needed.
The pressure is taken before giving the treatment
and if taken after shows an average reduction of
about 10 to 12 millimeters. In a few hours the pres-
sure back nearly to where it was before the net
is
reduction being from one-half to two millimeters,
according to the individual and the degree of pres-

sure. When the pressure is over 200 I expect to get
a net reduction of two millimeters for each treat-

ment. Between 200 and 160 I look for an average of
one and one-half points, while below 160 it will be
from one down to one-half millimeter. In some cases
it goes down steadily for 10 to 15 points, and then
remains stationary for a week or two, and then down
another series.
Dr. John Ritter of Chicago has shown that the

blood pressure, like the pulse, varies with the posi-
tion of the patient, whether standing, sitting or
lying down. Therefore, it should be taken on sub-
sequent occasions with the patient in the same posi-

tion.
It should not be taken too often, say, once a week,

as otherwise the gain is not specially noticeable.
Occasionally, just as the pulse had been cut off
by the pressure of the brachial artery and I had

noted the systolic reading, the pressure would go
up five, ten or twenty millimeters. This I have
attributed to a spasm taking place in the brachial
artery from too frequent taking of the pressure. |
At the end of ten treatments, if the blood pres-

sure is not reducing in accordance with the rate
given above I increase the length of the treatments,
about one-half (3,750 E.), but do not increase the

HIGH rRKQUENCY CURRENTS 177
meter readings. After another ten treatments, if
the reduction is sufficient, I lengthen the time to

twice the original (making 5,000 E.), and so I keep
crowding the dose until I get results or convince
myself that it is impossible. Many operators fail

because afraid to push the dose.
When taking the pressure, take both systolic and
diastolic, and note their difference, pulse pressure.
In these cases we are only interested, as a rule,
in low pulse pressure, and this should never remain
long under 20. If it does we have carried auto-con-
densation as far as do any good, and it must
it will
be stopped, as further treatment will entirely dis-

turb compensation and endanger the patient.
Ordinarily the systolic and diastolic pressures go

down simultaneously, though not always the same
number of millimeters. Occasionally the systolic
goes down faster than the diastolic until the pulse
pressure reaches 20. I then lessen the dose to 1,000

or 1,250 E., or skip a treatment or two, and if after
this it remains at 20, or possibly goes down to 18, I
stop the treatment altogether, whether the systolic

is down to normal or not, and usually give some
sharp sparks to spine to raise the systolic, and there-
by also the pulse pressure, until the latter is above 20.
178 EBER HART'S MANUAL otf
I have met with occasional cases in which no bene-

fit or only a very temporary reduction followed the
use of auto-condensation.
Increased determination of blood to the surface
of the body lowers the blood pressure and, con-
versely, driving the blood from the surface, raises it.
Therefore; any remedy that increases peripheral cir-
culation lowers the blood pressure. In addition to

the drugs employed for this purpose may be men-
tioned electric light baths, oxygen baths, etc. In
advanced cases care should be exercised not to re-
duce the blood pressure too rapidly at first.
We must not lose sight of the fact that either
auto-condensation or auto-conduction, if capable of
lowering blood pressure, is equally capable of pre-
venting the development of arteriosclerosis when
employed at the first sign of increased pressure. In
brief, the effects of old age may be discounted.

view of many authorities when I state
I voice the
that a man past forty, who is under considerable

strain or carrying a heavy load in his business or
profession, and who finds difficulty at times in con-
centrating his attention, awakens in the morning

more tired than when he went to bed has occasional
;
spells of dizziness or light-headedness, or notices

occasional tingling or numbness in the extremities,

owes it to himself to ascertain whether or not these
symptoms are pointing toward the development of
arteriosclerosis. If his fears prove groundless, well
and good; but if evidences of arterial involvement
are present, they will be discovered in time to pre-
vent their untoward effects.
Articular Rheumatism (See Rheumatism).
Asthenopia. Use the body electrode carrying a

spark from one-fourth to three-fourths of an inch,
according to the sensitiveness of the patient, and

keep the tube at full sparking distance. Pass it
rapidly up and down the spine for three minutes.

This treatment is satisfactorily applied through
some layers of clothing, as the latter insure a defi-
nite spark length. In women the corset should be
removed if any steels are where they will be charged
by the current. If a chain is worn around the neck
it should be taken off.
Follow the spinal treatment by an application of

the same tube to the back of the head and neck for
three minutes longer, then over the eyes for two or
three minutes, keeping it in contact with the skin.
Finally use the double eye tube, Fig. 6, for three

minutes. Three to six treatments per week.
Ozone inhalations and vibration are useful ad-

juncts.
Asthma. The treatment of asthma may be by
vacuum tube applications over the chest or by plac-
ing a diaphragm so that a powerful effleuve or fine

fall upon the chest.
sparks will
The vacuum tube should be used with as sharp a
spark as the patient will permit and is conveniently

applied through the underclothing.
Mechanical vibration is especially useful in con-
nection with high frequency.
Direct D'Arsonval application with one sponge to
the back and the other moved back and forth over
the chest is another method. Daily treatments of
about ten minutes' duration. A cure should not be
expected.
Ataxia (See Locomotor Ataxia).
Atonic Dilatation of the Stomach. In this disease
we have complete relaxation of the motor fibres of

the stomach and the treatment must be that which
will cause them to actually contract and regain their
normal tone. The first cases treated by high fre-
quency were those reported by Chisholm Williams.

He employed the vacuum tube for five minutes lo-
cally over the stomach, followed by auto-condensa-

tion for ten minutes. This treatment was repeated
daily. In one case a cure resulted in six weeks.

This author also reported results in seventeen cases
treated by Drs. Crobie and Bokenham. The results
were proved by skiagraphs.

One method that has been used in treating this
disease has been to localize the effects of auto-con-
densation by using the metal electrode and placing
a piece of plate glass between the electrode and the
stomach area. The plate glass is the di-electric. The
electrode corresponds to one layer of condenser, and
the gastric area to the other, thus obtaining the ef-
fect of auto-condensation.
I have found general auto-condensation treat-

ments (2,500 to 7,500 E.) were entirely satisfactory
for this disease often combining with mechanical
vibration. The sinusoidal current has proved of
essentially equal value. While applying the general
auto-condensation on the couch, it is possible to
draw sparks from the body with the vacuum tube
locally over the stomach at the same time with
benefit. The foregoing treatment is equally effec-
tive in atony of the stomach when dilatation is not
present.
Atrophic Rhinitis (See Ozena).
182 KB^RH ART'S MANUAL Off
Atrophy of the Optic Nerve. The method of treat-
ing this disease with high frequency currents has

been by the use of the eye electrode, single or double,
as required, the same being held in contact with the
closed eyelid and the current allowed to pass for
from five to ten minutes. The current is of a strength
just short producing painful sparks on the

of
lid. In the place of the eye electrode, I have used the
form shown in Fig. 21, No. 11, using a current
thatwould not be capable of producing a spark of
more than one-sixteenth of an inch, and keeping it
in light contact with the lid while it is passed back
and forth for several minutes. Another author sug-
gests at the same time an application with a stronger
current, keeping the tube in loose contact with the
skin over the temple for about the same length of
time. Daily treatments are advised.
Baldness (See Alopecia).
Barber's Itch (See Sycosis).
Bladder Disease (See Cystitis).
Bladder, Papilloma of. See technique under Ful-
guration, Chapter VI.

Blepharitis. In a large number of cases of ble-
pharitis a cure has resulted from the use of a very

mild spark from the vacuum tube. Sometimes it has
to be persisted in over a long period on account of a,
marked tendency to relapse. One case referred to

me by Dr. Eager which had resisted all of the usual
routine treatment improved rapidly under three ap-
plications a week of the high frequency current in

connection with the high candle power light. Over
sixty treatments were given, however, before the
case was essentially cured. Fox treated 100 cases
with no failures.
The technique which I employ is as follows: I
use the electrode shown in Fig. 21, No. 11, with

just enough current to produce a stinging sensation
when applied to my own eyelid, the fine spark from
it being from one-thirty-second to one-sixteenth of
an inch in length. I raise the upper lid by pressure

with the thumb and apply this fine spark along the
edge for two minutes, and then pull the lower lid
down and do the same. Then while the patient
closes the eye I pass the electrode over the whole
surface of the lids for two or three minutes longer.
A daily treatment is preferable, but three times a
week will suffice.
Blindness from Intra-Ocular Hemorrhage. In this

condition the current used to promote absorption,
is
and as the blood pressure is always high, there is an

184 EBERHART'S MANUAL o?
indication for the use of auto-condensation or auto-

conduction for the purpose of reducing it.
most interesting case which occurred in

I report a
the wife of a Methodist clergyman. She became

suddenly blind in the left eye and applied to me for
treatment. Not being an oculist I referred her to

Dr. Good for diagnosis and he found on examina-
tion that a considerable hemorrhage had occurred,
thus obstructing the vision. An unfavorable prog-
nosiswas given. I treated the case in the following
manner: The patient's blood pressure was 156 and
there were abundant signs of arteriosclerosis, so she
was given first 2,500 Eberharts on the auto-conden-
sation couch, after which the vacuum electrode
(Fig. 21, No. 11) was rubbed gently over the closed
eyelids, temple and supra-orbital region, using a
mild current, capable of giving a slight stinging
sensation when passing in. loose contact with the
skin. After this, very mild mechanical vibration

was applied through my fingertips to the closed eye
for thirty to sixty seconds only. Daily treatments
were given and the result was little short of marvel-
ous. Inside of two weeks the sight returned to the
eye and a few weeks later it was stronger than

before the hemorrhage occurred, as the patient had.

had some difficulty with this eye for many years.
Blood Pressure. See Hypertension (High Blood
Pressure), also Hypotension (Low Blood Pressure),

and Arteriosclerosis.
Boils. (See Furunculosis.)

Brachial Neuritis. (See Neuritis.)
Brain Fag. " Brain has come to represent
Fag"
a condition just one step removed from complete
nervous prostration. It is common in business men,
especially where too close attention to business has
been accompanied by too little exercise. The favor-

ite prescription has been a complete change of scene,
such as a sea voyage. This treatment is not always
possible, and much may be accomplished by the use

of high frequency currents, ozone, and mechanical
vibration.
The nature of the high frequency treatments

should be in accordance with the patient's blood
pressure. If the blood pressure is high, auto-conden-
sation or auto-conduction is clearly indicated, and

2,500 to 5,000 E. should be applied daily, or even
twice a day if the case is urgent. Following this,
the vacuum tube with a spark just strong enough

to have a good tonic effect should be applied to the
forehead over the eyes and to the back of the head

and neck. The patient will nearly always complain
of pain in the back of the neck, the pain so common
in neurasthenia.
In many of these cases the blood pressure is below

normal and in these the use of auto-condensation
down the spine for four or five minutes, then over
Instead there should be the application of sharp
sparks, say one-half inch or more in length, up and

down the spine for four or five minuttes, then over
the abdominal region for three minutes more, finish-
ing with the application over the eyes and back of

the neck, as outlined above.
In all cases, two or three minutes' inhalation of

ozone after the high frequency treatment is desir-
able, or if possible the patient should install an

ozone machine in his office and also in his sleeping
room so that he is constantly breathing air charged

with a large amount of ozone. (See Chapter IX.)
When the blood pressure is low a mild stimulating
application of mechanical vibration along the whole
spine is indicated, dwelling somewhat longer over
the back of the neck.
Bronchial Asthma. (See Asthma.)

Bronchitis. High frequency currents are useful

in acute bronchitis but circumstances usually render
them unavailable. If, however, the physician has a

portable high frequency outfit and there is elec-
tricity in the patient's room, he will find that a rea-

sonably sharp spark over the chest and back, until
they are well reddened, will give relief. This treat-
ment may be repeated every hour until sufficient
moderation of congestion is obtained.
An ozone generator should be placed in the room
to ozonize the air. This is really more important
than the high frequency application.
In chronic bronchitis the vacuum tube may be
used over the chest and back, as in the acute form.
At the present time in connection with the vacu-
um tube application general auto-condensation is
employed (2,500 E.) or it may be applied locally

according to the ''Plate-glass method" described in
Chapter VI: Here ozone is again clearly indicated,
the preferable method being ozonization of the air
in the room where the patient sleeps or works; this
being superior to the temporary administration of

ozone in the physician's office. Treatments should
be given daily at first, gradually dropping to two
or three times a week.
Callouses. Callosities of all kinds, including corns,
are treated by the application of sharp high fre-

quency sparks either from glass or metal electrodes
;
or by means of the regular fulguration point.

Caustic fulguration is preferable.
Cancer. (See Carcinoma.)
Canities. (See Gray Hair.)
Carbuncle. In treating carbuncle the high fre-
quency currents are used as an adjunct to the X-ray,

although they have proved effective when used
alone. Enough current should be sent through the
tube to produce a one-fourth to three-fourths inch
spark and the tube should be kept in loose contact

with the inflamed area and passed back and forth
over it for ten or fifteen minutes. This should make
an appreciable difference in the pain and promote
an early ripening of the carbuncle.
In cases where suppuration has already occurred
the progress of the case may be hastened by the
same technique.
Carcinoma (Cancer). The best treatment for can-
cer is the use of the X-ray in connection with sur-
gery, but in many instances benefit is obtained from

the local use of high frequency sparks. The present
method of utilizing these sparks is by means of caus-
tic fulguration. (See Chapter VI.) Anaesthesia may

be necessary.
In Fig. 53 is shown a case of cancer treated by Dr.
Carreras by fulguration, a small portable coil being
employed. The middle picture was taken three

weeks after commencing treatment and the right
hand picture in another three weeks.
Fig. 53 Cancer Treated by Fulguration. Three Weeks'

Time Between Successive Pictures.
Cataract. In the early stages of cataract benefit
may be expected from the high frequency current in

a reasonable percentage of cases.
It is applied according to the eye technique given
in Chapter VII. Five minute daily treatments with
not too great an intensity of current; tube in con-
tact with the closed lids.
190 EBSRHART'S MANUAL o*
Catarrh of Bladder. (See Cystitis.)

Catarrh of Bowels. (See Colitis and Enteritis.)
Catarrh of Nose. (See Nasal Catarrh; also Ozena.)
Catarrh of Womb. (See Endometritis ;
also Cer-
vicitis.)
Cellulitis. The red vacuum is preferable in treat-

ing cellulitis. After freely incising the parts to
establish drainage, apply wet dressings and then use
the high frequency current through the dressings,
five to seven minutes, repeating frequently.
Occasionally in an early stage the application of
the high frequency in connection with a high candle
power light may arrest the progress of the trouble;

but if it does not do so quickly, the above method
is advised.
In this instance the current is merely an adjunct
to our usual methods.
Cerebral Hemorrhage. Dr. L. M. Bowes, who has

had a wide experience in these cases, states :
The prophylaxis consists in treating the underly-

ing cause arteriosclerosis, nephritis, chronic alco-
holism or syphilis which is described under the
proper heading.
When there are prodromal indications of hem-
orrhage headaches or dizziness in one whose arte-

ries are liable to rupture the patient should be

placed in bed with the head raised and feet lowered.
If there is hypertension auto-condensation or auto-
conduction is indicated.
Give a brisk purgative followed by an enema.
During the attack the patient should be kept abso-
lutely in the position given above, with an ice-cap
on the head and heat applied to the extremities.
Hot baths should be absolutely forbidden.
The absorption of the extravasated blood is pro-
moted by the use of auto-condensation or auto-con-
duction combined with the use of small doses of the
iodides.
For the paralysis the treatment should be the

same as outlined under the heading of paralysis, re-
membering that only the weak muscles should be

treated. If the strong muscles are treated the con-
tractions are liable to be increased.

Cervical Adenitis. (See Tuberculosis of Glands).
Cervicitis. In inflammation of the neck of the
womb, with or without hyperplasia, the use of the
high frequency current through the vagina is very

effective.
The insulated vaginal tube is employed and care

is taken to be sure that it is in contact with the cer-
vix. Seven minute treatments, daily or every other

day, using a current strength that would be capable
of producing a one-half or three-fourths inch spark
if the tube were not in contact with the body.
A small tube, such as the nasal tube, may be

inserted in the neck of the womb in cases accom-
panied by relaxation, where the mouth of the uterus

is open. This tube must not come in contact with a
metal speculum or it will charge it with the current.
It must be insulated with rubber or dry sufficient
gauze. A glass speculum of the old-fashioned tubu-

lar type is preferable. The direct D'Arsonval cur-
rent (diathermy), is also useful in this disease.
(See Chapter XI.)
Where the cervix is considerably enlarged me-

chanical vibration is advised. I have devised a uter-
ine vibratode which is very convenient and service-
able in treating these cases, because the vibrations
may be limited to the desired area. It consists of a
flexible uterine sound with a section of rubber tub-

ing between it and the attachement to the vibrator
to prevent undue force being used, and application

is made directly to the cervix through an ordinary
speculum.
Chancroid may be treated with the spark from the

vacuum tube or by caustic fulguration. One treat-
ment should suffice and is superior to acid cauter-

ization. Take care not to apply too long. One-
half to one minute is usually sufficient. Sometimes
I place the vacuum tube over the chancroid with
two or three layers of gauze between, thus utiliz-
ing short but rather thick sparks. In this instance
keep in contact for five minutes and repeat in eight

to twelve hours.
Where a soft chancre exists just within the
meatus, treatment by means of the end of an

urethra! electrode is extremely satisfactory for ap-
parent reasons. Treat for seven minutes and re-
peat twice a day in the start.

Chilblains. Use a vacuum tube with a current
strength capable of producing a quarter or half
inch spark, but keep the electrode in contact with
the skin. It may be held steadily over the chilblain
or moved slowly about as desired. Treat for ten
minutes or until relief is manifest and repeat daily
or every other day until cured.
In connection the soaking of the foot in a strong
solution of acetate of zinc (tablespoonful to the
quart) is advised.
If a porcelain bowl is used the high frequency

electrode may be placed in the solution after the
manner of using the faradic current.
Chloasma. (See Moles, Moth-patches, etc.)

Chlorosis. (See Anemia and Chlorosis.)
Chorea. In chorea general treatment with a sharp
stimulating spark to the spine, abdomen and ex-
tremities, taking about 15 minutes for the treatment

and repeating daily or every other day, is advised.
Auto-condensation alone, or in connection with

the foregoing, is indicated; also mechanical vibra-
tion and ozone.
Chronic Ulcers. Use at first a sharp spark from
the vacuum tube to get a stimulating effect, which
is not only locally germicidal, but also converts the
chronic condition into an acute one which will heal
readily. Afterwards treat through two or three

layers of gauze, with a tube in contact, capable of
giving a quarter-inch spark.
Fulguration, with mild spark may be employed.
Cicatrices. (See Scars.)

Cold Extremities. I have included this symptom
because it is so common and because the high fre-
quency is really an ideal treatment for the condition.

Vacuum tube applications to the extremities to
the production of redness give an immediate result.

In order that it may have a permanent effect, a
tonic dose along the spine and over the abdomen
is advised ;
the treatments to be repeated three times
a week.
Diathermy is also indicated. (See Chapter XI.)

Colitis. (Inflammation of colon, mucous colitis.)
This is which has not yielded to ordinary

a condition
methods, but which has proved singularly amenable

to the high frequency current.
Several methods of employing it have been almost
equally effectual. They are:
1. The vacuum tube with a current intensity
capable of emitting a half or three-quarter inch
spark may be passed lightly over the bowel area,
either in contact with the skin or through the under-
clothing. Duration, fifteen minutes. Repeat daily

until improvement takes place, and then continue
three times a week until cured.
2. The Tesla current or the direct D'Arsonval

(diathermy) applied with one electrode over the
bowel and the other in the rectum.
3. Auto-condensation, either general or local or
by the "plate-glass" method. (See Chapter VI.)
Ten or fifteen minute treatments daily or every

other day.
Auto-condensation may be combined with any of
the other forms. It is my preference 2,500 E. daily.
Constipation. I believe mechanical vibration and

the sinusoidal current are superior to high fre-
quency in these cases, but the latter may be used
advantageously.
A vacuum tube application over the abdomen is
indicated. The lower the frequency the more effec-
tive the treatment.
For this reason treatment with the small Tesla

coils is especially satisfactory j
also the use of pulsa-
tory currents, (tube attached to one pole of X-ray

coil).
Considerable current should be passing through

the tube, averaging an intensity capable of deliv-
ering a spark of from one-half to one inch, but

taking care to keep the electrode in close contact
with the abdomen and thereby avoid any sparking.
Ten minutes daily is advised first, later dropping
to two or three times a week.
Another method is to use the Tesla current or

the direct D'Arsonval (diathermy) with one elec-
trode on the abdomen (stationary or moved about),
and the other in the rectum. Local auto-condensa-

tion commends itself and the author's D'Arsonval
surgings given with a pad or metal electrode over
abdomen, will give motor effects.
Convalescence. In convalescence the general tonic

effect of auto-condensation 2,500 E., or a mildly stim-
ulating vacuum tube spark to the whole body, will
aid the patient in regaining strength.
Corneal Opacity. Applications are made with the

eye tube through the closed lids or may be made
directly to the cornea, taking care to have perfect
electrical contact. Three to ten minutes at a treat-
ment, frequently repeated.
Corns. (See Callouses.)
Coryza. For cold in the head a low vacuum tube

carrying enough current to produce a half inch
spark rubbed over the outside of the nose, along

is
the supra-orbital region, and sides of the face.
Ozone is inhaled directly from contact with the

tube or by means of an inhaler.
Intra-nasal application with the nasal electrode
(See Figs. 20 and 21) is also advised.
Two or three treatments a day may be employed

if necessary.
198 EBERH ART'S MANUAL of
Cystitis. The effect of vacuum tube treatment

through the rectum or uretha is remarkable in
inflammation of the bladder.
In one case where many clots of blood were pass-
ing with the urine, and had been doing so for some
days, was greatly lessened after the first treat-
it
ment and entirely disappeared after the second.

The uretha was too sensitive to admit the sound
and the treatment was administered per rectum.
The technique for urethal or rectal applications
will be found in Chapter VII.
A seven minute treatment is given daily at first
and then every other day. Two treatments a day

may be employed if the physician thinks best. It is
remarkable how fast the urine clears up in nearly
all of these cases.

In acute cases I always use the rectal technique
but in old chronic cases I alternate with the ure-
thal method. In women the vaginal technique is
used.
Local treatment over the bladder with the body
tube is also beneficial, or diathermic currents with
electrode in rectum and pad over bladder. A bi-
polar Tesla treatment may be given in the same

manner.
Dandruff. (See Seborrhea.)
Deafness. In catarrhal deafness the high fre-
quency current in connection with mechanical vibra-

tion will yield remarkable results in ninety per cent
of the cases treated. Not that it may be expected'to
cure so large a per cent ;
but the degree of improve-
ment will be so marked that both physician and
patient will be well satisfied. The ear tube is used
as outlined under ear technique in Chapter VII, the
duration of the treatment being from two to seven
minutes, according to the toleration of the patient.

The current must not be too sharp.
The sensation of heat will become so marked that

the patient will tell you when to stop. If he does
not, do not carry the seance beyond seven minutes,
for either ear.
Two treatments a day are not too many in the

start, but this seldom practicable
is and we must
content ourselves with from three to six per week.
Diabetes. In the earlier use of high frequency

currents we were confronted by a variety of reports
regarding the effectiveness of this treatment in dia-

betes, but even those who gave adverse opinions
concerning the disappearance of sugar, admitted
200 EBERHART'S MANUAL Of
" sense
that there was improvement in the patient's
of well-being."
I am willing to put myself squarely on record

as believing auto-condensation to be the best single
remedy we have for diabetes, and best of all it does

not prevent us from using at the same time all of
the other measures which experience has shown us
to be valuable.
In my first cases I used auto-condensation without
altering patient's diet, or prescribing any internal

treatment in order to determine exactly how much
reliance might be placed on this method. All speci-
mens of urine were sent to a reputable laboratory
for examination so that no personal wish might in-

fluence my judgment of results.
In one of these cases the sugar and all accom-

panying symptoms disappeared in the incredible
time of six weeks. (There was six per cent of sugar

in the beginning). Three to six months has been
more nearly the average time required. The sugar
has not disappeared in every case, but in no case
has there not been a perceptible decrease in amount
and a general improvement where the treatment
lasted over two months.
One case died in four weeks, only ten treatments
being given. The acetone increased and I predicted

death within two weeks. A sudden and decided in-
crease in acetone or its appearance when none has

been present, regard as an unfavorable sign usu-
I
ally indicating a fatal termination within two or

three weeks.
One of myworst cases where the patient could
scarcely get to the office for treatment made such
a steadyimprovement that in five months the sugar
had dropped from seven and a half per cent to one
and three-tenths per cent, he had resumed work and
was gaining rapidly in weight, and I was absolutely
sure a complete cure would result, when he died
suddenly. The cause was apparently the result of
an excess in drinking (which had been forbidden),
raising the blood pressure to the point of rupturing
one of the arteries in the brain.
Treatments should be given daily at first, starting
with 2,500 E., and if improvement is not manifest
within a week increasing to twice that amount or
even more. The only exception is where there is
an advanced case of arteriosclerosis with marked

hypertrophy of the heart muscle, when the blood-
pressure should not be diminished too rapidly.
When improvement is pronounced, decrease the

dose and treat three times a week.
In examining the urine the total amount for
twenty-four hours must be collected and measured
and a specimen from this examined; otherwise a
test for the percentage of sugar will be valueless,
for if half a dozen separate specimens are examined

in a day, there will be given an equal variety of
percentages.
As diabetes is apparently a disease resulting from
disturbed or impaired metabolism it is entirely rea-
sonable to expect benefit from the administration of
auto-condensation.
I do not enforce a rigid diet, but a regulated one.
Other operators have employed in place of the
auto-condensation a vacuum tube spark over the
abdominal area. Many find the X-ray of decided
value, exposing over the liver.
Diarrhea. One author

"After preliminary
says,
treatment of the canal or being assured that no
foreign matter remains in apply tonic dosage
it,
of high frequency current over the region of the

solar plexus, stomach, intestines, liver and spinal
nerves." I note that he advises essentially the same
method for constipation.
As few cases of diarrhea come under the treat-
ment of the electro-therapist I am not able to give

would think a prolonged but
a definite opinion, but
soothing treatment over the abdominal organs pref-

erable. Inhibitive vibration I know to be effective
and would advise it in conjunction.
Drug Addictions. In drug habits I have found

more benefit from vibration than from high fre-
quency currents, but the latter may be used con-
jointly. In alcoholism, a sharp stimulating spark

over liver, solar plexus and fifth to ninth dorsal
spinal centers is advised; also auto-condensation,

2,500 E. repeated three to six times per week, pro-
vided blood-pressure is high. (It is usually.)
In the cocaine habit use mild vacuum tube treat-
ment to soles of feet; and to arms and legs to the

point of marked reddening. If blood-pressure is
low use stimulating sparks to the spine ;

if high give
auto-condensation. In opium users
morphine or
give sharp stimulating spark over liver and solar
plexus, with auto-condensation or spinal sparks ac-
cording to whether the blood-pressure is high or
low.
In all of these habits treat insomnia, constipation
or other accompanying symptoms as advised under
those headings.
Dupuytren's Contraction. For the contraction of
the fascia in the palm of the hand known under this
name, high frequency currents have been success-

fully used by Herdman.
Auto-conduction or auto-condensation, 2,500 E.
three to six times per week with vacuum tube sparks
locally for five minutes. Mechanical vibration indi-
cated.
Dyspepsia. The technique to be followed is es-
sentially that outlined under atonic dilatation of the

stomach. The best treatment is auto-condensation,
2,500 to 5,000 E. daily. It may be employed locally
" "
by the plate-glass method (see Chapter VI), thus
making it possible to utilize the small coils for the
purpose. D'Arsonval surgings (see Chapter VI) are
of equal value.
Vacuum tube applications over stomach and solar
plexus are advised if auto-condensation is not avail-

able. The general tonic effect of ozone inhalations
or of ozoning the air of room or office, makes it a
useful adjunct.
Earache. This symptom is frequently relieved by
the application of the ear tube, using a mild current
for from three to seven minutes, the benefit being
apparently due to the heat evolved.

Another method has been the use of a flat elec-
trode over the mastoid.

Ear Diseases. The principal diseases of the ear
which are benefited by high frequency currents are :
catarrhal deafness, tinnitus aurium, and chronic

middle ear affections. The method of treating each
of these is given under its appropriate heading.

Eczema. In the treatment of eczema the high fre-
quency is an invaluable adjunct to the X-ray, but

may be used independently of it with successful re-
sults. This disease reacts to the X-ray very quickly

so that care must be used in the number and length
of exposures. The high frequency is applied accord-
ing to the technique described in Chapter VI, under
skin diseases, where the body tube or the tube shown
in Fig. 21, No. 11, is used with a sufficient amount
of current to produce a spark from one-fourth to
three-fourths of an inch in length, but during the
greater part of the treatment it is kept in light con-

tact with the surface, or the treatment is applied
through a layer of gauze.
Where there is intense itching it is found that
raising the tube to produce a moderately sharp
spark proves quickly effective and is very agreeable
to the patient. As with the X-ray we must be care-
206 EBERHART'S MANUAL, off
ful and not treat the case too long at one sitting.
From two or three to eight minutes daily or three

times a week is advised; the shorter treatments
should be given when used in connection with the
X-ray. One of the high frequency X-ray tubes made

to hold and apply to the surface in a manner simi-
lar to that of the ordinary vacuum tube would un-

doubtedly be especially satisfactory in these cases.
An ozone spray (see Chapter IX) is recommended
when available.
Enlarged Prostrate. (See Prostatic Diseases.)
Endometritis. Treat same as cervicitis.
Enteritis. In enteritis of a chronic character high
frequency currents may be expected to benefit in

the same way that they benefit all catarrhal condi-
tions. In acute forms there is a question whether
the current is of sufficient value to warrant its em-
ployment when there are so many other agencies of
equal or greater effectiveness that are more easily
resorted to.
The treatment advised would be tonic applications

over the abdomen with the vacuum tube and a mild
spark ;
or local auto-condensation, three to six treat-
ments per week, of ten minutes each.
Epididymitis. In acute forms a vacuum electrode
applied with mild current and held in contact with

the area involved or the use of diathermy is ad-
vised. In either case a ten-minute application re-
peated in two or three hours until relief is obtained.

In the chronic form the same method is employed.
The treatments are then given daily or three times
a week.
The X-ray is very effective in these cases, but on
account of its tendency to produce sterility, it is
sometimes objected to. The surrounding parts

should be protected by a lead shield or the treat-
ment may be applied through one of the narrow
tubes or speculums connected with a tube shield.
In my experience where there has been any con-
siderable inflammation of the epididymis, that side
is already inactive, and there is no special reason
to hesitate about using the X-ray.
Epilepsy. The high frequency current in connec-
tion with the X-ray has been used in treating epi-

lepsy with a number of apparent cures according
to several authors. The method employed is the use
of a medium or high vacuum X-ray tube, placed at
ten inches and used for five or ten minutes, followed
by vacuum tube application over the brain, and

along the spine for five minutes longer. Treatment

is repeated three times a week.
It is questionable in my mind whether there is
sufficient benefit in these cases to warrant the use

of the high frequency current.
Epithelioma. In skin cancer our best non-oper-

ative treatment is the X-ray, whether generated by
high frequency apparatus or with the ordinary ma-
chine. The high frequency in the form of fulgura-
tion is also effective in the great majority of cases.
Even the use of a very sharp spark, say three-fourths
of an inch in length from a vacuum tube, has proved

successful.
Where the X-ray is used it has been my custom

to give three exposures per week, of from seven to
twelve minutes, with a low or medium tube, fol-
lowed by two or three minutes' application of as
sharp a spark from the vacuum tube as the patient
would tolerate.
We also have in carbon dioxide snow an excellent

remedy After the glands have be-
for these cases.
come involved the chance of cure by any method is
greatly lessened.
Erosions of the Cervix Uteri. These are treated
with the vaginal tube, the insulated form being
.
HIGH l-'REQUENCY CURRENTS 209
used, according to the vaginal technique described

in Chapter VII, taking care to bring the tube in
contact with the cervix. The treatment should last
for seven minutes and may be repeated daily or
every other day, as desired. Diathermy has been
used in these cases, the patient holding a metal
electrode connected to the other pole. No treatment
should be given during menstruation.
Exophthalmic Goitre. (See Goitre.)
Eye Diseases. The specialist will find the

high
frequency current a very valuable adjunct to his
armamentarium. Fox, in 1907, reported one hun-
dred cases of blepharitis marginalis treated without
a single failure. My own experience in this disease
dating back to 1902 will bear this out. Iritis,
retinitis, atrophy of optic nerve, conjunctivitis, tra-
choma, glaucoma, incipient cataract, paralysis of

ocular muscles, intra-ocular hemorrhage have all
been treated by high frequency currents. The spe-

cial technique for each of these diseases is given
under the appropriate heading.
Favus. This condition which yields so nicely to
the X-ray is also amenable to treatment by high
frequency. A spark is employed as sharp as the
patient will tolerate for from three to five minutes,

three times a week.
Fissure (Anal). So many reports of successful
results in anal fissure have been made that there
seems to be no doubt of its efficacy. It has always
been my opinion that as much benefit was derived
from the stretching of the parts as from the heal-
ing effect of the current. The rectal vacuum tube
isemployed as directed in Chapter VII and a seven
minute treatment is given from three to six times
per week.
Flabby Breasts. It is claimed by Monell that a
stimulating application with the vacuum tube to the

relaxed nipple of the flabby breast will immediately
show its beneficial effect.
Frontal Sinusitis. (See Sinusitis.)

Furunculosis. In treating boils a mild spark from
the vacuum tube is employed over the affected area
for ten or fifteen minutes. The treatment may be
repeated two or three times a day if operator finds

it advisable. It is well to cover a reasonable area
surrounding the boil in order to prevent recur-

rences, if the boil is discharging. Another method
is to use the fulguration point with a sharp spark
for a few seconds. This frequently aborts a boil

if employed in the early stages. Operators using

the Tesla coil have told me that they obtain better
results when the patient is directly attached to one
pole of the machine and the grounded vacuum tube

or metal point held within a short distance of the
surface treated, thus drawing the sparks from the
skin (indirect sparks).
Open boils heal readily under an application of

the ozone spray.
Gastritis. In chronic gastritis the high frequency

treatment indicated is local or general auto-condensa-
tion, or the methods may be followed which are
given under atonic dilatation of the stomach.
Genito-urinary Diseases. The genito-urinary dis-

eases in which these currents have proved useful
include gonorrhea, gleet, prostatitis, cystitis, orchi-
tis, stricture, etc. The directions for treatment will
be found under these various headings.
Glaucoma. As this condition is usually associated
with high blood pressure as well as hypertension in

the eye-ball, the use of auto-condensation 2,500 to
7,500 E. daily to reduce blood pressure naturally

suggests itself and it was for this reason that I first
employed high frequency currents.

212 EBERHART'S MANUAL, OF
In conjunction with auto-condensation, I use the
eye tube applied to the closed eye for five to eight

minutes, when a very mild spark is employed over
the eye-lid, eye-brow and temple with any flat sur-
faced vacuum electrode.
I do not find any record of this condition having

been previously treated by anyone else. There is, of
course, no reason to omit any of the customary rem-
edies used in these cases. The benefit is noticed fre-
quently after a single treatment.

Gleet. There are two methods that I have found
equally satisfactory in the treatment of chronic pos-
terior urethritis. The first is by employment of the
urethal tube with the technique given in Chapter
VII, taking care in the introduction of the glass

sound not to break it and seldom extending the treat-
ment over seven minutes at any -one seance. The

treatments may be given daily or every other day.
The second method is through the rectum
to treat
with the rectal or prostatic tube, which I have found

quite as effective, and much easier to employ and
devoid of any danger from breaking of the tube. I
have treated a large number of these cases, begin-
ning as far back as 1902. The early cases were
treated in conjunction with the X-ray, but on ac-
count of the risk in using the latter, I have aban-

doned it of late years and find high frequency cur-
rents even more effective.
Cases are cured frequently in from ten to twenty
treatments; occasionally it has taken more than

twice the latter number.
Goitre. In simple goitre the high frequency cur-

rent is applied with the vacuum tube, using an
intensity capable of producing a half or three-quar-
ter-inch spark.
The tube should be kept in light contact with the

surface of the skin, treating the sides of the neck
as well as over the goitre itself. After five minutes
of this treatment, raise the tube and use as sharp a
spark as the patient will permit for two or three

minutes.
The X-ray is always in connection with the

iised
high frequency and mechanical vibration also. About

one-half of the cases are cured.
In exophthalmic goitre the results are much better

than in simple goitre.
The vacuum tube is employed in the same manner

followed by auto-condensation, 2,500 E. X-ray and
vibration recommended.
Gonorrhea. In acute gonorrhea in the male the

current is markedly beneficial. If the canal is not
too sensitive the urethal vacuum tube may be used,

but this seldom possible.
is
A method in vogue abroad is to wrap the penis

in wet cotton or gauze and wrap lead or tin-foil
around it, which is connected to the resonator or to
the Tesla coil, or used with direct D 'Arson val cur-
rent (diathermy).
Another method is to use a glass tube containing
boric acid solution and having a metal bottom to
which the connecting cord is attached.

A daily treatment should be given, and I have not
hesitated to give as many as three in one day in
some instances.
In the female the vaginal tube is used or the
vagina may be packed with moist gauze and a me-
tallic electrode attached to the gauze.
Usual methods of treatment may be carried out in
connection with the high frequency.
In sub-acute or chronic forms the vacuum tube
method is preferable in either sex. In men, treat-
ment through the rectum is effective.
The precise action of high frequency in these cases
is still in doubt. It may be the germicidal effect of

the ozone liberated, or the increased leucoeytosis es-

tablished. With tubes of high vacuum the chemical
rays emitted are entitled to credit.

Gout. Auto-condensation or auto-conduction is
the high frequency treatment for gout, as in all

diseases resulting from disturbed metabolism. The
urine is found to have immediately an increased
amount of urea, while the excessive uric acid rapidly
decreases to normal.
2,500 to 7,500 E. daily or three times a week is
a proper dosage. A slight aggravation of pain may

be present after the few treatments, for which
first
reason I sometimes start with a smaller dose and

gradually increase.
No treatments should be given during an acute
attack. Arc light or electric light baths are bene-
ficial in any stage.
Where the vacuum tube is applied in these cases,
it should be kept in close contact with the skin,
avoiding all sparking. Indirect spark during auto-
condensation is very beneficial.
Gray Hair. I discovered, accidentally, the action

which these currents have in restoring the natural
color to gray hair. This apparently is not limited to
premature grayness.
The chief drawback to the treatment is that it
may have to be kept up for months and months.

Vibration of the scalp to aid in increasing nutri-
tion is desirable. The high frequency treatment
consists in vacuum tube applications.
From my original article on this subject, pub-

lished in the American Journal of Clinical Medicine,
November, 1909, I quote some paragraphs :
"As early as 1902 I began using high frequency

currents, usually in connection with vibration, in the
treatment of various conditions of the scalp where
the hair was thin or falling out rapidly.
"Vibration was employed because of its stimulat-
ing effectson the circulation, and high frequency

sparks because of this same beneficial influence on
the nourishment of the hair roots, and further on
account of its germ-destroying action where bacteria
were responsible for the falling hair.
"The possibility that high frequency currents

might be useful in restoring the original color to
gray hair did not occur to me, and had it done so I
should have thought it impossible in consequence of

the fact that these currents have been used com-
mercially in bleaching flour and other substances.

"My first discovery of the 'restorative' effect on

gray hair came about in an accidental manner.
"I was treating a woman whose hair was falling

out very rapidly, employing both high frequency
current and vibration. Her
was very black,
hair
but sprinkled over her head were three or four

dozen gray hairs which were especially conspicuous
by contrast. She asked me would do any harm
if it
to pull out the white hairs, and I told her that as

long as she was losing so much hair, anyway, she
might as well pull out the objectionable gray ones.
"After about two months of treatment the hair

had practically ceased falling out and I noticed that
there were scarcely any gray hairs. I thought she

had been pulling them out and said so. When she
replied that she had been afraid to do this despite
my permission, I said to her that the treatment must

be restoring the color and proceeded to investigate.
The finding of a few hairs white at the upper end
and dark for a varying distance next to the scalp
convinced me absolutely that my surmise was cor-
rect. From that time on I have employed high fre-
quency currents in all of these cases that have come
under my care.
"For a long time I believed that only in prema-
turely gray hair any improvement could be ex-

pected, but a recent case makes me think that if
patient and physician are sufficiently persevering,
results may be obtained in many instances where
the gray hair is the natural result of advancing
years.
"The case referred to is one in which I have for
somewhat over a year and a half been treating a
very stubborn case of lupus, situated behind the left
ear. The patient, a man in the fifties, has gray hair

which can scarcely be called premature.
"The treatment for several months consisted in
an application of high frequency sparks six days a

week, preceded every other day by exposure to the
X-rays; and even now^ that the patient is nearly
cured he is still receiving two such treatments a
week.
"Recently I noticed that around the ear where I
had been applying the sparks there was a band of
dark-brown hair about an inch in width. I thought
possibly this was so all around the margin of the

hair, but found it did not exist except, over the area
receiving the high frequency sparks, and a reference

to a picture of the man taken when treatment was
begun shows that at that time there was no apparent

difference in the shade of the hair at this point.
''All of this brings me to the conclusion that gray
hair must be entirely a result of disturbed nutrition,
preventing the carrying into the hair of the pigment

that gives it its color. This pigment-carrying prop-
erty, in all probability, depends largely upon the

natural electrical currents which traverse various
tissues and which when interferred with in the hair
result in grayness.
"Laying aside theory, results tell, and it is easy

for anyone to prove the truth of my statements.
The only drawback is the comparatively long time
required. Some cases show results in two or three

months, but six months is nearer the average.
"In the case of naturally gray hair I fear few
patients could be kept under treatment long enough,
since in the instance cited, a year and a half elapsed
before the change was noticed.
"The method which have employed is first to
I
use a rubber brush or soft rubber vacuum cup on a

vibrator and for three or four minutes thoroughly
massage the scalp; stroking from the edge of the

scalp inward toward the center of the crown of. the
head, or else using short circular strokes and grad-
ually passing from the margin to the center. Fol-
lowing this, vacuum tube is employed and

a glass
passed rapidly back and forth over the scalp for

five minutes, with as sharp a spark as the patient
can conveniently tolerate. This is usually one about
one-half or three-fourths of an inch in length. Too
sharp a spark might make the scalp sore and even
have a slight caustic effect, which is to be avoided.
"Daily treatments are the best. I employ a simi-
lar technique in falling hair. Keeping the tube in

loose contact with the scalp is equally effective."
Grippe. (Influenza.) In connection with the usual
medicinal treatment great benefit will be derived
from the general application of the high frequency
current and the inhalation of ozone.
Ozone is particularly valuable in these cases, es-
pecially where the patient can have an ozonizer in
the room.
Otherwise inhalations by means of any of the sev-
eral generators, or in default of one, the vacuum
tube held with the hand in contact with the vacuum
will give a sufficient amount if brought near the
nose.
The general treatment is by tonic spark to spine
and solar plexus also mild treatment over eyes and
;
sides of nose. (Intra-nasal with special tube is ad-

vised in certain cases.)
Hair, Falling. The. vacuum tube applied as de-

scribed under scalp technique in Chapter VII, es-
pecially in conjunction with vibration, is very ef-
fective where the hair is falling out. (See Alopecia.)
Hay Fever. (Periodic Hyperesthetic Rhinitis.)

Many reports have been made of the favorable in-
fluence of high frequency in these cases. Direct ap-
plications to the nose with the nasal vacuum tube

and mild current, also using any suitable tube to
stroke over the nose externally, as in nasal catarrh,
is the customary technique with tonic spinal treat-
ment or auto-condensation as indicated.
Inhalations of ozone are of even greater import-

ance or still better ozonizing the air of the room.
The patient should be examined for enlarged tur-
binates or nasal polypi and if found they should be
removed.
The hyperesthetic areas in the mucous membrane
should be destroyed. Fulguration sparks may be
used for this purpose, although I see no advantage
over customary measures.
Headaches. Frontal or congestive headaches are
relieved by using the vacuum tube with an intensity
capable of producing a half or three-quarter inch

spark and by passing the tube back and forth over
the seat of pain.
Tn.-6.f-
Fig. 54 Areas Where Headaches Occur.
Keep the tube in loose contact and prolong the

treatment until relief takes place, which will be five,
eight or occasionally ten minutes.
Inhibitive vibration in connection is advised, being

fully as effective as high frequency.
Only temporary relief may be expected in toxic

headaches or in reflex headaches from organic dis-
eases unless the underlying cause is ascertained and
treated.
' '
In Fig. 54, taken from
' '
my Vibratory Technique,
the areas where headaches occur are outlined. This
will be useful in suggesting the probable line of
treatment.
Headaches at A or B are congestive or frontal.

At A they may come from errors in refraction;
frontal sinus disease or nasal disease. Stomach dis-
eases also frequently cause pain at A. Constipa-

tion A-B. Decay of front teeth A-B. Anemia; en-
dometritis; bladder diseases, C. Middle ear dis-
ease ;
throat disease ; eye disease ; decayed teeth, D-E.
Womb disease; spinal irritation; nervousness, E.
Ovarian reflex pains usually at C and E. Neuras-
thenic headaches involve the back of the neck.
Heart Disease. One author says: "Tesla currents

are often of great value in organic heart disease in
assisting nature to establish compensation. In later
stages when compensation fails the current is pal-

liative through its action on the vaso-motor system

and its tendency to disperse dropsical effusion."
Treatments are given according to the indications
shown by the patient's blood pressure. If the lat-
ter is high auto-condensation is called for ;
if low
sparks to the spine and solar plexus.
Hemorrhoids. Outside of the use of fulguration

for the removal of hemorrhoids, I am not impressed
with the value of high frequency currents in these
cases, despite a number of favorable reports. Of
course they are palliative and relief may result from
their treatment with the rectal electrode as directed
in Chapter VII, under Rectal Technique.
For well-marked cases my advice is operation.
Whether they are removed by the knife or scissors,
or whether by the electro-cautery, or by fulguration
sparks, is a matter for individual choice.
Local anesthesia will suffice for fulguration in

these cases and the spark need not be a very long
nor sharp one. More than one application may be
necessary.
Herpes Zoster. (Shingles.) Application of the,
vacuum tube discharge to the eruption in herpes is

almost uniformly serviceable in hastening a cure.
The tube should be capable of delivering a quarter,

half or three-quarter inch spark, but should be used
in loose contact with the surface or through a layer
or two of gauze. Treatment should be applied to
the nerves supplying the area. Repeat the applica-

tion daily as long as required. Two to four treat-
ments ordinarily are sufficient.
Mechanical vibration advised and ozone inhala-

tions for their tonic effect.
High Blood Pressure. (See Hypertension.)
Hyperesthetic Rhinitis. (See Hay Fever.)
Hypertension. (High Blood Pressure.) This
symptom is the most common one accompanying

arteriosclerosis, and the technique of treatment is
given under that heading.

The technique of taking the blood pressure is de-
scribed in Chapter VI.
High blood pressure always calls for auto-conden-
sation, or auto-conduction. It also contra-indicates
the application of sharp stimulating sparks to the
spine, as these tend to raise it still more.
Hypotension. (Low Blood Pressure.) In this con-

dition we have the opposite to the preceding head-
ing, and the treatment indicated is sharp stimulat-

ing sparks to the spine and solar plexus, while auto-

conduction or auto-condensation is theoretically
contra-indicated, although with low pressure it does
Fig. 5 4a Portable Outfit.
not seem necessarily to lower it, depending on the

pulse pressure (See Chapter VI).
Hysteria. Many operators have reported success-

ful results in hysteria. Auto-condensation should be
used if blood pressure is normal or above.
If the pressure is below normal, as is often the
case, sharp vacuum tube sparks to spine and abdo-

men are advised. ,
Impetigo. Treat according to the technique given

for acne vulgaris.
Impotence. The method of treating this condi-
tion is by means of the vacuum electrode. Use the

body or prostatic tube with enough current to pro-
duce spark one-quarter or one-half inch long or

more.
Keep the tube in loose contact with the surface

while passed back and forth over genitals, in-
it is
guinal and bladder region and to the lower half of

the spine.
With the spinal application raise the electrode to
get reasonably stimulating sparks.
Sometimes a special electrode is used which takes

in the genitals, or they may be immersed in boric
acid solution or water in a glass or porcelain vessel,
and one pole of the D' Arson val current (diather-
mic) in contact with the fluid, while the other elec-
trode is in the patient's hand or applied to his back.
Ten minute treatments daily. Rectal applications

for seven minutes are often beneficial.
Incontinence of Urine. (Enuresis.) Apply a tonic
spark to the lower part of the spine and also over

the bladder area.
In selected cases treatment through the rectum

to influence the neck of the bladder is desirable, and
were it not for the fact that these cases occur in
children the methods outlined under cystitis would
be indicated.
Infantile Paralysis. (Anterior Poliomyelitis.;

These cases call for the daily appplication of stimu-
lating sparks to spine and over all of the paralyzed

muscles. Use a spark one-fourth or one-half an inch
in length, with body tube.
Interrupted galvanism and vibration are of equal

value and should not be omitted. The tonic effect
of auto-condensation makes it desirable.
D'Arsonval surgings (See Chapter VI), with the

connection made directly to the ankles when the legs
are affected, is of marked benefit because of the mus-
cular contractions produced.
Influenza. (See Grippe.)
Insomnia. (Sleeplessness.) There are few cases

of insomnia that cannot be cured by high frequency
currents.
The technique which I have found to be most

satisfactory has been the use of a vacuum tube with
sufficient current to produce a quarter or half-inch
spark, which is kept in light contact with the back
of the head and neck for about five minutes, fol-
lowed by three or four minutes' application over

the eyebrows.
After this auto-condensation 2,500 to 7,500 E. I
always use vibration in connection with high fre-
quency and ozone is indicated.

Patients often fall asleep while taking auto-con-
densation ;
in fact, when using this method for other
conditions you will often find your patients asking

what it is that makes them so sleepy.
I have cured so many aggravated and severe cases

of insomnia with these measures that I am inclined
to believe there should be no failures.
One of the worst cases I have encountered was

that of a man who found it necessary, on account
of the sudden death of his brother, to work night
after night until two or three o 'clock in the morning
in order to getthrough with his business. This and
the shock of his brother's death (he was killed by
a car) caused such a state of mind and body that
230 EBERHART s MANUAL OF
when it became possible for him to take plenty of

time to sleep, it was found that sleep was impossible.
At the time I undertook his treatment all of the
customary measures had been exhausted and power-
Fig. 54b New Type of High Frequency Coil.
ful narcotics only gave a transient respite in short, ;
grave fears for the man's mind were entertained.

I refused to take the case unless the patient agreed
to take daily treatments for six weeks. It was with-
in three or four days of the end of this time before

any improvement was manifested, but the second
course of treatments, covering the same length of
time, entirely cured him.
Intestinal Indigestion. With imperfect intestinal
digestion we have indican present in the urine.
Auto-condensation, either general or local, will
cure these The technique outlined under

cases.
atonic dilatation of the stomach is equally useful

here. The sinusoidal current also has cured many
cases.
The administration of suitable drugs does not con-

flictin the least with the electrical treatment. The
diet should be regulated carefully.
Intra-ocular Hemorrhages. The high frequency

current is applied through the eye electrode in eon-
tact with the closed lid for five minutes.
The blood pressure is always high in these cases

and calls for auto-condensation, 2,500 to 7,500 E.
Daily treatments.
Iritis. Treat as outlined under eye techniue,
Chapter VII. The current relieves the pain and re-
duces the inflammation.

In syphilitic have had especially satisfac-

iritis I
tory results in breaking up the adhesions which had

formed.
Keloid. Keloid may be destroyed by sharp sparks
from the vacuum tube or caustic fulguration. The
X-ray should be used in connection with high fre-
quency.
Drs. Frater and Frater, Shreveport, La., have re-
ported remarkable results in one severe case.

Laryngitis. In the acute form the application of
a vacuum electrode to the throat externally, for
five or ten minutes, either by loose contact or by a
mild spark will greatly aid the customary medical
measures. Ozone inhalations and diathermy advised.
Leucorrhea. The treatment is by means of the
vaginal vacuum tube according to the method out-
lined in Chapter VII.
Three to six treatments a week in connection with

antiseptic and astringent douches will cure these
cases.
Tonic spinal sparks are advisable, frequently ;
also
vibration.
Leukemia. Prior to 1910 I believed high frequency
currents were contra-indicated in leukemia because
they increased leucocytosis.

This I still consider true of vacuum tube applica-

tions (except orificial), but some experiments with
auto-condensation have convinced me that in it we
have a valuable aid in this disease. 2,500 E. is the
dose.
The following case of splenic leukemia in an early

stage, as shown by the blood count at the beginning
of the applications and again a short time later, is
one of the arguments that won my advocacy of the
treatment.
January 29, 1910, blood examination showed 3,360,

000 red cells (89%) ; hemoglobin, 60%; white cells,
9,580 (135%) ;
color index, 9. Besides variations in
the proportion of normal white cells there were many
poikilocytes and 1^% of myelocytes.
June 3, 1910, the red cells had increased to 4,200,-
000 (97%) ; hemoglobin, 90% ;
white cells, 7,860
(100%) ;
color index, 1. Poikilocytes and myelocytes
entirely absent.
I believe the X-ray is the bestremedy we possess
in alternation with arsenic, and there is no reason
why auto-condensation should not be employed with
both.
Lichen Planus. Use a vacuum tube in loose con-
tact with the lesion, following the general technique

outlined under Skin Diseases in Chapter VI. X-ray

in connection.
Lichen Rubra has yielded to the same treatment

as that for lichen planus.
Lithemia. (See Gout.)

Locomotor Ataxia. (Tabes Dorsalis.) Relief of
pain and improvement in gait is accomplished in

many cases of locomotor ataxia. I always employ
heavy spinal vibration in connection with high fre-
quency. Apparent cures in occasional cases where

even the pupillary reflex has returned has caused
me to believe that we sometimes diagnose cases of
multiple neuritis as tabes.
In multiple neuritis we have absence of the knee-
jerk, and if the nerves of the eye were involved

loss of pupillary reflex and diplopia might be pres-
ent, which would apparently indicate locomotor
ataxia, as the latter is the more frequently met with.
This would also account for cases in which no evi-
dences of syphilitic infection are obtained.
In genuine cases of tabes a cure need not be looked

for by this or any other method that we are at pres-
ent acquainted with, but marked relief is not un-
usual.
I use as sharp as the patient will tolerate,
along the spine, over buttocks, abdomen and to the
back of the legs, followed by ten or more minutes

on the auto-condensation couch or pad, 2,500 E.
Fig. 54e Portable Outfit with Two Inductors.
Anesthetic areas call for short stimulating appli-

cations of the spark and also of mechanical vibra-
tion, while hyperesthetic places will call for pro-
longed applications of mild sparks and vibration.

Daily treatments at first; gradually decreasing to

three times a week.
Low Blood Pressure. (See Hypotension.)
Lumbago. Immediate relief follows the use of
either high frequency or vibration in this form of
muscular rheumatism.
With the muscles "on the stretch" apply sharp
sparks over the painful area. As the pain eases have
the patient assume a different position in order to
again excite pain and proceed as before until any
posture may be assumed.
Customarily I precede the high frequency with

prolonged (inhibitive) vibration, but the order is of
no importance.
Localized auto-condensation is a good method to
employ; also direct D 'Arson valization, that is, dia-
thermy.
In an acute case the treatment may be repeated
every three or four hours if necessary. In chronic
cases three to six treatments per week. The length
of each treatment is regulated by the time required
to afford relief. Do not stop until you do give
relief.
This may be ten minutes or it may be half an

hour.
The use of high candle power lamps producing a
great deal of heat will be found effective in conjunc-
tion with the above method.
Lupus. In lupus the Finsen light and the X-ra>

are probably superior to high frequency, but it ha
been so successful that it should be employed in con-
nection with the X-ray.
The technique consists in the use of a sharp spark

to get its escharotic effect. Caustic fulguration may
be used, as this is essentially the action of a sharp
vacuum tube spark.
Nodules are successfully destroyed by this method.
Sometimes it is desirable to keep a tube of con-
siderable intensity in light contact with the lupus
instead of employing the sharp spark.
When fulguration is employed await the result of

one treatment, before another is given.
When a short application of the spark is made
it may be used after each X-ray treatment.
The use of carbon dioxide snow is a quick and
satisfactory method of treating lupus.
Mastoiditis.
(Mastoid abscess.) Ordinarily I
would consider it unwise to resort to any method

outside of surgery for mastoid abscess.
I have succeeded in a few cases with the X-ray,
and in a good many have employed the ray after
operation, where the latter was not wholly success-
ful and obtained excellent results and in these cases
I made use also of the high frequency current in
connection with the ray.
A special tube for the mastoid is illustrated in
Fig. 22 (the upper tube).
The following quotation from Strong is pertinent :
"In a severe case of mastoid abscess with cerebral

and pyemic 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 with-
drawn, and although cover-glass preparations

showed countless numbers of streptococci and staph-
ylococci, but a few scattered colonies were obtained
in a plate culture on nutrient gelatin."
Menopause. High frequency currents are particu-

larly suited to alleviating the various nervous symp-
toms that accompany "change of life."
The most satisfactory method is auto-condensation,
2,500 E. three times a week.
In the absence of an auto-condensation couch

make application with a mild spark along the spine ;
to the back of the head and neck and over the

;
abdominal organs, taking fifteen or twenty minutes

for the treatment.
Special symptoms that are present call for the

treatment outlined under the appropriate heading,
such as constipation, headache, etc.
HIGH 1-REQUENCY CURRENTS 239
Menorrhagia. (See Metrorrhagia.)

Metrorrhagia. Treatment of this condition has
been successfully accomplished through the intro-
duction of a copper electrode into the cavity of the
womb, protecting the vagina by means of a rubber
tube.
As these currents have shown an emmenagogue
effect it is to be presumed that their opposite action
in this case is due to the electrode being used within
the uterus.
The cases cited were reported by Franchon-Ville-
plee in the Bulletin of the French Electrical Society,
February, 1905.
The direct D'Arsonval (diathermy) current seems
best suited to metrorrhagia or menorrhagia.
Migraine. Temporary relief in ''sick headache"

may be obtained by prolonged treatment over the
seat of the pain, which usually involves one-half of
the head.
Use a tube capable of producing a half or three-
quarter inch spark, but keep it in light contact with
the surface. When treating through the hair, in
women it may be necessary to let the hair down
or to reduce the strength of the current because the
thickness of the hair may cause too sharp a spark.
Migraine probably a toxic headache due to im-

is
perfect metabolism (sub-oxidation). This clearly

indicates the advisability of auto-condensation.
Long treatments, fifteen to twenty minutes or

even longer, if during the attack if between attacks,
;
fifteen minutes three times a week. Dose, 2,500 to

7,500 E. or more.
Moles, Moth
Patches, Etc. Caustic fulguration is
used for moles or moth patches (chloasma).
Use care and avoid destroying too much tissue.
See technique for fulguration, Chapter VI.
The indirect Tesla spark with the fulguration tube
is preferred by many for the removal of moles and
warts.
Molluscum Contagiosum. The method of treating
this skin disease is with the vacuum tube, following
the general technique outlined in Chapter VI.
Muscular Rheumatism. (See Rheumatism.)
Myxedema. On account of its effect on meta-
bolism auto-condensation has been used in the treat-
ment of myxedema.
Daily treatments of 2,500 E.
Nasal Catarrh. For this coalition the nasal tube
is used within the nose with a mild current, treating
for three or four minutes on each side, followed by
an application to the nose externally with one of
the surface electrodes.
Inhalations of ozone are of the greatest impor-
tance.
Nasal Diseases. Many diseases of the nose are
benefited by the use of high frequency currents.
The technique is given under the appropriate

heading, as ozena, etc.
Fig. 54d Portable Outfits.
A number of different nasal vacuum tubes are

shown in Figs. 20-24.
Nephritis. (See Albuminuria.)
Nervous Debility. (See Neurasthenia.)
Neurasthenia. Numerous cases of nervous ex-

haustion have been reported cured by high fre-
quency currents. When the blood pressure is high,
auto-condensation, 2,500 E. daily, is usually suffi-
cient. The average number of treatments required
is from twenty-five to forty.
When the blood pressure is low, auto-condensation

is contra-indicated and tonic sparks to spine, back
of head and neck and over solar plexus are appro-
priate.
Ozone is a desirable adjunct, and in selected cases,

vibration.
Neuralgia. Application for the relief of neural-

gia are made with a vacuum tube carrying current
sufficient to produce a one-half or three-quarter inch
spark.
Ordinarily it should be passed. back and forth over

the painful area, in light contact with the skin. At
times it is advisable to raise the tube and apply a
sharply counter-irritant spark which will quickly
redden the surface.
I remember the old definition of neuralgia, as
"the cry of a starved nerve for blood," and certainly
the high frequency will supply this want.
In addition to the local treatment, auto-condensa-

tion or spinal sparks should be applied in accordance
with the state of the blood pressure.
The diathermic currents on account of the heat

generated are advantageously employed. See Chap-
ter XL
Fig. 54e Portable Outfit with Cautery and Diagnostic Lamp.
Various names have been given to indicate the

differentforms of neuralgia as facial neuralgia,
ovarian neuralgia, etc.
The treatment is essentially the same for all va-

rieties.
High candle power lamps may be used in connec-

tion with high frequency.
Neuritis. In neuritis we have an inflamed condi-
tion of a nerve, the pain simulating that of rheuma-
tism or neuralgia. Any nerve may be involved.
Brachial neuritis is a common form.
The high frequency current is positively curative
in all cases but must be used judiciously.
Sharp sparks must not be employed at first, but

a mild sedative current should be applied. This
means that the tube should not carry more than
enough current to produce a quarter-inch spark and
should then be kept in comparatively close contact
with the surface.
It should be explained to the patient that the
first few treatments sometimes aggravate the pain.
After this stage is passed mild or medium sparks
may be used, but if employed in the start the pain
often will be so great that the patient may abandon
the treatment.
I always give auto-condensation, 2,500 E., in con-
nection with the local application, unless the blood
pressure is quite low. Many cases have been re-
ported cured by this general treatment alone.
Recently the diathermic or heat currents have
been shown to be very satisfactory in the treatment
of neuritis, and the use of the ultra-violet ray.
Obesity. The treatment for obesity is auto-con-

densation, 2,500 to 7,500 E., or more. Patients lose
from four to fourteen pounds per month in some
instances.
In those that do not show as great an actual re-
duction in weight there seems to be a re-distribution,
so to speak, of the fat, which greatly increases bodily
comfort.
Superfluous fat is a result of imperfect metabolism
and that is why auto-condensation is beneficial.
Cormelles has noted a greater tolerance of thyroid
extract after auto-condensation has been employed.
Vibration is indicated and the method of Bergonie
with special faradization chair.
Opacity of Cornea. (See Corneal Opacity.)

Orchitis. In the acute form we seldom have an
opportunity of employing these currents, although
with a portable coil it may be possible to do so if
there is electricity in the patient's home.
In a sub-acute orchitis the vacuum tube is used
with a mild effleuve or spark.
Guilleminot recommends the diathermic current,
one pole over the testicle and the other over the
spermatic cord. The X-ray is advised, protecting
the other testicle with lead-foil or treating through
a speculum attached to a protective shield.
Otitis. In all forms the application of a mild cur-
rent through a vacuum tube inserted in the ear will
246 EBER HART'S MANUAL OF
be found beneficial, alone or in connection with

other methods.
In chronic suppurative otitis the X-ray is advised,

also an ozone spray. This latter is sometimes ad-
ministered through an eustachian catheter.
Ozena. Atrophic Rhinitis. Application with the

nasal tube, and the inhalation of ozone, summarize
the methods of treating this disease with high fre-
quency.
Papilloma. The technique of fulguration for the

destruction of papillomata is given fully in Chap-
ter VI.
Paralysis. In general the treatment of this symp-

tom calls for the application of the vacuum tube
along the course of the paralyzed muscles, employ-

ing a current strong enough to produce a half or
three-quarter inch spark. Part of the time keep the
tube in contact with the skin and part of the time
raise it above the surface to get the effect of the
spark.
Bi-polar Tesla treatment is excellent and also
D'Arsonval surgings (see Chapter VI).
The value of galvanism and faradism must not
be forgotten and vibration is certainly useful.
Paralysis Agitans. Cases of paralysis agitans ben-

efitedby auto-condensation or auto-conduction have
been reported. 2,500 to 7,500 E. or more.
Two cases which I treated for a short time did not

show any perceptible improvement.
Paralysis, Infantile. (See Infantile Paralysis.)
Paralysis of Sphincter Ani. Tousey reports marked

improvement produced by fifteen treatments. Rectal
applications and spark to spine.
Pelvic Abscess. Use the vaginal vacuum tube for
seven minutes, repeating daily or twice a day; also
mild applications externally over pelvic region.
Diathermy advised. See Chapter XI.
Pelvic Adhesions. Intra-vaginal vacuum tube

treatment and mild spark over abdominal area.
Three to six treatments per week. Vibration advised
in conjunction. The D'Arsonval current is preferred
by some operators either by the direct method or by
auto-conduction, while others prefer the bi-polar
Tesla current.
Pelvic Exudates. The same technique is followed
as in pelvic adhesions.
Periostitis. The vacuum tube carrying a medium

intensity of currentis passed lightly back and forth
over the diseased area for from five to ten minutes,

three times a week, followed by a few minutes' ap-
plication of the X-ray, or the high candle power
light.
Condenser electrodes are preferred by some oper-

ators.
Pharyngitis, In the acute form diathermy is use-

ful in combination with customary remedies, or the
vacuum electrode may be employed.
In the chronic form the spark may be used to de-
stroy the follicles in the throat. See Fulguration,
Chapter VI, for technique.
Fig. 54f Portable High Frequency.
Phlebitis has been relieved by mild vacuum tube

applications, keeping the tube in light contact with
the skin. Customary methods should be kept up at
the same time.
Piles. (See Hemorrhoids.)
Pityriasis. Follow the general technique given
for skin diseases in Chapter VI.
Pleurisy. Treat through a layer or two of cloth-

ing, using a medium intensity of current (one-quar-
ter or one-half inch spark) and appty over both the

front and back of the chest, keeping up the treat-
ment for a long time until marked reddening of the
skin indicates a proper degree of counter-irritation,
three treatments a day if necessary in the begin-
ning, in conjunction with usual medicinal methods.
Chronic forms call for ozone and usually for the
X-ray.
Pneumonia. The high frequency treatment of
pneumonia the same as that employed in pleurisy,

is
as given in the preceding section. In addition the

inhalation of ozone by ozonizing the air of the room
is absolutely essential and always should be em-
ployed from the start.
It is much more sensible to administer this form
of oxygen throughout the disease than it is to ad-
minister oxygen as a last hope in extremis.
Post-fracture Conditions. The local application of
the vacuum tube discharge in conjunction with vi-
bration of great benefit in restoring a normal
is
condition of the parts. Its physiological action
clearly indicates its value here.

Post-operative Conditions. Here the current may
be applied as given in the preceding section or it
may be employed by means of auto-condensation or
a general vacuum tube application for its tonic
effect.
2,500 E. daily at first; later two or three times a

week.
Proctitis. In the chronic forms of this disease the

direct D 'Arson val
current (diathermy) is advised,
using a metal electrode in the rectum, while a metal-
lic electrode is held by the patient. Ten minutes,
three to six times per week.
Vacuum electrodes with Tesla or Oudin currents
may be used.
Prolapse of Rectum. Use a mild spark over the
prolapsed tissuewhich almost always will cause an
immediate contraction. If it does not, replace and
follow with a seven-minute intra-rectal treatment.
Three to six applications per week.
Prostatic Diseases. The results following the high
frequency treatment of all forms of prostatic dis-

ease are extraordinary.
One authority found in a large series of cases over
85% were cured. In my own experience the ap-

parent cures have been over 90% with no case in
which perceptible improvement was not present.
In enlarged prostate I was of the opinion that
recent cases and those with an inflammatory infil-
trate were all that could be reduced, but I have had
positive reduction take place in a few cases of senile
hypertrophy and I believe the possibilities in these
cases are worthy of investigation.
The technique is described in Chapter VII. In
Fig. 55 is shown a special form of insulated vacuum
tube for prostatic treatment originated by Dr. Sam-
uel Stevens. My spatulate tube is shown in Fig. 27.

I use vibration in conjunction with high frequency
in nearly all of my cases, and diathermy is advised
in acute cases.
Pruritus (Itching). This annoying symptom ordi-
narily is relieved by the high frequency effleuve or
spark. Generally speaking the vacuum tube spark

is will tolerate, but
employed as sharp as the patient
not for a long time. In other cases light contact
with the tube is desirable, giving longer treatments
than with the spark.
Fig. 55 Special Prostatic Electrode.
In itching skin diseases the spark is very grateful
to the patient and relief is immediate though often

temporary.
Pruritus ani. Treat with spark for 30 to 60 sec-
onds and then use rectal tube for a six or seven
minute treatment. Three to six applications per
week.
Pruritus vulvae. The vaginal vacuum tube is used
firstfor seven minutes, followed by a medium spark
externally over the itching surface. Daily treat-
ments if possible.
These cases frequently are caused by irritating

vaginal or uterine discharges or by too acid urine.
For the first use alkaline douches and for the latter
give alkalies internally and see that plenty of water
is drunk.
Psoriasis. This is treated by the same technique
as that employed in eczema.
Purpura rheumatica. This form of purpura has

been successfully treated by auto-condensation.
Pyorrhea alveolaris. (Rigg's Disease.) In this
common but intractable disease of the gums the cur-
rent is locally applied by means of special tubes.
See Chapter XII.
The disease is very difficult to cure and high fre-
quency is beneficial because germicidal in character
as well as nutritional.
Seven-minute daily treatments with tube in con-

tact with the gum, using adjustable socket handle
so that the patient may hold the tube in place.
See complete discussion of technique in Chapter
XII. .
These cases always call for general treatment usu-

ally of an antacid character.
Auto-condensation is suitable on account of its
constitutional effect and its marked influence on
elimination.
Ozone by inhalation or by means of the local use
of an ozone spray is directly indicated.
Pyosalpinx. Intra-vaginal applications of the cur-

rent have proved effective in some cases of pysal-
pinx. Seven-minute treatments three or more times
per week.
Raynaud's Disease. I have had no experience
with this disease, but French operators report suc-
cessful treatment. Auto-condensation was employed
2,500 E. or more.
The number of seances varied from twelve to one
hundred and twenty-five, and in the longer cases
the treatment required about two years.
Rectal Diseases. Many diseases of the rectum
have been treated with apparent success, by means
of these currents. The general technique is given
in Chapter VII.
Among the diseases are included proctitis, fissure,
hemorrhoids, prolapse of rectum, pruritis ani, paraly-
sis of sphincter, etc. The method of treating each is
given under its appropriate heading.

Renal Calculus. Dr. J. 0. Chase reports the dis-
solving of a renal calculus by means of auto-conden-
sation. Ametal electrode was placed over the ab-
domen, instead of the patient holding the handles.
2,500 to 7,500 E. daily. Diathermy relieves the pain.
Retinitis. The method employed is the use of the
double eye tube as in Fig. 47, or using a tube with
a mild amount of current in light contact with the
eyelids, eyebrows and temples.
In 1902-4 I treated successfully a number of dis-

eases of the eye with high frequency and X-ray, in
connection with Dr. G. F. Suker, at whose sugges-
tion thesemethods were employed. Among these
was one case of retinitis pigmentosa.
Rheumatism. High frequency currents are of ex-
ceptional value in muscular and in chronic articular
rheumatism.
In the acute articular form the results have not
been so satisfactory.
Articular rheumatism, also known as inflamma-
tory rheumatism or rheumatic fever, is known at
the present time to be an infectious disease. Ordi-
narily the attack is ushered in by a sore throat and
the infection enters by way of the tonsils. It affects
fibrous and serous tissues in particular and one
reason for believing the disease infectious is the
similarity between the symptoms and those of gonor-
rheal rheumatism where a known infection causes
the pain, etc. Frequently abscessed teeth are the
foci of infection.
Rheumatism is often confounded with rheumatic

gout. quickly produces impoverishment of the
It
blood (anemia), and this is one reason why auto-

condensation has proved so beneficial.
In the acute form, both articular and muscular,
the application of high candle power lamps is ad-
vised in connection with high frequency, and in the
chronic type vibration is a valuable adjunct. Dia-

thermy recommended.
In muscular rheumatism, of which lumbago, stiff
neck, etc., are common types, the vacuum tube is
used with either a mild or sharp spark and during
the application the patient changes position fre-
quently to keep the muscles on the stretch and to
ascertain whether this posturing causes pain. The
treatment is persisted in until relieved whether it
be ten or thirty minutes.
In chronic rheumatism the best treatment is auto-

condensation, 2,500 to 7,500 E. daily, and vaccines.
During the first treatments the symptoms may be

somewhat aggravated, but after the second or third
week improvement is steady and rapid.
Vacuum tube treatment over the painful area
may be used in connection with auto-condensation
if desired, but a cure will result without thi. Rid.
Where
the operator has no couch or pad prolong, i
mild treatments with the vacuum tube may take
the place of auto-condensation. In this case the
application should last at least twenty minutes.
The amount of uric acid in the urine is imme-
diately increased by auto-condensation, which prob-
ably accounts for the aggravation of symptoms in
rheumatism and gout where long treatments are
given in the beginning.
Dr. J. P. Sutherland, Dean of Boston University

School of Medicine, furnishes the following report:
"The patient commenced treatment Dec. 24, 1905,
but the first analysis was not made till Dec. 31,
1905."
Date.
Both of the cases cited show the remarkable ef-
fects of auto-condensation in increasing elimination.
Rhinitis (Atrophis). (See Ozena.)

Rigg's Disease. (See Pyorrhea alveolaris.)
Ring- worm. (See Tinea.)
Rodent Ulcer. The method of treating rodent
ulcer is the same as that
employed for epithelioma,
(q. v.).
Scars. (Cicatrices.) Vacuum tube sparks have

a softening effect on scar tissue. Even contact with
the tube without sparking has a similar tendency
(as in treating strictures).
If the spark is made very sharp and therefore
caustic or escharotic, or if caustic fulguration is
used, the scar tissue will be destroyed and pliable
new tissue takes it place.
For small scars about the face the application of
a medium spark (one-fourth to one-half inch) is rec-
ommended, the treatment repeated in five to eight
days if fulguration is employed. (See Chapter VI

for technique.)
If a vacuum tube spark is used the treatment may
be repeated daily or every other day until a suffi-
cient degree of irritation has been set up.
Apply the vacuum tube along the course

Sciatica.
of the nerveand over the lower part of the spine.
Use enough current to produce a spark from one-
half to one inch in length but ordinarily do not raise
258 EBERHART'S MANUAL off
the tube from the skin. Give a ten or even fifteen

minute application repeating daily or every other
day.
I nearly always follow this with auto-condensa-
tion, 2,500 Eberharts.
Seborrhea. For dandruff or any seborrheic con-
dition the vacuum tube is used, carrying enough
current to give a quarter to a half-inch spark. It is

then kept in light contact with the surface treated
and passed back and forth about ten minutes; re-
peating three to six times per week.
Seminal Emissions. For nocturnal emissions
sparks to the lower part of the spine are advised,
followed by a seven-minute treatment of the seminal
vesicles by means of the rectal tube.
Sinusitis. In frontal sinusitis I have on a number
of occasions applied the vacuum tube over the
sinuses, keeping it in light contact, although employ-
ing a medium intensity of current. This was always
in connection with vibration.
The .first time I gave this treatment it was for the
purpose Of affording temporary relief until the
patient could arrange to consult a specialist as I
believed operative interference necessary. I almost
questioned my diagnosis when informed the follow-
ing day that the pain had practically disappeared.
Subsequent experience shows that this result may
be obtained in a fair proportion of cases that are
seen early in the disease.
HIGH TREQUENCY CURRENTS 259
If relief is not afforded by one or two treatments,

the sinus should be drained by a competent rhinolo-
gist.
Skin Diseases. The vacuum tube effleuve or spark

is one of the most useful agents in treating a num-
ber of skin diseases.
The general technique is outlined in Chapter VI.,
while special methods are indicated under a num-
ber of the diseases, to which reference may be made.
The high frequency current should be in the office
of every dermatologist. It benefits practically the
same class of skin diseases that the X-ray has been
employed in.
Sore Throat. (See Pharyngitis and Laryngitis.)

Sprains. Use a vacuum electrode and with a
moderate intensity of current. Keep the tube in
light contact while rubbed gently back and forth
over the sprain. A long treatment fifteen or twenty
;
minutes repeating in two or three hours if necessary.

;
The direct D'Arsonval current (diathermy) is

equally useful.In old sprains use a sufficient spark
to produce marked reddening of the skin as counter-
irritation is necessary.
Sterility. General tonic treatment by auto-con-

densation or by the vacuum tube is to be employed
together with local treatment with the mild spark
over the region of the ovaries or testicles. In women
intra-vaginal treatments are indicated, and in men
the use of the glass ufethral tube has seemed to

exert a beneficial influence, although results in these
cases are uncertain.
StiffNeck. (See Torticollis; also Rheumatism.)
Stricture of the Urethra. I have had excellent
results in a large number of cases of stricture treated
by means of the urethral The general
electrode.
technique is given in
Chapter VII.
Three to six treatments a week are advised.
This method will not cure every case and galvanic
electrolysis; dilation under anesthesia; or operative
measures may be required.
Sub-involution. The use of an intra-uterine elec-
trode with the direct D 'Arson val
current (diather-
my), as explained under metrorrhagia, is the method
which gives the best results in sub-involution,
although vaginal vacuum tube applications have
proved efficacious.
Suppuration. Vacuum tube applications always

tend to limit suppuration.
Where a suppurating area is accessible, the ozone
spray is the best application which can be made to it.
Sycosis. In barber's itch and other forms of syco-

sis the X-ray is our best method, but it may be ad-
vantageously supplemented by application of the

spark from the vacuum tube, used in accordance
with the tolerance of the patient. Mild fulguration
also may be employed.
Synovitis. Treat as directed for sprains, that is,

use vacuum tube without a spark, for a long sedative
application in the acute form, or use the diathermic
current, 600 to 1,200 milliamperes.
For the chronic case, short, thick, counter-irritant

sparks are required.
Tabes Dorsalis. (See Locomotor Ataxia.)
Throat Diseases. High frequency currents are
useful in connection with routine methods in laryn-
gitis, pharyngitis, etc. See Chapter VII for general
technique. A
number of throat electrodes are illus-
trated in Figs. 20 to 23.
Tic Douloureaux. Trigeminal neuralgia has been

successfully treated by applications of the high fre-
quency current, one operator reporting the cure of
a case where resection had failed. Prolonged ap-
plication over the course of the nerve with medium
intensity of current, but without producing a spark.
Diathermy is indicated.
Tinea. In ringworm and in all forms of tinea the

X-ray the best treatment supplemented by vacuum
is
tube applications, either by direct contact or by a

reasonable sharp spark.
Tinnitus Aurium. The administration of the cur-

rent through the ear tube as outlined in Chapter VII
has proved curative in cases of
" " in the
ringing
262 EBERHART'S MAN\*AI, OF
I always employ vibration in conjunction with the

high frequency.
Tonsillitis. The throat has been treated externally
with the vacuum tube in tonsillitis, following the
method suggested under pharyngitis and laryngitis.
It is only of value in connection with our usual
methods, and is not advised as the sole treatment.

Diathermy is recommended.
Tonsillotomy. I have seen a number of reports of
the successful destruction of the tonsils by means
of fulguration.
Judd says For the removal of the tonsils we have
' '
in this agentan ideal method. It is bloodless, not

very painful and avoids the danger of hemorrhage
in fibrous growths."
Torticollis. Wry neck or stiff neck in an acute or
sub-acute form is cured by vacuum tube applications
along the sterno-cleido-mastoid muscle.
A long application with a tube capable of emitting
a half-inch or inch spark, kept in light contact with
the skin or applied through a sufficient number of
layers of cloth to get short, sharp, thick sparks.
Trachoma is successfully treated by using the eye
tube in connection with the X-ray, or using a tube
exhausted to a vacuum high enough to give off some
X-rays.
Tuberculosis of Glands. In the treatment of tu-
berculous glands, the vacuum tube spark is em-
ployed in combination with the X-ray. High fre-

quency without X-ray is not advisable for this con-
dition.
Any surface or condenser electrode may be used

with an intensity of current capable of producing a
one-half to one inch spark. The tube may be used
in light contact with the skin or slightly separated
to give a short but comparatively thick spark. This
may be regulated by treating through a sufficient
thickness of cloth. Five to ten minute applications.
The best method is to give a seven minute X-ray
treatment three times a week followed by the high
frequency application. Ozone strongly advised.
Tuberculosis of the Peritoneum. Tuberculous

peritonitis treated by the local application of the
is
vacuum tube over the abdominal area or by localized

auto-condensation. The effleuve from a diaphragm
electrode may be used.
I prefer general auto-condensation, 2,500 E. daily,

with mild vacuum tube spark applied through a
layer of clothing. Ozone indicated.
Tuberculosis (Pulmonary). In local forms of tu-

berculosis theX-ray is superior to high frequency;
but in pulmonary tuberculosis conditions are re-
versed and in auto-condensation and ozone we have
two remarkably effective remedies which should be
understood better by the profession.
264 EBERHART'S MANUAI, o*
My attention was directed to the use of auto-con-

densation in this disease by Chisholm Williams' book
in which he reported thirty-two out of forty-three
consecutive cases as symptomatically cured, this
being about 75%.

Previous to this time I employed the X-ray, using
with it vacuum tube or diaphragm applications of
high frequency.
I am now convinced that either auto-condensation
or auto-conduction is superior to other forms of high
frequency in this disease.

Ozone is especially effective in consumption and
if I could only have one remedy I would prefer to
take my chances with ozone. It must not be limited
to inhalations at the physician's office, but the air
of the patient's room must be thoroughly ozonized,
so that he or she is constantly getting a suitable
amount in the air they breathe. If they can only
respire one-half as much air as formerly, but that
amount by reason of the ozone
twice as powerful
is
in oxydizing properties, the proper balance is main-

tained.
Williams observed that the use of auto-condensa-

tion was followed at first by an increase in symp-
toms. The expectoration increased, the cough was
more frequent but easier there was a lower morn-
;
ing but a higher afternoon temperature; and an

average loss of weight of about a pound a week
during the first three weeks. The concurrent use of

ozone shortens this first stage.
After this period improvement was steady, al-

though some attenuated tubercle bacilli were present
long after all other symptoms had disappeared.
On account of the rise in temperature produced

by auto-condensation we must be careful not to give
too long a treatment at the beginning if the patient
is carrying a comparatively high temperature, for
instance, 103 degrees or over, or is in an advanced
stage of the disease.
The reaction is similar to that from tuberculin.

The rise in an already high temperature might be
too great if a long treatment was given. For this
reason a good plan to give five .minutes on the
it is
auto-condensation couch or pad and then await the

subsidence of the reaction before given the second
treatment. I would not employ more than from
1,000 to 1,250 E. in the first three or four treatments,
after which the patient will quickly establish a toler-
ance for the treatment and the dose may be increased
to 2,500 E. or more. As soon as this
period is
reached daily applications are urged and should be
followed by spinal sparks to offset the blood-pressure
reducing effect of the auto-condensation.
In cases that carry very little temperature at the
time of starting treatment, a ten-minute daily appli-
cation may be made from the beginning.
The direction for the use of ozone and reports of

itsremarkable effects will be found in Chapter IX.
I have made it a rule to send the specimens of
sputum a reliable laboratory for examination,

to
thus having the proof of the value of the treatment
made by a disinterested party.
The following gives a comparative idea of the im-

provement taking place in an average case :
Mrs. B., Jan. 2, 1908. Many tubercle bacilli pres-

ent. Other organisms not numerous. Staphylococ-
ci; dipplococci of catarrh; fibrin, mucus; pus cells.
April 8, 1908. Tubercle bacilli few, averaging
about seven to the microscopic field. Bacilli deep-
staining, showing extremely few vacuolated forms.
Phagocytosis very prominent; clumping not promi-
nent. Other organisms noticeably absent.
The specimen was so remarkable in the marked

degree of phagocytosis and the absence of other or-
ganisms that the physicians in charge of the labora-
tory took occasion to call me up and ask the nature
of the treatment employed.
Two months later this patient was so well that

she refused to continue the treatment, having re-
gained her normal weight and strength, although an
occasional bacillus was still to be found.
The value of ozone and of auto-condensation is so

marked and so easy of demonstration that T ?tn sur-
prised the methods are not better known and in
general use in institutions for the treatment of con-

sumption.
They possess the advantage not only of being cura-
tive in themselves but also of not preventing the use
of all the established methods of treatment in con-
nection with them. They afford two additional non-
interfering methods of equal value with any used,
and thereby increase the patient's chances to that
extent.
Ulcers. (See Chronic Ulcers.)
Urethritis. The directions for treating specific
urethritis will be found under gonorrhea. Non-
specific froms yield to the same methods.
Uric Acid Conditions. All methods of employing
high frequency currents aid in eliminating both
urea and uric acid, but auto-condensation and auto-
conduction are specially effective.
Their value can be tested readily and is easy to
ascertainby a few urinalyses.
Urticaria. (Hives.) Vacuum tube applications
using a medium spark or with the tube in contact
with the surface is the method of treatment.
Speaking of the value of high frequency currents
W. Allen says in the Medical
in skin diseases, Dr. C.
Record: "The vaso-motor effects may be well
studied in urticaria. Here sparking the wheal pro-
duced entire disappearance of the lesion, which is
replaced in a few moments by a balanced area.
Vascular redness soon returns, the area of this being

larger than the lost wheal. The effect of contraction
followed by dilatation is very marked. The spray
soothes the itching. Internal measures are not to
be neglected."
Uterine Diseases. Treatment through the vagina

to the womb has been beneficial in cervicitis, endo-
metritis, etc. The general technique is given in
Chapter VII. High frequency currents are always
indicated in inflammation of any mucous membrane.
(See Cervicitis.)
Vaginitis, whether simple or specific, is treated ac-

cording to the technique given under gonorrhea in
the female.
Varicocele. A medium sparkapplied over the

scrotum has been used, also immersion of the scro-
tum in a glass vessel with metallic connection to one
pole of the D'Arsonval circuit the other held in the
hand. The current may be applied with two metal
electrodes so placed as to include the varicocele be-
tween them. own opinion is that the only real
My
cure for varicocele is radical operation.
Varicose Ulcers. "Long, thick, muscle-toning,

high potential sparks over the affected limb on the ;
spinal centers, and upon the general muscle masses

of the entire body for alterative, nutritional, circu-
"
latory benefits are indicated. (Monell.)
Warts and other small growths may be removed

by fulguration, as described in Chapter VI.
Writer's Cramp. This an occupation neurosis
is
variously known as piano player's cramp, telegra-

pher's cramp, etc. It is the result of repeated use
of the same muscles to the point of exhaustion and
chronic fatigue. The vacuum tube is used with a
current sufficient to produce a quarter or half-inch
spark. The tube is kept in light contact with the
skin and the application is made from the finger tips
to and including the shoulder area, brachial plexus
and upper spinal centers. For the latter the tube is
raised to obtain a stimulating spark, and I frequently

employ the spark for the whole treatment. The use
of vibration in conjunction is strongly urged. Three
treatments a week.
Many authorities advocate general eliminative

treatment in connection, such as auto-condensation
or electric light baths.
Wry Neck. (See Torticollis.)

CHAPTER NINE.
Ozone; How Produced; Physiological Action; Dos-
age; Indications and Principal Diseases
in Which It Is Employed.
Nature and Production. Whenever an electric
spark passes through the air, ozone is liberated.

Ozone is known under the chemical symbol and ;}
is an allotropic form of oxygen. At the same time

that ozone is liberated, nitrous and nitric oxides
are also produced. The less the perceptible spark
accompanying the production of ozone, the less the
amount of these objectionable oxides, and in admin-
istering the ozone, it is necessary by filtration or
otherwise, to dispose of these gases.
Physiological Action. Ozone increases the oxy-
genation of the blood and tissues, increasing oxy-
hemoglobin and also increasing the number of red
blood corpuscles. It is claimed that a decrease in
white corpuscles is produced if they are above
normal. In strongly concentrated form, ozone is
destructive in its effect on mucous membranes and
even to life itself. Germs are destroyed by it and it

has been shown capable of so thoroughly disinfect-
ing sewage that the filtered water was pronounced
suitable for drinking purposes. It is distinctly
deodorant and even a small ozonizer running in a

room will quickly destroy the most objectionable
odors.
In a Chicago bank an ozone machine was placed
in a room where six employes were working. Their
weight and chest expansion was taken at the time
the machine was installed and again in sixty days.
The result is shown in the following table:
No. Nov. 6 Jan. 6 Nov. 6 Jan. 6 Nov. 6 Jan. 6
1 127.5 128.25 35. 36. 31. 32.

2 118. 121.5 34.25 36. 31.5 31.5
3 130. 131.25 35.25 36.5 30. 30.5
4 123. 126.75 34.25 36.75 30.5 30.5
5 131. 138.5 35. 37.5 30.5 31.
6 118. 117.50 31.75 32.5 29. 29.
Indications. In one sense of the word, since oxy-
gen is so essential, it might easily be claimed that
ozone was indicated in any bodily ailment, and I am
of the opinion that its inhalation would be beneficial
to the extent that pure air would be desirable, but
there are some diseases in which it is of particular
benefit. Among these are anemia ;
all diseases of
the respiratory organs, including tuberculosis; in-
fectious diseases; and all conditions where there is
imperfect oxidation and impaired nutrition. An
ozone spray has been demonstrated to be healing in
all forms of ulcers, etc.
Methods of Administration. As ordinarily em-
ployed, ozone is administered in the form of inhala-
tions in the doctor's office, orby ozonizing the air

of the room which the patient occupies. In em-
ploying the ozone directly from the generator, it
has been found necessary to filter it through essen-
tial oils in order to remove the nitrous and nitric
oxides. Oil of pine two parts and oil of eucalyptus

one part is a favorite form. In many instances it
seems to me to be much more sensible to administer
Fig. 5-6 Small Ozone Generator for Portable Outfits.
constantly ozonized air than to depend upon occa-

sional inhalations. This is especially true in con-
sumption. Several ozone generators are illustrated
herewith.
Effect on Nutrition. The following is taken from
reports by Doctors L'Abbe and Oudin before the
Paris Congress for the study of tuberculosis :
"We investigated the influence of ozonized air on

nutrition in general and especially in anemia or
persons physically reduced. When the percentage
of oxyhemoglobin is below normal (say 9% to 10%),
as is usually the case with tuberculosis patients, in-
halation of ozonized air for a quarter of an hour
increases it by 1%. The increase, temporary at first,
becomes permanent after a number of treatments,
and one can affirm that at the end of two or three

weeks' treatment, the patient has reached a normal
figure.
"This is necessarily accompanied, in the case of
anemic patients, by more energetic oxidation, more
rapid combustion, which calls for more rapid re-
newal of nutritive materials (increased metabolism)
and from this there speedily arises an increase in
appetite, which in some patients takes the form of
a demand for food such as has been hitherto un-
known to them, with return of strength, disappear-
ance of complications, in short, restoration to health.
' '
Out of twenty-eight patients weighed before and
after treatment, including those in all stages of
tuberculosis,
One gained 1.1 Ibs. Six gained 3.3 Ibs.
Three gained 4.4 Ibs. Two gained 2.5 Ibs.

One gained 6. Ibs. One gained 6.6 Ibs.
Two gained 7.7 Ibs. Three gained 8.8 Ibs.
One gained 9.9 Ibs. One gained 11 Ibs.
Two gained 15.2 Ibs. One gained 19.9 Ibs.
One gained 23.1 Ibs. Two remained stationary.
' *
With the return of flesh there was a correspond-
ing increase of oxyhemoglobin as follows:
Two gained 1%. Ten gained 3%.
Five gained lj^%. One gained 3%.
Four gained 2%. Six gained 4%.
Five gained 2j%. One gained 5%.
Four were not examined."
In view of the reputation and standing of the

physicians making this report, more than ordinary
consideration should be accorded the statements.
Dosage. It is claimed that large amounts of ozone
are capable of producing death, and that rabbits
have succumbed in ten minutes in an atmosphere
containing eight milligrams of ozone to the litre.
The proper proportion for therapeutic inhalation is
one,two or three milligrams to the litre. Inhalations
given in a physician's office last from ten to twenty
minutes and may be repeated frequently. The indi-
cation that the patient has had a sufficient dose is
usually a slight sensation of light-headedness.
Tuberculosis of the Lungs. Daily inhalations of
ozone in connection with auto-condensation. Ozon-
izing the air of the patient's room is the best method
of employing ozone in this disease. H. de LaCoux,
Chemical Expert to the Council of the Prefecture of
' '
the Seine, Paris, says : In the application of ozone
for tuberculosis, it is an undeniable clinical fact that
the number of bacilli in the sputum diminishes after
the second or third treatment, even before the gen-
eral condition of the patient is improved."
Dr. George Stoker, London, reports nine cases of
tuberculosis treated within a year at the Stoker
Oxygen Hospital, of which eight were discharged
with the disease definitely arrested.
Dr. J. T. Gibson says in Advanced Therapeutics:
"In advanced cases with cavities and much expec-
toration, I think there is no means of so much use

as inhalation of ozone. It empties the lungs of
detritus and pus, revivifying the blood, disinfecting
the parts of the lungs reached, and after the first
Fig. 57 Ozone Generator for Office Use.
irritation of its use has passed off, there is nothing

that gives the lungs the sense of rest and quiet as
does this agent. I have seen the quantity of sputum
lessened to a most remarkable degree, and fever dis-
appear, and all symptoms improved by the use of
ozone inhalations. "
Sletoff has treated 147 cases of tuberculosis with
ozone, with favorable results.

Anemia and Chlorosis. In a paper read before
the American Pediatric Society, Boston, Dr. A.
Caille reports the favorable influence of ozone in a
number of cases of chlorosis and anemia as well
Fig. 58 Room Ozonizer.
as other diseases, and in his conclusion, says: "In

chlorosis and anemia, ozone inhalations are exceed-
ingly valuable from a therapeutical standpoint, and
give better and prompter results than any other form
of medication."
Chronic Middle-Ear Deafness and Tinnitus. Dr.
Stoker of the London Throat Hospital and of the
Oxygen Hospital, has published a series of twelve
cases of chronic dry catarrh of the middle ear with
deafness and in nearly all with tinnitus, which were
treated with an ozone spray. Improvement, some-
times remarkable, occurred in every case.
The technique consisted in passing the ozone "in

a gentle current through an eustachian catheter into
the middle ear for about four minutes at a time, the
operation being repeated several times a week, daily
if possible.
Whooping Cough (Pertussis). The efficacy of

ozone in treating whooping cough has been attested
by many authorities, among them being Caille,
L'Abbe, Derecq, Doumer, Delherm, Bordier and
Oudin. In practically all of these cases the ozone
was administered in ten to twenty minute inhala-
tions. Ozonizing the air in the patient's room should
prove a better method.

Says L 'Abbe :
' '
My personal experience rests on

over 100 cases. In all I have obtained amelioration,
prompt and rapid at first, and later a complete cure
in a time ordinarily covered by a very light attack.
Ozone is the remedy par excellence for whooping
cough."
Asthma, Bronchitis and Hay Fever are benefited
or cured by ozone. Inhalations combined with ozon-
ization of the air of the room is the method; the
latter being more efficacious.
Hay fever victims have found that the use of a

room atomizer constantly for two or three months
prior to the expected attack has prevented the latter
from coming on. During the attack inhalations have
given a great relief.
278 EBERHART'S MANUAL o
Insomnia. Daily inhalations for ten or fifteen

minutes, or have patient sleep in a room with an
ozonizer in operation.
Pneumonia. Ozonize the air in the room, keeping

the machine near the head of the patient's bed.
Fig. 59 Room Ozonizer.
s
Nervous Debility, etc.Three to six ozone inhala-
tions per week, preferably in connection with auto-
condensation or with vacuum tube sparks.
Other Diseases. On account of its oxidizing prop-
erties, ozone should be a valuable adjunct to auto-
condensation in diabetes, gout, obesity, etc.
Its beneficial action in syphilis has been attested

by many physicians.
CHAPTER TEN.
High Frequency X-ray; Its Nature; Generation and
Therapeutic Indications.
Explanatory. This is intended as an elementary

chapter on the X-ray for the possessor of a small or
portable high frequency outfit who wishes at times
also to avail himself if its X-ray possibilities.
Scope of Portable Outfits. Portable outfits are

constructed on the Tesla type, and it is surprising
how well some of them light up the X-ray tube.
They are suitable for the treatment of skin diseases
and all superficial lesions. This includes practically
all of the conditions in which the X-ray is really ef-
fective. For radiographic purposes the manufac-

turers only claim them to be capable of skiagraph-
ing the extremites, although some of them make
satisfactory pictures of thicker parts. Their porta-
bility is at times of considerable advantage. They
are not claimed to take the place of the larger equip-
ment in the office of the radiologist, but bring the
use of the X-ray and high frequency within the reach
of many physicians who wish to employ it in connec-
tion with their regular work. They are not suited
to the requirements of the X-ray specialist.
Nature of the X-ray. The X-ray was discovered

by Roentgen in 1895. It possesses the property of
penetrating supposedly opaque bodies, but cannot
be seen by our eyes, nor felt as it passes through
the body. It is produced by means of a tube ex-
hausted to a vacuum of one-millionth of an atmos-
phere.
The Tube. For high frequency coils a special
X-ray tube is required. These are of various shapes,
some monopolar and some biopolar. One form is
shown in Fig. 62. The metal disk in the center is
called the target or anti-cathode and at this point
the X-ray generated. According to the degree of
is
vacuum existing in the tube it is spoken of as high,

medium, or low. The higher the tube the greater
penetration its
rays possess.
Adjusting- the Tube. There are gauges for meas-
uring the penetration of the tube.
To accomplish results in X-ray treatment the rays
must be stopped and absorbed by the area including
the lesion treated. For this reason the higher the
vacuum and therefore the greater the penetration
of the rays the farther away the tube must be placed
from the part treated.
The average distance for a low tube is from 4 to
8 inches ;
medium tube, 8 to 12 inches ; high tube, 12
to 20 or more inches.
Protecting Patient and Operator. As an overdose

of the X-ray is injurious, it is necessary to guard
Fig. 60 Large Office Ozone Generator.

EBERH ART'S MANUAI,
against indiscriminate exposure of the patient and

also of the operator.
The simplest method is the use of a protective
shield to encircle the tube, permitting the exit of the
rays only through a small aperture that may be reg-
ulated as required.
In addition the use of leadfoil or sheet lead to
cover all parts which are to be protected from the
ray is customary.
The Fluoroscope. In order to see the findings of
the X-ray a screen is employed containing barium
platinum cyanide, a substance which shines or fluor-
esces when exposed to the X-ray. Interposing an
object between this screen and the X-ray tube pro-
duces a shadow on the screen commensurate with
the amount of the ray which has been prevented
from reaching the screen. We
have, therefore, a
shadow picture showing the relative density of the
object traversedby the X-ray.
The Skiagraph. The rays act upon the bromide
of silver gelatin coating on photographic plates in
the same manner as ordinary light. When a plate
takes the relative position of the fluoroscopic screen
the resultant picture is called a radiograph, or skia-
graph, and affords a permanent record of the condi-
tion shown.
The X-ray plates have a heavier coating than
ordinary photographic plates and are enclosed in
two envelopes so that they may be handled in day-
light. The flaps on the envelopes are on the non-

sensitive side of the plate. The plate placed on
is
the table, the part to be skiagraphed resting on the

plate and the tube some distance above, the target
being directly over the center of the part radio-
graphed.
Fig. 61 High Frequency Coil Giving All Modalities.
As the rays diverge from the point on the target

where they are produced, the image on the plate is
always enlarged. The nearer the part is to the tube
the greater the magnification.
284 MANUAL
Fig. 62 High Frequency X-Ray Tube.

PLATE
TABLE
Fig. 63 Proper Position of Tube, Plate and Hand for a

Skiagraph.
In order to obtain a picture without distortion of

the image the following rule must be kept in mind :
An imaginary line from the point on the target where

the ray is generated to the center of the plate must
be perpendicular to the plate and pass through the

center of the part skiagraphed.
Fig. 63shows the proper relationship of the tube,
plateand hand for a skiagraph of the latter.
The length of exposure is from a few seconds to
several minutes, according to the apparatus em-
ployed and the density of the parts. A few ex-
perimental pictures will enable the physician to de-
termine the approximate time for his individual
outfit.
The method for developing is the same as for or-
dinary photographic plates, but takes much longer,
averaging about ten to twenty minutes.
Dental Films. For skiagraphs of teeth, a film is
used. Two small films wrapped in two opaque paper
coverings is the way they are supplied to the doctor.
The film is held inside the mouth, back of the teeth,
the smooth side of the paper toward the tube. Head
is adjusted so that the line from target to film is in
accordance with the rule given above. With small

machines it will be necessary to experiment to get
the time of exposure. It will average 30 to 60 sec-
onds. The films are developed, washed and dried;
the one retained by the radiographer, the other by
the patient.
Diseases Grouped According to Technique. In

treating with the X-ray the average number of
treatments is three per week. The length of ex-
posure during the first two weeks should not be over
five minutes each time to guard against possible idio-
syncrasy to the ray.
Fig. 64 Portable X-Ray and High Frequency Coil.
After two weeks the treatment may be lengthened

to seven, or, in some cases, ten minutes, and con-
tinued until improvement takes place or the charac-
teristic reaction appears.
288 EBERHART'S MANUAL, OF
In the former instance, the frequency of the treat-

ment is gradually decreased; in the latter it is sus-
pended entirely for a few treatments until the signs

of dermatitis have subsided, when it is resumed as
before, providing the evidences of disease have not
disappeared with the reaction.
With a low tube the tube-wall is from five to eight
inches from the surface treated ;
medium tube eight
to twelve inches ; high tube twelve to twenty inches.
A number of diseases suitable for X-ray treat-
ment are given herewith, grouped according to the
vacuum of tube best suited to their treatment. The
lower the tube the quicker the reaction produced.
Some diseases are included under two headings,
where it is a matter of choice, either method yield-
ing results.
Low Tube.
Acne, eczema, epithelioma, lupus, rodent ulcer.
Medium Tube.
Acne, blastomycosis, cancer (superficial), favus,

goitre, hyperidrosis, keloid, nevus, pruritus, psoria-
sis, sarcoma, sycosis, trachoma, tuberculous glands,
neuralgia.
High Tube.
Alopecia areata, cancer (deep seated), leukemia.
X-ray Burns. An X-ray burn or dermatitis is the
result of an overdose of the ray. The earlier symp-
Fig. 64a A Method of Applying Diathermy to the Chest.
toms are itching, redness and pigmentation. By

keeping these in mind it will be possible to avoid
severe burns.
Mild burns should be let alone and they will sub-
side of their own accord. In severe forms the con-
dition is an X-ray gangrene or necrosis and calls for
surgical measures.
290 EBERHARr*S MANUAL 0?
CHAPTER ELEVEN.
Diathermic Currents.
Characteristics As long ago as

and Synonyms.
1899, Prof. D 'Arson val
noticed that passing the
D'Arsonval current through certain tissues of the
body produced a higher temperature in these tissues.
Nagelschmidt, Doyon and others confirmed these
early observations, and the name diathermy was ap-
plied to this method of increasing the temperature
of the internal tissues of the body.
The D'Arsonval current is used and dia-
direct
thermy is also with the terms thermo-
synonymous
penetration, electro-coagulation and electro-thermic
coagulation. The application is always bi-polar.
It really amounts to the application of electrically
generated heat, which may be made to cover cer-
tain definite areas between the poles of the appa-
ratus, and may be used to raise the temperature of

the tissues or even carried to the point of coagu-
lation with the formation and separation of a slough.
In the latter case it is the equivalent of a surgical
procedure.
We are familiar with the action of the galvanic
current. If we pass this current through water,
owing to electrolysis, the water is decomposed into

hydrogen and oxygen which collect at the positive
and negative poles respectively, or, if the current is
passed through a solution of potassium iodide and
starch, a dark color is immediately noticed at the
negative pole, due to the decomposition of the po-
tassium iodide and consequent action of the iodine
on the starch solution. If we dip our hand into the
water while the current is passing there is a dis-
tinct tingling sensation.
If, now, instead of using the galvanic current, we
pass the direct D'Arsonval current through the wa-

ter or solution, no electrolytic action is apparent
and the only effect is an increase of temperature in
the solution, as is evidenced by the introduction of
a thermometer which shows the steady rise in tem-
perature until the water boils. It is estimated that
with the diathermic current the internal tempera-
ture of the body, located between the points of
application, can be raised to a temperature of 110
to 140 degrees Fahrenheit, though many believe
110 degrees to be about the limit of skin and tissue
resistance.
Effects. On account of there being practically
no skin resistance to the passage of the diathermic
current, the current passes directly from one elec-
trode to the other, heating the tissues that ilie
between the electrodes. The current can be concen-

trated in this manner, and is always under absolute
292 EBSRHART'S MANUAL OF
control. This is of great value, as a little experi-

ence will enable the operator to gauge the amount
of current required to produce any given tempera-
ture in the tissues and reduces the application of
this current to exact measurement, so difficult to
obtain when applying an ordinary high frequency
current.
If electrodes of the same amount of surface are
used on the opposite sides of a part, the same effect
would be produced at each electrode or a uniform
effect produced between the two, making allowance
for the fact that fatty tissues heat quickly and that
bones are slow to heat, but retain their heat longer,
while muscular tissues are slower to heat than either
fat or bones.
If we decrease the size* of one electrode, since the
same amount of current is passing, there will be a
more intense heat over the area of the smaller elec-
trode. If sufficient current is used the heat acts like
the cautery, coagulating and destroying the tissue.
By regulating the size of the electrodes the heat
may be delivered wherever desired within the tis-
sues, thus the value of this current in all inflamma-
tory conditions of joints, etc.
When the cauterizing effect is desired, the active
electrode is usually a metal point or a wire. In this
form represents one form of fulguration. It is
it
employed in papilloma of the bladder. (The tech-

nique is given under this heading in Chapter VI.)
Diathermic currents are measured with the hot-

wire meter.
Range of Usefulness. Outside of their use in one
form of fulguration as above referred to, they have
been very successfully used in connection with deep
Roentgen therapy in malignant growths, and in the
form of increased heat without carrying it to tissue
coagulation, in arteriosclerosis, local or peripheral

disturbances, sciatica, neuralgia, lumbago, asthma,
neuritis, headaches and rheumatic or other forms
of arthritis. Many
other conditions naturally sug-
gest themselves where these currents may be em-
ployed.
Technique. For increased internal heat, the
method of the use of this current is as follows Con- :
necting cords are attached to electrodes of suitable

size or shape for the part that is to be treated.
These electrodes are made either of solid discs, or a
thin brass sheet covered with absorbent material.
In order to make better contact they are first cov-
ered with gauze saturated with a normal salt solu-
tion, and the part to be treated is also moistened
with this solution. The control of the current is
easily maintained by using a meter and the exact
amount that is applied can be measured at all
times. In general treatment, the current is slowly
turned on until the meter shows from 700 to 800
milliamperes passing, and then it is gradually in-
creased up to the tolerance of the patient. The
operator should remember that it is better to com-

mence with a small current and gradually and uni-
formly heat the part between the electrodes rather
than to start with a heavier current where the great-
est effect is nearer the two electrodes, for if too
much current is used, the tissues near the electrodes
will be heated beyond the point of tolerance before
lie deeply are heated as much as they
the tissues that
should be, and burns will be produced.
Fig. 64b A New Electrode for Modified Diathermy.
In the second method, where coagulation and cau-

terization are desired, the active electrode must be
metallic, and if extensive work is to be done anaes-
thesia is required.
Dr. G. E. Pf abler (Journal Advanced Therapeu-

tics, Dec., 1914) has accomplished remarkable re-
sults by combining this method with deep Roentgen
therapy in malignant growths. The work is done
under an anaesthetic, as the pain is severe. In most
of his cases ether was employed, but in mouth cases
hypodermic injections of one or one and a half
Fig. 64c Diathermy Electrodes.

296 EBERHART'S MANUAL o
HMC tablets (hyoscine hydrobromide gr. 1/100;

morphine hydrobromide gr. J4 an d cactoid gr.
5
1/64) were used. These in some cases had to be
supplemented by ether.
He uses an instrument capable of generating 1,000
to 2,000 milliamperes. In removing a portion of a
lip he uses a ball electrode inside, about three-
eighths of an inch in diameter, and a needle-point
He " I would outline
electrode externally. says :
the area of the diseased tissue to be removed by

allowing the current to flow from this point toward
the ball electrode on the inside, and then coagulate
the entire diseased tissue. At first I depended upon
the needle electrode to actually carve out the dis-
eased tissue, but now I find it simpler to cut this
away with a pair of curved scissors after coagula-
tion,always cutting within the coagulated tissue. In
this way there is no bleeding and the edges are
completely sealed off.
"In destroying an extensive lesion in the cheek

I used a one inch in diameter, on the
flat electrode,
inside and a point electrode on the outside. In de-

stroying a portion of the tongue I have used two
point electrodes. The electrodes are held in contact
with the tissue.
"
CHAPTER TWELVE.
High Frequency in Dentistry.
General Field of Usefulness.High frequency cur-
rents are coming daily into more and more frequent
use by dentists. They are employed in pyorrhea, in
drying cavities, in devitalizing teeth, in sterilizing
root-canals, in bleaching teeth, in abscesses, in locat-
ing devitalized teeth, and for the relief of pain. The
author not a dentist, but has tried to give in this
is
chapter a resume of current dental opinion and

technique as gathered from various sources. Sev-
eral dental electrodes are illustrated in Fig. 68.
Pyorrhea. Pyorrhea early manifests itself by a

slight reddening of thegums at the margins and a
tendency to bleed on slight provocation. A large
majority of patients having pyorrhea are anemic,
and in these the gums, instead of being red, may
have a yellow and discolored appearance and are
apt to be flabby or receding instead of puffy. In the
second stage of the disease, pus appears, attacking
firstthe peri-dental membrane. Later the bony
socket of the tooth may be slowly eaten away or
destroyed. The gum gradually recedes and the
tooth becomes loose in its socket and painful to the
touch.
From this we can see at once indications for the
employment of high frequency currents.

A French authority says that it is necessary "to
destroy the microbic and suppurative state of the
gums, currect the depleted nutrition in the tissues
and produce an over-active phagocytosis and increase
the index of leucocytic destructions. For this result
one uses high frequency currents with the greatest
success in the two forms, the effleuve (spray) and
the spark.
"
Gremeaux and Arnal (1'Est Dentaire, Sept., 1913)
' '
use the high frequency as follows One introduces
:
the metallic fulguration electrode as far as possible

between the loosened gum and the tooth, in order
that the spark may reach all the recesses and puru-
lent foci.During the operation, which lasts an
average, of a minute for each tooth, one sees the
margin of the gum blanch and the pus bubble out at
the neck of the tooth. When all of the recesses
have been penetrated, the fulguration point is re-
placed by a small vacuum electrode, which is passed
over the external and internal surface of the gums
for about ten minutes."
They wait three or four weeks to note results be-

fore giving a second treatment, employing a rigor-
ous antiseptic regime in the meantime, consisting in
brushing with an alkaline powder night and morn-
ing,and numerous rinsings with boiled water, etc.
About a week after the treatment the patient mas-
Fig. 66 lyArsonval Outfit for Diathermy.

sages the gums with the finger twice a day. In three

or four weeks, if pressure on the gum shows pres-
ence of pus, the treatment is repeated; otherwise
the case is dismissed, with instructions to keep up
the massage of the gums and antiseptic care of the

mouth. One to three treatments were required in
the cases treated.
Dr. F. Morel (Bulletin du Syndicat des Chirur-

giens-Dentistes de France, Sept.-Oct., 1910, Jan.-
Feb., 1911) makes use of medicaments in connec-
tion with the high frequency. He claims that the
high frequency effleuve renders mucous membranes
porous and facilitates the penetration of medica-
ments, and that the simultaneous application of the
solution and the current produces an electro-chemic
effect. He decomposes by the currents a solution of
potassium bichromate, claiming that the base will
be taken up by the diseased tissues.
After thoroughly removing the tartar from the

teeth, he carefully irrigates with peroxide and
evacuates all of the pus. Then he paints the teeth
and gums with the following solution, using a
spatula to get it up as far as possible around the
roots :
R Fluoride of Ammonia 1 gramme

Chloride of Ammonia 1 gramme
Chloride of Potash 1.5 gramme
Salicylate of Theobromine 1 gramme
Meythl Alcohol 50 centigrammes

Distilled Water 20 grammes
M. Filter.
This solution favors ionization and lessens the

resistance of the tissues to porosity.
A pad is then soaked in a ten per cent aqueous

solution of bichromate of potash and held over four
teeth and a vacuum electrode held over this for
about fifteen minutes, with close contact. He only
treats four teeth at a time. In advanced cases he
uses a metal point and carries a few sparks up into
the infected canals.
The vacuum tube application is for cataphoric

purposes, and one of the electrodes illustrated here-
with having a cup to hold the saturated cotton may
be used for this purpose.
He repeats this treatment every second day, some-

times giving three five-minute seances with eight
minutes' rest between. Usually four treatments pro-
duce a cure, occasionally six, seven or eight have
been required. During the whole course of treat-
ment the patient washes the mouth six times a day
with the following solution, using half a glass each
time:
Sodium salicylate 10 grammes

Sodium fluorosilicate 2 grammes
Distilled water . , 1 litre
Dr. Irwin Jirka applies methyl salicylate in these

cases, driving it in with the vacuum electrode. He
treats for eight minutes every other day. Reports
a number of cases cured in three to fifteen treat-
ments. Hubbel uses the cataphoresis electrode first
and then the ball pointed pyorrhea electrode to mas-
sage the gums for five or six minutes each, treating
daily until improvement takes place.
Desiccation, Metallic lonization and Phoresis, I
have been furnished with a translation of a paper
by Dr. A. A. Nouel of Venezuela. This paper, read
at the Dental Section of the Medical Congress at
Caracas in 1911, is entitled,
"
Desiccation, Metallic
lonization, and Phoresis of the Canals in One Sit-
ting with High Frequency Currents." The author 's
methods seem to be distinctly original. He speaks
of using at first a coil and resonator and with this
used iodide of potash because this chemical absorbed
the ozone when the current was introduced into in-
fected root canals. After four years of experiment-
ing he found a method and a machine that enabled
him to get simultaneously metallic ionization and
thermopenetration.
He says:"I have used the * * * high frequency
coil, but even though the machine is just as efficient
as other more powerful coils for fulguration with
vacuum electrodes and with the ozone inhaler, in
the desiccation of the canals, the current is found to
be of too pronounced faradic character.
"I have also used several other types of high fre-

quency machines, and found the one most suitable
giving a smooth, high frequency current without
any faradic sensation, such as is used in diathermy.
In this case there will be felt by the patient nothing
Fig. 68 Dental Electrodes.
but a progressive increase of warmth, if there is no

continuity of solution. If there is one, no matter
how small, beside the progressive thermic increase,
there will result an ionization of the canal in which
a small arc will be established.This arc is formed
between the walls of the canal and extends the full
length of the electrode.
' '
The electrode is connected by means of a flexible
and well-insulated metallic conductor to the right-
hand 'auto-condensation' terminal. The electrode
handle may be about ten centimeters long, and made
of either fine wood or ivory, with a metallic point
similar to that of the broach holders employed in
dentistry. Small pieces of either copper or zinc
wire, as required in each case, will be fitted to the
handle. In some cases, where no abscess is formed,
I believe the copper is superior to the zinc electrode.
To substantiate this statement, I have observed that
after a diseased spot has been treated with a copper
electrode no pain is felt if that spot is touched.
" Before the current turned on,
is it is better to
thoroughly dry the cavity leading to the canal in
order that the sparks may not be diverted, but will
confine themselves to the length of the wire and
walls of the canal throughout its length.
"I firmly believe that the metal, during its ioniza-
tion, cataphorically introduced into the dental

is
canals through the apex, and that once in the pres-

ence of the salts that form the composition of the
blood, a chloride is formed, this being the reason
why the periodontium and adjacent parts are irritated
when zinc is employed. A zinc electrode is bene-
ficial in case of an abscess on account of the chemical
composition formed by the zinc.
"The ionized and ozonized copper is also intro-
duced into the dental canals by means of the cata-
phoric action of the current, thus forming a deposit

of oxide or bi-oxide of copper, which will perma-
nently act as a disinfectant. I shall later on explain
the method through which its action Is brough
about.
"Although a tooth may be profoundly infected

(it understood that I refer to a tooth without
is
pulp), with inflammation of the periodontium, with

'
an abscess or fistula, it can be stopped' in one sit-
ting, fearing no ulterior difficulties, if this novel
method is employed.
"The technique very simple: After the pulp
is
chamber is
open to be moistened with a small
it is
quantity of trikresol and iodoform or trikresol and

formalin, after which the electrode is applied, being
held at a distance of a half to one millimeter and
moving it over the surface until the cavity is dry. A
broach is now
employed, being operated into one-
half the length of the canal, drying with cotton and
compressed air, not too warm then the copper wire
;
is introduced and the current turned on for five min-
utes. is now used again, this time reach-

The broach
ing to the apex. The canal now being perfectly
freed from the bits of pulp and other foreign bodies,
is now thoroughly dried with cotton inserts. The
copper electrode treatment is then repeated for five
minutes, and, after this time has elapsed the tooth
may be 'stopped.'
306 EBERHART'S MANUAL OP
"The great efficacy of this modality is supported

by the fact that the dental canals constantly main-
tain a certain humidity, which serves as an easy
conductor for the introduction of the ionized metal,
and permits the easy access of the flowing-in process
of the ozone while being dried by the thermopene-
tration, which goes to complete the oxidation and
the consequent coating of copper, leaving it perma-
nently deposited in a state of oxide or bi-oxide of
"
copper.
Abscesses. The dental technique advised by some
operators consists in ten or fifteen minute applica-
tions of a mild current in contact with the cheek,
followed by the use of one of the cataphoresis elec-
trodes containing cotton saturated with iodine and
aconite solution. Duration of this application about
eight or ten minutes. Jirka uses methyl salicylate,
and also speaks of formo-cresol, which I infer is used
with the cataphoresis electrode.
Drs. Barber and Van Valkenburg have reported a

case where the copper wire was employed in treat-
ing an abscess.
Post-operative Pains. For the pains and soreness

existing after extraction or after setting bridges or
crowns, the use of the cataphoric electrode with any
suitable solution has been recommended, followed
by application of mild current with the ball-pointed
pyorrhea electrode.
Sterilizing Root Canals. Another method of ster-
ilizing root canals is the touching of the pointed

dental electrode (carrying current enough for a
half -inch spark), to a broach which has previously
Fig. 69 Portable Outfit for Dentists.
been inserted in the canal.The broach carries the

current into the canal.The direct D'Arsonval cur-
rent may be used the same way.
' '
Bleaching the Teeth. Hubbel says Place your

:
bleaching solution on a fibre of asbestos or cotton,

placing it in the cavity of the tooth and applying
the point of the electrode directly against this fibre,

the cataphoric action of the current driving the solu-
tion into the dentine, getting results much quicker
than from ordinary measures. Care must be taken
that the apex of the tooth is first stopped with gutta-
percha so that there is no danger of the solution
"
being forced through the apical foramen.
Diagnosing Live from Dead Pulp. The pointed

dental electrode is used with a mild current, and
the point applied to the cusp of the tooth. If the
pulp is alive the patient will feel the current; if he
does not, the tooth is devitalized.
Obtunding Sensitive Dentine and Devitalizing

Teeth. "In obtunding sensitive dentine, a small
crystal of carbolic acid is placed in the cavity and
the pointed electrode is used in the generator, the
current being toned down as mildly as possible.
The point of this electrode is then placed against
the cavity arid held for from 30 to 50 seconds. Now,
test the cavity, and if still sensitive, use the current
for a half minute longer. You may now start to
excavate, and if the one application of the carbolic
acid does not last sufficiently long to complete the
operation, place another tiny crystal in the cavity
and apply as before. In the majority of cases, oper-
ations have been rendered entirely painless by this
method of treatment.
"In
devitalizing the teeth a small crystal of novo-
cain placed in the cavity, or, if no cavity is appar-
is
ent, cut into the enamel with a very small stone,

placing a crystal of novocain therein and dipping
the tip of the electrode in adrenalin. Apply the
high frequency current to this with a very mild flow
of current the sameas in obtunding sensitive dentine,
using the current for about one minute. Drill into

the teeth until as close to the pulp cavity as possible
without unnecessary pain, and again apply a crystal
of novocain and use the current for about a minute
to a minute and a half, and in most cases it is then
possible to cut into the pulp cavity. If the nerve

is then sensitive, pressure anesthesia is advisable.
The greatest trouble that we find in getting success
from this treatment is the inability of the operator
to successfully control his current, as it takes con-
siderable practice in order to get the proper amount
of stimulation. But, after some experimenting, it
is possible to get results in the majority of cases."
Hubbel.
GLOSSARY.
Names of Diseases and Terms Defined in the Text
Are Omitted.
Ampere. The unit of current strength or intensity.

Anemia. A deficiency in quantity or quality of the
blood.
Arteriole. A small artery.
Asepsis. Freedom from
septic matter or infection.
Atonic. Lacking tone.
Atrophy. Wasting of a part.
Bi-polar. Attached to both poles of the apparatus.
Capillaries. Hair-like vessels connecting the arteri-
oles with the smallest veins.
Carbon dioxide. C0 2. A poisonous gas eliminated
through the lungs.
Carbon dioxide snow. Under high pressure the gas
liquefies and on liberation the evaporation pro-
duces snow-like crystals which are moulded and
applied to a growth that is to be removed. It
is frozen and separates in -10 to 12 days without
leaving a scar.
Cataphoresis. Driving a substance into the tissues
by means of an electric current.
Coagulum. A clot.
Condenser electrode. A vacuum tube containing a

metal disk which acts as one plate of a con-
denser, the tube wall being the di-electric and
the body surface in contact, the other plate.
Shown in Fig. 21.
Conductor. A material readily transmitting elec-

tricity.
Contra-indicated. Not indicated.

Dermatitis. An
inflammation of the skin; used to
signify the inflammation produced by an over-
dose of the X-ray, or X-ray "burn."
Di-electric. A substance separating two charges of

electricity in a condenser, as the glass in a Ley-
den jar.
Diplopia. Double vision.
Effleuve. The fine spray from a vacuum tube or

other electrode, too fine to be termed a spark.
Electrolysis.Breaking up a compound into its ele-

ments by means of an electric current. Electric
analysis.
Elimination. Carrying a substance out of the sys-
tem.
Endarteritis. Inflammation of the lining of an ar-
tery.
Escharotic. Caustic.
Exudate. A substance deposited in or on a tissue,
either by vital action or by disease.
Functional. Pertaining to the natural action of a

part, which may vary somewhat without an ac-
tual change in the structure of the organ or
part.
Hemoglobin. The coloring matter of the red blood
corpuscles, containing iron.

Hyperemia. An increased amount of blood.
Hyperesthetic. Over-sensitive.
Hyperplasia. Abnormal increase in tissue elements.
Hypertrophy. Overgrowth.
Hypertension. Above normal pressure.
Hypotension. Less than normal pressure.
Ion. A moving particle of electricity.
Indican. A substance found in the urine as a result
of imperfect intestinal digestion (from proteid
putrefaction).
Inductance. The phenomenon of induction.
Induction. The generation of an electric current
in a body by the influence of another electrified
body.
Inhibitive. Producing inhibition.
Inhibition. Soothing or arresting a process or func-
tion.
Intra. Within.
Intra-ocular. Within the eye.
Intra-vaginal. Within the vagina.
Lesion. A
disease or diseased area.
Leucocytosis. An increase in the number of white
blood cells.
HIGH FREQUENCY CURRENT^ 313
Metabolism. The process of changing inorganic ma-

terials into living cells.
Milliampere. One one-thousandth of an ampere.

The unit of dosage of medical electricity.
Modality. Any one of the different forms of elec-
tricity.
Monopolar. Connected to one pole.
Myelocyte. A pathological white blood cell found
in leukemia.
Neurosis. A nervous disease especially a functional
one.
Ohm. The unit of resistance to the passage of an
electrical current.
Orificial. Pertaining to one of the openings or ori-
fices of the body.

Oxidation. Combining or causing to combine with
oxygen. Same as oxidization.
Oxy hemoglobin. Hemoglobin charged with oxygen

in the arterial blood.
Phagocytosis. The destruction of harmful cells by

cells called phagocytes which envelop and ab-
sorb them.
Physiological. Natural or normal.
Plastic. Tending to build up or form tissues as a
plastic exudate.
Poikilocytes. Malformed, over-sized, non-nucleated
red blood corpuscles present in pernicious and
other anemias.
Potential. Electric pressure (measured in volts).
314 EBERH ART'S MANUAL 0*
Reciprocal. The reciprocal of a fraction is the in-

version of it. Thus the reciprocal of y2 is 2-1
or 2.
Serosangninous. Serum and blood mixed.

Solenoid. A coil of wire.
Suppuration. Formation of pus.

Suppurative. Tending to form pus.
Supra. Above.
Supra-orbital. Above the orbit or eye.
Tension. 1. Electromotive force; potential. 2.
Pressure, as the pressure of blood in the ar-

teries.
Thermostat. An apparatus registering heat expan-
sion or regulating a mechanism through this
action.
Transformer. A coil that changes the voltage. If
increases called a
"
it it, it is step-up" trans-
former.
Unipolar. Connected to one pole ;
same as mono-
polar.
Volt. The unit of electrical pressure.
INDEX
Bipolar Tesla, technique, 91.
Bladder, disease, see cystitis.
Abscess, 158-306. Bladder, papilloma of, 96.
mastoid, 158-237. Bleaching teeth, 307.
pelvic, 247. Blepharitis, 182.
Acne rosacea, 158. Blindness, 183.
vulgaris, 159. Blood pressure, 120-170.
Actinomycosis, 162. in arteriosclerosis, 170.
Adenitis, see tuberculosis of in various diseases, 134.
glands, 262. high, 170-225.
Adhesions, 163. low, 225.
pelvic, 247. method of taking, 120.
Adjustable tube handle, 54. Boils, see furunculosis.
Albuminuria, 163. Brachial neuritis, 244.
Alcoholism, 164-203. Brain fag, 185.
Alopecia, 164. Breasts, flabby, 210.
Alternating current, 14. Bright's disease, 163.
Alternation, 13. Bronchial asthma, see asthma,
Amenorrhea, 166. 180-186.
Anal fissure, 210. Bronchitis, 187-277.
pruritus, 251. Burns, high frequency, 64.
Anemia, 169-276. X-ray, 288.
Aneurism, 169.
Anterior poliomyelitis, 228.
Appendicitis, catarrhal, 170. Callous, 188.
Arteriosclerosis, 170. Cancer, 188.
Articular rheumatism, 254. Canities, see gray hair.
Asepsis, 73. Carbuncle, 188.
Asthenopia, 179. Carcinoma, 188.
Asthma, 180-186-277. Cataphoresis, 89-302.
Ataxia, locomotor, 234. Cataract, 189.
Atonic dilation of the stomach Catarrh of bladder, see cystitis.
180. bowels, see colitis.
Atrophic rhinitis, 246. nose, see nasal catarrh and
Atrophy of optic nerve, 182. ozena.
Author's auto- condensation pad, womb, see cervicitis.
108-109. Cauterization, 87.
D'Arsonval surgings, 115. Cautions, 72-115.
spatulate tubes, 54. Cellular massage, 20.
Auto-condensation, 39-103. Cellulitis, 190.
couch, 104. Cerebral hemorrhage, 190.
local, 118. Cervical adenitis, see tubercu-
measurement of, 79. losis of glands, 262.
pad, 108. Cervicitis, 191.
pad, home-made, 109. Cervix, erosious of, 208.
Auto-conduction, 101. inflammation of, 191.
Chancroid, 193.
B Change of life, 238.
Chilblains, 193.
Baldness, 164. Chloasma, see moth-patches.
Barber's itch, see cycosis. Chlorosis, 169-279.
Basedow's disease, 213. Chorea, 194.
Chronic ulcers, 194.

Cicatrices, 257.
Climacteric, 238. Earache, 204.
Coagulation, electric, 290. Ear diseases, 205.
Cocaine habit, 203. Ear technique, 136.
Coil, Tesla, 35. Eberhart Unit, 79.
Cold extremities, 194. Eczema, 205.
Colitis, 195. Effects of vacuum tubes, 61.
Colon, inflammation of, 195. Electrical oscillation, 26.
Condenser, 22-25. Electric coagulation, 290.
cushion, 109. Electrodes, cataphoresis, 89-302.
plate, 26. fulguration, 91.
Constipation, 196. vacuum, 45-62.
Constitutional effect, 63-64. Emissions, nocturnal, 258
Contraction Dupuytren's, 204. Endometritis, 206.
Convalescence, 197. Enlarged prostate, see prostatic
Corneal, opacity, 197. diseases.
Corns, see Callous, 188. Enteritis, 206.
Coryza, 197. Enuresis, 228.
Cutaneous cancer, 208 Epididymitis, 207.
Cycle, 13. Epilepsy, 207.
Cystitis, 198. Epithelioma, 208.
Erosions of cervix, 208.
Exophthalmic goitre, 213.
Eye diseases, 209.
Eye technique, 139.
Dandruff, see Seborrhea.
D'Arsonval current, 34.
administration, 39-290. Favus, 209.
effects of, 291. Fissure, anal, 210.
surgings, 115. Flabby, breasts, 210.
technique, 39-293. Fluoroscope, 282.
Deafness, 199-276. Frequency defined, 14.
Definition of alternation, 13. Frontal sinusitis, 258.
cycle, 13. Fulguration, 91.
di-electric, 25. Furunculosis, 210.
frequency, 14.
high frequency, 13
oscillation,13.
period, 14. Gaiffe's meter, 42.
periodicity, 16. Gastritis, 211.
pulsatory currents, 16. Genito-urinary diseases. 211.
Dental films, 286. Glands, tuberculosis, 262.
Dentistry, high frequency in, Glaucoma, 211.
297. Glossary, 310.
Devitalizing teeth, 308. Gleet, 212.
Diabetes, 199. Goitre, 213.
Diarrhea, 202. Gonorrhoea, 214.
Diathermy, 135-290. Gout, 215.
Di-electric, 25. Gray hair, 215.
Dilation of stomach, 180. Grippe, 220.
Dosage measuring, 41-77.
rough method of standard-
izing, 77.
Drug habits, 203. Habit, alcohol, 164-203.
Dupuytren's contraction, 204. cocaine, 203.
Dyspepsia, 204. drug, 203.
morphine or opium, 203. Leyden jar, 22.

Hair, falling, 221. Lichen, 233.
gray, 215. Lighting tube not proof of high
loss of, 164. frequency current, 21.
Handles for tubes, 54. Lithemia, see gout.
Hay fever, 221-277. Locomotor ataxia, 234.
Headache, 221. Loss of hair, 164.
Heart disease, 223. Low blood pressure, 225.
Heat penetration, 290. Low frequency currents, 18.
Hemorrhoids, 224. Lubrication of tubes, 71.
Herpes zoster, 224. Lumbago, 236.
High blood pressure, 170-225. Lupus, 237.
High frequency burns, 64.
constitutional effects, 62-64.
defined, 13. Mastoid abscess, 237.
development of, 22. Mastoiditis, 237.
measurement of, 41. Measuring dosage, 41-77-79.
physiological action of, 60. Measuring high frequency, 41,
surgings, 115.
therapy, 152. Medium frequency, 18.
water spray, 117. Menstruation, suppression of,
X-ray, 279. 166.
Hives, 267. Menopause, 238.
Hot-wire meter, 42. Menorrhagia, 239.
Hyperesthetic rhinitis, 221. Meter, hot-wire, 42.
Hypertension, 225. Metrorrhagia, 239.
Hypertrophy of prostate, see Migraine, 239.
prostate diseases. Moles, 240.
Hypotension, 225. Molluscum contagiosium, 240.
Hysteria, 226. Morphine habit, 203.
Moth patches, 240.
Mucous colitis, 195.
Muscular rheumatism, 254.
Impetigo, 227. Myxedema, 240.
Impotence, 227.
Incontinence of urine, 228. N
Indigestion, intestinal, 231.
Indirect sparks, 118. Nasal catarrh, 240.
Infantile paralysis, 228. diseases, 240.
Influenza, see grippe. technique, 142.
Insomnia, 228-278. Nephritis, 163.
Insulated tubes, 52. Nervous debility, 242-278.
Intestinal indigestion, 231. Neurasthenia, 242.
Intra-ocular hemorrhage, 231. Neuralgia, 242.
blindness from, 183. Neuritis, 244.
Iritis,231.
Itching, 251.
K Obesity, 245.
Opacity of cornea, 197.
Keloid, 232. Opium habit, 203.
Optic nerve, atrophy of, 182.
Orchitis, 245.
Orificial technique, 88.
Laryngitis, 232. Oscillation, 13.
Leucorrhcea, 232. electrical, 26.
Leukemia, 232. Otitis, 245.
Oudin's resonator, 40. Rectal diseases, 253.

Ozena, 246. technique, 143.
Ozone, 270. Rectum, prolapse of, 250.
effects of on nutrition, 272. Red nose, 158.
methods of administering, Resonator, 40.
271. Restoring gray hair, 215.
physiological action of, 270. Retinitis, 253.
Rheumatism, 254.
Rigg's disease, 252-297.
Ringworm, see tinea.
Pad, auto-condensation, 108. Rodent ulcer, 257.
Piffards, 108.
Papilloma, 96-246.
Paralysis, 246.
agitans, 246. Scalp treatment, 145.
infantile, 228. Scars, 257.
of sphincter, 247. Sciatica, 257.
Patient, preparation of, 83. Seborrhcea, 258.
Pelvic abscess, 247. Seminal emissions, 258.
adhesions, 247. Sexual impotence, 227.
exudates, 247. Shingles, 224.
Period, 14. Sick headache, see migraine.
Periodicity, 16. Sinusitis, 258.
Periostitis, 247. Sinusoidal current, 18.
Pertussis, 277. Skiagraph, 282.
Pharyngitis, 248. Skin cancer, 208.
Phlebitis, 248. Skin diseases, 259.
Piano player's cramp, 269. technique in, 84.
Piles, 224. Sleeplessness, 228-278.
Pimples, 159. Sore throat, see pharyngitis
Pityriasis, 248. and laryngitis.
Plate-glass method, 118. Sparks, indirect, 118.
Pleurisy, 248. Sphygmomanometer, 120.
Pneumonia, 249. Sprains, 259.
Poliomyeliiis, 228. Sterility, 259.
Post-fracture conditions, 249. Sterilizing root-canals, 307.
Post -operative conditions, 249. tubes, 73.
pains, 306. Stiff neck, see torticollis and
Preparation of patient, 83. rheumatism.
Proctitis, 250. Stricture, 260.
Prolapse of rectum, 250. Sub-involution, 260.
Prostatic diseases, 250. Superfluous fat, 245.
technique, 143 Suppuration, 260.
Pruritus, 251. Surgings, author's, 115.
ani, 251. Sycosis, 260.
vulvae, 251. Synovitis, 261.
Psoriasis, 252.
Pulsatory currents, 16.
Pulse pressure, 125.
Purpura rheumatica, 252. Tabes dorsalis, 234.
Pyorrhea, 252-297. Technique, bi-polar Tesla, 91.
Pyosalpinx, 253. classification of, 71.
diathermic, 290.
ear, 136.
eye, 139.
Ray fungus, 162. general, 84.
Raynaud's disease, 263, nasal, 142,
*REQUNCY CURRENTS 319
orificial, 88. handles for, 54.

proatatic, 143. spatulate, 54.
rectum, 143. vacuum, 45, 63.
scalp. 145. various forms, 45.
skin, 84. X-ray, 280.
special, 136. Tuning coils, 40.
throat, 147. Types of apparatus, 30.
urethral, 147.
uterine, 149.
vacuum tubes, 71-136.
vaginal, 149. Ulcers, chronic, 194.
Technique for auto-condensa- Urethral technique, 147.
tion, 103. Urethritis, 267.
auto-conduction, 101. Uric acid conditions, 267.
cataphoresis, 89. Urticaria, 267.
cauterization, 87-91. Uterine diseases, 270.
fulguration, 91. technique, 149.
orificial treatments, 88-143.
relief of pain, 87.
skin diseases, 84.
surface lesions, 84. Vacuum, blue or blue-white, 46.
taking blood pressure, 120. color, effect of, 46.
vacuum tubes, 71-13fi high, low or medium, 46.
Teeth, treatment of, 297. red or red-pink, 46.
Tesla coil, 35. Vacuum tubes, 45.
portrait of, frontispiece. care of, 73.
transformer, 35. effects of, 61.
type, 35. lubrication of, 71.
Therapy, high frequency, 152. technique with, 71-136.
ozone, 270. Vaginal technique, 149.
X-ray, 279. Vaginitis, 268.
Thermic penetration, 290. Varicocele, 268.
Throat diseases, 261. Varicose ulcers, 268.
technique, 147.
Tic douloreux, 261. W
Tinea, 261.
Tinnitus aurium, 261-276. Warts, 269.
Tonsillitis, 262. Whooping cough, 277.
Tonsillotomy, 262. Writer's cramp, 269.
Torticollis, 262. Wry neck, 262.
Trachoma, 262.
Transformer, Tesla, 36.
Tuberculosis.
of glands, 262. X-ray, 279.
of lungs, 263. burns, 288
of peritoneum, 263. diseases suitable for treat-
of skin, see lupus. ment by. 287.
Tubes, insulated, 52. tube. 280.
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A Working Manual of High Frequency Currents ( (c1920) )

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presented to

By NOBLE M. EBERHART, M. D., Ph. D., D. C. L.

Formerly Head of the Department of Physiologic Therapeutics,

Author of "Practical X-ray Therapy;" "Brief Guide to Vibratory

Sixth Edition; Revised and Enlarged.

extensive and most of it is too technical for the

average physician, who is more interested in the

application of these currents than he is in the pre-

cise manner in which they are generated.

space to the consideration of the various forms of

My intention has been to make this a practical

hand-book for the busy physician who wishes to use

daily use of High Frequency Currents and upon six-

My indebtedness for data furnished is acknowl-

Pitcher, S. Stevens, R. E. Farmer, and Messrs. F. H.

tion; Frequency; Lighting Vacuum

II. The Development of the Current Ley- ;

den Jars Plate Condensers Electrical

III. Types of Apparatus; D'Arsonval Type

IV. Various Forms of Vacuum Tubes; Ef-

Tubes; Fixed and Adjustable Socket

V. Physiological Action of the Current;

VI. General Technique; Vacuum Tubes; Lu-

Relief of Pain Cauterization Orificial

tion; Auto-Conduction; Auto-Conden-

Pads; Surgings; Water Spray; Local

Taking the Blood Pressure. 70

VII. Special Technique for Ear, Eye, Nose,

VIII. Practical High Frequency Therapy, Dis-

IX. Ozone; Nature; Physiological Action;

X. High Frequency X-ray; Its Scope and

XI. Diathermy; Electro-coagulation; Ther-

XII. High Frequency in Dentistry. -

Fig. 1 Large Tesla Coil.

dicity; Lighting Vacuum Tube Not

What a High Frequency Current? A high fre-

quency current is an alternating (oscillating) cur-

producing muscular contractions.

A Cycle is two alternations. It constitutes the

round or circle of the current embracing one posi-

ing waves which flow alternately in opposite direc-

tory currents periodically reproduce similar series

of waves, as shown in Fig. 3. Their frequency is

very high and is the reciprocal of period. It is com-

puted on the number of double alternations, thus

Frequency is the number of complete cycles oc-

curring in one second of time. It is the reciprocal

Explanation. In order to understand the fore-

going definitions it will be necessary to recall some

The direct current is one which always' acts in

rection or polarity, and we represent it by a waved

the wave 110 volts. The current starts at zero,

Fig. 2 Portable High Frequency Coil.

negative side. This complete reversal of the cur-

we would have in this case a circle, and the word

shape of a semi-circle, but may represent any form

undulations as represented graphically in Fig. 3.

Frequency is a term properly belonging only to

in which the current broken up into a rapid series