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rent medical literature and the textbooks are crowded with the reports of an immense number of diseases and morbid conditions in which electric- ity, in one form or another, has been recognized as serviceable in therapeutics. Perhaps the best use t can make of the time at my command this afternoon will be to devote it to the consideration of a few applications that I have found especially serviceable in my own experience. In concluding, I will make a comment based upon personal observation with buying tetracycline online regard to the proper field of usefulness of this potent force. In order to obtain the best results in practice it is important that we shall bear in mind the limita- tions of electricity in clinical medicine, because^ if these are disregarded buy tetracycline 500mg we may expect to meet with certain disappointment. Extravagant claims made by too enthusiastic advocates are not only unjust to this valuable therapeutic resource, but they are also unjust to the patients who are led to expect impossibilities. I think it will lead to a clearer view of electricity from the medical standpoint if we lay aside for the moment any preconception we have in our minds with regard to its being a mysterious, life-giving force, capable of working miracles upon the human body, and as being at all times constructive, ener- gizing, and beneficent in its effects in pathological conditions. This I know is the popular idea, which has been largely founded upon the seductive and boastful advertisements of charlatans, who have tetracycline mail order found this a fruitful field in which to work on the credulity of the ignorant public. "There is no sa- cred disease," said Hippocrates, "or all diseases are equally sacred." So we may say with regard to remedies, there is no mysterious remedy, or all rem- edies are equally mysterious. *Read 500 mg tetracycline acne before the Pennsylvania State Medical Society at Bedford Springs, Pa., September 11, 1906. Mercury, arsenic, and other potent drugs may, according to circumstances, act as caustic online tetracycline agents and destroy tissues, or they may act as tonics and favor physiological changes. In the same way elec- tricity may be used in medicine to destroy tissue, or, on the other hand, to favorably influence metab- olism, depending upon the form in which it is used and the skill with which it is applied. Let us now briefly consider the forms in which electricitj' is utilized in medical practice. We ob- serve, in the first place, that it is used both indirectly and directly. Among the indirect applications of electricity are those in which it is employed as a source of heat, light, magnetism, and ;r-rays. As illus- trations of the tetracycline 500mg capsules for acne former I may mention the galvano- cautery, the electric light, and the Roentgen appa- ratus; also the electro magnet. Illustrations of the direct application are the galvanic, the static, and the induced currents, obtained from the ordinary medi- cal coil orjrom the large commercial dynamo. The latter, however, is much more powerful than is re- quired for medical purposes, but it may be reduced by transformers and controllers, or "stepped down" so that it can be used therapeutically, as well as for heating and lighting the doctor's office. The first point that I wish to make is that elec- tricity is always the same in itself, but, like the other agents I have named, it may be given in different dosage and in different ways, so that entirely differ- ent therapeutic results may be obtained. Success in therapeutics, whether in the use of electricity or any other remedial agent, depends, as we know, very largely upon the personal skill and good judg- ment of the physician who makes use of it. Inci- dentally, I may observe that this method of regard- ing the subject will help to explain why certain conditions, such as neuralgia, may be treated suc- cessfully either by galvanism, static electricity, or by the Roentgen ray ; these apparently different forms of electricity being skilfully employed to pro- duce apparently the same local effects. Taking a broad view of the subject, we observe that electricity is employed in therapeutics to accom- plish certain definite ends. The clinical fact that these objects may in some cases be attained by sev- eral different methods or forms of application I have already alluded to. It is also true that others apparently, so far as we know, can only be accom- plished by special apparatus and by a single method or technique. In fact, particular means are often employed to obtain definite results, because at pres- ent they appear to be the best which have yet been devised to fulfil the special conditions. With regard to the modus medendi, or the physio- logical action of the agent, we may observe that electricity may be used to produce the following effects : 1. To produce local necrosis, or an eschar. Limited applications may not go so far as to cause tissue or cell destruction, and may only produce local vascular changes, or, in other words, they may act as rubefacients or counterirritants. Powerful currents, if passed through the body, will, on the contrary, abruptly terminate and abolish all physio- logical processes. 2. To disturb the electrical relations of the ele- ments of nerves and muscles. This is shown by muscular contractions, produced when a nerve trunk and a voluntary muscle are brought within the in- fluence of a current of appropriate strength. It is to be observed here that the electricity primarily gives no additional strength to the nerve or muscle, but simply calls into action energy which is already Nov. lo, 1906] MEDICAL RECORD. 733 there. However, by its power to call into play the latent energy of the muscle, it causes movements of the muscle, which in turn leads secondarily to increased blood supply and improvement in nutri- tion. generic version of tetracycline Illustrations of this are very common, as in treating muscular paralysis. 3. To modify metabolism. Its effects in this di- rection are well illustrated by the Roentgen appar- atus. Exposure to the .v-rays causes local nutritive changes in the skin, the linugo hairs fall out from the operator's hands, the skin becomes glossy and thin from the atrophy of the glands, chronic ulcera- tion may occur, which in turn may be followed by malignant disease. It has been repeatedly observed that unguarded exposure of the body to the .i-rays causes degenerative and atrophic changes in the deeper parts, especially in the fundus of the eye and in the generative organs. In therapeutics this in- hibitory and atrophic action may be skilfully direct- ed against cancerous or tetracycline mgd other new growths. The buy tetracycline latter having less power of resistance than normal tissue, are made to undergo retrograde change and to wither away. This is especially noticeable in epithelioma of the tetracycline hcl bp 250 mg skin, and also in accessible organs such as the rectum and mammary gland. 4. To act as a temporary stimulant to nutritive processes, and especially to the nervous system and the circulatorv apparatus. This is illustrated by the good effects upon nutrition produced by the static current and electric bath, in anemia, neurasthenia, atonic dyspepsia, chronic rheumatism, and incipient 500 mg tetracycline rosacea tuberculosis. 5. To accomplish certain local effects by stimu- lating physiological functions. This is shown in the use of electricity doxycycline tetracycline to increase the flow of milk from the mammary gland in the nursing woman. The use of the rectal electrode in overcoming con- cheap tetracycline stipation I have called attention to elsewhere. The increased function of the ovaries produced by the induced current or by the static spark is very useful in overcoming dysmenorrhea. The systematic ap- plication to the scalp causes improved nourishment of tetracycline 500mg capsules hair follicles, and not onlv prevents baldness, but also actually increases the growth and thickness of the hair. 6. To destroy parasites upon the surface of the body. Many infectious diseases of the skin caused by vegetable microorganisms are promptly cured by the .^--rays. Among these I may mention tinea favosa, and tricophytina, tinea barbs, trichorrhexis nodosa, impetigo contagiosa, acne pustuiosa, pityria- sis versicolor, lupus, both exedens and erythematosa, and others that will occur to you from the accounts given in the medical journals. 7. To produce electrolysis. By means of needles introduced into the skin and the passage of a suita- ble galvanic current, decomposition of fluids and solids occurs, and as a result there may be absorp- tion of new growth. This is utilized in treating keloid or hypertrophied tissue of the nose or throat, and in the destruction of pigmented moles, and the removal of superfluous hair. It also has an appli- cation in the treatment of stricture of the urethra by Neumann's method. 8. To produce intense where to buy tetracycline light. The method, intro- duced by Finsen, which has been modified by the use of the electric source of illumination, has yielded tetracycline 250 mg acne really remarkable results from its action upon lupus, and on some superficial malignant growths. The electric-light bath has been vaunted as a great res- torative agent, tetracycline 250mg tablets but its utility is doubtful. In its operation the entire bodv is exposed to several hun- dred incandescent lights. In studying its effects it is difficult to separate the effects of the heat of the bulbs (which acts like a Turkish bath) from the effects of the light itself. We know that light is very irritating to the nervous system, and that the intense sunlight of tropical regions makes these un- fit for a permanent residence for white races of men, as shown by Major Charles E. Woodruff of the United States Army in his recent work on the "Effects of Tropical Light on White Men." At all events, the electric-light bath does not act like the electric bath, but simply as a light and heat bath. 9. To produce high degree of heat. I need not stop to speak of the uses of the galvanocautery in surgery. It is a complete substitute for the actual cautery, and is superior to it when used as the caus- tic loop in removing vascular growths where can i buy tetracycline on the tonsils, especially in cases of hemophilia. 10. To produce magnetic effects. The electric magnetic coil is used to extract iron fragments from the eye in surgery. It is also utilized in the electric balance for detecting the location of a foreign body such as a bullet embedded in the tissues. The use of the .r-ray in photography and in diag- nosis, as in the skiascope, does not properly come within the province of the therapeutic applications of electricity. I have now mentioned quite a number of tetracycline hydrochloride capsules usp 500mg useful applications of electricity in medicine, and I have by no means exhausted the list, but I fear if I pur- sue the subject further I may exhaust your patience. The second practical point I wish to make with regard to electricity, and with which I will close these rather desultory remarks, is this, and I regard it as a most important one : Electricity, in most cases, is to be regarded as only an adjuvant to other treatment. While giving the special electric application we should also give appropriate remedies to act upon the glands of ex- cretion and secretion. We should consider the state of the blood and give hematinics to increase the blood corpuscles and hemoglobin, or give antidotes to certain toxins, or climinants to carry off gouty, rheumatic, or other pathogenic agents, in addition

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