Eberhart's Manual of High
Noble M. Eberhart, M.D., Ph.D., D.C.L., 1911
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 chapter VIII, where particular
diseases are considered, the method of using vacuum electrodes in treating various
portions of the body is given herein, together 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 electrode is
employed, plain and insulated types of which are shown in Figs. 20 and 21. These are
used most conveniently in the authors 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 connecting to the
apparatus hangs clear of the patient. See Fig. 45.
Fig. 45 Treating the Ear.
It is certainly a great improvement over the old method,
which required the patient to hold the handle almost at arms length.
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 to 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 circumstances continue the treatment longer than seven minutes.
I designed a holder a few years ago which permitted 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 diseases).
Special Technique in Treating the Eyes. For
applying high frequency currents to the eye, a double electrode is used, as shown in Fig.
46, which is inserted 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 electrode in contact with
the eyes, without taking any chances of touching the cord connecting the electrode 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 duration of the application varies from three to ten
minutes. If only one eye is affected, only one lobe of the tube may be brought in
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 employed in
treating the eye and kept in motion back 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
Fig. Fig 47a An Outfit Specially for Eye, Ear, Nose and Throat
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 results in glaucoma. Blepharitis, trachoma, iritis, paralysis
of the ocular muscle, and cataract, are other conditions in which they have been employed.
Fig. 48 One Form of Nasal Tube.
Nasal Technique. The diseases of the nose that
are specially suitable for treatment are all catarrhal conditions, including ozena
(atrophic rhinitis), coryza, 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 minutes. 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 insulated 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 conditions 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, catarrhal 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 surfaces toward the prostate gives a larger
contact surface, it being doubtful whether with the other tube the gland really ever fits
into the depression. In prostatic diseases of all kinds, the high frequency current
has proved most efficacious, whether used alone or in connection with some other modality.
Fig. 49 Treating the Scalp.
In treating both the rectum and the prostate, my special
technique consists in placing the patient on one side in the Sims 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
during 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 virgins 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
The special technique for itching is given in Chapter VIII
Scalp Treatment. In treating the scalp, the body
electrode, Fig.49, is used. The electrode is moved 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 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 Scalp Electrode.
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 to pass, according to the nature of the case. Sparks from the regular tube
or from the fulguration point have been employed to destroy follicles in pharyngitis or in
place of nitrate of silver cauterization, and the fulguration point has even been used in
the removal of the tonsils.
Fig. 50 Throat Electrode.
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
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 subsequent days it will be found
that the stricture gradually disappears until finally the glass tube will pass by it.
When the urethral tube has been properly inserted, the socket
of the holder is slipped over it, and the handle bent back over the patients
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 removed. 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 adhesions. Low or medium vacuum tubes should be used in the latter
The technique which I use in applying the current 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 authors movable socket holder is inserted, and then the
handle is bent down to touch the table and the patients skirts folded over it, thus
anchoring the tube and preventing it from slipping out. A towel is then wrapped
around the metal connection between the tube and handle to prevent the latter from tipping
sideways 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 ro three
treatments in a day 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 metal speculum, if the latter
is used. (An old-fashioned glass one is better.) In cancer, the fulguration
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
DArsonval current may be used in the vagina by this method. Direct
DArsonvalization is now known as diathermy. See Chapter XI