Electrotherapy

Electrotherapy is the use of electrical energy in the treatment of impairments of health and a conditions of abnormal functioning. ^[1] It is basically composed of the use of electric currents, referred to as "Tesla currents" ^[2][3][4], in therapeutic applications.

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History

The history of electrotherapy and electrical stimulation of the body, as anything more than a novelty, began in the mid-18th century with the invention of the Leyden jar that permitted static electrical charges, generated by a device invented in the 17th century by Otto von Guericke, to be accumulated for a vigorous shock. Benjamin Franklin experimented with the arrangement, and his method of treatment became known as Franklinism. Franklin himself judged the device creative of more pain than healing. At about this same time Luigi Galvani observed a frog's leg mounted on metal hooks twitch when a Leyden Jar was discharged nearby, and he noted the same thing when he touched a scalpel to that leg. He hypothesized 'animal electricity' was involved, or vis viva, the fluid of life, an electrical fluid. In 1800 Alessandro Volta demonstrated that what was involved was nothing 'vital', but instead the reaction between two metals. Galvani's speculation about animal electricity, dismissed by ignorant scientists of the time, could not have been appreciated for over a century, when the role of the electron in chemical bonding and the periodic table of the elements was understood in the 1920s. For Alessandro Volta and generations after him, electricity was a fluid whose nature was poorly understood. That biological organisms functioned by the action of this electrical fluid, this Galvanic animal electricity, was taken by some to discredit vitalism when the more scienfific approach would have been to conclude that Galvanic current, or DC like that from a battery, was the key to understanding the vitalist world.

In the meantime, the field of electrotherapy became populated by quacks and hucksters, and genuinely interested experimenters who investigated the effects on health of electrical shocks. It was widely accepted, by the 1830s, amongst physiologists, that the nervous system was electrical, a conclusion following from repeated witnessing of muscles twitching when stimulated.

In 1855, Guillaume DuChenne, who later became known as the father of modern electrotherapy, pronounced that AC was better than DC for electrotherapy. At the time, and for long after, it was taken as evidence of the working of electroshocks that muscle contractions were elicited upon stimulation, and it was concluded that such shocks were a way to act upon the nervous system. DuChenne noticed that with AC, a type of current discovered by Michael Faraday involving induced electrical flow from a conductor passing through a magnetic field Faradic current, the current could be applied to the body of the patient, and the muscle would contract as long as the current ran, without leaving any damage to the skin. On the other hand he noticed that with DC, the current would have to be turned off an on, with the contraction momentarily occurring with the start of current flow. The skills of a telegrapher were needed to make a muscle contract repeatedly using DC, and this was cumbersome for those who sold therapeutic sessions to the trusting and desperate, or researched the effects of electrical stimulation on the body and mind. Furthermore, Galvanic current would cause the skin to blister and pit. Because AC was easier to work with and did not have the skin problems for the patient, DuChenne, not having any idea what electricity was about, said AC was better than DC for electrotherapy. This ended the brief history of electrotherapy as a potentially powerful treatment for a wide range of disorders, including DuChenne's muscular dystrophy. For Galvani was right about one thing, animal electricity or DC, was the way the body works. DC is chemical energy, and the body is chemical, not mechanical. Discharging a battery into the body supplemented the energy of that body, and triggered chemical reactions needed for the building of tissue.^{[citation needed]} None of this was possible with AC.

The difference between the two types of current is readily apparent when voltage waveforms for the two types of current are considered. In the case of AC the waveform, when graphed as voltage versus time, is biphasic, which means that the curve of the voltage rises above and drops below the x axis, the axis for time. The area between the curve and the axis is the same above and below the axis. The area between the curve and the axis is the amperage or rate of flow of electrons. With AC the area above the x axis is canceled by negative area below the axis, so that the amount of amperage passed, no matter how long the current runs, is no more than that for any single pulse. With DC, on the other hand, the curve is monophasic, that is, the area is either above, or below the axis, but not both. Amperage is not repeatedly introduced and removed. Instead it is either introduced at the anode, or removed at the cathode. To get this effect with AC the AC must be changed into DC, or rectified.

At the beginning of the 20th century physiological researchers steeped in the understanding of electricity that informed DuChenne's abortive speculation, and prior to the understanding of the role of the electron in electricity and chemical bonding by the physical scientists, cobbled together a version of bioelectricity as ion movement since it was thought that cathode rays (as electrons were known at the time^{[citation needed]}) had no place in biology. Vitalism's place in medical science was assured by this account, which lent it superficial scientificity through the introduction of mathematics. Whereas Galvani's animal electricity has been found to be DC current, in 1902 Julius Bernstein defined a new sort of animal electricity based upon the idea of ionic currents, and, to explain the nature of this new sort of animal electricity, Bernstein called upon a thermodynamic equation of Walther Nernst devised in 1888. The equation has not a single electrical term in it, except 'volts', the term used at the time for pressure. Nernst insisted his equation was not about electromagnetism, and that the volts were not expressions of electrical pressure, but were instead expressions of entropic pressure, that is, the pressure for two solutions of different concentration of an atom or molecule or substance, to mix so that concentration was uniform.^{[citation needed]}

But biologists were not about to give up the idea that there was something magically special about life, something vital. So Nernst's provisos were disregarded, and, instead, a version of bioelectricity was institutionalized that served to obstruct understanding of the nature of energy transduction in biological systems. This version was dependent upon the idea there are such a things as Ion Currents that are analogous to an electrical current in every way, including detection, but that do not involve electrons. This bit of biological insularity, known as 'chemiosmosis'(in which mysterious proton motive forces/proton pumps do the work of electrons) is so celebrated (winning Nobel Prizes in physiology and medicine in 1962, 1978, 1991), that attempts to understand metabolism in genuine electrochemical terms are seriously impeded and rendered inconsequential, despite the potential of electrochemistry to restore the reputation of electrical medicine singlehandedly. For example, in "An electrochemical description of metabolism" [M.N.Berry, M.V.Grivell; Bioelectrochemistry of Cells and Tissues, 1995, ed. Walz, Berg, Milazzo) the authors write, "This circulation of protons is driven by the flow of electrons through the electron transport chain, but the molecular mechanism by which this driving force is generated remains unknown." A startling confession indeed despite that the driving force behind electricity has been well understood for three quarters of a century in the physical sciences.

The authors declare the "...chemiosmotic hypothesis relies on concepts of an electrochemical nature," but can get no farther than the claim what is involved is an electrochemical proton gradient. They assert there is a difference between chemical and electrical energy, with Nernst-style proton gradients providing the poorly-understood driving force behind the former, while the latter involves electron flow. Electrical energy is the same as chemical/metabolic energy, and the latter needs not to be supplemented with archaic speculations in order to span the gap between life and chemistry. This point is discussed at length in the section Galvanic Stimulation, in which the terms I and R in Ohm's Law V=IR are elaborated upon with regard to the definition of the terms and their referent value. When the equation is applied with regard to electrochemistry involving redox coupling in a biomass, i.e., the recharge of an electrolytic cell, the proton flows do not appear as a mysterious energy force or conductor, but are defined by their place in the equation.

Biological understanding of the nervous system's organization and functioning was based upon extensive electrical work by people like Sir Charles Sherrington who, knowing nothing about electricity, published a treatise on the nervous system's electrical functioning in 1906, titled Reflex Activity of the Spinal Cord that was re-printed and considered authoritative, for the next 50 years. 1906 was still two decades away from understanding on the part of physical scientists of the role of the electron in electricity, the periodic table of the elements, and chemical bonding. Known as cathode rays in 1906, the role of the electron in electrification was only beginning to be grasped. Sherrington and Bernstein could not possibly have understood electricity, and, since the neurotransmitter acetylcholine had not yet been discovered, there was just no way their work could have been even close to modeling or describing electrical or electrochemical nervous functioning. Both ideas are still taught today. Clinical neurologists still check for 'reflex arcs' in a patient before making a prognosis. The Nernst equation figures prominently in all physiological and neuroscientific textbooks, accounting for the electrical functioning of the nervous system in terms of Bernstein's animal electricity.^{[citation needed]} The belief still prevails that biological electricity is somehow special and beyond the province of the physical sciences.^{[citation needed]}

The superficiality of Bernstein's and Sherrington's accounts of the electrical functioning and organization of the nervous system were repeatedly re-enforced by the Nobel Prize Committee of the Swedish Academy of the Sciences and the Karolinska Institute. This bit of biological sophistry was possible only because of the intervention of organized medicine which saw to the stamping out of electrical medicine as quackery and hoax during the 1930s. This intervention effectively shut the door through which the life and physical sciences could have met. In 1937, the American Medical Association banished electrical medicine as something to be considered a healing modality^{[citation needed]}. In England, at Guys Hospital, a promising mode of therapy being researched and involving the use of electroplating techniques to deliver electrical charge to broken limbs, was terminated despite positive findings. In the 1940s what later became known as the Veterans Administration conducted research on hands withered from disuse following a severed nerve in the arm of soldiers wounded in action that had been repaired surgically. The technique involved what was called galvanic exercise. It was found that those who received this treatment in addition to physical therapy, restored muscle mass, strength, and use, far faster than those who received just physical therapy. The findings were noted, and filed away. The next decade one of the researchers, Ernest Guttman, even denied the findings, making the claim that no sort of electrical stimulation could affect atrophy^{[citation needed]}.

Since muscle contraction is taken to be the evidence that electrical stimulation is having an effect on the body, it is curious to find that the US Food and Drug Administration (FDA), in its regulations on electrically-powered muscle stimulators, states clearly that it has no guidance from the medical community as to what works to build muscle. Consequently, in its concern for safety, the FDA prohibits stimulators that pass more than one half of one milliampere^{[citation needed]}, in keeping with the 1855 proviso of DuChenne advising against the use of DC or Galvanic Current. In other words, electrochemistry is not allowed by FDA regulations. This is why, if an electrotherapy device has been approved for muscle stimulation by the FDA for marketing, it cannot in principle cause the chemical changes necessary for the protein synthesis that underlies muscle building.^{[citation needed]} Chemical bonds needed for the building of tissue cannot be triggered by voltage changes; they can only be triggered by amperage.^{[citation needed]}

Electrical power is the product of voltage and current flow. When electrical power is put to the patient using a biphasic voltage waveform (as with a TENS unit), power is produced through high voltage and low amperage. This is seen in TENS units that, in addition to doing nothing, do it safely, according to the FDA, by delivering a 400 volt shock that has very, very low amperage, thereby eliminating electrochemistry as a consideration. Furthermore, when DC is used, the poles are changed back and forth with each pulse so that a biphasic wave is achieved using DC, and a monophasic wave is avoided. This creates AC from DC, little or no amperage passed,^{[citation needed]} no electrochemistry, no chemical effects, no results.

Despite the gatekeeping role of organized medicine to prevent quackery, quackery still abounds in the field of electrotherapy where certificated physicians disregard lab research that shows things like functional electrical stimulation (FES) do not in fact build muscle tissue at all. These physicians advocate the use of FES for the handicapped to build muscle when, if it actually did this, it would be certainly be used by athletes, bodybuilders, orthopedists, and NASA, but it isn't. The FDA claims it has no guidance from the medical community as to what works and what doesn't, in the world of electrical muscle stimulators^{[citation needed]}. Electrotherapy should be contrasted with electrochemistry. The latter still has no place in medicine, a discipline devoted to surgery, pharmaceuticals and radiation, and noted for its ineffectiveness at treating chronic, nervous, and degenerative disorders of all sorts, including cancer.

The importance of electrochemistry for life and metabolism is clearly shown in the allometric scaling equation relating metabolic rate to body mass and metabolic efficiency, called Kleiber's Law. The equation is MR = W^(4μ-1)/4μ where MR is metabolic rate, W is mass of the organism (whether cell or whale), and μ is metabolic efficiency. μ is the ratio of the rate of capture and use of energy by organism of mass W, to the rate at which this energy is available for capture and use by that organism. The denominator of this ratio, the rate at which energy is available, is expressed in amperes. The numerator is just how many of those amperes the organism of mass W is able to capture and use to trigger tissue-building, anabolic reactions, and motor activity. μ is basically a statement of the efficiency of what is called redox coupling, where redox stands for oxidation-reduction reactions. This is an electrochemical term for the movement of electrons from an oxidation reaction to a reduction reaction, as the former gives off energy that is captured by the latter. Oxidation reactions are found in batteries, but also what characterize the connection between the stomach and the nervous system, where food energizes activity. Reduction reactions are what is triggered by the battery's power. Discharging a battery into the body to trigger anabolic reduction reactions there similar to those triggered by the nervous system, is akin then to having a second stomach, without the food. This is electrochemistry. To the extent that the exponent μ can be even slightly increased by increase of its numerator, without corresponding increase of the denominator, metabolic rate can be advanced greatly. But this option is not available to electrotherapy as currently permitted and practiced by organized medicine which has effectively outlawed the clinical application of electrochemistry.

Below an earlier author has detailed the working of TENS units and Interferential Current, the sort of thing the AMA prohibited as not medicine, in 1937, but which has crept back into the field of medicine, despite having little or no effect, because of the enduring ineffectiveness of medicine at treating pain. These modalities are poorly understood not because they have not been investigated. These modalities have been around in various forms, researched and used for decades, though without any predictable and repeatable affect. They are poorly understood and perpetuated not because of the complexity of the subject matter, but because of the poor understanding of electricity endemic to medicine and biology for whom they are a last resort.^{[citation needed]} Neurophysiological understanding of electricity is so lacking in scientific rigor, and the field so hobbled by the collegiality that prevents self-examination and criticism, that cries of quackery about electrical medicine are heard only for those who are not certificated. It is a shame that galvanic stimulation is tarred with the same speciousness.

Several different electrical stimulation devices exist, each producing different frequencies, waveforms, and effects. Electrical modalities include

1. Transcutaneous Electrical Nerve Stimulation (TENS) (the most commonly used)
2. Interferential Current (IFC)
3. Galvanic Stimulation (GS)

Transcutaneous electrical nerve stimulators (TENS)

A person may use a TENS is not a unit at home for pain relief on a long-term basis. TENS units allow the user to adjust the intensity of the stimulation; some units also allow the user to select high-frequency stimulation (60 - 200 Hz) or low-frequency stimulation (<10 Hz).

High frequency stimulation, sometimes called "conventional", is tolerable for hours, but the resultant pain relief lasts for a shorter period of time. Low-frequency stimulation, sometimes called "acupuncture-like", is more uncomfortable and tolerable for only 20-30 minutes, but the resultant pain relief lasts longer.^{[citation needed]}

Interferential current (IFC)

Interferential current is essentially a deeper form of TENS. In essence, IFC modulates a high frequency (4000 Hz) carrier waveform with the same signal produced by a TENS unit. The high frequency carrier waveform penetrates the skin more deeply than a regular TENS unit, with less user discomfort for a given level of stimulation. Deep in the tissues, the carrier waveform is cancelled out, resulting in a TENS-like signal deep under the skin.^{[citation needed]}

Anecdotal evidence suggests that the IFC units may be useful for patients who have not had relief from TENS. However, IFC devices tend to be more expensive than TENS units.

Galvanic stimulation (GS)

As a subset of Electrotherapy, a largely ineffectual field, galvanic stimulation includes what is termed electrochemical therapy (ECT). ECT is extensively discussed in the journal Bioelectrochemistry, for its effectiveness in both the destruction of tumors, and for changing the chemistry and structure of nervous tissue in the treatment of nervous disorders, in the form of transcranial electrical therapy. Although transcranial therapy is also performed using magnetic fields, the affects are minor when compared to those triggered by an electrical field, especially where regeneration and the synthesis of ATP is concerned [S.D.Smith et al., "Effects of magnetic fields on living systems", Bioelectrochemistry of Cells and Tissues, 1995, ed. Waz, Berg, Milazzo]. A 2000 paper "Insufficient scientific evidence for efficacy of widely used electrotherapy, laser therapy, and ultrasound treatment in physiotherapy," [1] by the Dutch Health Council, reports the lack of clinical research supporting the idea that electrotherapy has any affect at all, and urges the restriction of its use within the medical profession. Yet ECT researchers have noticed that both the anode and the cathode destroy tumors with astounding effectiveness. These contrasting views are compatible if the nature of electrical energy is considered.

Electrotherapy is variously described as the introduction of electrical energy to the body to achieve desired results, with those results being, for the most part, muscle building and rehabilitation. Important for understanding the ongoing history of ineffectiveness of electrotherapy to achieve muscle building, or any desirable results, for that matter, is knowledge of the nature of electrical energy. Initial entrance to this discussion will be along the lines of the history of electrotherapy [Sidney Licht, "The History of Electrotherapy," Therapeutic Electricity and Ultraviolet Radiation, ed. Sydney Licht, 1969.]

The history of electrotherapy and electrical stimulation of the body, as anything more than a novelty, began in the mid-18th century with the invention of the Leyden Jar that permitted static electrical charges, generated by a device invented in the 17th century by Otto von Guericke, to be accumulated for a vigorous shock. Benjamin Franklin experimented with the arrangement, and his method of treatment became known as Franklinism. Franklin himself judged the device creative of more pain than healing.

At the time of Franklin, Luigi Galvani, an experimenter into anatomy and life's processes, working in Bologna and Padua, Italy, observed a frog's leg mounted on metal hooks twitch when a Leyden Jar was discharged nearby, and he noted the same thing when he touched a scalpel to that leg. He hypothesized 'animal electricity' was involved, or vis viva, the fluid of life, an electrical fluid the nature of which was not understood. The nature of this electrical energy was elaborated upon in 1800 by Alessandro Volta, who demonstrated that what was involved was nothing 'vital', but instead the reaction between two metals used to mount the frog's leg, and to excise it. Volta announced the voltaic pile, what became known as a battery. The battery made possible the investigation of the effects of electrical energy on tissue.

In 1908 physical scientists agreed upon a term for the rate of flow of electrical energy, the ampere. Amperes are what the term I in V=IR represents. V is an electrical pressure driving amperes (I) along or against an impediment, R. Without R, there is no I, but there may still be a V, a pressure, causing I to flow when R is introduced. R can be a conductor then, and a load; that is, R can be a pathway for I, and R can be the resistance to the flow of I that is overcome when V is great enough. As R increases, I gets smaller, unless V is also increased, but when R = 0, V= 0. There is no I without some R.

In energy terms what is taking place is energy movement from one place to another. This is called an oxidation-reduction reaction, where energy as amperes moves from a chemical reaction that gives off energy to one that requires energy, unless this energy is lost, as it would be if R were 0. For example, in a battery chemical reactions within it, at what is called the cathode, release energy/amperes that are then available from the anode of the battery to be used to power a cellphone, for example. If the anode and cathode of the battery were touched together without the intervening cellphone (i.e., R = 0, where R would otherwise be the cellphone), then the battery quickly discharges, and the energy is lost.

The harnessing of energy given off by chemical reactions in the battery at its cathode, is termed reduction, after the sort of chemical reaction that takes energy. Oxidation or catabolism, is what gives off this energy to be captured in reduction or anabolism. The movement of amperes from cathode to anode along R is called redox coupling. The efficiency of the capture and use of energy in anabolism is expressed as a ratio of amperes captured versus amperes that escape.

Electrotherapy is based upon the idea that some of the electrical/chemical energy (amperes) given off, can be drawn off and used by the body to trigger anabolism within the body, appearing as the building of tissue or as protein synthesis, or the creation of ATP, a tiny organic molecule that acts like a capacitor, holding charge until it breaks down.

There are essentially two types of batteries, those that can be recharged (also called accumulators, or electrolytic cells), and those that can't. The latter are called primary cells. To the extent that a biological cell is like a battery, it is like an accumulator; it is an electrolytic cell. Otherwise all life would involve a violation of the first law of thermodynamics which states that energy can neither be created or destroyed, just moved around. The proliferation of biological cells is not understandable without the idea that somehow these cells can be recharged.

In what is called a biomass, the recharging of the organic molecules that would otherwise break apart and degenerate without constant recharge, is accomplished the same way a battery functions. The recharge rate of this biomass is determinate in its longevity. In an electrolytic cell the movement of ions (cations, positively charged atoms or molecules) is R in V = IR. The recharge rate of the biomass is termed its metabolic rate (MR), which is then directly related to the longevity of the biomass. The ratio of redox coupling efficiency that characterizes a biomass is termed its metabolic efficiency (ME). What this efficiency measures is the ability of the biomass to capture and process amperes. It is essentially a ratio of amperes available to amperes captured and used. ME ranges from 0 to 100%. Values at the low end reflect an abundance of energy that is lost, or else, if energy is not abundant, limited ability to capture and process what is available.

An equation relating biomass recharge rate/longevity (MR) to ME and to the size of the biomass is given in a common equation of mathematical biology. The equation is essentially MR (in watts) = biomass (in grams) raised to a power in what is termed a power law. The power, or exponent, is then (4ME - 1)/4ME. When ME is 100%, the exponent is 3/4. This is what is called Kleiber's Law which purports to show how increase in biomass translates to increase in MR, and so longevity of the biomass.

Kleiber's Law, touted by some as the reason why large creatures live longer lives, is based upon the notion that ME could ever be 100%, or even anything near that, in biology. The law is troubled with exceptions like two species of similar mass living greatly disparate life spans, e.g., birds vs. rats, primates vs. sheep. Furthermore the law, as it were, is troubled by the fact that even amongst rats those that are more massive tend to live shorter lives, not longer. These shortcomings are readily amended with allowance of the term ME to vary from 100%, a minor correction that has so far evaded the mathematical biology community.

In terms of electrotherapy then, the introduction to the body of amperes from a battery is hypothesized to increase the ME of the biomass, where the biomass is, for example, a 75 kilogram human being. The human biomass's recharge rate is its MR, with ME being essentially the ratio of energy captured and used, per calories/watts available from food sources. A 75 kg. human with a 2000 calorie/day diet who used 620 of those calories to build or maintain tissue, with the balance being lost as heat or undigested matter, would have an ME of 31%. The numbers, when interpreted with the number 1 for MR being roughly equivalent to 10 years, suggest that our 75 kg. human, operating at 31% ME, has a maximum potential life span of 88, by which time the human will have developed some sort of disintegrating problem associated with systemic functioning or cancer. If ME drops to 30%, maximum potential life span decreases to 64, and at 29% it is 47. A 1 kg. bird lives many times the life span of a 1 kg. rodent because the bird operates at an ME of around 30% while the rodent is less than 25%, meaning the rodent eats more per unit mass. If the rodent is forced to eat less (caloric restriction), its ME increases, and it lives longer.

If a battery were discharged into that person so that instead of only 620 calories being used out of 2000 consumed, anabolism was triggered as if 640 calories were used, ME would increase to 32%, and our 75 kg. primate would live to 116. If the battery were used more effectively still, increasing effective caloric intake to 660 calories, ME would increase to 33%, and potential life span would be close to a century and a half, a life span whales currently live at an ME of 29-30%, but of far greater biomass. Humans can live a significant portion of that span because of increased ME rather than increased biomass, but can live that long for fewer calories than in a single slice of bread, but coming regularly from a battery.

Kleiber's Law, when it includes the term ME, opens up the world of electrotherapy as involving electrochemistry and amperage. It models the energy relations of the cell to the organism of cells, it models basal metabolic rates to field metabolic rates, where the latter include the former, but also include the motor behavior of the organism. The organism's eating habits and activity determine the ME for itself, and that ME is the same for the organism's cells. For the electrotherapist Kleiber's Law explains how ME supplementation using battery discharge, is absorbed by things with the biomass of a cell, as increased biomass, or else lost. What this reveals is that the way to increase muscle mass is to repeatedly bombard with amperage from the anode of a battery, the neuromuscular junction. This amperage normally comes from the nervous system, the anode of the battery that has the stomach of the organism as its cathode, in essence. The nervous system delivers this charge to the neuromuscular junction to trigger contractions in the muscle. When this discharge is simulated using a battery, the muscle can be easily overloaded in less than one second (with ME for the muscle reduced to less than 25%) and, in response and over time, the muscle mass increases. Loss of muscle mass is a defining symptom of the aging process.

Despite centuries of electrotherapy, nothing has ever been wrung from it for muscle building or rehabilitation. The field is crowded with charlatans and hucksters lacking understanding of the nature of electrical energy. For example, in the U.S., the Food and Drug Administration even prohibits the marketing of electrical muscle stimulators that pass amperage. Popular but ineffective forms of electrotherapy usually involve what is called a bi-phasic voltage wave form, as with AC, that does not pass amperage, and so cannot trigger any form of anabolism. Some electrotherapy devices use Direct Current, but apply it using a bi-phasic voltage wave form rather than a mono-phasic one, that is, the poles are changed with each shock. This defeats the passing of amperage, and is similar to calories lost to heat or undigested substance when overall MR for the organism is considered, having no affect on biomass.

The history of electrotherapy is disappointingly dismal, but not unexpectedly so, given the failure of the life sciences to fathom the nature of electrical energy. This failure can be traced to the 1902 hypothesis of Julius Bernstein (discussed above in the history section) six years before the term ampere was universally agreed upon by physical scientists, that bioelectricity involved the movement of ions along diffusion gradients. Bernstein's hypothesis perpetuated the ignorance of DuChenne (mentioned above in the history section) who advised against the use of DC's amperage in electrotherapy. In the world of the physical scientist this involved mistaking R for I in V=IR. No physicist who has a had a high school course in electricity ever heard of such a thing as an ion current that was able to be measured in amperes, a term reserved exclusively for I. Yet Bernstein's hypothesis was picked up by neurophysiologists as the orthodox model of bioelectricity, and is taught today as a fundamental by tenured professors of the life sciences, the writers of textbooks, and the assorted charlatans of organized medicine who dismiss electrotherapy as so much buncombe.

Galvanic stimulation, also known as galvanic revivification, involves the discharge of a battery into the body. To achieve the maximum affect of this form of supplementation of metabolic energy,^{[citation needed]} the discharge should be delivered, transcutaneously, to the site of the neuromuscular junction, also called the motor end plate region. While open circuit voltages can be as high as 100 volts DC, the current passed should not exceed 5 to 50 milliamperes, and should be delivered in pulsed form, in simulation of the way the nervous system delivers energy to post synaptic structures, be they organs or muscles. These pulses can be as brief as 1/4 of a millisecond, and the frequency of pulses can be as high as 900 Hz. This transcutaneous delivery can be achieved using a wand, or merely immersion into water containing one of the electrodes, while the other is attached to the body outside of the water. The pulse delivered to the motor endplate region comes from the anode, not the cathode. The cathode should be allowed to corrode so that the electrical charge delivered to the body is greater than the electrical charge removed from the body by the cathode. The balance comes from the corroding cathode and the battery.

Applications and fields

Various cells in the body are influenced by electricity, these include fibroblasts, macrophages, neutrophils and erythrocytes, along with bone, cartilage, ligaments and tendons. It is believed that stimulating these cells can promote healing in injured tissue.

Electrotherapy, in the form of transcutaneous electrical nerve stimulation (TENS) is increasingly used in the management of certain types of pain, although there is still much debate regarding its actual effectiveness. Some research has reported TENS to be as much as 65% effective in reducing pain in acute injuries.

Other forms of electrotherapy include Scenar, Ultrasound (US), Pulsed Shortwave Diathermy (PSWD), Interferential Therapy (I/F), TECAR therapy, Laser Therapy and Combination therapy.

Proponents of electrotherapy argue that the different modalities affect different tissues, e.g. ultrasound affects small areas such as ligaments and tendons and has no effect on muscles. Pulsed shortwave, however, can have a therapeutic effect on muscles.

From a treatment perspective, the questions with electrotherapy are related to the type of injury (sprain, haematoma, fracture, etc.) and the stage the injury is at (acute, repair phase, remodeling phase). From that position we must decide what type of cells we want to stimulate and what is the best way to influence them.

See also

• Neuromuscular diagnostics
• Galvanic bath
• Frequency Specific Microcurrent

References and notes

1. ^ Institute of Electrical and Electronics Engineers, "The IEEE standard dictionary of electrical and electronics terms". 6th ed. New York, N.Y., Institute of Electrical and Electronics Engineers, c1997. IEEE Std 100-1996. ISBN 1-55937-833-6 [ed. Standards Coordinating Committee 10, Terms and Definitions; Jane Radatz, (chair)]
2. ^ IEEE, "The IEEE standard dictionary of electrical and electronics terms".
3. ^ Dugan, William James, "Hand-book of electro-therapeutics". F.A.Davis Company, 1910. Page 123. "[...] speak of "Tesla currents" when we really mean the high frequency currents."
4. ^ Snow, William Benham, "Currents of high potential of high and other frequencies". Scientific authors' publishing Co., 1918. page 121.

External links and articles

Further readings

• Watkins, Arthur Lancaster, "A manual of electrotherapy.". 2d ed., thoroughly rev. Philadelphia : Lea & Febiger, c1962. 272 p.
• Scott, Bryan O., "The principles and practice of electrotherapy and actinotherapy". Springfield, Ill., C.C. Thomas, c1959. 314 p. LCCN 60004533 /L
• Neuroelectric Conference (1969 : San Francisco, Calif.), " Neuroelectric research; electroneuroprosthesis, electroanesthesia and nonconvulsive electrotherapy". Editor, David V. Reynolds and Anita E. Sjoberg. Springfield, Ill., Thomas, 1971. LCCN 75115389 (ed. Selected papers presented at the 1969 Neuroelectric Conference, the second annual conference of the Neuroelectric Society.)

Websites

• Electrotherapy on the Web Tim Watson's website on electrotherapy, containing in-depth discussion and dose calculations.
• The Turn of The Century Electrotherapy Museum