GALVANIZATION — use with the medical purpose galvanic (constant, not changing in time) electric current of low tension (30 — 80 in) and small force (to 50 ma). The method and a form of current received the name by name the Italian physiologist L. Galvani , the direct electric current which for the first time found emergence in the liquid conductor (a muscle of a frog) at its connection with two diverse metals. In to lay down. the purposes the galvanic current was for the first time applied at the beginning of 19 century, but its scientific research fiziol and to lay down. actions began only in the second half of 19 century.
Mechanism of action. Electric current, including galvanic, is distributed in tissues of a body depending on sizes of potential difference and ohmic resistance in each point of a body in an area of coverage of electric field. Resistance depends on many factors and in particular on quantity in fluid mediums of a body of the dissociated ions of inorganic elements and their mobility. The largest resistance to current is shown by skin, a bone, connective tissue covers, the smallest — fluid mediums and fabrics rich with liquid — blood, a lymph, muscles. Direct penetration of current into internals is interfered by their connective tissue covers, resistance to-rykh exceeds 10 4 ohm therefore impact on them current is implemented preferential via the reflex mechanism. Dry skin has resistance about 10 6 the ohm, during the moistening, napr, during the imposing of electrodes on it with wet hydrophilic laying, its resistance goes down to 2×10 2 ohm and below and thereof current, getting through skin, has direct effect on the subject fabrics.
The dissociated ions of inorganic elements and water in fabrics move in electric field of current in the direction of the poles opposite to their charges. The colloid particles getting a charge at the expense of the adsorbed ions also take part in this movement. Speed of movement of charged particles at the same potential difference depends on diameter of particles, their valency and hydration; the largest speed hydrogen ions, monovalent potassium ions and sodium have. In cells of the tissues of body which are under the influence of electric field, the moving charged particles reach cellular membranes, and here on both sides of the last there are complex electrochemical processes of interaction of variously loaded ions: bioelectric potential of a membrane changes, arises polarization (see), the double electric layer is formed, diffusion potential is created (see. Membrane equilibrium ), trapped ions of inorganic matters are released and their activity, etc. increases. Depending on dynamics of these processes and the created ratios in ion concentration on membranes of cells there is a functional condition of excitement or oppression of cells described in the ionic theory of excitement of P. P. Lazarev (1923).
Increase in excitability of fabrics is found more clearly in a negative pole of current, at a positive pole its decrease is noted (see. Electrotonic phenomena ).
The specified physical. - chemical changes in cells and fabrics under the influence of a galvanic current are the cornerstone various fiziol, the reactions arising neurohumoral in the way. The receptors located in skin (or in mucous membranes of walls of perigastriums where by special techniques enter electrodes for G.), perceive the irritation caused by current and in the form of nervous impulse come to the relevant centers of a nervous system where answers of an organism form and transferred to effector bodies. In the place of the direct appendix of current already during to lay down. procedures are observed reflex the arising vascular reactions: under the anode erubescence, under the cathode to vasodilatation appears (generally capillaries) their short-term spasm precedes. The dermahemia keeps within several hours after. After long G. tactile and painful sensitivity of skin usually goes down. G.'s impact on neuromuscular system at the moderate density of current is characterized by short-term («fulminant») visible motor reaction at the time of inclusion and switching off of current (see. Elektrodiagnostika ); at more high densities of current there is a sensation of pain.
At an arrangement of electrodes in the head there can be reactions characteristic of irritation not only skin, but also other analyzers — flavoring (feeling of metal taste in a mouth), visual (emergence of phosphene), etc. At the transversal run of electrodes (e.g., in temples) there can be dizziness as a result of irritation of a vestibular mechanism.
A galvanic current, irritating the receptor device of skin, causes both the local, and more or less expressed general reaction of an organism. Its character depending on localization, intensity and duration of influence and from a reference functional state of an organism can be various. Under the influence of G. regulatory function of a nervous system in case of easing by her disease amplifies, regeneration of the struck peripheral nerve fibrils, regeneration muscular accelerates, epithelial and other fabrics, oxidation-reduction processes in fabrics and processes of a resorption amplify, also the lymphokinesis improves krovo-, etc. G. exerts impact and on mediator exchange: in skin under the cathode the maintenance of acetylcholine increases and activity of cholinesterase decreases respectively, the quantity of a histamine increases; in skin under the anode the quantity of acetylcholine decreases and activity of cholinesterase increases. Such changes are observed not only in skin, but also in all organism what corresponding changes in the maintenance of mediators in blood testify to. These complex processes are carried out on the anatomo-physiological bonds between receptors in skin and the highest regulatory centers in a brain (a reticular formation, limbic system, the centers of a hypothalamus and, at last, bark of big hemispheres) passing through a spinal cord and nodes of a sympathetic boundary trunk (a so-called skin and visceral sympathetic reflex on Shcherbaka). So, an example of emergence of preferential general reaction of an organism in response to influence of a galvanic current is G. of «collar area», at a cut the cardiovascular system is involved in response through irritation of cervical sympathetic nodes, blood circulation in the bodies innervated from the corresponding segment of a spinal cord including and in a brain improves, exchange processes improve.
Preferential local responses from internals arise at influence by a galvanic current on skin of hl. obr. in the field of one or together with it and the next metametr of a body. E.g., at an arrangement of electrodes on skin in a liver and the right infrascapular area G. promotes strengthening of a blood-groove in vessels of a liver and improves its metabolic function, along with it can improve also functions of heart.
Influences also a functional condition of endocrine system. So, at localization of electrodes in a zone of an arrangement of a thyroid gland its activity increases; at localization of electrodes in lumbar area (its upper part) the functional condition of adrenal glands and all sympathoadrenal system changes: content of adrenaline and noradrenaline in blood increases; glucocorticoid function of adrenal glands also changes.
Under the influence of G. also others change towards normalization, the functions broken by pathological process: phagocytal activity of leukocytes and all reticuloendothelial system increases; trophic function of the autonomic nervous system and so forth improves. The normalizing and recovering G.'s influence is shown most clearly in cases of functional frustration and is noted at use of preferential small dosages (density of current not higher 0,05 — 0,1 ma/cm 2 the areas of an electrode and duration of the procedure are no more than 15 — 20 min.).
Indications: defeats of a peripheral nervous system of an infectious, toxic and traumatic origin — a polyradiculoneuritis, a radiculoneuritis, a plexitis, neuritis and neuralgia of various localization, in particular neuritis of a facial nerve, an epileptiform neuralgia, etc.; effects infectious and traumatic defeats of c. N of page — a head, spinal cord and a meninx; neurasthenia and other neurotic states, hl. obr. in the presence of vegetative frustration and sleep disorders, hypertensive and ulcer diseases in early stages of process, nek-ry endocrine diseases (e.g., early stages of a myxedema), migraine, vasculomotor and trophic disturbances, functional went. - kish. and sexual frustration, a miositis, hron, arthritis and polyarthritis, nek-ry stomatol, diseases (with disturbance of a trophicity of tissues of oral cavity and inflammatory character), etc.
the Main contraindications for G. new growths and suspicions on them, acute inflammatory and purulent processes, disturbances of a hemostasis, a hamaturia, sharply expressed atherosclerosis, a decompensation of cordial activity, skin diseases with an extensive zone of defeat, pregnancy, individual intolerance of a galvanic current are.
Devices for galvanization
The electronic rectifier of 50-periodny alternating current of lighting network is a source of a galvanic current. The straightened tension smoothes out the filter (the block from consistently connected induction resistance — throttles and in parallel the connected tanks — condensers) and is brought to adjustable ohmic resistance — a potentiometer, the toddler to-rogo is connected to an operating handle on the panel of the device for G. Polzunok and one end of a potentiometer is connected by wires to «terminals of the patient» on the panel of the device. Current is measured in «a chain of the patient» by the milliamperemeter on the panel of the device having two limits of measurement: 5 and 50 ma; switching of the shunt is carried out at the switched-off chain of the patient. The domestic industry for local and general G.'s procedures the wall device AGN-32 (fig. 1) and the portable device AGP-33 are issued. They provide output current to 50 ma at resistance in «a chain of the patient» of 500 ohms.
Also desktop device «Flow-1» (AG-75) (fig. 2) with the same physical is issued. parameters; for stomatol, procedures — the device GR-GM. The maximum current in this device — 5 ma at resistance in «a chain of the patient» of 5000 ohms; it is completed with a set of special electrodes. The installation consisting of the device AGN-32 of the increased power with a prefix for connection of wires and four faience bathtubs for extremities is applied to procedures G. in four-chamber hydroplating baths; in each bathtub in special nests about two graphitized or baked carbons are placed. Electrodes are connected to a source of a direct current through the switching prefix allowing to establish the necessary polarity of electrodes in any of four bathtubs.
on the surface of skin apply the electrodes consisting from metal To procedures G. (lead, staniol, a foil) plates 0,3 — 1,0 mm thick (replacement of metal with conducting fabrics is possible) and multilayer laying from hydrophilic uncolored matter (a baize, a flannel, a fustian) not less than 1 cm thick; laying made of cloth shall be more metal part of an electrode on 2 cm from each party and be located between a metal plate of an electrode and skin of the patient. At vulval procedures G. use electrodes in the form of the cores from the pressed coal wrapped by a gauze. At G. areas of eyes apply special electrodes trays (fig. 3). For G. the fields of outside acoustical pass or a nose use gauze tampons, the outside ends to-rykh connect to the metal plate of an electrode located about an ear or near by. Laying or a gauze just before the procedure are moistened in warm (t ° 37 — 38 °) mains water and moderately wrung out. Electrodes are applied various form depending on the area of a body which is subject to G., the area of their from 3 — 5 to 600 cm to outside imposing 2 more. Electrodes or on the opposite surfaces of the area of a body subjected to G. have — cross either on diagonal, or on the same surface — it is longitudinal (tangentsialno). The cathode and anode electrodes can be the identical area or one of them can be the smaller sizes (a so-called active electrode). Density of current is at 1 cm 2 laying at an active electrode owing to a condensation of power lines it is bigger.
At G.'s appointment admissible current is established according to the area of an active electrode, taking into account features of the area of a body subjected to influence, and hl. obr. conditions of the patient. Procedures are carried out at the density of current ranging from 0,01 to 0,1 ma/cm 2 . Duration of the procedure is from 10 to 30 min. Repeat them daily or every other day, number of procedures on a course from 10 to 25. The course G. can be repeated not earlier than in 3 — 4 months. Repeated courses are usually shorter (prior to 12 — 15 procedures). To children and elderly procedures are carried out at the density of current reduced on 25 — 30%. To children electrodes are bandaged surely.
Before imposing of electrodes it is necessary to examine the respective sites of skin carefully. Skin shall be pure. For the prevention of substantial increase of density of current in sites with the injured epidermis (grazes, scratches etc.) they are greased with vaseline and covered with pieces of a raw cotton, thin rubber or an oilcloth. It is incompatible with the influences (physical or chemical) which are followed by irritation of skin in zones of placement of electrodes. Electrodes fix on a body bandage (rubber, linen, gauze) or sacks with sand and connect by means of the flexible, multicore, isolated wires to output terminals of the device for. Before turning on of the device the handle of the switch of the shunt of the milliamperemeter is installed according to that current, at a cut it is supposed to carry out the procedure, and the handle of a potentiometer and the shooter of the milliamperemeter shall be on zero. Current should be changed slow smooth rotation of the handle of a potentiometer. In view of the fact that at G. resistance of skin the first 1 — 2 min. usually decreases, current should not be brought to the set size at once. During the procedure it is necessary to watch feelings of the patient and indications of the milliamperemeter, without allowing exceeding of the set current.
, carried out with observance of the specified rules, usually causes a feeling of «crawling of goosebumps», an easy pricking or weak burning on the sites of skin which are under electrodes. At feeling of sharp burning or pain even on small sites of skin it is necessary to bring smoothly into zero situation the handle of a potentiometer, to switch off the device, to find out and remove the causes of adverse reactions. They can depend as on technical specifications (failure of the device, the insufficient or uneven thickness of laying made of cloth, accidental shift them and a touch of edge of a metal part of an electrode, terminals or badly isolated wires to skin), and on a condition of an organism (the general hypersensitivity to current, discrepancy of current of regional sensitivity of skin, existence of its superficial damages, etc.). At course use of G. in order to avoid a peeling of skin, emergence of the cracks which are quite often interfering continuation of treatment it is recommended to grease skin after the procedure with the lanolin or glycerin diluted with water (in equal parts). Laying after the procedure should be washed out in running water and to boil.
The main methods of galvanization
Distinguish the following main Methods.
The general G. across Vermel (fig. 4); the hl is applied. obr. at an idiopathic hypertensia, an atherosclerotic cardiosclerosis, neurosises, etc. One electrode of 300 cm 2 (15X20 cm) place on interscapular area and connect to the anode, two others on 150 cm 2 (10 X 15 cm) impose on the back side of gastrocnemius muscles and connect to the cathode; density of current 0,05 ma on 1 cm 2 , areas of laying; procedures lasting 15 — 30 min. are carried out daily or every other day according to indications, their number on a course 10 — 12.
Of a «collar» zone («a galvanic collar» on Shcherbaka); it is applied at neurosises, a hypertension, sleep disorders, migraine, effects of cherepnomozgovy injuries, etc. One electrode in the form of a collar up to 1000 cm 2 from the ends reaching subclavial area impose on nadlopatochno-cervical area and connect it to the anode; second electrode up to 600 cm 2 place on lumbosacral area (fig. 5); current, beginning from about ma, consistently through each two procedures increase by 2 m to 16 ma; duration of the procedure from 6 to 16 min., each subsequent procedure increases for 1 min. Procedures are carried out every other day, their number on a course 15 — 30.
Of a «trusikovy» zone («a galvanic belt» on Shcherbaka); it is applied at inflammatory diseases of bodies of a small pelvis, sexual frustration, etc. One electrode of 255 cm 2 (17 X15 cm) or in the form of a belt place on a waist and connect to the anode, two others on 200 cm 2 — on a front side surface of both hips also connect to the cathode (fig. 6); density of current 0,05 ma on 1 cm 2 areas of an electrode; procedures lasting from 10 to 20 min. are carried out daily, on a course prior to 15 procedures.
Of area of the person (Bergonye's mask); it is applied at neuritis of a facial nerve, epileptiform neuralgia, etc. The three-blade electrode is placed on the struck half of the face, covering a zone of an arrangement of three branches of a trifacial, and connect usually to a positive pole of the device, the second electrode of 10X20 cm in size — on an opposite shoulder (fig. 7); current is up to 5 ma; duration of the procedure 10 — 15 min., their number on a course 10 — 15.
Of area of the head (a glaznichnozatylochny technique, transcerebral G. according to Bourguignon); it is applied at a number of vascular, traumatic and inflammatory damages of a brain, etc. Two round electrodes impose on eye-sockets at the closed centuries and connect to the anode; the electrode connected to the cathode of 50 cm 2 place on a back surface of a neck (fig. 8); current to 4 ma, procedures are carried out every other day 10 — 20 min., total number of procedures on a course to 15.
«Ionic reflexes» on Shcherbaka (fig. 9); it is applied at a hypertension, neurosises, in particular cardioneuroses, a peptic ulcer, etc. One electrode of 80 cm 2 place on an outer surface of the left shoulder (anode), the second, same area — on its inner surface (cathode); current is up to 15 ma, procedures 15 — 25 min., total number on a course to 15.
Nasal technique (across Grashchenkov — to Kassil); it is applied at vascular, inflammatory and traumatic damages of a brain, a peptic ulcer, nek-ry endocrine diseases, etc. Enter the electrode consisting of the gauze turundas, skintight to a mucous membrane, moistened with warm water into both nostrils, from the ends brought to an upper lip near by, and covered with wet laying and over it a metal plate; the electrode is connected a wire to the device for G. (anode); other electrode of 8X10 cm in size is placed on a back surface of a neck in the lower cervical vertebras; current is up to 2 ma, duration of procedures 10 — 20 min., number on a course 20 — 25 (every other day).
Hydroplating four-chamber baths; are applied at arthritises, polyarthritises, polyradiculoneurites, plexites, polyneurites, etc. The patient takes seat on a screw chair with a back between the trays filled warm (t ° 37 °) water, and lowers in them hands and legs (trays for legs are established on a floor, for hands — hang on mobile brackets); by means of the switch electrodes of a bathtub connect to the corresponding poles of the device; current is up to 30 ma, duration of the procedure is up to 20 min. every other day or daily, total quantity on a course — to 15.
Lech. a method of the combined impact on an organism a galvanic current and the medicinal substances and the drugs administered with its help — see. Electrophoresis (medicinal).
Bibliography: Anikin M. M. and In and r-shaver G. S. Fundamentals of physical therapy, M., 1950; Kirichinsky A. R. Reflex physical therapy, Kiev, 1959; Liventsev H. M and Livenson A. P. Electromedical equipment, page 86, M., 1974; Taryan I. Physics for doctors and biologists, the lane with vengersk., Budapest, 1969, bibliogr.; Ulashchik B. C. Theory and practice of a medicinal electrophoresis, Minsk, 1976, bibliogr.
B. V. Likhterman, A. N. Sbrosov; Yu. Ogurtsov (tekhn.).