Remarks on the Treatment of Uterine Tumours by Electricity: Its Effect on Small Tumours
Authors: T. Keith
Journal: BMJ (1891)

Mvy soni anid I have already published in detail every case of uterine fibrous tumour whichl, to the end of 1888, was treated by us 1)r.Apostoli's metlhod.No classification of these cases iwas attempted.We could not tell if the results obtained wvere permanent, cand we knew well that many would draw lifferent conclusions from ourselves.These rouglh notes, they were taken at the time, were intended for the informationi of those wlho lhad taken up this treatmelnt later than we lhad done, and in the lhope of enabling some to avoid the rock]s on whliel we lad split.One's early work in any direction is almost certainly imperfect, anid had we to (to those same, cases over aigain, doubtless more satisfactory would be slhowni.Now, we lhave two more years' ex- perience to gui(le us, and we lhave a better idea than before of what this electrical treatment consists.The criticisms with whichl Apostoli's treatmeint has been so generally received g-ive us now no concernl.It is a good anid right treatment, a,nd must in time be recognised as such.AWe know some tlings that it cainot do, we know better what it can do.We;ire disappointed that it seems to have broken down in so manly lhands -at least, we judge this to be so from the number of patients who have come to us more or less imperfectly treatedl.So far as we can make out, the fault was on the side of thbe operator.In some, the want of tenderness of manipu- latioln in the introductioni of the internal electrode, or an ainiounf unnecessary paini caused by the currenit, or the slougliing of large pieces of skin of the abdominal wall from imperfectioni of the external electrode-a thing that cannot happen Dr.Apostoli's directions be followed-appear to be the cllief causes of an interrupted treatment.Delicacy of Iiianipulatioii, perseverance, and a knowledge of electricity in carrying out this treatment with any hope of succoiss or improvemenit to ourselves, or comfort to the patient.Prog,ress here must be slow, and thouglh it lhas on the whole beeni slow%, we are not dissatisfied.Ae have reason to believe thcat patienits tlhus treated are also satisfied withtlle efforts mnade them operation that either risks their lives, leaves them with a mutilation, abhorrent to a woman, and, besides, does not always cure them.great proportioin of our early cases were in hospital or dispensary practice.It seemed impossible to hurt these women any way.They might be seen, a dozen or more, stanidini,goutside cold wintry weatlher long before the dis- pensary door opened.The treatment was then carried on by my son, current was given to as many as twenty afternioon, and in as strong doses as could be borne.In somlle, thwe tuinouns were punctured.There was no place for these women lie dowin in.They dressed, and went their way again into the cold, and no lharm was ever done.It ainotlher thing altogether wlheni we camie to treat the luxuriously livinig, gouty, neurotic womlen of tlheb southt.It did not long to teaclh.us that these required more care.They the currenit far less well, and complained miore readily pain.As a rule, smaller doses had to be given at the expense a longer treatment.In not a single instance did thlein discontinue the treatment of lherself, never they stop; yet these same womien bear opera- mairvellously well.I have never had better results operations,