Thermotherapy

This research was presented at the largest International Pain Conference in the world in Chicago June 7-10, 2015 with Johns Hopkins, Mayo Clinic, Cleveland Clinic & Harvard.

Evaluating thermotherapy using the amethyst Bio belt and the infrared negative ion amethyst Bio-Mat

https://www.youtube.com/watch?v=k3okh08uh-s

I am currently doing research on the reduction of cancer pain using the Bio Mat. Email me for details. drgrant@rogers.com

Clinical use of Richway Amethyst BioMat Professional mat and BioMat MX
Professional 2005 MX Controller.
SUMMARY
The Richway Amethyst BioMat Professional is a IIb category medical device approved by the US Food
and Drug Administration (FDA) and is certified for use in the EU. The manufacturer declares that the
product is a source of long-wave, 5.5-12m wavelength infrared/far-infrared radiation (FIR), using
amethyst crystals that potentiate the FIR frequency up to in excess of 30 mHz and also produce anions
through ionization.
This equipment was used as supporting and alternative medical device to potentiate known and established
long term and complex intensive therapy, with a goal to use already known thermic and non-thermic
clinical effects of FIR on 6 patients (5men, 1woman). Each patient had different levels of consciousness,
different etymology (craniocerebral injury, stroke, conditions resulting from interruption of blood circulation
and cardiopulmonary resuscitation) and with advanced but different degree of central spasticity of upper
and lower extremities.
Diagnosis of 2 patients included organic psychosyndrome with psychomotor hyperactivity, other 2
patients were also diagnosed with trophic skin disorder with tendency to develop excoriation and decubitus.
Each patient used Amethyst BioMat for a total of 30 days with the following schedule:15 days of
application – 14 days break 15 days of application.
Patients with organic psychosyndrome: during first 10 days the temperature setting 35-45C was used twice
a day for 4 hours 08am-12:00noon and 8pm-12am, for remaining days temperature setting of 50-53C or
55-60C was applied according to each patients tolerance (30-60 minutes) always from 9 am and
temperature mode of 35-45C for 4 hours always from 8pm to 12am.
Patients without organic psychosyndrome: The temperature setting of 50-53C or 55-60C was used daily
according to each patients tolerance for 30-60 minutes always from 9:00am and temperature setting of 35-
45C for 4 hours always between 8pm and 12am.
Complex neurological, psychiatric, psychological and anesthesiological-physiological testing was
conducted at beginning and end of each 15 days cycle according to standard protocols of the hospital and
contracted laboratory. Indicated laboratory blood tests were expanded to include characteristics of possible
effects of FIR on systemic and cellular level.
After processing of all tests and their results, following conclusions are available:
1.Right away during the first series of therapy all patients experienced pronounced reversal of central
muscles spasticity of extremities, improvements in range of motion of affected joints and extremities. It
was possible to apply and broaden specialized physiotherapy including following verticalization.
2. At the end of first series of therapy all patients experienced less pain during manipulation- evaluated
where possible by objective reactivity parameters of patients or use of a visual range of pain.

http://www.bio-mats.com/academyofwellness/store

Evaluating the reduction of Cancer Pain using the Infra-Red Negative Ions Amethyst Bio Mat in 12 subjects over 6 months.
By Dr. George Grant, Ph.D., IMD

Abstract:

The amethyst Bio Mat was used by 12 subjects for one hour three times per week as well as using the Detox Salt during sleep daily over 6 months period. We used two different biofeedback devices to measure pain reduction, CBC 12 hours fasting blood test including WBC & HS-CRP to measure inflammation.
The Far Infrared/Negative Ions Amethyst Bio Mat reduced pain by 21% and reduced HS-CRP by 15% and reduced Stress by 52% of 12 subjects in 6 months as validated by Pre and Post Biofeedback Brain Scans as well as fasting blood test to measure the stress hormone cortisol.
Thermotherapy was enhanced when the Bio Mat was combined with the Detox salt during sleep to reduce pain and side effect of chemotherapy.

The Bio Mat technology is a combination of far infrared rays, negative ion effects and the conductive properties of amethyst channels. These three powerful health stimulators are combined in a single, easy-to-use product with remarkable healing properties. The Bio Mat delivers soothing, deep-penetrating heat while stimulating the regeneration of damaged cells in the body. Its a safe and natural way to achieve optimal health now and maintain a stronger, more resilient body in the future. The combination of the bio-belt and the bio mat is a highly effective thermotherapy available to medical professionals and home consumers who want to reduce pain, stress and abdominal fat. The Bio Mat is an approved medical device by FDA.

Objectives of the study:

Examine the Benefits of the Bio Mat using the Infra Red & Negative Ions for reducing pain in cancer patients for 12 subjects over 6 months.

The main objective of the study is to measure the reduction of inflammation, joint pain and stiffness for 12 subjects suffering from cancer over 6 months using biofeedback devices and blood tests including HS-CRP that correlates with pain & inflammation.

Methods:
12 subjects were tested before and after using the Bio Mat for one hour 3 times per week and sleep on the Bio Mat daily over 6 months. The biofeedback test for stress using ICAP Brain Scan, and the measurement for pain was done using the Bio Resonance Magnetic analyzer Biofeedback Device.
The results were reduction in stress by 52% among subjects tested and an increased sense of well being.
The pain was reduced by 21% and the HS-CRP was reduced by 15%.
All 12 subjects were tested at our clinic in Richmond Hill, ON Canada.

The ICAP biofeedback device was used to measure stress reduction. The Bio Resonance Magnetic Analyzer Biofeedback Device was used to measure pain and inflammation. Blood test including HS-CRP was used to measure pain.

——————————————————————————-
Conflict of interest disclosure: The author is not employed nor compensated by Richway International or Fuji Bio Sciences the manufacture and distributor of the bio -belt and bio mat. The company provided both the bio belt and the bio mat at no charge to conduct the case study for 12 subjects at our clinic in Toronto, ON Canada. The author has no financial interest in the company.

Subject Selection Criteria: 12 subjects who were diagnosed with cancer and experienced moderate to severe pain were selected to participate in this case study and signed an informed consent. Subjects with medical, psychiatric conditions and those with heavy cancer medications were excluded from the study.
Subjects were tested using Bio feedback Devices and blood tests before and after using the Bio Mat every week and a blood test to measure HS-CRP levels was obtained from each subject before and after 6 months at the completion of the case study.
Introduction:

The Bio Mat is a natural heating pad which lies on top of a massage table or a home mattress. It converts electricity through a computerized control panel, produced by Texas Instruments, into Far Infrared Rays (FIR), natures invisible light. FIR was discovered by NASA to be the safest, most beneficial light wave. This reduces pain, swelling, increases blood flow and reduce stress by increasing the secretion of serotonin.

The Bio Mat also produces Negative Ions, natures energizer, which deliver a molecular level massage. This accelerates and deepens all healing and cleansing processes. It balances pH by decreasing acidity and is considered the Master Power Switch which activates the body’s entire cellular communication system, making every body function work better! Negative Ions alleviate allergies, migraines and sinus problems.

These two components are transferred through Amethyst Quartz channels which cover the entire Bio Mats surface. Amethyst Quartz is natures Super Conductor, scientifically found to offer the steadiest, most powerful delivery of healthy far infrared light waves and the highest vibrational frequencies into the body.

The core of Bio Mat technology is a combination of far infrared rays [6-12 microns], negative ion effects and the conductive properties of amethyst channels. These three powerful health stimulators are combined in a single, easy-to-use product with remarkable healing properties. The Bio Mat manufactured and distributed by Richway International Inc. delivers soothing, deep-penetrating heat while stimulating the regeneration of damaged cells in the body. This highly effective therapy is now available to medical professionals and home consumers who want to improve health and well-being with products based on Nobel prize-winning scientific research pioneered by NASA and developed using pure, natural materials.
The Bio-Mat Professional is registered an FDA Medical Device #2954299.

Biofeedback devices used to measure stress reduction:

1. Quantum Resonance Magnetic Analyzer [QRMA]: measures electromagnetic waves emitted by human bodies which represent condition of cells, tissues and organs. The data is compared with standard spectrum to detect imbalances and measure stress reduction. This biofeedback device provides the stress of vital key organs and systems. Test Results provides a range of mild [0-30], moderate [30-60] and severe stress [70-100]. This correlates with DASS [Depression Anxiety Stress Scale] the International Stress Scale.

2. ICAP [wireless Brain Scan EEG]
Fig.1 ICAP Release Meter to measure stress zone
to monitor brain imbalance & blockages & Stress. The results also correlate with DASS.
The ICAP Release Meter System is made up of the EEG sensor, the signal transmitter, the USB base station that captures the signal, the proprietary algorithm that translates the raw data from the transmitter (Release Vector) and the visual representation of that data in the ICAP Release Meter software. The system also incorporates the Release Technique, a method used to retrain the brains responses. The device provides 3 distinct stress zones as well as an average stress score at the end of the measurement. A value of less than 500 indicates manageable stress, 500-700 medium stress and from 700 to 900 high stress. A value over 950 indicates extremely high stress.

3. Blood Test Results HS-CEP. Many scientists believe inflammation is a primary causative factor in many chronic diseases of today, such as diabetes, heart disease, cancer and degenerative brain disease.
C-reactive protein (CRP) is produced by the liver. This protein was discovered in 1930 by William Tillett and Thomas Francis, investigators at the Rockefeller University. They found it could be isolated from the blood of patients with a specific type of pneumonia. Later it was discovered that elevated CRP-levels can be measured in blood in response to inflammation.
The difference between CRP and HS-CRP is contained in the HS abbreviation; high sensitivity.
CRP is traditionally measured down to concentrations of 3-5 mg/L, whereas hs-CRP measures down to concentrations around 0.3 mg/L. This improved sensitivity allows hs-CRP to be used to detect low levels of chronic inflammation.

Results:

Table 1. Summary of Results:

Pain Scale 0 to 100 Blood HS-CRP mg/L [3-5]

Subject #1[Pre] 88 6.1
Subject #1[post] 68 3.5

Subject #2[pre] 76 6.5
Subject#2[post] 57 4.2

Subject#3[pre] 92 7.3
Subject#3[post] 73 5.6

Subject#4[pre] 77 6.8
Subject#4[post] 53 4.8

Subject#5[pre] 83 6.5
Subject#5[post] 37 4.9

Subject#6[pre] 79 5.8
Subject#6[post] 66 3,8

Subject#7[Pre] 75 6.8
Subject#7[post] 54 5.7

Subject#8[pre] 82 5.8
Subject#8[post] 67 4.8

Subject#9[pre] 89 5.0
Subject#9[post] 67 4.1

Subject#10[pre] 75 6.3
Subject#10[post] 65 4.1

Subject#11[pre] 74 6.8
Subject#11[post] 65 3.3

Subject#12[pre] 81 6.3
Subject 12[post] 52 3.3

Discussion:

Subject #1 [TC] male accountant mid sixty who is taking chemotherapy. He has improved after using the bio mat for 6 months with noticeable improvement in his pain and crp level.

Subject #2[NB] male in his mid-seventy suffering from pain as a result of a cancer for 5 years. He did notice a difference in pain reduction in the first 8 weeks and after 12 weeks, he reported better sleep and less pain and less stress.

Subject#3 [DL] a mid-forty female suffering from breast cancer. She had severe pain in her lymph which improved after 3-5 months test on the Bio mat. She also reported less pain and less stress as shown in her biofeedback scan, brain scan and her crp improved.

Subject#4[TS] female mid-fifty with minor cancer pain and moderate sleep problem. She reported less stress and pain after only 7 weeks of using the bio mat as well as better sleep.

Subject#5[VR] women in her early menopause that had cancer and pain. Her stress was high but felt less stress after 9 weeks of using the bio mat. She reported less hot flash, increased libido, less pain and better sleep.

Subject#6 [IK] male in mid sixty with moderate pain but no medications. He has reported less pain, better sleep and less stress after using the bio mat but his pain remained mild during the 6 month study.

Subject#7 [OL] female in mid seventy with high cancer pain but felt better after using the bio mat in 4 months. She was using pain killers but stopped taking medication after 9 weeks of using the bio mat.

Subject#8[RK] women in her early forty with no medication but moderate cancer pain & stress. Her stress and sleep habits improved dramatically in her first month of using the bio mat. Her CRP improved after 6 months of using the bio mat.

Subject#9[ID] young male in his early forty with high pain and high stress after being diagnosed with prostate cancer. After using the bio mat for 6 months, his stress level was reduced and he noticed better sleep pattern with no need for sleep or pain medication. He stopped his chemotherapy after completing the study with moderate recovery.

Subject#10[PL] female in her mid sixty with lots of pain from cancer and stress. Her stress was high with poor sleeping habits. She experienced chest pain, back pain and she had made remarkable improvement after 6 months on the bio mat.

Subject #11[CR] male in his early fifty with moderate cancer pain and very high stress and poor sleeping habits. His stress was improved after using the bio mat for 6 month.

Subject#12 [SJ] female in her late sixty who takes 2 cancer medications, pain medications and sleep medication. After using the bio mat for 6 months she felt less pain, stress and reduced her medications by half.

It appears from the above case study that the 12 subjects received above average improvement in pain reduction, stress reduction, better sleep, less discomfort and overall improvement particularly when they change also their lifestyle habits. The test results from the biofeedback devices correlated well with each other as well as with the blood test results.

Detecting inflammation can be tricky, but a marker called C-reactive protein (CRP), or [HS-CRP as measured] is released into the bloodstream by the liver when inflammation is present, and can be revealed in blood tests. Although doctors and scientists are still uncertain about the specifics around when the test should be done or who should have it, most clinicians use HS-CRP tests to monitor acute or chronic inflammation for cancer patients.

Pain is most often caused by the cancer itself. But pain can also be caused by cancer-related treatment or tests. You may also have pain that has nothing to do with the cancer or its treatment. Like anyone, you can get headaches, muscle strains, and other aches and pains.
Pain from the cancer
The amount of pain in Cancer Patients depends on the type of cancer, its stage (extent), and the pain threshold (tolerance for pain). People with advanced cancer are more likely to have pain.
Pain from the cancer can be caused by a tumor pressing on bones, nerves, or body organs.
Spinal cord compression
When a tumor spreads to the spine, it can press on the spinal cord. This is called spinal cord compression. The first sign of compression is usually back and/or neck pain, sometimes with pain, numbness, or weakness in an arm or leg. Coughing, sneezing, or other movements often make it worse. If you have this pain, get help right away. This compression must be treated quickly to keep you from losing control of your bladder or bowel or being paralyzed. The cancer care team can treat the cause of the pain and give the patrient medicine to help relieve the pain. The treatment for the compression soon after the pain begins, can usually avoid serious outcomes. Treatments usually involve radiation and steroids to shrink the tumor. Surgery can ve done to remove a tumor thats pressing on the spine, which may then be followed by radiation.

Far Infrared bio mat/bio belt increases blood circulation and oxygen supply to damaged tissues (aiding reduction of chronic joint and muscle pain or sport injuries), promotes relaxation and comfort, induces sleep and relieves stress as shown in this case study.
Recently there have been reports detailing the hazards of exposure to certain kinds of electromagnetic fields, such as those from high-tension power lines, cell phones, or from computer display terminals. Far Infrared heating systems have been tested in Japan and found free of toxic electromagnetic fields. The Swedish National Institute of Radiation Protection has also concluded that infrared heaters are not dangerous. Instead, Japanese researchers have reported that far infrared radiant heat antidotes the negative effects of toxic electromagnetic sources.

Further research is needed to elucidate the synergistic effect of using the bio mat/detox salt in several biological functions including the reduction of pain, stress, and reduction of CRP.

References:

Alberts, B. The molecular biology of the cell (2nd ed.). New York: Garland Press. 1990

Kaltsas, H. (2009). What is ionization? Retrieved February 14, 2010.

Grant, George, Ph.D. Your 101 ways to 101 Rx: Healthy, wealthy, sexy and wise, 2013. The core Publishing Group.

Grant, George, Ph.D. 101 great ways to improve your life, 2006, vol 3, Mark Victor Hansen & David Ricklan

Grant, George, Ph.D. The all in one guide to natural remedies, 1996

Grant George, Ph.D. Doctoral thesis, University of Toronto, Stress Factors affecting college educators, 1995.

Grant George, M.Ed. Thesis, Brock University, Measuring stress affecting college professors, 1992.

Grant, George Chicago International Pain Conference, June 2015. Chicago, IL USA

Jones DP. Redefining oxidative stress. Antioxidant Redox Signal. 2006; 8(9-10):1865-1879.

P.l. Piller, N Tribune Business News. (1999, September). The scientific basis and
therapeutic benefits of far infrared ray therapy. Health Food Association, 1-7.

Richardson, W. Spiritual values and gemstones. Marina Del Ray: Devorest Company. 1998.
P. F. Lovibond and S. H. Lovibond , Behaviour Research and Therapy, Volume 33, Issue 3, March 1995, Pages 335-343
http://www.cancer.org

Author’s Bio
Author Contact information and Bio:
Name:
Dr. George F Grant, Ph.D., I.M.D
Email:
drgrant@rogers.com
Website:
www.academyofwellness.com

Biography:

Dr. George Grant, Ph.D., I.M.D., D.H.S., M.Sc., M.Ed., B.Sc. (Hons.), C.Chem., R.M., C.B.S.
who is known as The Caring Doctor, is considered the Canadian authority in Integrative & Functional and Nutritional Medicine and Canadas Wellness Ambassador. He pioneered the research on Beta Endorphins at the faculty of Pharmacy, University of Sask. in 1981. Dr. Grant organized and presented at the International Pain Conference in Chicago, IL. USA June 2015.
Dr. George Grant is an International Expert in Biofeedback, Stress Management, Nutrition, Natural Pain Management, Functional & Integrative Medicine, Anti-Aging and Nutritional Medicine. He is the founder & CEO of the Academy Of Wellness in 1980.
Dr. Grants Inclusive Health philosophy encompasses preventing disease, orthomolecular nutrition regular exercise mindfulness and stress-reduction. He has helped over 7500 clients worldwide to reduce their dependency on medications, prevent surgeries and lead a normal healthy life style to 101+.
Dr. Grant believes that Prevention is better than Intervention, Self Care is better than Crisis Care and Meditation is better than Medications.
Dr. George Grant has published over 150 scientific papers and numerous poster session presentations, organized 2 International Conferences, completed 7 university degrees, have 7 worldwide patents, member of 6 advisory board of several Neutraceutical & Pharmaceutical companies, member of the editorial board of 8 International Journals, 17 fortune 500 companies, 10 nonprofit organizations and an active member of 6 professional organizations in Canada & USA.
Dr. Grant enjoys a stellar academic and a fascinating career in research. He is a specialist in functional & integrative medicine, scientist, professor, chemist, toxicologist, nutritionist, biofeedback, stress management and a natural pain specialist. Dr. Grants work has been endorsed by Nobel Laureates, Olympic Athletes, Scientists from various disciplines, Medical doctors, Integrative doctors, Pharmacists, Natural doctors, Acupuncturists, Massage therapists as well as allied health practioners worldwide.
Dr. Grant worked as a Senior Consultant for Health Canada, with MOU at FDA and CDC as well as in private practice. He has helped over 7000 clients naturally worldwide including clients at Sunnybrook hospital in Toronto to recover naturally from clogged arteries within few months.
Our Philosophy is: We care, serve and educate NOT medicate, operate, radiate and vaccinate.
We believe that prevention is better than intervention. Dr. Grant supports the upcoming health care reform which will make Integrative & functional Medicine, the primary health care system. Self-care is more effective than crisis care and will cut health care funding/costs by half by the year 2020.
Dr. George Grant has helped several key fortune 500 companies in Canada, USA and worldwide; nonprofit organizations in 7 countries; and top Olympic Athletes from Canada, USA along with 7500 clients worldwide.
Dr. Grant is an Editor of several refereed scientific journals, has over 150 published articles, over 150 conference presentations, over 180 book reviews and 10 bestselling books/ DVDs with New York Bestselling Authors.

PDF]Red Negative Ions Amethyst Bio Mat in 12 Subjects Over 6 …
medcraveonline.com/MOJCR/MOJCR-03-00055.pdf
Nov 2, 2015 – Evaluating the Reduction of Cancer Pain Using the Infra-. Red Negative Ions Amethyst Bio Mat in 12 Subjects Over. 6 months. Volume 3 … as well as using the Detoxi Salt during sleep daily over 6 months period. We used two …
Thermotherapy using the Bio Mat to Prevent Cancer | Health …
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Sep 26, 2013 – Evaluating thermotherapy using the amethyst Bio belt and the infrared …. The Far Infrared/Negative Ions Amethyst Bio Mat reduced pain by 21% and … Ions for reducing pain in cancer patients for 12 subjects over 6 months.
Evaluating the reduction of Cancer Pain using the Infra-Red …
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Evaluating the reduction of Cancer Pain using the Infra-Red Negative Ions Amethyst Bio Mat in 12 subjects over 6 months. 10/21/2015. 0 Comments. Picture.
Blog – HDRB – Holistic Doctors Recognition Board
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Oct 21, 2015 – Evaluating the reduction of Cancer Pain using the Infra-Red Negative … The Far Infrared/Negative Ions Amethyst Bio Mat reduced pain by 21% and reduced HS-CRP by 15% and reduced Stress by 52% of 12 subjects in 6 months as validated by Pre … Dr. Besrminji has been practicing for over 30 years.
Research | Biomat
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The results were reduction in stress by 78% among subjects tested and an … Evaluating thermotherapy using the amethyst Biobelt and the infrared … results of a 3 month study using the BioBelt and Bio-Mat to reduce fat, pain, … Too Hot for Cancer … (A peer-reviewed study that concludes that bright light and negative ion …
Biomat Amethyst soothing Infrared Heat Rays and Negative …
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Interested in buying the Amethyst Biomat for a patient with spinal cord cancer … Do the Far Infrared Rays (FIR) harm or heat titanium producing inflammation around the area? … Perhaps that’s where the negative ions come from? …. their baby is at least 6 months old before using the Biomat on low heat only (95F-104F) or …
BioMat Thermotherapy Medicine Overview – Dr. Sircus
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Apr 4, 2013 – Living through a bad cold/flu with a BioMat was a dream. … and have one’s body radiated with light and heat and negative ions by … Few weeks ago I published an essay on using hyperthermia and far-infrared for cancer and pain. …. the best in far infrared technology with amethyst/tourmaline crystals into a …
[PDF]Articles and Studies on Far Infrared Therapy – BioMat
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Aug 15, 2008 – 2008;47(16):1473-6. … therapy) as a new method of pain treatment in patients with FMS. … each phantom limb pain attack has significantly reduced from over 24 hours … 12 subjects were tested before and after using the Biomat for one hour … Far Infra Red/Negative Ions Amethyst Biomat reduces Stress by …
Medical Congress Scientific Program Pain …
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Jun 9, 2015 – The amethyst bio belt was used by 12 subjects for one hour three times per week as well as using the amethyst Bio Mat during sleep daily over 3 months period. … The Bio belt and the Far Infra-Red/Negative Ions Amethyst Bio Mat ….. are Post-operative pain control; cancer pain, chronic non-cancer pain;
How Does Stress Promote the Spread of Cancer?

Cancer cells typically spread to other areas of the body either via your blood vessels, or through your lymphatic system. Stress hormones affect both of these pathways or channels. Here they were trying to determine how stress hormones affect the spread of cancer cells through the lymphatic system.

The mechanism they found is related to the way adrenaline activates the sympathetic nervous system (SNS) to increase the rate of lymph formation. Adrenaline also causes physical changes in the lymph vessels, allowing cancer cells to migrate into other body parts at a faster rate.

When it comes to improving your health, some of the simplest strategies can have a tremendous impact. For example, did you know that exposure to extreme temperatures can serve as a catalyst to improve your health?

In a previous interview, biological scientist Rhonda Patrick, Ph.D. discussed the importance of mitochondrial function a topic she expands on in this interview. As it turns out, exposure to extreme temperatures, be it hot or cold, actually improves mitochondrial function.

Mitochondria are the energy generators in your cells. While you have about 35 trillion bacteria and as many cells in our body, you have about 500 to 1,000 times more mitochondria. Estimates suggest you may have anywhere from 15 to 50 quadrillion mitochondria.

When your mitochondria are not working properly, your body’s ability to generate energy is impaired. The key is to get the old ones out and to create new ones a process known as mitochondrial biogenesis. There are a number of strategies that can do that, including:

Exposure to extreme hot and cold temperatures
Exercise
Intermittent fasting or time-restricted feeding
Certain supplements, such as resveratrol
All of these strategies stimulate the peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (PGC-1 alpha), which is the primary driver for mitochondrial biogenesis. And when it comes to maintaining biological functioning and good health, the more mitochondria you have the better.

Mitochondrial Biogenesis Benefits From Hormesis

According to Patrick, exposure to extreme cold is likely the most effective way to boost mitochondrial biogenesis, followed by exposure to heat, and exercise.

All of the strategies listed above place stress on your body, and while stress is generally viewed as a detriment to health, short bouts of stress actually produce benefits by way of hormesis.

Hormesis refers to a process of exposing your body to a very short burst of stress, be it exercise, heat, cold, fasting, or antioxidants like resveratrol.

Because it’s a short burst of stress, your body reacts to this stress by activating a variety of stress response pathways that are hardwired and encoded in your genes. As explained by Patrick:

“It turns them on because they’re thinking, ‘I’ve got to prepare for war. This is stress. I need to make sure I fight this off.’ Not only does it activate all these really good pathways to fight off the stress you’re dealing with immediately, but it is preparing for future war.

[Your body] is basically thinking to itself, ‘I may encounter this stress again. I have to activate all these good pathways that can help me deal with stress. That way, the next time I encounter it, I’m ready to fight it off.’

That’s really one of the main reasons why short bursts of stress are so good for you, because we have so many amazing genes in our body that are so powerful. The problem is that as we age, they don’t become activated as often. We need to find ways to activate them more …”

Benefits of Heat Stress

Exercise is one form of heat stress, as you’re elevating your core temperature. Other ways of raising your core temperature include taking a hot bath, or using a steam room or sauna. The heat stress generated helps activate genes that are important for optimizing heat shock proteins (HSP) inside your cells.

This is important, as these proteins get damaged with time and need to be renewed. Accumulation of damaged HSP can lead to plaque formation in your brain and/or vascular system.

Heat stress helps prevent this adverse chain of events. HSP are also involved in longevity, so it’s really good to have a lot of HSP. They’re also important for preventing your skeletal muscle from atrophying, because they prevent proteins from being degraded.

“Animal studies have shown that when mice are exposed to the sauna they increase their protein synthesis by 30 percent compared to the mice that are not being exposed to the sauna.

This was shown to be dependent on the heat shock proteins, HSPs, in the muscle. The important thing here is the actual heat stress. You want to feel uncomfortable. You want to feel hot. That’s when you know that these good pathways are getting activated.

The other thing that happens in terms of mitochondrial biogenesis and the reason why it occurs when you’re exposed to heat, is that heat itself is a stressor on the body and it creates reactive oxygen species (ROS).

[ROS are also] generated when you exercise; when you’re causing your body to work more. These ROS act as a signaling molecule to make more mitochondria.

If you exercise and take a supplemental vitamin E or something that can sort of soak up the ROS, you can negate some of the positive benefits from exercise because you are now not getting those signaling molecules saying, ‘Hey, we’ve got stress here. Let’s make more mitochondria to deal with the stress.’

It’s really important that you actually have some of that stress. That’s part of the mechanism by which it increases mitochondrial biogenesis.”

How Heat Stress Benefits Athletic Performance

Heat stress can also help boost endurance in athletes a topic she covers more in-depth in her Hypothermic Conditioning Report, available for free download here.

In one study, athletes who spent 30 minutes in the sauna after their workouts, two times a week for three weeks, were able to increase the time it took for them to run until exhaustion by 32 percent, compared to baseline. As noted by Patrick in her report: “In other words, hyperthermic conditioning through sauna use doesn’t just make you better at dealing with heat; it makes you better, period.”

But how exactly does heat boost athletic endurance? First of all, heat stress causes a number of adaptations that reduce the adverse effects associated with elevated body temperatures. This includes:

Reduced heart rate
Lower core body temperature during exercise
Higher sweat rate and increased thermoregulatory control
Increased plasma volume, which optimizes blood flow to your heart, muscles, skin, and other tissues
Reduced rate of glycogen depletion due to improved blood flow to skeletal muscle
In short, being heat acclimated helps enhance endurance, and there are three different mechanisms at work here:

By increasing plasma volume and blood flow to your heart, it reduces cardiovascular strain and lowers your heart rate during exercise
By increasing blood flow to your muscles, more nutrients such as glucose and oxygen are delivered, thereby reducing fatigue. According to Patrick, hyperthermic conditioning can reduce muscle glycogen use by as much as 50 percent
By improving thermoregulatory control and increasing sweat rate, your core body heat can remain lower even during high exertion. Once you’re heat acclimated, sweating occurs at a lower body temperature than previously, and you sweat longer
How Heat Stress Benefits Your Brain

Heat also has very robust and profound effects on your brain. Your body responds to heat by cooling itself down, and it does that by increasing production of dynorphinthe chemical opposite of endorphins. However, dynorphin sensitizes your brain to endorphins, which can have a mood boosting effect. Dynorphin is responsible for that dysphoric feeling when you’re hot, when you’re lying in the sun, or when you’re exercising.

“I think what’s really important for people to understand is everyone’s always trying to avoid stress. They want to be comfortable. I think the reason for that is people are aware of the fact that chronic stress is bad. When you’re constantly having a stressor, you don’t have this positive hormetic response to it …

But the short burst of stress is really good … It has this feedback mechanism where it increases the expression of a receptor that binds to endorphin, called the mu opioid receptor. You make more of these receptors. That way, the next time you produce endorphin, you’re more sensitive to it … So you actually can relieve anxiety,” Patrick says.

The ROS generated when you’re exposed to heat also benefits your brain by increasing production of growth factors, such as brain-derived neurotrophic factor (BDNF), which in turn promote the growth of neurons. With age, neurons are lost in many brain regions, and sauna bathing can be an important strategy to slow down or prevent brain aging.

Sauna Bathing Is Good for Your Heart

Heat also has a profound effect on your heart and cardiovascular health. A Finnish study published last year found that men who used the sauna two to three times a week had a 27 percent lower death rate from heart disease and a 24 percent lower all-cause mortality rate compared to those who only used the sauna once a week.

Men who used it four to seven times a week had a 50 percent reduction in death from heart disease, and a 40 percent reduction in all-cause mortality. So there’s a clear dose-dependent response, meaning the more frequently you use the sauna, the greater the beneficial effect. These heart and cardiovascular benefits are related to the fact that when you get hot:

Your heart rate increases, just as during exercise
Your blood vessels dilate
The smooth muscle cells that line your blood vessels relax
Temperature matters, of course. In this study, they used the traditional hot, dry Finnish sauna. The temperature averaged 79 degrees Celsius (174 degrees Fahrenheit), which is extremely hot by most standards. The duration was typically 20 minutes or longer. Infrared saunas and steam rooms operate at lower temperatures, so the outcomes might not be identical were you to compare them. Still, heat that isn’t as extreme will provide similar benefits.

Benefits of Cryotherapy

As with heat, the rationale for exposing yourself to very cold temperatures also has to do with the benefits associated with hormesis. You may have heard that cold temperatures can help you burn more body fat, and mitochondrial biogenesis is directly involved in this process.

When you’re exposed to cold, your body increases production of norepinephrine in the brain, which is involved in focus and attention. It also improves mood and alleviates pain, partly because it lowers inflammation. You can increase norepinephrine two-fold just by getting into 40-degree water for 20 seconds, or 57-degree water for a few minutes.

While best known as a neurotransmitter, norepinephrine also acts as a hormone. One of its functions is causing vasoconstriction, which helps your body conserve heat. Norepinephrine also acts as a signaling molecule to make more mitochondria in your fat tissue (your main energy reserves), and a byproduct of energy production is heat.

This also helps prepare you for the next time you’re exposed to cold. The more times you’re exposed to cold, the more mitochondria you make in your fat cells and the better you can withstand lower temperatures. This is a topic Dr. Patrick covers more in-depth in her cold shock report, available for free download here.

So yes, you do “get acclimated” to colder temperatures with time. Wim Hof, aka. “The Iceman,” is a perfect example of this. He’s exposed himself to cold on a daily basis for decades. As a result, he’s now able to withstand the cold for much longer periods than one might consider normal, because his body can generate more heat. As explained by Patrick, “The more mitochondria you have in your fat, the more fat you’re burning, the more heat you can make, the longer you can stay in the cold.”

The Hormesis of Cryotherapy

As mentioned, when you expose yourself to heat, you make heat shock protein. When exposing yourself to cold, in addition to increasing norepinephrine you also make cold shock protein, known as the RNA-binding motif 3 or RBM3, in your brain.

This is another intriguing example of hormesis. Interestingly, when you’re exposed to cold, you actually degrade synapses (the connections between neurons), but RBM3 completely regenerates them. This has been shown in hibernating animals like bears and squirrels.

“There’s this really great study that was published not long ago that showed when you take a mouse genetically engineered to get Alzheimer’s disease and expose it to cold, so that it’s increasing RBM3, it delays the onset of Alzheimer’s. Even though they were genetically engineered to get Alzheimer’s disease, they get it much, much later,” Patrick says.

Studies have also been done on human cells, showing that RBM3 does get activated when the brain cells are exposed to cold, and that the temperature change needed is only about 1.5 degrees Fahrenheit. More research needs to be done, but preliminary work such as this suggests cryotherapy (cold treatment) could have a neuroprotective effect.

Caveat: Avoid Cryotherapy Directly Following Strength Training

There is one important caveat worth mentioning. When you’re doing strengthening exercises you generate ROS that help increase muscle mass. If you expose yourself to cold within the first hour after strength training, you suppress that beneficial process, so avoid doing cold immersion (such as a really cold shower or ice bath) immediately after strength training.

On the other hand, spending some time in the sauna after exercise may actually help increase muscle mass. It’ll also help with detoxification, allowing you to sweat out toxins that can wreak havoc on mitochondrial function in general. As explained by Patrick:

“This is what’s important to understand Exercise is a stress on the body. You’re making reactive oxygen species. You’re generating inflammation. But that’s a good thing because it’s a short burst, and you want it.

… There’s a one hour timeframe from the time you stop exercising [in which inflammation peaks]. That is the stressful period. But then as soon as an hour hits, the stress response kicks in and you start to have a potent anti-inflammatory [response]. You start having an antioxidant response from activating all these good genes that stay activate for a long time.

What happens is that because the cold also is causing an anti-inflammatory response, it’s important that you don’t get that anti-inflammatory response too soon, because you need some of that exercise-induced inflammation. You want that inflammation to happen to get the anti-inflammatory response. That’s important for the strength training.

The inflammation you generate during the strength training is part of the mechanism for making more proteins in the skeletal muscle. If you blunt that, then you’re going to blunt the effects of the strength training. The question is then can you do it an hour or two hours later? Studies have shown, yes, you can do cold exposure, cold water immersion and actually get some performance enhancements even from doing [that].”

Listen to Your Body

While sauna bathing and cold water immersion are generally safe, if you have any sort of medical condition, discuss it with your doctor beforehand, since both hot and cold put stress on your heart and cardiovascular system. Also listen to your body. Individual tolerance for hot and cold temperatures vary widely, and if you push it too far you can do yourself harm.

Cryotherapy tends to be a bit riskier than sauna, which is typically very beneficial for people with cardiovascular-related diseases, courtesy of the vasodilation and increased blood flow. Cold causes acute vasoconstriction, which can be potentially dangerous if you have a heart condition. A quick cold shower would probably be okay, but avoid ice baths or other extreme cold water immersion techniques.

“With that said, in general it’s really, really good to listen to your body. You need to recover from the stress; otherwise it’s not going to be beneficial,’ Patrick says. ‘If you’re exercising all day, every day, you’re going to die. You can’t constantly keep stressing your body without a recovery period, which is part of the reason why sleep is so important for recovery, you repair all this damage that you generated throughout the day.

I tend to push things to the extreme. I’m getting better with that now. But I have experienced, with myself, when I’ve sat in an ice bath for several minutes, I start to feel light headed. I shouldn’t be feeling light headed. That’s enough. I need to get out. The same with the sauna. Feeling uncomfortable is good.

You want to push a little bit past that comfort and feel a little uncomfortable. That’s important for some of the hormetic benefits. But you don’t want to faint. Also, never drink alcohol in the sauna.”

More Information

You can learn more about hyperthermic conditioning, cryotherapy, and cold water immersion via the free reports by Patrick.She also has a podcast where she interviews health professionals and scientists on a variety of topics related to health.

I regularly listen to her programs as they’re always packed with great and usable information. On her website, you can find many videos on a variety of topics in which she summarizes key information in clear and easy to understand layman’s terms. You can also sign up for her newsletter, in which she publishes longer, heavily referenced articles and special reports.

2016 Total Health Show Presentation, Toronto, ON Canada:

Preventing Cancer using the Amethyst Infra Red Bio Mat.
http://www.totalhealth.webcast.guru/s1-pr2erles/

http://www.bio-mats.com/academyofwellness/store

Infrared Light Irradiation on Retinal Artery, Vein Blood Flow & Atherosclerosis-inducing Factors
January 10, 2018 in Alzheimers, Cardiovascular Health, Diabetes, Type II, Home, Home Slider
In this small pilot study, published in Integrative Medicine Research (Dec. 2017), researchers evaluated the influence of pinpoint plantar long-wavelength infrared light irradiation (stress-free therapy; SFT) on chorioretinal hemodynamics (retinal artery and vein blood flows) as well as its influences on atherosclerosis-inducing factors (triglycerides; TG, low-density lipoprotein cholesterol; LDL-C, high-density lipoprotein cholesterol; HDL-C), and vascular endothelial growth factor (VEGF) in patients with dyslipidemia.

In previous studies, it was reported that SFT suppresses the stress reaction mediated by cortisol and and contributes to alleviation of insulin resistance and elevation of intracranial blood flow in patients with type 2 diabetes mellitus (DM). And, the same researchers demonstrated that SFT activates the immunoresponsive CD19+ CD24hi and CD38hi B-reg cell groups and induces the expression of IL-10 on lymphocytes.

It has been reported in recent years that the risks for vascular dementia (VD) and Alzheimer disease (AD) onset are high in patients with diseases such as dyslipidemia, hypertension and diabetes mellitus (DM). It is also known that insulin resistance and hyperinsulinemia, which are problems associated with type 2 DM, can induce low insulin levels in the central nervous system which are closely associated with the onset of AD through reduction of cerebral blood flow, accumulation of amyloid-β, phosphorylation of tau protein and so on. In addition, diabetic retinopathy is known to be associated with abnormal VEGF expression and AD.

Infrared Light Irradiation Methods
This study involved 4 untreated patients with dyslipidemia (3 men and 1 woman; mean age, 54.8  13.5 years) and 4 healthy volunteers (2 men and 2 women; mean age, 48.8  9.7 years; undergoing only placement of a probe without irradiation) serving as SFT controls.

Irradiation for SFT was applied to 4 points in total, including the point of intersection of the vertical line of the medial malleolus with the line joining the first and second metatarsal bones of the planta, the right and left orbital foramens and the depressed point one finger breadth above the center of the line joining the medial ends of the eyebrows (the latter 3 points were selected in view of increases in chorioretinal blood flow).

IMAGE 1

Infrared Light Therapy

The maximal effect was obtained via 15 minutes-treatment. Changes in blood flow to the facial artery were analyzed using a laser Doppler flow meter (Advance ALF 21) in a similar manner as a previous report (Laser Therapy 24,1:27-32). Three SFT sessions were applied to each participant at a frequency of once per week. See FIGURE 1 BELOW

Infrared Light Therapy Blood Flow

Results
In all 4 patients with dyslipidemia, LDL-C had been higher than normal before SFT (151.3  4.9 mg/dl) and decreased to 131.5  9.1 mg/dl after SFT. TG was 309.3  154.4 mg/dl before SFT and decreased to the normal range after SFT (154.8  30.5 mg/dl) (Table 1). HDL-C showed no marked change, remaining within the normal range. VEGF rose after SFT in cases in which levels before SFT had not exceeded the upper limit of the normal range of 38.3 pg/ml, while it tended to decrease after SFT in cases in which levels before SFT had exceeded the normal range. SEE TABLE 1

Changes in LDL from Infrared Light Therapy In the analysis of fundus chorioretinal circulation (retinal artery and vein blood flows), the laser speckle flowgraphy (LSFG-NAVI) images revealed enlargement of the red area (showing fundus chorioretinal blood flow) and increases in vascular diameter and blood flow (the areas marked with white circles) See FIGURE BELOW.

fundus chorioretinal blood flow

The results of this study suggest that SFT, i.e. irradiation delivered to frontal points, reduces TG and LDL-C levels to within the normal ranges in patients with dyslipidemia, accompanied by increased chorioretinal blood flow and normalization of VEGF, raising the possibility of SFT contributing to the normalization of atherosclerosis-inducing factors. Our results suggest that SFT for dyslipidemia reduces TG and LDL-C levels, enhances chorioretinal blood flow and promotes the normalization of VEGF levels, thereby contributing to the normalization of atherosclerosis-inducing factors and, ultimately, the prevention of atherosclerosis.

The researchers noted that further studies are needed to show whether the effect of the SFT on retinal blood flow is just temporary or long lasting persistent and that imaging other than laser speckle flowgraphy may present better visual data.

 

History of Thermotherapy:

HEAT HAS been used to appease aches and pains ever since man first experienced what the heat of the sun could do for him. Sigerist (137) called the use of heat in therapy instinctual. Of the many therapeutic agents used in ancient times, few have been used as continuously through the past into the present, and except for exercise, none has continued to be used more extensively and in more different forms than heat. Heat is generally available, relatively inexpensive and safe, and, when effective, gives almost immediate and obvious relief. In cool climates, heat has always been a comfort, and even in warm climates the people have exposed themselves and their children to the sun. This once may have had a religious or other significance, but heat was the immediate and desired experience.

Heat has always been available where the sun shines or wherever dry sticks could be rubbed together. Since dry sticks were difficult to find in wet weather, many ancient tribes kept a fire burning at all times. According to Frazer (63), this was the probable origin of the “Eternal Flame”.

In many parts of the world, warm to hot water springs from the ground, or there is sand which heats only too rapidly in the sunshine. Although all these forms of heat are available free, they are not freely available, and man had to learn to make heat artificially. In so doing, he not only supplied heat for cooking and comfort, but he burned himself. He soon learned to fear and respect the destructive as well as the comforting attributes of fire. Artificial heat was first used therapeutically to burn. The word cautery comes from the Greek word to burn.

Many primitive peoples exposed their persons to fire to drive out the demons of disease. For some it meant applying the smoldering plant materials to the skin in tiny bonfires (moxa); in others it was as dramatic as walking over glowing coals (63). It was an easy step from contact with combustion to cautery with heated metal, a procedure which has been used in some form by surgeons of all eras. Since the earlier methods of producing heat for medical applications were sometimes the same as those for cautery, and since some methods used in therapeutic heat entered medicine through the doorway of the cautery, it will be mentioned briefly.

THE CAUTERY

Fire production was one of man’s first inventions, and there was something magical about it. The open flame has remained a thing of wonder and fascination. From the beginning it had been associated with religious ritual and the healing arts. People still “light a candle” with a prayer for improvement in health. Fire was used by many tribes to exorcise the demons of disease. Fire could be applied as a glowing coal or moxa 2. Those tribes which learned to smelt and work iron used the red hot iron instead of burning leaves, but in regions where metal was scarce, the moxa was used until recent times. The magic of the cautery was enhanced in ancient times by the use of special preparations. Some physicians insisted that it be made of gold or bronze, or fig wood (88).

The oldest written record of the use of the actual cautery may be found in the Edwin Smith Papyrus 3 (29) which is believed to have been written about 3000 B.C. 4. Next in antiquity to the Egyptian medical writings are those of Asia. The ancient Hindus regarded Charaka as the highest authority in medicine and Sushruta as the highest in Surgery. Sushruta said that caustic is better than the knife, and the cautery 5 is better than either (78).

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2 The moxa of the last century was imported from Japan where the cottony down of the wormwood plant was rolled into a cone and placed on the skin. The tip of the cone was ignited and smoldered slowly. The burning produced a pain “which often resulted in a most salutary change in chronic illness.”

3 “One having tumors with prominent head in his breast, and they produce cysts of pus. An ailment which I will treat with the fire drill.” The fire drill or fire stick was an improvement on rubbing two sticks to produce fire.

4 At a later period the Egyptians and others in North Africa saw a great vogue in the use of the actual cautery. A wooden handle was mounted wi th a steel rod which was brought to red to white heat over a coal fire. The end of the rod was rounded into one of many designs which by the end of the nineteenth century had dwindled to five: the rose, the cone, the disc, the octogon and the lancet. There were three ways of applying the cautery: the objective, in which the hot metal was brought close to the part without contact; the transcurrent, or very brief contact; and the inherent, in which the contact was more than momentary. It was used after the bite of rabid animals or poisonous snakes, in gangrenous inflammations, to stop hemorrhage, after ligation and compression had failed, and against ulcers, cancer and other tumors (88).

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Asiatic medicine did not have much influence on Greek medicine, but one of the things the two did have in common was the cautery. Hippocrates was not only the best known of the ancient Greek physicians, he was also the strongest advocate of the cautery among them. He used it in many conditions, and his aphorism that fire will succeed where all other methods fail was a guide for many centuries after, especially among the Arabs. Hippocrates treated epilepsy by applying the cautery to the head. He also used it in phthisis 6 to ward off irritation in the early stages or to procure a favorable exudation in lung suppuration (88).

In ancient times the heat most often used by physicians was the actual cautery. It was used principally for surface lesions, especially swellings which were chronic, for by definition, swellings which went away by themselves were called abscesses (abcedere- to go away). Intense heat in the form of boiling water was also used as a vesicant. Almost every important physician of ancient times used the cautery. Thus in 1598, when Fienus (61) of Antwerp wrote the first book on the subject, he was able to list 66 authors who had written on the cautery before him. He wrote this lengthy treatise because he considered the cautery useful although difficult and dangerous. He felt that too few physicians of his time were adequately informed on the subject. Although he used a lens 7 to cauterize a lip cancer, he insisted that “fire is the most effective and active of all cauteries.”

Ancient Greek and Roman medical writings were kept from oblivion during the dark ages by the Arabs. Thus it is no surprise that Albucasis regarded the cautery highly (96). The Arabs used it in empyema, liver abscess, rectal ulcer, fistula and prolapse. Mohamet, the religious leader, was an amateur practitioner of medicine. His medical philosophy consisted of a trinity of treatments: honey, scaritication and cautery. He stopped hemorrhage in one Sad ben Maaz with cauterization (91).

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5 The actual cautery of the Hindu practitioners was applied in several forms: substances in a state of combustion, boiling fluids, heated metallic bars or probes. Often, the metal applied to the body had fanciful shapes such as the form of the rose apple, or a serrated trident. Such instruments were used to destroy surface growths. Live charcoal was applied to the bite caused by a serpent (149).

6 Celsus went much further with the .cautery in phthisis. Be wrote that in severe cases, an artificial ulcer should be made with the hot iron under the chin, another on the neck, two each on each breast and an equal number at the tips of the scapulae. Laforgue Sainte Rose characterized this treatment as a “cruel practice”. However, it is questionable whether Celsus ever did this, since, although we have proof that he was an informed writer, we have none that he ever practiced medicine.

7 The heat concentrating powers of the lens were known for a long time. Aristophanes wrote of burning glasses prior to 420 B.C. (2). Pliny wrote, “I have read that some physicians believe the best cautery is a crystal ball through which the rays of the sun have passed” (12).

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The actual cautery was used to stop bleeding until compression and the ligature became more widely used after the recommendation of de Mondeville in the fourteenth century. Although the cautery continued to be popular with the people 8, its acceptance by physicians fluctuated. Thus in 1751, Lafaye (67) decried the diminished use of the cautery among surgeons. Larrey and Dupuytren restored its popularity among surgeons by recommending it against virus, poisons, tumors and gangrene; Percy used it for rheumatic pains. Heated metal remained the most widely used form of cautery, but the burning lens 9 was not completely displaced until electricity entered the field, about 1850.

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GALVANOCAUTERY

Within a very short time after Volta’s description of the electropile (144) interested experimenters were using it in a variety of ways. Vauquelin (3) passed the newly created current through iron wire and reported that it became red hot. Even though Davy generated great light and heat with the carbon arc a few years later, the heat potential of the electric current was not given serious consideration 10 until about the fourth decade when Recamier and Pravaz began to use it to destroy 11 uterine cancer 12 which in a few years became so widely used for that purpose that Pichard (115) called attention to its overuse.

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8 As late as 1856, Chrestien (38) wrote, “The use of the cautery is so widely accepted that many people apply it without consulting a physician.”

9 Baptiste Porta had favored the lens (136), but the writings of Faure (60) gave it its greatest impetus. A generation later, Bertrand (13) said that it was sometimes preferable to the moxa or hot iron, and this is readily understandable since its action was slower, thus more easily controlled and less likely to result in deep scars.

10 In 1847, Richet (121) wrote that electricity could not be considered as a source of heat. The word electricity was used in the nineteenth century to refer to the static form.

11 The first use of the galvanic current was for its caustic rather than its thermal cautery effect. Scudamore was apparently the first to note that the blood could be coagulated by electricity. In 1831 it occurred to Guerard that he could obliterate aneurysms by coagulating the blood in them, but it was not until 1846 that Petrequin of Lyon actually succeeded in doing that. In 1837, Clavel had proposed electric coagulation of aneurysm in his doctoral thesis (28).

In 1846, Crusell of Russia used galvanocautery for urethral stricture and two years later destroyed a fungoid growth of the face with it. (He took daguerreotypes before and after the operation (April 22, 1847), certainly one of the earliest uses of clinical photography.) In 1850 John Marshall used galvanocautery to close a salivary fistula (98), and two years later Hilton and Nelaton destroyed erectile tumors with the electric cautery. Sedillot (135) claimed that he had reported on that procedure in 1849.

In 1851 Marshall proposed its use with an electrode made of a porcelain olive wound with platinum wire. Middeldorpf used a platinum loop, and in 1862 SerE developed the galvanic knife which Boeckel perfected in 1873 (21).

12 Becquerel (12) credited Fabre-Palaprat (58) with having first burned tissue puncture with an electrified platinum needle in 1830 (100). Petrequin claimed priority and admitted that the idea came to him after reading Sarlandiere’s book published in 1823 (55).

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In 1851 there appeared an article in Lancet in which Harding described a test on nerve pulp with the galvanic current. This set Middeldorpf of Breslau to work on the destruction of tissue with electricity which resulted in the classic, Die Galvankaustic, published in 1854, that eventually led to the introduction by Paquelin (96) in 1875 of the galvanic thermocautery. An important development of this instrument was its reversion to one of the first uses of the actual cautery-hemostasis. Skene (139) adapted the hot iron cautery of Thomas Keith which he touched to the compression clamp placed on the pedicle containing a bleeder 13. In 1913 Jacobaeus (77) first cauterized adhesions through a thoracoscope and opened the field to cauterization of structures in closed cavities. The cautery continued for some time to be used in most conditions previously treated with the nongalvanic instrument. De Lamballe and later Valleix recommended the sweep of burning irons over the skin for the treatment of neuralgia 14.

HIGH FREQUENCY CAUTERY

In 1842 Joseph Henry (147) suggested that the phenomena accompanying the discharge of a Leyden jar included oscillation, a conclusion at which Helmholtz arrived in 1847 (79). In 1853 the Danish physicist Feddersen, by means of mirrors turning at great speed, showed that Henry had guessed well. Soon after, William Thomson (Lord Kelvin) established the theoretical considerations of high frequency currents, and in 1886 Hertz 15 in Hamburg showed that an oscillating current could be produced in a sustained manner and transmitted with the speed of light (73). Within the next few years, Tesla, an engineer in America, and d’Arsonval, a physician physiologist in France, were working with methods of producing high frequency currents. Each suggested their use in medicine but neither for elevating tissue temperature at first 16. In 1893 Oudin (107) modified the circuit suggested by d’Arsonval by adding a resonator, which markedly increased the voltage. With the augmented voltage he tried to destroy 17 the lesions of psoriasis. Riviere was the first to use the Oudin current on skin cancer in 1900, but the voltage he used was too low to destroy cells. For the rest of his life Riviere battled for recognition of his priority 18 with de Keating-Hart who first applied the spark to destroy tumor tissue and demonstrated the procedure at the International Congress of Electrology in Milan in 1906 (151). While the great battle of words was beginning in Paris, Finley R. Cook in New York accidentally short circuited the current from a static electricity machine through his fingers with resultant tissue destruction. This gave him the idea of treating small tumors with the spark of static electricity, and he published his findings (43) unaware of the work begun in France.

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13 “While thinking of an improved way to heat the clamp, my attention was
drawn to the use of electricity in heating laundry smoothing irons. It then occurred to me to adapt the same heating power to surgical instruments such as the clamp and forceps.” He used 10 to 35 watts of electricity.

14 A treatment which persisted for so long that it was demonstrated to this writer when he was a senior medical student in 1930.

15 In 1871 von Bezold published his findings on the alternating aspects of the electric discharge. In 1881, Ward and Spottiswoode produced an oscillatory current of 6000 cycles per second with a spark gap. Oliver Lodge carried out experiments similar to those of Hertz independently and at about the same time.

16 The priority controversy was kept alive for a long time (27). D’ Arsonval published his first article on the subject in February 189l. Tesla’s first article appeared on May 23, 1891. Tesla’s apparatus was superior to that of d’ Arsonval.
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All these applications gave relatively superficial tissue destruction, and Doyen sought a method which would give deeper penetration than the fulguration of de Keating-Hart. Doyen believed that normal cells could withstand a temperature of 60 C but that cancer cells would die at a temperature of 55 C (54). He tried to heat tissues selectively with electricity and hot water to destroy cancer cells. He believed that if he could increase the current frequency from 700 kilocycles to 3 megacycles, he would be able to raise tissue temperatures to desired heights with greater accuracy. He asked Gaiffe, the leading manufacturer of electromedical equipment in Paris, to build such a generator, which they did with a small condenser, a resonating coil and a rotating spark gap. When the current was passed through a 2-cm disc electrode, coagulation was noted at a depth of 5 to 8 millimeters after only two minutes of contact. Thus, instead of using the Oudin resonator with the single pole electrode, he led the current into the patient through a moist pad attached to one pole of the generator with the other pole feeding the active electrode.

American physicians have treated hemorrhoids using electric modalities for more than 100 years; using almost every conceivable electric modality available. Advocates claim some methods to be more successful than others, but results vary in the hands of the medical practitioner. Varying factors include experience, duration, intensity of treatment, and a clinician ability to selectively match a hemorrhoid with the electric modality best suited. The procedure takes about 10 minutes. A galvanic [DC] electric current is painlessly introduced directly into the offending vein. The current, negative or positive, causes a chemical and/or a thermal reaction within tissue, that either destroys and/or obliterates the hemorrhoid.

At about the same time (1907) Lee de Forest constructed the first radio tube high frequency medical apparatus – the “cold cautery”. With it Neil and Sternberger made clean incisions in dogs, but American surgeons refused to try it on patients (83). De Forest offered it to physicians in Paris and Vienna where it was soon used effectively (48, 57). It was not until many years later that any American surgeon adopted this most useful invention. In 1923 Wyeth introduced an improved cutting current apparatus with controlled cutting depth. William Clark of, Philadelphia altered the fulguration apparatus by increasing the amperage at the expense of the voltage, and this enabled deeper and more efficient destruction with a hotter spark. Since under the microscope the destroyed cells looked longer and shrunken, he called the process electrodesiccation when he first demonstrated it in 1910 (40).

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17 In 1888 Inglis Parsons tried to destroy tissue with the interrupted direct current from the secondary coil of an inductorium which delivered a 60 cycle current at 400 to 800 rna. (112).

18 The controversy between Riviere and de Keating-Hart took a strange form. Each man started a personal periodical subscribed to and written largely by his partisans. Every issue of each journal was full of self praise, and in each issue the old priority quarrel was mentioned.

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One of the more important uses of electrosurgery is in the removal of the prostate. Edwin Beer (11) was the first to use it within the bladder through a Nitze cystoscope 19. Collings (42) was the first to use the cutting current through a cystoscope in 19232. That was the year Novak (105) destroyed tonsils with electrical coagulation. Bierman (15) devised a special clamp in 1926 which enabled him to destroy hemorrhoids without sending the current through the entire body. Kelly and Ward (83) obtained hemostasis with the high frequency current in 1925 which allowed them to perform a breast amputation without ligatures. In the following year Cushing (47) used electrosurgery on the brain.

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SOURCES OF THERAPEUTIC HEAT

The oldest known sources of heat are those which occur naturally.

Although the heat of the sun, sun-heated sand, and thermal waters are still widely used by the people to counteract real or imagined pains or illnesses, they are often self-prescribed and seasonal in use. The antiquity of these forms of therapeutic heat is too great to trace to their beginning. Medical science continues to lessen their need, but their use has not diminished much in Europe. Most forms of therapeutic heat prescribed by physicians are artificially produced and range in complexity from warmed water to ultrasound waves. Heat may be applied to the surface of the body by changes in environmental temperature (convection), by contact with warmed substances (conduction) or by radiating energy into the body.

In ancient times conductive heat was easiest to apply and was thus prescribed most often. Such prescribing included the application of hot water directly or in a container, the application of heated sand, oil, grain, salt or other solids and liquids. Radiant heat was found in the sun, the open flame or glowing coals or metals. Until about a century ago, artificial heat was made only from the combustion of solids and liquids such as wood, coal, peat, oil, tallow or alcohol. The inflammable properties of natural gas were known to the ancients but could be used only at the spot where it escaped from the ground. Its commercial manufacture and distribution started about the middle of the nineteenth century 21. Electricity was not used for heating until the last decade of that century. Thus, until relatively recently, the limitations of fuel and apparatus restricted most local applications of heat to conduction, and most general applications to heated air, water and vapor.

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19 Bottini of Pavia had tried galvanocautery for prostatic obstruction but failed because of uncontrollable hemorrhage (66).

20 In 1932, J. F. McCarthy developed the electrotome which became the standard instrument.
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In ancient times, home heating was expensive to install and maintain; only the wealthy few could afford it. Others who wished to experience indoor heat in the winter went to public baths 22 where there were rooms with hot dry air, hot vapor or hot water. Although the baths were used largely for cleansing and pleasure, physicians did prescribe the various forms of available heat for hygiene and illness. When the baths were eventually closed for moral, religious and economic reasons, generalized applications of heat virtually disappeared during the colder months for centuries. Sweating was considered a very healthful procedure by the ancients (and by a great many people throughout the ages). It was a latter day translation of the idea of exorcism. Sweating “carried the poisons of the body out through the pores”. Reddening of the skin was also considered a desirable procedure, especially over painful areas, and heat as a rubefacient was also available at the public baths. There were many special rooms in the Roman baths. There were rooms with water or air baths at different temperatures, and these were used in varying patterns of increasing and decreasing exposures to heat and cold. The Romans used the heated bath for patients. If the patient was too weak for a full bath, he was given a partial bath. One form of bath, the embasis, was a tank of hot water which Aurelianus (8) mentioned as good for sciatica. The same author mentioned swimming in warm springs for the treatment of paralysis. For the poor people it was water, for the wealthy there were baths of heated milk or oil (136).

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CONDUCTIVE HEAT

The oldest forms of conductive heating were contact with the waters of thermal springs and the sand heated by the sun. Almost as soon as man learned to build fires, he noted that stones in or near them maintained their heat for a long time. He soon learned to place the heated stone against a painful part. Man could not establish communities away from fresh water until he learned how to store it. Two of the earliest water containers were the bladders or skins of animals and hollow dried fruits such as gourds. Hippocrates recommended the use of small bags or bladders of warm water for sciatica and for local inflammations of the rectum. Aurelianus (8) wrote of gourds filled with hot water applied as a fomentation 23. Hot water and vapor early became part of folk medicine and were so widely used and commonplace that they were mentioned infrequently in the medical literature, a status comparable to the great use and relatively infrequent mention in current literature of aspirin for headache. But as a medical prescription, heat therapy was neglected for many centuries. It was resurrected by Ambroise Pare. Although he put an end to one form of heat (boiling oil for wounds), Pare revived interest in less drastic applications24 (110). “Diverse fomentations are used for broken bones. When we use warm water for fomentations we mean a temperature between hot and cold, that is, which feels lukewarm to the surgeon and patient. A fomentation of such water used for a short time moderately heats, attenuates and prepares for resolution the humor which is in the surface of the body and draws blood to the atrophied part. It assuages pain, relaxes that which is too tight and moderately heats the limb which has become cold as a result of tight binding or other reasons.” Fallopio, a contemporary of Pare, proposed that ulcers be treated with bathing in warm water (59). “Stoving” was used frequently in the eighteenth century.

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21 Illuminating gas was first produced by van Helmont in the early seventeenth century but not used for illumination until 1792 by Murdoch. In 1832, Sharp used gas for cooking, but it was not until the work of Bunsen in 1855 that it became practical for heating.

22 At one time there were 800 public baths in Rome. The admission fee was very small for adults, and children were admitted free (67).

23 Fomentations were also made by pouring warmed liquids over the body or a part of the body. In De affectionibus Hippocrates wrote, “When the ears become painful, bathe them and foment them abundantly with hot water” (134). Warm water fomentation was recommended by many for various complaints, especially colic. Alexander of Tralles and Aretaeus used it in urinary colic, and much later, Mead used it for painter’s colic. Warm baths were used by Hoffmann for asthenic mania, a form of treatment which persisted almost until the middle of the twentieth century. Sydenham and Boerhaave used hot baths to prevent chills.

24 Pare devoted an entire chapter in one of his books (Ill) to the construction and use of a device for treating patients with heated vapor. “Stoves may be dry or moist. In dry stoves a hot dry exhalation is developed for application to the body making it hot and opening its pores so that sweat may pour out of them. There are many ways to develop dry heat. At Paris, and wherever there are stoves or public hot houses they are made by fire under a vaulted furnace which heats the whole room. Also you may put hot cobble stones or bricks into a tub, having first laid the bottom with bricks or iron plates. Then place a seat in the tub where the patient will sit with a canopy drawn over him so that he may receive the heat rising from the stones and thus have the benefit of sweating. But we must look at the patient often, for it sometimes happens that some, neglected by their keepers, otherwise engaged, become faint, and their sense failing them by the dissipation of their strength, by the heat of the exhalation, have sunk down on the underlying stones and so have been carried half dead and burned into their beds. Some also take sweating in a furnace or oven as soon as the bread has been removed, but of this I do not approve because the patient cannot turn around or lie down therein.” The ancients produced therapeutic vapor baths by throwing red hot stones into water (67).

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Vapor baths were resurrected in 1809 by Cochrane (41) who devised a boiler-fed bedside tent. He was able to collect signed testimonials from 70 of the most prominent physicians in London on the effectiveness of his steam tent in treating patients. La Beaume (87) found the tent soothing to the point of putting the patient to sleep.

HOT WATER

Hot water is perhaps the most widely applied form of conductive heating, whether it be a local soak or compress or a full tub. Many variations have been used, and many special containers and appliances hare been tried. Water has been poured, thrown or rubbed on the body. Pools, tanks and other containers have been devised especially for therapeutic heat. One example was thepediluvium, a hot foot bath in which the leg could be immersed up to the knee. “These baths produce marvellous effects in spasmodic pains of the head, in asthenic fluxions of the eyes, in convulsive asthma, suppression of the menses, palpitations of the heart, nervous fevers and delirium” according to one author (37). The same author, Chortet, reserved his highest praise for the more universally accepted indication for heat-pain. In 1802 he wrote, “Almost all pains from the most severe to the most tolerable are more or less calmed by the application of hot water to the painful parts …. Heat is good in rheumatism and sciatica …. ”

But there is something about an ordinary container of hot water which is too commonplace to be considered therapeutic by patients when they encounter it in a hospital or physician’s office. When the hot water is placed in a vessel of special shape or material, it is accepted as therapy more readily by physician and patient alike. The whirlpool bath and Hubbard tank are examples. Although in each there is the element of forced air or water, we must look for the primary effect to the hot water rather than to the bubbles.

Warm to hot water has been used in musculo-skeletal derangements for a long time. The ancient Romans sent their wounded soldiers to warm mineral springs for all kinds of war injuries 25 (64). Aurelianus was most explicit in his recommendations for exercising paretic muscles in warm springs. Thermal springs continued to be frequented for bathing and drinking, but their use in heating involved joints and muscles diminished somewhat during the latter half of the nineteenth century thanks to the efforts of Priessnitz and his followers who extolled the virtues of the “cold water cure” (39). But the heroically unpleasant swing to cold water dimmed towards the end of the century, and warm water resumed its deserved place. In 1898 von Leyden and Goldscheider (92) recommended underwater exercise in warm water, and shortly thereafter Preiss (120) designed the first whirlpool bath activated by an electric motor (and used primarily for gynecologic conditions). The whirled warm water bath was virtually forgotten until World War I, during which, according to Pope (ll8), it was used in France for military patients26. The apparatus was seen by Dr. Fox who had one installed at the Walter Reed Hospital 7; from there the idea slowly spread throughout the United States so that by the time World War II was over, the device could be found in almost every hospital with a physical therapy department. In 1928, Dr. Walter P. Blount 28 first described a much larger bath, the Hubbard tub (or tank), to which the whirl was eventually added.

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26 During the French Revolution and for years after, heated water enjoyed a considerable vogue in the treatment of wounds. Percy, Surgeon General of the French Army, spoke highly of this treatment which Lombard had resurrected in 1786 (Dictionnaire des Sciences Medicales, Paris, 1814).
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OIL AND WAX

The ancient Romans poured warmed and hot oils on the body as an embrocation especially in preparation for massage. Celsus (60) and Aetius wrote of melted wax in the treatment of styes. Arnold of Villeneuve poured melted wax on the body as therapy, and Constantin used it for ecchymosis of the eye (136). Aurelianus (8) devoted space to ceromata which were animal hides soaked in oil and heated in the sun 29. But the use of melted wax in treatment as we know it today is of recent introduction.

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26 We have made inquiries in France, especially at the library of the Val de Grace (principal military) Hospital, and were unable to learn about the eau courante which is now a rarity in the country of its origin.

27 Captain F. A. Bardwell designed the air injector used to whirl the water (Sampson, C. M. Physiotherapy Technic, St. Louis, 1923).

28 Although primarily designed for underwater exercise, the Hubbard tank has since become equally important as a method of generalized therapeutic heating, particularly in arthritis. We are indebted to Dr. Walter P. Blount for an account of the little known details concerning its origin. The daughter of Mr. Henry Pope was severely paralyzed by poliomyelitis. He had heard about underwater gymnastics and gave his daughter exercises in an old wooden tub in the basement of his Chicago home. He asked MI’. Carl Hubbard, an engineer residing in the same city, what shape would be most suitable for such a tub. One day while Dr. Blount, Mr. Pope and Mr. Hubbard were all at Warm Springs, Georgia, “we lay on the floor and waved our arms and legs and conceived the idea of the ‘key hole’ tub. One was built for Warm Springs and one for the Wisconsin General Hospital in Madison, where I was a resident”. When Dr. Blount moved to Milwaukee he had a tub installed at the Columbia Hospital where he continued to improve upon it until it reached its present form.
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In 1913 Barthe de Sandfort (127) described the first paraffin bath, and in the following year Bouet-Henry (24) brushed melted paraffin on wounds. The paraffin bath was not too widely used in France, but it received enough publicity to come to the attention of a Mr. W. L. Ingle who owned a tannery at Cherwell in Yorkshire. He noted that some workers in his factory immersed their hands and feet in the wax vats, following which they spoke of benefits. Mr. Ingle offered the commanding officer of the nearby military hospital at Leeds, Colonel Littlewood, his wax facilities. The Colonel introduced the use of melted paraffin in his hospital in 1918 (75) whence its use spread in England as the “wax bath” 30.

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HEATED SOLIDS

The heating properties of sand are immediately apparent to anyone who walks on sun-baked sand with bare feet, a daily routine for many primitive peoples. There is much sand in Egypt, and Herodotus wrote of the sun baths he saw there. Oribasius (106) quoted the account of Herodotus as did Galen who mentioned a patient, the wife of Boethus, for whom he prescribed it (136). Dioscorides (99) recommended beach sand dried in the sun for drawing water from hydropics. The patient was covered with sand up to his neck in a sunny location. Aurelianus (8) advised this treatment in arthritis and obesity 31.

Conductive heating was applied with all sorts of vegetable products.

The favorites were hot cereals, breads and apples. Other poultices were made with grape grounds, leaves, wood chips, eggs, animal parts and mud (142). Sylvius used cooked apples which he applied hot in ophthalmia. Benedict applied the same mash for hemorrhoids. Rhazes used a foment of hot mashed millet to the cheek for toothache (136). The introduction of the hot water bag and the heating pad displaced the poultice which retained its place in thermotherapy into the twentieth century.

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29 The patient was advised to roll back and forth in the oiled skins so that the combined heat of the oil and friction would warm his body.

30 In 1926 Portmann (119) described an electric heating chamber for paraffin, which, when it became commercially available, greatly stimulated the use of the paraffin bath.

31 Sand was preferred by most writers since it remained drier than the alternative salt, but Aetius preferred the bath of heated crushed salt. He advised that the pile be at least a foot and a half high to prevent rapid dissipation of the heat (136). Hot sand baths have continued in use throughout the ages. They were especially popular during the second half of the nineteenth century. Grawitz (68) collected reports on their use from England (1872), France (1874) and Russia (1889). There are still “health stations” along the French and Italian Riviera where psammotherapy is practiced.
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HOT WATER BOTTLE AND HEATING PAD

The idea of the hot water bottle is very old. Hippocrates used flat earthenware dishes filled with boiling water and applied them to the chest and abdomen. Rudius used a vessel filled with hot cinders for abdominal pains. Celsus wrote of lenticulars which were earthenware pots filled with hot oil and applied to the abdomen to provoke sweating. Vessels containing hot mixtures were applied to the soles of the feet by Hollier (136) until felt as high as the thighs in cases of sciatica32. Soon after the introduction of electricity as an agent for therapeutic (luminous) heat, Salaghi (126) described a heating pad he designed in 1893. In 1898 Cerutti (67) also in Italy improved upon the thermophore by threading a light compressed cloth material with insulated wires and a temperature level regulator.

FRICTION

Friction, rubbing or massage 33 is no longer considered a form of therapeutic heat, but it was at one time for the obvious warming to both patient and operator.

CONVECTIVE HEAT34

Warmed or heated air was used fm many conditions, but especially for pains in joints. Pliny (136) advised exposure in a hot air furnace 35 for arthritic joints. The hot oven was popular to induce sweating, and sweating has always been popular with a sizable proportion of the population. The Arabs used the oven frequently. When the Calif Watek-Billah was dangerously ill during an epidemic, his physicians placed him in a warm oven so often and for so long that his death was probably due to over-heating (67). Gaspard Torella wrote that “the best way to cure small pox is to make the patient sweat in a stove or warm oven for about 15 days” (67). Jean Fernel favored an even greater dosage: “the patient was placed in an oven and kept there at elevated temperatures for 20, 30 or more days.” Boissier de Sauvages (22) found that heated air “relaxes our fibers which lengthen appreciably. That is why it is appropriate for the dissipation of cold tumors, painful catarrhs, to open vessels, to restore circulation to the parts which the cold deprived or movement and sensation; to increase perspiration because it dilates the pores of the vessels and the flow of liquids, to excite an intestinal movement 36 which exalts the saline and sulfurous matters, which disposes the body to a more prompt putrefaction and to move the excremental matter which stagnates.”

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32 This reference is made by Severin, Professor of Anatomy at Naples, the first physician (after Pare, a surgeon) to write extensively about thermotherapy. He listed all forms of heat used from the time of Hippocrates to his own in 1668.

33 The chief value of massage can hardly be said to be that of supplying heat. Arnold of Villeneuve, Savonarola and others used massage as a form of heat for colic (136). Guy de Chauliac wrote, “in hydropsy, the patient should be rubbed in the sun, while protecting the head and liver, for in this condition the heat of the sun is admirable” (35).

34 The dividing line between heated air, radiant heat and convective heat is at times tenuous. Heated air will be considered as convective heat in this survey.

35 He described a hot air furnace heated by the sun. Heated air, especially heated moist air, could be found at all the major public baths. Some of these were recommended by physicians for general or specific treatments.

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The first scientihc clinical study In thermotherapy occurred in France before 1840. It was soon all but forgotten because of local medical politics. Jules Guyot (69), a young Parisian surgeon, began in 1833 to meditate on the value of heat in wound healing. He selected some rabbits and dogs and went to his house in the country where he set up an animal hospital and for three months devoted himself to experiments and observations on therapeutic heat. He constructed a hot air cabinet, very similar to one that Bier devised about a half century later, heated with alcohol lamps in such a manner that he could maintain, at will, an environmental temperature anywhere between 30 and 70 degrees centigrade. He found that when the temperature was maintained at about 30 degrees, the healing of wounds was more rapid. His house was near that of Magendie whom he invited to witness his experiments. When Magendie saw the results, he insisted that the method be tried on his patients at the Hotel Dieu. Guyot began with the treatment of ulcers, white tumor (tuberculosis) and sciatica. “Each new trial confirmed my belief that heat incubation was a powerful therapeutic agent … but while at the hospital, I encountered many difficulties which a young man without influence or authority might experience.” Eventually he was allowed to work on the kind of wound he felt could be helped most the fresh wound following amputation. His first two trials proved so successful that he was forced to present them at the Academy of Medicine, and there, as he had suspected, he was criticized for rushing into publication with only two cases.

Guyot noted that warm baths had been used in medicine a long Lime.

They had been given for an hour at about 30 degrees or with steam at 40 to 45 degrees. His inquisitive mind asked, “Why has not the action of heating agents been analyzed? Why has no one tried to differentiate between the effect of the gas, liquid or solid on the one hand, and the temperature on the other? It should have been recognized that heat is the sole agent and that humidity was more a hindrance than a help.” He recommended an air bath with a temperature of 36 degrees, which he considered the temperature of the circulating blood. Soon after his book was published, Guyot became too ill to work. “Thus there occurred what usually happens in such circumstances; the method was not pushed and was soon forgotten by everyone” (9). And so it remained until Bier (14) began to work on tuberculosis of the extremities 37.

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36 De Boissieu (23) also praised the virtues of heat in increasing intestinal motion and in lowering the viscosity of body fluids.
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When the tubercle bacillus was discovered in 1882, many workers tried to find a way to kill it without at the same time killing its human host. In little time it was found that heat affected the bacillus adversely. Bier tried to warm the site of tubercle invasion by increasing its blood supply – hyperemia. He tried the Esmarch bandage and found it too painful. He also tried massage, exercise, electricity and chemical rubefacients but soon came to the conclusion that “The most practical and useful agent to promote local hyperemia is heat.” Since cataplasms, mud, thermophores and compresses interfered with circulation, the hot air approach was considered the most logical. In searching for an appropriate apparatus he was inspired by the apparatus of Quincke who had warmed the entire body in a gas heated chamber to promote generalized sweating. Bier devised his Bunsen burner heating hood in 1891 and reported on it in 1893. He advised the use of the alcohol lamp as the source of heat if gas was not available but predicted that “the heating apparatus of the future will be electrical” 38.

Bier developed special cabinets for each part of the body and “for the rich patients I have every individual box made to measure by a carpenter … for hospitals the openings should have larger diameters which must be reduced with cotton as needed.” Soon after the introduction of Bier’s apparatus there were many who tried to imitate or improve upon it. The Tallerman-Sheffield apparatus, first used in England (129) in 1895, found considerable favor in Europe. It was a boiler shaped tank of copper, closed at one end and open at the other to receive an extremity. A series of gas flames beneath a closed kettle heated the air in the tank. This hot air device was much drier than that of Bier. By the end of the century there were several manufacturers in America who were offering cylindrical and boxlike cabinets heated by gas, gasoline or electricity with valves for the interexchange of air since it was felt that the accumulation of moisture in presence of high temperatures would result in serious skin burns (140).

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37 In the same year, Clado (14) devised a hot air oven for heating joints in an attempt to kill the tubercle bacillus in them with heat. Thus, the great stimulus to heat therapy was an attempt to kill the tubercle bacillus.

38 At virtually the same moment, Kellogg was using electrical luminous energy to cure joint disease in cabinets not too unlike those of Bier. In spite of Bier’s prediction, nonelectrical heaters were used with Bier equipment for the next half century in Europe. Bier preferred hot air to radiant heat since air is a poor conductor, has a very limited capacity for heat and because the vigorous evaporation of sweat protects the part against burns.
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As might have been expected, the new treatment with heated air used by many in different countries with glowing reports. Hollae found currents of hot air under pressure of value in lupus (1897); Cal found the warm air bath effective in relieving attacks of epilepsy (Schmeltz used thermal insuffiations of the vagina in pelvic inflammations (1899). The most glowing reports were in joint disease. Sarjnet, (129) using a tempemture of 240 F for 40 minutes told of eight case, arthritis and sprain in which the “pain is generally not only relieved entirely removed.”

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RADIANT ENERGY

Sunshine, the open fire, glowing coals and irons and heated stones constituted the chief sources of radiant heat among the ancients. Oribasius has left one of the best accounts. “Patients suffering from a chroI >ain are treated with the heat from coals set up in the treatment plac rhe painful parts will be heated to the point at which the patient finds difficult to continue 39.” Oribasius (106) also used the sun as a Source heat. “Exposure to the Sun is eminently necessary for people who needs be restored to full health and to gain weight …. Too much heat is bad for weak patients. Expose the back to the Sun or the fire, for the voluntary nerves are found chiefly in that region and when they are exposed to gentle heat the body will be healthier, but remember to guard the head with some covering.”

Nothing of genuine importance in radiant heat therapy occurred for many centuries because there were no new methods for producing it 40.

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39 The same book goes on to tell of another widely used form of conductive heating: “The treatment which consists in receiving heat from a heated wall produces the same effect. When the wall is moderately heated (with the built-in flue), the part to reated is placed directly in contact with it, but if the wall is very hot, the part lid be covered with heavy cloths before it makes contact with the walI.”

40 The very subject of heat was not formally investigated until 1620 when Lord Bacon, inDe forma calidi(143), concluded that heat was motion. Boyle supposed this motion is in small particles of heated bodies and consists of their rapid motion. Newton also subscribed to this view, but the French and German chemists observed that heat was a highly elastic penetrating fluid which entered the pores of bodies and made them hot. When the French chemists contrived the new Chemical nomenclature in 1787, they thought it would be advantageous to have a distinct for each kind of heat. They called the sensation heat and the state caloric. 1800, Herschel (72) investigated the heating effects of different parts of the spectrum because “It is sometimes of great Use in natural philosophy to things that are commonly taken for granted.” He showed that red rays heat three times as much as the violet. “I likewise concluded that the full red fall still short of the maximum heat; which perhaps lies even a little beyond visible refraction. In this case, radiant heat will at least partly, if not chiefly consist, if I may be permitted the expression, of invisible light.”
These rays were really above the red and should have been called ultrared, whereas the rays on the other end of the visible spectrum discovered by Ritter one year later should have been called infraviolet. In 1835, Ampere showed that heat and light rays could be separated by passing them through quartz or ice.

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Artificial radiant heat was limited largely to holding heated substances near the part to be treated. In 1774, Faure (60) wrote, “It is with this application of heated bricks that one lessens rheumatic pains …. We can see with the naked eye that when heat is applied to the neighborhood of an ulcer, the surface becomes rosy in the intact places and a true flow occurs from the broken area. The improvement in circulation is demonstrated by the decreased indolence in the neighborhood of the ulcers I have treated in this way.” Other forms of radiant heat included the open hearth, the flame of a candle or a glowing coal.

ELECTRICAL HEAT

Therapeutic heat did not come into its own until heating devices activated by electricity were introduced. The first attempts to generate heat electrically were incident to the search for electric light. At the beginning of the nineteenth century Davy produced a powerful light with the carbon arc. In 1841 de Moleyne in England (90) tried to make an incandescent lamp. Four years later, Changy in France and Starr and King in Cincinnati tried again, but it was not until 1878 when Edison developed the U-shaped carbon filament in the vacuum glass envelope, that the lighting habits of the world were changed.

LUMINOUS HEAT

George N. Beard must be counted among the first specialists of physical medicine in America. In 1875 J. H. Kellogg became one of his proteges (19). The new Edison light lamp 41 interested him, for to Kellogg who believed in “natural” medicine, it represented an effective substitute for sun light. He began to work with the electric light because he believed that, since sun light was so important to life and nutrition in plants and animals, it might be beneficial in certain illnesses. In 1891 42 he built a rectangular cabinet with 40 lamps of 20 candle power, and interior reflectors. He had his patients sit in the cabinet completely nude, with the head outside as in the vapor baths or sweat cabinets of Quincke. He used it on many patients in the Battle Creek Sanatorium and exhibited the apparatus at the Chicago Exposition of 1893. A visitor from Germany saw the bath, visited Battle Creek to become familiar with it, and on returning to Germany began its manufacture. “The bath soon became very popular in Germany, and hundreds of Light Institutes were opened in the leading cities. King Edward of England came to Hamburg for a case of distressing gout and was relieved after a series of light baths. He ordered one installed at Windsor Castle and another at Buckingham Palace. Kaiser Wilhelm soon followed his example as did many other titled families in Europe. In time the fame of the bath spread back to its home. A New York firm actually imported a bath from Germany as a therapeutic novelty. That bath was made from a description of it published by the author at the annual meeting of the American Electrotherapeutic Association in New York on September 25, 1894” (82).

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41 The first lamp gave only a 10 candle power light and could burn for only two months. In 1903, Just used tungsten for the filament, but this did not gain commercial acceptance until 1913. Dowsing, a British engineer, invented a luminous heat lamp in 1896 which was used therapeutically by Hedley of London, but by that time Kellogg had used the Edison lamp on a great many patients.

42 Guimbail insisted that he was the first to use the electric light bath (Revue de Therapeutique par les Agents Physiques, Paris, 1896). If he did, he did nothing to further its use among physicians.

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Light baths or heating cabinets were installed at all spas but were also considered necessary equipment in almost all new hospital installations with physical therapy departments up to the time of World War II. But the more lasting result of Kellogg’s work was the influence it had on the introduction of the local light bath. Smaller units were soon proposed. Lacquer designed a highly reflective nickel cabinet with six incandescent lamps to be placed over the involved area (62). Modifications of this device became the heat cradle, called by too many for too long a “baker”. Marie (97) suggested that individual lamps be placed in silvered parabolic reflectors for local applications. By that time (1901) carbon filament lamps of 500 candle power were widely used in the clinic for such conditions as neuralgia and arthritis.

Few advances in luminous heat followed because it was so difficult to improve on so simple and effective a device as an incandescent lamp in a reflector. Lenses of various colors, materials or construction were used to alter the light emitted. Humphris (74) suggested that the lamp be made to swing back and forth over the affected part for half an hour. The chief advance after Kellogg was the introduction of the tunngsten filament lamp which emitted a smaller percentage of infrared rays and could he applied at greater energies before an uncomfortable sensation was experienced. Sonne (141) emphasized this in 1929 when he said, “We can absorb twice as much irradiation by visible as by invisible heat rays” 43.

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43 In 1820, Grotthus (76) announced a most important “law”. He said, “only the rays absorbed are effective in producing chemical changes.” About a century later, Winkler (148) reminded us of its application to thermotherapy with, “There can only be an effect when the light is absorbed.”
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One of the chief weaknesses of heat therapy has been the difficulty of measuring the amount of heat absorbed by the patient; another of measuring or controlling the amount introduced. Thermometers were used in conjunction with light and sweat baths to record but not to control. Bierman (16) descrIbed a method of controlling the environmental temperature of the luminous heat cradle in the treatment of vascular disease in 1934.

INFRARED

At the beginning of the twentieth century, the work of Bernhard and Rollier focused attention on the use of ultraviolet light 44 in the treatment of extrapulmonary tuberculosis. By 1910 electrically produced ultraviolet light oecame commercially avaIlable, and its use increased rapidly. In 1919 when Huldschinsky proved the relationship between sun light and rickets, the demand for apparatus increased, and the field of actinotherapy drew sufficiently large so that soon there were journals devoted to it in at least three languages. But when Hess and Steenbock showed in 1924 that the artificial light could be taken “by mouth”, there was a sudden diminution in the demand for ultraviolet light equipment in the office and hospital. According to Beaumont (10), manufacturers of ultraviolet light equipment looked for a way to continue in business. They had the stands, electrical parts, factories and skilled workers. It had long been known that when iron is heated to a barely visible red, heat is emitted in the infrared range. It was a simple conversion from making clinical ultraviolet light lamps to infrared burners, and soon manufacturers were promoting them as superior to luminous heat lamps. Many physicians accepted the suggestion. The infrared burner was something not commonly found in the home and therefore more medical than the luminous lamp which anyone could purchase at the corner shop. (It did not take too long for the infrared generator to find its way to the corner store.) Claims and counterclaims were made by the proponents of luminous and infrared sources of heat. The question of superiority remains inconclusive, and the choice of clinical apparatus has become a matter of personal conviction.

HIGH FREQUENCY CURRENTS

The static spark was obvious to the first sandalled man who walked across a carpet in a cold dry room. Yet it was not until 1600 that William Gilbert studied it and called it electricity. In 1672 Otto von Guericke developed a frictional machine to produce sparks, and 1746 the Leyden jar was found to store it. It was the frictional machine, the Leyden jar and a coil that Hertz produced high frequency currents, In 1889 Joubert showed that when the frequency of the current was increased beyond a certain level, the electricity would no longer cause contractions of the frog muscle. In the followmg year d’Arsonval repeated Joubert’s experiments and found that with frequencies above 5,000 cps contractions diminished and that at about 10,000 cps they disappeared. He applied the high frequency current to himself at an intensity of three amperes and felt on!y a slight sensation of warmth 45.

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44 A decade earlier, Palm had indicated the relationship between sunlight and rickets, and Finsen used filtered sunlight in the cure of skin tuberculosis.
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By 1892 d’ Arsonval was working with an apparatus capable of delivering a frequency of several hundred thousand oscillations per second (5). Until that time electricity had been used to contract muscle or burn tissue. The idea of merely warming tissue with electricity had not been given serious consideration. Thus d’Arsonval looked for physiologic rather than thermal effects. “I say to you that the immediate sensation produced by these currents is nil. Their passage is accompanied by physiological changes which I shall describe briefly. If the current is sent through the hands covered with large electrodes, the skin becomes unfeeling for from a few minutes to a half hour.” He found flushing of the skin and increased sweating and attributed these to a general vasodilating action rather than to a heat reaction. He wrote, “I believe that high frequency currents will render great service to therapeutics,” but he was thinking of their effects on blood pressure and kidney output.

In 1897 (7) he added the method of autocondensation to the other manners of application previously suggested. Autocondensation which remained popular for many years was, in effect, an unrecognized form of diathermy when first proposed. The d’Arsonval current was used by many pnysicians in France, and their reports were as optimistic as any had been with previous forms of electricity when first introduced into therapy. Claims were made of its effectiveness in diabetes, gout and obesity. In fact, the claims were so extravagant that many failed when they tried to repeat them. Thus, as early as 1904, Freund (65) wrote that clinical trials fell far short of what had been expected, “consequently in some quarters the whole method received unqualified condemnation.” As so often happens during the early period of a new discovery in medicine, the press had its share of enthusiastic reporting. In 1899 newspapers published a sensational report that Tesla had cured pulmonary tuberculosis with the high frequency current, whereas actually he had only suggested the possibility, based on his findings that high frequency current which ‘passed directly through bacilli killed them.

In that same year, von Zeyneck published a paper in which he briefly alluded to the “Durchwarmung” or heating through of his finger tips when an alternating current passed through them. He believed that the heat was produced by the passage of current through tissues just as it would when passed through any other resistance (45). According to Dark (49) he said, “The d’ Arsonval oscillations may prove to be the only method to make it possible to produce an even warming of the body” 46. In September 1907, at a medical meeting in Dresden, Franz Nagelschmidt showed the “Durchwarmung” possible with high frequency currents, and at the Natur forscherkongress in Budapest in 1908 he demonstrated a more powerful machine which left no doubt about the deep heating effect of the high frequency current. Soon after he coined the word diathermy (102) to describe the procedure.

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45 A similar intensity of continuous current would have been destructive, possibly fatal. Tesla thought that the high frequency current was not destructive because it spread over the body rather than through it. D’ Arsonval said it was the speed of alternation that permitted safe penetration.
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The first high frequency machines were rather large and noisy. In 1900 Duddell placed a condenser across the spark gap, which changed the wave form to a more continuous type of oscillation with a musical note which came to be called the singing arc 47. The high frequency machine was not generally used until a few years after Nagelschmidt’s demonstrations. Its chief use continued for some time to be the activation of a glass vacuum electrode with a violet brush discharge which reddened the skin and gave a pleasant tingling sensation. By 1910 diathermy machines were beginning to make their appearance in supply houses.

At first rigid metal electrodes were used, and sparking occurred where contact between them and the skin was poor. Even heavy wetting could not always prevent this. In 1911 Delherm and Laquerriere (1) introduced flexible electrodes made of fine wire screening, and soon after Ronneaux molded tin electrodes from plaster casts of the parts to be treated. Another favorite early electrode was sponge-tin backed with chamois. The electrodes which finally came into greatest use because of their malleability were made from thin Crooks metal which could be cut with an ordinary pair of shears into any size and shape desired.

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46 Several writers, in an attempt to lessen the importance of later workers, have given undue prominence to this paper, for although von Zeyneck made this observation in 1899, nothing further on it came from his pen until February, 1908, when in conjunction with von Berndt and von Preiss he published a paper on the use of high frequency current in joint disease. In that paper heat penetration was mentioned as an essential part of the treatment (45), but this was months after Nagelschmidt had given his impressive public demonstration.

47 As the first quarter of the twentieth century was ending, a physical therapy clinic could be a rather noisy place with its static wheels spinning to make minor thunderclaps, and its spark gaps humming away. The original spark gap arced between carbons. In 1903, Poulsen improved the arc by substituting copper for the carbon (26). Later, tungsten was used. The spark gap continued to be used on diathermy machines long after electron tubes became commonplace, and even when short wave diathermy was introduced, one manufacturer insisted on using it for his earlier machines.
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Diathermy was soon used for many conditions. Morlet (101) treated all forms of arthritis with it in 1911. Bordier (25) used in it conjunction with x-rays to the spine for poliomyelitis, a treatment which was still considered so effective by some in Europe that in 1952 it was mentioned favorably in a paper given at the First International Congress of Physical Medicine. There was just about no organ, superficial or deep, which was not treated with diathermy. Special electrodes were devised for most of the body orifices, and it enjoyed much favor in gynecology in the treatment of pelvic disease. In 1923 Stewart wrote an entire book on the use of diathermy in pneumonia which exhausted two editions. But it reached its greatest publicity when in 1929 the King of England who had worsened on ultraviolet light treatment was improved by diathermy when given at the suggestion of Frank D. Howitt (30). At almost the same moment, across the Channel, short wave diathermy was born 48.

SHORT WAVE DIATHERMY

Until 1929, the frequency of the current used in diathermy was approximately one megacycle 49. In 1928 Esau, a physicist at Jena, constructed for Schliephake at Giessen a machine which delivered a three meter wave at 400 watts. Schliephake was the first to use short wave diathermy clinically, and the first patient he treated with it was himself. In 1929 he began to work on the “selective” (that is, specific bactericidal) effects of short wave, and in March “I cured myself of a furuncle on the nose in the shortest time” (132). He did much basic work on the heating 50 of animal tissues. Apparatus for the clinical application of the new form of diathermy was not placed on the market outside of Europe until 1934. In 1935 manufacturers, large and small, began to produce and sell increasing quantities of machines. At the beginning, as with the d’ Arsonval current, there were many exorbitant claims. There were talk and even writing about cures of tuberculosis and cancer. The new current could light up neon tubes without contact. The glow tube was used to prove the presence of electromagnetic radiation. It was also used by a few to impress patients with the marvelous properties of short waves. In the early days, overenthusiasm and lack of precautions resulted in moderate and occasionally severe burns but with improvement of circuit design and electrodes, burns became increasingly uncommon. The first electrodes recommended by Schliephake consisted of metal discs housed in thick glass “shoes” with considerable air spacing. In the United States, the first popular electrode was a sheet of flexible metal covered with thick layers of rubber. Although many found that the pad electrodes were efficient and more convenient to apply, they were condemned by organized medicine in favor of the cable electrode, first as cable wrapped around the part and later as coiled within an insulating drum.

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48 Few in 1929 would have believed that the diathermy which had saved a royal life would be outlawed a quarter of a century later. In July 1954, by international agreement, long wave diathermy could not be used unless so well shielded that its radiations did not escape from the building in which treatment was administered.

49 When higher frequencies were introduced, the lower frequencies were called long wave or conventional diathermy. The higher frequencies were called ultrashort or short wave diathermy. Later, when long wave diathermy was abandoned, the short wave diathermy was called simply, diathermy. An engineer named Lakhovsky (89) wrote that he began experiments in 1923 at the Salpetriere Hospital in Paris with a radio-cellulo oscillator which he claimed produced waves of two to ten meters. He did not state what power he used originally, and there was much secrecy about his work. In 1924 Gosset built a two meter apparatus with which he was able to destroy plant tumors caused by Bacterium tumefaciens. In the following year Stiebiick produced a machine which would deliver a 38 meter wave and s~ggested its use in treatment. In 1926, Schereschewsky placed small animals in a condenser field of an apparatus which could deliver a 2 to 36 meter wave at 7.5 watts. He was able to kill flies with it, and the press responded by calling it the new “death ray” (36). In 1929, Saidman developed and used a 1.8 meter apparatus which could deliver 6 watts of energy.

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Short wave diathermy was promptly used in all those conditions in which long wave diathermy had been used. At first it enjoyed great use and acceptance in the treatment of paranasal sinusitis, a field well surveyed by Jouard (80). By 1937, when the first book on the subject was published in the United States (36), more than 750 articles and 18 books had been devoted to it. By 1954, when long wave diathermy had been outlawed, the short wave apparatus had become a virtually fool proof device (as far as the infliction of burns) and was holding its own very well against the still newer form of diathermy-microwave.

MICROWAVE DIATHERMY

Although currents of extremely high frequency were developed by the first investigators in the nineteenth century, it was not possible to produce them with sufficient power for therapeutic purposes until after the First World War 51. Nevertheless, several investigators discussed the possibliltles and even used the radiations which came to be known as microwaves. In 1925 Stiebock (124) wrote, “Perhaps we could profit therapeutically by using wave lengths of .1 mm to 10 meters instead of those of 300”. But this was only a speculation. Perhaps the first physician to use microwave diathermy was Denier 52 (50). He used an 80-cm wave combined with x-rays against tumor. Brunner-Ornstein (32) reported in 1937 on the use of a 60 cm-80 watt device designed by Randa, which she claimed made an x-ray refractory carcinoma disappear when treated with the combined energies of the two. It must be emphasized that the early workers were seeking not therapeutic heat but a “specific” or “selective” therapy. Microwave heating was introduced by Frank H. Krusen and his associates (86). In June, 1946, they began to heat living tissues with it and reported 53 on its thermal properties in May 1947. They properly delayed clinical trials until the limitations of this potentially dangerous 64 radiation were established in animals. Later that year microwave diathermy was “accepted” 55, and in the following month 56 Osborne and Frederick reported on how the radiation raised temperatures in normal human subjects.

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50 Weissenberg was the first proponent of the non-thermal effects of short wave diathermy-low intensity treatment (146).

51 In 1920, A. W. Hull invented the magnetron which employed the principle of the magnetically-controlled electron beam. In 1922 Nichols and Tear (71) experimented with radio waves of .2 mm., and soon after Arkadieva (125) using ground metal in oil suspension claimed to reach a radiation of 81 m (in the infrared range).
In 1935 Reils described the principle of velocity modulation which led to the development of the klystron, another type of microwave tube. In 1940, R. T. Randall of England conceived the multicavity magnetron with which it became possible to develop microwaves of sufficient wattage to aim at a distant object and by means of reflection identify its position and general outline. The military possibilities of such a device (RADAR) were so great that the new tube was sent to the Massachusetts Institute of Technology for further development. The Institute needed a manufacturer to produce the multicavity magnetron and called on nearby Raytheon Manufacturing Company. The manufacturer saw the possibilities of the new high frequency source in clinical medicine, and as the War ended began to produce an apparatus which delivered a 2450 megacycle current at 125 watts. Since the frequency of such a device depends upon the internal structure of the magnetron, and since tooling for different size magnetrons is expensive, tube manufacturers have not produced equipment which will permit clinical research on other microwave frequencies.

52 Andre Denier of Tour-du-Pin, France, was one of the first clinicians anywhere (if not the first) to use microwave diathermy, ultrasound in diagnosis and treatment, and infrasound therapy.

53 Mayo Clinic Proceedings, 22: 209.

54 Microwaves introduced into tissues at the same wattage as short waves can cause severe burns rapidly. Microwaves introduced through the cornea can produce opacities in it without heating to a painful level.

55 The Council on Physical Medicine of the American Medical Association for more than a quarter of a century “accepted” new therapeutic devices if they met certain standards of performance and were advertised ethically.

56 Osborne, S. L., and Frederick, J. N. Microwave radiation. J. A. M. A., 137: 1036, 1948.
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PHYSICALLY INDUCED FEVER THERAPY

Elevation of the body temperature for therapeutic purposes was an ancient idea. The presence of fever remained a clinical guess until the clinical thermometer was popularized by Wunderlich (150) in 1868. Some years later, Phillips (114) showed that fever could be induced physically with a hot bath. The body temperature was raised slightly, but not to induce fever, by the light baths of Kellogg. D’Arsonval (6) showed in 1893 that the body temperature of an animal could be elevated by placing it in a solenoid through which a high frequency current was passing. In 1912 Rechou (124) raised the body temperature with diathermy. In 1918 Cumberbatch (46) tried to induce generalized fever with diathermy but was only able to raise the temperature one degree. In 1923 Domaggio suggested generalized diathermy for general paralysis which had been treated for some years with malaria or foreign-protein-induced fever. Clarence Neymann wanted to treat syphilis with physically-induced fever as early as 1925 (104). Schamberg (130) advocated the use of physically induced fever for syphilis in 1927. Two years later, Kahler and Knollmayer (81) gave short courses of fever in a light cabinet, and Nagelschmidt (103) described a powerful autocondensation diathermy with which “we can produce fever artifically up to any desired degree.” It was during that year that the General Electric Company’s Orville Melland (125) noted that certain employees working near powerful short wave generators felt feverish. The thought occurred to him that this energy might be used to raise the temperature in the treatment of syphilis. A 30-meter apparatus was given to the Western State Hospital at Bolivar, Tennessee, where J. Cash King and E. W. Cocke 57 (85) were the first to report on artificial fever produced by very high frequency currents.

Although the first reason for using artificial fever therapy was to treat syphilis, its greatest use was against gonorrhea in which it continued to be the only successful treatment until the advent of penicillin made the use of fever therapy in both venereal diseases obsolete by the end of World War II. Long before it was known that any disease was caused by a microorganism, Serre of Uzes (134) in 1832 proposed that gonorrhea be treated with currents of very warm water. Soop after the gonococcus had been identified by Neisser as the cause of gonorrhea, many bacteriologists determined that the gonococcus was thermosensitive.

In 1913 Santos (128) developed urethral electrodes with a central thermometer to record the heat produced by urethral diathermy. In the following year Bromberg (31), in the belief that gonococci die when exposed to a temperature of 49.5 C for five minutes, raised the temperature of the urethra to 50 C for 15 minutes with diathermy through a urethral sound. He determined that the tissue could withstand that amount of heat for that time. He probably killed most gonococci near the sound but could not reach the deeper organisms. In 1917 Risselada (122) accepted the lethal temperature for gonococci as 42 C and placed patients in tubs of hot water until their body temperatures just exceeded that level. He had the idea which was later crowned with success, but the entire duration of his treatment was only 40 minutes. Carpenter (33) repeated earlier experiments on the lethal temperature for spirochetes and gonococci, and they reopened the attack on venereal diseases with artificially-induced fever therapy. Bierman and Horowitz (18) ensured the local rise of temperature by adding local diathermy to urethra and pelvis during generalized fever therapy. Kendell, Rose and Simpson (84) raised the cure rate to well over ninety per cent by combining fever with high oral doses of sulfone drugs. Fever therapy was tried in many diseases with and without drugs, with varying degrees of success claimed in arthritis, chorea, Malta fever, multiple sclerosis and subacute bacterial endocarditis.

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57 In a personal communication, Dr. Cocke noted that he had begun experiments on animals with physically-induced fever of high frequency origin before 1926.
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ULTRASOUND

Towards the end of the eighteenth century, Spallanzani (93) studied the flight of bats and noted that in spite of partial blindness they did not fly into obstacles unless their hearing was impaired. He recognized that there was a “sound” inaudible to the human ear 58. There are many ways of producing ultrasound, but the one best suited to medical use is the reverse of that discovered by Pierre Curie 59 who found that a vibrating quartz crystal produced a high frequency electric current as it was compressed and relaxed by the vibrations. In 1912, a British engineer named Richardson suggested that another “Titanic” disaster might be averted if icebergs could be detected by the echo from pulsed waves emitted from the approaching ship. When war broke out, an Allied Submarine Detection Investigaion Coommittee (ASDIC) was set up and in 1915, Langevin of Franci succeeded in producing the first piezo-electric generator for the practica use of ultrasonic waves. It was soon noted that ultrasound radiations wen injurious to marine life. In 1929, Harvey and Loomis (70) showed that ultrasound at 400 kc. per second was able to destroy luminous bacteria.

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58 Sound is a longitudinal vibration audible to the human ear at cyclic frequencies between about 16 and 18,000 per second. Frequencies above the audible are called ultrasonic. Supersonic refers to a speed of travel greater than the speed of sound propagation through the air. Many investigators believe that ultrasound has only one effect on living tissues-that of heat. These are probably outnumbered by those who feel that the effects of ultrasound in the test tube and the human cannot all be explained as reactions to heat alone.

59 In 1881 Lippmann reversed Curie’s findings. He placed a thin layer of quartz crystal between two layers of steel and noted oscillations in the quartz when high frequency current was applied to the steel plates. (Denier, A. Les Ultra-Sons Appliques d la Medecine. Paris, 1951).
The information of ASDIC was generously supplied by Dr. Reginald W. Windle of Hove, England.

60 Lynn, J. G., and Putnam, T. J. Histology of lesions produced by focused ultrasound in brain tissue. Am. J. Pathol., 20: 637, 1944.

61 More than 1,200 articles and books on ultrasound are listed under the section Bibliography by J. M. van Went in her book Ultrasonic and Ultrashort Waves in Medicine, New York, 1954.
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The first suggestion for ultrasonotherapy was made by Voss (145) in 1933 when he proposed to reduce deafness with it. Dognon and Biancani (53) gave a real stimulus to medical ultrasound when they published collected reports from the literature on the effects of ultrasound energy on tissues in 1937. Pohlman (116) and his associates in Zurich gave the first treatment with ultrasound, as we now know it, to a woman with sciatica on June 22, 1938, after having tried it on themselves first. They used an 800-kc. generator and employed mineral oil as the coupling medium between the massage head and the skin. Their report was published on the eve of World War II. High priorities on electronic equipment for war interrupted the progress in ultrasound with a few exceptions. Dussik (56) in Austria used it as a diagnostic agent during the war, and in France, Denier (51) and Dognon used it for treatment. In 1942 Pagniez (109) described the work of Gohr and Wedekind completed just prior to the war. He explained the action of ultrasound as one of micromassage. Denier used an instrument from 1941 to 1946 which delivered a 961-kc. wave at 3 watts. In 65 patients he found best results with arthritis, asthma, scleroderma and ankylosis.

In the United States, Lynn and Putnam60 focused ultrasound on exposed animal brain tissue and showed they could control the degree of destruction caused by it, suggesting its neurosurgical possibilities. When War ended, interest was revived in Western Europe. First to write about it was Denier. He was soon followed by Anstett (4) who in 1948 reported good results in most of the 60 asthmatics he treated with it. By 1949, many workers had resumed or begun work in the field so that by the time of the Erlangen Conference, held on the subject in that year, 75 papers were presented on ultrasound. One of the earliest of these was again Pohlman (117) who reported on its value in neuritis, myalgia and arthritis61. One of the first clinicians to give it a critical appraisal in the United States was Bierman (17) who emphasized its value in fibrous tissue derangements.

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