The Spark of Life: Electricity in the Human Body (38 page)

One of the best known of the Victorian medical equipment makers was Isaac Louis Pulvermacher & Co, whose patented electric chain bands were used for treating rheumatism, neuralgia and similar complaints. Advertisements claimed that philosophers, divines and eminent physicians, in all parts of the world, recommended them and that the effects were instant and agreeable. The cheapest cost five shillings, a not inconsiderable sum in those days. The Pulvermacher electric belt was made of copper or zinc and was dipped in vinegar before being applied. Some idea of what it looked like in use may be obtained from a description in
Madame Bovary
of the one used by the chemist Monsieur Homais. ‘He was enthusiastic about hydro-electric Pulvermacher chains; he wore one himself, and when at night he took off his flannel vest, Madame Homais stood quite dazzled before the golden spiral beneath which he was hidden, and felt her ardour redouble for this man more bandaged than a Scythian and as splendid as one of the Magi.’ Nor were the chains used solely by fictional characters. Charles Dickens, writing to the actress Mrs Bancroft, who had apparently recommended the device to him, said, ‘As I shall be in town on Thursday, my troubling you to order the magic band would be quite unjustifiable. I will use your name in applying for it, and will report the result after a fair trial. Whether Mr. Pulvermacher succeeds or fails as to the Neuralgia, I shall always consider myself under an obligation to him for having indirectly procured me the pleasure of receiving a communication from you.’

A plethora of similar electrical machines proliferated during the Victorian age. They included devices for curing all manner of ailments, for stimulating muscles, and for invigorating the flagging male organ (it didn’t work). A few are still in use today, such as the diathermy device that uses an electric current to heat the tissue or blood vessel to such a degree that blood coagulates. It is used routinely in surgical practice to cauterize wounds, as it is quicker and simpler than manually tying them off, or to destroy abnormal tissues, such as small polyps or cancer cells. In a bizarre twist, modified medical diathermy machines were used during World War II to interfere with the radio navigation system used by the Luftwaffe to pinpoint bombing targets over England, as they broadcast radio noise over a wide range of frequencies that jammed the German transmissions.

A Shock to the System

The sensational machines that caused a mild electric tingle subsequently morphed into those that gave a substantial electric shock. Electroconvulsive therapy (ECT) became the treatment of choice for patients with severe depression in the mid-twentieth century. It was introduced by the Italian physician Ugo Cerletti, who was looking for a new way to treat schizophrenia that had fewer side-effects and greater efficacy. At the time, it was believed that inducing a seizure in the patient could help the condition. This was usually achieved by administration of a drug (insulin, for example), but Cerletti was aware that an electric shock could induce epileptic convulsions in animals and wondered whether this might be an alternative approach for treating schizophrenia. Initially, he rejected the idea, as he was uncertain of the correct ‘dose’ of electricity to use, but he subsequently discovered that the slaughterhouse in Rome was using electric shocks to the head to stun pigs (prior to slitting their throats) and that if the animal was allowed to recover from the electric shock it seemed unharmed. He experimented to find the amount of current needed to stun a pig temporarily and then, in April 1938, he tested it on a human being.

The patient was a schizophrenic, who had been found wandering around the railway station suffering from delusions, hallucinations and confusion. He uttered incomprehensible gibberish. The first shock – which was given without anaesthesia – induced only an absence seizure, but the patient then spontaneously started to sing. Cerlatti suggested they repeat the experiment with a higher voltage, but before he could actually do so the patient suddenly sat bolt upright up in bed and cried – in perfect Italian – ‘Non una seconda! Mortifera!’ (‘Not another one! It will kill me!’). Undeterred, Cerlatti gave him a series of further shocks. After these, the patient seemed quiet and helpful, and was discharged from hospital professing he was cured. Subsequently, Cerlatti and his colleagues used ECT on hundreds of patients (and animals) and determined both the safest dose and which maladies it was most successful at treating. Its use quickly spread throughout the world.

In ECT, a brief electric shock is applied across the head. Its magnitude is sufficient to produce a severe seizure akin to that of a grand mal epileptic fit. Because the shock stimulates the part of the brain that controls the motor nerves, the muscles convulse and the limbs become rigid. Our limbs are controlled by two sets of opposing muscles, one of which contracts and the other which relaxes when we make a movement. ECT stimulates both sets of muscles so that they contract simultaneously, making the limbs stiff and rigid. In the past, the convulsions could be so great that they even broke the patient’s bones, but these days a muscle relaxant is administered to stop the muscle spasms and a general anaesthetic is also given. Usually patients are given several treatments, a few days apart.

Sylvia Plath describes her experience of electric shock therapy in a powerful way in several of her writings, such as
The Bell Jar
and ‘The Hanging Man’:

         By the roots of my hair some god got hold of me.

         I sizzled in his blue volts like a desert prophet

         The nights snapped out of sight like a lizard’s eyelid:

         A world of bald white days in a shadeless socket.

         A vulturous boredom pinned me to this tree.

She was adamant she never wanted it again.

ECT was widely used in the 1950s and 1960s, but is much less common today, following the introduction of effective anti-depressant drugs. NICE, the UK’s National Institute of Health and Clinical Excellence, advises that it should only be used to treat severe depression, severe mania or catatonia (muscle rigidity), and only when other treatments for these conditions have proved ineffective (at least a third of people with severe depression fail to respond to drugs). Ironically, given its history, ECT is no longer recommended as a treatment for schizophrenia.

Although its medicinal use is well established, ECT remains a controversial procedure. Whether it really works, and how well, is highly contentious. Some medical reports conclude that it is effective at relieving depression in the short term, whereas others have found no significant difference one month after therapy when compared to a placebo. In many cases the effects seem to be temporary and weak in the absence of concomitant drug treatment, and there is no evidence that it lowers the suicide rate of depressed patients. Yet some patients testify it has caused a dramatic improvement in their condition, ridding them of depression and enabling them to live a normal life once again – even to return to a high-profile career. This probably reflects the heterogeneity of the disease: clinical depression is unlikely to have a single cause.

Unfortunately, ECT is not without side-effects. All patients experience some short-term memory loss, presumably because the brain circuits associated with short-term memory storage are disrupted: indeed, this is one reason why short-term memories are believed to be stored as electrical signals. The accompanying amnesia has the singular advantage that most patients do not remember being given the shock. However some patients suffer permanent memory loss. Ernest Hemmingway, who had ECT in 1961, told his biographer: ‘What is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient.’

If the effectiveness of ECT is unclear, how it might work is even more uncertain. The massive shock affects the electrical activity of brain cells, causing them to fire at very high rates and generating an electrical storm similar to that seen in an epileptic seizure. One argument is that this leads to a massive release of chemical transmitters from nerve cells. As these chemicals control our moods, and the balance between them is thought to be disturbed in mental disorders, it is argued an increase in the concentration of certain transmitters may be responsible. But our brains are delicately balanced organs and what is needed is the right transmitter, at the right place, for the right amount of time – ideally without any increase in chemicals with opposing effects. How such fine adjustments can be achieved with something as crude as ECT is far from clear.

In the past ECT was exploited by some mental institutions to subdue troublesome patients. This abuse famously came into prominence in 1975 when Jack Nicholson starred in
One Flew Over the Cuckoo’s Nest
, a film based on Kevin Kesey’s novel of the same name, in which electric shock therapy was used by Big Nurse to instill fear in inmates and ensure they remained docile and acquiescent. It caused a sensation and led to a heated public debate on the use of ECT. Currently, one of the most controversial aspects of its use concerns whether it can be given without the patient’s informed consent: this differs between countries, but it is legal in the UK and USA (although judicial consent may be necessary).

A Shocking End

A. S. Byatt’s novel
Still Life
has a shocking ending – it concludes with the accidental death of the heroine, Stephanie Orton Porter, who is electrocuted by an ungrounded refrigerator in her own kitchen as she is trying to rescue a trapped sparrow. Byatt was once almost electrocuted in the same way herself, but was saved by her husband. As we all know, mains electricity can be dangerous. But how, exactly, does it kill you?

For a person to be electrocuted, sufficient current must flow to ground through their body to stop their heart, paralyse their respiratory muscles or severely damage their organs. The amount it takes to kill a person is small, only about 50 milliamps, which is why homes in many countries are protected by safety trip-switches that disconnect the electricity supply if they detect a dangerously high flow of current to ground. In the UK, such devices typically trip out in response to 30 milliamps of current flowing for about 30 milliseconds. The settings are even lower in the United States - around 5 milliamps for 30 milliseconds. This is because lower currents can also be dangerous; a current of 15 milliamps is enough to cause your muscles to contract so vigorously that you cannot let go of a live wire.

Electrocution was a relatively common occurrence when electricity was first introduced, and even experts were killed. As Hilaire Belloc succinctly put it,

          Some random touch – a hand’s imprudent slip –

          The Terminals – flash – a sound like ‘Zip’!

          A smell of burning fills the startled Air –

          The Electrician is no longer there!

It almost happened to me. Late one night, I was wiring up a high-voltage amplifier for use in my experiments. Being tired and careless, I accidentally touched the printed circuit board. I received a shock of almost 400 volts (DC) and ended up on the other side of the room, thoroughly shocked and badly frightened, with an arm that hurt all down its length. Yet it did not kill me. This is because it is the current that kills you rather than the voltage and, happily, in my case the current was very small, even though the voltage was very high. For the same reason, the shock produced by static electricity generators like the Van de Graaf machine used to produce spectacular ‘lightning shows’ in science museums, which may be millions of volts in magnitude, will not kill you – although it may make you jump and your hair stand on end – because the current is both momentary and very tiny.

But amps and volts are bound together in an eternal embrace by Ohm’s Law, which states that volts equals amps times resistance. Volts are also dangerous because they drive the current through the body. Their ability to do so depends on the resistance they encounter: the higher the resistance, the more volts are needed to produce the same amount of current flow. Our skin has a certain resistance to an electric current and you probably won’t feel anything if the voltage is less than 30 volts AC. If your skin is wet, however, its resistance falls and the threshold for electrocution is reduced. Thus both volts and amps are potentially lethal, depending on the magnitude and duration of the shock received and the resistance of your skin.

The War of the Currents

Electrocution is not always accidental. It is used as a means of capital punishment in several countries. The development of the electric chair is an extraordinary twisted tale of power, corruption and a desire to reduce suffering, and it went hand in hand with the choice of whether AC or DC electricity should be used to power the embryonic electric grid.

In electric circuits, current is defined as the flow of electrons through a conductor, such as a wire. If the current flows in one direction only it is known as direct current (DC), and if the direction of current flow alternates in a cyclical fashion it is known as alternating current (AC). Batteries supply direct current, but mains electricity is supplied as alternating current. The reason that mains electricity is supplied as AC current is because its magnitude can be easily increased or decreased using a transformer. This means that electricity can be carried at very high voltages (hundreds of thousands of volts) in overhead power lines but stepped down to normal household levels when it reaches your home. This is less feasible for DC current, which is one reason that AC electricity finally won out in the ‘battle of the currents’ and was adopted worldwide. In European countries AC current switches direction 50 times each second, whereas in the USA there are 60 cycles per second; the magnitude of the voltage supplied also differs, being 110/120 volts in the USA and 240 volts in Europe. The reason for these differences is largely historical.