As we begin this new millennium, we rely on various forms of technology to diagnose our patients through an ever-increasing armamentarium of new devices. New therapeutic technologies for a variety of disorders also offer a remarkable and unprecedented track record in both safety and efficacy.
A fresh look at physiology is needed to better understand and intervene in the primary medical complaint of pain. Western universities are still teaching that life is based on a chemical model. Given the explosive growth in electrical technologies and our ever increasing understanding of physics, it is more realistic in the 21st century to view biological processes on an electrochemical basis rather than on a chemical basis alone.
Modern thinking on the subject far transcends the use of force in electromedical interventions. Scientific electromedicine has only evolved recently, over the past 50 years. This is due, in part, to advances in electrical technology and our understanding of biophysics as a distinct discipline from biochemistry. The most recent advancements involve only microcurrent levels of stimulation, often sufficiently minute as to not even be felt by the patient being treated.
Integrating Biochemistry and Biophysics
Robert O. Becker, MD, an orthopedist/researcher at the State University of New York, spent more than 30 years attempting to determine how trillions of cells, with hundreds of subtypes, can function harmoniously in life.1 He found that a primitive direct current data transmission and control system exists in biological systems for the regulation of growth and healing. He calls this the fourth nervous system. His studies of extraneuronal analog electrical morphogenetic fields have established the importance of bioelectricity for all life processes. Becker has laid the groundwork for the medical professions to start to evolve towards a more reasonable integrated view of biology, incorporating our understanding of both biochemistry and biophysics.
Björn Nordenström, MD, Emeritus Professor of Radiology at Karolinska Institute in Stockholm who also served as Chairman of the Nobel Assembly, has proposed a new and distinct model of bioelectrical control systems he calls biologically closed electric circuits (BCEC).2,3 Nordenström's theory is that the mechanical blood circulation system is closely integrated anatomically and physiologically with a bioelectrical system. The principle is analogous to closed circuits in electronic technology.
The earliest concept of such field effects can be traced back to ancient China. Traditional oriental medicine is based on the controlling power of ch'i or ki energy; a concept that predates electricity but may be considered analogous today.4 East Indians use the term prana to represent a similar observed phenomenon. Homeopathy is based on the energetic residual of the chemical after it has been so diluted that chemists question its continued existence. Western allopathic medicine is limited to a mechanistic approach to physiology and accordingly stands alone in its reliance on synthetic chemical treatments and invasive procedures. While no system has come close to the overall contributions made by Western medicine, the reported results in electromedical pain management to date are reason enough to re-explore the underlying mechanisms of traditional therapies towards modernizing them and automating technologies to function harmoniously in concert with clinical protocols.
In Western civilization, the first documented use of electricity to manage pain was by the physician Scribonius Largus in 46AD. He claimed that just about everything from headaches to gout (head to toe) could be controlled by standing on a wet beach near an electric eel. Not surprisingly, attempts at producing pharmaceutical preparations from dead eels proved ineffective. In 1791, Luigi Galvani discovered that electrical impulses could cause muscle contraction. By 1800, Carlo Matteucci showed that injured tissue generates an electric current. The discovery of alternating current by Faraday in 1830 opened the door to the development of man-made devices as sources of electricity. Over 10,000 medical practitioners in the United States alone made use of electrotherapeutic modalities until publication of the 1910 Flexner report which stated that there was no scientific basis for electromedicine at that time. Dr. Flexner's report was originally prepared by the American Medical Association and sponsored by the Carnegie Endowment for the Advancement of Teaching.5
Since then, arguably the greatest development in the field of electromedicine was when Becker electrically induced limb regeneration in frogs and rats as a model to study bioelectrical forces as a controlling morphogenetic field.6 Regeneration represents a return to embryonic control systems and cellular activities within a localized area. It can therefore be considered a more accessible and more observable form of morphogenesis. The complexity of instructions required to designate all of the details to recreate a finished extremity is impossible to transmit by biochemical processes alone.7
Evolution of Electromedicine
Transcutaneous electrical nerve stimulation (TENS) came on the scene in the 1970s following Melzack and Wall’s introduction of the Gate Control Theory of pain in 1965 in which counter stimulation could effectively close the gate to peripheral pain messages attempting to ascend spinal pathways to the brain.8 TENS stimulation is typically applied at a level of 60 or more milliamperes of current. Nearly 40 years later, microcurrent electrical therapy (MET) now attempts to alter or eliminate the pain message by inducing normalization of neural function, as well as healing at the pain site, as opposed to serving as a counter-irritation analgesic.9
Following closely behind TENS was the introduction, in the 1980s, of electromagnetic bone healing devices that are utilized to heal non-union fractures. For the first time this allows physicians to heal non-union fractures that previously necessitated amputation.