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The Science Behind CES Introduction

“He ought not to risk his reputation by presenting to the learned body anything which
appeared so much at variance with established knowledge, and withal so incredible.”
-The British Royal Society

At the beginning of every book on electromedicine there is a brief history of the use of electricity to cure physical and/or emotional ailments of mankind, dating back to early Greek practices. Since this book is being authored by Dr. Daniel Kirsch, a pioneering inventor of microcurrent treatment for pain, it can simplify matters to quote from his Alpha-Stim 100 Owner's Manual, now printed in six languages:

"The application of electromedical currents is not a new concept. Ancients recognized the therapeutic value of naturally occurring electrical phenomena long before William Gilbert defined electricity in 1600. Both Aristotle and Plato refer to the Black Torpedo (electric ray fish), prescribed in 46 AD by the physician Scribonious Largus for the relief of a variety of medical conditions from headaches to gout…In the 1800's dentists reported excellent results using crude electrical devices for pain control.
"…One hundred years ago, electrical devices were in widespread use to manage pain and ‘cure’ everything from cancer to impotency. Because of the unrefined early electrical technologies… this form of therapy fell into disrepute by the medical profession in the early part of the 20th century…"2

It is interesting that by the end of the 1700's a British surgeon, Charles Kite, had invented and was using an electrical cardiac defibrillator creating a storm of protest from the Christian community saying that this was reviving the dead and therefore the work of the devil. The treatment was soon abandoned, but now electrical defibrillators are back again. They are widely found in ambulances, emergency treatment rooms in hospitals, and in post surgery intensive care units, among other places. Their use is no longer tainted with the occult or an alleged association with mesmerism, which disbanded their earlier use. Bringing the otherwise dead back to life with a defibrillator is no longer the work of Satan, but of good, 20th century scientific medicine.3

A precursor to the modern transcutaneous electric nerve stimulator (TENS) was on the market by 1850. In that device, the patient held in one hand a metal handle which was attached to the generator by a wire and placed the other metal piece against the painful area on the body. The therapist turned a crank on the box which generated electrical current. That treatment had disappeared by the end of the 1800's, only to be revived after Melzack and Wall published their Gate Control theory of pain, causing TENS to reenter the U.S. market in the 1970's. TENS are now widely used in American medicine.4

Also in the 1800's an electric belt was manufactured that went around many parts of the patient's body, from his head, down his abdomen and back, around his arms to his hands, and down around his legs to his feet. Small batteries were attached at regular intervals that provided electrical stimulation along the entire belt. That invention was dismissed as a fraud. We now apply stimulation to similar points with acupuncture needles or microcurrent stimulator probes.5

In 1816 Berlioz published an early report on the potentiating effect of electroacupuncture,6 and in 1825 Sarlandiere reported his use of electroacupuncture in treating gout, rheumatism and stress.7 Fifty years later, in the U.S., Cohen reported one of the first uses of electricity in tumor surgery.8

In 1985, Robert O. Becker wrote about the very intricate and involved scientific investigations that led to the use in the 1980's of electrical stimulation to stimulate healing in broken bones. That was seen as an incredible breakthrough until one of Becker's research assistants discovered that they had been beaten to this discovery by 150 years. Becker recounts:

"Back in 1812, Dr. John Birch of St. Thomas' Hospital in London used electric shocks to heal a nonunion of the tibia. A Dr. Hall of York, Pennsylvania, later used direct current through electroacupuncture needles for the same purpose, and by 1860 Dr. Arthur Garratt of Boston stated in his electrotherapy textbook that, in the few times he'd needed to try it, this method had never failed."9

Becker began his research in an effort to understand bone regrowth in fractures. He did this by studying the regeneration process in salamanders. In an earlier study in 1909, an American researcher named Owen E. Frazee found that if he passed electrical currents through the aquarium water in which larval salamanders lived he could speed up their limb regeneration process.10 That was one of the seminal lines of research that was to lead to Robert O. Becker's breakthrough work on the body's electromagnetic fields beginning in the late 1950's. While it may seem incredible that this was not followed up on at the time, it so happened that very shortly after the 1909 study results were published, electromedicine would be officially on its way out in the United States.

During the time of Frazee's experiments, the Carnegie Endowment for the Advancement of Teaching funded a study by the American Medical Association to look into electromedicine to see if there was anything to it. The committee appointed to do this study delivered its report the year following Frazee's findings and said there was no scientific basis for the use of electricity in medicine.11

In large part, that was due to the lack of sensitivity of then available electrical and electromagnetic measuring devices. Electrotherapists could point to therapeutic results but had no way to show how the applied electricity could possibly effect changes in the body. Unfortunately, it also allowed genuine frauds to be perpetrated by those so inclined, since no one could prove that they could not cure every disease they named, without expending more time and effort than most self appointed watchdogs wanted to apply to the task.

Not so the Flexner Committee. They did what such committees do by definition: If something could not be proved it could not be said to exist, so they dismissed electromedicine, as, then, did the American Medical Association.

Interestingly, just five years prior to that, the Chinese Emperor, embarrassed by the primitiveness of medical practice in his country, prohibited the further use of acupuncture in Chinese medicine, requiring physicians in his country to take up the more advanced Western medicine in their practices instead.12

General Douglas MacArthur, similarly, forbade the "primitive" Japanese practice of shiatsu in medicine when U.S. forces occupied Japan in 1945. Fortunately the order was overturned by President Truman, and at the turn of the 21st century we find many practitioners of shiatsu therapy in the U.S. and around the world.13

So here we were in the first ten years of the 20th century and everyone everywhere wanted to update medicine and make it modern. Among the first steps taken was to get rid of electromedicine and acupuncture.

Modernizing medicine was no easier then than it is now, as it happened, and acupuncturists continued to practice in China, albeit quietly for a while. The communist regime both resurrected and formalized the practice of acupuncture when they came in. As a bonus, they forced China's last emperor to learn and practice acupuncture and moxibustion while he was imprisoned by them in the 1950's.14 Its practice had been mainstreamed again by the time President Nixon's group visited there in 1971 and exposed its obvious usefulness. Members of his team essentially brought it home to America over a half century after it had been banned in its homeland. Meanwhile, Hitler chose as his personal physician, Theo Morell, a doctor with a thriving business in Berlin who was still using electrical stimulation to treat prostatitis and impotence in his private practice at the time.15

If so-called useless medicine has been hard to stamp out, however, it has always been just as hard to get something new started in medical practice. For example, scurvy, which had forever been a grave problem for seafaring nations, took the lives of three-fourths of Lord Anson's crew on his trip around the world as late as 1740-44, and the Channel Fleet had 2,400 cases of scurvy after just ten weeks at sea in 1778. But the latter losses occurred twenty-five years following the publication of Lind's Treatise of the Scurvy in which, following his experiments, he reported limes or lemons to be the prevention and the cure.16 Eventually, it was to take the British Admiralty 40 years and thousands upon thousands of lost lives to get limes aboard its sailing vessels following Lind's discovery. Of course it was true that the ships' stores were already laden with other things, and no one wanted to replace a few rum barrels with limes.

Similarly, more British soldiers (8,000) died of typhoid fever in the Boer war in Africa than were killed in action, even though a professor of pathology at the Netley Military Hospital had perfected a vaccine made of dead typhoid bacteria and recommended its use by the army. A successful trial of the vaccine in the Indian Army had proved its safety and effectiveness, the report appearing the same year the Boer War began.17

Becker reports the serendipitous finding in Sheffield Children's Hospital in England in the early 1970s that children up to 11 years of age who lose the tip of a finger, up to the first major crease behind the nail, will totally regenerate the finger tip including muscles, nerves, nail, and skin, provided it is a clean cut and no one attempts to treat it. Any attempt to suture the missing part back on, or close the wound by suturing a protective skin flap over it, etc., will result in a deformed or missing finger tip.

Surgeon Cynthia Illingworth, who discovered this phenomenon, began treating other children who had lost a fingertip by simply cleaning the wound and loosely bandaging it to keep the dirt out. Within four years she had documented several hundred regrown fingertips, and other clinical studies confirmed it. That was in 1974, and it was well publicized, yet 25 years later, doctors throughout the world are still maiming children's hands by diligently providing medical treatment for children with missing fingertips.18

Now that it had been purged of electrical charlatanism, medical practice in the U.S. continued as a proud melange of herbs, mustard packs, blood letting, mercury shots, cathartics, purges and the like. Since the use of safe intravenous drips would not be discovered until World War II was underway, many medications of the day, including not a few very elaborate food supplement preparations, were simply injected into the person via the sigmoid colon.19

Surgery was still a recognized field of medicine, of course. Among the more common surgical procedures in the early 20th century was cutting patients open and tying down their floating kidneys, thus curing backache. In that same era some surgeons decided that the colon was not only useless but also a deterrent to good health, so they had begun removing that also.20

By 1936, physicians still recognized that bad eyesight was often caused by "autointoxication due to imperfect elimination" and though no longer doing colonectomies, for better eyesight they recommended a good cleansing of the colon whose poisons were still widely known to pollute the body and to be responsible for all sorts of ailments, including bad vision.21

Just prior to and during World War II we entered the magic bullet period in medicine, first with antibiotics, then with other medications, notably the psychoactive drugs. Western medicine quickly began to lose interest in purges, herbal remedies, any placebo effect from a warm bedside manner, and so forth, and entered its current drug-dominant phase. Pharmaceutical companies vied with one another to produce and market the next powerful, wide spectrum antibiotic and the next psychopharmacologic wonder. Their sales reps became the new postgraduate medical educators to the medical profession.

The transition, as usual, was not as fast as we sometimes think. The antibiotic sulfonamide had been used as a skin antiseptic as early as 1913, and the ability of sulphanilamide to kill streptococci, the agent then killing patients with septicemia was known as early as 1932, when I.G. Farben successfully researched, then patented it. The first report on penicillin had been published back in 1929.22 Luckily, World War II was on, and there was an emergency need to do something about thousands upon thousands of wounded and dying out on the battlefield. Antibiotics were then rushed into medical practice.23

Interestingly, it was not penicillin that began the medical revolution as many people now think, but the use of the various new sulfa powders following the bombing of Pearl Harbor, that began the new antibiotic phase of medicine.24 Slaughter, in 1946, furnished a vivid reminder of those heady days as the transition in medicine was still in progress. He breathlessly reported, "New methods of preparing the drug (penicillin) hold promise that soon it may be given by one or at most two injections (in patients suffering from gonorrhea), and probably will not even require hospitalization."25

It is interesting to speculate how much longer it would have taken antibiotics to enter medical practice if the war had not been on. Certainly the medical conservatives would have demanded years of research on the possible harmful effects of injecting the products of fungi directly into the human body. Many years of animal research would have been demanded therefore, and finally small initial trials on human volunteers, probably prisoners serving life sentences, would gradually be made. It is conceivable that widespread use of antibiotics may have entered mainstream medicine no earlier than by the early to mid 1960s had it not been for the terrifying war that was in progress.

The origins of today's cranial electrotherapy stimulation (CES)

In the late 1960s the Dallas Morning News carried a small filler about a portable electrical device that was being used to relax the engineers who drove the bullet train in Japan. It said that they would drive the train from Tokyo to Kyoto, then lie in a darkened room on a cot for a few minutes with this device connected to their head via electrodes. It was said to relax them prior to their return trip north. An enterprising engineering firm from Garland, Texas, whose business it was to research new products, sent a small delegation to Japan to check out the device. They returned to Dallas with the Russian Electosone device, which pulsed 100 times per second with a sinusoidal waveform. Its output was limited to 1.5 milliamperes (mA), and there were four electrodes, two to be placed over the eyelids and two to be placed at the base of the head in back. The device was about the size of a businessman's brief case, though much heavier due to its internal rechargeable batteries.

One of the engineers, Ray Gilmer, left the parent organization with this new idea and began NeuroSystems, Inc., in Garland Texas. He began to manufacture his Neurotone 101 device that had treatment settings of either 50 Hz or 100 Hz, stimulated sinusoidally, on an 80% duty cycle, with stimulus intensity limited to 1.5 mA. Because of the uncomfortable pressure and visual effects when the frontal electrodes were placed over the eyes, he early on decided to place them just above the eyebrows on the forehead.

Later he added to his armamentarium transcutaneous electrical nerve stimulation (TENS) devices, electromylogram (EMG) biofeedback devices, and a device that did both CES and EMG biofeedback. He was making nationwide sales efforts by the early 1970s.26

Meanwhile, an early researcher in the U.S.A., Saul Rosenthal, M.D., led a group of scientists at the University of Texas Medical School at San Antonio in their study of the Russian Electrosone unit, which was called an electrosleep device, and later the Neurotone 101. In fact, during the 1960s and early 1970s CES in the U.S.A., like CES in most of the world, was called "electrosleep." Rosenthal and other researchers who followed were to expend much research time and effort using the device in an attempt to put people to sleep. It did not do so reliably, but it did seem to relax them and eliminate much stress in the process.

Consequently, beginning in the early 1970s sleep studies became increasingly rare apart from some that did achieve notable improvement of sleep when the subjects went to sleep at some later time, sometimes several hours after treatment. Serendipitously, it was discovered that CES reduced stress states, which included anxiety and depression. Research then began focusing on the treatment's ability to effectively treat depression and anxiety, such as that found in persons withdrawing from addictive substances, along with cognitive deficits that presumably sprang from the depression and anxiety states.

The Neurotone 101 was called before the U.S. Food and Drug Administration’s (FDA) Neurology Panel in 1978 after new laws required the assessment of the safety and effectiveness of devices then on the market. They suggested to Gilmer that the name "electrosleep" might be a misnomer. Gilmer suggested that they call it "cranial electrotherapy". The FDA wasn't willing to commit to the "therapy" part, and they settled on "cranial electrotherapy stimulation." The FDA decided that any small electric current that went across the head, from any medical device used in the U.S.A., was to be called cranial electrotherapy stimulation. Thus even TENS units, when they placed electrodes so that current flowed across the head, would now be CES devices.

Electrosleep circles at that time spread throughout the world, but most notably in the Eastern European nations, plus several countries in Western Europe such at Austria, where an international electrosleep conference was held every three years. As a group these clinicians theoretically thought of CES as just another electrical stimulation whose intensity was reduced down from a stimulation continuum that began at its most intense with electroshock, then was reduced down in intensity to electroanesthesia, which in turn could be reduced down to electrosleep levels. In their thinking it had nothing to do with acupuncture points, meridian therapy, the yin and yang and such. It was, effectively, mini-electro- shock treatment, without the negative side effects of its brothers that stimulated at higher intensity.

Soon to come from a quite different theoretical perspective in Hong Kong, however, was Margaret Patterson. She was a British surgeon working in a hospital that used acupuncture for anesthesia during surgery. To avoid the concentrated staff effort involved in twirling inserted needles, plus the additional physiological insult to the patient from inserted needles, they developed the habit of applying small amounts of electrical stimulation to the acupuncture points instead. They were using a bipolar spike wave, AC current, pulse width of 0.6 milliseconds (mS) and a frequency of 111 Hz. After one such surgical procedure, the patient seemed amazed. He had not told them that he was a heroin addict beforehand, and yet later admitted to the staff that he was having no withdrawal symptoms even several days following the procedure.

This profoundly impressed Patterson and she assisted as her colleagues began trying this stimulation out on known addicts who were being withdrawn from various drugs or alcohol.27 To her amazement, the treatment aborted the withdrawal syndrome in her patients, and a new therapy was born. She named it “neuroelectric therapy” (NET). She went on to discover (or decide, it was never clear) which pulse rates were best for which condition treated, and began to proselytize heavily for NET, both back in England and later in the U.S.A. She added disorder-specific electrical stimulus rates to NET's armamentarium, and thus moved away from the pure theoretical concepts of acupuncture, but not into the mini electroshock school.28

Both she, and now NeuroSystems, were utilizing two electrodes instead of four, placed just behind the ear lobes for the treatment. This new placement was well researched by both, and found to effect the same cures that had been obtained by either the frontal/occipital placement in the Neurotone treated patient, or the auricular (heart-lung) acupuncture points formerly used in NET.

By the late 1970s and early 1980s, both Margaret Patterson and Ray Gilmer were marketing a small, pocket size unit. The difference was that Gilmer's "Relaxpak" was limited to 100 Hz and 800 microamperes, now pulsing with a modified square wave. Dr. Patterson's had different frequency (Hz) capabilities, 10 Hz for serotonin production and turnover (from rat studies), below 75 Hz for barbiturate addictions, 75 Hz - 300 Hz for narcotics, 2000 Hz for cocaine, etc. The pulse was a bilateral, modified square wave of unstated intensity. She liked to keep her pulse widths between 0.1 and 1.5 mS. By 1986, she was on the eighth version of her device. A lot of secrecy was still being maintained surrounding its stimulus characteristics. Its stimulus intensity was not published, but she stated that year that available stimulation should range from 1 Hz to 2000 Hz, so her newest device probably did.

At about that same time Dr. Daniel Kirsch was inventing microcurrent stimulators for pain treatment. He had begun his studies of electrical stimulation parameters as early as 1972, working with physician-acupuncturists. Like Patterson, his later work took him far afield from acupuncture. His present Alpha-Stim technology takes into account the pulse wave harmonics available in the specialized basic pulse characteristics of the stimulators he has developed. In his pain treatment device he designed a technology that did not require numerous separate pulses per second, as in Patterson's device, since they are all readily available in the harmonics. These would later be made a part of his CES technology also.

The mini-electroshock vs. acupuncture theories died down or become less important as other device manufactures attempted to enter the U.S. market. The FDA made it very difficult for all of them, even though the FDA had permitted entrance into the American market of TENS stimulators for pain control, electrical biofeedback monitors, cardiac pacemakers, and electromagnetic bone healing devices, among others. Unlike CES, these were for medical problems, not psychiatric complaints. For more than twenty years and counting, the FDA has created two major blocks to the success of CES in the U.S. marketplace.

To comprehend this, it helps to know that the Device Amendment Act of 1976 required the FDA to call-in for review and classification all medical devices on the market at the time the law was passed. Since they could not get to all of them right away, these devices were retained on the market in a so-called grand- fathered open market status. In something of a semantic quirk, all devices were classified as either Class I, for devices that met all safety and effectiveness standards, and in addition had developed precise good manufacturing practice (GMP) guidelines, Class II, for devices that met safety and effectiveness standards but lacked the GMP guidelines, and Class III for those that were still undergoing basic research only and had shown neither safety nor effectiveness. The latter were not allowed to be marketed in the U.S. The catch was that the FDA also had another Classification III, in which were put all grandfathered devices that they had not yet reclassified, but which legally remained on the market.

Like all electrical stimulators in the U.S.A., CES had earlier been declared a prescription only device, so it was not available over the counter in the U.S., and third party payers were usually billed for the treatment. When CES marketers attempted to make sales to medical professionals for use in treating their patients, third party payers sometimes called the FDA regarding CES, and were invariably simply told that it was a Class III device, with no additional explanation. The third party payer would hang up and refuse to pay for treatment with what they assumed was a research device. Medical insurers do not knowingly pay for research, of course. They presumably would have paid for grandfathered Class III devices, however, had they known or been told. An exception to FDA's practice in this regard occurred when a senator called at the request of a CES company in his home state and asked the status of CES. An FDA lawyer wrote him a fine letter explaining in detail the actual situation of CES being a grandfathered Class III device with legal access to the open market. This indicated that FDA personnel knew the difference in the two Class III categories, they just were not telling.29

The second thing of note that FDA did, to all appearances, was to make an in-house decision in the early to mid 1990s to get rid of CES once and for all. They published a call-up for CES in the Federal Register, and companies then on the market were required to submit all their scientific evidence for CES's safety and effectiveness. FDA's Neurology Panel was to go over all of this data and make its classification recommendation to the Commissioner. If no CES company complied, CES would automatically fall out of its grandfathered open marketing status and be pulled off the market. Several companies sent in all of their data, however, including some that had legally come onto the market tied to the apron strings of the original grandfathered device. Only Electromedical Products International, Inc., submitted a full-blown Premarket Approval Application, the device equivalent of a new drug application.

FDA knew not to trust its Neurology Panel too far, since its earlier panel, convened in 1978, had recommended the approval of CES for the treatment of addictions. So FDA now inserted into the middle of this process one of its staff members who had a masters degree in mechanical engineering. Her task was to review all of the scientific studies, published in peer reviewed science journals, plus several Masters Theses and Doctoral Dissertations, completed under supposedly competent university faculty. Every study, without exception, she discounted as not being science, for reasons she determined on a case by case basis as she read them. To say it another way, this rather low ranking staff member did something she presumably would not have had the political intestinal fortitude to do unless she was under a direct order from higher in the organization. She single handedly dismissed over 100 clinical and scientific studies, 90% of which were behavioral science studies, a subject not taught in schools of mechanical engineering, and then stated that there was nothing to present to the Neurology Panel which therefore would not be convened to review CES. Based on her analysis and recommendation, the Commissioner supposedly had no choice but to pull CES off the U.S. market once and for all, sending it back to square one as a research device. FDA's permission (its Investigational Device Exemption - IDE) would then be required prior to the initiation of any proposed research project with CES in the future. Simply by choosing to withhold the IDE, no future research studies would have been possible, and CES would have been dead once and for all in the U.S.A.

Luckily, Electromedical Products International, Inc., one of the few CES companies remaining, if not the only one, had in the interim accumulated enough earnings (and potential earnings, as it ultimately required) to file a lawsuit against the government, the result of which was that the FDA backed down. As of this writing CES remains in the grandfathered Class III category, and therefore legally still on the open market, but a reclassification petition with supporting documentation is on the FDA Commissioner's desk for his consideration in down classifying it to Class II.

The major explanatory systems

When marketers go into the medical market place with a new treatment, physicians typically want to know how it does what it is said to do. While physicians used aspirin for over a hundred years before they knew about prostaglandins, they were not to be that easily persuaded to put electricity into a patient's head, unless of course it was the more acceptable electric shock (still in FDA's grandfathered Class III status as of this writing). So it seemed necessary and advisable to discover CES's treatment mechanism, and that presented its own problems.

An interesting phenomenon that occurs when scientists around the world get together to discuss medical treatment, "electrosleep," in this instance, especially when it involves the head, is that there are in existence completely different theoretical explanatory systems. When these are translated into English, Americans find that although all the words are in their English vocabulary, they have no clue as to what the other person is saying. Or as one American researcher succinctly stated the problem, following a paper read by a Yugoslavian researcher at an international CES conference in Bulgaria which had been simultaneously translated into English over our headphones, "What the hell?!"

The Russians have a theoretical science built on the great Pavlov's research and concomitant theoretical constructs. They conceptualize most neural conditions and events in terms of inhibition, disinhibition, neural excitation, conditioning, and the like. Thus, in a paper given at an international congress on CES, one researcher reported, "According to current concepts (Land, Myasnikov), hypertension is a neurosis of the higher regions of the central nervous system which involves the appearance of stagnant foci of excitation in the cerebral cortex and adjacent subcortical structures. As a result, various autonomic-humoral disturbances develop, including increased arterial pressure."30 He had researched the successful use of CES in patients with high blood pressure.

Another East Block researcher stated, "positive therapeutic effect(s) occur more frequently in patients showing signs of protective inhibition in the cerebral cortex," adding, "Patients with the best therapeutic results of electrosleep were distinguished by the extraordinary instability and speedy wearing off of their conditioned responses and by the presence of a well marked external and after-inhibition." It was concluded that the predominant defect in this group of patients was weakness of the excitation process, accompanied by a tendency towards the development of protective inhibition in the cortex.31 In any event, CES successfully treated the condition.

Thus, a great number of positive findings by former East Block researchers are still lost to the American scientist and clinician because of our theoretical differences and the consequent ways of understanding and stating study findings.

In the West, we tend to conceptualize brain activity in terms of neurochemical reactions at the presynaptic/postsynaptic neural membrane juncture. Thus, Pozos and his group at the University of Tennessee Medical Center studied the cholinergic/adrenergic system in several experiments with dogs. They injected their subjects with reserpine, a dopamine reuptake blocker, then applied electric current to engender increased dopamine release into the synapse and consequent depletion when this was broken down by monoamine oxidase (MAO). This gave the dogs Parkinson-like symptoms. Then, while the reserpine was still blocking the dopamine reuptake, atropine was injected to act as a blocker to the postsynaptic uptake of acetylcholine, thereby preventing or reducing acetylcholine's effect on the postsynaptic membrane. Now the dogs' Parkinson- like symptoms disappeared and they returned to normal appearance. To further check their theoretical system, the researchers removed the atropine and added physostigmine to the still reserpinized dogs. The physostigmine was intended to knock out the MAO breakdown of intrasynaptic acetylcholine, making more of it available. The dogs responded with their most profound Parkinson-like symptoms. Finally, the researchers removed all drugs from the dogs' bloodstream and found that dogs allowed to go about their normal activities recovered in three to seven days, while a similar group given CES stimulation recovered in two to eight hours.32

Similarly, Mark Gold and his group did a double-blind study in which medical inpatients who were addicted to narcotics were withdrawn using either alpha methyl dopa as an a-blocker at norepinephrine's postsynaptic receptor in the locus ceruleus (to make up for the relative lack of available ß-endorphins to balance norepinephrine's stimulation effect), or CES. The CES group received no medication, but received stimulation for one hour per day during the withdrawal period, which lasted a minimum of three days. The physicians who evaluated the patients on a daily basis during their withdrawal could not tell which patients were on which treatment, until the a-blocker was removed from that group and they responded with rebound depression, presumably due to the newly MAO depleted levels of norepinephrine which had built up in the intrasynaptic gap. The CES patients, who were theoretically stimulated by CES to increase their ß-endorphin production up to a prior homeostatic level, did not show rebound depression following the cessation of CES therapy.33

To restate, in the West we tend to theorize in terms of neurochemicals balancing each other in a homeostatic relationship in the brain. As a result, in medical practice we add additional chemicals to an unbalanced system, dopamine in Parkinson patients, for example, a-blockers (e.g. clonodine in withdrawing alcoholics), ß-blockers (e.g., sometimes used in heart dysrhythmias), or MAO blockers to increase the effective amount of a given neurochemical being ejected from the presynaptic vesicles.

Where does the need for all of this intervention come from? Hans Selye, M.D., warned us some time ago that persons who experience continuing environmental stress will readjust their ongoing homeostasis to the stress response and experience recurring physiological problems as a result of our sympathetic neurohormonal system constantly being poised for the fight or flight reaction. If this continues, after a short time the entire immune system begins to break down.34 That we, as a people, frequently shift into abnormal neuroelectrical states should not be surprising.

Our brain presumably evolved as we ambled over an open plain with a couple of goats, a cow and a few chickens to keep us company. Now we speed along the highway to work and back from 30 to 70 miles an hour, often work in high rise buildings where we can look out a window and see the ground some fifteen floors or more below, then come home to our house, in a crowded neighborhood full of people we've never met.

For restful entertainment after dinner, we glue ourselves to the television and watch bodies blown apart with submachine guns, thrown out of the windows of skyscrapers or burned to death in spectacular conflagrations. In addition, we easily forget that there is a Central or a South America right on our doorstep until something really bad goes wrong down there and we get to see the resulting starving, bleeding, drowned, or mangled bodies in our living room on the six o'clock news. Ditto Africa, Bangladesh, etc.

For health reasons, it would obviously be best if we could get back to our brain's more normal homeostasis, but when we medicate the brain in an effort to force it back, we encroach upon the brain's natural mechanisms and it can never return to normal while the drug is present. Often the drug becomes essentially addictive in that it can not then be removed without sending the patient through the dreaded withdrawal syndrome complete with its intense depression and anxiety.

CES on the other hand is intended to gently prod the various neurohormonal systems back into their pre-stress homeostatic relationships. Once it has done that, CES ceases to have an effect, and no patient to date has shown habituation, much less an addiction to CES upon clinical follow up of from one year to twenty months post prescription.

A third major theoretical system, held in China and much of the Far East, theorizes in terms of man existing in a unified nature, the Tao, which contains and consists of polar and complementary aspects, the Yin and Yang. Nature is in constant motion, and when the Yin and Yang forces are in balance, life is harmonious and flourishes. Not so when the forces are out of balance. Man is seen as a microcosm of Nature. Chi is the life force in the body. Organ networks communicate with each other via an invisible web of channels transporting Chi.

These pathways are called meridian pathways. There are twelve paired meridians, half on the right side of the body and half on the left, plus two mid-line meridians. Robert T. Story gives an excellent summary of recent research in which these channels have been delineated with radioactive tracings, and gives some basic ideas of how these interact with the neuronal system in the body.35 The Chi courses through the body in perpetual motion in channels that empty into one another, intersect, and have underground as well as surface streams, connecting the interior with the exterior of the body. In a healthy person, Chi moves freely throughout the body. In the ill person, Chi is heavy, oppressive, constrictive and congestive. It is no longer moving freely.

Acupuncture is a process of stirring up the Chi so that stasis is overcome, thereby restoring circulation. The system then returns to normal. By eliminating congestion and activating circulation of Chi, then, acupuncture interrupts and disorganizes patterns of illness.36

The theoretical action of CES in this system would be to electrically stimulate the Chi when in stasis and encourage its free movement throughout the body once again.

New theoretical models

There is every evidence that we are on the threshold of moving on to new theoretical explanatory models in the West. In the forefront of these theories are those regarding biologically closed electric circuits, put forth by Björn Nordenström, M.D.,37 and the extraneuronal semiconducting ion flow network theory, put forward by Robert O. Becker, M.D. Both men have spent their careers as research scientists, their work cutting across lines of established scientific and professional specialties.

Both systems recognize the current of injury in which the polarity at the site of an injury in the body turns positive almost immediately, then back to negative as healing begins and continues. Both recognize that there is an electromagnetic energy field surrounding the electron flow channel, and that this can interact with electromagnetic pressure impinging on it from the outside to change the ion potential and ion flow characteristics inside the closed channel.

In more than 20 years of research, Becker elaborated the direct current system that flows not thorough the nerves, but through the ubiquitous nerve support cells, the glial, ependymal, and Schwann cells. These, he found, act as semiconductors, passing slow speed analogue DC current from the central to the peripheral body areas along the motor nerve support cells, and from the periphery toward the central body axes via the sensory nerve support cells.38 He speculated that the system interlocks physically with the nervous system and is most likely its precursor.

Once he had found the current of injury, Becker devoted a great deal of his career to studying these energy relationships as body parts repaired or regenerated in various lower animals, most notably the salamander. As a result of his work the FDA authorized the marketing of an electromagnetic device to treat nonunion fractures in 1979. By 1986, over 15,000 fractures had been treated with these devices. In 1984, the queen of England had a painfully strained shoulder successfully treated with two, ninety-minute treatments with a pulsed electromagnetic field device.39

Once Björn Nordenström had discovered biologically closed electrical circuits, his research led him into the vascular system to discover what drew white blood cells and other disease fighting organisms to the wound site, followed by other blood components that nourished and supplied the wound as healing took place. He discovered that it was the electrical changes in the wound site and within the vascular system itself that was working the changes at the wound area. He went on to discover that the vascular system functions as a closed electrical system, whose blood elements serve as ion conductors while the vascular walls act as insulators. The arteries, the veins and the capillaries all have distinct and separate functions in this organic system. He concluded that the release of energy by injured and dying cells could be the driving force - the battery - of the intravascular electric circuits.

Both researchers, working separately, concluded that since these DC currents are electrical, and have electromagnetic fields, many, if not all of them can be measured with the extremely sensitive instruments now available. These fields are also sensitive to impinging electromagnetic fields from inside and outside the body.

Becker found that an external electromagnetic field imposed on the body's electromagnetic field could reverse ion flow and change ordinary positive areas in the body, to negative and vice versa. By imposing a magnetic field around the normally negatively charged part of the head of a salamander he could force the charge into positive such as it was when the animal was under anesthesia. Immediately, whole body anesthesia resulted. Similarly, the human head records negative in front and positive in back, and both poles rotate positions when the person is asleep or is under general anesthesia.

In following up on his earlier findings, Becker worked with a hypnotist and discovered that under hypnosis the front of the person's head changed from its normal negative potential, dropping down toward zero as the hypnotic trance deepened. That is, the potential changed just as it would have in anesthesia, just not as far. Also, following a post hypnotic suggestion that a subject's arm would not feel pain, the arm potential went from negative to positive, just as it did when procaine was injected.

Meanwhile, Nordenström's research centered on cancer and he began to use electrodes inserted into cancers and nearby areas in the lung to test his theories. With his techniques, he reliably reduced or totally eliminated cancers up to 4 mm in diameter. In the process, he found the vascular-interstitial closed electric circuit, which represented energy pathways available in vascularized tissues. Its function is for blood vessels to serve as electrical conducting "cables" which are capable of connecting different regions of tissue over conducting interstitial fluid.

Interestingly, both Nordenström and Becker recognized acupuncture points as active areas for energy input into the body, and Becker went so far as to measure the unique electrical potential around each of the 50% of the points he found electrically active, a subject that others had also been investigating.40 In systems described by both researchers there are theoretical mechanisms in which ions moving through the acupuncture meridians could enter the otherwise closed circuits. In Becker's system, the Nodes of Ranvier appearing as microscopic gaps between the Schwann cells lining the neural axon would be among several other such sites where externally impinging ions could change the physical characteristics of the electrical impulse as it moves down the axon toward the dendrites. This would, in turn, effect a quantitative change in either the activating or inhibiting outcome of the neuron's fire. In Nordenström's system, charged membranes of the cells of the capillary walls admit impinging ions via gates and vesicles. When electrons cross an enzyme bridge through the capillary wall it closes this local, capillary circuit and forces ionic flow through the longer distance circuit of the arteries and veins. Also, in the presence of injury, the venous walls do not close, and ions from the blood interact quite readily with those in the immediate environment, such as any that might be coming in via the meridians.

Both researchers showed intense interest in and not a little fear from the high levels of electromagnetic pollution present in the modern world, saying unequivocally that these were surely having large, unknown, and most likely negative effects on the body's electrical and electromagnetic control functions.

Both systems, then, add new and additional concepts to our present systems of theorizing about the body and its inner workings. Nordenström's words were, "(this) means that we must revise extensively our present concepts of conversion of energy in biochemical reactions."41

Among Becker's comments were, "I predict that research on this system will eventually let us learn to control pain, healing, and growth with our minds alone, substantially reducing the need for physicians. …A combination of biofeedback, recording electrodes, and the Super Quantum Interference Device, an ultrasensitive magnetometer, would seem to be the ideal setup for the next level of inquiry into the mind's healing powers."42

In the near future, it is more than likely that these theoretical systems will be further developed and will be seen as the major players in much of the neurochemical related changes that are so central to the present medical theories in the West. Kirsch and Lerner have been early theoreticians heralding this new age.43 New theories will give great importance to the fact that major cellular functions appear to be controlled by the body's own DC electrical fields. The new theories will give us for the first time a way of conceptualizing the forces than can guide the development of the human body from the first divisions of the egg in the womb to the incredible multitudes of cell differentiations that result in the finished body, and how these are maintained in wellness or interrupted in illness.

The people who are already out there well ahead of these theories that are likely to be next molded into being, will continue to be pelted with stones by otherwise respectable people until sometime in the future when even these pioneers may be brought into the fold of scientific respectability. I refer to those persons who say they are passing energy into other persons by the laying on of hands, those who are sure that stones pass healing energy via their innate semiconducting properties, and those who focus their energies in prayer onto the diseased or disabled, among many others.44

Unlike these, CES fortunately has found respectability within the old neurochemical explanatory system, but it can be expected that CES will also find a strong foundation in the newly developing theories in which incoming pulsed electrical stimulation will be seen to provide a helpful and perhaps even necessary stimulation to the stalled flow of Chi in the body, or of some intransigent positive electrical potential remaining where a negative potential is wanted, either along the extraneuronal semiconducting analog pathways, or in the biologically closed electric circuits within the vascular system.

The following chapters in this book will indicate what is known about CES so far.

Ray B. Smith, Ph.D., M.P.A


1. Gordon, Richard. The alarming history of medicine. New York: St. Martin’s Press, 1993. P. 49.

2. Electromedical Products International, Inc. Owner’s manual: Alpha-Stim 100 microcurrent stimulator. EPII, Mineral Wells, Texas, 2002.

3. Editors of Time-Life Books. Mysteries of the unknown; Powers of healing. Time-Life Books: Alexandria, Virginia, 1997. P. 88.

4. Melzack, Ronald, & Wall, Patrick. Pain mechanisms: a new theory. Science, 150: 971-979, 1965.

5. Editors of Time-Life Books, Ibid, P. 88.

6. Berlioz, Louis, Memoires sur les maladie chronique, les evacuations sanguines et l’acupuncture. Paris: Croullebois, 1816.

7. Sarlandiere, Jean Baptiste, Memoires sur l’ectro-puncture, considere`e comme moyen nouveau de traiter efficiacement la goute, les rhumatismes et les affectiones verveuses. Paris, 1825.

8. Cohen, L.H. Galvanopuncture; with a successful case of operation by electrolysis in a glandular tumor. New York Medical Journal, 223:380-387, 1875.

9. Becker, Robert O. & Selden, Gary, The body electric; electromagnetism and the foundation of life. William Morrow, N.Y., 1985. P. 172.

10. Becker, R. Ibid. Pp. 74-75.

11. Kirsch, Daniel L. & Lerner, Fred N., Electromedicine: the other side of physiology. In Weiner, Richard S. (Ed.) Pain Management; A practical guide for clinicians. St Lucie Press, Boca Raton, Florida, 1998, P. 830.

12. Cameron, Meribeth E. The reform movement in China, 1898-1912. Standford University Press, Stanford, CA, 1931.

13. Editors of Time-Life Books. Ibid. P. 55.

14. Brackman, Arnold C. The last emperor. Carroll & Graf; N.Y., 1975, Pp. 322-323.

15. Gordon, R. Ibid. P. 229.

16. Gordon, R. Ibid. P. 60.

17. Richardson, Robert G. Surgery: Old and new frontiers, N.Y.: Charles Scribner’s Sons, 1968, P. 169.

18. Becker, R. Ibid. P. 155-156..

19. Gordon, R. Ibid. P. 162.

20. Gordon, R. Ibid. Chapter 8.

21. Peppard, Harold M. Sight without glasses, Doubleday, Garden City, N.Y., 1936. P. 25.

22. Fleming, A. On the antibacterial action of cultures of a penicillin with special reference to their use in the isolation of B. influenzae. British Journal of Experimental Pathology, 10:226, 1929.

23. Gordon, R. Ibid. Pp. 69-73.

24. Slaughter, Frank G., The new science of surgery. Julien Messner; N.Y., 1946. Chapter 4, God’s Powders.

25. Slaughter, F. Ibid. P. 47.

26. Personal communication from Ray Gilmer, 1980.

27. Wen, H.L. & Cheung, S.Y. Treatment of drug addiction by acupuncture and electrical stimulation. Asian Journal of Medicine, 9:138-41, 1973.

28. Patterson, Meg. Hooked? NET: the new approach to drug cure. Faber and Faber, London, 1986. Chapter 3.

29. Personal communication with Larry Paros, 1992.

30. Kostyukhina, N.A. Comparative evaluation of capillarographic data of hypertensives during treatment with pulse currents (electrosleep, interference currents, and thythmic galvanic collar). In Wageneder, F.M. & St. Schuy (Eds.), Electrotherapeutic Sleep and Electroanesthesia. Vol. II, Amsterdam, Excerpta Medica, 1970.

31. Titaeva, M.A. Changes in the functional state of the central nervous system under the influence of a pulse current as used in electrosleep. In Wageneder, F.M. & St. Shuy (Eds.) Electrotherapeutic sleep and electroanaesthesia. International Congress Series, No. 136. Excerpta Medica Foundation, Amsterdam, 1967.

32. Pozos, Robert S., Strack, L.F., White, R.K. & Richardson, Alfred W. Electrosleep versus electroconvulsive therapy. In Reynolds, David V. & Anita Sjoberg, (Eds.), Neuroelectric Research. Charles Thomas: Springfield, 23:221-225, 1971.

33. Gold, M.S., Pottash, A.L.C., Sternbach, H., Barbaban, J. & Aunitto, W. Antiwithdrawal effect of alpha methyl dopa and cranial electrotherapy. Paper presented at Society for Neuroscience, 12th annual meeting, October, 1982.

34.Selye, Hans, The stress concept: past, present and future. In Stress Research, Cary L. Cooper (Ed.) 1983, John Wiley and Sons, N.Y., Pp. 4-6.

35. Story, Robert T. Comprehensive meridian therapy. New York Chiropractic College, Seneca Falls, N.Y., 1995.

36. Beinfield, Harriet & Korngold, Efrem, Between heaven and earth; A guide to Chinese medicine. Ballantine Books: N.Y., 1991.

37. Nordenström, Björn E.W., Biologically closed electric circuits; clinical, experimental and theoretical evidence for an additional circulatory system. Nordic Medical Publications: Stockholm, Sweden, 1983.

38. Becker, R.O., The basic biological data transmission and control system influenced by electrical forces. Ann NY Acad Sci. 238:236-41, 1974.

39. London Times, The. Rubbing shoulders, The times, London, 1984; Sept. 5:12(Col 1).

40. Bergsman, O. & Wooley-Hart, A. Differences in electrical skin conductivity between acupuncture points and adjacent skin areas. Am. J. Acupuncture. 1:27-32, 1973.

41. Nordenström, Björn E.W., Ibid. P. 319.

42. Becker, Robert, Ibid. Pp. 239, 242.

43. Robbins, Jim, A symphony in the brain. Grove Press: N.Y., 2000, pp 200-202.

44. Pert, Candace B. Molecules of emotion; the science behind mind-body medicine. Simon & Schuster: N.Y., 1999, P. 182.

45. Underwood, Anne. Searching for a new and improved Prozac. Newsweek, December 31, 2001.

46. Kirsch, Daniel L. Electromedicine: the other side of physiology. In Weiner, Richard S. (Ed.) Pain management: A practical guide for clinicians, 6th ed., Chapter 60, CRC Press: Boca Raton, 2002.

47. Kirsch, Daniel L. A practical protocol for electromedical treatment of pain. In Weiner, Richard S. (Ed.) Pain management: A practical guide for clinicians, 6th ed., Chapter 61, CRC Press: Boca Raton, 2002.

48. Gerber, Richard, Vibrational medicine for the 21st century. Harper Collins: N.Y., 2000.

49. Lichtbroun, Alan S., Raicer, Mei-Ming C., Smith, Ray B. The treatment of fibromyalgia with cranial electrotherapy stimulation. Journal of Clinical Rheumatology, 7(2), 2001 Pp. 72-78.

50. Smith, Ray B. The use of cranial electrotherapy stimulation in the treatment of multiple sclerosis. In process, The International Journal of Multiple Sclerosis Care, 2002.


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