Results, Theories, and Concepts
Concerning the Beneficial Effects of
Pulsed High Peak Power Electromagnetic Energy
(Diapulse® Therapy) in Accelerating the
Inflammatory Process and Wound Healing. |
Jesse Ross, Ph.D., New York
Presented of
The Bioelectromagnetic Society
3rd Annual Conference
Washington DC. August 9.12. 1981 |
I would like to preface my presentation with the following quotation:
"The Abbe Nollet says, that he received more pleasure when
he discovered that the motion of fluids in capillary tubes and
the insensible transpiration of animated bodies were augmented
by electricity, than by any other discovery he had made; because
they seemed to promise such abundant advantages to mankind when
properly applied by a skillful hand. It is true, that like every
other simple medicine, which has proved beneficial to mankind,
electricity met with much opposition from the interested views
of some and the ignorance of others, has been treated with contempt,
and injured by misplaced caution. I shall recommend to those
who thus oppose it, not to condemn a subject of which they are
ignorant, but to hear the cause before they pass sentence; to
take some pains to understand the nature of electricity."
This was a statement that appeared in a book entitled, "An
Essay on Electricity", Fifth Edition, dated 1799. It appears
that not much has changed since that time.
I am most pleased that we are now, through the efforts of this
Society, starting to have an understanding of the beneficial
biophysical effects of electromagnetic energy. I am equally
pleased to see that the controversy between "thermal"
and ‘non-thermal" is at last being laid to rest.
My presentation today relates only a small portion of the potential
use of electromagnetic energy in medicine. I hope that it will
contribute to raising the curiosity and enthusiasm of my audience
to further investigate its application.
Since electromagnetism is the basis of life itself, I feel that
we are on the threshold of an entirely new concept in medicine.
I want to present a brief overview of the Diapulse Therapy research
that has been ongoing, since 1932, in the United States, Canada,
Western and Eastern Europe, and Mexico. The Diapulse equipment
utilized the following specific parameters:
1. A frequency of 27.12 megahertz (11 meter band)
2. A pulse repetition rate of 80 to 600 pulses per second.
3. A pulse width of 65 microseconds.
4. A power range, per pulse, of between 293 and 975 watts.
5. A duty cycle between 1⁄2 of 1% to 3.9%.
6. A square pulse, with a rise and fall time less than 1%.
And, in addition, it is possible to tune the patient to resonance
at the applicator.
In the early 1930’s, Abraham J. Ginsberg, MD. and Arthur
Milinowski, a physicist, developed a unique ultra-shortwave
unit, and then proceeded with experimentation. Ginsberg’s
article in 1934, entitled "Ultrashort Radio Waves as a
Therapeutic Agent"2 was presented at the New York Academy
of Medicine, and was first to be published on this subject in
the United States. The equipment was perfected in 1936 and Westinghouse
undertook to manufacture and market the unit.
In 1940 - 1941, animal studies were performed at Columbia University
by Halsey,1 to prove the efficacy and safety of Diapulse. In
1940 Ginsberg presented the first clinical report to the New
York Academy of Medicine, titled, "A Description of My
Athermal Shortwave Apparatus, with Clinical Applications’.5
The clinical work had been performed at the New York Hospital
for Joint Diseases, and in his private practice.
World War II interrupted manufacturers of all short wave equipment.
In addition, the Federal Communications Commission (FCC) imposed
strict operating frequencies on all future medical short wave.
i wasn’t until the early 1950’s that Diapulse harmonics
were controlled for FCC approval.
In 1954, Col. George M. Knauf, M.D., then Director of the Tri-Service
Research Program for the United States Government, investigating
the biological effects of microwave energy, obtained Diapulse
machines and performed research at several Air Force bases in
the New York area. After three years of research, he reported
to me in 1957: Although it may take 20 years to determine the
mechanism of action, Diapulse is safe and effective and certainly
should he marketed.
At this point, the Diapulse Corporation of America was formed
and entered into an agreement with Remington Rand to manufacture
the apparatus. A research program was developed to prove the
value of the Diapulse parameters on inflammation, and in hone
and tissue healing.
In 1958 Julia Herrick and Frank Krusen at Mayo Clinic arranged
for a basic study on the effect of electromagnetic energy. They
repeated the Pearl-Chain formation studies that Ginsberg"
had done on fat globules of milk, and expanded the study to
include blood cells and lymph cells. They reported their findings
in the Archives of Physical Medicine and Rehabilitation in 1959.7
This study was again repeated, by Heller8 at the New England
Institute for Medical Research.
Before I discuss the human research, let me give a brief resume
on the animal studies in this historical review:
In 1960, Hans Selye and Nadasdi, at the University of Montreal,
published a paper entitled, "Inhibition of Experimental
Arthritis by Athermic Pulsating Shortwaves (Diapulse) in Rats."’
The summary states, "Treatment of rats with interrupted
shortwave current (Diapulse) significantly inhibits the topical
irritation arthritis produced by formalin and the anaphylactoid
inflammation produced by dextran."
In 1961, Cameron at Baylor University Medical School in Houston,
published his work, "Experimental Acceleration of Wound
Healing". " He found that the actual process of healing
was accelerated by 50% or better.
In 1967, Wong and Erlich," at the University of California,
reported the results of their study on tensile strength in rats
treated with Diapulse. They found that in seven days the treated
group of wounds was 25% stronger than the control group, and
in 14 days found that the treated were still 18% stronger than
the controls.
Additional tensile strength studies were performed at the University
of Indiana,12 The Royal College of Surgeons in London,"
the University of Toronto,14 and at the Veterans Administration
Hospital in Indianapolis,15 demonstrating a significant increase
in tensile strength in the Diapulse treated animals as compared
to the controls.
In 1967 Booker and Chung 16 at Howard University presented a
controlled pathology study. Their results showed less inflammatory
changes, good evidence of epithelial regeneration (by means
of margination), and much smaller size of the lesions indicating
better healing in the experimental animals than in the controls.
In 1968, King, Hathaway and Reynolds, at Georgetown University,
published on, "The Effect of Pulsed Shortwave (Diapulse)
on Alveolar Healing of Dogs."’7 During the first
five days, the inflammatory response within the alveolus was
greater in the treated animals, This supports evidence that
Diapulse Therapy increases leukocytic infiltration in the presence
of injury.., treated animals showed a moderate increase in the
rate of collagen formation as compared to the controls. Collagen
appeared sooner and was more mature during the first eight days.
Bone formation was seen at five days in the treated animals
and at eight days in the controls.
Also in 1968, in a study, Horton and Chapman’s at Virginia
Medical College on standard fractures in the femur of dogs,
observed that the Diapulse treated dog’s fracture had
healed at twelve weeks, while an unstable fibrous union was
present in the control animal.
In 1969, Fenn and associates, at the University of Toronto reported
on, "The Effect of Pulsed Electromagnetic Energy (Diapulse)
of Experimental Hematomas."" Fenn found, "that
these experiments demonstrate that Diapulse Therapy significantly
accelerates the absorption of experimental hematomas in rabbits’
ears.
In 1972, Wilson and Jagadeesh at Leeds University in England
undertook a research program on, "The Effects of Pulsed
Electromagnetic Energy (Diapulse) on Peripheral Nerve Regeneration."2
They reported their findings at The New York Academy of Sciences
in 1973, stating, "Clinical observations showed that wounds
in treated animals healed in four days whereas they required
seven days to heal in control animals. Treated rats began to
use their left forelimb after ten days, but twenty-one days
were necessary before the untreated rats reached this point
of recovery. Nerve conduction studies at twelve days showed
a modified response in the treated nerve but none in the untreated.
At thirty days a biphasic action potential was demonstrated
in the treated animals, and at forty-five days the nerve conduction
tracing was indistinguishable from that of a normal nerve. Sixty
days passed before the nerve conduction began to return in the
untreated nerves. Histological preparations revealed that at
thirty days the nerve in the treated animal has progressed further
towards recovery that has the nerve of untreated animals at
sixty days."
In 1974 Wilson began a study, which was published in 1976, on
"Experimental Regeneration in Peripheral Nerves and the
Spinal Cord in Laboratory Animals (Cats) Exposed to the Electromagnetic
Field (Diapulse)."21 The preliminary results on hemicordotomy
indicated that Diapulse therapy had induced nerve fiber regeneration
across the region of the scar at the end of three months. None
were observed in the control.
The nerve tissue regeneration study was repeated at Vienna University,22
and at The Royal College of Surgeons.2’ In all of these
studies it was reported that the dissection in the treated animals
was relatively simple (very few adhesions) but the untreated
animals possessed considerable scarring and fibrous tissue around
the nerve, which caused the dissection to be tedious and difficult.
These have been a few of the important animal studies. Now I
shall review some of the research with human parents:
The following two reports demonstrate a basic physiologic response
in normal and dis eased patients, which is important for the
relief of inflammation as well as the acceleration of tissue
I healing:
In 1960 Erdman at the University of Pennsylvania reported on,
"Peripheral Blood Flow During the Application of Pulsed
High Frequency Currents (Diapulse)" 24. By placing the
treatment head of the Diapulse apparatus on the epigastric area
and taking measurements off the toes on a plethysmograph, he
demonstrated the average maximum increase in blood flow was
1.75 times the testing pulse. The conclusions were, that in
normal subjects it is possible to produce an increased pulse
tracing in the extremities during the application of Diapulse
Therapy without any significant pyrexia. This was accomplished
without an increase in pulse rate.
In 1966, Prof. Hedenius, Odeblad and Wahlstrom at Karolinska
Institiute in Stockholm, reported, ‘Some Preliminary Investigations
on the Therapeutic Effects of Pulsed Shortwave in Intermittent
Clandication."25 Working with diseased patients he found
that the clinical effect of Diapulse Therapy significantly increased
the
skin temperature and the walking tolerance tests in the treated
patients as compared with the controls.
Following are some of the clinical results obtained in treatment
of wound healing and inflammation with Diapulse Therapy.
In 1959 Dana Street, Prof. of Orthopedic Surgery at the University
of Arkansas studied the use of Diapulse Therapy on post operative
hip-joint infections with and without metal implants, decubiti
with staph aureous, as well as non-union. In 1960 he stated
in a film,2" "during the past two years we have received
much help from the use of pulsed high frequency radiation (Diapulse
Therapy) in approximately one hundred patients." He went
on to review one group of patients to illustrate his results.
In 1962, Lobell at Harlem Hospital in New York published on,
"Pulsed High Frequency (Diapulse) and Routine Hospital
Antibiotic Therapy in the Management of Pelvic Inflammatory
Disease: A Preliminary Report.27 He stated that the average
hospital stay for the treated patients was 7.4 days as compared
to the controls which were hospitalized for an average of 13.5
days.
In 1964 Cameron28 reported on one-hundred patient double-blind
study on wound healing in surgical patients. He stated that
the use of Diapulse Therapy as an aide in wound healing demonstrated
that there was improvement in the general condition, early removal
of sutures, and an average shortening of hospitalization by
i 1⁄2 days.
Also in l966, Taylor29 at Boston City Hospital confirmed Cameron’s
work demonstrating the beneficial effect of Diapulse Therapy
on wound healing. He reported that, "From he patient’s
symptoms, from the clinical appearance of the wound, front comparison
of the control and experimental sections, we have concluded
that t here is evidence in this preliminary study that treatment
with Diapulse Therapy enhanced the wound healing to a considerable
degree."
In I 966, H errera30 at the Azucarera Hospital in Mexico City,
performed a controlled study of Diapulse treated versus untreated
patients following tonsillectomy. He summarized that i patients
treated with Diapulse Therapy required a statistically significant
lesser period of hospitalization than two similar groups receiving
either placebo or no Diapulse Therapy.
Also in 1966, Kaplan and Weinstock’’ at Civic Hospital
in Detroit, conducted a double-blind study to determine the
effectiveness of Diapulse Therapy in reducing edema, erythema,
and pain after foot surgery. They concluded that Diapulse Therapy,
when administered in conjunction with major foot surgery, exhibited
a statistically significant reduction in the amount of postoperative
edema. Accompanying this reduction in edema was a concomitant
reduction of erythema and pain.
In 1971, Aronofsky32 at the Jefferson Clinic in Dallas, did
a controlled study of Diapulse treated and untreated post surgical
dental symptoms. He stated that the Diapulse treated patients
evidenced a statistically significant reduction in inflammation,
pain, and healing time, over the controls
In 1972, Prof. Jarabak 33 at the University of Oregon Dental
School in Portland did a controlled study of Diapulse treated
and untreated patients to evaluate the effect on postoperative
oral tissue after mandibular third molar surgery. He found that
Diapulse treated patients showed statistically less swelling,
less pain, less discomfort, no postsurgical osteitis (dry sockets)
and better postoperative course.
Again in 1972, Wilson 34 at The General Infirmary in Leeds,
Eng., performed a double-blind study to evaluate the effects
of Diapulse Therapy on soft tissue injury of the ankle. He reported
that with a non-sequential method of analysis, the Diapulse
treatment was found to be significantly preferable on all four
counts - swelling, disability, pain and total scores.
And in 1974 Wilson did a comparison of shortwave diathermy and
Diapulse Therapy in the treatment of soft tissue injuries of
the ankle, in a controlled study. He found that Diapulse Therapy
significantly promoted the healing of recently injured soft
tissues (ankle) as compared with short wave diathermy treated
patients.
In 1975, Bentall and Eckstein36 at Queen Mary’s hospital
for Children in Carshalton, England, performed a double-blind
study to evaluate the use of Diapulse Therapy on children undergoing
orchidopexy. The Diapulse treated patients demonstrated a significant
accelerated bruise resolution, wound healing, and reduction
in postoperative edema as compared td) placebo controls.
In 1978, at the Rehabilitation Center in Warsaw! Konstancin,
in Poland, Drzewinska and Buczynski 37 evaluated Diapulse Therapy
applied in the treatment of bedsores. They published their results
stating that Diapulse Therapy indicates positive influenced
in healing of bedsores. in the sense that healing is accelerated
in comparison with other conventional methods.
In 1981 Rhodes, 38 at the Rhodes Dental Hospital in Norfolk,
Virginia published his second paper (the first having been in
1970)" evaluating the effects of Diapulse Therapy on tissue
healing following oral surgery. He reported that the adjunctive
use of Diapulse therapy significantly reduced hemorrhage, pain,
edema, and healing time in the Diapulse treated patients as
compared with untreated patients.
In 1981, Goldin"’ and associates, in Wordsley Hospital,
Stourbridge, England conducted a con trolled double blind study
to evaluate the effects of Diapulse on the healing of wounds
- donor sites. His published results state that clinically and
statistically, Diapulse treated patients healed faster than
placebo treated.
In conclusion, I want I to stale emphatically that t here are
many areas of research for various conditions, yet to he investigated.
If a non-invasive technique was developed to measure the electrical
potential of healthy and of damaged tissue, the answers to the
basic effects of pulsed, high peak power electromagnetic energy
would be accessible.
However, as adjunctive therapy in the treatment of wound healing
and the reduction of inflammation, there can be no doubt that
the research presented all support the value of Diapulse Therapy
(pulsed high peak power electromagnetic energy) parameters.
References
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(1978), Polski Tygodnik Lekarski, XXXIII (22):
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on the healing of wounds in humans: a controlled study."
Accepted for publication, July issue, British J. of P1. Surg.
(1981). |
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