US2190383A - Therapeutic apparatus - Google Patents

Description

Feb. 13, 1940. L. B. NEWMAN THERAPEUTIC APPARATUS Filed Aug. 29, 1936 U IT ED "STATES I Patente d Feb. 13 1940 PATENT OFFICE THERAPEUTIC APPARATUS Louis B. Newman, Chicago, Ill.

I 15 Claims.

I'his .invention relatesfto therapeutic appar'atus, and. moreparticularly tosuch apparatus as is usedfor the application of heat or cold for the destruction of pathogenic micro-organisms 5' infecting an internal or external part of the f human body, or for other purposes, such for instance, for improving the circulation and aiding the resolution of abscesses and other abnormal conditions, and for improving the distribution 10* and :action: of medicaments. I, It is known that many pathogenic microprganisrns are destroyed by the continuous application vof heat thereto at a temperature below theydestructive temperature for human tissue, and therapeutic apparatus for dealing with such micro-organisms is well known. Such apparatus generally. consists of an applicator in the form ofa thin rubber bag of the requisite shape for the particular organ of the body to be treated, and means'for circulating water at the proper temperature through the applicator. The applicator is made of thin rubber so that when it is distended or inflated by the hot water it will contact with as'large a proportion as possible of the surface of the organ being treated.

' One of the great dangers in the use of therapeutic apparatus of the above character is that of breakage of the thin rubber applicator. This always causes discomfort or severe pain to the 0 patient, and frequently severe burns. It is known that the destructive temperatures for the tissue of different parts of the body is not the same, and that the, requisite destructive temperature' for certain pathogenic micro-organ- 5 isms is only very little below that which will destroy' the affected tissue, and may be even above the temperature which will injure more sensitive tissue adjacent the afl'ected tissue.

order to maintain the affected tissue at the proper elevated temperature there must be a continuous flow of heat through the applicator to the tissue,

. which means that the temperature on the in side of the applicator must be above that on the outside of the applicator, namely above that of the tissue being treated- When it is considered that the temperatureto which the tissue is subjected for. the destruction of the pathogenic micro-organisms is only slightly below that which will result in destruction of the tissue itself, and may be above the maximum safe temperature for adjacent tissue, it will be appreciated that rupture of the applicator, withthe consequent I release of the hot water therefrom, is very likely to cause burning of the tissue. Also, the rem leased hot water will flow into the body beyond Also, in

1 Application August 29, 1936, Serial No. 98,437

the applicator and may seriously burn more sensitive tissue. In addition there is the danger of infection being carried by the released water, as Well as the possible injury by the water itself. This danger is aggravated by the fact that for 5 many uses the applicator must be made very thin so that, when it is distended, it will contact the. entire internal surface of the organ in which it is placed. It is an object of this invention to provide a therapeutic apparatus of the above character which is not subject to the dangers above mentioned, as well as others, in the event that the applicator should break. By eliminating the possible injury resulting from breakage of the applicator it is possible to use thinner applicators with safety, or to use higher destructive temperatures without fear that possible breakage of the applicator will cause injurious overheating of the tissue. The above result is accomplished by using heated air instead of water as the fluid for inflating and carrying heat to the applicator. By circulating hot air instead of hot water through the applicator a breakage of the applicator can do no harm because the specific heat of air at the elevated temperature is negligible in comparison with the corresponding heat carried by water at the same temperature. Furthermore, a breakage of the applicator will not result in wetting of the patient and consequent embarrassment to both patient and doctor.

It is a further object of the present invention to provide a simple and reliable means for controlling the pressure in the applicator. This result is accomplished by providing a small hand pump for increasing the amount of air in the closed circulating system which includes the applicator, thereby increasing the pressure and causing distention of the applicator. A hand operated relief valve is provided for permitting controlled escape or" the air to reduce the pressure in the applicator for partially or completely collapsing the same. In addition, a safety valve is provided for limiting the pressure. By this arrangement the physician can inflate the applicator to the desired degree without danger of injuring thepatient, even in the remote contingency that the applicator should break or tear While it is in position. Having thus properly inflated the applicator, the physician is assured that the pressure in the system cannot possibly go up, regardless of what may happen to the electrical system. At such times the applicator is a part of a closed air system containing a fixed amount of air which is maintained in circulato Fig. 1.

tion by the fan andis maintained at a proper temperature by the heating means. The attendant can then leave the patient, during treatment, because even if an accident were to happen and the applicator should break, no possible injury can result.

It is a still further object of the present invention to provide an applicator so arranged that it may receive a thermometer which will indicate the temperature at the applicator. The thermometer is located at the very point in the system where the heat treatment is being applied so that the physician knows at all times the exact temperature being applied It is a still further object of the present invention to provide a new method for increasing the effectiveness of various medicaments now applied to the surfaces of human tissue in the treatment of disease or other pathological conditions. When ointments, drugs, or powders are applied to body surfaces, or into body cavities for their therapeutic or medicinal effects, the action is necessarily slow, and frequently uncertain. I propose to increase the effectiveness and speed of action of the medicaments by applying heat to the body tissue, thereby causing the natural dilation of'the pores or other tissue surface, and thus increasing the effectiveness of the medicaments. This is particularly important in the treatment of vaginal afflictions.

' By my process, the various medicaments used are introduced, as in the past, and then the applicator is inserted in place. The heat and pressure of the applicator results in a spreading of the medicaments over the entire tissue and causes more rapid and effective penetration of the medicaments.

. It is a still further object of the present invention to use the apparatus above set forth, for treatment where reduced temperatures are desirable, as well as where elevated temperatures are required. When a reduced temperature is desired, the air within the applicator may be cooled, as, for instance, by circulating a refrigerant in a coil within the closed air circulating system, although it is to be understood that any other of a plurality of well-known methods of cooling the air may be resorted to.

The attainment of the above and other objects of the present invention will be apparent from the following specification taken in conjunction with the following drawing forming a part thereof.

' In the drawing:

Fig. 1 is a diagrammatic view illustrating one embodiment of the present invention;

Fig. 2 is an enlarged view of that end of the apparatus to which the applicator is attached;

Fig. 3 is a sectional view taken along the line 3-3 of Fig; 2; and

Figure 4 is a sectional view, in partial elevation, illustrating another embodiment of the present invention.

Reference may now be had more particularly The applicator is indicated at I and comprises a thin rubber bag of a proper shape, depending upon the particular body cavity for which the applicator is intended, and an applicator head to which the bag is attached. The bag is of thin rubber so that upon inflation it expands to fill the body cavity in which it is placed and contacts as large a portion of the surface of the cavity as is possible. The applicator bag illustrated at I is of a shape particularly adapted for treatment of the female pelvic region. The applicator head is indicated at 2, the applicator bag being secured to the lower end of the applicator head. A thermometer 3 extends through a suitable opening in the applicator head into the applicator bag, so that the thermometer indicates the actual temperature within the applicator bag. The applicator I is provided with an air inlet opening adapted to receive a pipe or tube 4, and an air outlet opening adapted to receive a pipe or tube 5. The tubes 4 and 5 extend to the control apparatus located at a convenient adjacent place and which includes a tempering casing I for heating or cooling the air, and a fan housing 8, connected together and to the pipes 4 and 5 so as to constitute a closed air circulating system. Air is moved by the fan 8 through the casing I, thence through the tube or pipe 4,

.through the applicator I, outlet pipe 5 and back to the inlet of the fan. The pressure within this circulating system is determined bythe quantity of air in the system. The system is made leakproof to guard against escape of air and consequent loss of pressure. Means is provided for increasing or decreasing the amount of air in the system so that any desired pressure is obtained. This means comprises a bulb pump I0 connected by a tube II to the air circulating system at any desired point, for instance at the casing I. The bulb pump I0 comprises a rubber bulb and a suitable valve arrangement so that upon compression of the bulb the air therein is forced through the tube I I, whereas upon release of the pressure on the bulb I0, air is drawn into the bulb from the atmosphere through an inlet I2, instead of through the tube II. The inlet I2 may also be operated manually to permit escape of air from the system. This is the usual type of bulb pump used with the ordinary portable blood pressure determining device. A pressure gauge I4 is provided for determining the pressure in the system.

An electric motor I5 is provided for operating the fan 8, and a coil I6, hereinafter referred to as a tempering coil, is provided for heating or cooling the air in the circulating system. In the case of an apparatus designed for cold treatment, the tempering coil I6 may comprise a coil connected to receive a refrigerant from a refrigerating system. In the case of a heat treating ap-' paratus, the coil I6 comprises an electrical resistance coil. The desired temperature can be changed by operating a knob I! of an automatic thermostatic control I8. In the case of an electric system the knob I'I adjusts a resistance in the control apparatus II.

Reference may now be had more particularly to Fig. 2 showing the construction of the ap-' plicator head. The applicator headconsists of an outer pipe 20 having an enlargement 2I at its lower end for receiving the applicator I. A bore 22 is formed in the enlargement for receiving the thermometer 3. The thermometer seals in the bore 22 so that there canbe no escape of air from the applicator at the point of entrance of the thermometer. The pipe 20 is adapted to be connected with a pipe 24 by means of a universal coupling 25 suitably gasketed at 26 to prevent the leakage of air. The pipe 24 has two branches, viz: a branch 28 and a branch 29. The branch 28 is adapted to receive a rubber tube 5 at its outer end and constitutes the airy outlet side of the applicator. The branch 29 has a pipe 30 therein which extends through that branch and through the pipe 20 to the applicator. The branch 29 is adapted to receive for therapeutic treatment.

a rubber'tube or pipe 4 which constitutes the air inlet side to the applicator. The applicator is slipped over the head 2| of the pipe 20 and may then be insertedin place for treatment of the patient. Thereafter the physician connects the pipe 29 to the pipe 20 by means of the universal connection 25. This subjects the patient to a minimum amount of discomfort during the insertion of the applicator into position.

It is apparent from my above description that I have provided a simple and reliable apparatus By means of this apparatus the treating temperature can be changed atwill and with great rapidity. Also, after the applicator is inserted in place, the physician does not have to maneuver the applicator to eliminate air bubbles, such as must be done with applicators employing water as the heating fluid. Also, in the event that the applicator should rupture while in use, the patient is not subject to the possibility of being burnt, nor to the discomfort, annoyance and embarrassment that results when a water-treating therapeutic device ruptures. Furthermore,

in the event of rupture of the applicator bag, a

new bag can-quickly be inserted in place and treatment continued. With. therapeutic devices employing water as the heating fluid, this cannot escaped,

be done quickly because of the water that has Not' only must the fresh water be heated, which takes time, but the bed linens must be changed, which takes additional time. This means that the entire effect of the heating, up to the time of the rupture of the applicator,

' maybe lostbecause of the time delay.

Reference may nowbe had to Fig. 4, wherein Ishow, diagrammatically, an applicator of the type illustrated in Fig. 3, but of a simpler construction, in that here the heater is placed directly-in the applicator, and the air is not circulated through the applicator. The applicator is indicated at I, being mounted at the end of a tubular handle 32, to form a seal-tight fit. The handle ,32-isprovided with an opening 33 whereby air may be forced into the applicator by means of a bulb pump H], which is connected to the handle 32 by means of a tube 34. Tempering apparatus 36 is inserted into the applicator, said tempering apparatusbeing sup- :1 ported by the tubular handle 32 and provided with a sealing tube 38 for preventing the escape of air or other gas from the applicator I through the inlet for the tempering device. The tempering device may consist of a cooling coil, when 11 the apparatus is to be used for cooling purposes,

or it may consist of an electric heater when the apparatus is to be used for heating purposes. A thermometer 3 is provided for indicating the temperature within the applicator. A baffle 39 shields the end of the thermometer from the direct influence of the tempering apparatus. In

using the device of Fig. 4, the physician insertsthe applicator in place and then inflates it the requisite amount. Thereafter, the temperature within the applicator is raised or lowered, depending upon the type of treatment, by means of the tempering device. If desired, a pressure gauge, such as the gauge I 4 of Fig. 1, may be provided for this purpose.

While the applicator shown in the drawing is particularly useful for insertion into a body cavity, it is not limited to such use, as it may readily be applied to the exterior surface of the body, wherever heat or cold treatment is desired. Also, the applicator may be made of any shape,

depending upon the particular body surface where it is to be used.

In compliance with the requirements of the patent statutes, I have here shown and described a preferred embodiment of my invention. It is, however, to be understood that the invention is not limited to the precise method here disclosed, nor to the precise method and apparatus here shown and disclosed, it being merely illustrative of the principles of the invention. What I consider new and desire to secure by Letters Pattent is:

1. Therapeutic apparatus comprising an airtight flexible applicator, means for moving a gas through the applicator, and means for changing the pressure of the gas in the applicator.

2. Therapeutic apparatus comprising a gas system including an applicator,-means for circulating a gas through the applicator, means for controlling the temperature of the gas in the applicator, and means for varying the pressure of the gas in the applicator.

3. Therapeutic apparatus comprising a distendable applicator, means forming a closed, air-tight circulating air system including said applicator, means for circulating the air in said system, and means for increasing the air pressure in said system to distend the applicator.

4. Therapeutic apparatus comprising a distendable applicator, means forming a closed, airtight, circulating air system including said applicator, means for circulating the air in said system, means for increasing the amount of air in said system to distend the applicator, and means for regulating the temperature of the air in the applicator.

5. In combination with an inflatable applicator having means forming gas inlet and gas outlet openings, connections between the two openings for establishing a closed gas circulating system including said applicator, means in said system for circulating gas through the applicator, means for regulating the temperature of the gas in the system, and means for forcing gas into the system to increase the pressure and thus distend the applicator.

6. A therapeutic device comprising in combination, an inflatable applicator having means forming gas inlet and gas outlet openings, connecting means between said openings forming a closed air circulating system including said applicator, a fan in said system for circulating air through said applicator, a hand operated air pump receiving air from the atmosphere and having an outlet connected to said system for delivering air to the system to increase the pressure in the system for distending the applicator, means for controlling the temperature of the air in the circulating system comprising an electric heating coil and controlling means for controlling the amount of heat generated by the coil, thermally responsive means located in the applicator for indicating the temperature of the air in the applicator, and a relief valve for relieving the pressure in the applicator.

'7. Therapeutic apparatus comprising means forming a gaseous fluid system including an applicator having a distendable applicator bag, means for increasing the amount of gas in the entire system for inflating the bag and means for effecting a heating of the body structures adjacent the applicator bag, said heating means being substantially spaced from parts of the applicator which come into contact with parts of the body, and fluid of said system being in said space.

8. In combination, a tubular member having a substantially thickened end portion, an inflatable applicator bag having a neck fitting over and embracing the thickenedportion, a thermal responsive member extending through the thickened portion and into the bag, with that part of the thermal responsive member which is outside of the bag and outside of the thickened portion being located adjacent the tubular member whereby the tubular member acts as a protective shield for the thermal responsive member, and means connected to the tubular member for forcing fluid therethrough into the bag for inflating the bag.

9. Therapeutic apparatus comprising in combination an air system including an inflatable applicator having an air inlet opening and an air outlet opening, means for moving air through the applicator and increasing the pressure of the air above atmospheric pressure to maintain the applicator inflated, said means including an air fan connected to the air inlet side of the applicator and continuously operable to maintain a continuous movement of air through the applicator from the inlet to the outlet side of the applicator, and means for varying the temperature of the body structures adjacent the applicator by varying the temperature of the air in the applicator.

'10. Therapeutic apparatus comprising an airtight flexible applicator, means for moving a gas through the applicator, means for changing the pressure of the gas in the applicator and means for refrigerating the gas.

11. Therapeutic apparatus comprising a distendable applicator, means forming a closed, airtight, circulating air system including said applicator, means for circulating the air in said system, means for increasing the quantity of air in the system to increase the air pressure of the air in said system to distend the applicator and means for cooling the air in said system.

12. Therapeutic apparatus comprising in com bination an air system including an inflatable applicator having an air inlet opening and an air outlet opening, means for moving air through the applicator and increasing the pressure of the air above atmospheric pressure to maintain the applicator inflated, said means including an air 'fan connected to the air inlet side of the applicator and continuously operable to maintain a continuous movement of air through the applicator from the inlet to the outlet side of the applicator, and means for cooling the temperature of the body structures adjacent the applicator,

said last named means comprising means for refrigerating the air.

13. Therapeutic apparatus comprising an airtight flexible applicator, means for moving a gas through the applicator, and means for changing the pressure of the .gas in the applicator, said flexible applicator including a bag through which the gas is moved and said applicator having inlet and outlet openings for movement of gas simultaneously into and out of the bag, said bagbeing sufficiently thin and flexible to enable it to conform itself to the shape of an adjacent surface of the human body with which it is in contact.

14. Therapeutic apparatus comprising an airtight flexible applicator including a bag adapted to be inserted into a human body cavity, means for moving a gas through the applicator and maintaining the gas in continuous movement within the applicator, means for changing the pressure of the gas in the applicator bag to inflate the bag into engagement with the inside surface of the body cavity, said bag being sufiiciently thin and flexible to enable it to conform itself substantially to the shape of the body cavity when inflated and thus to contact a substantial area of the surface of the body cavity, and means outside of the applicator bag for heating the body tissues adjacent the bag to a temperature substantially above body temperature by varying the temperature of the air in the bag.

15. Therapeutic apparatus for destroying iniectious micro-organisms near a cavity in the human body by elevating the temperature of the infected region above the destructive temper ature for the infectious micro-organisms but below the temperature at which objectionable destruction of adjacent human tissue takes place, said apparatus comprising an air-tight flexible applicator including a bagadapted to be inserted into a body cavity, means for moving a gas through the applicator and maintaining the gas in continuous movement within the applicator, means for changing the pressure of the gas in the applicator to inflate the applicator bag into engagement with the inside surface of the body cavity, said bag being sufficiently thin, elastic, and flexible to enable it to conform itself substantially to the shape of the body cavity so that when inflated it contacts a substantial area of the body cavity, and means outside of the applicator bag for heating the gas to raise the temperature of body tissues adjacent the bag sufficient to effect destruction of infectious micro-orgam- 151115.

LOUIS B. NEWMAN. I5

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