US 2327874 A
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Description (OCR text may contain errors)
Aug. 24, 1943. H. DE JONG 2,327,874
PORTABLE ELECTROMEDICAL APPARATUS Filed April 16, 1942 12 Sheets-Sheet 1 INVENTOR 26 Herman d2 .Jbny
. OWM Q iWW ATTORNEYS Aug. 24, 1943. H. DE JONG l 2,327,874
PORTABLE ELECTROMEDICAL APPARATUS I Filed April 16, 1942 2 Sheets-Sheet 2 INVENTOR fie/man afs Lfozgy BY JZMWW ATTORNEYS Patented Aug. 24, 1943 Modem :I'nvention's'? Corporation Application April "1'6, 1942." Ser'lialNo. 439,177"
The present invention is concerned with electro-medical apparatus of the type used for'diagnostic and for therapeutic purposes in connection with degeneration in peripheral nerves and muscles following nerve lesion, inflammation and the like.
As conducive to a clear understanding of the invention, it is noted that where a peripheral 'nerve lesion is inflicted, as for instance, by
shrapnel in Warfare, the prompt location and therapeutic treatment of such lesion will in many cases result in complete restoration of the nerve and muscle, while delay might leadto chronic paralysis. Known equipments in use fortreating such injuries are costly and bulky in that they involve a cabinet which encloses the various electrical control and metering units, from which wires or cables lead to separate electrodes that are to be applied to the human body. Such instruments are also difficult to use, because the switch control cannot conveniently be operated, without distracting the attention of the physician from the physiologicalresponse to'the electrical stimulation, so that the services of a skilled assistant are required in-addition to those of the physician'for effective use of the instrument.
It is accordingly an object of the invention to provide a small, light, compact, portable equipment which incorporates various electrical vcontrol and metering elements as wellas the electrodes to enable the ready application .of the electrodes, the adjustment of the controls and the reading of the instrument by a single op-,
erator, for both diagnostic and therapeutic purposes. In the accompanying drawings in whichare shown one or more of various possible embodiments of the several features of the invention, Fig. lis a perspective view of the complete apparatus,
Fig.2 is a longitudinal sectional view thereof, Fig. 3 is a transverse sectional view taken on line 3-3 of Fig. 2,
Fig. 4 is a circuit diagram of the apparatus of Figs. 1 to 3,
Fig. 5 is a fragmentary sectional viewof a modification, and
Fig. 6 is a circuit diagram of the modified 'form shown in Fig. 5.
Referring now to the drawings, the device shown in Fig. 1 may comprise. a casinguniit in,
which includes a handle H unitary and rigid therewith. The casing and handle unit is preferably of insulating material, desirably of two complementary casing tarts! IT and 12 connected together rim to rim engagement at 13 by cement or .fas'tenin-g' screws (not shown) in. manner conventicnal with; electrical" shavers, for .instance. in the. interior of the casing are various electrical control elements operable from the exterior and a metering device exposedto view, at the exterior .ofthe' casing .as will be hereinafter described. The handle accommodates the conductors l5 thatTlead to the electrical elements withinthecasing.
electrodes l'ii and,l,llare.both mounted,
.desirablyadjustably, upon ithepasing .unit. For this purpose, the 3 stimulation electrode 16 is atfixed to the forwardportiori of the casing, desirably to the inwardly inclined lower section of the .forvvard wall t8 thereof. To this end a .metal stud L3 is: clamped at its base 211 against said wall-W ley nut it at the interioriof the casing. The s m all ball-shaped outer end ofstimulation electrode 16 .is preferably embraced by a moist f-ab 'ric wrapper 22. The rod "215 of said electrode is mounted by a universalball and socket joint 24 at the extremityhof stud l9, said universal ,joint being tightened in adjusted clamped position ,by'a thumb -nut 25.' i
The second or so-called indifferent electrode ,lilds desirably a disk much larger than the stimulation electrode t6 and is enclosed in a moistened lens shaped fabric cover .26. It is affixednotonly tor addustment in angularity,
but alsofor adjustment in its distance from the stimulation electrode, 13o this end a metal mounting hard! is affixed at its forward end by ,means of =a nut 28 to'the-lower part H of the .casing from-which its foot extends downward and thence itslength rearward along the length ofand ata distancefrom the casing. The rear ,end cf said 'bar 21 is supported in a hig 29on theouter end of ana'rm 30 molded asan integral part of the casing bottom and spaced from the handle as at Gl -to afiordnroom for the fingers in graspingthe'device. For reix'iforcernent, the
:outer end of the arm 36 is .coniiected 'by a unitary bridge piece 3'2t'o the-outer end of the handle H.
The lectrodell'i isimounted on a metal block end of thejrod 36 that carries the" electrode [1.
Electrical connection to the respective electrodes istmade at b inding pcsts si ana seat the inner ends of their mounts "within the casing;
Ii; 1S seenthat the electrode l'lmay beslidably adjusted to any distance Trdm electrode I GWithbe associated with the knob 42. switch or circuit closer is shown at 44 and is through the casing cover.
the order of 150 volts, the secondary 39 of which transformer feeds its output to an auto-transforuner 43. One terminal of the auto-transformer is connected to terminal 16. by way of conductor 4 l. auto-transformer leads through meter 43 and manually operated treatment switch 44 to the other electrode ll, the circuit between the electrodes being, of course, closed through the body to which the electrodes are applied. v
' Fordirect current diagnosis or treatment the alternating current isrectified. To this end a changeover switch 45 is used which places rectifier 41 in circuit. Switch" 45 i interconnected with meter switch 46 to change its reading-scale or range from A. C.to D. C. i The rectifier 41 may be of any conventional dry type, such as a selenium or a cuprous oxide rectifier. 'When the switch45 is thrown, the output of the auto transformer is rectified by passing through said rectifier 41 and otherwise the circuit is exactly as in the alternating current operation. Switch 45 is desirably. interlinked with switch4l completely to disconnect rectifier '41 from the circuit in alternating current operation.
A reversing switch 48 is desirably also provided to reverse the polarity of the electrodes l6 'and l'! at will in the direct current operation.
The various electrical elements referred toa-re compactly disposed within the casing Ill and the adjustments thereof are readilyefiected from the exterior of the casing. Referring to Figs; 2 and 3, the milliammeter is shown at 43 mounted in the cover of the casing with its dial exposed thereabove. The auto-transformer is shownat 4B resting on the bottomof the casing and its operating knob is shown at 42 adjacent handle H. A suitable calibrated scale (not shown) may The treatment operated from a push-button 44 accessible The switch 45 for shifting from A. CrtO D." C.
and conversely is desirably operated from a turn knob 45' that may be coaxial with the pushbutton 44. The'rectifier 41 is shown aflixed to the cover by a bracket 41. The electrode reversing "switch 48 is desirably accessible from the-side of the casing as shown. The neatand compact arrangement of the elements within the small casing, and the ready accessibility of the operating parts are manifest from the foregoing.
In use, the electrodes, properly moistened with 'tap water or other electrolyte, are applied-to the selected parts of the body, their angularityand distance being readily adjustable as previously described. The device is plugged into; an outlet box and the physician holding the instrument b its'handle H, may apply its electrodes to'the .region of the body to be tested or treated. Since the electrode supports are relatively rigid,"the instrument may, if desired, be applied to the patient and the adjustment thereof may be'con- The adjustable terminal 42 of said to the electrode I'd trolled by one hand. Thus, the push-button switch 44 may be depressed and released at will, and the meter read, all with as great facility and. convenience as in the use of the conventional sphygmomanometer. By turning knob 45, the operation may readily shift from alternating to direct current output as required. In direct current operation, turning of the lateral switch 48 permits reversal of polarity.
Thedevice is thus seen tobe a simple portable equipment for effectively determining the loca tion of peripheral nerve lesions caused by shrapnel, for instance, and enables speedy classification of casualties and distribution to proper centers of treatment/contributing considerably to the rehabilitation of casualties.
The invention is by no means limited in its utility to the particular purpose set forth above.
Among the diagnostic uses to which the device may readily be put are to determine:
(a) Whether or not a peripheral nerve has been injured,'severed or inflamed,'for the condition of th'e nerve is measured'by the conductivity of direct or alternating current therethrough, as determined by the meter,
(b) The particular type of degeneration of muscles evidenced by wormlike contraction'thereof on stimulation with galvanic current,
(0) Such conditions as tetany in children which is measured by increased excitability of muscles and nerves to the galvanic current, and,
(d) Chronic degeneration of nerves and muscles measured by decreased excitability by galvanic current.
Among the therapeutic uses to which the device may be readily put arei (a) The stimulation of muscles and nerves in peripheral lesions in order to prevent muscular atrophy by application of direct or alternating current through the nerve;
(b) Anodic stimulation by galvanic current in the cases of irritationof the sensory nerves;
(0) Iontophoresis, that'is, the introduction of drugs into the tissues by means of weak galvanic currents applied through the device, and
(d) The electrical stimulation in so-called functional disorders such as she1l-shock,'by resort to direct or alternating current.
.Inthe embodiment of Figs. 5 and 6 the power is derived from a dry battery, illustratively shown 'as two series connected cells 50 and BI mounted 'in the hollow handle H; and retained in place 'by removable screw' plug 52. within the casing'is generally similar to that of Figs. 2 and 3. In Figfithe induction coil 53 and the associatedpotentiometer 54 replace the autotransformer of Fig. 4 and the potentiometer is operated from a knob 56 similar to that used for operating the auto-transformer in-the embodiment of Figs 2 and 3. As appears from-the circuit diagram of Fig. 6-, the treatment switch 51 when closed, causes the induction coil to step up the Voltage greatlyinthe interruptions of the primary circuit at the interrupter 53.
stepped-up voltage is stepped' down to desired extent by the potentiometer 54. I
In the alternating current setting shown in full lines in the drawings, the impulsesimparted in the closing and opening of the inductioncoil circuit are passed through the potentiometer 54, the
meter 59 tothe electrode ll" through the body returning to the other terminal of theinduction coil secondary, f
"In theidirect current reading the impulses in- :curred in the opening of the induction coil alone The equipment 7 are imparted to the body and. those inthe closure are. suppressed; 'This operation' is efrectedby turningthe switch-60 to the opposite setting and with it the associated meter: switch li l' s'o that the current from these'condary of the induction coil passes through tharectifier- 62, then'ceto the potentiometer 54, the meter 59 an'd by way of the electrodes back to therectifier andto'these'condary. Switch 62' is int'erlockedzwith switch '60 =forthe same purpose as in the circuit of Figi' l.
It will be understoodthat in each of-:the em'- bodiments disclosed the treatment swit'ch dni ght be locked a closed positionfor continuous treat ment whenever'desired f J The apparatus in each of its'embodimen ts-is so simple, inexpensive and easily ope'rated that it may be standard equipment in th'eoifice of general practitioners and surgeonsfand-as above noted, it is especially useful to army doctor-sin the field; The electrodes, as'well as the controls are immediately accessible to the operator who can observe the physiological responses andthe corresponding reading of the instrument atithe same time. V i It is obvious that suitable circuit elements, such as condensers and chokes (not shown) in the elementary circuit diagrams of Figs. 4 and 6 could be incorporated in the apparatus, to attain specialized wave forms for particular applications. l 1
It will be understood that the instrument may be energized by any suitable source of current of any desired frequency or wave form, and operation is by no means'lin'iited to the conventional sources of power diagrammatically show n 'in the drawings. For instance, "a motor generator set, or a rotary convertor, operated from any suitable source of mechanical or electrical ower could be used. Also-"an electronic generator irr' ay be used to advantage. Instead of the dry cells,'-u'sed in the embodiment'of Figs. and 6, an external battery primary or secondary of any desired voltage or an electronic power supply could be used, as well understood by those skilled in the art.
As many changes could be made in the above construction, andmany apparently widely different embodiments of this invention could be made without departing from the scope of the claims, it is intended that all matter contained in the above description or shown in the accompanying drawings, shall be interpreted as illustrative and not in a limiting sense.
Having thus described my invention, what I claim as new and desire to secure by Letters Patent of the United States is:
1. A portable electro-medical apparatus comprising a combined casing and a handle unit, an electrode near the forward end of said unit having a universal joint mount and a second electrode having a sliding mount along said casing and a universal joint between said sliding mount and the electrode for adjustment in position and inclination of the latter, said electrodes in adjusted position being substantially rigid with said casing, whereby the apparatus held by the handle may be positioned with its electrodes against the patient. I
2. An electro-medical apparatus comprising a, combined casing and handle unit, a pair of electrodes mounted on said unit in spaced relation, one of said electrodes being slidable along the casing to permit adjustment of the distance between the electrodes and electrical control apparatus in said casing leadingto the respective electrodes, said electrodes in adjusted position beingLsubstantially rigid with said casing, where;- by the apparatus, held by the handle, may be positioned with'its electrodes against the patient.
3-; An electrd-medical apparatus comprising a stimulation electrodeandto said bar for energizing said electrodes-in all positions of adjustment thereof.
-' 4.-An' electr c-medical apparatus comprising a 'combined'casing and handle unit, a stimulation electrode having a rod unitary therewith, a uni- =versal-joint afiixed to theforward end of said casing for accommodating said rod and permitting adjustment in the position of the electrode, a bar affixed'at its ends to saidcasing and handler. unit, and extending longitudinally thereof, a second electrode having a rod unitary there'- with, a, universal joint mounting said rod, and a sle'eve mount for said universal joint encompassingsaid bar to permit adjustment in the distanceof'the'secondelectrode from the first, and control andiindicating apparatus in said casing connected nearthe forward end of the casing tol the electrodes and through the respective mountsofthevlatten i l m 5. A portable electromedicalequipment comprising a casing- "unit khaving terminals for a source of. applied voltage and including a handle, aipair of electrodes protruding in longitudinally spaced relationship from said unit, each of said to position the apparatus against the patient,
control apparatus within .said casing including a'device for stepping: up the voltageapplied to said terminals, means including a knob accessible at the exterior of the casing unit for adjusting the voltage, a switch also accessible from the ex terior for closing and opening circuit with respect to said electrodes, and indicating means exposed at the front of said casing for showing the physiological response to the electrical impulse.
6. A portable electro-medical apparatus comprising a casing and handle unit, electrodes adjustably aflixed in spaced relation upon said unit, said electrodes having conducting means terminating in the interior of said casing, means encompassed by said handle for delivering current to said casing, means in said casing to vary the applied voltage, a knob upon said casing for ad- ;justing said means, manually operated means accessible at the exterior for opening and closing circuit to said electrodes, and a meter for indicating the current supplied to the electrodes.
7, A portable electro-medical device adapted to be operated from an alternating current source comprising a casing and handle unit, electrodes mounted in longitudinally spaced relation upon said unit and adjustable in relative position for adaptation to the body portion to which said electrodes are to be applied, said casing having therein an auto-transformer supplied from a source of alternating current, a knob upon the casing for setting the auto transformer and determining theapplied voltage and a manually operated switch for opening and closing circuit to said electrodes, said switch being accessible to the hand by which the device is held.
8. Aportable electro-medical device for applying direct current from an alternating cur.- rent source; said apparatus comprising a casing and handle unit, a pair of. electrodes mounted at longitudinally spaced positions upon said. unit and adjustable inposition for adaptation to the parts of the body to which they are to be applied, an auto-transformer in the casing supplied from such source of alternating current, a knob on the casing for determining the, voltage delivered by said auto-:transformena rectifieivcone nected to said auto-transformer and in turn con,- nected to one of said electrodes, and a meter in the circuit to indicate the current through the electrodes. a
9. The combination recited in claim 8 in which a reversing switch is accessible from the side of the casing.
10. A portable electro-medical apparatus adapted at will for alternating or. direct current use comprising a casing and handle unit, a pair of electrodes mounted exteriorly of said unit at points spaced longitudinally thereof, apparatus in said casing including an auto-transformer, a dry rectifier and a treatment switch, means accessible at the exterior of said casing including a knob for setting the auto-transformer, a push button for operating the treatment switch, a meter for indicating the current passed through the electrodes, and a switch for selectively set.- ting the device for. alternating or direct current operation, said switch in the alternatingcurrent setting cutting the rectifier. out of circuit, and a reversing switch for determining the polarity of the electrodes in the direct current setting.
11. A portable electro-medical apparatus comprising a combined casing and handle unit, electrodes mounted on said casing in longitudinally spaced relation, a batterymounted in the handle element of said unit, electrical control ,and indicating apparatus in said casing connectedto the electrode means, said apparatus including an inductioncoil, a. potentiometer adjustable from theexterior of the casing,:a treatment switch for opening and closing circuit with respect to said electrodes and. an indicating: meter.
12. A portable electro-medical apparatus com prisinga combined casingand handle unit, electrodes mountedon saidcasing in longitudinally spaced relation, abattery-mounted in the handle element of said vunit, electrical control and in- ,dicating apparatus in said casing connected to the electrode means, said apparatus-includingan induction coil, a potentiometer operable from the exterior, a treatment switch for opening and closing circuit with respect to saidelectrodes. a rectifier and a switch for selectively cutting the rectifierinto-and out of circuit. e
13. A portable electro-medical apparatus comprising a casing unit, a pair of electrodes mounted upon said unit, said unit being adapted to be held by the physician to position the apparatus upon the body of the patient with, its electrodes in contact with the patient,- and energizing means for said electrodes lodged Within said casing unit, said casing unit including control apparatus for determining the electrical impulse applied through said electrodes and indicating means for reading the magnitude of said impulse.
14. A portable ,electro-medical apparatus comprising a combined casing and handle unit,v a pair of electrodes mounted upon said unit, said unit serving to position the apparatus uponthe body of the patient with its electrodes in contact'with the patient, and energizing meansfor said electrodes extending through the handle length to said casing, saiddcasing unit including control apparatus for determining the electrical impulse applied through said electrodes andindicating means for reading the magnitude of sal impulse. I p 1 HERMAN DE JONG.