US 2646042 A
Description (OCR text may contain errors)
July 21, 1953 QQUANG HSI HU MEDICAL APPARATUS Filed May 18, 1951 2 Sheets-Sheet l INVENTOR.
BY QUANG HS/ HU @wcl Mira/(51%., g w
July 21, 1953 QUANG s U 2,646,042
MEDICAL APPARATUS Filed May 18, 1951 2 Sheets-Sheet 2 FIG. 3
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BY QUANG HS] W10 wuuPW/i u I. OKQQM- Patented July 21, 1953 um-rsc srArcs P ENTZO FICE" V z,64e,c42 MEDICAL APPARATUS Quang Hsi Hu, New York, N. Y Application lVIayl8, 1951, Serial No, 227,053
10 Claims. (Cl. 128-214) A This invention relates to medical apparatus and more particularly to a medical device for simultaneously injecting and extracting body fluids under constant pressure indicatingand control conditions;
In the medicalart, various types of syringes and medical apparatus are used for extracting fluids from and injecting othersinto the body. These types of apparatus usually contain'a syringe with a multiple-way valve and a hypodermic vneedle so that by operating the valve once the needle has been inserted into any part of the body, the fluid is withdrawn by mean of one of the'syringes from the body. After this operation has been completed fluids of any suitable kind or air, depending upon the kind of operation being performed by the physician, is forced into the body through said syringe needle. It is apparent that this process is tedious with such type of apparatu particularly since provision'is made in such type of apparatus for asirjxiultaneous extraction of fluid from the body and injection 'of necessary fluid or air into the body with constant pressure control of, the'bodycavities. Nor is there any control of the fluid pressure in the body. Furthermore, itis oftentimes ex ceedingly difficult even to the skilled surgeon and physician to make uch injections and body fluid V extractions. It fact thereare known tube instances where the insertion of a syringe needle into-some part of the body without knowing how to control the pressure of such fluids in the body ohcounter-balance the body fluid pressure has caused considerable and needless pain and suffering to the patient. The pressure drop caused by the removal of such fluids without providing any hydrostatic pressure control and compensation may cause a state of severe shock.
With the above disadvantage in view, it is a jected into the body.
The hydrostatic pressure within the body cavity will be controlled by suitably maintaining the outflowing of the body fluid and the injecting speed of another kind of fluid or air' into the body;
A new pressure indicating device according to my invention, make this operation tobe controlled much easier and safer.
Another object of my invention is to provide a device used for measuring the pressure within the body cavity without losing any of the fluid. In accordance with my invention, the pressure condition will remain constant in the body.- The usual method of measuring the pressure of the body cavity, for example the intrathecal pressure, is performed by using a hypodermic needle connected with a pressure gauge or a U,-tube filled with fluids. Asa result of pressure difierences between the body cavity and the atmosphere, the :body fluid will be flowing out into the hypodermic needle and compressing the air within the pressure gauge or the fluids in the U-tube or the air will be sucked into the body. Inother words; the condition within the body cavity has been already affected by such a procedure. It
*might be the cause of dangerous complications such as hemorrhage or shock. Death may occur suddenly as in the'case of intracranial tumors.
' To ofiset this danger, it is another object of my invention to provide a device with a needle, a syringe, an equalizing indicator, pressure compensator and manometer or pressure gauge, by means of which the body fluid will be prevented body cavity will be noticed promptly. Theusual types of manometer to measure the pressure within the body cavities are pressure or mercury. With the exception of the U-tube gauges of spring type or U-tubes filled with Water filled with water, the others cannot give the fractional readings, but the water U-tube' is about one meter long and therefore very inconvenient to use, for-example, in clinics or doctors oflices.
; The device made according to my invention does 'not have such disadvantages.
The attached syringe made according to my invention,- is designed for injecting relatively large quantities of fluid or air continuously without detaching the syringe from the inserted hypodermic needle [ormanipulating a three-way valve. Furthermore, the syringe in my invention is used for effecting a low injection of fluids, for example, strophantin or calcium salt solution and for injecting a fluid of high viscosity and with a flne calibered hypodermic needle easier,
and for diluting a solution in a large ratio within the syringe containing the fluid to be injected for makin the mass treatment convenient or for saving time and work with accurate dosages.
A flow indicator according to my invention, will help the physician quickly to locate the place where he desires to'puncture the body. The loop of the capillary tube in my invention permits the flow indicator to be attached in any position without the indicating fluid escaping from the device.
Another object of my invention also is to pro- I vide a flow regulator to control theoutflow of Fig. 2 is a sectional view of a pressure regulating valve also forming part of my invention;
Fig. 3 is a longitudinal sectional View of a syringe forming part of the embodiment;
Fig. 4 is a front view of the syringe shown in'Fig. 3; and
Figs. 5 through 10, inclusive, are detail view of parts of the syringe shown in Figs. 3 and 4.
Referring now to the drawings in which like reference numerals refer to like parts throughout, it will be noted that according to my invention, I provide a syringe I0, a dual channel needle 20, a flow indicator 30, a flow regulator 49, a
calibrated pressure indicating equalizer device ill, a compensating device 56, and a pressure regulating valve or attachment EU. 7
The syringe II), as shown in Fig. 1, is provided with a cylinder II which can be provided with a single nozzle opening as shown in Fig. l or with a combination of a three-way valve I8a with two outlets I8?) and I80 with grooves I8d for rubber tubing connection, as shown in Fig. 3. There is provided in said syringe II, a longitudinally movable interplunger I2, a flat indicating holder I1 and plunger I3. The cylinder II' and the interplunger I2 are preferably made of transparent material. Also, said cylinder is graduated, as shown. The p1unger l3 may be made of metal or transparent material. Said cylinder II and plunger I3 have aduations I9 and I311, respectively, as shown in Fig. 4. The unit of the graduations on the plunger I3 is only a fraction of that onv cylinder I I. Said cylinder I I, furthermore, is provided with a head or collar Ila. On one of the flat surfaces, the indicating holder plate no can be allowed to slide only in the direction of the cylinder axis. One end of said indicating holder plate I'Ib is mounted with, ring Ila. This ring I'Ia is fixed in the groove I2e on the interplunger I2.
Stop He, is hook shaped, is made of metal wire and is connected through an L-shaped rod IId with the indicating holder plate I l). The stop Ile and thejoined part of the L-shaped rod I'Id are fixed in the groove I2c on the flange I2a of the interplunger I2 and its loop projects into the bore IZd. Plunger I3 is allowed to slide below the stop He, until the latter falls into the groove I312 on the plunger l3, as shown in Fig. 10. By rotating the plunger I3 around its axis it can be pulled out of the interplunger I2 so that the stop He can be pushed out of the groove Itb on the plunger l3. The groove I3b is so formed that it allows plunger I3 to be pushed in the direction for injecting but not for withdrawing.
It will be noted that said stop He may be separated and fixed in groove I20. It also may be disconnected from L-shaped rod I'Id to permit rotation of interplunger I2. Interplunger I2 is a thick walled cylinder whose outside and insidewalls are fitted closely to the cylinder II and the plunger I3, respectively. It will also be noted that the interplunger I2 is allowed to slide between the cylinder I I and the plunger I3 and is provided with a flange [2a and an annular groove [2e in which the ring Ila of the indicating holder I'I is fixed and groove I in which the stop Ile is fixed. On the inside Wall of the flange I2a there is a marking I2b, as shown in Fig. 8. This marking indicates the amount of fluid or air that has been withdrawn when read against the scale ISd of the plunger I3. The surface of the flange I2a is convex and operates as a magnifying glass so that the scale I3d may be easily read.
For withdrawal of fluid or air, interplunger I2 will be pulled back and the plunger I3 will also be automatically pulled back. The free end of the indicating holder plate Ill) has the same length as the interplunger I2 and is rubber lined on its under surface I Is, as shown in Fig. 5. The amount of the fluid withdrawn will be indicated on the scale IS on the cylinder II'. The
"fluid within the space I5 as shown in ig. 3 will be injected to a definite extent by pushing the plunger I3 which would push the interplunger I2 automatically in the same direction if the plunger were continually pushed. If a fractional amount of fluid is to be injected into the body then the interplunger I2 will be pushed forward and the plunger I3 will be pushed back, the fiuid filling the space I6 according to hydraulic principle until the required amount is obtained. Indicating holder plate ill; will be pushed down against the outside wall of the cylinder II and held by the finger of the physician so that the interplunger I2 is fixed and not allowed to be pushed back when the plunger I3 is being pushed forward. The fluid in the space I6, as shown in Figs. 1 and 3, will be pushed into the space I5. From said space 55 the fluid exercises hydraulic pressure upon the interplunger I2 and against the opening Isa, Fig. 3, to the attached hypodermic needle. As a result of the interplunger I2 being fixed b the indicating holder'plate I'Ib against the cylinder II by the finger, the fluid will be forced into the hypodermic needle only. The procedure can be repeated continuously for mass treatment.
After the solution has been drawn into the syringe by pulling the interplunger I2 back to let the syringe become filled with the required amount of the fluid in the space I5, the interplunger I2 then is pushed and the spacer Iii will be automatically filled with the solution. Interplunger I2 will be fixed by pushing the indicating holder plate I'Ib against cylinder II. The fluid inihe space IE; will be forced into the space I5 by'pushing the plunger #3 against the syringe opening I5a, as shown in Fig. 3. The fluid in space I5 will be forced into the hypodermic needle 20 through the opening Ifia. This operation is continued until the whole amount of the fluid in the syringe has been used up. This procedure is especially convenient when injecting fluids of high viscosity or when a fine calibered needle has to be used. If the syringe is used for diluting, then the interplunger I2 will be fixed in the usual way, as above described. The fluid to be diluted will be withdrawn by pulling the plunger I3 back to the required amount indicated on the scale I312. The diluting fluid, water or saline solution, for example, will be withdrawn by pulling back the any August 21, 1951.
interplunger I2 to the required amount indicated in the scale l9. Stop We on the indicating holder I ll will prevent the plunger |3 fromsliding out of the interplunger l2. In the syringe H, as shown in Figs. 3 and 4 it will be noted that holder may be readily separated or fixed in groove I20. Also, such holder I! may be disconnected from rod lid to permit selective rotation of interplunger |2.
The dual channel needle is already fully described in my copending application Serial Number 71,600, filed January 19, 1949, which has now matured into U. S. Patent No. 2564977, issued As described in said application, the needle provides a body member 2! with 'two inlets 22 and 23 and an outlet 24, and a three- 'way Valve 2 5 which can be rotated into any desired position according to the kindof operation to be used by the physician or technician. Said needle is also provided with two channels 26 and 21, respectively, and with an opening 28 for channel 26 and a side opening 29 for channel 21, as
It will allow simultaneous extraction of the body fluid and injecting fluid of other kind or air into the body.
Inlet 22 in said body member 2| is connected with a flow indicator 30 which is of circular or spiral construction. Outlet 24 is connected with a rubber tubing 46 or directly to a flow regulator or a pressure regulating valve 60, as shown in Figs. 1 and 2. Flow indicator 38 is a circular or spiral shaped capillary tubing. Its upper end 33 is flared to allow attaching thereto the tapered opening of a hypodermic syringe, not shown.
'The other end 34 is tapered to allow its attachment to body member 2|, as shown in Fig. 1. Both ends 33 and 34 provide grooves 35 and 35a respectively, for rubber tubing connection. Within the loop 3| there is an indicating fluid 32 of any suitable type. Said flow indicator 3|] is made of transparent material. As a result of its spiral shape indicator 30 can be put into any position without the indicating fluid 32 escaping from the flow indicator 35.
As soon as the opening 28 of the needle 20 reaches the desired portion of the body cavity being punctured, the fluid will flow into the channel 26 and the air will be pushed from the channel 26 into the flowindicator whereupon the indicating fluid in the indicator 20 starts to move. The physician will know that the opening 28 is at the right place and need not push the needle any deeper into the body. Then the valve 25 is adjusted so that the channel 23 is closed to the flow indicator 30 and open to the attached syringe ||l. 1
Flow regulator 45, as shown, is provided with a T-sh'aped tubing 42, a stop cock 4| and a' capillary tubing 44. Stop cock 4| may be closed to the capillary tubing 44 if desired. The outlet 24 of needle 25 connects the end of T-shaped tubing 42 of the flow regulator 46 through a rubber tubing while the other end of tubing 42 connects with the calibrated pressure indicating device 5| via rubber tubing 45.
Pressure regulating valve 60, as shown in Fig. 2,'is provided with a tapered stem 62 having a groove 62a for rubber tubing connection. Stem 62 is adapted to fit into any of said inlets. Said pressure regulating valve or attachment 60, furthermore, is provided with a central channel or conduit 65a and side entering channels or con duits 53 and 64, respectively. Conduit 63 is adapted to accommodate a manometer or pressure indicating device 50 while conduit 64 can be connected in any suitable manner with a syringe or suction device. It will be noted that the valve 60 may be used in lieu of flow regulator 40.
Said conduit 60a is enlarged at the end opposed to'the stem 62 to accommodate a regulating-ball member 65. 66a has a threaded portion 66 for accommodating the externally threaded bonnet 61 of the manually operable check ball valve unit 68. Said valve unit consists of a flexible diaphragm 69, against which is aholding member 10, a spring member H, a screw member 12, a nut washer member 13 and a washer member 14. The movement of diaphragm 69 against ball member is controlled and therefore the desired pressure to be maintained in conduit 60a and passage way 21 as well as in the human body around the side opening 29 of the needle 2|! inserted in the body can be controlled by adjusting the screw member 12. The purpose of this unit is to control the pressure under which fluids may be added to the body or removed from the body. Said unit 50 is further provided with an air escape opening 15.
Pressure indicating device 5!] is provided with a pressure equalizing indicator 5|, a three-way valve 52, a bypass 53, an extending arm 54" a manometer or pressure gauge 55 and a pressure compensator 55. The pressure equalizing indicator 5| is provided with U-tube 5|b with an indicating fluid 5|c and an indicating scale 5|. At the ends of its two arms there are providedtwo bulbs 53a and 531) within which there are two hook tubes 53c and 53d. The hook tube 530 is v in connection with the outlet 43 and the bypass 53 through three-way valve 52. that the valve 52 can be rotated in any desired position depending on the operation of the indicator 5|. The hook tube 53d is connected with the bypass 53, the manometer or pressure gauge 55 and the pressure compensator 56 through the tubing 54, 54a, 54b and rubber tubing 55a. Said valve 52 may be set on tube 53 intermediate the hook tubes 53c and 53d.
The pressure compensator 56 is provided with a rubber bulb member 5601, a horseshoe shaped supporting plate member 551) with a tap hole 56a, adjusting screw member 56a and adjusting plate 560. The rubber bulb memberfifid willbe compressed or decompressed by the action of the adjusting screw member 56a against the adjusting plate member 560 as shown in Fig. 1. The valve member 52 will be placed in the position as shown in Fig. 1, so that as the channel 21 of the needle 20 is in communication with the equalizing indicator 5|, and the stop cock member 4| of the flow regulator. 40 is closed to its capillary part 44 at the same time. The pressure at the opening 29 of the needle 2|] will be transmitted to the pressure equalizing indicator-5| and the indicating fluid 5|c will be pushed in the arm 5|b of the U-tube 5|a downward and in the arm 5|d upward. The.
difference between the arms 5|d and 5|b will be cancelled by compressing the rubber bulb member 5601 of the pressure compensator 56. The body fluid in the channel 21 of the needle 2|] will be pushed back and prevented from further flowing into the channel 27 by the compensating pressure in the pressure indicating device 56-. Thus there will. be no body fluid lost by this kind of pressure measuring device and the true value of pressure can be obtained thereby. The condition in the body remains unchanged. This is very important for measuring the .intrathecal pressure with suspect of an intracranial tumor. By opening the stop cock member 4| of the flow regulator 40 to the atmosphere the pressure in the pressure Said enlarged portion of the conduit It will be noted needle 29 will drop as a result or" any body fluid flowing out. The pressure within the body will be reduced in the same. ratio. The indicating fluid E0 will be pushed downward into the arm 51d and upward in the arm 5H) by the compressed air in the manometer or pressure gauge 55 and its connecting tubings.
The difference in pressure, as shown by the fluid between the arms 51b and 51d will be cancelled by injecting fluid or air through the syringe l0, channel 26, opening 28 of the needle 28 into the body after the three-way valve member has been adjusted so that the passage from the syringe IE! to the opening 28 is open while it is closed to the flow indicator 3! The body cavity pressure will be kept constant by maintaining the injection speed or rate and the outflow oi the body fluid and will be controlled by the pressure equalizing indicator 5|. The fractional reading of pressure will be made on the indicating scale 5|. It will be noted that the bulbs 53a and 53b and the hook tubes 53c and 53d will prevent the indicating fluid 519 from escaping from the equal izing' indicator 5| at the moment when the pressure changes suddenly in case of the needle being detached from the body. The pressure equalizing indicator can be put out of operation by adjusting the three-way valve 52 so that the channel 2? of the needle 29 communicates directly with the manometer or pressure gauge 55 and the pressure compensator 55 through the bypass 53.
It will be noted from the foregoing description of my invention, that it can be usedfor puncturing various parts of the body such as the cerebrospinal canal, the thorax cavity, joints, sinuses, abscesses, arteries, veins and the eyeballs. Also the attached pressure indicating device can be modified for measuring the blood pressure and the oscillation of the arterial pressure which will be indicated by the pressure equalizing indicator. The flow indicator can be used for puncture of any body cavities, abscesses and vessels as a great aid for the physician to localize his desired puncture places and the patient will thereby suiier less. Particularly by my invention I can use it in combination with the said syringe l6 with a threeway valve as shown in Fig. 3 for intravenous injection of solutions of high viscosity and a. flne calibered hypodermic needle.
While a preferred embodiment of my invention has been described in connection with the, accompanying drawing, it is to be understood that various changes or modifications as to the form, arrangement of parts, and use of materials may be made without departing from the spirit and scope of the invention as claimed herein.
1. Medical apparatus for injecting into and withdrawing fluids from the body, comprising a body member having a three-way passage and a needle with a multiple channel in communication with said passage, operable means for selectively passing fluid through the passage, selectively r0- tatable plug means for directing the flow of fluids through the body member, and syringe means attachable to the body member having an interplunger and a measuring plunger movable in the interplunger to regulate the flow of fluid through the body member into one of the channels of the needle, said needle having a channel with an external side opening disposed short of the puncturing end thereof and being concentric with respect to the axis of the needle.
2. Medical apparatus, for injecting into or eX- tracting controlled quantities of fluids from the body under regulab-le controlled hydrostatic pressure conditions, comprising a multiple channel needle, a three-way plug in connection with said needle, and a syringe in connection with said plug having an interplunger and a plunger longitudinally movable and concentric with said syringe, for injecting controlled quantities of fluid into the body.
3. Medical apparatus for injecting into or extracting fluids from the body under regulable controlled hydrostatic pressure conditions, comprising a multi-channeled needle, a body member in connection with said needle, a syringe in connec tion with said member having a plunger and an inner longitudinally movable concentric measurement adjusting member, fluid control regulating means in connection with the body member, to permit the flow of a fluid therethrough into one of the channels of the needle, as fluid is withdrawn from the body through the other channel and directed through the body member by said means the body member. 4. Medical apparatus for injecting into or extracting fluids from the body under regulable controlled hydrostatic pressure conditions comprising a multichanneled needle, a three-way body member in connection with said needle, a syringe in connection with said member having a plunger and an inner longitudinally movable concentric measurement adjusting member in said plunger to inject minute quantities of fluid into the body, regulable drainage means in connection with said needle to permit the flow therethrough of fluids being removed by the needle and syringe from the body, and equalizing measuring means in communication with the drainage device for determining and-equalizing the pressure between the body fluid being withdrawn from the body and the fluid being injected thereinto by the syringe.
5. Medical apparatus for injecting into or extracting fluids from th body under regulable controlled hydrostatic pressure conditions comprising a dual channeled needle, a three-way plug in connection with said needle for selectively directing the flow of fluids through the plug, a syringe in connection with said plug having an interplunger and an inner longitudinally movable concentric measurement adjusting member, a fluid passage regulator in connection with the delivery passage directly communicating with the channel of the needle, and adjustable compensating means in connection with the regulator to compensate for any diilerence in pressure shown by said equalizing means.
6. Medical fluid injecting and extracting apparatus comprising a two-way needle, a body member, a three-way plug in the member in connection with said needle, a syringe connected with said plug having a plunger and an interplunger, said plunger and interplunger being relatively movable with respect to each other and with said syringe, said needle having a pair of independent channels one of which is in communication with the multiple-way plug and the other is in direct communication with the control means, said last named channel being closed at the puncturing end of the needle but opened to th side thereof.
7. Medical fluid injecting and extracting apparatus under controlled hydrostatic pressure conditions, comprising a multiple channeled needle, a. body member, a three-way plug in the member in connection with said needle, a. syringe connected with said plug having a plunger and a graduated interplunger, said plunger and inter- 9 plunger being relatively removable with respect to each other and with said syringe, a spiral pressure flow indicator in connection with said plug, regulable fluid drainage means in connection with said needle, a pressure equalizer in connection with said drainage means for indicating and equalizing the pressure between the body fluid and the fluid being forced into the body by said syringe, and compensatory pressure regulable means in connection with said equalizer adapted to compensate for the diirerences in pressure arising from the extraction of fluid from the body and the injection of fluid into the body, said equalizer device having two-way means for bypassing the pressure exerted therein from the drainage means to the compensating device.
8. Medical fluid injecting and extracting apparatus comprising a needle, 2. body member, a three-way plug in the member in connection with said needle, a, syringe connected to said plug having a plunger and an interplunger, said plunger and interplunger being relatively movable with respect to each other and with said syringe, stop means for said plunger and interplunger, and means attachable to the body mem ber to regulate the flow of fluid through the body 1 member into one of the channels of the needle, said needle having a channel with an external side opening disposed short of the puncturing end thereof and being concentric with respect to 30 the axis of the needle.
9. Medical apparatus according to claim 2, in which the plunger is calibrated, has a cross sectional groove adjacent the end insertible into the Y the 1'0 syringe, the interplunger has an annular groove at one end, a longitudinally extending recess at said end and an index marking adjacent said nd, a holder having an annular member sur rounding the interplunger at one end, and a longitudinally extending angularly bent member slidable along th periphery of the syringe, an L-shaped hooked member connected at one end to the interplunger and having its other end fixed to the longitudinally extending angularly bent member, adapted to be flxed in the recess of said lunger.
10. Medical apparatus according to claim 2, in which th interplunger is provided with a holder having an annular member surrounding the in-.
'terplunger at one end, and a longitudinally extending angularly bent member slidable along the periphery of the syringe, an L-shaped hooked member slidably connected at one end to the interplunger and having its other end fixed to longitudinally extending angularly bent member, adapted to be fixed in the recess of said plunger.
' QUANG HSI HU.
References Cited in the file of this patent UNITED STATES PATENTS Number Quang Hsi Hu Aug. 21, 1951 I