US 2126070 A
Descripción (El texto procesado por OCR puede contener errores)
Aug; 9, 1938. F. c. WAPPLER ELECTROTHERAPY.
Filed April 29, 1932 Patented Aug. 9, 1938 UNITED STATES PATENT OFFICE 8 Claims.
My present invention relates generally to electro-therapy, and has particular reference to a novel and unique method of subjecting portions of the human body, both exterior and interior,
to certain novel therapeutic effects. I
The art of electro-surgery and electro-therapeutics, in so far as the employment of sustained high-frequency alternating current is concerned, is veritually in its infancy, and yet the advent of improved means for feasibly and economically enabling surgeons and doctors to generate alternating currents of safe low voltage and sustained oscillations of relatively high frequencies has given rise to extremely rapid developments in the new techniques involved. So little is known of the remarkable characteristics and capabilities of high-frequency alternating currents, especially as to the effects which such currents may be caused to produce in connection with therapeutics, that the established surgical and medical art can hardly be relied upon as a guide or prognosticator of the apparently remarkable and unique results that seem to be capable of accomplishment by the newly developed types of highfrequency currents. 1
My present invention, for example, is predicated upon the discovery that the generation or formation of a disruptive high-frequency are within the body. of a conductive fluid is accompanied by phenomena which have proven to have new and highly beneficial capabilities from the standpoint of therapeutics. It is, accordingly, a general object of my present invention to provide a new technique which involves the therapeutic application to the human body of fluids in which a. disruptive arc of this characteris generated.
I have found, for example, that the formation of an are within a fluid with which medicaments 40 are associated has peculiar and often inexplicable effects in liberating or releasing the medicaments or similar active elements. Accordingly; by applying a mass of such fluid to the portion of the human body which is to be treated, coincidentally with a formation of a disruptive highfrequency are therein, it. is possible in a new and unique and highly effective manner to liberate such medicaments in intimate contact with the body and under conditions producing a definitely ascertainable, efiectivepenetration of the medicaments into the body.
By means of my present invention, I am enabled to provide a new and effective method of medicating or .similarlytreating interior portions of the body which have heretofore been wholly inaccessible. The walls of interior cavities may, for example, -be' subjected to the medicating and other beneficial effects of my present mode of procedure by filling the cavities with the proper current-conductive fluid and causi'ng'a disruptive arc in the fluid to produce its efiects. v
In producing or forming a disruptive arc of the character hereinbefore mentioned and capable of producing the beneficial effects sought to be' accomplished, it is a feature of my invention to employ a current-concentrating electrode in combination with a generator or source of suitable high-frequency current whose sustained low voltage high-frequency output of power is suflicient to generate a sustained disruptive arc beneath the surface of the fluid in which the electrode is immersed.
I have found that the electrode may itself under certain circumstances be caused to 1ncorporatemedicaments or active elements which are adapted to be released under heat, as a result of which the generation of an arc of the character mentioned causes these active materials to be re-, leased, apparently in colloidal condition. My invention thus has further recourse to the well known phenomenon whereby colloids are caused to move at a rapid rate away from a rupturing arc, and I am enabled by my present invention to produce colloids in situ and simultaneously drive them with penetrative efiect against the cavity wall or other body portion which is under treatment. I
Further effects of a rupturing'arc of the present character lie in the production or generation of an intense light, coupled with a highly eflective vibratory efiect which lends itself readily to beneficial therapeutic use. Whether such vibration is due to a bombardment of the body portion by minute bubbles or particles of gas, or of minute particles of suspended colloidal matter, or both, or whether it is due in some other way to certainstresses which are set up in the fluid by the disruptive arc, Iazn not enabled at this time to state. Extensive experimentation has demonstrated, however, that at least a part of the remarkable vibratory effect which is produced by an aqueous solution in which the are is formed is due to the rapid generation and forceful propulsion through the liquid of minute particles. or bubbles of pure or nascent oxygen. 9. phenomenon which readily suggests some of the extremely beneficial effects which a therapeutic procedure of the present character may be caused to produce.
One of the main features of my invention,
which greatly enhances its utility and facilitates the practice thereof under a variety of conditions, is based upon the discovery that a disruptive arc of the present character may be produced without necessarily establishing what would ordinarily be referred to as a complete electrical circuit. Where a proper type of highfrequency generator is used, for example, I have found that an electrical connection between only one terminal of such generator, on the one hand, and either the immersed electrode or the body under treatment, on the other hand, is sufilcient' to produce the desired effects. Where a connection is made with the electrode, for example,
it appears that most of the energy, or at least athe body under treatment being dissipated or radiated from this body very much as energy is radiated or dissipated from a broadcasting antenna. Similarly, where an electrical connection is made with the patient, usually at some convenient exterior area, I have found that it is utterly unnecessary to connect the immersedelectrode with the high-frequency source, and that the disruptive arc may be produced and maintained, despite such utter disconnection of the immersed electrode from any other portions of the apparatus. The energy is in this instance dissipated or radiated through and by the body The adof an operator grasping the electrode. vantages of this mode of carrying out the effects of 'my invention need hardly be elaborated upon, but it may be stated by way of example that in the generation of a disruptive arc in a fluid which is contained within a body cavity, the disconnected nature of the electrode from any wires or leads is of tremendous value not only in facilitating the procedure itself but also in the design and manufacture of surgical instruments for insertion into body cavities.
Other features and advantages of my invention, and of its almost innumerable possible ramiflcations will be more fully appreciated after this specification has been read. For illustrative purposes, Ihave shown in the accompanying drawing one manner of carrying out my pres ent invention. In the drawing- Figure l is a perspective view of the arm of a patient showing, by way of illustration, how my present mode of electro-therapy may be applied to the forearm;
Figure 2 isa view similar to Figure 1 showing an alternative procedure;
Figure 3 is a more detailedelevational crosssection through one illustrative type of apparatus for applying a current-conductive fluid to a portion of the body;
Figure 4 is a cross-sectional view taken substantially along the line [-4 of Figure 3;
Figure 5'is an enlarged cross-sectional view of :ne type of current-concentrating electrode;
Figure 6 diagrammatically illustrates the manner in which my present invention may be employed to subject internal cavities to certain treatments.
The current which I employ in connection with my present invention is an alternating current of high frequency, the voltage being relatively low and sustained and the amount of current bein a variable factor which depends partly upon the sire of the area being treated, partly upon the tolerance of the patient, and partly upon the conditions under which the disruptive arc is to be generated. The source of this current may be of any suitable character which complies with the necessary requirements, and has not been i1- lustrated herein in detail, being represented di-' agrammatically at ill and I0. Merely by way of example, a high-frequency current generator of the character described in my earlier Patent Number 1,962,796 will furnish the current necessary. It will be understood that the amount of current or energy available is suflicient to permitthe desired arc to be formed and sustained, and that the frequency is sufficiently high to bring the currentwell within the range of present-day electro-therapeutic and electro-surgical high frequencies. Wherever the term high-frequency" is used herein and in the appended claims, it is intended to refer to highfrequency alternating current or this character.
In Figures 1 and 2, I have illustrated two alternative methods of practicing my invention in connection with the therapeutic application of the current, and of the eifects produced by a rupturing arc of the present character, to the forearm of a patient. In each case, a vessel or similar suitable instrumentality is adapted to be applied to the body portion to be treated in a manner. whereby a current-conductive fluid may be maintained in contact with the area to be subjected to the treatment. In Figures 3 and 4, I have shown, merely by way of illustration, the general type of vessel or apparatus which might be used for this purpose.
sel I! may, for example, beof glass or the like and of substantially circular or other suitable cross-section, and at its lower edge it may-advantageously be provided with a pneumatic rim i3 preferably of rubber or the like. The vessel is adapted to accommodate the current-conductive fluid which may, for example, be a liquid electrolyte i4; and the apparatus shown is -il- 'lustrative of one possible arrangement whereby the joint is made fluid-tight and whereby the fluid or liquid I4 iscaused to remain in sustained contact with the portion ii.
The vessel I! may be filled and emptied in any suitable manner, and I have illustratively shown the possibility of arranging an inlet and outlet tube is which may be normally capped, as at I, by any suitable closure.
I have shown the vessel upper end .or neck ll through which a currentconcentrating electrode member I! may be arranged to extend, preferably in a removable manner. for example, by the employment of a rubber nipple I! or the like. The member i8 is so constructed that only a relatively small and attenuated end portion thereof is uninsulated and adapted to be immersed within the current-conductive fluid or liquid It, In the illustrated form, I have shown the member I! as a hollow or tubular rod which accommodates an electric lead wire 20 therein. The rod is made of insulation, such as rubber, and the portion near the operative current-concentrating electrode 2| may be'advantageously constructed of quartz or similar vitreous material, as indicated at 22.
The electrode Il may have any suitable shape or configuration, and need not necessarily be spherical, as herein illustrated. It is, however,
i2 with an attenuated current therethrough will be sumciently theory,
ample, to the 5 and it is my beliefthat 50 .=the patient.
' which the arc is concentrated to generate a disruptive are around this electrode when the latter is inserted into a current-conductive fluid, In Figure 1, I have shown a vessel 23 of thegeneral character illustrated, by way of example, in Figures 3 and 4, and I have shown a lead wire 24 connecting the immersed electrode with the high-frequency generator it. The latter may be assumed'to be grounded, as at 25. Without any further connections to the generator iii, it is not only possible but highly practical and feasible to generate a disruptive arc of this present character in what-. ever fluid is accommodated in the vessel 23, as a result of which the desirable therapeutic effects of the present invention are produced upon the forearm 26 or other area with which the conductive fluid is in contact. ,Without endeavoring to give a full explanation of the phenomenon, since it is not fully understood by me, it is my supported by tests and experiments, that most of the energy from the generator i0 is expended at the immersed electrode, and that the remainder of the energy passes into the arm 26 and is radiated by the body of the patient.
'The same desirable eifects may be produced as indicated in Figure 2 wherein the generator it; grounded asat 25, has one terminal thereof connected as at 24 with a contact member or plate '21 secured to the body of the patient, as, for exupper portion 28 of his arm. A vessel 23', preferably of the character hereinbefore described, is applied by a person other than the patient to the forearm 26' as before, but the immersed electrode is entirelydisconnected from the generator l0, and in fact there is no connection whatsoever between the vessel 23' or any parts associated therewith and the generator iii. .If the electrode member It is suitably constructed so as to be graspable by the hand 29 of an opera "tcr, as indicated in Figure 2, the desireddisruptive arc will be generated and sustained, as before, despite the utter disconnection of the electrode fromthe source'of current. The theory hereinbefore advanced serves to explain this phenomenon,
most of the energy is expended at the electrode and the remainder of it surges upwardly through the electrode into the hand 29 and thence into the body of the operator, where it is radiated.
In Figure 6, I have illustrated this highly advantageous characteristic or possibility of my present invention, in so far as the treatment or medication of interior portions of the body is concerned. I have diagrammatically illustrated an illustrative internal'cavity 3|! which is caused to be filled with a suitable current-conductive fluid 3|. Connection is established between a suitable high-frequency generator, as in Figure 2, and a suitable accessible portion ofthe body of An electrode 32 is then caused to be immersed in the fluid 3|, as, for example, by insertion into the cavity through an endoscopic tube 33 or the like. If the rear end of this electrode is grasped by an operator, a disruptive arc 351s formed in the fluid 3|, and all the desirable effects of my present invention are accomplished in intimate proximity. with the walls of the cavity 30, despite the fact that neither the operator nor all connected with the '0 source of high-frequency current.
the electrode 32 is at Highly beneficial and desirable effects are produced, as hereinbeiore stated, when medication is associated with the current-conductive fluid in combination of such eifects.
formed. One method of aCCOml- :i' plishing this is to form the fluid of. a liquid electtrolyte with which the medicament or'medica ments have been associated. The range of possibilities is so varied that only a few will be herein specified for illustrative purposes. For example, an argyrol aqueous solution may be employed, in-
whichcase the present invention and-the form'a tion of a disruptive arc in this solution:=will liberate the argyrol and cause it. to penetrate into whatever body'portion is in contact therewithto a far greater extent than that which has heretofore been possible by ordinary-direct applicaparently due in some way to the peculiar effect of the disruptive are upon the fluid in which it 15 tion of the medicament. This penetration is a'pi is immersed, possibly because of a disruptive effect 1 upon the constituency of the fluid, possibly because of some liberation or precipitation of the medicament under the action of the heat or our rent or both, or possibly because of some sort of argyrol, which is a colloid of silver, it may be In the case of T that the effect is produced by the capability of the current or are to drive the colloid forcefully away from the arc, thereby causing the silver to'-' be driven with force The valuable medicative effects of silver are, of course, well known.
been clearly shown to be thrown down by the against the tissue and into 7 Where potassium iodide is employed, iodine has generation of the present disruptive arc, and the" penetration of this element into the tissue "has obvious advantageous effects. Other medications that might, for example, be employed with equaland similar advantages are mercuric potassium iodide, salts of uranium such as uranium nitrate, bicarbonate of soda, ordinary salt, boric acid or its salts, silver nitrate or other salts or compounds of silver, and other compounds of similar" medicative character.
In the case of uranium salts, the effects produced by my present invention may cause the compound to decompose and liberate either the" radioactive character ofwhich at once suggests theextremely valuable possibilities of my invenvaried, and its effects upon the human body of its pure uranium or compounds of the latter, the
tion in connection with the treatment of tumors and the like. It will be understood, however, that the characteristics of my present process are so at: I
various phases are so little known at the present time, that I cannot at this time specifically attribute any particular advantage or eflect to any particular feature or group of features oi the invention.
In some instances, the generation of the disruptive arc has an effect upon the immersed electrode itself, gradually wearing it away and causing its constituents to be forced into the fluid. 1 Accordingly, the electrode itself may in many instances be advantageously caused to incorporate medicaments of the character herein discussed. For example,'the electrode may be composed of pure silver, platinum", tungsten, arsenic,
or the like, or of compounds of such substances,
for example, amalgams, under whichcircumfly stances the material itself or the medicaments associated therewith are adapted to be liberated,
probably by virtue of the extreme heat, and areforced into colloidal suspension in the liqu d, thereafter being forcibly directed away from the arc and into penetration into the tissue.
Where the disruptive arc is generated beneath the surface of a liquid, it manifests itself by an aura of sparks surrounding the electrode, and by the development of extreme bubbling, and intense light, and a strong'vibration which produces standing waves upon the surface of the liquid. These phenomena. lend themselves readily to the production of brand new therapeutic effects, and these are capable of accomplishment either alone or in combination with the advantages hereinbefore mentioned. For example, intense light has well-recognized therapeutic advantages, especially in combination with the ap plication of heat, warmth and heat being capable of generation in the tissue by the passage of the current itself. Similarly, the vibratory eil'eot, which is probably due to some unique type of bombardment of the submersed body portion, and appears to be due to a bombardment of minute particles of nascent oxygen where. the arc is formed in an aqueous solution, has marked beneficial massaging effects; and these effects are obviously of great advantage and benefit, especially in conjunction with the medicative effects hereinbefore mentioned. Under certain circumstances, nascent chlorine appears to be liberated, and if it should develop that the vibratory effect is actually due to a bombardment of minute gas particles, the liberation of such a gas, or of a number of other gases which different conductive fluids may give rise to, has obvious beneficial eflects.
Although I prefer to use a liquid electrolyte, it will be understood that a gaseous fluid may be employed, as, for example, neon or the like, the
electric disruptive arc having the possible effect .of producing still further therapeutic results upon thebody portion which is submersed in the fluid.
So far as the capabilities of my present invention in connection with internal cavities is concerned, I will refer illustratively to one specific type of treatment which will demonstrate its remarkable utility. So-called Hunner" ulcers in the bladder are usually treated with argyrol, but they are diflicult to observe since they are embedded within the walls of the bladder. By filling this cavity with an aqueous argyrol solution or the like, as indicated in Figure 6, the practice of my present invention may be caused to subject every minute area of the bladder wall to the medicative, and other, eflects herein mentioned.
So far as I. am aware this mode of treatment of the bladder, or, for that matter, of any interior cavity, for'diathermic or medicative purposes, is entirely novel and unique.
Although I have mentioned some of the possible beneficial eflects of the phenomena resulting from the generation of a disruptive high-frequency arc in a conductive fluid, it will be understood that so little is known of the human body and of its reactions, and so little is known of the exact nature of the phenomena which the high-frequency current produces under the conditions herein described, that in many cases it is not possible to definitely state whether the beneficial effects are produced by the heat or. warmth, by
the passage of the current itself, by the impregnation with medication, by the vibratory effects produced, by the bombardment of tissue with gases or particles, by the dissociation of the conductive fluid, by the effect of .the are upon colloids, or by the intense light which is produced. In all probability, many of the effects are the result of combinations of these phenomena, and
it will be mderstood that the application of my invention to specific instances will have specific results and particular advantages which willdepend largely upon the particular requirements and circumstances of each case.
Regardless of the causes or reasons for the results attained, it appears that the characterizing feature of my invention lies in the formation and sustention of a disruptive high-frequency arc beneath the surface of a current-conductive fluid, preferably, though not necesarily, a liquid; and preferably, though not necessarily, a liquid with which medicaments are associated, as, for example, in solution, in suspension, or incorporated with the current-conductive electrode itself. Furthermore, I deem it of particular importance to be enabled by my invention to produce these effects and to form the desired disruptive arc by a single connection to a suitable source of highfrequency current, either by connecting the source directly to the electrode and permitting the energy to be radiated by the patient, or by connecting the source with the patient and permitting the energy to be radiated by the operator.
In general, it will be obvious that changes in the details herein described and illustrated for the purpose of explaining the nature of my invention may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claim. It is therefore intended that these details be interpreted as illustrative, and not in a limiting sense.
Having thus described my invention, and illustrated its use, what I claim as new and desire to secure by Letters Patent, is:
1. The herein-described method of liberating medication in intimate contact with an interior cavity of the human body, which consists in filling said cavity with a current-conductive fluid with which the. medicament is associated, immersing only a single current-concentrating electrode in said fluid at a distance from the wall of said cavity, and generating a high-frequency alternating current disruptive arc in said fluid atsaid electrode.
2. The herein-described method of subjecting the walls of an interior cavity of the human body to vibrations, which consists in fllling said cavity with a current-conductive liquid, immersing a current-concentrating electrode in said liquid at a distance from the walls of said cavity, and generating a high-frequency alternating current disruptive arc in said liquid at said electrode.
3. The-herein-described method of subjecting the walls of an interior cavity of the human body to intense light for therapeutic purposes, which consists in filling said cavity with a currentconductive fluid, immersing a current-concentrating electrode in said fluid at a distance from the walls of said cavity, and generating a highfrequency alternating current disruptive arc in said fluid at said electrode.
'4. The herein-described method of liberating medication in intimate contact with an interior cavity of the human body and simultaneously subjecting the walls of said cavity to vibrations and intense light, which consists in filling said cavity with a current-conductive liquid with which the medicament is associated, immersing a current-concentrating electrode in said liquid at a distance from the walls of said cavity, and generating a high-frequency alternating current disruptive arc in said liquid at said electrode.
5. The herein-described method of liberating 76 medication in intimate contact with a portion oi the human body, which consists in submersing the body portion to be treated beneath acurrentconductive fluid with which the medicament is associated, immersing a current-concentrating electrode in said fluid at a distance from the submersed body portion, establishing an electrical connection between said electrode and a source of high-frequency current, the latter being suflicientiy large to generate a disruptive arc in said fluid at said electrode, and permitting the body under treatment to remain entirely disconnected from said source and to radiate the energy fed into it through said electrode and fluid.
6. The herein-described method of liberating medication in intimate contact with a portion 01' the human body, which consists in submersing the body portion to be treated beneath a currentconductive fluid with which the medicament is associated, immersing a current-concentrating electrode in said fluid at a distance from the sub.-
mersed body portion, establishing an electrical connection between the body under treatment and a source of high-frequency current, the latter being sufliciently large to generate a disruptive arc in said fluid at said electrode, and causing the energy fed into said electrode through said fluid to-be radiated by an operator grasping said electrode and entirely disconnected from said source.
'l. The herein-described method of liberating medication from a current-conductive fluid with which the medicament is associated, which consists in immersing only a single current-concentrating electrode in said fluid, and generating a I high-frequency alternating current disruptive are in said fluid at said electrode, whereby the walls of an interior body cavity filled with said fluid will be subjected to intimate contact with the liberated medication.
8. The herein-described method of liberating medication in a current-conductive fluid, which consists in immersing only a single currentconcentrating electrode in said fluid, said electrode incorporating'a medicament adapted to be released under heat, and generating a high-frequency alternating current disruptive arc in said fluid at said electrode, whereby the walls of an interior body cavity filled with said fluid will be.
subjected to intimate contact with the liberated medication. 9
FREDERICK CHARLES WAPPLER.