US1945327A - Combined tongue depressor and electrode for electrocoagulation of tonsils - Google Patents

Description

Jan. 30, W, B. MORSE COMBINED TONGUE DEPRESSOR AND ELECTRODE FOR ELECTROCOAGULATION OF TONSILS Filed June 30, 1932 Patented Jan. 30, 1934 UNITED STATES TONSILS Willis B. Morse, Washington, D. C.

Application June 30, 1932.

12 Claims.

This invention relates to a combined tongue depressor and electrode for use in the removal of tonsils by the electro-coagulation method. r At the present time the long-used method of removing the tonsils by cutting them out, with its attendant inconvenience to the patient and danger from loss of blood, is being superseded by an electrical method of removing them. According to this method the tonsil tissue is gradually destroyed with an electrical current of high frequency. When it is desired to remove the tonsils by this method, an electrical apparatus is used through which flows a current of high frequency but very loW voltage. One end of this circuit terminates in an electrode which is adapted to be secured to, or held against a part of the patients body, and may comprise an electrode which is clamped to the persons neck or leg, or an electrode Which is inserted into the patients mouth and is pressed against the inside thereof adjacent the tonsil Which it is desired to remove. The use of the latter type of electrode is preferable because the moist condition of the mouth and throat enable a better contact to be made and as the contact is close to the tonsil to be operated upon, a smaller amount of current may be used with less inconvenience to the patient. The other end of the circuit terminates in an electrical needle which is adapted to be contacted with or penetrate the tonsil. When this is done an electrical circuit is established through the electrode which is pressed against the inside of the mouth or throat, the electrical needle, and the tonsil Which is being operated upon. The high frequency electric current causes a portion of the tonsil tissue to coagulate. This coagulated tissue in the course of a few days or a Week Will slough off, and When that has taken place the patient is given another such treatment, and so on until the entire tonsil has been destroyed. This is usually accomplished in three or four treatments. This method of removing the tonsils has many advantages over the former method of placing the patient under anaesthetic and cutting out the tonsils, as there is no danger of hemorrhages and the patient is not incapacitated for several days as is the case Where the tonsils are cut out. After a sitting for the removal of a portion of a tonsil according to this method, the patients throat or tonsil is only slightly sore and he may go about his business as before and it is not necessary for him to mass a single meal.

As the tongue has to be depressed While the tonsil is being operated upon, the use of the electrode which is inserted inside the mouth of. the

Serial No. 620,259

patient has the disadvantage that an assistant has to be present to assist the doctor in the removal of the tonsil, as the doctor cannot both depress the tongue and hold the electrode against the inside of the mouth or throat of the patient with one hand, While operating the electrical needle against the tonsil With the other hand.

The present invention aims to overcome the disadvantages in connection with the use of an electrode which is held against the inside of the mouth and to enable the doctor to properly perform the operation Without assistance. To this end the invention comprises an electrode for use in the electro-coagulation method of removing tonsils which is combined With a tongue depressor. With such a combined tongue depressor and electrode the doctor may maintain the tongue depressed and the electrode in contact with the inside of the patients mouth with one hand While operating the electrical needle to co- .75 agulate the tonsil tissue with the other. The combined tongue depressor and electrode also preferably has secured thereto an electrical bulb which may be lighted to illuminate the inside of a patients mouth so that the doctor Will have a Well lighted field in which to Work.

More specifically, my invention comprises a combined tongue depressor andelectrode With a suitable handle which may be grasped by the do'ctor and through which high frequency coagulating $5 current passes. To this handle is secured a tongue depressor which is preferably made of some insulating material, such as bakelite, hard rubber, or the like, and has projecting from the inner end thereof an electrode which is adapted to be pressed against the inside of the throat or mouth of the patient, preferably around the tonsil to be operated upon. Passages are provided through the tongue depressor so that a suitable electrical conductor may pass from the diathermy plug in the q handle to electrode sockets in the end of the tongue depressor, so that a complete circuit may beY established to the electrode.

Preferably, the end of the tongue depressor is provided With two sockets into which the electrode may be inserted, one at the left side and the other at the right side so that the electrode may be placed in either socket depending upon Whether it is desired to remove the right or left tonsil. The electrodes are provided with a hook-like portion so that the anterior pillar adjacent the tonsil may Y be held retracted at the same time that the tongue is held depressed, thereby enabling the doctor to have free access to the tonsil upon which he is Operating.

The invention will be further described in connection with the accompanying drawing, but it is to be understood that this further disclosure is to be taken as an exemplincation of the invention and that the same is not limited thereto.

In the drawing, Fig. 1 is a vertical sectional View through the combined tongue depressor and electrode,

Fig. 2 is a horizontal sectional view through the outer end of the tongue depressor showing the sockets on each side for the electrodes, and vran electrode inserted in one of the sockets, and

Figs. 3 and 4 are elevational Vvievvs: of 'amodified form of electrode.

In the drawing, the numeral 1 designates a tongue depressor which is formed of .insulating material such as bakelite, hard rubber, gutta percha, or the like. The inner-endof thetongue depressor comprises a pair of arms 2 and 3 which diverge to a distance approximating the Width of .azpersons `tongue `and which are connected at their-ends by the cross-piece e. .In order that the .tongue depressor'may be readilygrasped and manipulated inthe Ipatients mouth by .the doctor, .the youter end ,portion thereof has integrally formed therewith a dependinghandle 5.

.Both the tongue-depressor 1 and the handle 5 are reinforced bya strip of metal 6 which is fse- .cured .to theunder side of the tongue depressor .and .the innersside .of the handle portion. The under sidepof the metal which underlies the tongue l.depressor is serrated .as at '7, so as to bettermain- :tain @its :position on the'tongue, While the lower 'portion of theireinforcing metal adjacent .the handle pis .curved .inwardly and upwardly as at v8 to rprovidea restfor thedoctors hand.

JBothrthe'tonguedepressor and thehandle have formed therein a .passagezg :through which extends .anelectrical vconductor 10. The innerportion of -the passage :9 .in-the ytongue .depressor 'communivcates :with :a pair of passages 9a and 9b which -extendrthrough the diverging arms .2 and Band iterrninate. in electrode sockets 11 and 12,fformed in :the inner 'end portion of the `tongue .depresson iOne-of these electrode sockets is locatedvonthe right side of thetongue depressor 'and-the other .on :the Ileft side thereof, so that an electrode 13 fmaybe vinserted intoeither one depending upon Whether the rightor left tonsil is to Abeoperated Eupen. The electrical conductor 1,9 which extends ithroughthegpassage 9 likewise/connects with di- .vergingfelectricalconductors 10a and 1Gb located -in the passages 9a and 9b.

Theouter end of the passage 9 terminates in a ysocket 1.4i intoWhich a diathermyplug -15 may be :removably inserted. The diathermy plug extends .from a common form of diathermy machine which -is-notishown and'to which no claim is made in this -application. `HoWeven-it might be stated that the l:diathermy machine is such as to furnish a current :of highfrequencybut very low voltage, Va current Loria-.very vfevv hundred milliarnperes being suincient.

.The velectrode .13 shown in Figs. 1 and 2 com- ;.prises-.fa taperedend portion .15 Whichis adapted `fitobefrernovably retained in thesockets 11 and 12 4byuneansnof:a set screw 1'?, and an outer arcuate `:portion 18 which may be placed around-the tonsil fan'd thereby make electrical contact with the body .of Vthe patient whose tonsils are to be removed. Theiel'ectrode'nasi-formed onone side thereof a ihook-'shaped.pillar-retractor 19 so that the anterior pillar maybeheld'retracted by the electrode, n"thereby giving thel doctor better access tothe tonsil which is being operated upon. The outerportion of the tongue depressor has an electric socket 2i) therein, into Which may be screwed a small electric bulb 2l which Will properly illuminate the interior of the mouth and thereby give the doctor a Well illuminated eld in which to work. Current from a dry cell or a transformer-rheostat (not shown) may be supplied to the electric bulb by means of the conductor 22 which is inserted into the socket 23. For convenience in manufacturing, the sockets ll, 12, 14 and 23 are preferably made .of the same size.

The electrode shown in Figs. 3 and 4 is substantially the sameas the .electrode shown in Figs. 1 and 2, except that the outer end portion 24 is made circular instead of arcuate, so that it may vextend completely around the tonsil.

When it is desired to remove a persons tonsils `by the electro-coagulation method, the tonsil is first -aneesthetized with a suitable local anaesthetic, and the tongue depressor having the electrode in the -end thereof is then rinserted Vinto the patients mouth and the electrode pressed against the 7patients throat adjacent the tonsil which is to be operated upon. Thisoperation, and also the depression ofthe patients tongue, .can be simultaneously performed by the doctor with one hand, While his other hand .is leftfree .tornanipulate the electrical needle whichextends from the-diathermy machine and is incircuit with the electrode.

In the actual operation, the electrical needle is touched upon or inserted .into .the 'tonsil v`at ,different points for a sufficient length .of time to-coagulate a portion of the tonsil tissue. .After a period of severaldays ora Week,When the .,coagulated tissue will have sloughed oif, thepatient returns for .another such treatment, `and this .is .continued untileach tonsil has been .completely removed. Ordinarily `three .or .four such treatments `for each tonsil are suicient.

.From the .foregoingit Will be Vapparent that the present invention ,provides a very compact and -eifective means for .simultaneously maintaining the patients tongue `depressedand. .for forming an electrical .contact of the electrode with the .inside of the patients mouth .adjacent the tonsil, whereby the doctor vmayperform the operation Without an .assistant and Without .the necessity of clamping the .electrode .to the neck or .leg .of the lpatient as ihas heretobefore been done.

I claim:

1. vA tongue depressor for use in the 'electro- .coagulation method of removing tonsils having .an inactive electrode secured thereto and means l carried by .the tongue depressor `for conducting electrical current to said electrode.

2. A tongue depressor for use in the .electrocoagulation method of removing tonsils `having an .inactive electrode secured to the inner end vportion thereof and means carriedby the'tongue depressor for conducting electrical current to said electrode. K

3. A tongue non-conducting .depressorfor .use

in the .electro-coagulation method of Aremoving tonsils having an inactive electrode secured to the inner end portion thereof and means for con- .ducting an electrical current throughthe tongue depressor to the electrode.

1i. A tongue depressor for use in the electro-p;

its

coagulation method of removing tonsils having an inactive electrode removably secured to the inner end portion thereof and means carried by the tongue depressor for conducting electrical current to said electrode.

6. A tongue depressor for use in the electrocoagulation method of removing tonsils having a pair of electrode sockets formed in its inner end portion whereby an electrode may be placed in either socket depending upon whether the right or left tonsil is to be operated upon and means carried by the tongue depressor for conducting electrical current to said sockets.

7. A non-conducting tongue depressor for use in the electro-coagulation method of removing tonsils having a passage for an electrical conductor extending longitudinally therethrough, said passage communicating with a pair of passages Which terminate in electrode sockets at the distal end of the tongue depressor.

8. A non-conducting tongue depressor for use in the electro-coagulation method of removing tonsils having an enlarged inner end portion, said inner end portion having a pair of electrode sockets formed in the distal end, one on the right side thereof and the other on the left side thereof.

9. A non-conducting tongue depressor for use in the electro-coagulation method of removing tonsils, the inner end of said tongue depressor being enlarged, and having formed therein a pair of electrode sockets, a handle secured to the outer end of said tongue depressor, and a diathermy current conductor extending through said handle and tongue depressor and having its inner end branched and the branches thereof connected to said electrode sockets.

10. An electrode for use in the electro-coagulation method of removing tonsils having a pillar retractor carried at one side thereof.

11. An electrode for use in the electro-coagulation method of removing tonsils having a hookshaped pillar retractor at one side thereof.

12. An electrode for use in the electro-coagulation method of removing tonsils, comprising a portion adapted to t Within an electrode socket, and an outer arcuate portion, said electrode having formed at one side thereof a hook-shaped pillar retractor.

WILLIS B. MORSE.

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