improvements in, and connected with, Stethoscopes.
Year: 1897

page_text: Date of Application, 24th Sept., 1897
1000
1012
1000
PROVISIONAL DIMUITICATION.
improvements in, and connected with, Stethoscopes.
I, CARL AUGUST TESKE, of 6, Moore Street, Cadogan Square, Chelsea, Surgical
Instrument Maker, do hereby declare the nature of this invention to be as
follows:
:―
•
My invention relates to improvements in stethoscopes and has for its principal
object to improve the efficiency of the instrument and particularly to facilitate
auscultation by causing the audible pulsations or murmurs of the heart and
other thoracic organs to be much more energetically transmitted to the ear of
the observer than by other instruments of the kind now in use.
With this object my improved stethoscope consists of a body portion which
is made particularly heavy either by being composed of a solid mass of metal
or by being made hollow and loaded with mercury or other heavy metal so that
said body portion will by its inertia oppose such resistance to being set in motion
by the pulsations to be auscultated as will cause the energy of those pulsations
to be transmitted to the column of air which forms the medium of communica-
tion between the body of the patient and the ear of the observer.
In order to prevent as far as possible the absorption of those pulsations by
a comparatively large volume of air, as in the bell mouth of an ordinary stetho-
scope, I make the body portion which is double ended, flat or but slightly
concave at the ends and provide it with an encircling flange formed by a ring
of indiarubber projecting slightly (a millimetre or two) from the end of the
body portion so that when applied against a plane surface a thin film of air of
large area but slight volume will be confined within the closed chamber thus
formed at the mouth of the instrument and will form the medium whereby the
pulsations are received and are propagated through the air passages leading to
the ear tubes of the instrument, the indiarubber ring or flange being divergently
coned by being sprung onto a divergently coned groove about the body portion
so that it will readily adapt itself to inequalities of the surface to which it may
be applied and be highly sensitive or respond to the slightest vibrations or
movements.
The body portion is traversed by an axial passage of small bore and the one
end of the body portion is made of small diameter to suit it for direct intercostal
observation. When auscultating, the bore at the end which for the time being is
not in use is closed by the finger of the observer and to enable either end to be
brought into position for use the body portion is pivoted (like the pendant of a
watch chain) between the ends of a tubular bow in communication by lateral
passages in the body portion, with the axial passage, and to which the flexible
ear tubes are connected.
The body portion above described may be made in one piece or in two or
more pieces screwed together for convenience in packing into a pocket case and
in connection with the stethoscope as above described I provide a pocket tablet
adapted to be used in conjunction with the stethoscope for purposes of ausculta-
D
077

page_text: tion in the following manner: -The tablets are composed of thin flexible leaves
of celluloid, say three in number, pivoted together fanwise, one of the leaves
having cemented to its face a thin ring of indiarubber of a diameter about
corresponding to that of the larger end of the body portion of the stethoscope,
this leaf being also perforated with a hole concentric with the ring. Upon
this ring may be superposed one or other of the other leaves, one of which has
a perforation to coincide with that of the first mentioned leaf whilst the other
is imperforate so that between the two leaves a disc-like film of air is confined
equal in thickness to that of the rubber ring. The one or other pair of superposed
leaves is interposed between the stethoscope and the body of the patient and
forms the plane surface; against which the rubber flange of the body portion
of the stethoscope is applied as previously mentioned.
For use in connection with the stethoscope there is also provided a pleximeter
available for use as such and also as a plane surface for application to the
large end of the body portion of the stethoscope to enable that end to be used
for intercostal exploration. With this object it is provided with an undercut
flange so as to form a cap fitting securely but loosely on the large end or mouth
of the body portion of the stethoscope and is provided at its other side with a
projection adapted to be pressed between the ribs of the patient during the
auscultation.
DI
J
1007
A. M. & WM. CLARK,
Chartered Patent Agents, 53, Chancery Lane, London.
Improvements in, and connected with, Stethoscopes.
I, CARL AUGUST TESKE, of 6, Moore Street, Cadogan Square, Chelsea, Surgical
Instrument Maker, do hereby declare the nature of this invention and in what
manner the same is to be performed to be particularly described and ascertained
in and by the following statement:-
My invention relates to stethoscopes and has for its principal object to
improve the efficiency of the instrument and particularly to facilitate
auscultation by causing the audible pulsations or murmurs of the heart and
other thoracic organs to be much more clearly and energetically transmitted to
the ear of the observer than by other instruments of the kind now in use.
The invention will be described with reference to the accompanying drawings
forming part of this specification wherein Figure 1 shews a sectional elevation of
one form of the body portion of the instrument. Figure 2 is a similar view
'of a modification. Figure 3 is a cross-sectional view of a pleximeter for use
in connection therewith.
My improved stethoscope consists of a body portion A which is made of a solid
mass of metal so that it will, by its inertia, oppose such resistance to the pulsa-
tions to be auscultated as will cause the energy of those pulsations to be trans-
mitted to the column of air which forms the medium of communication between
the body of the patient and the ear of the observer. The body portion is double-
ended, the one end a being of large diameter and the other end b of small diameter,
the body being traversed axially by an air passage of small bore extending
from end to end of the body portion.
In order to prevent, as far as possible, the absorption of the pulsations by a
comparatively large volume of air, as in the bell mouth of an. ordinary stetho-

page_text: scope, I make the large end a of the body portion flat or nearly so and provide
it with an encircling flange formed by a ring of indiarubber d which projects
slightly (a millimetre or two) from the end of the body portion so that when the
edge of this ring is applied against a plane surface (such as a slip of celluloid
or a visiting card for instance) a thin film of air of large area but slight volume
will be confined within the closed chamber thus formed at the mouth of the
instrument and will form the medium whereby the pulsations are received and
are propagated through the passage c and the air passages in connection there-
with leading to the ear tubes of the instrument. The indiarubber ring or flange
is not perpendicular to the end of the body portion but is divergently coned
by being sprung into a divergently coned peripheral groove e in the body, as
in Figure 1, or by being clamped between a divergently coned flange on the
body and the edge of a disc f screwed to the body, as in Figure 2, the effect of
this divergent conical form being that the arris of the rubber will bear against
the surface to which it may be applied and the elasticity of the rubber will be
brought into play in such manner as to render the instrument highly sensitive
to the slightest vibrations or movements of the surface with which it is in contact.
The opposite end of the body portion being made of small diameter is suited
for direct intercostal observation, the one body portion thus forming a double
stethoscope either end of which may be brought into operative position. When
auscultating, the orifice of the bore c at the end which for the time being is not
in use, is closed more or less by the finger of the observer, and to enable either
end to be brought into position for use, the body portion is pivoted to turn on
a tubular axis in one with the tubular Y-piece to which the usual flexible car
tubes are attached. In Figure 1 this axis is formed by the ends of a tubular
bow h which are in communication with the axial passage c whilst in Figure 2
the pivot is formed by the tubular stem i of the Y-piece g the said stem being
circumferentially grooved and transversely perforated so as to always maintain
connection with the bore c.
The body portion may be made in one piece, as in Figure 2, or it may be made
in two or more pieces separably fitted together for convenience in packing into
a pocket case. Such a connection is shewn in Figure 1 where the one part has
a plug fitting in the other part, this plug being circumferentially grooved and
transversely perforated where it comes opposite the lateral bores which communi-
cate with the tubular bow so that the latter will always be in communication
with the bore c. In the case of the modification shewn in Figure 2, the end of
the stem is split and sprung into its seat in the body so as to ensure a friction-
tight fit and be easily separable.
The smaller end b may be cupped, as shewn in Figures 1 and 2, and provided
with a removable projecting head of rubber p to admit of the body of the
stethoscope being used as a hammer in percussive observation, the rubber head
being perforated to correspond with the bore c, and being removed when the
small end b is used for auscultation.
For use in connection with the stethoscope there is also provided a pleximeter
shewn in Figure 3, available for use as such, and also as a plane surface for
application to the large end of the body portion of the stethoscope so as to
constitute therewith a stethonoscope and also to enable that end to be used for
intercostal exploration. With the first mentioned object it is formed of a disc k.
(which may be of celluloid or other suitable material) provided with an upstanding
peripheral flange undercut as at m so as to form a cap adapted to loosely
embrace the rubber ring 7 at the large end of the body portion of the stethoscope
in such manner as to be easily applied or removed but not to fall off therefrom.
It is provided at its other side with a projecting stem or stud n adapted to be
pressed between the ribs of the patient, this stud being preferably of slightly
divergent form and being screwed into a central through hole in the disc k of
the pleximeter, so as when removed to leave a through aperture for the trans-
mission of the pulsations, the disc then answering the purpose of the celluloid

page_text: slip or visiting card before referred to. The inner surface of the disc k may
have an apertured lining of sheet rubber o as a pad to receive the blows made
in the percussive method of observation.
Having now particularly described and ascertained the nature of the said
invention and in what manner the same is to be performed, I declare that what
I claim is:-
1. A double-ended stethoscope having ends of different sizes as described and
the body portion of which is massive or solid and is traversed by a passage of
small bore, the said body portion being pivoted about a tubular axis in connection
with the said passage and with the usual ear tubes as and for the purposes
described.
2. A stethoscope having a massive body portion of large diameter at one end
traversed by an air passage of small bore in communication with ear tubes, in
combination with an encircling flange formed by a rubber ring of divergently
coned form projecting slightly beyond the flattened end of the body portion so
as to enclose an air space of large area but small volume, the rubber ring
presenting an arris to contact with the surface against which it is to be applied
substantially as and for the purpose specified.
3. The herein described improved forms of stethoscope substantially
described and shewn in the drawings.
as
4. The combination with a stethoscope such as described, having a divergently
coned rubber flange as specified, of a pleximeter in the form of an apertured
cupped disc having undercut flanges adapted to embrace the rubber flange of
the stethoscope as described.
5. The combination with a stethoscope such as described, having a divergently
coned rubber flange as specified, of a pleximeter in the form of a cupped disc
having undercut flanges adapted to embrace the rubber flange of the stethoscope
and provided with a projecting stud for intercostal observation as described.
Dated this 24th day of June 1898.
A. M. & WM. CLARK,
Chartered Patent Agents, 53, Chancery Lane, London.