Electrical Surgical Instruments.
Year: 1892

page_text: COMPLETE SPECIFICATION.
Electrical Surgical Instruments.
1, STEPHEN ROWE BRADLEY, of Nyack, Rockland County, State of New
York, United States of America, Gentleman, 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 electrical surgical instruments, and it consists in a
peculiarly constructed electrical device whereby physicians or surgeons can
ascertain the interior conditions of various organs of the body and can detect the
presence therein of harmful matter, as for instance stone in the bladder.
The instrument is designed to be used in any of the organs of the human
anatomy accessible by instruments but into which the hand of the surgeon cannot
pass nor optical observation be obtained.
The purpose of my invention is to supply a device which shall be in effect an
electrically operating extension of the finger of the operator which shall convey
from the end of the instrument to his actual finger upon which it is attached,
substantially or at least measureably the same sensations that he would experience
if his actual finger were present where the device is and in contact with the same
surfaces.
The apparatus consists generally stated in a series of insulated electrical wires
which pass through a rubber or a similar tube having at one end a finger sheath
adapted to be placed upon one of the fingers of the hands of the surgeon, so that
electric sensation will be conveyed to his hand, and at the other end there is an elastic
bulb-like device composed of an inner and an outer part and near the surface of the
inner part the ends of the wires are arranged so that when the outer part, the inside
lining whereof is a conductor of electricity, is compressed upon it, an electric
circuit will be closed and the physician will receive in his finger slight electrical
sensations resembling those which would be experienced by his naked finger if in
contact with the same surface, which will indicate to him the presence of
unhealthful or disordered conditions in the interior of the organ. One of the
wires connects with the lining of the said outside bulb and carries the current
continuously to it; the other wires are insulated from each other and are wrapped
about between the finger sheath and the enlarged terminal by any suitable substance
preferably insulating material, so that they in the aggregate constitute a flexible
device somewhat like a catheter which will have the requisite rigidity to serve the
purpose, and yet be sufficiently flexible.
I also provide a tube connected to the instrument through which solvents or .
medicinal preparations may be injected upon the unhealthful spot.
In the drawings,
Figure 1. is a plan of the device ;
Figure 2. is a section view of the finger sheath and adjoining parts. In this
figure the wires do not quite touch the finger of the operator, as they do in actual
use, I show them separated for the sake of clearness in the drawings.
Figure 3. is a sectional view of the terminal or double bulb. This figure is very
much enlarged from the actual size.
Figure 4. illustrates an alternative construction of the device.
A is the exterior wrapper shown in this instance as in the form of the rubber
tube or covering.
At its forward end it is divided into two bulb shaped parts one within the
outer.
The inner one is marked B. the outer one C. D. D. etc. are wires which I

page_text: sometimes arrange in groups of three as shown for a special reason hereafter
explained, but a single wire may be used in each place.
Each of these wires or groups of wires as the case may be, are at their ends
embedded in the inner bulb B, their terminals being exposed in little sunken
recesses or pits, E, E, made in the surface of the bulb B, and they are preferably
so arranged that one of the wires comes nearly but not quite to the surface of the
bulb, but the others are preferably set somewhat lower not coming quite so near the
surface of the bulb.
The outer bulb C is lined upon its interior with a conductor of electricity G.
This may be a thin film of metal deposited thereon electrically, or a metal foil
attached thereto so that it will be flexible, the body of the bulb C being of rubber
as before stated. One of the wires shown at H extends through the inner bulb B
and engages with the metallic lining G of the outer bulb. It is connected with a
suitable generator of electricity. The wires D all come together within the inner
bulb as shown at D' and being laid snugly side by side are covered with a wrapping
which may be a continuation of the rubber tube-like structure A as illustrated or
any equivalent thereof, and in as much as the wires or sets of wires D are
insulated it is not essential that this material should be an insulator but I prefer it
to be so. These wires or sets of wires are thus formed into a structure somewhat
resembling a catheter and may be of such length as desired, a foot or more,
depending upon the special organ of the body for the treatment of which it is to
be employed. At the other or finger sheath end of the device the wires are
arranged in exactly the same relative position that they are in the bulb and they
project through the rubber lining J of the finger tip K and terminate slightly
beyond the inner surface of this lining so as to come squarely against the finger of
the operator. And in order that they may be held in good contact with the end of
his finger, I prefer to extend the finger tip somewhat over the back of the hand
of the operator and provide it with rubber bands L, L, which, at their rear ends
are attached to a band or wristlet M which buckles tightly round the wrist of the
operator, the rubber bands serve to pull the finger sheath tightly upon the finger of
the operator, thus securing good contact of the ends of the wires with his finger.
a is a little tube of very flexible rubber which passes through the exterior
wrapping of the wires near the finger sheath, the end 6 of which may be applied to
any suitable injecting instrument, as for instance a bulb 6¹, see Fig. 1, adapted to
contain liquid; it, the tube, passes down within the exterior casing A by the side of
the wires through the bulb and opens at the surface of the outer bulb at c, and it
passes through the inner bulb as at d, the opening in the bulb is quite large so that
there is no possibility of frictional contact between the tube and the sides of the
opening. This little tube is very flexible so that it will not interfere at all with
the movements of the outer bulb. It is, of course cemented or otherwise attached
water-tight to the outer bulb.
In Fig. 4, I show an alternative method of constructing the bulbs and disposing
the wires therein. In this form a great number of very fine wires are employed;
I prefer as many as it is mechanically possible to place or embed properly
insulated, in the inner bulb, they are of course exceedingly fine wires and their ends
are retracted slightly from the surface of the inner bulb, some of them being
preferably more retracted than others.
This adjustment of the ends of the wires relative to the surface of the bulb
may be accomplished in various ways as by pulling the wires back after they
have been embedded in the rubber or equivalent material of the bulb, before it
has hardened, or the rubber may be applied to the wires in the first instance so as
to cover their ends and be allowed to harden or dry, which is then removed as by a
sand wheel or equivalent device so as to expose the wires, the nature of the rubber
is such that it will yield before the wheel and afterwards rebound or expand so as
to practically cover and protect the wires when no pressure is applied.
The operation is as follows:-
The surgeon or physician after adjusting the finger sheath on one of the fingers

page_text: of his left or right hand as preferred, introduces the other end of the instrument
into the organ in the manner that catheters and like instruments are now introduced.
In so doing he may employ his other hand in aid of the one upon which the finger
sheath is, or an assistant may manipulate the instrument. The bulb being intro-
duced, is moved about within the disordered organ with as near as may be the same
movements and into the same parts or places that the physician would move his
actual finger to detect or ascertain its interior condition, and the pressure of the
walls of the organ against the outer bulb compresses it with greater or less pressure
upon the inner one and the outer surface at least of the inner one being elastic and
preferably decidedly so. It yields slightly so that the ends of the wires are brought
in contact with the metallic lining of the outer bulb, thus the electric circuit is
closed, and the surgeon feels in the end of his finger an electric sensation at
exactly the same spot upon the end of his finger that he would if his finger was
actually where the bulb is, because as before stated, the wires are arranged upon
the bulb in exactly the same relative position that they are in the finger sheath."
If the bulb comes in contact with any abnormal enlargement or disordered
condition, as for instance a stone in the bladder, tumor, or the like, then the bulb
may be carried all about such thing, whatever it may be, and by increasing the
pressure of the bulb against it the wires which are furthest from the surface of
the inner bulb will be likewise brought in contact with the metallic lining of the
outer one, thus the electrical sensation will be increased in exactly the same way that
the physician would receive increased sensation if the actual finger pressed harder
upon such body. I do not mean that the electrical sensations produced in this
manner are of exactly the same character as the sensations experienced through
the nerves of the finger, but after little experience with the instrument the surgeon
will learn to associate the electrical sensations which he receives through the
instrument with their properly corresponding nervous sensations if his actual
finger were in contact with the disordered part in place of the bulb of the
instrument.
In this way he can determine with considerable exactness and frequently
absolute positiveness the presence, size and extent of the disordered part or
abnormal growth and its precise location.
After he has ascertained these facts he can inject liquids, as for instance a solvent,
directly upon the part requiring them and not haphazard into the organ generally
as now usually done, through the tube a by the use of an ordinary injection syringe
or other preferred device, such as the bulb 6' connected with the open end of the
tube near the finger sheath.
It will be observed that there are no wires extending to the part of the bulb
which would correspond to the part of the operator's finger upon which finger
nail is placed. This is because there is practically little sensation receivable
through the finger nail of the actual hand. I make, however, the bulbs round
in shape because they will be more readily introduced than if of any regular
contour.
The electrical circuit may be completed through the body of the operator to the
ground and thence to the other pole of the generator or a return wire may be
engaged with the wrist or other part of the body of the operator extending thence
to the other pole of the generator.
The information which the surgeon receives by the use of this instrument is
frequently of vital importance: great suffering can often be avoided if this
knowledge is had and sometimes the necessity for serious if not fatal operations
may be postponed for relatively long periods, or perhaps entirely avoided, also
sometimes this knowledge will show the surgeon that an operation is immediately
necessary.
It will be obvious to those who are skilled in this art that certain alterations
may be made in the details of construction of my device and yet the essentials of
the invention be employed. I therefore do not limit myself to the details as
described.

page_text: Having now particularly described and ascertained the nature of my said inven-
tion, and in what manner the same is to be performed, I declare that what I
claim is :
First. The above described instrument comprising a finger sheath, wires extending
from the interior of the sheath to or near the exterior of the bulb at the other end
of the instrument, an elastic exterior bulb or covering for the said bulb, the inner
surface whereof is a conductor of electricity, and a wire extending to the said inner
surface of the exterior bulb, substantially as set forth.
Second. The above described instrument comprising essentially a finger sheath,
wires extending from the interior of the sheath to the exterior of a bulb at the
other end of the instrument, an elastic exterior bulb or covering for said bulb, the
inner surface whereof is a conductor of electricity, a wire extending to the said
inner surface of the exterior bulb and means to hold the finger tip firmly upon the
finger of the operator, substantially as set forth.
Third. The above described instrument comprising a finger sheath at one end,
wires extending from the interior of the sheath to or near the exterior of a bulb at
the other end of the instrument, an elastic exterior bulb or covering the inner
surface whereof is a conductor of electricity, a wire extending to the said inner
surface of the exterior bulb and a tube extending from near the finger sheath and
discharging at or near the exterior bulb substantially as set forth.
STEPHEN ROWE BRADLEY.
J. C. Chapman, C.P.A.,
70, Chancery Lane, London, W.C., Filing Agent.