Apparatus for Enabling the Positions of Foreign Bodies Visible by the X Rays to be Located, and for Guiding the Operator in Searching for and Extracting the same.
Year: 1899

page_text: Apparatus for Enabling the Positions of Foreign Bodies Visible by the
X Rays to be Located, and for Guiding the Operator in Searching
for and Extracting the same.
I, CHARLES REMY, Surgeon, 'of 31, Rue de Londres, Paris, in the Republic of
France, do hereby declare the nature of this invention to be as follows:-
My apparatus belongs to the category of radiographic apparatus, in which one
or more Crookes' tubes are employed for collecting, on a screen or sensitive plate,
the shadows thrown on to the opaque body interposed between the tubes and the
screen. By uniting each shadow thrown on to the focus whereby they have been
formed, rays are obtained which intersect one another exactly at the seat of the
object for which search is being made. The problem to be solved consists in
fixing or materializing these rays, the intersection of which determines the seat
of the body being sought for, in such a manner that this seat may be found
again at will after the radiographic operation. In the processes known at
present the portion of the rays comprised between the screen, or the sensitive
plate, and the focus, has alone been considered, this giving rise to difficulties
easily foreseen, since the body to be acted on is itself in this space between the
screen and the focus, this clearly constituting a cause of trouble in the operation.
In my apparatus, on the contrary, I fix or materialize the portion of the rays
situated beyond the screen, in relation to the foci. This portion of the rays
being outside
to
is the body
space in which
be operated on,
and as far from this body as is desired, it will be seen that the
fixing or materializing of this portion of rays is in no way interfered
with by the presence of the body to be operated on. The materializing of this
portion of the rays being effected, the materialized rays may be displaced for the
purpose of returning them to their initial position by suitable marking or adjust-
ing parts, if this be necessary. Thus, my apparatus enables the seat of foreign
bodies to be determined and the patient to be operated on immediately afterwards,
the operator being able to displace momentarily the materialized rays which
indicate to him the position of the foreign body, in order to return these rays
to their initial position, if the examination should require it. My apparatus
the

page_text: thus serves not only for localizing the seat of the foreign bodies but for guiding
the surgeon in what is properly speaking, his surgical operation.
99
In one way of carrying out this invention the improved apparatus comprises an
incomplete frame in the form of a bracket, capable of being fixed en any operating
table by means of suitable jaws or clamps. The lower arm of the frame is
beneath the table and carries the support for a Crookes' tube. The support for
this tube may be movable on the frame in such a manner that the focus of
the tube may occupy two precisely determined extreme positions. The employ-
ment of two fixed tubes is thus avoided. The upper bent arm of the frame
carries a metal plate perforated with two circular slots having as their respective
centres the points corresponding to the extreme positions in the Crookes' tube.
In each of these slots, slides a ferrule carrying, a long thin rod. These ferrules
can be fixed by a suitable tightening screw at any point of the slot. In every
position of the ferrules the extensions of the rods always run through the foci
of the tube. The rods may thus serve for materializing all the X rays com-
prised in the plane of the rods which also 'passes through the foci of the tube.
A visor fixed on the vertical arm of the frame enables the position of the "focus"
of the Crookes' tube to be so regulated that the direction of the rods runs exactly
through the respective foci. For this purpose, the support of the rod is furnished
with suitable mechanism enabling the position of the "focus" of the said tube
to be precisely regulated.
The bracket frame carries another frame preferably of rectangular form
intended for the reception of the diffusing screen or the photographic plate
The bracket frame is able to rotate on its own axis and this rotation can be
regulated by means of a slide which moves in the groove of a sector furnished with
a movable stop. In this way, it is easy to determine the angle of rotation and to
bring the frame back again into any given position.
Besides this rotary motion the frame can be moved vertically in the support
which serves for fixing it on the operating table.
Instead of employing slots and ferrules for the adjustment of the rods in the
frame or bracket I might employ a metal plate bearing two series of flutes or
grooves very close together, the one series converging towards one position of
the focus and the other towards the other position. In this way, the rods might
be placed in the appropriate grooves so that the points of the rods would come in
contact with the shadow of the foreign body on the diffusing screen.
The patient being placed on the operating table, the focus of the Crookes' tube
from one extreme position throws a shadow of the foreign body searched for
on to the diffusing screen. The frame or bracket is then turned and one of
the rods mounted thereon placed with its, point in contact with the shadow on
the screen. At this moment the rod will represent the materialized ray which
has issued from the focus of the tube and is passing through the foreign body.
Again, the frame remaining fixed in the same position, the Crookes' tube 'is
displaced so as to bring the "focus" of the same into the second extreme posi-
tion thus obtaining a second shadow of the foreign body on the screen. The
point of the second rod is brought over this shadow and thus materializes a
second ray, the intersection of these two rays giving the precise position of the
body in the plane determined by the position of the frame. By means of a
sheet of paper I can, as required, reproduce graphically the direction of the two
rays, determine their intersection and the exact position of the body. By raising
the screen I can lower the rods until they touch the body of the patient, which
determines the direction of the foreign body in the body of the patient and con-
sequently enables the surgical operation to be effected immediately and without
any fumbling. If the presence of the rods and of the frame cause any incon
venience in the surgical operation, they can, after having by any means noted
or fixed the position of research "of the frame, be moved out of the way by
rotating the frame on its own axis so as to move it away from the table. If
later on it is necessary to determine on the spot the position of the foreign body

page_text: I can return the frame to its original position, which I call the "position of
research."
It will thus be seen that the apparatus not only enables the seat of foreign
bodies to be quickly determined but the surgeon to be guided during his surgical
5 operation.
Datadh 0141 1... & Natahou 1000
WHEATLEY & MACKENZIE,
40, Chancery Lane, London, W.C.,
Agents.
Apparatus for Enabling the Positions of Foreign Bodies Visible by the
X Rays to be Located, and for Guiding the Operator in Searching
for and Extracting the same.
I, CHARLES REMY, Surgeon, of 31, Rue de Londres, Paris, in the Republic of
France, 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 apparatus belongs to the category of radiographic apparatus, in which one
or more Crooke's tubes are employed for projecting, ou a screen or sensitive
plate, the shadows thrown by the opaque body interposed between the tubes and
the screen. By uniting each shadow thrown on to the focus whereby they have
been formed, rays are obtained which intersect one another exactly at the seat
of the object for which search is being made. The problem to be solved is the
fixing or materialising of these rays, the intersection of which determines the
seat of the body being sought for, in such a manner that this seat may be formed
again at will after the radiographic operation. In the processes hitherto known
the portion of the rays between the screen, or the sensitive plate and the focus,
has alone been considered, this giving rise to difficulties easily foreseen, since
the body to be acted on is itself in the space between the screen and the focus,
thus clearly constituting a cause of trouble in the operation.
In my apparatus, on the contrary, I fix or materialise the portion of the rays
situated beyond the screen in relation to the foci. This portion of the rays
being outside the space occupied by the body to be operated on, and as far from
this body as is desired, it will be seen that the fixing or materialising of this
portion of rays is in no way interfered with by the presence of the body to be
operated upon. The materialising of this portion of the rays being effected the
materialised rays may be displaced for the purpose of returning them to their
initial position by suitable marking or adjusting parts if necessary. Thus my
apparatus enables the seat of foreign bodies to be determined and the patient to
be operated on immediately afterwards, the operator being able to displace
momentarily the materialised rays which indicate to him the position of the
foreign body, in order to return these rays to their initial position if the examina-
tion should require it. My apparatus thus serves not only for localising the seat
of the foreign bodies but for guiding the surgeon in what is properly speaking,
his surgical operation.
In the accompanying drawings; Fig. 1 is an elevation of apparatus constructed
according to this invention, and Fig. 2 a plan of the same.
My apparatus comprises a frame or bracket a capable of being fixed on an
operating table e by means of suitable jaws or clamps. The lower arm of the
frame a is beneath the table e and carries the supports for the Crooke's tube l.

page_text: The support for this tube may be movable on the frame in such a manner that
the focus of the tube may occupy two precisely determined extreme positions b
and The employment of two fixed tubes is thus avoided. The upper bent
arm of the frame a carries a metal plate perforated with two circular slots kk,
having the points band bas their respective centres, the extreme positions in
the Crooke's tube. In each of these slots slides a ferrule f carrying a long thin
rod d. These ferrules can be fixed by a suitable tightening screw at any point
of the slot. In every position of the ferrules f, the extensions of the rods d
always run through the foci 6 and 6 respectively. The rods d may thus serve
for materialising all the X-rays comprised in the plane of the rods which also
passes through the foci b and b₁. A visor fixed on the vertical arm of the
frame a enables the position of the focus of the Crooke's tube to be so regulated
that the direction of the rods d runs exactly through the respective foci. For
this purpose, the support of the rod is furnished with suitable mechanism enabling
the position of the focus of the said tube to be precisely regulated.
The bracket frame a carries another frame h preferably of rectangular form
(Fig. 2) intended for the reception of the diffusing screen c or the photographic
plate.
The frame a is able to rotate on its own axis y and this rotation can be
regulated by means of a slide which moves in the groove of a sector i.furnished
with a movable stop. In this way it is easy to determine the angle of rotation
and to bring the frame back again into any given position.
Besides this rotary motion, the frame a can be moved vertically in the support
which serves for fixing it on the operating table e.
The patient being placed on the operating table, and assuming that o is the
foreign body to be searched for, the focus of the Crooke's tube throws a shadow of
this body on to the diffusing screen c. The focus of the tube being at b, I return
the frame a and displace the corresponding rod d, so that the point of this rod
comes in contact with the shadow m of the body o. At this moment the rod d
will represent the materialised ray which has issued from the focus b and is
passing through the body o.
Again the frame a remaining fixed in the same position, I displace the Crooke's
tube so as to bring the focus of the same into the second extreme position 61
thus obtaining a second shadow m¹ of the body o on the screen c. I bring the
point of the second rod d over this shadow m² and thus materialise a second
ray, the intersection of these two rays giving the precise position of the body o
in the plane determined by the position of the frame a. By means of a sheet
of paper I can as required reproduce graphically the direction of the two rays,
determine their intersection and the exact position of the body o. By raising
the screen c I can lower the rods & until they touch the body of the patient, which
determines the direction of the body o in the body of the patient and con-
sequently enables the surgical operation to be effected quickly and without any
fumbling. If the presence of the rods and of the frame a cause any inconvenience
in the surgical operation they can, after having by any means noted or fixed,
the position of research of the frame a be moved out of the way, by rotating
the frame on its own axis so as to move it away from the table. If later on
it is necesary to determine on the position of the body o I can return the frame a
to its original position, which I call the position of research.
It will thus be seen that my apparatus not only enables the seat of foreign
bodies to be quickly determined, but the surgeon to be guided during his surgical
operation.
It is of course, understood that I do not limit myself to the constructional
details described above and illustrated in the accompanying drawings, furnished
by way of example but reserve the right of modifying these details without
altering the nature of my invention. For instance instead of slots kk and
ferrules ff, I might employ a metal plate bearing two series of plates or grooves
very close together, the one series converging towards the position 6 of the focus

page_text: and the other towards the position b¹. In this way, the rods d might be placed
in the appropriate grooves so that the points of the rods would come in contact
with the shadow of the foreign body on the diffusing screen. Thus the same
result would be obtained as with the arrangement indicated in the accompanying
drawings.
Having now particularly described and ascertained the nature of my said
invention and in what manner the same is to be performed, I declare that what
I claim is
1. An apparatus for determining the position of an opaque body by means
of two points of shadow projected on to a screen or a photographic plate, in
searches effected with the Röntgen rays, the distinguishing feature being that
the rods d indicating the direction of the rays determined by the luminous source
and the opaque body can be displaced and fixed behind the screen or plate in
grooves and guide ferrules kf in order that it may be possible after the removal
of the screen, to immediately determine the points of entry of the rays into
the body to be examined.
2. In an apparatus for determining the position of an opaque body by means
of two points of shadow projected on to a screen or a photographic plate, in
searches effected with the Röntgen rays, mounting the screen or plate e and
the rods d on a frame a fixed by jaws or clamps on the operating table and capable
of being turned towards the sides so as not to cause inconvenience during the
surgical operation.
Datad this 26th day of Tul 1000
WHEATLEY & MACKENZIE,
40, Chancery Lane, London, W.C.,
Agents.