Year: 1886

page_text: I ARMAND EDOUARD ALBERT RUAULT of 1 Boulevard St. Denis Paris, France,
Doctor of Medicine do hereby declare the nature of this invention to be as
follows:-
In the instrument or pump which forms the subject of this invention the end of
the caoutchouc or flexible tube which is introduced into the stomach (or cavity to
be operated on) is fitted with a conical caoutchouc valve which is slit by two cross
cuts at right angles to each other and in a line with its axis. The end of the tube
is also for a certain portion of its length formed with longitudinal slits at the sides,
these slits being merely incisions without any removal of the substance of the
tube. Thus during suction or exhaustion the valve opens wide and all the liquid
passes through its opening, the elasticity of the caoutchouc tube keeping the two lips
of each of the side slits in perfect contact. On the other hand when an injection is
made the elastic power of the tube is soon overcome by the liquid pressure and when
this pressure is sufficient the tube tends to expand; the valve closes while the two lips
of each side slit separate slightly so that the liquid escapes from each slit in a thin
stream at right angles to the axis of the tube; as these streams are all round the
tube the douching or washing out of the stomach is effected. The flexible tube
bas at a suitable part of its length a rigid piece composed of a ring or collar and a
disc, the ring being placed between the teeth of the patient and the disc against his
lips during the operation. Beyond this rigid piece, that is to say in the part which
is not introduced into the patient's mouth the flexible tube is attached by a metallic
or rigid connection to two other caoutchouc tubes of a diameter or bore the same
as its own. These two tubes are connected respectively to two caoutchouc stoppers
of a size to fit any ordinary bottle such as a wine or mineral water bottle. Each
stopper has two metallic tubes passed through it, one of these tubes being for
putting the corresponding caoutchouc tube into communication with the inside of
the bottle and the other for putting the upper part of the bottle in communication
with a corresponding air bulb or air ball; the one of these air bulbs serves as the
forcing bulb and is fitted with a valve opening outwards and the other serves as
the suction bulb and is fitted with a valve opening inwards. The stopper of the
bottle containing the liquid to be injected has a caoutchouc tube to extend to the
lower part of the bottle

page_text: The
The action of the instrument is as follows:-The stoppers are placed in two
bottles, of which one is empty and the other contains the liquid to be injected,
space being left for a small volume of air. The stopper connected to the suction
bulb is placed in the empty bottle and the stopper connected with the forcing bulb
in the other bottle. The flexible pipe is then introduced into the stomach.
operator then closes the tube leading to the empty bottle by compressing it with
his fingers while with the other band he works the forcing bulb. The air thereby
compressed forces the liquid from the bottle into the flexible tube and as soon as
there is sufficient pressure the douching or washing out of the stomach takes place.
When the operator thinks that enough liquid has. been injected he leaves go of the
forcing bulb, and with his fingers compresses the tube leading from the liquid
bottle while with the other hand he now works the suction bulb. The air in the
empty bottle will thus be exhausted and the liquid will flow from the stomach into
this bottle. These actions can be repeated as often as thought necessary.
With this instrument the objections of pumps or instruments such as have
hitherto been used for the purpose are avoided; the washing out of the stomach
can be performed under the most favorable conditions, that is to say, the most
completely and in the shortest possible time and with the smallest possible quantity
of liquid. The entire wall of the stomach can be submitted to the action of any
medicated solution which will not affect the caoutchouc tube, and the solution can
be left in contact with the walls for as long as thought desirable, after which the
organ can be washed out with another liquid.
Although the instrument has been specially designed for injecting liquids into
and withdrawing them from the stomach it can be employed for other like
surgical operations.
(.

page_text: other like Surgical Operations.
I ARMAND EDOUARD ALBERT RUAULT, of 1 Boulevard St. Denis, Paris, France,
Doctor of Medicine 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:―
In the instrument or pump which forms the subject of this invention the end of the
caoutchouc or flexible tube T which is introduced into the stomach (or cavity to be
operated on) is, in the preferred modification which is represented in Figure 1 of
the annexed drawings, fitted with a conical caoutchouc valve m (see the enlarged
detail view Figure 2) which is slit by two cross cuts at right angles to each other.
and in a line with its axis. The end of the tube is also for a certain portion of its
length formed with longitudinal slits f,f at the sides, these slits being merely.
incisions without any removal of the substance of the tube. Thus during suction
or exhaustion the valve m opens wide and all the liquid passes through its opening,
the elasticity of the tube T keeping the two lips of each of the side slits f, f in
perfect contact. On the other hand when an injection is made the elastic power
of the tube T is soon overcome by the liquid pressure and when this pressure is
sufficient the tube tends to expand; the valve m closes while the two lips of each
side slit f separate slightly so that the liquid escapes from each slit in a thin stream
at right angles to the axis of the tube; as these streams are all round the tube the
douching or washing out of the stomach is effected. The tube T has at a suitable *
part of its length a rigid piece composed of a ring or collar i and a disc I, the
ring i being placed between the teeth of the patient and the disc I against his lips
during the operation. Beyond this rigid piece, that is to say-in the part which is
not introduced into the patient's mouth the flexible tube is attached at y by a:
metallic or rigid connection to two other caoutchouc tubes t and t¹ of a diameter
or bore the same as its own. These two tubes are connected respectively to two
caoutchouc stoppers B and B¹ of a size to fit any ordinary bottle such as a wine or
mineral-water bottle. Each stopper has two metallic tubes m, n, m, n, pissed
through it, the tubes m and m¹ being for putting the corresponding caoutchouc
tubes t and t¹ into communication with the inside of the respective bottles F and F¹
and the tubes n and n³ for putting the upper part of the bottles in communication
with corresponding air bulbs or air balls P and P¹; the air bulb P serves as the
forcing bulb and is fitted with a valve opening outwards and the bulb P' serves
as the suction bulb and is fitted with a valve opening inwards. The stopper of
the bottle F containing the liquid to be injected has a caoutchouc tube p forming,
a continuation of the tube m and extending to the lower part of the bottle.
The action of the instrument is as follows:-The stoppers B, B₁ are placed in
two bottles F, F of which one (F¹) is empty and the other (F) contains the liquid.
'to be injected, space being left for a small volume of air. The stopper B¹ connected
to the suction bulb P¹ is placed in the empty bottle Fl and the stopper B connected.

page_text: with the forcing bulb P in the bottle F. The flexible pipe T is then introduced
into the stomach. The operator then closes the tube t¹ leading to the bottle F
by compressing it with his fingers at a while with the other hand he works the
forcing bulb P. The air thereby compressed forces the liquid from the bottle F
into the flexible tube T and as soon as there is sufficient pressure the douching or
washing out of the stomach takes places. When the operator thinks that enough
liquid has been injected he leaves go of the forcing bulb P and with his fingers
compresses the tube t at while with the other hand he now works the suction
bulb P¹. The air in the bottle F¹ will thus be exhausted and the liquid will flow
from the stomach into this bottle. These actions can be repeated as often as thought
necessary.
Figure 3 represents a modification of the instrument in which there are two
caoutchouc tubes fitted the one within the other the outer diameter of the inner
tube being equal to the inner diameter of the outer one. They are united to each
other at the end A for a short distance. At the other end B the two tubes are
connected separately to a metallic or rigid piece B, C, D. At the end A the outer
tube is formed with slits a, b. The inner tube is continued unobstructed through
the piece B, C, D in the direction C, E and the outer tube is connected to the
piece B, C, D at B. This piece thus consists of two cylinders the one within the
other; the inner cylinder has an inner diameter equal to that of the inner
tube A, B and the outer cylinder has an inner diameter slightly larger than that
of the outer tube A, B. The annular space between the two cylinders communi-
cates with the outside by the tubular socket D. This socket D is connected as
shown by a caoutchouc tube to a forcing air bulb P connected with a liquid vessel
at G whereby liquid can be forced in the direction indicated by the arrow f.
At the end C of the piece. B, C, D is a tube E of the same diameter as the inner
tube A, B and forming a continuation thereof and (with an intercalated glass tube)
communicating with an air bulb P which in turn is connected with a vessel where
a valve is fitted at H. I is a collar or ring with disc to be placed against the
patients lipa The action is as follows:-The tubes A, B having been introduced
into the stomach and the bulb P having been put into communication with the
liquid at G, the bulb P is worked and the liquid is forced between the two
tubes A, B. The inner tube flattens a little and the outer tube expands under the
pressure and the liquid issues by the slits a, b. When the working of the bulb P
is stopped the inner tube A, B resumes its normal diameter. The bulb P' is then
squeezed and allowed to expand again, the liquid will then be syphoned up the
inner tube and be discharged through the valve at H. There are holes at d to
ensure access of the liquid to the inner tube. When the stomach has been emptied
the bulb P can again be worked to inject fresh liquid and when the working of
this bulb is stopped the contents of the stomach are again syphoned out through
the inner tube and so on the actions being repeated as often as thought necessary.
If the double tube A, B were made so long that the part external to the stomach
was longer than the internal part the air bulb P¹ would not be necessary. When
the pressure on the outside of the inner tube is sufficient this tube becomes
completely flattened and discharges the air contained in the cavity of the stomach.
When the pressure diminishes sufficiently the inner tube returns to its normal
form and owing to the valve at H the liquid will enter the stomach. The length
of the tube being sufficient the syphoning action takes place.
With this instrument in either of the forms described the objections of pumps
or instruments such as have hitherto been used for the purpose are avoided; the
washing out of the stomach can be performed under the most favorable conditions,
that is to say-the most completely and in the shortest possible time and with
the smallest possible quantity of liquid. The entire wall of the stomach can
be submitted to the action of any medicated solution which will not affect
the caoutchouc tube, and the solution can be left in contact with the walls for as
long as thought desirable, after which the organ can be washed out with another
liquid,
"

page_text: Although the instrument has been specially designed and has herein been
described for injecting liquids into and withdrawing them from the stomach it
can be employed for other like surgical operations such, for example, as for injecting
liquids into and withdrawing them from the bladder, the large intestines, the
uterus, or the back part of the nostrils, the form of the instrument being suitably
modified, as will be well understood, to adapt it to each particular cavity.
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. The construction substantially as hereinbefore described of instruments or
pumps for washing out the stomach or for other like surgical operations.
2. In an instrument of the kind referred to the combination of slits at the sides
of that portion of the tube that enters the stomach or other cavity and of a conical
valve at the tube end slit by two cross cuts, substantially as set forth.
3. In an instrument of the kind referred to, the combination of two air bulbs,
two bottle stoppers and two branch tubes communicating between the respective
stoppers and the principle tube, in such manner that the action of the one bulb effects
the forcing of the liquid into the stomach or other cavity and the other bulb the
suction or exhaustion of the liquid therefrom, substantially as set forth.
J. C. MEWBURN,
169, Fleet Street, London,
Agent.