Year: 1885

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:-
Exhausters as hitherto constructed for surgical purposes possess many defects;
I may mention especially that the multiplicity of the cocks renders the manipulation
very delicate and makes the apparatus difficult to keep in order.
In order to follow up the exhaustion of a morbid liquid with a medical injection
into the cavity which contained it, double action apparatus have also been
constructed; compression is then obtained by putting the apparatus in connection
with a second pipe of the pump which then acts as a force pump instead of as
a suction pump. The bottle or vessel which has been used for the exhaustion is
emptied, the caoutchouc stopper is placed in the bottle containing the liquid to be
injected after having fitted a dip pipe to the stopper, and the apparatus is thus
transformed into an injector. But the stopper which answers well in the first case
where the atmospheric pressure comes to its assistance is altogether insufficient
and if it be not held down by hand it is liable to be forced out by the compressed
air in the bottle.
Further, for injection as for exhaustion the fixing of the apparatus composed of
a number of separate pieces requires time and is complicated; it is necessary to see
that the pump is in proper place, to examine the cocks and to find a bottle with a
neck adapted to the caoutchouc stopper. When all is ready and the operation is
about to be commenced it is sometimes found that some cock has been incorrectly
left closed or opened and the instrument does not act at once causing a delay
which disturbs the patient.
Now in order to avoid all these defects possessed by existing apparatus,
I construct a combined exhauster and injector, the manipulation of which is so
simple that any error and even any hesitation is impossible. This instrument can
be employed in all cases where a surgeon requires to exhaust or inject, as well for
the operation of hydrocele as for washing the stomach. With it the operator can
measure exactly the quantity of liquid exhausted or injected, or alternate the two
operations at will.

page_text: The apparatus is composed of two bottles or vessels graduated the one from
bottom to top for the exhausting bottle and the other from top to bottom for the
injecting bottle. This graduation enables the quantity of liquid exhausted or
injected to be seen at any instant. The two bottles are placed side by side on the
same stand or platform and between them is vertical metal column in which a
rod can slide; the lower end of this rod is connected to a lever which can be raised
and lowered together with the rod by means of a screw and nut. The upper part
of the rod carries a jointed beam at the ends of which are respectively the stoppers
of the two bottles. These stoppers are connected to the ends of the beam by knee
joints. Above the beam is a handle for carrying the apparatus. Below the beam
is the distributing cock hereinafter described. From the above description it will
be seen that the closing of the bottles is controlled by the rod sliding in the column
above described and that according as this rod is moved up or down the two
bottles are simultaneously opened or closed. The joints of the beam on the rod
and of the stoppers on the beam insure a good fit of the stoppers on or in the top
of the bottles. The rapidity with which the bottles can be stopped or unstopped
allows of either of them being quickly removed, emptied or filled, and returned to
position.
The stoppers are each composed of a metal plate with a caoutchouc washer on
the underside. At its centre the plate has a metallic cylinder in which are two
channels parallel to the axis of the stopper. These two channels lead to the
bottom of the cylinder and are in communication with the inside of the bottle.
Externally they are connected to two tubular sockets at right angles to the
channels. On the injector side of the apparatus one of the channels has at the
lower end a branch to receive a tube that dips into the bottle; the other terminates
in a screw thread hereinafter referred to.
The distributing cock is cylindro-conical and is placed at right angles to the
beam and in a plane passing through the axis of the two bottles. It has nine
openings of which six (three on each side) are in a plané passing through the axis
of the cylinder, the seventh is in the axis of the cock at one end and the two
others are at the other end the one at top the other at bottom in a line at right
angles to the plane in which are the six first.
The openings of the cock are connected with the bottles as follows:-The two
openings in the stopper of the injector bottle are connected with two of the
openings on the corresponding side of the cock. The samne is done with regard to
the stopper of the exhauster bottle. Two openings one on each side of the cock
are put in connection respectively with two pipes from the pump hereinafter
described. To a socket in the axis of the cock is fixed by means of a bayonet joint
or other hermetic fastening a caoutchouc tube which at its end receives the
instrument which has to be introduced into the cavity where it is required to effect
the exhaustion or injection. The two remaining openings of the cock serve as air
holes for the action of the pump. This pump is single acting and is fitted with
the two pipes already mentioned; in each of these pipes is a valve, one acting in
the one direction and the other in the other. The pump is operated by a handle
which when the apparatus is not in use can be hooked on to a support projecting
from the column hereinbefore described.
The distributing cock can occupy four positions; each of these corresponds to a
fourth of the circumference. They are for the following purposes:-(1) Rarefaction
of the air in the exhauster bottle; (2) Direct suction from the pathological cavity;
(3) Compression of air in the injector bottle; (4) direct injection into the patho-
logical cavity.
To make the apparatus ready for use, the injector bottle must be supplied with
the liquid to be injected, and the exhauster bottle be empty and both be carefully
stopped; and the instrument that has to be introduced into the pathological cavity
must be connected to the tube at the end of the cock,

page_text: When the liquid to be injected is required to be absolutely aseptic and not
to carry any germ with it all the passages and pipes and the injector bottle must
be sterilized by antiseptic washings. Before commencing the operation I screw a
cotton wool filter into the screw thread of the air channel of the stopper of the
injector bottle. This filter is composed of two tubes one within the other. The
inner one is fixed to a metal piece that can be screwed to the air channel that
passes through the stopper; it is open at both ends. The outer one is fixed to
the same metal piece, is a little longer than the inner one and is closed at bottom.
At its upper part it has small holes for the outlet of air. The space between the
two tubes is filled with cotton wool for filtering the air which must pass through
it before it reaches the inside of the bottle.

page_text: A Combined Exhauster and Injector for Surgical Purposes.
:
4
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:-
Exhausters as hitherto constructed for surgical purposes possess many defects;
I may mention especially that the multiplicity of the cocks renders the manipulation
very delicate and makes the apparatus difficult to keep in order.
In order to follow up the exhaustion of a morbid liquid with a medical injection
into the cavity which contained it double action apparatus have also been con-
structed compression is in this case obtained by putting the apparatus in
connection with a second pipe of the pump which then acts as a force pump
instead of as a suction pump. The bottle or vessel which has been used for the
exhaustion is emptied, the caoutchouc stopper is placed in the bottle containing
the liquid to be injected after having fitted a dip pipe to the stopper, and the
apparatus is thus transformed into an injector. But the stopper which answers
well in the first case where the atmospheric pressure comes to its assistance is
altogether insufficient and if it be not held down by hand it is liable to be forced
out by the compressed air in the bottle.
Further, for injection as for exhaustion the fixing of the apparatus composed of
a number of separate pieces requires time and is complicated; it is necessary to sec
that the pump is in proper place, to examine the cocks and to find a bottle with a
neck adapted to the caoutchouc stopper. When all is ready and the operation is
about to be commenced it is sometimes found that some cock has been incorrectly
left closed or opened and the instrument does not act at once causing a delay which
disturbs the patient.
Now in order to avoid all these defects possessed by existing apparatus I con-
struct a combined exhauster and injector the manipulation of which is so simple
that any error and even any hesitation is impossible. This instrument can be
employed in all cases where a surgeon requires to exhaust or inject, as well for the
operation of hydrocele as for washing out the stomach. With it the operator can
measure exactly the quantity of liquid exhausted or injected, and alternate the
two operations at will.
The apparatus is represented in the annexed drawings. It is composed of two
bottles or vessels, A and B graduated the one from bottom to top for the exhausting
bottle and the other from top to botton for the injecting bottle. This graduation
enables the quantity of liquid exhausted or injected to be seen at any instant. The
two bottles are placed side by side on the same stand or platform Č and between
them is a vertical metal column D in which a rod E can slide; the lower end of
this rod is connected to a lever F which can be raised and lowered together with
the rod E by means of a screw G and nut N. The upper part of the rod E has
jointed to it a beam I at the ends of which are respectively the stoppers K L of
the two bottles. These stoppers are connected to the ends of the beam I by knee

page_text: joints a, a. Above the. beam is a handle M. for carrying the apparatus. Below
the beam is the distributing cock R hereinafter described. From the above
description it will be seen that the closing of the bottles is controlled by the rod E
sliding in the column D and that according as this rod is moved up or down the
two bottles are simultaneously opened or closed. The joints of the beam I on the
rod E and of the stoppers K L on the beam I insure a good fit of the stoppers on
or in the top of the bottles even if the latter are of different heights. The rapidity
with which the bottles can be stopped or unstopped allows of either of them being
quickly removed, emptied or filled, and returned to position.
The stoppers are each composed of a metal plate b with a caoutchouc washer c
on the underside. At its centre the plate b has a metallic cylinder d in which are
two channels f, g parallel to the axis of the stopper. These two channels lead to
the bottom of the cylinder and are in communication with the inside of the bottle.
Externally they are connected to two.tubular sockets m, m at right angles to the
channels. On the injector side of the apparatus one of the channels has at the
lower end a branch i to receive a tube j that dips into the bottle; the other
terminates in a screw thread hereinafter referred to.
The distributing cock R is cylindro-conical and is placed at right angles to the
beam and to a plane passing through the axis of the two bottles. It has nine
openings of which six k, l, n, k, l, n² (three on each side) are in a plane passing
through the axis of the cylinder, the seventh o is in the axis of the cock at one end
and the two others p, q are at the other end, the one at top the other at bottom, in
a line at right angles to the plane in which are the six first.
The openings of the cock are connected with the bottles as follows:-The two
openings f, g in the stopper of the injector bottle B are connected with two of the
openings on the corresponding side of the cock. The same is done with regard to
the stopper of the exhauster bottle A. The two openings.n, n¹ one on each side of
the cock are put in connection respectively with two pipes r, r from the pump H
hereinafter described. To the socket o' in the axis of the cock is fixed by means
of a bayonet joint s or other hermetic fastening a caoutchouc tube t which at its
end receives the instrument which has to be introduced into the cavity where it is
required to effect the exhaustion or injection. The two remaining openings p, q
of the cock with the cavities V, V of the plug serve as air vents for the action of
the pump H. This pump is single acting and is fitted with the two pipes r, ras
already mentioned; in each of these pipes is a valve one acting in the one direction
and the other in the other. The pump is operated by a handle X, which when the
apparatus is not in use can be hooked on to a support Y projecting from the
column D, a projection Z on the end of the pump at the same time entering a recess
in the lever F.
The distributing cock can occupy four positions; each of these corresponds to a
fourth of the circumference. They are for the following purposes :-(1) Rare-
faction of the air in the exhauster bottle; (2) direct suction from the pathological
cavity; (3) compression of air in the injector bottle; (4) direct injection into the
pathological cavity.
To make the apparatus ready for use, the injector bottle B must be supplied with
the liquid to be injected, and the exhauster bottle A be empty and both be
carefully stopped; and the instrument that has to be introduced into the patho-
logical cavity must be connected to the tube t attached to the socket o¹ at the end
of the cock.
When the liquid to be injected is required to be absolutely aseptic and not to
carry any germ with it the passages and pipes and the injector bottle must be
sterilized by antiseptic washings. Before commencing the operation I screw a
cotton wool filter u into the screw thread of the air channel of the stopper L of
the injector bottle. This filter is composed of two tubes one within the other. The
inner one v is fixed to a metal piece that can be screwed to the air channel that
passes through the stopper; it is open at both ends. The outer one is fixed to
the same metal piece, is a little longer than the inner one and is closed at bottom,

page_text: between
At its upper part it has small holes y for the outlet of air. The space
the two tubes is filled with cotton wool for filtering the air which must pass
through it before it reaches the inside of the bottle.
The bottles may be provided with pressure and vacuum gauges.
From the arrangement of the apparatus as above described it will readily be
understood that according to the position of the plug of the cock R when the pump
is being worked, a vacuum can be formed in the exhauster bottle A, or direct suction
can be effected without first forming a vacuum, or direct injection can be effected
from the injector bottle B, or air can be compressed in this bottle before making
the injection. These several results are very easily attained; it suffices, while the
pump is being worked, to turn the plug of the distributor R so that a fixed hand
or pointer W shall be opposite one of the indications "Rarefaction," "Suction,"
"Compression," "Injection" marked on a piece U attached to the plug, and the
corresponding result is immediately effected.
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. A combined exhauster and injector for surgical purposes constructed and
acting substantially as herein before described.
2. As a characteristic feature of the combined exhauster and injector, the arrange-
ment substantially as described consisting of the beam, the stoppers, the joints, and
means for raising and, lowering the beam, whereby the injector and exhausting
bottles can be simultaneously opened or closed.
3. As a characteristic feature of the combined exhauster and injector, a cock or
distributor common to the exhauster and injector bottles and capable of varying
the relations between the pump, the exhauster, the injector, and the pathological
cavity, substantially as described.
4. As a characteristic feature of the combined exhauster and injector, the
arrangement of a filter substantially as described for filtering or rendering aseptic
the air put, by the action of the pump, in relation with the liquid to be injected.
Dated this 17th day of Amount 100