US1388170A - Retractor - Google Patents

Description

W. J. CAMERON.

RETRACTOR.

APPLICATION FILED OCT. 26. 1918.

Patented Aug. 23, 1921.

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W. J. CAMERON.

RETRACTOR. APPLICATION FILED OCT. 26, 1918.

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RETRACTOR.

Specification of Letters Patent.

Patented Aug. 23, 1921.

Application filed October 26, 1918. Serial No. 259,767.

To ail whom it may concern: 7

' Be it known that I, \VILLIAM J. CAMERON, a subject of the King of Great Britain, and a resident of Chicago, county of Cook, and State of Illinois, have invented certain new and useful Improvements in Retractors; and Ido hereby declare that the following is a full, clear, and exact description thereof, reference being had to the accompanying drawings, and to the letters of reference marked thereon, which form a part of this specification.

This invention relates to improvements in retractors and consists of the matters hereinafter described, and more particularly pointed out in the appended claims.

The retractor shown herein as embodying the several novel. features of the invention is one primarily intended for use in connection with operations upon parts within the mouth or throat, but as will appear, the improvements are not limited to that kind of a retractor.

The several advantages and the specific objects of the invention will be pointed out as I proceed with my specification.

In the drawings:

Figure 1 representsa perspective view of my improved retractor,illustrating the same as when applied to a patient, to hold the mouth in an open position, to illuminate the interior thereof and to hold the tongue of the patient in a depressed position.

Fig. 2 represents a vertical section through the retractor, the plane of the section being indicated by the line 2-2 of Fig. 3.

Fig. 3 represents a view of the retractor in front elevation.

Fig. 4 represents a horizontal section through the retractor, the plane of the section being indicated by the line 4-4 of Fig. 3.

Fig, 5 represents, on an enlarged scale, a detail, horizontal section through a part of the retractor, the plane of the section being indicated by the line 5--5 of Fig. 2..

Figs. 6 and 7 represent perspective views of parts of the retractor which will be more specifically referred to later.

The improved retractor is of a general type now well known. It includes two frame members comprising opposed arms bearing hooksat their outer ends, to engage the part-s to be retracted, and connecting bars spaced laterally from the hooks and extending substantially at right angles to the hooks.

Referring now in detail to that embodiment of the invention illustrated in the accompanying drawings :1( and 11 indicate the two frame members, in this case bottom and top frame members, of the retractor.

The bottom frame member 10 comprises a relatively long upright bar 12 having teeth 12 in its outer edge, and a shorter horizontal part or arm 13 which terminates at its inner end in a short upright plate 14, the top end of which is bent forwardly and downwardly to providea hook 14. The top frame member 11 comprises a relatively short, downwardly extending bar 16and a horizontal arm 15. The bar 16 is provided with a sleeve 17 that embraces and is capable of a sliding bearing on the upright bar 12 of the bottom frame member 10. The outer end of the horizontal arm 16 terminates in a depending late 18 arranged in the vertical plane of the plate 14 and the bottom end of said plate 18 is bent forwardly and upwardly to form a hook-18. As is apparent, the hooks 14 and 18 are oppositely disposed with reference to each other. In the spurpinion 17 that meshes with. the teeth 12 in the arm' 12, and said pinion has a butterfly nut or extension 17 by means of which it may be rotated. When the butterfly nut is rotated, a relative vertical adjustment or movement will take place between the frame members 10 and 11.

Removably mounted on the hook 18 of the top frame member 11, is an illuminating attachment indicated as awhole at 20. As said illuminating attachment is thesame as that shown in my prior Patent No. 1,231,702, I will here refer to the same in general terms only and not in detail. Said. attachment includes. a forwardly extending casing or barrel 21 that carries a light 22 at its front end and a slotted plate 23 at its rear end. The slotted plate 23 which is bent to conform with the curvature of the hook 18, embraces the rear part of said hook, while the main part of said plate rests upon the top surface of said hook. Said plate carries at one end, a contact plug 24 which is adapted to be connected up with a socket 25 in the end of an electric current conducting cord 26 (see Fig. 1).

Fixed to the rear or outer face of the upright plate 14 of the bottom frame member 10, is a hinge plate or leaf 27. To the top edge of said leaf is hinged the front end of another plate or leaf 28 which swings or tilts in a vertical plane and which normally assumes a substantially horizontal position. The leaf 27 has at its bottom end, a rearwardly extending, rectan ular casing 29 that is open at its rear end. fixtending vertically through alined. openings in the top and bottom walls of this casing, is an adjustment screw 30 which is connected at its top end by a swivel joint 31 to the rear edge of the leaf 28, the bottom end of said screw having a head 30" by means of which it may be rotated. In the casing 29 is located a pair of co-acting clamping armsor blocks 32 (see Fig. 5) which normally clamp about the screw 30 so as to provide the necessary screw-threaded, supporting engagement for said screw. The blocks 32 are pivoted at about their middle upon a vertical pin 33 in the casing, and the inner ends 34 of'said,

blocks which are within the casing, are engaged by a leaf spring 35 mounted on the inner end of the casing, to normally hold said blocks in a clamped, threaded engagement with the screw 30. The outer ends 36 of said blocks are located without the casing in a position to be easily grasped between I the fingers of the operator and moved toward each other so as to spread the inner ends of said blocks apart to release them from screw-threaded, clamping engagement with the screw 30.

Pivotally mounted on the leaf 28 at about its middle, so as-to be capable of being swung in a plane parallel to that of said leaf, is a support or holder 37 for a tongue depressor plate 38. As shown in the drawings, and more in detailin Fig. 6, said support or holder is of a length greater than its width and is attached near its inner end to the leaf 28, by a rivet 39 which provides the pivotal connection between said leaf and said support. This holder has one of its marginal edges turned upwardly to provide a shoulder 40 while its other marginal edge is bent upwardly and inwardly toward the shoulder 40 to provide a hooked flange 41. The outer end of said holder is bent downwardly to provide a shoulder 42 and a part of the hooked flange 41 at the outer end of the support or holder is cut away as at 43.

Mounted on the bottom surface of the outer end of the support, and capable of a limited transverse movement thereon, is a clip 44 which is shown in perspective in Fig. 7. This clip includes a main body part 45 having a short transverse slot 46 and a rivet 47 extends through said slot and into the support 37 in a manner attachingsaid clip to said support, but permitting a transverse movement ofthe clip upon said support. The rear edge of said clip has guiding engagement with the end flange 42 on the support 37 so that when movement is imparted to said clip, it will not rotate about the rivet 47. One end of the clip 44 is bent to provide a hooked flange 48 which normally overhangs the outer end part of the said shoulder 40 on the holder 37, while the other end of said clip is bent into a U-shaped thumb piece 49. Said thumb piece receives a similarly shaped leaf spring 50 which has one end fixed in the slot 43 in the support tongue of the patient upon which the retractor is used. The outer end 38 is bent into a hook to provide a convenient grip on the depressor plate by the operator. I have described the tongue plate as illustrated in the drawings, but as is apparent, the shape of this tongue depressor may be such as to best suit the conditions to be treated. Said tongue plate is frictionally engaged at its margins by the flanges 41 and 48 in such manner that an in or outsliding adjusting of the tongue plate may be had with reference to the supporting or holding plate, or the said tongue plate may be quickly detached from and attached to said supporting plate for a purpose and in a manner to presently appear.

Assuming that the retractor is to be used upon apatient for the purpose of an examination of the mouth andthroat of said patient, the manner of applying the same to said patient and its use thereof after having been applied is as follows:

\Vith all the parts in place upon their respective frame members, the butterfly nut 17 is rotated to move the horizontal arms 13 and 15 toward each other, until they are close enough together to permit the introduction of the hooks into'the open mouth of the patient. lVith the frame members placed on the right hand side of the face of the patient, the inner end of the depressor plate is inserted in the mouth of the patient and the hooks are then lined up with the anterior teeth of the patient, on the median line of the face. The butterfly nut 17 is actuated to rotate thepinion 17, which, by reason of its engagement with the rack teeth 12, causes the hooks 14 and 18 to engage with said anterior teeth. This movement is continued until the jaws of the patient have been separated to present the desired mouth opening} Should discomfort be caused to the patient, by reason of the too great 'sepa- 7 up said discomfort.

VViththe parts in this position,the tongue depressor 38 may be moved forwardly against the frictional resistance of the support 37 and clip '44, untilthe widened-out inner end 38 of said depressor enga es that part of the tongue near the palate. y turning the adjusting screw 30 the leaf 28 and with it the supporting or holding plate 37 and tongue depressor 38, is tilted vertically so as to depress the inner end of the tongue depressor to suitably hold the tongue in the position most convenient to suit the requirement of the surgeon or dentist using the retractor. Should it be desired to shift the inner end of the depressor to engage either side of the tongue, the hooked outer end of the depressor 38 is grasped by the operator and moved laterally in the proper direction about the rivet 89 as a pivot,'unti1 the inner end of-the depressor engages that part of the tongue before determined.

Should this pressure on the tongue tend to gag or otherwise discomfort the patient, the pressure may be instantly relieved by the operator pinching together the outer,

ends 36 of the clamping blocks'32, to release the clamping engagement of said blocks with the adjusting screw 30. This will permit the depressor to assume a pressure upon the tongue which is convenient to the patient 30 without gagging. Should it be desired, this pressure may be increased again by turning the screw 30 as before mentioned. While the means just described will instantly release the pressure of the depressor 3.8, it

need not be used unless desired or necessary,

because as is apparent, the pressure of the depressor on the tongue may also be brought about byturning the adjusting screw in the opposite direction.

hould it be found necessary to instantly remove the tongue depressor from the mouth of the patient, this may be done in the following manner. That part of the depressor outward beyond its supporting plate 37, is grasped by the operator with the thumb engaging upon the U-shaped thumb piece 49 of the clip 44. Thumb pressure upon said thumb piece will move the clip 44 laterally of the holder 37, against the action of the spring 50, until the hooked flange 48 is disengaged from the said tongue depressor, after which that edge of the said tongue depressor just disengaged, may be tilted upwardly into a position above that of the flange-48, after which the tongue depressor may be removed bodily from its supportand then withdrawn from the mouth of the pa tient.

Should it be desired to again replace the depressor plate, that edge of the same normally engaged under the flange 41 is first inserted inplace, and the clip 44 is then moved by thumb pressure as before described, until the other edge of the depressor will pass the flange 48 of the clip 44 and the depresser plate be caused to lie flat upon the supporting plate 37. By removing the ment of the clip 44 and that, by reason of the engagement of the flange 42 on thesupport 37, said clip is guided in said move ment in -a straight path and held against any rotative movement. v

It is apparent from theforegoing description, that the retractor as a whole may be quickly applied in position and without discomfort to. the patient, and after having been applied, the tongue depressor may be adjusted vertically and quickly released by the clamping blocks 32. Furthermore, the said tongue depressor may be adjusted inwardly or outwardly or laterally in either direction, or may be quickly removed from andap' plied to the rest of the retractor without disturbing the position of the frame members 'out in the appended claims.

I claim as my invention:

1. The combination with a retractor having a pair of separable arms, a hinge one element whereof is secured to one of said retractor arms, means for holding the elements of said hinge in desired positions, a tongue depressor, a carrier securing said tongue depressor to the movable element of said hinge whereby said tongue depressor may be moved longitudinally, and means permitting. the pivotal movement of the tongue depressor in horizontal and vertical planes.

2. In combination with a retractor, a hinge one element whereof is secured to said 'retractor, means for holdin the elements of said hinge in desired positions comprising a screw having pivotal engagement with one of said hinge elements, a spring-actuated latch normally bearing against the threads of said screw and carried by the other hinge element, and a tongue depressor carried by the movable hinge element.

3. A retractor comprising in combination coacting'frame members each having a horizontal arm, means providing a vertical adjustment between said frame members,fa tongue depressor associated with the-arm of one of said frame members, a supporting element to which said depressor is slidably attached and capable of pivotal movement vertically and horizontally, said supporting element being operatively connected to said frame member to tilt in a vertical plane, and means for imparting a vertically tilting movement to said supporting member.

4. A retractor comprising in combination, top and bottom frame members, each including a horizontal arm, said arms terminating in vertically alined, oppositely disposed hooks, means providing a vertical adjustment between said frame members, a tongue depressor associated with the hook on, one of said frame members, a supporting plate for said depressor operatively'connected to said frame member to tilt in a vertical plane, an adjusting screw for imparting a tilting, adjustable movement to said support, and

F a clamp carried by said frame and providing.

a threaded bearing engagement for said screw, said clamp being manually operable of said frame members, a supporting plate for said depressor operatively connected to said frame member to tilt in a vertical plane,

an adjusting screw for imparting a tilting, adjustable movement to said support, and a pair of split clamping jaw blocks normally providing 'a threaded bearing engagement for said screw, said blocks including arm's adapted to be. pinched together to release said threaded bearing engagement.

6. A retractor comprising in combination,

top and bottom frame members, each including a horizontal arm, said arms terminating in vertically alined, oppositely disposed hooks, means providing a vertical adjustment between said frame members, a leaf hinged to the hookof one of said frame members and adapted to be tilted vertically, a supporting plate pivoted to saidleaf' to swing in a horizontal plane, a tongue depressor carried'by said supporting'plate, an adjusting screw mounted on said frame and operatively connected to said leaf to impart a vertically tilting movement to said leaf, and means for instantly releasing said screw from threaded engagement with that part of the frame with which it has screw threaded

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