US2237435A - Therapeutic bath apparatus - Google Patents

Description

8, 1941. F. w. KLLE T15 THERAPEUTIC BATH APPARATUS Filed Dec. 12, 1940 3 Sheets-Sheet l pril 8, 1941. R w L5- 2.231.435

mzmraunc BATH-APPARATUS Filed Dec. 12,, 1940 3 shuts-sham 2 10 BATH Mmmws Fiiw ms.

.L W W W THERAPEUT atented Apr. 8, 1941 res rrau

This invention relates to apparatus for efi'ectins massase and stimulation of tissues of human beinas during submergence in bath apparatus,

and has for a particular aim to present an improved form of bath apparatus and means for effecting the production oi water currents and for entraining air bubbles therein soas to cause the same to impinae upon the body of a patient or limbs of the patient, while submerged in a bath, as well as to present much improved apparatus for enablin the adjustment and movement or water and air iets, and in the construction of a water proiectins and air injecting and mixing device specially suited to the uses contemplated,

The medical profession has become well acuuainted with the benefits of massage in conjunction with submergence of the body or limbs oi the patient, especially when accompanied with assisted motions of the parts involved. It is a special aim of the invention to present a "novel construction of tank and operative mechanism havinn novel features and advantages in aiding and enabling the better treatment of conditions in which such baths and treatments are indicated. Experimental use of the invention has demonstrated its benefits in increasing the effects of treatments of those convalescent from infantile paralysis, especially due to the gentle nature of the stimulation of nerves affected; in reducing pain and muscle spasms, as well as in its application to treatment of various aiiiictions and diseases. Among effects that are notable, is improved mechanical removal of infection and exudate; improved tissue oxidation; notable softoning of scar tissues and adhesions; relief or pain in joint and bone injuries, and in peripheral nerve injuries, as well as in treatment of painful injuries of the extremities; improved normal functioning of the human organism; (a) followil'lg fracture; (h) following joint injuries and diseases such as contusions, sprains, infections, arthritis, synovitis, teno-synovitis with adhesions, and, (c) for muscle re-education in the after-care oi infantile paralysis.

it is an important aim of the invention to present means by which a controlled intermittent or constant aerated underwater stream may be delivered at velocities of wide range and under constant control. Another aim of the invention is duetion at highly increased intensities with a minimum liability of exceeding the tolerance of the patient. it is also an important aim of the invention to enable the application of hydromassase to a larger area of parts under treatment than has been practicable with equivalent effectiveness in prior apparatus. it is a particular aim of the invention to enable the coordination of these attainments of the invention in such to improve the aeration of the under-water stream so as to increase the quantity of air bubbles in such a stream; also to increase the manner as to achieve the maximum therapeutic benefits.

While the benefit of directing water streams upon the body of a patient has been sought heretofore, due to the fact that there is a possibility of injur by paralysis or atrophy due to sustained pressures of such currents, it is an important aim of my invention to develop the application of such means with proper intermission to produce stimulating and strengthening sheets on muscles and nerves.

A further important aim of the invention is to provide especially effective means for immediately and at will regulating and controlling the force of current or stream of water produced in a bath,

as well as enablin the simultaneous control of the amount of air introduced into such streams, independently, and to enable the maintenance of water temperatures suitable to the treatments at the same time.

'Glinical investigation has developed the fact that fast moving streams oi hot water can be tolerated at higher temperatures with adequate and proper intermiirture of air in the stream which impinges upon the patient, and it is therefore an important aim or my invention to enable the ready control of the proportion of air maintained in a stream directed against the body oi a patient at a high temperature inorder to raise the level of tolerance, as well as to sheet the benefit of massage in an increased degree, while at the same time producing improved nerve stimulation by the action of the air bubbles in such streams, which has been found highly beneficial in the various conditions outlined above.

Additional objects, advantages and features of invention reside in the construction, arrangement and combination of parts involved in the embodiment of the invention, as will be more readily understood from the following description and accompanying drawings, wherein- Figure 1 is a perspective view of bath equip ment embodying the invention,

Figure 2 is a plan of the tank and trackway. Figure 3 is a fragmentary cross section of the tank showing the jet device, its carriage and mounting. with tracks upon which it travels.

Figure 4 is an elevational view of the carriage at right angles to Figure 3.

Figure 5 is a fragmentary horizontal section of the tank and carriage.

Figure 6 is an enlarged vertical sectional view of the jet device, and oscillating means therefor. j

Figure 7 is a fragmentary horizontal sectional view of the automatic oscillating device for the nozzle.

Figure 8 is a fragmentary perspective view of the modification of the apparatus.

Figure 9 is a fragmentary sectional view of the tank illustrating the drain and overflow pipe connections.

Referring more particularly to the drawings, there is illustrated a tank or tub 10, which may be constructed of various materials appropriate for such use, but in the present instance is indicated in a construction adapted to be produced in sheet metal. The tank includes a simple bottom ll, mounted upon legs or other supports l2, and a continuous wall 13 set thereupon in watertight relation, this wall portion being substantially in the form of a figure 8, producing a waist portion l2, at which the wall of the tank at one side is projected toward the wall portion at the opposite side, both sides being symmetrically alike. The proportions of the tank may be modified, if desired, so as to adapt it specially to treatment of the upper or nether limbs, the

head bay H in the present instance being'indie cated as the larger, whereby to permit a patients arms to be swung in a wide are without interruption, while the foot bay 1 5 is of smaller lateral dimension, presuming that limited leg motions only are required. However, where necessary, both of the bays may be made large enough to permit wide swinging of the arms and legs of a patient, as might be required. In another instance, the foot bay may be enlarged, while the head bay may be of lesser dimensions than here illustrated, these details being sufilciently obvious not to require detailed illustration.

The tank may be provided with any suitable means for introducing and draining water therefrom, including means for heating the water, as may be required, and maintaining the temperature thereof at such degree as may be dictated by particular cases under treatment, with suitable controls variable for regulating the temperature of water maintained in the tank. The pipe connections for supplying and removing water are preferably located close to the wall l3, where it is necessary for these to rise beside the tank, as shown in the views.

The tank is preferably provided with an overhanging, outwardly projected rim or rail l6, and at an intermediate level, in parallel relation to the wall 13, an upper track rail 11 is mounted upon suitable bracketing attached to the wall of the tank, or otherwise, supported. A similar rail I8 is mounted adjacent the bottom of the tank, in the present instance being vertically alined with the rail 11, although this is not essential. These rails may extend entirely around the tank in the relation indicated, or may stop short, providing track ends in spaced relation if desired.

It should also be noted that the head bay H of the tank is provided with an inwardly projected portion l9, forming a recess in the outer side of the tub, of ample proportions to permit an attendant to stand therein, with portions of the bay extending longitudinally therebeyond, this recess being located on the mean longitudinal axis of the tank, and projected longitudinally inward, so as to give close access of an attendant to the head of a patient in the tank. Immediately at the recessed portion 19, a shelf, hammock, or other support 20 is mounted, which may be vertically adjustable, if desired, upon which a pillow or other cushion may be provided as a head-rest for the. head of a patient under treatment in the tank.

It should be noted that the track I1 is so mounted upon supporting brackets 2| that its upper edge is exposed to receive a suitable flanged wheel to be described, while the track 18 is correspondingly mounted with its lower edge projected and shaped for reception of a flanged wheel thereon slightly. The mounting of the track is such that a waste-pipe and water supply pipe shown at 22 and 23, respectively, may be located inwardly of and clear of the track rails, close beside the wall [3 of the tank. Mounted upon the track rails, there is a carriage frame 24, extending above the upper rail, and below the lowermost rail, and having transverse upper and lower cross arms provided at each extremity with respective grooved wheels 26, into which the edges of the rails I1 and 18 are fitted, respectively. The ends of the arms are projected sufliciently in a horizontal direction beyond the carriage to insure that the two wheels on each cross arm will hold the carriage securely in a vertical position for carrying and properly sustainingthe jet apparatus to be subsequently described. The carriage frame lies, in the-main, outwardly of the rails 11 and I8, and has fixed thereon a vertical tube 21, rigidly fixed and secured in the frame 24, receiving telescopically a standard bar 28, slidable therein from the upper end, and carrying at its upper extremity a horizontal inwardly projected arm 29, located slightly above the rim l6 of the tank, and also extended inwardly beyond the wall of the tank for the support of an operating unit, as will be ,and upon the upper end of the carriage frame and fixed rigidly with respect to the frame and tube 21, there is mounted a hoist or elevator means 30, including the crank 32, by which the device is operated to elevate or lower the bar 28 in the tube 21. The hoist device may be of any conventional construction, of which there are various kinds available, in consequence of which full details thereof are not illustrated. Preferably, in the present instance, the bar 28 is fixed against rotation in the tube, but the arm 29 is formed with a hub portion 33, revoluble upon the upper end of the bar, so that the jet unit mounted at the inner end of the, arm may be swung to direct the course of water ejected thereby, arbitrarily, at the will of the operator or attendant. Automatic means may also be provided for oscillating the operating or jet unit, as will be subsequently described. Mounted upon the inner end of the arm 29, on a vertical axis and located over the arm, there is a motor 34 fixed to the upper side of the arm and having a switch box 35 thereon to which a flexible electric cable 36 is led, to supply current for the motor from any suitable source. The arm 29 has at its outer end .a fixed vertical tube 31, extended downwardly therefrom and adapted to extend within a short distance of the bottom of the tank when the bar 28 is at the lower limit of its movement. At the lower end of the tube ill an impeller casing 38 is provided, having a coaxial intake 39 at the lower side, and a lateral nozzle mouth 40 at one side. Leading to the intake 89, there is a pipe duct 4i, constituting an L, on the outer end of whichthere is mounted an intake valve 42, the stem of which is elongated and extended upwardly to a point closely below the arm 29, where a hand-wheel M is fixed thereon, the upper end of the stem 43 being supported by a suitable bracket 45 mounted on the tube 31, as shown. From the motor shaft 48 an extension shaft 41 is extended downwardly 1 coanlally in the tube 31, and bushed therein immediately above the case 38, the end of the shaft ll extending into the case and having an impeller as fixed thereon adapted to draw water inwardly through the intake, and ejected through the nozzle 40. Preferably, the bushing 49 at the case is of one of the familiar types adapted to provide a water-lubricated bearing for the shalt dl', as will be understood.

Preierably, the case of the motor at is extended at each end, as shown at M, to aflord a space for mounting of fan elements 52 on the motor shaft, adapted to draw air inwardly for the stream p170, duced in the tank by the impeller device 48. 'llhe case extension 5| of the motor is formed with an air outlet 53 closely adjacent the tube 31, and train this duct is extended downwardly, tern'iinatlng in an air supply control valve device 55 I interposed between the outlet 53 and duct 54, closely adjacent the motor, conveniently for operation by a patient in the tank, and the same is true of the water supply control valve wheel I. lhe duct M is continued downwardly to a point closely over the nozzle 40, being there turned outwardly and downwardly before the nozzle, terminating in a mouth 56 opening downwardly beiore the nozzle 40, and in line therewith, with the end of the duct 54- finished in a plane at a suitable angle to the path of water passing from the nozzle as to cause an ejector action across the mouth 56, by which air will be drawn downwardly into the stream ejected irorn the nozzle ill. in the present instance, the plane at which the mouth terminates is at an angle of five de grass to the horizontal, being divergent upwardly from the horizontal in the direction of movement of water from the nozzle 40.

There are thus provided in the device two pump elements, one being a centrifugal one in cluding the impeller 48, while the other is a fluidtank a. short distance. In the lower extension iii oi the motor case, which corresponds to the extension 5i before described, there is mounted on a vertical revoluble shaft 58 journalled in the case extension, having an eccentric with wrist pin dd, engaged in a longitudinal slot 60 in the arm bl, The shaft extends upwardly and has thereon a gear 5|, with which there is meshed a worm B2 carried by a horizontal shaft 63 mounted in the case, and having a second gear 64 thereon, meshed with the worm 65 on the motor shaft. As the wrist 59 is rotated by operation of the the slot 60, the arm 29 will be caused to oscillate correspondingly, as will be readily understood.

Strainers, filters, purifiers, and various watertreating devices may be employed, either in conjunction with the water-circulating device carried by the carriage 24, or in conjunction with the tank, or water pipes by which water is introduced thereinto, and any suitable means may be provided for heating the water in the tank, or heating the water supply as it is brought to the tank, in ways familiar in bath apparatus generally.

In the use bf this device, as described, it is cuetomary for the patient to be treated to be placed in the tank suitably supported so that the head may rest upon the device 20, while the body is surrounded by a substantial body of water at a proper temperature to suit the treatment required, the head rest 20 being adjusted to such height as to hold the head of the patient well above the water, so that the entire body may be submerged.

As is well understood, in cases oi infantile paralysis the support of the body in this manner enables the movement oi? limbs with a minimum muscular force, so. that exercise may be edeoted by which muscles may be trained and restored, and the involved nerves correspondingly built up. It is also well developed that such use is also beneficial in the restoration of wound tissues, and in limiting adhesions in course oi convalescence involving normal tissue repair. The patient may receive manual treatments from. competent operators for involuntary exercises, and the shape oi the tank as described materially contributes to enabling the fullest possible range oi movement by which all muscles may be exercised as may be required.

Incident to such treatments, my apparatus enables the application of massage and nerve stimulation in a novel way, by the production of currents or streams oil water in the body oi? water surrounding the patient, in such manner that the streams impinge against the body at the patient in directions appropriate to producing the desired results, the simultaneous drawing in of air by injector action and the projection of this air in fairly large bubbles against the body of the patient produces a multitude of mild concussions or ti-tillating pressures which serve very much as do high tension electrical discharges of mild power in stimulating nerve reactions, but without the painful effects of electricity. lit the same time, by the oscillation of the nozzle unit, this current pressure and the air bubbles massage is directed from one part to another, so that there is an intermission of the action upon any particular part of the body of the patient and so that tendency to partial strangulation of circulation is avoided. and pulsating effects produced which are found highly beneficial in treatments in the various forms of cases heretofore mentioned.

The control of the direction of discharge of the combined water and air stream malces it possible also to enhance the movement of circulatory fluids in the body of a patient in those directions which are most efl'ective in favoring the nourishment 7 of tissues, stimulation of nerves, and strengthening of muscles.

It will be appreciated that the mounting of the trackways entirely surrounding the tank, makes it possible to use a single motor ejector unit for projecting air and water streams against the body and limbs of a patient at any and all parts, minimizing the number of nozzles and mochamotor, by alternately wiping on opposite sides of nisms required for such expensive treatments,

although if desired, one such unit may be provided on each side of the tank, or additional ones introduced, so that respective limbs of the patient may .be treated simultaneously by respective units.

It will be understood that the device may be embodied in various sizes, as before indicated, and in the case of smaller sizes, may be made in portable form, so that arms or legs may be treated individually; also so that a patient may sit in the receptacle for treatment of the nether limbs while the device is operated for producing the effect indicated, and if desired, in certain instances, the mounting of the ejector device may be modified so that it moves within a more limited range than in the case first described. One such reduced size of tank is illustrated in Figure 8, where a motor and jet unit, identical with that used upon the large tank before described, is mountedupon the side of a tank 10, carried upon a suitable frame having casters for supporting it. A motor-jet-unit may be oscillated in this tank, and instead of moving the motor-jet-unit upon a trackway, in order to direct the air and water stream against the various parts of the limbs of a patient, the patient himself may be changed in position in the tank, or with respect to the tank. The bar 28 of the unit in this small portable device may be mounted in a stationary tube 2i, fixed at one end of the tank 10, which is preferably made oblong in plan. The tube 2| carries the same elevator device 30 as previously described, so that the motor-jet-unit may be raised and lowered as required.

For convenience in developing proper temperature in the water in the tank, an immersion heater device may be provided, with suitable control and thermometer and thermostat, indicated formally at I3 at the same end of the tank with the motor-jet-unit.

For using the small portable unit, to treat the nether limbs, the patient will sit upon a high stool, or-the device may be provided with a seat at the end opposite the motorjet-unit, so that the patient may sit in the tank. For treating arms and hands, the patient may sit beside the tank, with the limbs to be treated suspended in the water in the tank.

, In the use of the combined water and air stream, special effects may be obtained by directing the stream longitudinallybeside the limbs and thereagainst, with movementof the stream toward the extremities, which enhances circulation of the blood in such extremities without producing such sustained pressure that the return flow is impeded. p

Benefits may be obtained by alternately directim-a stream longitudinally toward the extremities, and in the opposite direction. In other cases, and especially for deep seated massage effects, the stream may be directed toward the body surfaces at a normal angle-that is to say, at or nearly at right angles to the surface impinged upon. In all of these treatments, especially in those wherein the stream is moved longitudinally along the limbs toward the extremities thereof, a pleasant, nerve-stimulating effect is produced, which greatly enhances recovery of control of paralyzed parts, and in reeducation of a patient of control of motor impulses. The treatment has been found entirely beneficial in mental cases, as well as for tissue and nerve rebuilding. In conjunction with heating of water used in the bath, in which the treatment is applied, the ejector device cooperates with high temperature water to enable treatments that could not be given otherwise, since clinical demonstration has made it apparent that much higher water temperatures may be tolerated by a patient when it is applied in a stream including a body of air in finely subdivided bubbles. In consequence of this, many therapeutic treatments are possible, giving benefits not otherwise attainable without apparatus of similar function.

The apparatus has been found especially valuable in treatment of cases of trauma, in hastening the healing of tissues, reduction of oongestion and other beneficial efl'ects.

While I have disclosed with particularity a specificconstruction of the invention, it will be understood that this is purely exemplary, and that many modifications in construction, proportion of parts, substitution of equivalents, rearrangement of parts, and otherwise may be made within the scope of the invention and without departing therefrom as more particularly set forth in the appended claims. I

It is apeculiar eifect of the pump device disclosed that it draws downwardly through the air duct a very large body of air, in fact, several times as much air, in bulk, as there is water ejected by the centrifugal pump device and by operation of the valves 42 and 55 in proper coordination the proportion of air and water may be greatly varied. Thus, by partially closing the valve 42 by operating the wheel 44, the quantity of water ejected will be reduced, but its force or speed somewhat accelerated, with the result that very little reduction in the quantity of air drawn from the mouth 55 will be caused. The inertia of such a stream is materially lessened as compared to that from a full open valve 42, and consequently it will impinge with less pressure against the body of the patient, by reason of its momentumbeing rapidly overcome by impedance of the body of water interposed between the nozzle and the patient. Such stream will also have much finer air bubbles than one produced by the wide open valve 42, and in consequence a very gentle massage and titillating effect is produced suitable to highly sensitive body areas or persons. By also restricting the air admitted past the valve 55, the frequency of the air bubbles in the stream is reduced so that a more noticeable intermission of their engagement with given areas-of the body of the patient may be produced. By opening the valve 42 to its maximum and closing the valve-55, a sustained stream or current of considerable mass will be produced capable of exerting considerable pressure against the body or limbs of a patient, and by oscillation of the motor-ejector unit on its support, a massage is effected corresponding to that of a barrel-like object pressed against the person and moved over the engaged surface. With both valves wide open, a stream of considerable force and volume is projected in the tank. It is a novel effect of my apparatus that the air intermixed in the water of the projected stream causes the stream to broaden out considerably, so that the massage and other effects are manifest over very large 2. The structure of claim 1, in which the means for projecting said stream is rotatable on a vertical axis.

3. The structure of claim 1 in which said means for projecting the stream is rotatable on a vertical axis, and means to raise and lower the streamprojecting device.

4. The structure of claim 1, in which said bath receptacle is provided with upper and lower track rails, said carriage having grooved wheels fitting the upper edges of the upper rail and lower edges of the lower rail respectively, telescoping support device on vthe carriage operable on a vertical line and including an upper member arranged to extend above the wall of the receptacle and having an arm extending inwardly thereover, and a motor and a pump device mounted at the inner end of said arm and constituting the means for projecting said stream, and means to raise and lower the upper member of the telescoping device, for the purposes described.

5. In a device of the character described, a bath receptacle having a trackway therearound including upper and lower rail edges, a carriage having upper and lower sets of grooved wheels receiving edges of the respective rails therebetween, whereby the carriage is sustained in a vertical position, a telescoping device thereon. and elevating means for the upper member thereof, an arm can ried by said upper member extending inwardly over the wall of the receptacle, a motor mounted thereon having a vertical shaft extension adapted to reach close to the bottom of the receptacle, a pump mounting extended downwardly from said arm and including a'centrifugal pump device having a horizontal outlet, said arm carried by the upper telescoped member being horizontally oscillatable for directing the discharge or said pump.

6. The structure 01' claim 5, in which said telescoped member is fixed against rotation of a vertical axis, an arm extended therefrom in fixed relation below said first named arm, a revoluble eccentric member operatively connected with the motor, and connections between said eccentric member and the second named arm, whereby the mounting 01 said motor will be oscillated.

7. In apparatus for the purposes described, a bath receptacle having convoluted walls. the convolutions of said receptacle including opposite side portions recessed to approach closely the body or a patient therein, and an enlarged bay portion to receive the extremities of such patient, and of a dimension to permit wide swinging of said extremities, track means following the contours of the walls, a travelling carriage thereon, and means carried thereby in the tank for projecting a stream or water adjacent the wall or the tank toward its inner Part.

FLOYD W. ILLE.

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