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Патент USA US2366030

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DBC- 25, 1944- I
Filed Aug. 5, 1940
2 Sheets-Sheet 1
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1‘ 1133i 36
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Dec-~26, 1944-
Filed Aug. 5, 1940'
2 Sheets—Sheet ' 2‘
Patented‘ Dec. 26, 1944
Ferry C‘. Houghten and Murray B. Ferderber, ‘
Pittsburgh, Pa.
‘ , Application August 5,1940, SerialNo'.351,¢l56
2 Claims.
((31.128-373) '
Our invention relates to a method of and an
and the method of operation and‘the apparatus
apparatus for applying fever therapy to individual
portions of a human body by conditioned air. In
our application, Serial No. 162,626, ?led Septem
described herein have been developed to permit
_the local application of fever therapy treatments
without affecting the healthy or normal portions
1 of the body.
' ‘ We have found, for example, that certain‘ail
ber 7, 1937, we disclosed a method of and an‘ ap
paratus for inducing arti?cial fever generally in
the human body.
ments affecting an extremity such as an arm or a
Heat has been used ‘therapeutically in many
forms for hundreds of years, including such
modalities as packs,‘ steam .baths, electrical ap
plications, such as ‘short wave, diathermy, etc.
Any or all forms are used to produce the same
effect, i. e., increased circulation of the part in;
volved. Some‘ means are considerably safer than
others, combining simplicity, ?exibility, and con
trol of conditions.
I-Iyperpyrexia (fever therapy, 'hyperthermia,
etc.) has become ‘an accepted form of treatment
that has been employed quite successfully where
its uses are indicated. However, there are numer
leg could be bene?cially treated by thelapplica
tion of moist heat to that affected part, or by the
application of such heat to an unaffected part,
such as a normal ‘arm or leg‘, inorder to establish
re?ex heat action in the arm or leg to‘be treated.
‘ We have also found that certain back ailments
have responded most satisfactorily to local ap
plications of moistheat, according to the present
The present apparatus in one form consists sub
stantially of a‘ cylinder three or four feet long,
and about ?fteen or sixteen inches internal di
20 ameter, with‘ one end of the ‘cylinder open to re
ous patients who require some form ‘of heat
‘therapy-but who object to general treatment
where only one extremity vmay be involved. Then,
too, there are patients who have reached the age
or who are‘ prematurely physically unsuited for
ceive an arm or leg, after which that end of the
cylinder is closed by a soft rubber curtain, tucked
around the‘ arm or leg. At the closed end of- the
general therapy“ These patients require treat
spray is arranged to establish‘ an air stream and
circulate the air within the cylinder while humidi
fying it at the temperature desired.‘ The spray
ment of the localpart-to relieve them of their
symptoms, which are frequently quite severe.
cylinder, is disposed an air-conditioning unit con
sisting of an'air circulating duct in which a water
Physiologically, heat produces dilation of blood
head may be supplied from the ordinary hot and
Vessels which in turn increases the circulating 30 cold water systems in any building, or from any
volume of the part involved. Capillaries which
auxiliary water circulating device.
are, normally very small became engorged with
‘ Evidence from work done with apparatus of this
blood, the elements of which are instrumental in
type has de?nitely shown that water saturated
producing relief of symptoms and in many cases
atmosphere will produce the desired increase in
complete resolution of the pathological processes, 35 temperature in the body, and is therefore par
ticularly desirable because the danger of burns to
Because of the stimulated circulation, the affected
area receives blood supply capable of handling the
the skin of a patient is greatly lessened on ac
metabolic processes and relieving symptoms which
count of the low dry bulb ‘temperatures.
frequently are severe and are caused by the ac
cumulation of metabolites.’
The apparatus disclosed in our previous ap
plication consists generally of a box large enough
to receive and accommodate the entire body of the,
patient from the neck down- The head of the‘
For example, inmost industrial hospitals the
40 whirlpool and‘foot baths‘ are used for soaking
and heating an‘injurecl extremity. The tempera
ture of these baths usually ranges from 108 to
120° F., and mostfrequently the-lower range is
used because discomfort becomes too great at the
patient extended out from the box, while the 45 high temperatures. Since this apparatus uses
body of the patient was subjected to a circulating
humidi?ed air and since theheat transfer from.
stream atmosphere of water saturated air. ‘
That large apparatus was employed‘where gen
the air to the body surface is not as great the air
temperatures may be‘ carried to a higher range
eral fever therapy treatment was necessary.
without any discomfort and de?nitely without
We have found certain conditions and ailments 50 danger of burning. To verify this, one extremity
was placed within the‘apparatus enclosure and
of the body, however, for which it was not neces
sarily desirable ‘,to‘ apply general fever therapy.v
the other in a water bath and the temperatures
of both raised simultaneously. When a tempera
However, the application of localized “fever
therapy ‘solely to an affected portion of the body‘
ture between 112 to 115° F. was‘ reached, the foot
has brought about unexpectedly bene?cial results, 55 was ‘withdrawn from the water bath because of
aspirator to draw air from the space or come
partment I2a within the shell l2, and to force
apparatus remained and no complaints of dis
that air in and around through the conduit I9
comfort were elicited.
and back into the compartment I2a through the
In another form of‘ apparatus, a semi-circular
upper or outlet end 24 of the, conduit.
shell is used where a part of the back is to be
The inlet end 23 is preferably disposed on a
treated with moist heat. In this structure, rubber
lower plane than the outlet end 24 in order to
curtains are also provided to con?ne the space
take advantage of the natural strati?cation of
within the shell to the portion of the body to be
the heated and moistened air as it is supplied to
treated; and a similar spray device is employed to
circulate, moisten, and heat the air within the 10 the treating chamber I2a. During the circula
tion of the air, as the air is heated and moistened
enclosing shell to create the circulating stream of
-1 by thelwater spray, and then supplied to the
saturated air at the desired temperature.
compartment I2a, that heated air tends to spread
The apparatus and the method of operation to
establish the desired treatment of the selected ' or stratify over the upper space in the compart
portions of the body of the patient are shown in 1'5' ment I2a. The temperature drop or gradient
discomfort, but the leg treated in the described
- -_ Within the compartment between the top of the
the accompanying drawings, in which '
Figure 1 is an end elevational view of a unit- > ‘compartment and the bottom of the compart
for treating the back part of the body of a pa
tient, and consisting of an arch-shaped cover to
?t over the back of the patient, with a principal
vment is relatively small.
However, as the warm, moist air comes into
contact ‘with the portion of the body being
treated, the moisture in the air condenses on
that portion of the body, and a corresponding
amount of heat that was stored in the air is de
livered to the body, and the temperature of the
Figure 2 is an end elevational view of therap- '
is correspondingly reduced. This cooler air
paratus in Figure 1;
25. air
thereupon drops toya lower level in the com
Figure 3 is a plan view of the apparatus in
partment. That cooler air is then drawn back
Figure 1;
up into the conduit, in which it is ire-conditioned
Figure 4 is a side elevational viewof an ap
by the water spray, and then forced through the
paratus for accommodating and treating an arm
or a leg;
30 conduit by the same water spray to re-circulate
through the compartment in the shell. The re
Figure 5 is an elevational view of the control
verse travel of the moistened and warmed air
unit that is mounted at the end of the appa
through the rising portion I9a of the conduit
ratus in Figure 4;
serves to remove any excess moisture that might
Figure 6 is a side elevational view of an ap
otherwise be carried in the circulating air stream.
paratus similar to that in Figure 4, except that
Such excess moisture and the part of the water
it is provided with a control unit of a different
spray that has not been absorbed by the air
stream pass out of the conduit at the bottom
Figure 7 is an end elevational view of the air
through the drain 22.
conditioning or control unit at the. end of the ap
The water spray head I8 may be supplied with
paratus in Figure 6; and
Figure 8 is an elevational view at the open end ' water of any desired necessary temperature by
suitably controlling the the valves 26 and 2'! re
of the apparatus in Figure 6, showing the open
spectively connected in hot and cold water cir
ing in the curtain through whichthe arm or the
cuits that are connected to supply water to the
leg of the patient extends during treatment.
The apparatus I0 shown in Figure 1 comprises, .45 spray head l8.
In order to determine the temperature of the
brie?y, a rubber mat or mattress II upon which “
unit mounted on the side of the cover to supply a
circulating stream of moist air at the desired
conditioned air stream,‘ an opening 28 is provided
at the top of the shell I2, to permit a thermom
eter to be extended therethrough into the com
partment I 2a.
the mattress I I, to con?ne the moist treating air
The foregoing unit with the shell I2 may, of
to that portion of. the body‘that isv to be treated.
course, be applied to any portion of the body to
The open ends of the cover I2 are provided with
be treated, but is primarily intended to treat
suitable closures such as rubber curtains I3 and
different parts of the back of the body of the
I4 that con?ne the moist air to the volumetric
space contained in the part of the cover‘ over the 55 patient, from the shoulders down to and includ
ing the hips.
body that is to be treated. Upon one side wall
The apparatus shown in Figures 4 and 5 is in
I6 of the cover or shell I2 is mounted a bracket
tended primarily for use in treating an arm or a
or frame I5 that is integrally secured to the side
leg. This unit 30 comprises in general a box 3I
wall I6 of the cover to serve as a support for a
plate I‘! upon which is mounted a water spray. 59 having a cylindrical inner space or compartment
32, with a rubber closure 33 at one end of the
head I 8 and a cooperating conduit I9.
boxand with a closing plate 34 entirely closing
The side wall I6 of the unit I2 is provided with
the other end of the box. The rubber closure 33
a large opening 2| which is entirely surrounded
is provided with an opening through which an
by the ‘bracket frame I5, so that the space or
arm or leg of the patient may extend to be dis
compartment within the shell I2 will communi
posed inside of the operating chamber 32 of
cate with the space within the frame I5, and so
the ‘box. '
that the air in the shell I2 can be conditioned or
Within the operating chamber is disposed a
moistened, heated, and circulated by the action
rubber mat or platform 35 to‘ support the arm or
of the water spray dropping from the head i8
down into the conduit I9. A suitable drain 22 19. leg that is to be treated.
At the closed end of the box, the end wall 34
carries off all excess water from the spray, and
consists of a plate which is ‘arranged to be suit
all water in excess of enough to saturate th cir
ably anchored by bolts 36 around the peripheral
culated air stream.
edge to a suitable ?ange or peripheral section of
As the water spray drops down vertically into
the inlet end 2~3~of the conduit I9, it serves as, an a the box 3|.
the patient’s body is to rest during treatment,
and an arch-shaped cover I2 to ?t over the por
tion of the body to be treated and to rest upon
2,3 66,030
proper ‘manner in" the air conditioning unit ‘from
* vThe end wall plate 34 serves as‘a‘support for a
water pipe 31 extending through the plate 34 to
the inlet opening 51 to the outlet or supply open
a permit its outer'end to be connected to a suitable
ing 58, the space in the shallow shell 53 is di
vided‘ substantially into three compartments 6|,
source of water supply, whose temperature may
be suitably ‘controlled to be ‘of the‘ temperature
of the ?nal mixture to be supplied to the inlet
pipe 31.
-62,‘and B3.
‘The lower endlof the compartment 6| termi
nates substantially in the inlet opening 51 through
which the air is drawn from the lower levels of
the main compartment of the box, The upper
The inner end of the pipe 31 supports a water
spray head 43 that is disposed over the inlet open
ing 44 of a conduit 45.
"10 end of the compartment 6| leads to the upper
The conduit 45 is of substantially J shape,vwith
the spray from the spray‘ head 43 dropping into
theinlet opening 44 of the conduit and ‘serving
.end of‘ the middle compartment 62, so that the
‘_ operation of the spray will draw the air upward
from the inlet'opening 51 through the compart
ment 6|, and then force it downward through the
the conduit 45. The air thus drawn into the con 15 compartment 62, and thence into and upward
through the compartment 63 to the outlet open
duit is heated or cooled, according to the‘ tem
ing 58. Two spacers or ba?ies 65 ‘and 66 are dis
perature of the water, and is then propelled on
posed adjacent to the spray head to establish
ward through the conduit 45. The other ‘arm
the intermediate space in the middle compart
46 of ‘the conduit rises vertically to an outlet
opening 41 that is disposed at a higher level than 20 ment 62, within which the spray from the spray
head is to be con?ned. The outer surfaces of the
the inlet opening 44.
as an aspirator to draw the air from the'box into -
ba?ies .65 and 66 are rounded substantially to the
curvature of the wall of the shell 53. The lower
end of the baiile 65 is provided with a tail piece
propelled air is caused to move downward under 25 65a that is disposed along the peripheral edge of
the inlet opening 51, and out to the inner surface '
the spray and back upward through the section
of the wall of the shell 53.
46 of the conduit, and out through the outlet
The upper edge of the ba?ie 66 ‘is similarly pro
opening 41 into the space of the compartment 32
The downward movement of the water spray
from the spray head43 moistens, heats, or cools,
and propels the air as already mentioned.’ The
in the box 3| .
vided ‘with a tail piece 66a that extends out to the
In the form of control conduit shown in Figures
4 and 5, the outlet opening 41 may be reduced in
diameter to provide a constricted throat at the
outlet, in order to impart an increased velocity
to the travelling air supply where it leaves the
conduit, if the treating box 3| is unusually long. '
wall of the shell 53, and substantially along the
edge of the outlet opening 58. These two tail
.pieces insure that the'air circulation will proceed
along the desired path from the inlet opening 51
up through‘ the compartment 6| and down
through the compartment 62, where the air will
be moistened and heated, or cooled, by the water
spray, and then forced by ‘that spray upward
through the compartment 63 and out through the
outlet opening 58 into the main or working cham
Ordinarily, the heated, saturated air,‘ when pro
jected from the outlet end of the conduit, will tend '
to stratify or distribute itself at the upper levels
of the box. When air is withdrawnto the inlet
opening 44 by the spray, the air at the upper
levelswill drop and will assure movement of the
saturated air throughout the entire space of the
box in which the arm or leg to be treated is dis.
ber of the box 5| .
The location of the inlet opening 51 is such
as to be substantially in the region of the lower
most portion of the main compartment in the box.
The outlet opening 58 leading to the box is lo
A drain .48 at the bottom of ‘the box removes all 45 cated practically along the upper region of the
‘main compartment of the box, so that the mois
of the condensation that accumulates in the box
tened and heated air will tend to stratify in hori
3|, and removes also ‘the excess water from the
zontal planes‘throughout the length of the main
sprayhead 44 that drops ‘down tothe drain 48,
chamber of thebox 5|. As the air is withdrawn
through an opening 49 at the bottom of the con
In Figures 6; 7, and 8, we have illustrated a
local treating unit 50 in which the box 5| itself is
similar to that shown in Figure 4, but the air
conditioning unit 52 is somewhat different in con
50 from the lower‘ regions of the box during the op—
eration of the water spray, the entire volume of
air in the box tends to move downward as a
blanket upon the arm or leg that is‘disposed in
the‘box,>to‘be treated by the hot moist air.
In each of the forms shown herein and in
_ It is arranged to be applied to or disconnected ' tended for local applications, the air condition
ing system is of the general dew-point type, in
from the end of a box 5|. The air conditioning '
unit 52 is shown as consisting of a shallow recessed
which the highly atomized water spray at the
circular shell 53, provided with ,a straightened
upper end of a small duct supplies both the mo
peripheral ?ange 54; by means of which the shell
53 may be secured to‘ the end of the box 5| through
tive power for circulating the air and the heat
and moisture for saturating the air at the desired
the medium of anchoring bolts or screws 55.. In
order to control the air movement in a predeter
spray gives the air a momentum that removes it
temperature. The downward movement ‘of the
from‘ the lower- portion of the box and delivers it
in saturated. condition at the desired elevated
temperature to the top of the working chamber
is provided with‘two diametrically ‘spacedopen
of the box. By reason of the stratification of the
ings 51 and 58, disposed substantially as indicated
in Figure '1.
saturated heated air as it is supplied to the work-v
ing chamber, there is little or no temperature
In order to moisten, and to heat and move the
stream of air, as ‘in the other modi?cations, a 70 gradient throughout a horizontal cross-section,
spray head 59 is supported on the shell 53, with
with a minimum controlled gradient from the top
mined path, a perforated plate 56 is disposed be
tween the shell 53 and the box 5| . The plate 56
the connecting pipe 60 extending back through
the back of the shell for connection to a suitable
source of water supply.
to the bottom of the chamber.
‘ With a forty pound water pressure and a four
inch duct throughout the air conditioning system,
_In order to control :the air movement in the 75 9.8 cubic feet of air per minute are removed from
the-bottom of the ibox,--iheated .and‘saturated to
more ‘beneficial than short ones. ‘.Theibodymust
the desired temperature, and returned to, .the
upper portion. Without insulation twenty-1 .to
thirty gallons of water per-hour are su?icient for
satisfactory conditions in the box, andif‘ the cyl
inder is insulated to insure-againstexcessive heat
loss to the surrounding atmosphere-a consider
ably smaller water volumeqwill ,suf?ce. _A water
temperature of 130° F. will ‘produce a uniform
saturated atmosphere of from 120° to 125° vF.
Since the air is saturated :upon? entering the box.
and loses heat before being [returned to the air
conditioning part of'the cycle,:saturation is'in
have time'to-adjustitselfto.any'change, and sud=
den forms of treatment, short-lived, are not 'as
bene?cial. This? apparatus can be used'for-two
to three or more hours without danger.
In view of the gradual'dilatation, the bloodpres
sure in the body is substantially unchanged, ‘and
the pulse rise, if any, is negligible. At the same
time, an increased rate 'of blood ?ow is estab
lished within the treated region or extremity.
.Such, increased local ‘circulation in the part of
the body that is treated is established withlittle
or no increase in thegeneral circulation, which
sured throughout. ‘
would cause an extra load on the heart, which
From a comparative standpoint the whirlpool .15 might be unable to standthat extra load. With
baths using rapidly'agitated‘water from 108° 'to
the present apparatus and the method‘of treat
120° F. have been used in. industrial‘ hospitals to , ment involved, it is, therefore, possible to treat an
produce a hyperemia (increased blood supply)‘.
arm orv leg of ‘a person whose heart would not
The upper range of temperature. in. this water
permit the application of general uncontrollable
bath is apparently too great .‘for comfort and 20 heat therapy. '
could conceivably cause certain di?iculties‘which
By means of the present equipment, it is pos
might arise in a patient with.impairedrcirculation
sible also to control the ratio of the area of the
in the extremities. The abilityof a patient 1-to
surface to which the heat is applied tothe-area
tolerate temperatures between 114° and 120° F.,
of the untreated surfaces,'which serve as heat
saturated, is outstanding sincemost‘of the cases 25 dissipating areas.
are treated at these temperatures without danger
The important feature of the present apparatus
of complications. From experience it‘has :been
iszthe- fact that it'provides a tolerable'heat which
I found that it is necessary'to treat a pateint one
the patient can tolerate for a substantial period
to three hours to producedesired'effects; and-the
of time, running continuously into hours, with
index of improvement increases with each suc
ceeding treatment. Usually a course of treat
ments would consist of thirty-‘sixihours at a pre
determined temperature usually divided into
twelve treatments of'three-hoursleach given daily
or every other day.
Theincrease in pulse rate 35
out anydeleterious effects. The long-continuous
treatment is, of course, ‘advantageous since it
rovides the greatest healing eifect by enabling
the system to remove the products of the ailment
over the extended period of continuous treatment.
With this apparatus there'is no burning, either
of the-skin or internal parts of the body. There
count would average about .1500-‘cells, which may
is no shock due to sudden application of heat
be purely a personal variation "in making the
energy in. alform that compels the body to absorb
counts. The rise- in body temperature resulting
it more suddenly than thebody can adjust itself
from this treatment is insigni?cant and varies 40 to absorbthat ‘amount of heat energy. The bene
from no rise to a maximum rise of from 1° to 11/2"
?cial action in the increased dilatation locally is
F. This increase doesnot a?ect even‘ those 1pa
not attended by any overloading on a heart that
tients su?’ering from severecardiac lesions.
is unable to tolerate-the more than normal-func
In comparative tests'ofiheat applications by
short wave, by infra-red'rays, andv by saturated
In our experience vwith the present equip~
is fairly insigni?cant, andthe rise' in leucocyte
air at slightly elevatedtemperatures ‘according
to the method described‘herein and by means-of
the present local apparatus, it‘was vfound that the
most rapid temperature increases occurred using
short-wave,»and the deepitemperature'was ele
vated as high as 108°-109° F. 'When the‘ short
wave generator was disconnected‘, the deepitem
perature dropped immediately, and it reached'its
normal within twenty=minutes. ‘Using infra-red
heat the vdeep temperature response was not so "
rapid nor was the temperature rise as great; and
removal of the heat sourceprecipitated a rapid
fall of the deep temperature. iMoist‘heat pro
ment, weihave employed saturated atmospheres
throughout, and‘have found that fully saturated
atmospheres have provided optimum conditions,
since-lower dry bulb temperatures could be em
In order, however, to be able to control the per
centage of moisture containedin case less than
vcomplete saturation might be desired, we may
dispose a heating element 10 just ahead of the
outlet end of the air conditioning conduit, as
shown, for example, in Figure '7. This heating
element 70 may be utilized if desired, and heat
from an external circuit through conductors ‘H
rise, not quite as high as short-wave, but even 00 to superheat the saturated airstream, and there
by reduce the relative moisture contained to a
when the heat source ' was removed and' cold
value below complete saturation,
water circulated through the apparatus at a tem
‘Our inventionisnot necessarily limited'to the
perature of-GO" F., the deeptemperature per
speci?c details of construction that are shown,
sisted for one-half hour before it‘ started to drop;
since these may be variously modi?ed without
and it was back to its previous normalin an
departing from the spirit andscope of the inven
hour. Thesigni?cance of this comparison is quite
important in view of the factxthat moist ‘heat
tion, asset forth in the appended claims.
‘We claim as our invention:
treatments are given for two ‘or three hours-with
out producing pain or burns.
-1..An apparatus for- applying moist‘. heat to a
‘For example, dilatation occurs-slowly but pro 70 localizedarea of‘ a. human body, comprising an
gressively, down tothesmallest capillaries; Since
enclosure to ?t over the portion‘of the body to
this is not sudden (as inshort-wave), fatigue of
betreated and providing a relatively‘free main
the nervousmechanism controlling the dilatation
space compartment ‘within the enclosure; and
or constriction does not occur. Therefore, we can
means for circulating a stream of saturated air
duced a considerably slower deep temperature
give long. periods .oftreatments?which-are always 75 through‘ the. compartmentrsaid- means compris
ing a conduit communicating with the main com
partment, of J-shape, a water-spray head dis
posed at one end of the J-conduit vertically, and '
body; a soft rubber curtain at both ends of the
cover to close the compartment above the body
vof the patient; and means supported on the side
operative‘ to, drop its ?uid spray into the conduit
wall of the cover to heat and saturate and circu
and to ‘aspirate the air from the main compart 5 late a stream of air through the compartment,
ment into and through the conduit, and thence
said‘ means comprising a conduit of substantially
, back into the main compartment; the conduit ‘
J-shape, both ends communicating with the space
having a drain at its lower‘ end for the removal
compartment, the lower end of the conduit being
of any water from the spray that is not absorbed
at a lower level and'the top end of the conduit
by the air stream, the spray end of the conduit 10 being at an upper level, the lower end opening
being disposed to draw the air from the lower
of the conduit being fully open to provide a low
levels of the main compartment, and the other ‘ velocity ori?ce for the air stream from the space
end of the conduit being disposed to direct the
compartment, and the top end of the conduit
propelled saturated air to the upper level of the
being reduced in diameter to provide a’, high ve
main compartment.
15 locity ori?ce for the air stream to be supplied to
2'. Apparatus for applying moist heat to a lo
the compartment; and a water spray head dis
calized area of a human body,’ comprising a rub
posed at the lower end opening of the conduit to
ber base or mattress to receive and support the'
drop its spray vertically into the conduit to heat,
portion of the body to be treated; a cover of
moisten, and circulate the air stream through the
inverted U-shape to ?t over that portion of the 20‘ conduit and through the space compartment.
body and to removably seat itself on the rubber
base with a free space‘ compartment above the
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