An improved method for applying pelvic heat using air

AN IMPR’OVED

METHOD FOR APPLYING USING AIR

LOUIS B. NEWMAN,

M.D.,

CHICAGO,

PELVIC

HEAT

ILL.

I

N USING any device for producing heat in any part of the body, two very important requirements must be fulfilled in order to treat the patient .&ely and effectively without the danger of burns and their associated effects. First, the maximum ti,ssue temperature at any time during the treatment must be known, and, second, the point or area of maximum heat concentration in the tissues must also be known. A new improved apparatus for producing dry heat has been developed by the author. and has been used for several years in the treatment of pelvic inflammatory conditions. This machine (Fig. 1) f&ills the requirements stated above. With it?

Fig.

L-A,

Bag:

B,

thermometer: F, temperature

C, applicator: control:

725

D, pressure gauge: G, rubber bulb.

E,

time

clock

:

726

AMEXICAN

JOURNAL

OF

OUSTETKICS

AND

CYNECOLOQY

heated air is circulated through a special shaped thin-walled rubber bag which is inserted in the vagina in a collapsed state and then inflated with air so as to distend the vagina. This distention of the vagina serves a two-fold purpose, first, the tissues are ( ‘ ironed-out ’ ’ ; all of the folds and rugae are flattened, thereby bringing the rubber bag in immediate contact with the tissues, and, second, due to this fact, the heat is radiated uniformly over a large area to the surrounding structures thereby eliminating so-called L ‘hot spots. ’ ’ The heated air is continuously circulated through the bag producing a uniform Therefore the maximum temperature throughout and an even distribution of the heat. tissue temperature during any time of the treatment is never higher than the temperature recorded by the thermometer which extends into the bag. The maximum heat concentration instead of being over a small area will be uniform over a large area in direct contact with the applicator bag. Any other type of electrode which is used in the vagina without producing distention of the cavity will only have point contact, or at best, a small area of contact with the tissues, thereby resulting in at, this spot and producing a burn. the possibility of the heat concentrating

Fig.

2.-B,

Bag;

S, sleeve:

A,

applicator;

T, thermometer.

The machine is small and consists essentially of a fan which circulates air through the applicator bag. The air is heated by an electrical unit, the temperature being controlled automatically by a thermostat set for any desired temperature. Temperatures up to 130” F. can be used, although lower temperatures for longer periods of time seem to be more beneficial. The thermometer which extends into the bag (Fig. 2) is protected by a bed of rubber. Broken thermometers can be readily replaced. A hand-operated rubber bulb similar to that used on blood pressure machines is used to inflate the rubber bag, thereby giving any degree of smooth and even distention. The pressure which is approximately 1 to 1.5 pounds is indicated on the pressure gauge. A time clock is incorporated in the machine so that the treatments can be timed for any desired period. Inasmuch as the bag is distended with air and since the weight of the contained air and bag is negligible, being less than 0.25 ounce, there is no pressure or feeling of weight in the pelvis to produce any discomfort to the patient during the treatment, as there is with a bag filled with water, the weight of which is approximately 0.5 pound. Observations and reactions of patients disclose a marked feeling of in-

NEWMAN

:

METHOD

FOR

APPLYING

PELVIC

7.27

HEAT

crease in the weight of liquid-filled bags as the treatment progresses. This senaation is not experienced when the air-filled bag is used. If the bag should tear during a treatment, the patient will not be burned, as the bag merely collapses; there is no escape of hot water. A double seal sleeve is incorporated on the applicator so that torn bags can be easily and quickly replaced, no cementing being necessary. The technique in giving treatments is very simple. The deflated bag is lubricated and inserted into the vagina. The bag is then inflated by means of the rubber bulb, the amount of distention being governed by the comfort of the patient. A pillow placed under the patient’s knees also supports the applicator holder so as to eliminate any pull on the pelvis. The time clock is set for the length of t,reatment, the temperature control is set for the desired temperature, the switch is turned ‘I ON” and the treatment is begun. No preheating is necessary as the air in the bag at the brginning of the treatment is never lower than room temperature and will not chill 111~: patient. During operation, the air is heated rapidly to the desired temperature As the volume of air increases when it is heated, the bag will expand slightly and t,hereby result in more perfect contact with the surrounding tissues which, by this time, have become softer and more pliable due to the heat. If the patient complains of too much distention, a little air is permitted to leak out by opening lhe air valve on the pressure bulb. At the end of the treatment, the switch is turned ‘(OFF,” the bag is deflated and withdrawn from the vagina. There is nothing to The applicator holder together with spill or leak to burn the patient or soil the bed. 3) can be sterilized as a unit. the bag and specially constructed thermometer (Fig. either by boiling or immersing in a suitable antiseptic solution. By using an n&iitional bulb, a massaging effect can be obtained if desired. When the applicator is removed, the machine may serve as an excellent SOUTW of dry-heated air which can be used for therapeutic purposes. With this machine, uniform dry heat together with distention may be safely given to both the male and female pelvis over long periods of time. The maximum temperature and the area of maximum heat concentration are known at all times during the treatment. This, coupled with the ease of operation, insures a high degree IQ circulating air through :1. coo!of safety, efficiency, and comfort to the patient. ing coil, low temperatures may he secure11 in the ruhher bug. 5146

Howkins, 1939.

WEST

25~~

J. and

STREET

Brewer,

H.

I?.:

Placental

Blood

for

Transfusion,

Lancct,

1:

1X.

The authors were able to collect an average of only 47 C.C. of placental blood in 50 consecutive eases of normal labor. Twenty-two per cent of the collections were contaminated when checked for sterility at intervals of six to fifteen days. The organisms found were B. subtilti, B. co%, Staph. albw, and B. pyooyaneus. The The writers conordinary personnel of the labor ward was used in the collection. clude that this source of blood is uneconomical and unsafe. CARL I?. HUBER. Halbrecht,

J. :

Transfusion

With

Placental

Blood,

Lancet

1:

202,

1939.

The author reports 116 transfusions of blood obtained from 520 placentas at the Beilinson Hospital, Palestine. Four reactions occurred of which 3 consisted of a chill and 1 of dyspnea and tachycardia. Blood preserved in 3.8 per cent sobrtion of sodium citrate stored at 4 or 5” C. for as long as fourteen days was used. An average of 50 to 60 C.C. of blood was drained from each placenta with a maximum of 160 C.C. The results are equal to those obtained with fresh blood and placental blood is looked upon as an important source of blood for transfusion. C&L

P. HUBEI:.