GB2129690A

GB2129690A - Therapeutic apparatus for treatment of living tissue

Info

Publication number: GB2129690A
Application number: GB08330370A
Authority: GB
Inventors: Rene Charmillot; Jean-Pierre Lebet
Original assignee: SYMTONIC
Current assignee: SYMTONIC
Priority date: 1982-11-15
Filing date: 1983-11-14
Publication date: 1984-05-23
Also published as: ES527245A0; ATE40526T1; ES8502344A1; CH677883A5; EP0109935A1; IT1203680B; HK34090A; IT8368185A0; DE3379100D1; GB2129690B; EP0109935B1; FR2535974B1; JPH0411230B2; JPS60500241A; DE109935T1; BE898196A; GB8330370D0; FR2535974A1; WO1984001905A1

Abstract

A control and display device (4) is connected to a low frequency direct current pulse generator (1) as well as to a high frequency alternating current generator (2) as well as to a laser source (3). The generators (1 and 2) and the source (3) are connected to a common endonasal probe (8) through a switch (9) controlled by the control and display device (4). The probe (8) allows to apply successively or simultaneously the electric current pulses emitted by the generators (1 and 2) and the laser beam provided by the source (3) to the same area of the endonasal membrana of a patient. Application as a therapeutic treatment apparatus, particularly for restoring the nurovegetative equilibrium and providing an anti-inflammatory and reconstituent activity.

Description

1 GB 2 129 690 A 1

SPECIFICATION

Apparatus fortreatment of livingtissue bystimula- 65 tion by means of pulses of electric current and/or by means of electro-magnetic waves.

The present invention relates to an appa ratus for the therapeutic treatment of living tissue by stimulation by mea ns of pu Ises of electric current andfor electro magneticwaves.

Apparatus has already been proposed, for there apeutic treatment by stimulation of living tissue by means of pulses of electric current and electro magnetic waves, especially of electro-magnetic waves. In the known apparatus the transmission of the electric current or of the electro-magnetic waves to the tissue to be treated is carried out by means of devices such as electrodes or antennae, each adapted to the type of cu rrent or wave to be transmitted. Also, each apparatus is designed to enable a well defined type of treatment to be put into effect.

The present invention seeks to provide an apparatus which enables a newtype of treatment, combining a plurality of stimulations by current orwaves of different natures, which are applied in succession or simultaneouslyto a region of a living organism.

According to the invention there is provided an apparatus forthe therapeutic treatment of living tissue bystimulation by means of pulses of electric current and/or by means of electro-magnetic waves, compris ing: at leasttwo generators of electro-magnetic waves and/or of pulses of electric current, having different characteristics, and meansfor applying the electric current and/orthe electro-magnetic waves output from the generators, in succession or simultanteously to a region of the living tissue to be treated.

The means of application of the generator outputs may be an endonasal probe.

The apparatus preferably has a generator of rec tangular d.c. pulses having a pulse duration from 0.5 to 5 milliseconds at a voltage from 10 to 100 millivolts with a repetition frequencyfrom 10 to 100 Hertz and a generator of a.c. pulses having a frequencyfrom 20 to Megahertz modulated preferably in sinusoidal form or in a form having an equivalent effect (for example, in the form of square pulses) with a frequency of modulation from 2.5to 6000 Hertz, as well asa generatorof electro-magnetic waves having a wavelength which corresponds with the visible band of the spectrum of electro-magnetic radiation, in the form of a beam of coherent light.

Alternatively the apparatus has simply a generator of rectangular d.c. pulses and a generator of high frequency a.c. modulated sinusoidally at lowfrequen cy or in a form having an equivalent effect, for example, in the form of square pulses, these two generators being arranged to generate outputs having the characteristics specified above.

Preferred embodiments of the invention will now be described with reference to the accompanying draw ings, in which:

Figure 1 is a general diag ram of an apparatus in accordance with a first embodiment, Figure 2 shows an embodiment of an endonasal probe which may form part of the apparatus represented in Figure 1, Figure3 is a section on a scale enlarged with respect tothatof Figure 2, of thefront portion ofthe probe represented in Figure 2, Figure4 is a section on thesamescale asthatof Figure3, of the rear portion of the probe represented in Figure 2, Figure 5 shows another embodiment of an endonasal probe, Figure 6 is a section of endonasal probe in accordance with a variant upon the embodiment illustrated in Figure 5, Figure 7 represent an energy applicator intheform of a forkwhich may be employed in replacement of the endonasal probes illustrated in Figures 2to 6, Figure 7b represents a variant upon the energy applicator as Figure 7, Figure 8 is a section of the applicator illustrated in Figure 7 along the plane indicated by the line VIII-VIII in Figure7, Figures 8bto 8dare sections similarto Figure 8, which illustrate variants upon the shape of the energy applicators represented in Figures 7,7b and 8, Figure 9 is a partial view of the applicator as Figure 7, along the plan IX-IX in Figure 7, Figure 10 is a partial view of the applicator as Figure 7, along the plan X-X in Figure 7, Figure 11 is a partial view of the applicator as Figure 7, along the plan XI-XI in Figure 7, Figures 12a to 12c represent respectively a side elevation and a plan of a supportfortwo endonasal probes aswell as a diagrammatic view illustrating the method of use of thissupport, and Figures 13ato 13care diagrammatic views illustrat- ing the method of use of a buccal energy applicator which may be employed in the apparatus in accordancewith the invention.

The apparatus represented in Figure 1 comprises a low-frequencyd.c. pulse generator 1 capable of producing current pulses in theform of a rectangular signal having, for example, a pulsewidth of the order of 0.5to 5 milliseconds with afrequency of 1 Oto 100 Hertz ata voltage of the orderof sometens of millivolts, preferablyfrom 1 Oto 100 millivolts, a high-frequency a.c. generator 2, modulated at lowfrequency, capable of producing an electrical signal formed of a sinusoidal wave orsquare pulses having a frequency of the order of sometens of Megahertz, preferablyfrom 20to 100 Megahertz, modulated in sinusoidal from with a frequency of modulation of the order of some tens of Hetz, preferably from 2.5 to 6000 Hertz, the power of this generator 2 being preferably of the orderof 0.1 to 1 Wattand a generator3which isa laser emitter comprising, for example, a Helium-Neon tube capable of emitting a coherent and monochromatic red light beam having a wavelength of 632.8 nanometres in the form of alight signal modulatedwith a frequency variable from 1 to 160 Hertz. In replacementof the Helium-Neontube one The drawing(s) originally filed were informal and the print here reproduced is taken from a later filed formal copy.

GB 2 129 690 A might equally employ any othersuitable source of coherent monochomatic light, for example, a Gallium Arsenide photodiode.

A control and display device 4 is connected to the generators 1 and 2, and to laser emitter 3 by respective 70 control signal transmission lines 5,6 and 7. The control and display device 4 enables the emission of energy bythe generators and the laser emifterto be controlled in accordancewith the needs of the treatmentwhich it is desired to carry out by means of the apparatus in accordance with a pre-established programme in which the characteristics of the lumi nous electrical signals are made to vary as well as the duration of emission and the sequence of application of each of the signals, and the data of the programme so chosen to be displayed.

The generators 1 and 2 and the laser emitter 3 are respectively connected to a probe 8 for application of energy, by way of the lines 10 and 11 fortransmission of electrical signals and of an optical fibre line 12for transmission of signals and of a switch 9 (shown schematically in Figure 1) which is likewise controlled bythe control and display device 4 byway of a control signal transmission line 13.

The switch 9 is arranged so asto enablethe signal transmission lines 10, 11 and 12 to be connected in succession or simultaneously to the probe 8 for application of energy, the connection between the probe 8 and the switch 9 being effected by means of a line 14for mixed transmission of electrical and luminous signals. The return of the electric current is effected by means of an electrically conductive handle (not shown) which is held in the hand bythe patient during the application of the electrical signals and is connected to the generators 1 and 2 by an electrically 100 conductive line which is likewise not shown.

The endonasal probe 8 represented in Figure 2 comprises a middle portion 20 consisting of an electrically insulating sheath 15 which is flexible or serni-6gid and, for example, of plastics matter, surrounding an optical fibre line 16 forthe transmis sion of luminous signals, round which is wound in a spiral a line 17 fortransmission of electrical signals, a front portion 18 intended for placing inside the enclonasal cavity of a patient and a rear portion 19 for110 connection with the mixed transmission line 14.

The front portion 18 of the probe 8, shown in Figure 3, comprises a tubular piece 21 of a material which is a good electrical conductor, forexample, copper or brass,formed of an elongated cylindrical portion 21 a 115 surrounded by an annular portion 21 b,while these two portions may be in one piece as shown in Figure3 they may equallywell consist of two distinct pieces assembled together by any suitable means,for example, by brazing to enable easyflow of electricity 120 from one portion to the other. The annular portion 21 b is placed slightly nearerthat end of the elongated portion 21a which is intendedto be placed towardsthe front of the probe 8 so thatthe length of the tubular section 21'a of the portion 21 a overhanging towards 125 thefront is smallerthan that, 21 "a, which overhangs towards the rear. This lattertubular section 21 "a is forced into the sheath 15 so as to ensure the integration of the piece 21 with this sheath 15. The line 16fortransmission of luminous signals may consist of130 a single optical fibre as shown in Figure 3, but it might equally well consist of a bundle of a numberof optical fibres. This line 16 fortransmission of luminous signals is preferably forced with lightfriction into the central bore in the piece 21 to project slightlytowards the front of the probe.

The end of the line 17 fortransmission of electrical signals, which consists,for example, of a copper wire, is connected electrically to the piece 21 byrneans,for example, of a spot of solder 22.

A rounded tip 23 of matterwhich is transparent or translucent at leastforthe radiation transmitted bythe line 16, is attached to the tubular section 21'a to surround this section as well asthe portion of the optical fibre line 16fortransmission of luminous signals, which project from the front of the piece 21, so thatthesidewall of the annular portion 21 b of the piece2l is left bare and lies flush between the outer wall of the sheath 15 and the surface of thetip 23 to form an annular area conductive of electricity. The sidewall of the annular portion 21 b remaining thus bare is advantageously covered with a coating which is a good electrical conductor and resistaritto the action of physiological media, for example, with a thin layer of gold.

The rear portion 19 of the probe 8 comprises a tubular piece 24 of a material which is a good electrial conductor, for example, copper or brass. An elongated cylindrical portion 24a is forced into the sheath 15 in the same way and with the same object as the section 21 "a of the tubular portion 21 a of the piece 21 is forced in at the other end of the sheath 15. The rear end of the line 16forthe transmission of luminous signals is forced partially inside the central bore in the piece 24 and the rear end of the conductorwire 17 is connected electrically to the piece 24 by a spot of solder 22'. The optical fibre transmission line 16 terminates in a plane cross-section 25 which is strictly perpendiculartothe axis of the optical fibre (orfibres) so as to enable an optical joint of good quality with another optical fibre 16'forming the componentfor transmission of the luminous signal in the mixed transmission line 14 which connects the probe 8 tothe remainder of the apparatus.

Itwill be understood thatthe front portion 18 of the probe 8 enables energyto be applied in succession or simultaneously in the form of electric current and in theform of luminous radiation in one and the same region of the same extent of the organism which isto betreated,which underthe circumstances is the endonasal mucous membrane.

The enclonasal probe represented in Figure 5 has the general shape of a stiletto or, more precisely, of a catheter. It is composed of a straight elongated middle portion 30, onlythe ends of which are shown in Figure 5 in orderto facilitate its representation, as well as a front portion 28 of a shapewhich is rounded in orderto facilitatethe introduction of the probe into the enclonasal cavum without risk of injury or of irritation of the mucous membrane, and of a rear portion 29 of cylindrical shape. As may be seen in Figure 5 the front portion 28 and rear portion 29 have a diameter slightly greaterthan that of the middle portion 30,the scale of Figure 5 corresponding approximately with a factor of enlargement of 10 with respectto the real dimensions.

11 3 GB 2 129 690 A 3 The body 58 of the probe represented in Figure 5 may consist, for example, of one single piece moulded from synthetic or natural plastics or elastomeric matter such as a synthetic resin like ABS or hard rubber. This body 58 advantageously exhibits a certain flexibility in orderto facilitate adaptation of its shape to that of the endonasal cavities and to contribute to reduction in the risk of injury to the mucous membrane atthe time of placing the probe in position in these cavities.

The outer surface of the body 58 is covered with a layer 26 of electrically conductive matter consisting, for example, of a thin metallic layer formed by atomisation, etc. The function of this conductive layer 26 isto enable transmission of the electric current andlorthe electromagnetic waves proceeding from the energy genators of the apparatus in accordance with the invention, from the rear portion 29 of the probe which enables connection with the energy transmission line proceeding from these generators, upto thefront portion 28 which forms the member which is the applicator of current or of the waves in the quite localised region of the surface of the endonasal mucous membrane with which it is in contact. The conductive layer 26 advantageously consists of a material having a high resistance to oxidation and to the action of the physiological media, for example, gold, silver, aluminium, chromium, etc. The cover of the surface of the body 58 bythe layer 26 maybe total or only partial, for example, in the form of continuous bands covering the middle portion 30 and connecting zones of wider area covering entirelythefront portion 28 and the rear portion 29 of the probe. The rear portion 29 plays the part of connector piece similarto the rear portion 19 of the probe 8 of the embodiment illustrated in Figures 2 to 4. However, because in the embodiment illustrated in Figure 5 the probe does not comprise any line fortransmission of luminous signals, it is suitable onlyforthe application of energy in theform of an electric current andlor of electromagneticwaves, to the exclusion of luminous waves.

On the contrary the probe in accordance with the embodiment represented in Figure 6, the general shape and the arrangement of which are similarto those of the probe illustrated in Figure 5, comprises in 110 addition aline 16fortransmission of luminous signals, which is placed on the axis of the body 68 of the probe and is similarto that which is designated by the same reference number in the probe in accordance with the embodiment illustrated in Figures 2to 4.

Hence it likewise enables the application of energy in the form of luminous waves, for example, in the form of coherent light, in addition to that of electrical and/or electro-magnetic energy conveyed by the conductive layer 26 which covers entirely or partially the body 68. 120 It should be noted that the conductive layer 26 is represented in Figure 5 to have a thickness which is exaggerated with respect to the real proportions between this thickness and the diameter of the different portions of the probe, in orderto facilitate understanding of the arrangement of the probe.

The energy applicator 78 represented in Figure 7 to 11 has the general shape of a fork composed of a middle portion 70, two curved arms 78a and 78b and a cylindrical connector rod 79 enabling electrical connection of the applicator to the generators of pulses of electric current andlor of electro-magnetic waves.

The section of the whole of the applicator 78 (Figure 8) and of different portions of it, that is, of the middle portion 70 (Figure 9) and oftwo cross-sections of the arms 78a and 78b (Figures 10 and 11) showdetails of the form of this applicator.

Apart from its particular shape, the aim of which is to guarantee great safety to the user by limiting the risks of injury and of irritation of the endonasal mucous membrane, the applicator 76 has an arrangement and operation similar to those of the probe illustrated in Figure 5. In particular it may consist of one single piece moulded fr ' om plastics matter entirely or partially covered with an electrically conductive layer (not shown) having the same function as the layer26 on the probe as Figure 5.

Numerous variations maybe applied as illustrated, for example, in Figures 8b, 8c and 8d, to theform of the applicator 78, especially as far as the spacing, slope and radii of curvature of the arms 78a and 78b are concerned. The dimensions of the applicator may likewise vary, especially in order to allow adaption to the dimensions of the users'nasal cavities as well as to the different exact points of application of the energy. On the other hand the applicator78 might be equipped with one or more lines for transmission of energy in theform of luminous waves, to playthe same part asthe line 16 in the probes illustrated in Figures 2 to 4 and in Figure 6. For example, as shown in Figure 7b such a line fortransmission of energy in the form of luminous waves might consist of a bundle of optical fibres 76, which is incorporated in the body of the applicator78 and connects the connector rod 79 to the free ends of the arms 78a and 78b by dividing in the middle portion 70 into two distinct bundles 73a and 73b which continue respectively inside the arms 78a and 78b outto thefree ends 80a and 80b of the latter, coming to lie flush with the rounded surfaces of these ends so as to enable there the outlet of the luminous rays conveyed bythese bundles of optical fibres.

The support 81 represented in Figures 12a, 12b and 12c is composed of a central portion 82 and two side portions 83a and 83b arranged on opposite sides of the central portion 82 and movable in rotation with respectto it about an axis consisting of a screw 84.

The three portions 82,83a and 83b of the support 81 are preferably realised in the form of pieces moulded from plastics matter, for example, of an ABS synthetic resin, the surface of which is at least partially covered with an electrically conductive layer, for example, a layer of a metal such as silver, chromium of aluminium, formed or applied by any suitable technique such a metallisation undervacuum orthermal atomisation.

Two endonasal probes8a and 8bsimilartothat which is represented in Figure 5, passthrough respective bores 85a and 85b arranged in the side portions 83a and 83b respectively of the support 81. The middle portions 30a and 30b of the probes 8a and 8b are arranged so as to be able to slide againstthe inner walls of the bores 85a and 85b which are likewise covered with an electrically conductive layer connected electrically tothat which coversthe portions 4 GB 2 129 690 A 4 83a and 83b. The conductive layercovering the portion 82 is likewise in electrical contactwiththat which coversthe portions 83a and 83b. Thusthe pulses of electric current or of electro-magnetic waves proceeding from the energy generators of the appar- 70 atus in accordance with the invention, by way of the transmission line 14 (Figure 1) may be transmitted to the rear portion 89 of the central portion 82, wh ich serves forthe electrical connection to the line 14, out to the conductive layers which cover the probes 8a 75 and 8b. Thanks to the rotation of the side portions 83a and 83b as well as to the sliding of the probes 8a and 8b in the bores 85a and 85b the probes 8a and 8b may be placed in position with very g reat accuracy so that theirfront ends are in contact with desired a reas of the 80 endonasal mucous membranes, as represented in Figure 12c. In addition, as shown diagrammatically in dotted lines in this Figure, the probes may be curled due to their flexibility, so as to adoptthe shape of the enclonasalcavurn.

The buccal energy applicator 138 represented in Figures 13a, 13b and 13c has a shape which is partially similarto that of a dental prosthesis. The central portion 139 of it is arranged so as to be able to adopt the shape of the palate as far as the reartermination of 90 the cartilaginous portion of the soft palate. The front portion of it comprises a clip 140 arranged so as to be able to be placed on the incisors, so as to enable the position of the applicator 138 to be fixed. It may in addition be kept in place by the pressure of the tongue. 95 The electrical and electro-magnetic connection of the energy applicator 138with the energy transmission line 14 (Figure 1) is effected by way of a connector portion 141 playing the same part asthe portion 79 of the energy applicator illustrated in Figures 7 to 11, the 100 surface of the applicator 138 being entirely or partially covered with an electrically conductive layer.

The buccal energy applicatorwhich hasjust been described might possibly be equipped with one or more lines fortransmission of luminous signals, 105 consisting, for example, of one or more optical fibres or bundles of optical fibres incorporated into the body of the applicator and lying flush with the surface of it at parts corresponding with zones which areto be treated, in a similar manner to the case of the 110 endonasal applicator illustrated in Figure 7b.

The invention is in no way restricted to the embodiments of the apparatus and of the probe of endonasal or buccal energy applicatorwhich have just been described and it is clearthat numerous other 115 variants and combinations of these embodiments are possible aswill easily appearto specialists.

In exerting effects by means of the apparatus which had just been descirbed, of succesive stimulations by a signal consisting of a series of rectangular d.c. 120 pulses having a pulse width of 2 milliseconds with a frequency of 70 Hertz at a voltage of 0.03 volts, the duration of each series of pulses being 15 seconds, a signal modulated sinusiodally with a frequency of 50 Hertz, of high-frequency a.c. having a frequency of 27 125 Megahertzwith a power of 500 milliwatts (alternating outputvoltage of the modulated signal: 50 volts), the duration of application of this second signal being 25 seconds, and a luminous signal of coherent light consisting of a laser radiation having a wavelength of 130 632.8 nanometres with a power of 2.5 milliwatts, this radiation being modulated at very lowfrequency (1 to 160 Hertz), the duration of application of thisthird signal being 30 seconds, thesethree types of stimulation being linked alternately without intermediate stopping time, for a total duration of 5 to 20 minutes, a combination is obtained of a favourable action upon the nervous equilibrium, especially upon the neurovegetative equilibrium, resulting probablyfrom the combination of stimulations bythe rectangular d.c. electric pulses and bythe high frequency a.c. modulated bythe signal atvery lowfrequency, and of an action which is anti-inflammatory and reconsituent of the cellularfunctions, which may be attributed to the effect of the stimulation bythe radiation from the laseremitter.

Of course the apparatus in accordance with the invention may be employed forthe application of combined stimulations by otherforms of energy,

Claims

especially by stimulations byfluxesfrom electromagnetic of magnetiGwaves of very varying characteristics. Similarlythe aplication of the stimulations may be carried out notonly upon the endonasal mucous membrane orthe buccal mucous membrane but likewise upon any other suitable portion of the organism which isto betreated. CLAIMS

1. An apparatus forthe therapeutic treatment of living tissue by stimulation by means of pulses of electric current and/or by means of electro-magnetic waves, comprising: at leasttwo generators of electromagnetic waves and/or of pulses of electric current, having different characteristics, and meansfor applying the electric current and/orthe electro-magnetic waves outputfrom the generators, in succession or simultaneously to a region of the living tissueto be treated.

2. An apparatus as claimed in claim 1, wherein the generators are operatively connected to control meanswhich can varythe characteristics of the outputsfrom the generators.

3. An apparatus as claimed in claim 2, wherein the generators are operatively connected to the means for applying the electric current and/or electro-magnetic waves by switching means which is controllable to provide the outputs from the generators in succession or simultaneously.

4. An apparatus as claimed in claim 1, 2 or3, wherein one of the generators provides rectangular d.c. pulses having a pulse duration from 0.5 to 5 milliseconds at a voltage from 1 Oto 100 millivolts with a repetition frequencyfrorn 10 to 100 Hertz and generator of alternating current having a frequency from 20 to 100 Megahertz modulated with a frequency of modulation from 2.5 to 6000 Hertz.

5. An apparatus as claimed in anyone of claims 1 to 4, wherein there is a generator of electro-magnetic waves having a wavelength which corresponds with the visible band of the spectrum of electro-magnetic radiation, in the form of abeam of coherent light.

6. An apparatus as claimed in anyof claims I to5, wherein there is a generator of electro-magnetic waves which is a laser emitter which emits abeam of coherent light.

7. An apparatus as claimed in any preceding claim, 1j; GB 2 129 690 A 5 whereinthe meansfor applying the pulses of electric current and/orthe efectro-magnetic waves consists of an endonasal probe having the general shape of a stiletto.

8. An apparatus as claimed in claim 7, wherein the 70 probe consists of one single piece moulded from plastics matter, the outer surface of which is at least partially covered with an electrically conductive layer arranged so as to enable transmission of an electric current between one rear end portion of the probe and 75 a front end portion byway of a middle portion of the probe.

9. An apparatus as claimed in claim 7 or claim 8, wherein the probe has aline fortransmission of luminous signals, which comprises at least one optical 80 fibre incorporated into the body of the probe.

10. An apparatus as claimed in anyone of claims 1 to 6, wherein the means for applying the pulses of electric current and/orthe electro-magnetic waves is an endonasal applicator of fork shape. 85

11. An apparatus as claimed in claim 10, wherein the applicator consists of one single piece moulded from plastics matter, which is composed of a middle portion of two curved arms and a connector rod, the outer surface of which is at least partially covered with 90 an electrically conductive layer enabling transmission of an electric current between the connector rod and the respective free ends of the arms.

12. An apparatus as claimed in claim 11, wherein the applicator has aline fortransmission of luminous 95 signals, which comprises a bundle of optical fibres incorporated into the body of the applicator and divided into two bundles which extend respectively into the arms, the free ends of these two bundles lying flush with the surfaces of the front faces of the free 100 ends of the arms so asto enable the transmission of luminous rays between the rear end of the connector rod and thefrontfaces of the ends of the arms.

13. An apparatus as claimed in anyone of claims 1 to 9, wherein there is a support which enables simultaneous application of two endonasal probes of stiletto shape in the endonasal cavum.

14. An apparatus as claimed in anyone of claims 1 to 6, wherein the means for applying the electric current andlor the electro-mag netic waves consists of a buccal applicator which comprises a central portion arranged so as to be able to adoptthe shape of the palate, a front portion comprising a clip for attachment to the incisors and a portion for connection to the generators of pulses of electric current andlor of electro-magnetic waves.

15. An apparatus as claimed in claim 14, wherein the buccal applicator has at least one line for transmission of luminous signals, which consists of at least one optical fibre incoporated into the body of the applicator and lying flush with the surface of the central portion so as to enable transmission of the luminous signals between the connector portion and the surface of the central portion.

16. An endonasal probe which forms in the apparatus, as in claim 1, the means for applying the pulses of electric current andlor the electro-magnetic waves to the endonasal mucous membrane of a patient, comprising a middle portion which consists of an electrically insulating sheath surrounding at least one line fortransmission of electrical signals and at least one linefor transmission of electro-magnetic waves intheform of a beam of coherentlight, a front portion which comprises an electrically conductive tubular piece connected to afirst end of the linefor transmission of electrical signals and having passing through it a first end of the line fortransmission of the beam of coherent light and a rounded tip of matter which istransparent ortranslucentto the radiation transmitted bythe line fortransmission of coherent light, thistubular piece exhibiting an annularwall which remains bare and liesflush between thewall of the insulating sheath and that of the tip, and a rear portion which comprises an electrically conductive tubular piece connected to the other end of the line for transmission of electrical signals and having passing through it partiallythe other end of the linefor transmission of coherent light, this latter line terminating inside a central bore in the tubular piece in a plane cross-section perpendicularto its axieto enable an optical jointto beformed with another linefor transmission of coherent light.

17. An apparatus for the therapeutic treatment of living tissue by stimulation by means of pulses of electric current andlor by means of electro-magnetic waves, substantially as herein described with reference to Figure 1, and Figures 2 to 4, Figures 5 and 6, Figures 7 to 11, Figure 12, or Figure 13 of the drawings.

18. A probe which forms the means for applying electric current and/orthe electro-magnetic waves output from the generators of an apparatus for the therapeutic treatment of living tissue by stimulation by means of pulses of electric current andlor by means of electro-magnetic waves, substantially as herein described with reference to Figures 2 to 4, Figures 5 and 6 ' Figures 7 to 11, Figure 12 or Figure 13 of the drawings.

Printed for Her Majesty's Stationery Office byTheTweeddale Press Ltd., Berwick-upon-Tweed, 1984. Published atthe PatentOffice, 25 Southampton Buildings, London WC2A lAY, from which copies may be obtained.