Note: Descriptions are shown in the official language in which they were submitted.
13~819~
1 BACKGROUND OF THE INVENTION
The present invention relates to a surgical
system, and more particularly, it relates to an
excrement treating system which can effectively and
safely be used or a patient who can not or almost not
evacuate bowels by himself so as to crush the excrement
in his rectum by mechanical vibration due to ultrasonic
energy and can extract it outside his body~
Recently, since the man's span of life is
prolonged more and more, the number of old folks who are
always in the bed has been remarkably increased. For
them, it is very important to successfully treat their
excrements. Up to date, however, in order to solve such
problem, although urine drawers have been proposed,
other effective ~eans for treating the excrement have
not yet been developed, and, therefore, normally, a
diaper has still been used. When using the diaper, not
only the patient who wears the diaper is subjected to
considerable spiritual suffering, but also a person who
nurses or attends to the diapered patient is also
subjected to remarkable physical and mental suffering
since he must frequently exchange the diapers.
Accordingly, the treatment of the excrement for the
patient who is always in the bed is still now an
important problem to be solved.
-- 1 --
13~8~9'~
In order to treat the excrement, normally, a
laxative, a clyster, an anal stimulus and the like have
been used to promote the evacuation of the bowels or
excrement according to the condition of constipation of
the patient; on the other hand, as to the patient who
can not or almost not evacuate the bowels by himself, a
high pressure clyster, a removal of excrement, a
suppository or the combination thereof has been used.
The "patient who can not or almost not
evacuate the bowels by himself 1I means a person who
cannot evacuate the bowels without help of other person.
For such a patient, the above-mentioned means (high
pressure clyster and the like) have been adopted to;
but, such means have the following drawbacks:
(1) In the high pressure clyster, a catheter and a
large-sized syringe are used so that a medical fluid is
injected into the patient's rectum through his anus.
However, in this case, there was no practical exclusive
instruments including the catheters used for such high
pressure clyster. Further, when the medical fluid i5
injected into the rectum, there are problems that the
air is introduced into the rectum together with the
medical fluid and/or the medical fluid escapes outside
the body, and that the wall of the rectum is damaged by
an injector inserted ;nto the rectum. In addition, if
the patient has hard feces, the high pressure clyster
cannot demonstrate its ability effectively, with the
result that the patient cannot fully evacuate the bowels
~31~
or it takes a long time for the patient to evacuate the
bowels, whereby the patient will be considerable
physical suffering.
(2) In the removal of the excrement, a doctor or
surgeon wears a sanitary glove on his hand, and he
inserts his finger into the patient's rectum directly to
scrape out the excrement outside the patient's body.
However, if the patient has hard feces, it is difficult
for the doctor to insert his fingers into the patient's
rectum. Further, it is feared that a mucous membrane on
the patient's rectum is damaged by the doctor's fingers
inserted in the rectum. In addition, when this method
is used, the patient often feels ashamed, and the doctor
(or a person who carries out this method) feels hatred
due to a bad odor given out from the excrement.
(3) As to the suppository, while it is useful for
a light constipated person or patient, it is useless for
the patient who has hard feces.
In this way, the constipation cannot be
relieved completely by the conventional excrement
treating methods. Particularly, when the patient has
hard feces, if the conventional excrement treating
methods mentioned above are usedr not only the patient
will be subjected to considerable physical and mental
suffering, but also it is feared that the mucous
membrane on the patient's rectum is damaged resulting in
hemorrhage and/or contagion~ In addition, for the
doctor or a person who treats the patient's excrement,
-- 3 --
~3~
it takes a long time to carry out the excrement treating
operation, and he suffers from the bad odor or smell
derived from the patient's excrement.
In order to eliminate the above-mentioned
conventional drawbacks, an improved excrement treating
apparatus, as disclosed in the Japanese Patent Laid-Open
No. 61-293472 and as described hereinbelow, has been
proposed. That is to say, in this improved apparatus,
which belongs to the high pressure clyster technique, a
slidable guide pipe is arranged into an outer pipe to be
inserted into the patient's rectum through his anus. In
operation, at first, the guide pipe is extended into the
patient's rectum beyond the outer pipe, and then the
medical fluid is injected into the patient's rectum;
after the excxement is softened, the guide pipe is
retracted and, at the same time, an free end of the
outer pipe is opened, thereby extracting the softened
excrement from the patient's rectum into an excrement
reservoir tank through the opened end of the outer pipe
by means of an appropriate vacuum pump~ This improved
conventional apparatus aims to treat the excrement in a
closed excrement treating ambience. However, since the
patient's excrement is softened only by the medical
fluid in this improved apparatus, this apparatus could
not demonstrate its ability effectively for the patient
who had hard feces.
:~ ~ 1 8 1 ~ ~l 257ll-525
SUMMARY OF THE INVENTION
An object of the present inventi.on is to provide an
excrement treating system which can effectively and safely crush
excrement in a patient's rectum by mechanical vibration due to
ultrasonic energy and can extract it outside his body, in
consideration of the fact that, for the patient who has hard
feces, when using the conventional methods such as the clyster,
removal of excrement and the like, the patient and/or the doctor
or the person who nurses the patient are subjected to the physical
and mental suffering for a long time.
The present invention provides an excretions treatiny
apparatus for evacuatiny excremen-ts in a rectum comprising an
insert accommodatiny a horn which is mechanically vibrated by
ultrasonic oscillation means, irriyation means for injectiny
cleaning liquid into the rectum, and means for excreting and
removiny excrements which has been crushed and emulsified,
wherein said irrigation means includes a preheater for previously
heating said cleaniny liquid.
The present invention also provides an excretions
treatiny apparatus for excrements in a rectum said apparatus
comprisiny: an insert including a horn capable of beiny
mechanically vibrated by ultrasonic oscillation means and a
protective cover disposed around said horn to define therebetween
a tubular space; a suction passage provided within said horn,
which opens at one end of said horn; an insulating wall di.sposed
in an opening portion in said suction passage and provided with
one or more through apertures; irrigation means for injecting
1 3 ~. 8 1 ~ ~ 257ll-525
cleaning liquicl into the rectum, said irrigation means
communicated with said tubular space through which the eleaning
liquid flows; means for excreting and removing excrements which
has been crushed and emulsifiedt said excreting and removing
means communieated with said suction passage.
- 5a -
~31~L 94
BRIEF DESCRIPTION OF 'rHE DRAWINGS
Fig. 1 is a whole constructural view of an
excrement treating system according to a preferred
embodiment of the present invention;
Fig. 2 .is an enlargedl sectional view of an
insert to be inserted into the rectum;
Fig. 3 is a schematic: side view of an
ultrasonic transducer incorporated into the insert;
Fig. 4A is a side view of the horn;
Fig. 4B i5 a sectional view of the horn end
taken along the lin0 B-B in Fig. 4A;
Fig. 5A is a side view of the horn according
to a ~urther embodiment;
Fig. 5B is a ~ectional view of the horn end
taken along the line B-B in Fig. SA;
Fig. 6A is a side view of the horn according
to the other embodiment;
Fig. 6B is a sectional view of the horn end
taken along the line B-B in Fig. 6A;
Fig. 7A is a side view of the horn according
to another embodiment;
Fig. 7B is a ragmentary sectional view of the
horn end taken along the line B-B in Fig. 7A;
Fig. 8A is a side view of the horn according
to the other embodiment;
- 6 -
~.3~$1'~
1Fig. 8B is a fragmentary sectional view of the
horn end taken along the line B-B in Fig. 8A;
Figs. ~ to 11 show end portions of the horns
according to further embodiments, respectively;
5Fig. 12A is a fragmentary sectional side view
of the protector cover and horn;
Fig. 12B is a sectional view taken along the
line B-B in Fig. 12A;
Fig. 13A is a sectional side view of a
protector cover according to another embodiment:
Fig. 13B is a sectional view taken along the
line B-B in Fig. 13A;
Fig. 14A is a sectional side view of the
cover;
15Fig. 14B is a sectional view of the cover end
taken along the line B-B in Fig. 14A:
Fig. 15A is a sectional side view of the horn
and cover; and
Fig. l5B is a sectional view of the ends of
the horn and cover taken along line B-B in Fig. 15A.
DETP~ILED EXPLANATION OF THE PREFERRED EMBODIMENTS
~ he present invention will now be explained in
connection with a preferred embodiment with referring to
the accompanying drawings. Referring to Fig. 1, the
excrement treating system mainly comprises an ultrasonic
generation section, an irrigation section and a suction
section.
~ 3 ~
1 First of all, the ultrasonic generation
section will be explained. An insert 1 includes an
transducer 3 of electrostrictive type or magnetostric-
tive type incorporated therein, and a horn 2 constitut-
ing an end of the insert 1, which i5 mechanic~lly
vibrated or oscillated by ultrasonic energy. An
oscillator 4 is an ultrasonic oscillator which can
supply high frequency electric power of ultrasonic area
to the transducer 3 through a cable 5 ~Fig. 3).
Next, the irrigation section will be
explained. An irrigation pump 6 is of roller-type which
is connected to the insert 1 and a cleaning liquid
container 7 accommodating therein a cleaning liquid such
as a clyster liquid, physiological salt solution and the
like that is harmless to a living body and isotonic with
the liquid in the living bodyO The irrigation pump 6
can inject the cleaning liquid from the container 7 into
the rectum through the insert 1. A pre-heater 8
including a heater therein heats the cleaning liquid to
be injected in the rectum up to an temperature near that
of the rectum, for example, 35C - 42C~ The pre-heater
8 may be installed in any position between the insert 1
and the cleaning liquid container 7. It preferably is
installed between the cleaning liquid container 7 and
the irrigation pump 6 since the pre-heater 8 is not
subjected to a liquid feeding pressure from the
irrigation pump 6. Further, when the cleaning liquid
container 7 is positioned in a higher position
-- 8
1 than the insert 1 by a predetermined level, for example,
by 50 cm - 100 cm, since the cleaning liquid is
introduced into the rectum by potential energy thereof,
the irrigation pump 6 can be omitted. An irrigation
tube 9 for conveying the cleaning liquid may be made of
appropriate elastic material such as soft vinyl chloride
resin, silicone resin and the like. However, the
irrigation tube 9 can be made of any other re~ins, if
they are not deteriorated and decomposed by the cleaning
liquid.
Next, the suction section will be explained.
A reservoir container 10 receives and stores the crushed
excrement such as feces crushed by the horn 2 at the end
of the insert 1, through a suction tube 11. The
reservoir container 10 is arranged between the insert 1
and a suction pump 12~ and includes therein plastic
container, a glass vase or bottle, or a disposable
plastic bag therein. The container 10 can endure or
resist the negative suction pressure of 0 mmHg - 760
mmHg derived from the suction pump 12. Further the
suction tube 11 may be made of appropriate flexible
material such as soft vinyl chloride resin, silicone
resin and the like, which can endure the negative
suction pressure derived from the suction pump 12.
In Fig. 2, the horn 2 is covered by an outer
protector cover 13 to which an irrigation nipple 14 for
introducing the cleaning liquid into the horn is
attached by an appropriate means such as screws,
~318~9~
1 adhesive and the like. The irrigation tube 9 shown in
Fig. 1 is conn~cted to the irrigation nipple 14.
suction nipple 17 extends through a lid 16 attached to
the rear end of an insert body 15, and is connected to
the transducer 3 incorporated in the body 15a The
suction nipple 17 is also connected to the suction tube
11 (FigO 1) to remove the excrement crushed by the
ultrasonic mechanical vibration by means of the horn 2.
In addition, the cable 5 passes through the lid 16 and
is connected to the transducer 3 in the insert 1 to
supply the high-frequency electric power to the
transducer. The cable 5 is also connected to the
oscillator 4 shown in Fig. 1.
The protector cover 13 is provided for
preventing the horn 2 which is vibrated by the ultra-
sonic energy from contacting the anus or the wall of the
rectum, and may be made of any material ~uch as metal,
plastics, rubber or the like. However, preferably, it
is made of plastics, synthetic rubber, natuxal rubber or
combination thereof so that it is smoothly inserted in
the anus and that the patient does not feel cold when
the insert 1 is inserted in the rectum. And, if neces-
sary, when the insert 1 is inserted into the rectum, a
lubricant such as jelly may be applied around the
protector cover 13. A length of a straight portion 27
of the protector cover 13 is selected enough to crush
the excrement from the anus to the rectum, and thus, is
normally about 5 cm - 12 cm, and is, preferably, 10 cm.
-- 10 --
~3181 ~
1 O-ring 18 is arranged on an inner peripheral surface of
the protector cover 13 in one or more positions
rearwardly of the irri~ation nipple 14 ~i.e., at the
side where the transducer 3 is positioned) to prevent
that the cleaning liquid flows into the transducer 3
through an annular passage formed between the horn 2 and
the protector cover 13. The protector cover 13 is
connected to the insert body 15 by an appropriate means
such as an adhesive, screw connection, fit connection
and the like. However, in consideration of the
replacement of the horn, the screw connection or fit
connection is desirable.
The insert body 15 incorporating the trans-
ducer 3 therein is desirably made of material which is
non-corrosive against the medical liquid, is light in
weight and has a higher mechanical strength, euch as
aluminum alloy, polysulfone resin, polyether sulfone
resin, polyimide resin and the like. Preferably, poly-
sulfone resin is used. O-ring 19 is arranged on an
inner peripheral surface of the insert body 15 in one or
more positions forwardly of a fixing plate 20 of the
transducer 3 ~i.e~, at the side where the horn 2 is
positioned~ to hold the transducer 3. The lid 16 may be
made of the same material as that of the insert body 15.
However, as stated above, since the lid 16 is provided
with openings for passing through the suction nipple 17
and the cable 5, it is feared that the water such as the
cleaning liquid enters into the insert body 15 through
-- 11 --
~ 3~81 ~
1 the clearances between the openings and the suction
nipple 17 and/or cable 5. Accordingly/ to prevent the
penetration of the water, such clearances must be sealed
by an adhesive and the like. Thus, the lid 16 is pre-
ferably made of polysulfone resin and the like which hasgood adhesion.
Since the irrigation nipple 14 and the suction
nipple 17 are frequently connected to and disconnected
from the irrigation tube 9 and the suction tube 11,
these nipples may be made of material which has good
strength and is non-corrosive, such as stainless steel
group metal, polysulfone resin and the like.
Fig. 3 shows an example of an ultrasonic
vibration portion (incorporated into the insert 1)
constituted by the electrostrictive type transducer. A
front plate 21 made of duralumin or titanium alloy is
arranged forwardly of the transducer 3 made of PZT
(plumbeous zirconate titanate) (i.e., at the side where
the horn 2 is positioned) and a backing plate 22 made of
duralumin or titanium alloy is arranged rearwardly of
the transducer 3 (i.e., at the side where the suction
nipple 27 is positioned), so that the unit is constitut-
ed as a so-called bolt fastening langevin transducer
(BLT) where the transducer is fastened by bolts (not
shown) through the front and backing plates 21 and 22.
The fixing plate 2G having an outer diameter larger
than that of the front plate 21 is provided on an end
surface of the front plate 21 facing the transducer 3,
i. 3 ~
1 whereby the transducer unit is fixed within the insert
body 15 through a flange portion of the fixing plate 20
by means of an adhesive, screws and the like.
A tubular vibrator nipple 23 is provided at
the rear end of the backing plate 22. The nipple 23 is
connected to the suction nipple 17 by means of a connec-
tion tube 24 made of material having good flexibility
and heat resistance, such as fluororubber, silicone
rubber and the like. The horn 2 rnay be made of non-
corrosive metal having good tension resistance feature,such as duralumin or titanium alloy and the like. Pre-
ferably, the horn 2 has a length substantially equal to
integral multiple of 1/2 of wavelength of ultrasonics.
A suction passage 25 is provided to pass through the
horn 2, front plate 21, transducer 3, backing plate 22,
transducer nipple 23 and suction nipple 17. The trans-
ducer 3 has a plurality of electrodes 26 to which the
high-frequency electric power generated by the oscil-
lator 4 is supplied through the cable S, thereby creat-
ing axial ultrasonic vibration in the transducer 3,which ultrasonic vibration is transmitted to the horn 2.
Next, an operation for crushing the excrement
in the rectum and extracting it by the suction force
outside the body will be explained with reference to
Figs. 1 to 3. At first, the straight portion 27 of the
protector cover 13 of the insert 1 is inserted into the
rectum through the anus by a proper extent, and then the
cleaning liquid such as the physiological salt solution
- 13
1318~
1 i5 introduced into the rectum through the irrigation
nipple 14, and at the same time, the tip of the horn 2
contacted to the excrement is subjected to the axial
ultrasonic vibration by supplying the high-frequency
electric power from the oscillator 4 to the transducer
3, thereby initiating the crushing operation for the
excrement. The excrement with the cleaning liquid is
emulsified with a cabitation phenomenon. The emulsified
excrement is discharged into the reservoir container 10
through the suction passage 25 in the horn 2, suction
nipple 17 and suction tube 11, by the action of the
negative suction pressure generated by the SUCtiOII pump
12, and stored therein. As the excrement in the rectum
is crushed and removed, the rectum contracts gradually;
thus, the excrement is always supplied to the tip of the
horn 2 due to this contraction movement of the rectum,
thereby crushing and removing all excrement in the
rectum.
The frequency of the ultrasonics generated by
the oscillator 4 is in the order of 17 kHz - 40 kHz, and
preferably 18 - 23 kHz, in consideration of the fact
that the straight portion 27 of the protector cover 13
inserted into the rectum through the anus can be
lengthened and that amplitude of the vibration of the
horn can be increased. Further, the electric power for
generating the ultrasonics may be in the range of 100 W
- 1 XW, and preferably, is 200 W - 500 W. In order to
effectively crush the excrement, the amplitude of the
- 14 -
1 3~19~
vibration of the horn 2 may be 40 ~m - 300 ~m, and
preferably 100 ~Im - 200 ~m.
Next, other embodiments of the horn will be
explained with reference to Figs. 4A to 11. In Figs. 4A
and 4B, a horn 28 has an irrigation feeding passage 29
and a suction passage 25 formed therein. The cleaning
liquid is directly injected onto the excrement in the
rectum from an irrigation nipple connecting port 30
formed in the rear end portion of the horn 28, through
the passage 29 and the tip of the horn 28, whereas the
excrement crushed by the ultrasonic vibration movement
of the horn 28 is removed outside the rectum by the
suction force, through the suction passage in the horn
28, a suction nipple connecting port 31 and the suction
tube (not shown). The suction nipple connecting port 31
may be formed in a threaded portion 32 of the horn 28.
nith this construction, since the cleaning liquid can be
introduced into the excrement directly from the tip of
the horn 28 inserted into the excrement, the speed of
the emulsion of the excrement i5 remarkably increased.
Figs. 5A to 8B show other embodiments of a
working tip 53 of the horn 51. With these embodiment, a
contacting area of the working tip 53 is increased to
improve the working efficiency, and the jamming of the
crushed excrement in the suction passage 54 are effec-
tively prevented. In the embodiment shown in Figs. 5A,
5B, the suction passage 54 extends through the horn 51,
and a shield wall 55 having a single hole or a plurality
131~
1 of small holes 56 is formed on the working tip 53 of the
horn 51. The shield wall 55 has a thickness of 0.5 mm -
25 mm, preerably 1 mm - 10 m. With such construction,
the contacting area of the working tip 53 is increased
S to improve the working efficiency considerably, and the
jamming in the horn 51 is effectively prevented since
the small holes 56 on the working tip i5 smaller than
the suction passage 54. Figs. 6A, 6B show an example of
the horn in which the suction passage 54 is opened to a
rear side surface of the horn 51. This suction passage
54 is connected to a metal tube, plastic tube or the
like arranged alon~ the side of ultra~onic operating
instruments through the medium of a nipple and the like
(not shown), and the crushed and emulsified excrement~is
directed to the horn and then is discharged therefrom.
A configuration of the small hole or holes 56
is not lim~ted to a circular configuration, but may be
an oval configuration, as shown in Figs. 7A, 7B.
Further, in place of the slngle or plural small holes, a
star-shaped hole 57 as shown in Fig. 8A or a polygonal
hole may be provided, by which the same technical
effects as the previous ones can be obtained.
Further, Figs. 9 to 11 show the working tips
of the horn~ In this case, it is devised that, when the
horn is inserted into the rectum through the anus, the
wall of the anus is not damaged by the horn. The tip 33
of the horn may be formed with an "R" or an oval arc as
- 16 -
~31~
1 shown in Fig. 9; or the tip 34 may be formed with a
tapered configuration as shown in Fig. 10; or the tip 35
may be formed with the combination of the "R" and the
taper, as shown in Fig. 11. With these construction,
the horn can be easy to be inserted into the anus
without damaging the same.
Incidentally, the horn 2, 28, 51 may be made
of metal such as titanium alloy, aluminum alloy, or
stainless steel, which is anti-corrosive and can re~ist
the ultrasonic vibration of the order of 1000 m/see -
6000 m/sec. In addition, carbon fiber reinforced metal
obtained by mixing the metal such as aluminum and the
carbon fibers, carbon fiber reinforced plastic obtained
by mixing the plastic such as polysulfone and the carbon
fibers, or graphite can be used to constitute the horn.
Next, Figs. 12A, 12B show anothex example of
the positional relation between the horn and the
protector cover~ In this example, the protector cover
36 is protruded from the horn 37 forwardly, thereby
preventing the tip of the horn 37 being mechanically
vibrated due to the ultrasonics from contacting with the
wall of the rectum directly. In this case, the cleaning
liquid is injected into the rectum from an end opening
39 of the protector cover 36 through an annular passage
38 formed between the horn 37 and the protector cover
36; on the other hand, the excrement crushed and emulsi-
fied by the ultrasonic vibration of the tip sf the horn
37 is discharged through the suction passage 25 of the
~ 3 ~
1 horn 37 outside the body. The tip of the protector
cover 36 with the opening 39 is formed with an "R" and
in a tapexed configuration 40, as shown in Fig. 12A, so
that the protector cover 36 can be easily inserted into
the anus. Further, a distance between the end face of
~he protector cover 36 and that of the horn 37 may be
selected to 0.5 mm - 10 mm, preferably 1 mm - 5 mm so
that the cleaning liquid is prevented from being sucked
directly into the suction pas~age 25.
Figs. 13A to 15~ show other protector covers.
In Figs. 13A, 13B, the protector cover 41 has a spiral
groove 42 formed in an inner surface o~ the cover.
Further, the protector cover 43 may have axial ælits 44
formed in an inner surface of the cover as shown in Fig.
14B. Figs. 15A, 15B show a condition that the horn 37
is covered by the protector cover 41 of Fiy. 13A.
The number of the spiral grooves formed in the
protector cover 41 is not limited, but may be two or
three, in consideration of the fact that the grooves can
be easily worked and that the cleaning liquid from the
tip 45 of the cover can be effectively injected.
Further, the configurations and the number of the axial
slits 44 of the protector cover 43 are also not limited,
but, preferably, the plural slits are arranged in the
start-shaped configuration in cross-section, as shown in
Fig. 14B. The minimum inner diameter of the protector
cover having such grooves 42 or slits 44 may be so
selected that, as shown in Fig. 15A, the horn 37 is
- 18 - .
~ 3 ~
1 inserted into the protector cover 41 or 43, the outer
surface of straight portion 46 of the horn 37 is
slidably engaged by the inner surface of the c~ver~ In
this arrangementl the irrigation nipple (not shown) is
attached to an irrigation nipple fixing threaded hole 47
or 48. Since the cleaning liquid supplied from the
irrigation nipple flows through a space defined hy the
horn 37 and the grooves 42 or slits 44 and is injected
from the tip 45 or 49 toward the excrement, the horn 37
heated due to the mechanical vibration (by the ultra-
sonics) of the horn itself can be effectively cooled,
and the deviation of the protector cover 41 or 43 from
the center of the horn 37 can also be prevented when the
cover is inserted into the anus. It comes within the
category of the present invention that above mentioned
suction passage and annular passage of cleaning liquid
can be used in the opposite way.
As mentioned above, according to the present
invention, the excrement in the rectum can be crushed
and emulsified and discharged effectively more than the
conventional methods such as the clyster, removal of
excrement, suppository or the like. Further, even the
hard excrement or feces which was difficult to remove by
the conventional methods can also be crushed easily for
a short time. In addition, when tAe shield wall is
provided on the tip of the horn, since the contacting
area of the horn with the excrement, the crushing
efficiency is still improved to reduce the treating
-- 19 --
1 3 ~
1 time, and further, since the small hole or holes formed
in the shield wall is smaller than the suction passage
in the horn, the jamming of the crushed excrement in the
horn is effectively prevented. Further, with the
excrement treating system according to the present
invention, the treating operating can be performed
safely and comfortably without damaging the rectum and
generating the bad smell and without suffering
physically and mentally for the patient and/or the
nurse. Accordingly the present invention provides an
excellent industrial and medical excrement treating
system.
- 20 -
