Anesthetic concentration adjusting device

Abstract

The invention provides an anesthetic concentration adjusting device, and belongs to the technical field of anesthetic adjustment. Comprising a machine body, an inner container, a volatilization tank, a pushing mechanism and a concentration adjusting mechanism, the volatilization tank is installed on the machine body for use, the concentration adjusting mechanism comprises an air inlet pipe, the air inlet pipe is installed on the volatilization tank, one end of the air inlet pipe extends into the inner container, an elastic piece is installed in the air inlet pipe, and the pushing mechanism is installed on the inner container. A sealing plug is installed on the elastic piece and movably installed in the air inlet pipe. The air inlet pipe is installed in the inner container, the elastic piece and the sealing plug are matched to seal the air inlet pipe, the pulling block moves in the inner container, part of the elastic piece can be extruded, the sealing plug blocks the air inlet pipe, meanwhile, the other part of the elastic piece can rebound, and the sealing plug is separated from the interior of the air inlet pipe; the amount of oxygen conveyed into the inner container can be controlled, and then the concentration of anesthetic inhaled by a patient can be changed.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of anesthetic concentration adjustment, and particularly relates to an anesthetic concentration adjustment device. BACKGROUND

[0002] When a large operation such as a heart operation, a hepatobiliary operation or a brain operation is performed, an anesthetic is given to a patient through intravenous infusion or inhalation. In order to make the concentration of the anesthetic appropriate, an anesthetic concentration adjustment device is used. The device can adjust the concentration of the anesthetic, so that the patient can maintain an appropriate anesthetic depth during the operation, and the operation can be performed smoothly, and the risk caused by excessive or insufficient anesthesia can be reduced.

[0003] At present, the concentration of the anesthetic is adjusted by controlling the control knob of a volatile tank and controlling the fresh air intake, so as to adjust the concentration of the anesthetic entering the patient's body. Since the air inlet hole of the volatile tank is limited, when the concentration of the anesthetic needs to be diluted, the air inlet hole is completely opened, and the anesthetic concentration cannot be quickly diluted. The gas needs to be stored for a certain period of time before being delivered to the patient's position, which wastes time and reduces work efficiency. Therefore, the present application provides an anesthetic concentration adjustment device to solve the problem. SUMMARY

[0004] In order to overcome the above problems or at least partially solve the above problems, the present application provides an anesthetic concentration adjustment device.

[0005] The present application is implemented as follows: The present application provides an anesthetic concentration adjustment device, which comprises a body, an inner container, a volatile tank and a concentration adjustment mechanism, and the volatile tank is installed on the body for use. The concentration adjustment mechanism comprises: An air inlet pipe is installed on the volatile tank, and one end of the air inlet pipe extends into the inside of the inner container. An elastic member is installed in the inside of the air inlet pipe, and a sealing plug is installed on the elastic member, and the sealing plug is movably installed in the inside of the air inlet pipe. A pulling block is movably installed in the inside of the volatile tank, and the pulling block is controlled to slide along the outer surface of the elastic member. A pushing mechanism is arranged in the inside of the inner container, and is used for shaking the anesthetic to generate gas.

[0006] In a preferred scheme, the pushing mechanism comprises a pushing rod, a round rod and a limiting column, the limiting column is installed on the inner wall of the volatile tank, a rubber sleeve is arranged on the outer end of the limiting column, and the rubber sleeve is used for limiting the inner container, and the outer surface of the inner container is 1cm away from the inner wall of the volatile tank.

[0007] In a preferred scheme, the inner bottom of the volatile tank is also provided with a rotatable round rod, and the inner container is placed on the round rod, and the round rod is embedded in the position of the inner bottom of the inner container.

[0008] In a preferred scheme, the inner container is provided with a connecting rod, one end of the connecting rod is stably connected with a pulling block, the outer side surface of the pulling block is rotatably connected with a pushing rod, one end of the pushing rod is connected with the inner wall of the inner container, the inner wall of the inner container is provided with a sliding groove, and a sliding block is arranged in the sliding groove, and one end of the pushing rod is movably connected with the sliding block.

[0009] In a preferred scheme, the upper end of the connecting rod is movably mounted with a lifting rod, the lifting rod extends out of the inner container and the volatile tank, the connection positions of the inner container and the volatile tank with the lifting rod are all provided with through holes with a diameter greater than 2 cm of the lifting rod, and sealing rubber cylinders are arranged at the connection positions of the inner container and the volatile tank with the lifting rod, and the outer end of the lifting rod is stably mounted with a protective cover.

[0010] In a preferred scheme, the bottom of the pulling block is stably connected with a round plate, the bottom of the round plate is mounted with a hollow warehouse, one side of the outer surface of the hollow warehouse is communicated with an air outlet pipe, a one-way valve is arranged on the air outlet pipe, and a plurality of air inlet holes are formed in the bottom of the hollow warehouse.

[0011] In a preferred scheme, the elastic member comprises a first damping rod, a movable rod and a positioning seat, the positioning seat is stably mounted on the inner wall of the inner container and corresponds to the position of the air inlet pipe, the movable rod is slidably mounted in the positioning seat, and the positioning seat and the movable rod are connected through a spring.

[0012] In a preferred scheme, the inner wall of the inner container is also stably mounted with a first damping rod, the telescopic end of the first damping rod is mounted at the position of the inner side surface of the movable rod, and a sealing plug is mounted at the position of the inner side surface of the movable rod, for controlling the movement of the sealing plug in the air inlet pipe.

[0013] In a preferred scheme, the top of the volatile tank is mounted with a second damping rod, the telescopic end of the second damping rod is connected with the protective cover, and a medicine inlet warehouse is mounted on the outer surface of the volatile tank, a conveying pipe is mounted in the medicine inlet warehouse, and one end of the conveying pipe extends into the inner container.

[0014] In a preferred scheme, the machine body is also mounted with a display, a drawer is arranged at the bottom end of the machine body, and an air bag and an air outlet pipe are arranged at the position of the outer surface of the machine body.

[0015] The anesthetic concentration adjusting device has the following beneficial effects. 1. By installing the air inlet pipe in the inner container, and using the elastic element and the sealing plug to cooperate, the air inlet pipe is sealed, and the pulling block is movably installed in the inner container, and by moving the pulling block in the inner container, part of the elastic element can be extruded, so that the sealing plug blocks the air inlet pipe, and the other part of the elastic element will rebound, so that the sealing plug is separated from the inside of the air inlet pipe, the amount of oxygen delivered to the inner container can be controlled, and by adjusting the oxygen content in the inner container, the concentration of the anesthetic inhaled by the patient can be changed.

[0016] 2. By installing the push rod on the pulling block, the push rod is connected with the inner wall of the inner container through the sliding block, and the push rod moves downward at the same time as the pulling block moves downward, and when the sliding block on one end of the push rod abuts against the inner wall of the sliding groove, the pulling block continues to move downward, which pushes the inner container to rotate through the push rod, so that the anesthetic in the inner container flows, and the anesthetic is quickly heated to generate more anesthetic gas, thereby increasing the concentration of the anesthetic inhaled by the patient. BRIEF DESCRIPTION OF DRAWINGS

[0017] In order to more clearly illustrate the technical solutions of the embodiments of the present application, the following will briefly introduce the drawings needed to be used in the embodiments, and it should be understood that the following drawings only show some embodiments of the present application, and therefore should not be regarded as a limitation on the scope, and for those skilled in the art, other related drawings can also be obtained without creative labor.

[0018] Figure 1 is a structural schematic diagram of the present application; Figure 2 is a protective cover structure schematic diagram of the present application; Figure 3 is a volatile tank internal structure schematic diagram of the present application; Figure 4 is a rubber sleeve structure schematic diagram of the present application; Figure 5 is an inner container internal structure schematic diagram of the present application; Figure 6 is a hollow bin structure schematic diagram of the present application; Figure 7 is an elastic element structure schematic diagram of the present application; Figure 8 is a limiting column position schematic diagram of the present application.

[0019] In the diagram: 1. Body; 2. Vaporizer; 3. Concentration adjustment mechanism; 31. Air inlet pipe; 32. Elastic component; 321. Sealing plug; 33. Pulling block; 4. Pushing mechanism; 41. Push rod; 42. Round rod; 43. Limiting post; 5. Inner liner; 6. Connecting rod; 7. Lifting rod; 8. Through hole; 9. Sealing rubber cylinder; 10. Protective cover; 11. Round plate; 12. Hollow chamber; 13. Air outlet pipe; 14. Air inlet; 15. Spring; 16. Second damping rod; 17. Drug inlet chamber; 18. Delivery pipe; 19. Display; 20. Drawer; 21. Airbag; 22. Air outlet pipe; 3201. First damping rod; 3202. Movable rod; 3203. Positioning seat. Detailed Implementation

[0020] To make the objectives, technical solutions, and advantages of the embodiments of the present invention clearer, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention. Example

[0021] Reference Figures 1-8 This invention provides a technical solution: an anesthetic drug concentration regulating device, comprising a body 1, an inner liner 5, a vaporizer 2, a pushing mechanism 4, and a concentration regulating mechanism 3. The vaporizer 2 is mounted on the body 1. The concentration regulating mechanism 3 includes an air inlet pipe 31, which is mounted on the vaporizer 2 and has one end extending into the inner liner 5. An elastic element 32 is mounted inside the air inlet pipe 31, and a sealing plug 321 is installed on the elastic element 32. The sealing plug 321 is movably mounted inside the air inlet pipe 31. A pulling block 33 is movably mounted inside the vaporizer 2 and controls the pulling block 33 to slide along the outer surface of the elastic element 32. The pushing mechanism 4 is located inside the inner liner 5 and is used to shake the anesthetic drug to generate gas.

[0022] In a preferred embodiment, the pushing mechanism 4 includes a pushing rod 41, a round rod 42, and a limiting post 43. The limiting post 43 is installed on the inner wall of the evaporation tank 2, and a rubber sleeve is adjusted at the outer end of the limiting post 43 to limit the inner liner 5. The outer surface of the inner liner 5 is 1 cm away from the inner wall of the evaporation tank 2. A rotatable round rod 42 is also installed at the bottom of the evaporation tank 2, and the inner liner 5 is placed on the round rod 42. The round rod 42 is embedded in the bottom of the inner liner 5. A connecting rod 6 is provided inside the inner liner 5. One end of the connecting rod 6 is stably connected to the pulling block 33. The outer side of the pulling block 33 is rotatably connected to the pushing rod 41. One end of the pushing rod 41 is connected to the inner wall of the inner liner 5. A sliding groove is provided on the inner wall of the inner liner 5, and a slider is provided inside the sliding groove. One end of the pushing rod 41 is movably connected to the slider.

[0023] When this device is in use, in order to control the generation of more vapor in the anesthetic agent inside the inner liner 5 and increase the concentration of the anesthetic agent, when the patient needs to inhale a higher concentration of anesthetic agent, the connecting rod 6 will be controlled to move downward, which will drive the pulling block 33, the circular plate 11 and the hollow chamber 12 installed at the bottom of the circular plate 11 to move downward together. During the descent, the corresponding sealing plug 321 is squeezed into the air inlet pipe 31 by the pulling block 33, sealing the air inlet pipe 31 and preventing it from delivering oxygen into the inner liner 5. At the same time, the downward movement of the pulling block 33 will also drive the push rod 41 to move downward.

[0024] One end of the push rod 41 moves downward together with the slider. When the slider abuts against the inner wall of the chute, the pull block 33 continues to move downward, which pushes the inner liner 5 through the push rod 41, causing the inner liner 5 to tilt inside the vaporizer 2. This controls the flow of the drug inside the inner liner 5, allowing the drug to quickly generate vapor and increase the amount of anesthetic vapor, thereby increasing the concentration of the anesthetic drug inhaled by the patient. This can be adjusted according to the actual situation.

[0025] A lifting rod 7 is movably installed at the upper end of the connecting rod 6. The lifting rod 7 extends into the interior of the inner liner 5 and the evaporator 2. The connection points between the inner liner 5 and the evaporator 2 and the lifting rod 7 are provided with through holes 8 that are 2cm larger than the diameter of the lifting rod 7. A sealing rubber cylinder 9 is also provided at the connection point with the lifting rod 7. A protective cover 10 is stably installed on the outer end of the lifting rod 7. To facilitate the control of the movement of the pulling block 33 inside the inner liner 5, a lifting rod 7 is installed at the upper end of the connecting rod 6. One end of the lifting rod 7 passes through the interior of the inner liner 5 and the evaporator 2, and a protective cover 10 is installed on the outer end of the lifting rod 7. The movement of the pulling block 33 can be controlled by simply operating the protective cover 10. Furthermore, the connection between the lifting rod 7 and the inner liner 5 and the evaporator 2 is provided with through holes 8 that are larger than the diameter of the lifting rod 7. In this way, when controlling the rotation of the inner liner 5, it will not be obstructed by the lifting rod 7, allowing the inner liner 5 to rotate at a certain angle.

[0026] A circular plate 11 is stably connected to the bottom of the pull block 33. A hollow chamber 12 is installed at the bottom of the circular plate 11. An air outlet pipe 13 is connected to the outside of the hollow chamber 12. A one-way valve is installed on the air outlet pipe 13, and several air inlets 14 are opened at the bottom of the hollow chamber 12. When the anesthetic is added into the inner liner 5, a large amount of steam will be generated inside the inner liner 5. The steam is the gaseous state of the anesthetic. The gas will enter the hollow chamber 12 and be transported along the air outlet pipe 13 to the air outlet pipe 22, and then to the breathing mask position for the patient to inhale the anesthetic.

[0027] The elastic element 32 includes a first damping rod 3201, a movable rod 3202, and a positioning seat 3203. The positioning seat 3203 is stably installed on the inner wall of the inner liner 5 and corresponds to the position of the air intake pipe 31. The movable rod 3202 is slidably installed inside the positioning seat 3203. The positioning seat 3203 and the movable rod 3202 are connected by a spring 15. The first damping rod 3201 is also stably installed on the inner wall of the inner liner 5. The telescopic end of the first damping rod 3201 is installed on the inner side of the movable rod 3202, and the sealing plug 321 is installed on the inner side of the movable rod 3202 to control the movement of the sealing plug 321 inside the air intake pipe 31.

[0028] This device controls the reciprocating movement of the sealing plug 321 inside the air inlet pipe 31, allowing it to close and open the pipe. This enables the adjustment of the oxygen content inside the inner liner 5 according to actual needs. When the oxygen content increases, the concentration of the anesthetic decreases, and vice versa. Therefore, during use, by controlling the upward movement of the pulling block 33, the sealing plug 321 below the pulling block 33 disengages from the air inlet pipe 31, allowing more oxygen to be supplied into the inner liner 5. When the pulling block 33 moves downward, it squeezes the sealing plug 321, forcing it into the air inlet pipe 31, thereby reducing the amount of air supplied to the inner liner 5 to meet usage requirements.

[0029] A second damping rod 16 is installed on the top of the evaporation tank 2. The telescopic end of the second damping rod 16 is connected to the protective cover 10. A medicine inlet chamber 17 is installed on the outer surface of the evaporation tank 2. A delivery pipe 18 is installed inside the medicine inlet chamber 17. One end of the delivery pipe 18 extends into the inner liner 5. The second damping rod 16 installed on the top of the evaporation tank 2 can limit the movement of the protective cover 10, so that the protective cover 10 can be stopped at any time when it moves up or down and can be stopped at a certain height position. This allows the pulling block 33 to be used stably inside the inner liner 5.

[0030] The main body 1 is also equipped with a display 19, and a drawer 20 is provided at the bottom of the main body 1. An airbag 21 and an air outlet pipe 22 are provided on the outside of the main body 1.

[0031] Specifically, the working process or principle of this anesthetic drug concentration regulating device is as follows: Currently, the method of regulating the concentration of anesthetic drugs is to adjust the control knob of the vaporizer 2 to control the amount of fresh air intake, thereby adjusting the concentration of anesthetic drugs entering the patient's body. However, due to the limited number of air inlets on the current vaporizer 2, in actual operation, when it is necessary to dilute the concentration of anesthetic drugs, even if the air inlet is fully opened, it is still not possible to quickly dilute the concentration of anesthetic drugs. The gas needs to be stored for a certain period of time before it can be delivered to the patient, which wastes time and reduces work efficiency. Therefore, this device was designed to solve this problem.

[0032] This device mixes oxygen with the vapor of the anesthetic agent. The concentration of the anesthetic agent can be changed by adjusting the amount of oxygen entering the inner liner 5. When the amount of oxygen entering the inner liner 5 increases, the concentration of the anesthetic agent decreases, and vice versa, the concentration of the anesthetic agent increases to meet the needs of use. Specifically, this device is used in the operating room and is connected to an external power source. The anesthetic agent is added to the inside of the inner liner 5 through the drug inlet 17. After entering the drug inlet 17, the liquid drug will automatically flow into the inside of the inner liner 5 from the inside of the inclined delivery pipe 18, ready for use.

[0033] This device can be equipped with an electric heating plate at the bottom of the vaporizer 2. The electric heating plate heats the liquid medicine to generate steam. When in use, medical staff first put the mask on the patient's mouth and nose, and then inhale the anesthetic gas into the patient's body. The concentration of anesthetic can be adjusted according to the patient's tolerance.

[0034] Because excessive inhalation of anesthetic drugs can harm the patient's body, the anesthetic concentration is usually reduced during operation. By pulling the protective cover 10 upward, the pulling block 33 and the circular plate 11 are lifted upward together. Initially, an air inlet pipe 31 supplies oxygen into the inner liner 5. As the pulling block 33 and the circular plate 11 move upward together, the circular plate 11 will pass the corresponding air inlet pipe 31. After the circular plate 11 passes the position of the air inlet pipe 31, the sealing plug 321 installed inside the air inlet pipe 31 will be pulled out of the air inlet pipe 31 by the moving rod 3202 while the sealing plug 321 is moved outward. At this time, oxygen will be continuously supplied to the inner liner 5 through the air inlet pipe 31. At this time, the oxygen content inside the inner liner 5 will continuously increase. The oxygen and the vapor generated by the drug solution will mix and be discharged through the hollow chamber 12. The gas will be quickly discharged under the action of pressure difference and inhaled by the patient, causing the patient to fall into a coma.

[0035] When the patient has a high tolerance to anesthetic, the concentration of the drug needs to be increased so that the patient can inhale more anesthetic. At this time, the protective cover 10 can be pushed down, and the pulling block 33 and the circular plate 11 can be pushed down inside the inner liner 5. During the downward movement, the pulling block 33 will compress the movable rod 3202 on the outer end of the air inlet pipe 31 and press the sealing plug 321 into the inside of the air inlet pipe 31, sealing the air inlet pipe 31 and preventing oxygen from entering the inner liner 5. The number of air inlets 31 that are sealed can be controlled according to the needs of use to reduce the amount of oxygen entering the inner liner 5.

[0036] Furthermore, as the pulling block 33 moves downwards, it controls the circular plate 11 to move downwards along with the hollow chamber 12, bringing the hollow chamber 12 closer to the medicine. The medicine is heated by the electric heating plate to generate steam, which is quickly drawn into the interior of the hollow chamber 12 and transported out through the exhaust pipe 13 and then through the exhaust pipe 22 to the breathing mask. At this time, due to the reduction in oxygen, the content of medicine vapor in the exhaled gas will greatly increase, thereby increasing the concentration of the medicine and making it easier to use.

[0037] Since the inner liner 5 is currently stationary, the rate at which bubbles are generated in the medicine is relatively slow. When the device controls the pulling block 33 and the circular plate 11 to move downward, it also drives the push rod 41 to move downward. One end of the push rod 41 is slidably connected to the inner wall of the inner liner 5 through a slider. As the pulling block 33 continues to move downward inside the inner liner 5, the slider will first be pressed against the inner wall at the bottom of the groove. During the continuous downward movement of the pulling block 33, the push rod 41 will be controlled to have a downward force, and the slider can no longer move inside the groove. At this time, the inner liner 5 will be pushed to rotate under the push of the push rod 41.

[0038] The inner liner 5 is installed inside the vaporizer 2. When pushed, it will rotate, and the medicine inside the inner liner 5 will flow inside the inner liner 5. As a result, the bubbles in the medicine will rise rapidly, and the rapidly changing gas will increase the concentration of the anesthetic medicine inhaled by the patient.

Claims

1. A device for adjusting the concentration of an anesthetic drug, characterized in that, It includes a body (1), an inner liner (5), a vaporizer (2), and a concentration adjustment mechanism (3), and the vaporizer (2) is installed on the body (1) for use; The concentration adjustment mechanism (3) includes: An air inlet pipe (31) is installed on the vaporizer (2) and one end of the air inlet pipe (31) extends into the interior of the inner liner (5); An elastic element (32) is installed inside the intake pipe (31), and a sealing plug (321) is installed on the elastic element (32), the sealing plug (321) being movably installed inside the intake pipe (31); A pull block (33) is movably installed inside the evaporator (2) and controls the pull block (33) to slide along the outer surface of the elastic member (32); The pushing mechanism (4) is located inside the inner liner (5) and is used to shake the anesthetic to generate gas.

2. The anesthetic drug concentration regulating device according to claim 1, characterized in that, The pushing mechanism (4) includes a pushing rod (41), a round rod (42) and a limiting post (43). The limiting post (43) is installed on the inner wall of the evaporation tank (2), and a rubber sleeve is adjusted at the outer end of the limiting post (43) to limit the inner liner (5). The outer surface of the inner liner (5) is 1 cm away from the inner wall of the evaporation tank (2).

3. The anesthetic drug concentration regulating device according to claim 2, characterized in that, A rotatable rod (42) will be installed at the bottom of the evaporator (2), and the inner liner (5) will be placed on the rod (42). The rod (42) is embedded in the bottom of the inner liner (5).

4. The anesthetic drug concentration regulating device according to claim 3, characterized in that, The inner liner (5) is provided with a connecting rod (6), one end of which is stably connected to a pulling block (33). The outer side of the pulling block (33) is rotatably connected to a push rod (41), one end of which is connected to the inner wall of the inner liner (5). The inner wall of the inner liner (5) is provided with a sliding groove, and a slider is provided inside the sliding groove. One end of the push rod (41) is movably connected to the slider.

5. The anesthetic drug concentration regulating device according to claim 4, characterized in that, The upper end of the connecting rod (6) is movably mounted with a lifting rod (7). The lifting rod (7) extends out of the interior of the inner liner (5) and the evaporator (2). The inner liner (5) and the evaporator (2) are both provided with through holes (8) that are 2 cm larger than the diameter of the lifting rod (7) at the connection points with the lifting rod (7). A sealing rubber cylinder (9) is also provided at the connection points with the lifting rod (7). A protective cover (10) is stably installed on the outer end of the lifting rod (7).

6. The anesthetic drug concentration regulating device according to claim 5, characterized in that, The bottom of the pull block (33) is stably connected to the circular plate (11), and a hollow chamber (12) is installed at the bottom of the circular plate (11). An air outlet pipe (13) is connected to the outside of the hollow chamber (12). A one-way valve is provided on the air outlet pipe (13), and several air inlets (14) are opened at the bottom of the hollow chamber (12).

7. The anesthetic drug concentration regulating device according to claim 6, characterized in that, The elastic element (32) includes a first damping rod (3201), a movable rod (3202), and a positioning seat (3203). The positioning seat (3203) is stably installed on the inner wall of the inner liner (5) and corresponds to the position of the air inlet pipe (31). The movable rod (3202) is slidably installed inside the positioning seat (3203). The positioning seat (3203) and the movable rod (3202) are connected by a spring (15).

8. The anesthetic drug concentration regulating device according to claim 7, characterized in that, The inner wall of the inner liner (5) is also stably installed with a first damping rod (3201). The telescopic end of the first damping rod (3201) is installed on the inner side of the movable rod (3202), and the sealing plug (321) is installed on the inner side of the movable rod (3202) to control the movement of the sealing plug (321) inside the air intake pipe (31).

9. The anesthetic drug concentration regulating device according to claim 8, characterized in that, A second damping rod (16) is installed on the top of the evaporation tank (2). The telescopic end of the second damping rod (16) is connected to the protective cover (10). A drug inlet chamber (17) is installed on the outer surface of the evaporation tank (2). A delivery pipe (18) is installed inside the drug inlet chamber (17). One end of the delivery pipe (18) extends into the inner liner (5).

10. The anesthetic drug concentration regulating device according to claim 9, characterized in that, The body (1) is also equipped with a display (19) and a drawer (20) is provided at the bottom of the body (1). An airbag (21) and an air outlet pipe (22) are provided on the outside of the body (1).

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