Improved Medical Apparatus for Enabling Regular and Increased Respiratory Action in the case of various Diseases.
Year: 1898

page_text: Date of Application, 23rd May, 1898
Complete Specification Left, 23rd Feb., 1899-Accepted, 23rd May, 1899
Improved Medical Apparatus for Enabling Regular and Increased
Respiratory Action in the case of various Diseases.
I, DEMETRIUS BOGHEAN, Doctor of Medicine, of Josefstädterstrasse 55, Vienna
VIII, do hereby declare the nature of this invention to be as follows:-
One of the main conditions of life is the action of the red corpuscles of the
blood, which convey oxygen to the tissues and then again the proper escape of
the residue of such action, the deterioration of the tissues, riz the carbonic
acid (CO). These results are mainly produced by the operation of breathing
(respiration). The lungs normally lie against the inner walls of the chest and
follow the motions of the latter. On the expansion of the chest, the lungs draw
in air and on contraction they expel the air thus drawn in, laden with carbonic
acid. If the difference of volume between the extended and contracted position
of the thorax is insufficient, the air i.e., amount of oxygen introduced by the
inspiration will be insufficient, and the expiration thus rendered more difficult, will
tend to cause the tissues to retain carbonic acid (cyanosis). If this action increases,
the breathing centre will be greatly irritated, and difficulty of breathing (dyspnoea)
and asthmatic symptoms will appear as for instance in the case of empysema. The
heart, too, in such cases will be over-exerted in order to bring the red corpuscles
of the blood more often into contact with the spare quantity of oxygen in the
lungs, and thus to substitute frequency for sufficiency.
Our body is, however, often subject to a surplus of CO, through stagnancy of
the circulation owing to substantial defects of the valves of the heart (ritia
cordis). The proper regulation of the action of breathing discharges also in such
cases the action of the heart and improves the quality of the blood. Similarly,
affections of the liver (cirrhosis) and kidneys (Bright's disease) produce defective
circulation and irregular breathing.
On the other hand, if a sufficient supply of oxygen is not present bloodlessness
(chlorsis and anæmia) will be observed, as also an incomplete oxydation in the
organism in certain cases of diabetes mellitus, or accumulation of only partially
oxydised injurious residues of the retrogressive metamorphosis of the life, such
as uric acid in the case of gout (arthritis urica). An insufficient expansion of the
chest (thoraxfixation) accompanies all those diseases of the lungs, which are the
results of microbical invasion (tuberculosis pneumonia).
Finally, the breathing action is injuriously influenced by the pathological
collection of fluids between the lungs and the interior walls of the chest (exsudate)
whilst the proper extension of one side of the lungs is also prevented by a deformed
spine (scoliosis).
The object of the apparatus forming the present invention is to heal cases
of the above description, or if healing is impossible, at least to make life endurable
by regulating the periods at which breath is drawn and the depth of the breathing
of patients, who, in consequence of illness are not capable of breathing properly,

page_text: or of such who, in order to attain certain healing effects, have to be forced to
a regular and higher respiratory action or to attain increased breathing capacity.
According to the invention a flexible cord or band is employed in connection with
the patient, said cord or band being arranged around the chest of the patient
and rhythmically tightened at equal intervals to produce the expiration and inter-
mittently loosened to allow of relaxation of the chest and lungs.
The band does not act directly on the body, but is employed in combination
with a series of plates or cushions, which are fitted only to those regions of the body
which are to be influenced as the most appropriate for the intended effect. The
nature of the disease to be treated determines number, size and disposition of
these compressing plates.
Thus according to one form of carrying out my invention, one curved plate
or cushion may be fitted to the back and sides of the patient, whilst two plates
may be placed on suitable parts of the breast. All the plates or cushions are
connected by means of a cord or flexible band encircling the chest and running
on antifriction rollers or the like mounted on the outside of the plates or cushions.
The two ends of the said flexible band may be attached to a disc, which may be
periodically swung or reciprocated so as to tighten and loosen the said band
alternately.
I may of course increase the number of plates around the chest or arrange the
same in any manner according to the nature of the disease. I may also hinge some or
all of the said plates or cushions together, providing each with antifriction means
for supporting the flexible cord surrounding the chest and also as above mentioned
means for periodically loosening and tightening the said cord.
The means for periodically contracting or drawing together the flexible band and
thus producing respiration, may be of any kind whatever. An electric motor is
advantage, as owing to the very small amount of power required-it may be
mounted on the back plate or cushion and carried by the patient. Although any
means may be employed to produce the oscillating movement of the dise to which
the ends of the flexible cord are attached, I will indicate a preferred form of such
device. This consists of two discs mounted one on the shaft of the driving medium
and the other on the shaft of the flexible band disc, the latter disc being mounted
in proximity to the former but eccentrically thereto and both discs being provided
on their adjacent faces with cam pins adapted to engage one with the other during
a certain part of each revolution of the motor disc. Thus owing to the eccentric
arrangement of the band disc to the motor disc its cam pin will slide, out of
engagement with the cam pin of the motor disc at a certain point of each revolution
of the latter. As soon as this takes place the cord or band will be released and
the said band will be returned, by the inspiration of the patient, to its initial
position and as the cam pin of the motor disc comes round again it will engage the
band cam pin and take the same round again a certain distance causing expiration.
Suitable stops may be employed to arrest the band disc in its proper position. If
an electromotor is employed it may be connected by means of wires to any suitable
source of electricity. The wires may be long enough to allow the patient sufficient
room for movement. In the event of a number of patients being supplied with
electricity in a limited space-for instance for walking exercise-the motor of each
patient may be connected by conductor wires to overhead conductors in the well
known manner.
From the above description it will be clear that the plates
adapted to any disease, according to requirement, their shape and the pressure
or cushions may be
of the cord thereon being variable to the finest degree. The periods of inspiration
and expiration may be varied at will by varying the number of revolutions made
by the driving motor.
"The depth of the breath taken will be determined by the periods of engagement
of the motor disc with the flexible band disc, which also regulates the periods of 5
respiration.
One feature of the invention consists in not connecting the cord or band direct to

page_text: the plates or cushions, but in allowing the same to run on antifriction rolls mounted
on the said plates. I have stated that the motor is advantageously mounted on
one of the back plates, but it may be mounted anywhere as long as the conditions
stated are complied with.
1000
Improved Medical Apparatus for Enabling Regular and Increased
Respiratory Action in the case of various Diseases.
1, DEMETRIUS BOGHEAN, Doctor of Medicine, of No. 55, Josefstädterstrasse,
Vienna VIII, do hereby declare the nature of this invention and in what manner
the same is to be performed, to be particularly described and ascertained in and
by the following statement:-
One of the main conditions of life is the action of the red corpuscles of the
blood, which convey oxygen to the tissues and then again the proper escape of
the residue of such action, the deterioration of the tissues, viz. the carbonic
acid (CO). These results are mainly produced by the operation of breathing
(respiration). The lungs normally lie against the inner walls of the chest and
follow the motions of the latter. On the expansion of the chest, the lungs draw
in air and on contraction they expel the air drawn in, laden with carbonic
acid. If the difference of volume between the extended and contracted position
of the thorax is insufficient, the air i.e. amount of oxygen introduced by the
inspiration will be insufficient, and the expiration thus rendered more difficult, will
tend to cause the tissues to retain carbonic acid (cyanosis). If this action increases,
the breathing centre will be greatly irritated, and difficulty of breathing (dyspnea)
and asthmatic symptoms will appear as, for instance, in the case of empysema. The
heart, too, in such cases will be over-exerted in order to bring the corpuscles
of the blood more often into contact with the spare quantity of oxygen in the
lungs, and thus to substitute frequency for sufficiency.
The body is, however, often subject to a surplus of CO, through stagnancy of
the circulation owing to substantial defects of the valves of the heart (citia
cordis). The proper regulation of the action of breathing discharges also in such
cases the action of the heart and improves the quality of the blood. Similarly,
affections of the liver (cirrhosis) and kidneys (Bright's disease) produce defective
circulation and irregular breathing.
On the other hand, if a sufficient supply of oxygen is not present, bloodlessness
(chlorosis and anemia) will be observed, as also an incomplete oxydation in the
organism in certain cases of diabetes mellitus, or accumulation of only partially
oxydised, injurious residues of the retrogressive metamorphosis of the life, such
as uric acid in the case of gout (arthritis urica). An insufficient expansion of the
chest (thoraxfixation) accompanies all those diseases of the lungs, which are the
results of microbical invasion (tuberculosis pneumonia).
Superficial respiration resulting from defect impulses of the centre of breathing
and concomitant weakened action of the heart is also observable in various nerve
and brain affections combined with psychical depression (neurastenia, traumatic

page_text: neurosis, melancholy, acute dementia, circular insanity etc.). A proper periphery
and as far as possible permanent regulator for the depth and frequency of respira
tion would obviate the pathological consequence of the defective central innervation
would improve the chemical quality of the blood by increasing of the CO,, resusitate
the action of the heart, provided the exhausted central nervous organs with more
and better blood and would prevent the invasion of microbes in the lungs (tuber-
culosis) which often occurs in such cases of disease.
Then again the breathing action is injuriously influenced by the pathological
collection of fluids between the lungs and the interior walls of the chest (exsudate)
whilst the proper extension of one side of the lungs is also prevented by a deformed
spine (scoliosis).
Finally, an apparatus which will work automatically for hours and may be
adjusted to suit all and any particular requirements, for regulating the breathing
has hitherto been wanting for purposes of saving life, in cases of intoxiation
(chloroform narcosis, carbonic oxide poisoning etc.) or for producing the first
breathing of children at birth.
The object of the apparatus forming the present invention is to heal cases
of the above description, or if healing is impossible, at least to make life endurable
by regulating the periods at which breath is drawn and the depth of the breathing
of patients, who, in consequence of illness are not capable of breathing properly,
or of such who, in order to attain certain healing effects, have to be forced to
a regular and higher respiratory action.
The apparatus is illustrated in the accompanying drawing and consists of a
series of soft, flexible compression plates b , which are connected together
and fitted to the proper parts of the body (Figs. 1 to 3). A flexible band or cord is
guided over rolls of the said plates as at a, said cord not coming into direct contact
with the body at any point. By means of mechanical power supplied from a motor
suitably mounted at any desired place, this cord is caused to perform rhythmic
contraction and expansions, so that the plates only cause the pressure during each
respiration, thus regulating the length of expiration and inspiration plus the
proper pause. The arrangement of the plates enables the pressure to be applied
to those parts of the chest only, which are necessary in order to attain the desired
healing effect, and thus to properly distribute the pressure, which is impossible
with a simple band, having no compression plates. The number size and arrange-
ment of the plates should be chosen according to circumstances.
In Figs. to 3 three different forms of compression plates are illustrated; in
Fig. the cord operates two plates and which are free to move in any
direction. In Fig. 2 the two plates are subdivided into several lamels 1 to 6 and
7 to 8. According to Figure 3 two pressure plates and are employed which
are capable of turning on hinges s' and 2, being hinged to a third plate be which
does not lie on the chest in this case, but is provided with suitable supports in
the neighbourhood of the collar bone and the hips, so that no pressure is caused on
the breast bone.
According to Fig. 4 the central part of the cord a is guided over rolls R' to R
to a swinging lever H! pivoted at 0, said lever being reciprocated by means of a 4
cam disc mounted on a shaft-f. The latter is rotated by means of any suitable
motor always in one and the same direction. To lessen the friction the lever H
is provided with a roll and in order to render the adjustment of the stroke of
the apparatus possible the said cord is attached to the lever H¹ by means of a
clamp T.
5
In Fig. 4 a device is illustrated by means of which the extent of the compression
may be exactly regulated. This device consists of a roll R+ mounted on a lever H
pivoted at and this lever may be adjusted to any desired position by means of
a screw s, which may be turned by the patient from the outside of the apparatus.
This device enables the cord to be tightened up and the length of the said cord 5
may be varied by means of buckles or the like inserted therein. The circumference
of the cam disc u is constructed to suit the normal breathing capacity, the length

page_text: of the cam surface being in proportion to the entire circumference of the dise as
the length of the expiration is to the entire respiration period.
In Figs. 5 and 6 a device is illustrated by means of which the requirements may
be fulfilled by two crank pin dises K and G provided that the proper diameter
and excentricity of the same are chosen.
According to this construction the ends of the cord are attached to a drum e
keyed to a shaft d, the said cord being wound on or off the drum according to
the direction or rotation of the same. The shaft is turned by means of a suitable
motor with a constant angular velocity, and the motion is derived from the shaft f,
in that the latter is coupled to the former for a certain part of a revolution—i.e.
during the period of expiration, and then released. In order to effect the coupling
and uncoupling of the shafts 7 and f crank dises y and h are keyed to each shaft
respectively, the said shafts being supported eccentrically to each other. The discs
are of varying diameter and the pins are placed in the same at varying or.
different radii. The disc turns constantly in the same direction and thus the pin
of the same will couple with the crank pin of the disc i during a certain part of
each revolution and will release the same during the remainder of each revolution.
A stop is provided for the pin g which will be returned to the said stop by the
inspiration of the patient and consequent expansion of the cord. The said dise
may however be returned to its initial position by means of a spiral spring which
may be arranged in any suitable manner. The are (Fig. 6) during which
the two crank pins are in engagement corresponds to the period of expiration or
breathing out, the rest of the revolution to the inspiration or drawing in of breath.
By altering the number of revolutions of the apparatus or motor the periods of
inspiration and expiration may be adjusted to suit the requirements of the case.
The mechanism for regularly tightening and loosening the cord is enclosed in
a housing (Figs. 1-4). The back plate 6, which is advantageously rigid, encloses
the back and part of the sides of the patient. This housing may also contain an
electro motor if desired, and in cases in which the motor is not simultaneously
employed to operate several apparatuses. If the apparatus is provided with its own
motor the connection between the shafts f and d is effected by means of a cord or
gear wheel mechanism by means of which the high speed of the motor is corre-
spondingly reduced. The motor may be controlled by a centrifugal governor
adapted to switch in or out suitable resistances or to effect short circuiting in the
known manner or may be otherwise rendered constant and adjusted to the required
speed.
Any suitable motor may be employed for operating the device. Electric motors,
mounted in the apparatus appear well adapted for the purpose owing to the
small amount of power required, viz., one and a half to two and a third foot-
pounds. The electromotor may be connected to the source of electricity by means
of flexible conductors of any desired length so that the patient may have a certain
amount of free movement. If several patients occupy the same space the appara-
tuses may be connected to the main conductors by means of runners or trolleys as.
in the case of electric cars, which may run along overhead wires.
The apparatus may also be driven from the axle of a chair for invalids or
from that of any vehicle employed by the patient for the purpose of locomotion, in
that the motion of the axle is transmitted to the apparatus by mean of gearing
and a flexible shaft or in any other suitable manner. By means of the apparatus,
the amount of air breath out is increased, particularly at the lower part of the
rib (regio hypochondriaca, regio inframammalis) owing to the increased pressure
and consequently decreased volume, so that the amount of carbonic acid given off
is increased and the quantity of the residual air decreased. The compression of
the thorax increases the difference of volume between the air drawn in by inspiration
and that exhausted or forced out at the expiration and consequently necessitates an
increase of volume of the air drawn in at the next following inspiration and
consequently an increase of the amount of oxygen inhaled. This means an increase
In the exchange of gas and consequently increased vital capacity.

page_text: Having now particularly described and ascertained the nature of
my said
invention and in what manner the same is to be performed, I declare that what
I claim is:--
1: Apparatus for mechanically regulating the period and depth of breathing
in connection with patients either unable to breath properly or requiring an
increased breathing capacity in order to attain certain cures, characterised by a
series of pressure plates adapted to the form of the body and means for rhythmically
moving the same and increasing the pressure of the same on the body to regulate
the depth and period of inspiration and expiration substantially as described.
2: An apparatus according to Claim 1 in which the band or cord encircling
the body is connected to a lever (H), reciprocated by means of a cam disc (")
rotated by means of a suitable motor, substantially as described.
3 Apparatus according to Claim 1 characterised by a drum (e) to which the
ends of the band or cord (a) are attached, and by a shaft (f) mounted eccentrically
to the shaft (d) of the drum (e) and driven by a suitable motor, and by erank pin
discs (k) with crank pins (ig) adapted to contact and couple the said dises during
a part of each revolution said drum shaft (7) being returned to a suitable stop
after each release from the constantly rotating shaft (f) either by means of the
inspiration of the patient or by a spring or the like substantially as described.
Dated this 23rd day of February 1899
CASTLE SMITH,
Invention" Office, Mitre Court, Fleet Street, London, E.C.
Agent for the Applicant.