Improvements in Apparatus for Treating Emphysema.
Year: 1889

page_text: [Communicated from abroad by ALEXANDER STEINHOFF, Doctor of Medicine, of
Briesnitz, near Dresden, in the Kingdom of Saxony, German Empire.]
Improvements in Apparatus for Treating Emphysema.
I, PHILIP ARTHUR NEWTON, of the Office for Patents 6 Bream's Buildings,
Chancery Lane, in the County of Middlesex, Patent Agent, do hereby declare the
nature of this invention and in what manner the same is to he performed, to be
particularly described and ascertained in and by the following statement:
The present invention relates to apparatus for treating emphysema, in which
apparatus besides the parts usually employed for such treatment, as, for instance, an
air accumulator and an inhalation mouthpiece or mask, connected together by pipes
or tubes, an expansible air vessel is made use of, said air vessel being arranged or
introduced between the air accumulator and the mouthpiece. This expansible air
vessel, while being put alternately in communication with the accumulator and with
the mouthpiece, has for its object to act by expansion against the chest or thorax of
the patient, when said vessel receives the charge of compressed air from the
accumulator, if connected with the latter, and if connected with the mouthpiece, to
discharge its compressed air for inhalation.
In such alternate action of the expansible air vessel, the change of its com-
munication with the accumulator, or with the mouthpiece, is not performed by any
special labour of the patient, said change being produced automatically by alternating
electrical connection of the valve of the mouthpiece with two valves, of which one is
arranged in the pipe connection between the accumulator and the expansible air
vessel, the other being arranged in the pipe connection between the expansible air
vessel and the mouthpiece.
The expansible air vessel, which is preferably called "a breathing belt," produces
in an automatic manner, by its expansion, a compression of the thorax during the
exhalation period, thereby essentially assisting the treatment of emphysema hv
compressed air.

page_text: In Fig. 1 of the annexed drawing, is shown the arrangement of the complete
apparatus during employment of same, whereas Fig. 2 shews a separate view of the
valves in their electrical connection with the mouthpiece or mask and the source of
electricity Figs. 3 and 4 are detail views of the valves.
The air, which, if necessary, may be mixed with any medical substances, is forced
by any of the known devices (say, for instance, pumps, bellows, etc., worked by
water pressure, motors or treadle, etc.,) into the accumulator A, which according to
the pressure with which the air is to issue from it, may be loaded by weights.
The air from the accumulator is conducted first into the box of the valve B
(which will hereafter be described in detail), and from thence into the breathing
belt C. This breathing belt C consists mainly of an expansible vessel of such form
that it may readily be placed on or against the thorax of the patient, and preferably
on or against the lower part of the thorax. The expansible vessel is kept in this
position by belis or straps over the shoulders of the patient, crossing on the back,
and being buttoned to straps or belts, which, coming from the ends of the expansible
vessel, are united by a buckle or otherwise at the back of the patient.
The side of the hollow breathing belt, which is away from the body of the patient,
is made of a less expansible material than the side of said breathing belt next the
body, so that if compressed air is admitted into the breathing belt, it will expand
towards the thorax, and will compress the latter by such expansion. The breathing
belt is made preferably of a properly formed sack of vulcanised caoutchouc, or other
suitable material may be employed. In order to make the outer side, away from the
patient, less expansible, it may either be made of thicker material, or be covered on
this side by some non-expansible fabric. If, now, this outer side or covering fabric
is provided at its ends with belts or straps buckled at the back of the patient, as
above stated, the expansion of the breathing belt, if compressed air is admitted, must
take place towards the thorax.
From the breathing belt, a pipe conducts the air into the box of the valve D, and
from the latter into the mouthpiece of the inhalation mask. The mask may be
suitably made of a wire framing, the wires being covered with cloth, and the whole
mask being covered by some flexible material. From the foregoing description, the
employment of the apparatus, composed as described, is readily understood,, if it is
taken into consideration that during the period in which the patient inhales or breathes
in, the valve B is closed, while the valve D is opened, whereas during the
exhalation period the valve B is opened while the valve D is closed.
By this alternate play of valves, inhalation of compressed air issuing from the
breathing belt takes place, while during exhalation through the nose, charging of
the breathing belt with compressed air takes place from the accumulator, by which
filling process the breathing belt exerts, by its expansion, a compression of the
thorax.
The play of the valves B and D is effected by an electric current from the
battery E, or from any other convenient source of electricity, in the following
manner: As indicated in Fig. 2, the pipe or tube a terminates in the inhalation
mask a¹, within which is a flap valve b, which, by its slanting position, is kept close,
and which flap valve will readily open by inhalation or breathing of the patient.
This flap valve is capable of conducting an electric current, and it is connected by
the wire c with the battery E, whereas the contact d projecting from the lower end of
the flap valve b, is arranged between the two contact ends of the wires e and f
The wire e is, at its other end, connected to the coil of an electro magnet in the box
of the valve D, from whence a return wire g leads to the battery E. The wire is,
at its other end, connected to the coil of an electro magnet in the box of the valve B,
from whence a return wire leads also to the battery E.
The construction of the valve box B is shewn in detail in Fig. 3, longitudinal
section, and Fig. 4 horizontal section.
.
B' is an electro magnet connected with the conducting wire fand the return wirey.
B is the flap valve arranged as an armature to the electro magnet B', which armature
is attracted by B' as soon as the current flows through the coils or bobbins of the

page_text: electro magnet. By such attraction the air inlet pipe is closed. As soon as the
current ceases by interruptions, the flap valve B will be withdrawn from the electro-
magnet by means of the spring B, thereby opening the air inlet valve, and
allowing the current of compressed air to rush through the valve box in the direction
of the arrows.
The valve box D is of same construction as B, the electro magnet in this case being
connected to the wires e and g.
Now returning to Fig. 2, it will be seen that if the flap valve b is in its closed
position (that is to say, during the patient's exhalation through the nose), the electric
current from the battery E goes through wire c, flap b, contact d, wire e, to valve D,
keeping the latter closed, so that at this period compressed air is admitted from the
breathing belt C into the inhalation mask. As, during this period, the contact d is in
no connection with the wire f, and therefore no electric current is communicated to
valve B, this latter is opened by its spring, and compressed air is admitted from the
accumulator A into the breathing belt C, thereby expanding the belt, and pressing
against the thorax. As soon as the inhalation period of the patient commences, he
will, by the effect of the inhalation, raise the flap valve b, thus immediately inter-
rupting the current connection with the valve D, which now opens under the influence
of its spring, and allows the compressed air to rush from the beit C into the mouth
piece of the mask. As, at the same time, the flap valve has brought its contact d
against the terminal of the wire f, the electric current now goes from E through
wire c, flap valve b, contact d, and wire f, to valve B, where the electric current will
cause this valve to close, thereby interrupting the admission of air from A to C.
The play of these valves B and D is, as is now readily understood, caused by the
alternate contact of the flap valve with the ends of the wires e and f, so that the
admission of compressed air into the breathing belt is interrupted when this latter
discharges its contents of compressed air by the valve D into the mouth-piece of the
mask, while the admission of compressed air into the belt C from the accumulator A,
through valve B, takes place during the exhalation period of the patient, said admis-
sion of compressed air into the breathing belt C causing the latter to expand, and to
press against the thorax during the exhalation period of the patient, which pressure
will greatly facilitate the exhalation process of the patient.
It may sometimes be convenient, instead of operating the valves as just described,
to so arrange the conduct of the electric current, that the alternate opening of
the valves B and D is caused by closing of the electric current, and that the
alternate closing of the valves B and D is caused by the action of the springs. If, in
the apparatus specified, a device for compressing air is employed, which is capable of
delivering a current of air of uniform and steady pressure, the accumulator A may
be dispensed with, and the piping from the air compressing device may be directly
fitted to the box of the valve B. However, the use of an accumulator like A may be
preferred, to be sure of an uniform and steady pressure of air.
Having now particularly described and ascertained the nature of the said
invention and in what manner the same is to be performed, as communicated to
me by my foreign correspondent, I declare that what I claim is:
.
1. An apparatus for the treatment of emphysema by compressed air, in which
apparatus an intermediate air vessel or breathing belt is inserted between the air
accumulator or air holding device and the inhalation mouthpiece, the walls of such
breathing belt being different in their expansibility, so that being placed with its most
expansible wall against the thorax of the patient, the belt will be automatically filled
with compressed air, and expanded during the exhalation period of the patient,
and will thereby, during such period, act against the thorax of the patient by
expansion.
2. In combination with the apparatus specified in claim 1, arranging a flap valve B
between the accumulator or the air compressing device and the breathing belt, and a
similar flap valve D between the breathing belt and the mouthpiece, which valves

page_text: play alternately by an electric current, which is automatically interrupted and closed
by the inhalation and exhalation action of the patient.
3. The combination with a mouthpiece and breathing belt, of a holder for air under
pressure, pipes leading from the same to the belt, and from the belt to the mouth
piece, valves for opening and closing the respective pipes, electro-magnets for acting
on those valves, and a circuit closing device and wires to the magnets, for closing
first one valve and then the other substantially as set forth.
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