Year: 1888

page_text: [Communicated from abroad by GEORGE EDWARD FELL, of Buffalo, New York,
United States of America, Physician.]
I, HENRY HARRIS LAKE, of the firm of Haseltine, Lake & Co., Patent Agents.
Southampton Buildings, in the County of Middlesex 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:-
This invention relates to an apparatus for producing artificial respiration in cases
where the action of the lungs is impaired or suspended, and artificial aeration of tho
blood becomes necessary to sustain life, as for instance in resuscitating drowned or
poisoned persons, in cases of shocks from wounds, or in conditions where the brain is
inactive from discase or otherwise.
The object of the said invention is to produce an apparatus which is reliable in its
operation and easily applied and manipulated. The invention consists of the improve-
ments which will be hereinafter fully set forth.
In the accompanying drawing
Figure 1 is an elevation of my improved apparatus.
Figure 2 is a sectional elevation of the tracheotomy tube by which connection is
made with the trachea.
Figure 3 is a sectional elevation of the air valve.
Figure 4 is a sectional elevation of the air warming apparatus.
Figure 5 is a sectional view of a modified construction of the air valve.
Figure 6 is a sectional view of another modified construction of the air valve.
Figure 7 is a sectional elevation of the trachea tube which may be employed in
place of the tracheotomy tube when desired.
Like letters of reference refer to like parts in the several Figures.

page_text: A represents a tracheotomy tube by which connection is made with the trachea or
larynx, as the case may be. The tracheotomy tube consists as usual of an outer
tube a provided with a shield a¹ and an inner tube b, which is held in place by a turn
button e represents a nipple which is attached to the end of the flexible air supply
tube d and which is connected with the upper end of the inner tube by a screw
thread, as shown, or in any other suitable manner, so as to form a tight and
secure joint, and at the same time permit the nipple to be readily detached from the
inner tube.
E represents a bellows or other suitable air forcing device, whereby air is
supplied through tubes d, d¹, d² and the tracheotomy tube A to the trachea and
lungs.
represents an air valve arranged between the air supply tubes dd' and
establishing at desire, communication between the tracheotomy tube and the bellows
or with the outer air. As represented in Figure 3, the valve F is provided with an
upright tubular shell or case open at its lower end and supported on legs, to
permit of the free escape of the air through the lower end of the shell.
g is the air
outlet nipple, and g' the inlet nipple arranged diametrically opposite each other on
the lower portion of the shell and connected respectively with the tubes d, d.
H represents a movable piston arranged in the shell and provided at its lower end
with a recess h, which opens downwardly and toward the exit nipple g. is a
diametrical passage formed in the piston H above the recess h, so that by depressing
the piston the two nipples can be placed in communication through the passage h
2 is a spring which holds the piston in an elevated position, and h³ is a push button
formed at the upper end of the stem of the piston. In the elevated position of the
piston represented in Figure 3, the recess establishes communication between the
trachea and the outer air.
is a vent or exhaust opening whereby the air from the bellows escapes when the
piston H is in an elevated position and the communication between the nipples y, g¹
is cut off by the recess h.
I represents an air warming apparatus which may be used in cold weather for
raising the temperature of the air to the proper point before supplying it to tho
patient, or for supplying stimulating medicine to the lungs. As shown in the
drawings, the warming apparatus consists of a vessel i which is filled with water and
is heated by a lamp. The air is conducted to the lower portion of the vessel i hy
the tube d, which descends nearly to the bottom of the vessel and the air escapes
from the vessel through the tube d¹. The tubes d², d may be connected by a coil
arranged in the vessel i if desired. A thermometer is provided in the vessel for
indicating the temperature of the water and air. The water in the vessel also serves
to intercept any impurities which may be contained in the air. When the outer air
has the proper temperature, this warming apparatus may be omitted.
My improved apparatus is used by introducing the tube A into the trachea and
alternately supplying air thereto and permitting it to escape therefrom. This
regulation of the flow of air is effected by the valve F. Upon depressing the
button ³ so as to bring the passage in line with the nipples g, g', the air is forced
by the bellows through the tube d and the tracheotomy tube A into the trachea and
lungs. Upon releasing the button the spring raises the piston H to the position
represented in Figure 3 in which the piston shuts off the air from the bellows and
permits the air to escape from the lungs through the tubes A and d, nipple g and
recess h. While the expiration is being made the air from the bellows is permitted
to escape through the vent . By working the bellows and depressing the piston H
at regular intervals, forced respiration is produced in a simple and certain manner.
When the patient has so far recovered that the lungs resume their action, the nipple c
and tube dare disconnected from the inner tube b, leaving the latter and the outer
tube a in place in the trachea, so that connection can be made again with the bellows,
if the action of the lungs should temporarily fail.
In the normal position of the piston H communication is established between the
lungs and the outer air, so that the patient can breathe through the valve, if capable

page_text: of doing so, and whereby a free passago is formed for the escape of blood, water &c.
which may be coughed up.
21
Instead of the valve Fa two way cock may be employed, as represented in figure 5.
K represents the case of the cock provided with nipples k k¹ connected respectively
with the tubes dd' and having a passage, which opens into the outer air. The
plug of the cock is provided with a bent passage by which communication can be
established between the tubes d d', as shown, for forcing air to the tube A, or by
which the air can be exhausted through the passage k, when the passage is arranged
as indicated by dotted lines. I prefer however, to employ a spring valve F as it
automatically establishes communication between the trachea and the outer air.
If desired, the air valve may be constructed as represented in figure 6, in which M
is a frame to which is pivoted a tube section m having a thumb piece m¹. N is the
inlet tube to which the section m is hinged at n and which receives the air from the
supply tube d.. N is the outlet tube which communicates with the tracheal or
tracheotomy tube. The tube section m is held out of register with the outlet tube
by a spring o. Upon placing the tube section m in line with the outlet tube N',
communication is established between the supply tube and the trachea, while by
releasing the thumb piece, the spring causes the movable tube section to break register
with the outlet tube N¹ and opens the latter and the inlet tube to the outer air. When
it is desired to avoid tracheotomy, a tracheal tube P of any suitable construction
may be employed for establishing communication with the lungs through the larynx
and trachea.
A tampon may be attached to the lower end of the tracheal tube P to close the
opening between the outside of the tube and the trachea, if desired.
The end of the tracheotomy tube is provided with a movable collar g which fills
the space between the outer side of the tube and the mucous membrane of the trachea,
to prevent the air from passing into the mouth. The collar q is preferably attached
by a screw thread so that a larger or smaller collar may be applied to the tube as may
be necessary to fit the trachea.
.
My improved apparatus may also be used in physiological laboratories to keep up
artificial respiration in animals as an improvement upon the methods now in use.
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 :-
First. The combination with the tracheal or tracheotomy tube composed of an
outer tube a and inner tube b, of an air supply tube d. detachably connected with the
inner tube b, substantially as set forth.
Second. The combination with a tracheal or tracheotomy tube of an air forcing
apparatus, a tube connecting said apparatus with the tracheal or tracheotomy tube,
and a regulating valve whereby communication can be established at will between the
tracheal or tracheotomy tube and the air forcing apparatus or the outer air, sub-
stantially as set forth.
Third. The combination with a tracheal or tracheotomy tube, of an air forcing
apparatus, a tube connecting said apparatus with the tracheal or tracheotomy tube a
regulating valve and an air warming apparatus, substantially as set forth.
Dal 1911...
L 1000
HASELTINE, LAKE & Co.,
45, Southampton Buildings, London,
Agents for the Applicant.