IMPROVEMENTS IN APPARATUS FOR THE TREATMENT OF THE RESPIRATORY ORGANS
Year: 1883

page_text: LETTERS PATENT to William Phillips Thompson of the Liverpool and London
Agency for Foreign Patent Solicitors 6 Lord Street Liverpool in the county
of Lancaster Fellow of the Institute of Patent Agents for an Invention of
LETTERS PATENT to William Phillips Thompson of the Liverpool and London
Agency for Foreign Patent Solicitors 6 Lord Street Liverpool in the county
of Lancaster Fellow of the Institute of Patent Agents for an Invention of
"IMPROVEMENTS IN APPARATUS FOR THE TREATMENT OF THE RESPIRATORY
ORGANS a communication from Joseph Ketchum the younger, of Brooklyn,
PROVISIONAL SPECIFICATION left by the said William Phillips Thompson
at the Office of the Commissioners of Patents on the 15th October 1883.
WILLIAM PHILLIPS THOMPSON of the Liverpool and London agency for Foreign
Patent Solicitors, 6 Lord Street, Liverpool in the County of Lancaster, Fellow of
the Institute of Patent Agents "IMPROVEMENTS IN APPARATUS FOR THE TREATMENT
OF THE RESPIRATORY ORGANS "-A communication from Joseph Ketchum the
younger, of Brooklyn, King's County, State of New York, United States of
America.
This invention relates particularly to medical and therapeutic treatments of lung
diseases and disorders.
The object of the invention is to provide a method of administering the desired
medicinal or remedial agents directly to the affected parts, so thoroughly and in
such quantities and manner as to secure positive beneficial results.
While the process or method is applicable to all classes of treatment in which it
is desired to reach the inner coatings and the structural portion of the lungs
whether for the purpose of benefiting the lungs themselves or, through that avenue,
reaching other portions of the body, the same has been developed with particular
reference to the class of diseases in which the lungs themselves are affected, and
when it is desired to administer agents directly to the seat of the disorder.
The invention consists in immersing the patient in a partial vacuum, thereby
removing, to a sufficient degree, the external pressure of the atmosphere; and at
the same time supplying the lungs with atmosphere at its normal pressure, and, to
a greater or less extent, charged or impregnated with the substance which it is

page_text: desired to administer. The degree of rarefaction to which it is desired to subject
the patient is usually that represented by the fall from one half of an inch to three
inches of mercury in the barometer. The method which is preferably employed
in removing or rarefying the air in the cabinet in which the patient is placed, is to
first produce a high vacuum in an air can or chamber which may be made to
communicate with the patient, and when the patient has been placed in the cabinet,
allowing a sufficient quantity of the air to pass from the latter into the exhausted
chamber. In this manner the patient is relieved from the successive impulses to
which he would be subjected were the rarefaction produced by means of an air
pump applied directly to the cabinet. In practice the use of this intermediate
chamber is found to be of great importance for the reason that the repeated
periodic removals of pressure otherwise occasioned are not only extremely
disagreeable to the patient but frequently result in positive injury especially to
persons of a nervous temperament. The decrease in the external pressure upon
the body coupled with the normal internal pressure of the atmosphere, causes an
inflation of the lungs and a dilation of their cells, the extent of which is primarily
dependent upon the difference in pressure. The portions of the lungs which may
have become inactive and unresponsive to voluntary respiration are thus forced to
expand. The act of respiration will cause the parts of the lungs to perform their
normal functions so long as this differential pressure is maintained. For the
purpose of preventing the air which is supplied to the patient from passing directly
through the breathing organs and escaping by way of the nostrils into the enclosing
case, thus both decreasing the degree of rarefaction and more especially precluding
the possibility of forcing the atmosphere to enter the ultimate cells of the lungs,
the tube whereby the air is supplied to the patient may be adapted to cover both
the mouth and nostrils, or an independent tube constituting an exhaling tube, may
lead from the nostrils to the outside of the cabinet or enclosing case. If the last
named method is adopted, it is desirable to provide the exhaling tube with some
device, such as a stop-cock, for closing its air passage during the time the patient is
inhaling. The exhaling tube should then be opened after the lungs have been
filled with the atmosphere supplied through the inhaling tube. The expulsion of
the air from the lungs will then be forcible, and will insure an expansion of the
lung cells which it will be impossible to secure by simply permitting the air to pass
into the mouth and escape directly through the nose. The desired result may also
be obtained, and this is the method usually preferred-by closing the nostrils by
means of a pressure clamp placed upon the exterior of the nose.
The patient may
himself close the nose passages by a muscular effort or with the aid of his hand.
The patient will then be obliged to exhale through the inhaling tube and the same
unusual effort will be required upon the part of the lungs to force the air outward
against the superior pressure of the external atmosphere. A calisthenic action is
thus obtained, in itself beneficial for many purposes, and this may be resorted to
without the employment of any medicinal or remedial materials. The removal of
external pressure has moreover the beneficial effect of causing an expansion of any
air which may be more or less imprisoned behind any obstructions which may
exist in the air avenues of the lungs, thus serving to forcibly expel the substance
causing the obstruction. For the purpose however of administering such agents as
are designed to operate for instance as antiseptics, germicides, tonics or any other
materials, the air, as it passes to the patient, is to a greater or less degree charged
or impregnated with the medicinal, remedial or other agent desired, in the form of
a spray, vapor or gas.
A still further useful purpose to which the invention may be applied is the
treatment of ear disorders. For certain affections of the ear it has been found
desirable to forcibly inject air through the eustachian tube thus reaching the
tympanum and tympanic membrane. Such a result has heretofore been
accomplished by forcing air through a tube inserted in the nasal orifice, but such
treatment is less effectual than that obtained by simply removing the external air
pressure according to this method.

page_text: It is evident that there are numerous ways in which this method of treatment
may be carried out, but a description of one only will be sufficient for the purpose
of fully explaining the same.
An air-tight closet or cabinet of convenient form and size is prepared for
receiving the patient. An opening is formed in the front of this cabinet serving
the purposes of an entrance door. This opening is provided with a cover which
for convenience in securing an air-tight joint, is fitted within a shoulder or
casement formed upon the closet. When it is desired to close the cabinet, the lid
being secured in place, a cap of rubber or other suitable material is placed over the
entire lid and the shoulder thereby forming an air-tight joint. This cap may, for
the better protection of the joint, be surrounded by a cord or wire adapted to be
drawn tightly about the shoulder.
It may be observed however that a belt of rubber may be substituted for the
cap, this belt simply covering the joint, and not the surface of the lid. If the
latter construction is employed it is desirable to insert a plate of glass in the
lid or the entire lid may be of glass for the purpose of admitting light to
the interior of the cabinet.
For the purpose of rarefying the air in the cabinet an air or vacuum pump of
any well-known construction is employed. As it is desirable that the air be
removed from the cabinet evenly and not with the successive impulses with which
the ordinary air-pump operates, it is preferred to insert in the pipe leading from
the cabinet to the pump a tank from which more or less of the air is first exhausted
by means of the pump. Suitable stop-cocks are interposed in the pipes for the
purpose of governing the flow of air. The method of employing this tank is to
first rarefy the air in the tank in the pipe leading from the cabinet, the stop-cock
being closed. The stop-cock in the pipe leading from the tank is then closed and
the cock in the pipe leading from the cabinet to the tank opened, thus allowing the
air from the cabinet to pass into the tank until the required rarefaction is produced.
A vacuum gauge is connected with the cabinet by means of which the degree of
rarefaction may at any time be determined.
A tube leads from the exterior of the cabinet to its interior, and this is united
with a flexible tube which is adapted to be held in the mouth or over the breathing
organs of the patient. A suitable cock is inserted in the pipe for controlling the
flow of air, vapor, or gas through this tube. Another tube may be employed as an
exhaling tube. This is provided with a cap adapted to fit over the nostrils and
with a stop cock for closing the same except at such times as the patient desires to
exhale. This stop-cock is placed inside the cabinet and may be operated by the
patient himself. A similar stop-cock is placed in the tube outside the cabinet
where it may be controlled by the attendant. A clamp adapted to fit upon the nose
and close the nostrils is also preferably suspended at a convenient point within the
cabinet by a cord.
A reservoir is employed for containing medicine or other substance which is to
be administered to the patient. This reservoir is connected with the inlet pipe by
means of a tube terminating in a spray-nozzle of well-known construction.
Through this the contents of the reservoir are forced, the flow being regulated by
means of a stop-cock. For the purpose of conveniently obtaining the required
pressure to produce this result, compressed air or gas is forced into the upper part
of the reservoir which may be provided with an elastic or expansible top, or by
means of the ordinary rubber or metal pressure pump. If it is desired to employ
a gas in the reservoir, the gas itself may be suitably compressed and the spray
nozzle may then be dispensed with. A steam atomizer may be employed with
good results in place of the reservoir and spray nozzle.

page_text: SPECIFICATION in pursuance of the conditions of the Letters Patent filed by
the said William Phillips Thompson in the Patent Office on the 15th April
1884.
WILLIAM PHILLIPS THOMPSON of the Liverpool and London Agency for Fo eign
Patent Solicitors 6 Lord Street Liverpool in the county of Lancaster Fellow of
the Institute of Patent Agents "IMPROVEMENTS IN APPARATUS FOR THE TREATMENT
OF THE RESPIRATORY ORGANS." A communication from Joseph Ketchum the
younger of Brooklyn, Kings County, State of New York, United States of
América,
This invention relates particularly to medical and therapeutic treatments of lung
diseases and disorders.
The object of the invention is to provide a method of administering the desired
medicinal or remedial agents directly to the affected parts so thoroughly and in
such quantities and manner as to secure positive beneficial results.
While the process or method is applicable to all classes of treatment in which it
is desired to reach the inner coatings and the structural portion of the lungs, whether
for the purpose of benefiting the lungs themselves or through that avenue reaching
other portions of the body, the same has been developed with particular reference
to the class of diseases in which the lungs themselves are affected and when it is
desired to administer agents directly to the seat of the disorder.
The invention consists in immersing the patient in a partial vacuum, thereby
removing to a sufficient degree the external pressure of the atmosphere and at the
same time supplying the lungs with atmosphere at its normal pressure, and to
a greater or less extent charged or impregnated with the substance which it is
desired to administer. The degree of rarefaction to which it is desired to subject
the patient is usually that represented by the fall from one-half of an inch to three
inches of mercury in the barometer. The method which is preferably employed in
removing or rarefying the air in the cabinet in which the patient is placed, is to
first produce a high vacuum in an air can or chamber, which may be made to
communicate with the patient, and when the patient has been placed in the cabinet
allowing a sufficient quantity of the air to pass from the latter into the exhausted
chamber. In this manner the patient is relieved from the successive impulses to
which he would be subjected were the rarefaction produced by means of an air-
pump applied directly to the cabinet. In practice the use of this intermediate
chamber is found to be of great importance for the reason that the repeated periodic
removals of pressure otherwise occasioned are not only extremely disagreeable to
the patient but frequently result in positive injury, especially to persons of a
nervous temperament. The decrease in the external pressure upon the body
coupled with the normal internal pressure of the atmosphere causes an inflation of
the lungs and a dilation of their cells, the extent of which is primarily dependent
upon the difference in pressure. The portions of the lungs which may have become
inactive and unresponsive to voluntary respiration are thus forced to expand. The
act of respiration will cause the parts of the lungs to perform their normal functions
so long as this differential pressure is maintained. For the purpose of preventing
the air which is supplied to the patient from passing directly through the breathing
organs, and escaping by way of the nostrils into the enclosing case, thus both
decreasing the degree of rarefaction and more especially precluding the possibility
of forcing the atmosphere to enter the ultimate cells of the lungs, the tube whereby
the air is supplied to the patient may be adapted to cover both the mouth and
nostrils, or an independent tube constituting an exhaling tube may lead from the
nostrils to the outside of the cabinet or enclosing case. If the last named method
is adopted it is desirable to provide the exhaling-tube with some device, such as a
stop-cock for closing its air passage during the time the patient is inhaling. The
exhaling-tube should then be opened after the lungs have been filled with the
atmosphere supplied through the inhaling-tube. The expulsion of the air from the &

page_text: lungs will then be forcible, and will insure an expansion of the lung cells, which it
will be impossible to secure by simply permitting the air to pass into the mouth and
escape directly through the nose. The desired result may also be obtained,-and
this is the method usually preferred-by closing the nostrils by means of a pressure
clamp placed upon the exterior of the nose. The patient may himself close the
nose passages by a muscular effort or with the aid of his hand. The patient will
then be obliged to exhale through the inhaling-tube and the same unusual effort
will be required upon the part of the lungs to force the air outward against the
superior pressure of the external atmosphere. A calisthenic action is thus obtained
in itself beneficial for many purposes, and this may be resorted to without the
employment of any medicinal or remedial materials. The removal of external
pressure has moreover the beneficial effect of causing an expansion of any air
which may be more or less imprisoned behind any obstructions which may exist in
the air avenues of the lungs, thus serving to forcibly expel the substance causing
the obstruction. For the purpose however of administering such agents as are
designed to operate, for instance as antiseptics, germicides, tonics or any other
materials, the air as it passes to the patient is to a greater or less degree charged or
impregnated with the medicinal, remedial or other agent desired in the form of a
spray vapor or gas.
A still further useful purpose to which the invention may be applied is the
treatment of ear disorders. For certain affections of the ear it has been found
desirable to forcibly inject air through the eustachian tube, thus reaching
the tympanum and tympanic membrane. Such a result has heretofore been
accomplished by forcing air through a tube inserted in the nasal orifice, but such
treatment is less effectual than that obtained by simply removing the external air
pressure according to this method.
It is evident that there are numerous ways in which this method of treatment
may be carried out, but a description of one only will be sufficient for the purpose
of fully explaining the same.
The accompanying drawing shows in elevation an arrangement of apparatus
suited to the purpose of the invention.
Referring to this drawing, A represents an air-tight closet or cabinet of
convenient form and size for receiving the patient. An opening B is formed
in the front serving the purposes of an entrance door. This opening is provided
with a cover C, which for convenience in securing an air tight joint is fitted within
a shoulder or casement D formed upon the closet. When it is desired to close the
cabinet, the lid C being secured in place, a cap E of rubber or other suitable
material is placed over the entire lid, and the shoulder D thereby forming an air-
tight joint. This cap may for the better protection of the joint be surrounded by a
cord or wire adapted to be drawn tightly about the shoulder D.
It may be observed however that a belt of rubber may be substituted for the
cap E, this belt simply covering the joint and not the surface of the lid C. If the
latter construction is employed it is desirable to insert a plate of glass in the lid C,
or the entire lid may be of glass for the purpose of admitting light to the interior
of the cabinet.
For the purpose of rarefying the air in the cabinet A an air or vacuum pump F
of any well-known construction is employed. As it is desirable that the air be
removed from the cabinet A evenly and not with the successive impulses with
which the ordinary air pump operates, it is preferred to insert in the pipe F¹ F,
leading from the cabinet to the pump F, a tank G from which more or less of the
air is first exhausted by means of the pump F. Suitable stop-cocks gl g³ are
interposed in the pipes F F for the purpose of governing the flow of air. The
method of employing this tank is to first rarefy the air in the tank G, the stop
cock g' being closed. The stop-cock g³ is then closed and the cock y¹ opened, thus
allowing the air from the cabinet to pass into the tank until the required rarefaction
is produced. A vacuum gauge H is connected with the cabinet A, by means of
which the degree of rarefaction may at any time be determined.
'

page_text: In some instances the desired rarefaction of the surrounding atmosphere may be
secured by the patient himself employing his breathing organs in lieu of the air
pump. By continuously inhaling from the atmosphere of the cabinet and exhaling
through the tube a partial vacuum may be obtained.
As already stated it has been found that the best results may be obtained under
a rarefaction represented by from one half to three inches of mercury.
A some-
what greater degree than this may be employed in some instances, but too high
a vacuum is unadvisable.
A tube K leads from the exterior of the cabinet to its interior and this is united
with a flexible tube k, which is adapted to be held in the mouth or over the
breathing organs of the patient. A suitable cock k¹ is inserted in the pipe k for
controlling the flow of air vapor or gas through this tube. A tube ² may be
employed as an exhaling-tube. This is provided with a cap k³ adapted to fit over
the nostrils and with a stop-cock 7 for closing the same except at such times as
the patient desires to exhale. This stop-cock is placed inside the cabinet and may
be operated by the patient himself. A similar stop-cock k is placed in the tube k³
outside the cabinet where it may be controlled by the attendant. A clamp k³
adapted to fit upon the nose and close the nostrils is also preferably suspended at a
convenient point within the cabinet by a cord k³.
A reservoir L is employed for containing the medicine or other substance which
is to be administered to the patient. This reservoir is connected with the pipe k
by means of a tube m terminating in a spray-nozzle m¹ of well-known construction.
Through this the contents of the reservoir are forced, the flow being regulated by
means of a stop-cock m². For the purpose of conveniently obtaining the required
pressure to produce this result, compressed air or gas is forced into the upper part
of the reservoir, which may be provided with an elastic or expansible top m³
or by means of the ordinary rubber or metal pressure pump. If it is desired to
employ a gas in the reservoir the gas itself may be suitably compressed and the
spray-nozzle m² may then be dispensed with. A steam atomizer may be employed
with good results in place of the reservoir L and spray-nozzle m¹.
Having thus described the nature of this invention and the manner in which it
is to be performed, as communicated to me by my foreign correspondent, I would
have it understood that I claim :-
1st. The combination, substantially as herein before set forth, of a vacuum
chamber, means substantially such as described for rarefying the air contained
therein, means substantially such as described for admitting air to an air containing
body placed within said chamber, and preventing the same from reducing the
rarefaction in said chamber.
2nd. The combination, substantially as herein before set forth, of an air-tight
chamber, means for exhausting more or less air therefrom, an inlet-tube for
supplying atmosphere from without to the lungs of a person within said chamber,
and means, substantially such as described, for preventing the escape into said
chamber of the atmosphere so supplied, and securing the forcible expulsion of the
said atmosphere from the lungs.
3rd. The combination, substantially as hereinbefore set forth, of the air chamber A,
the air-pump F, the reservoir G and the inlet and outlet tube k.
4th. The combination, substantially as herein before set forth, of the chamber A
and the inlet and outlet tube k and the gauge H.
In witness whereof I the said William Phillips Thompson have hereunto set my
hand and seal this tenth day of April in the year of our Lord one thousand eight
hundred and eighty four.