Year: 1886

page_text: Date of Application, 28th June, 1886
Complete Left, 23rd Mar., 1887.
Complete Accepted, 3rd May, 1887.
RESERVI
I ALFONSO JACOBELLI of Naples in the Kingdom of Italy, Professor of Anatomy
at the University do hereby declare the nature of this invention to be as follows:-
This Invention has for its object improvements in apparatus for administering
medicines.
The apparatus is represented by the drawings annexed; it is capable of fulfilling
numerous functions, and by means of it medicaments in measured doses can be
introduced into all normal and pathological cavities of the human body in
communication to the exterior. To this apparatus I have given the name atiniometer.
The apparatus is enclosed in a small leather trunk and is easily conveyed from
place to place carried in the hand by the handle 15; neither its size nor weight is
inconveniently large.
The atmiometer consists of a double cubical chamber with walls 48 made of glass
(see Figure II). It is divided into cubic centimetres by a graduated scale 45 on the
top. The chamber contains a perpendicular diaphragm 47 moved by a screw 76 and
crank 77.
The details are represented by Figure XV. The moveable diaphragm serves to
increase or diminish the capacity of the chamber.
The chamber is bound around by crossed bands of metal 40 to 44 and 61 to 78
Figure II communicates by stop cocks 50 to 59 and by different tubes with other
apparatus and its two lateral partitions formed by plates of glass contain the reflecting
pulvidensemeter 37 (and 17 Figure III) for measuring the dose of the chemical
principles.
The pulvidensemeter is lighted by lamps 25 and 84 which may be directed any way
and of which the light can be regulated.

page_text: The apparatus is fixed on any description of table by clamps at the sides Figure IV.
The graduated air pumps 17 and 107 Figure II by pistons and pincers Figure V and
by the rack 34, Figure III are put into communication with the chamber by the
tubes Figure XXV and produce in this when required, a current of compressed air
either rarefied or cold, and the multiple stop cock serves to change the.chamber very
rapidly from compressed to rarefied air or vice versa.
The filters 18 and 103 Figure II renew the still atmospheric air in the first instance
purifying it. All these different layers of air and of gas are measured as they pass
out by the pncometergraph (Figure VII which marks the quantity of air inhaled the
rhythm and the number of the respiration of the lungs per minute) and by the
conducting tubes (Figures XXIII and XXXII which can be applied as desired by
the connecters 1 to 6 Figure XVI and 1 to 7 Figure XVII) and they penetrate into
the organic cavities by means of special probes, mouth pieces, Figure XXI or
automatic inhaling masks or by inspiration and exhaling together 4 Figure XX.
A manometer 63 Figure II marks the positive and negative pressures and the
pneumodynamometer 38 records the force of respiration. (When required the one
can be transformed into the other). The thermometer Figure VI marks the heat of
the current of air and of liquids on leaving the chamber.
The gas purifier 10 Figure II absorbs by the chemical principles which it is
desired to employ vapour and gas such as the vapour of water and carbonic acid gas
from the lungs allowing only the oxygen to pass back into the chamber. The gas
may be contained in the indiarubber bag Figure XIII or in the gasometer Figure XI
and its flow regulated by the tube with opposite valves Figure XXIV.
The fumigator Figure XI produces sinoke and measures and regulates the supply
of smoke of the substances burnt.
The heater 6 Figure II (with lamp Figure 8) developes the vapour and exhalation
from liquids (measured in the pipette Figure X or in the automatic drop measurer
Figure IX) and it also produces air heated to various degrees and clouds from
compressed vapour by means of the stop cock 1 Figure XVIII and the leather
bands 5.
The instrument 24 Figure II reduces solids to dry meteoric impalpable powder; it
is measured by the pulvidensemeter above mentioned.
The graduated nefogene 91 Figure II transforms liquids into cloud and projects
them upon the accessible points by nebularising jets either of glass or of metal
arranged horizontally vertically or obliquely 29, 17, 12 and 26 Figure XX. These
clouds are propelled as currents by means of the rose blower 12 Figure XX by
continuous pressure of the air pumps or by the propellor 6 Figure XXIX connected
with the compressible bag 1 Figure XIX and the patient receives them by the
mask 1 Figure XX pieces 11, 5 and 8 or by the collector 34.
Artificial automatic respiration. Figure XI causes automatic respiration in the
lungs removed from animals to demonstrate how and up to what point the
medicaments penetrate into the lungs and cause the artificial tracheal artery to operate
Figure XII.
The hydraulic apparatus Figure XI with tube 12 or the smaller with cover 1
Figure XXII and tube 7 and the 8 and 11 form different douches. When the
chamber 48 Figure II is worked with water then not only can it be employed as a
douche but by means of the probe 3 Figure XXVI and the tubes 23, 24, 25 a rotary
flow of water may be produced either for washing or cauterization in the cavities and
then the chamber acts to propel liquid and the cylinder 1 Figure XI works as an
aspirator to withdraw the liquid more or less rapidly.
As to its use the atmiometer is intended to form ambients of which the vehicles are
either air or water regulated in volume velocity pressure and heat; medicated with
measured doses and with any medicament used in medicine either in the form of gas,
exhalation, vapour, cloud, smoke or powder either together or mixed as may be most
suitable.
The atmiometer applies not only plain or medicated air but also in accordance with
hydraulic laws solutions of divers medicaments.

page_text: The respiratory cavities themselves draw in the simple or medicated vehicles and
into those cavities of the living or dead body (whether human or animal normal or
pathological) which are inert these vehicles are forced by the apparatus itself put in
movement by the manual force or by an automatic motor.
Its utility is found in scientific studies, in physics, chemistry, hydraulics, physiology,
chemical, medicine and surgery, and all with the object of treatment by surgical and
direct means with air or medicated solutions in regulated dose the maladies of all the
open organic cavities whether normal or pathological of the human body in place of
employing indirect means as by the stomach and by which the effect of which is
always slow and often insufficient.

page_text: the mercury ball of a thermometer and having communication by a tube A with
the interior of the said cubic chamber, and also by the cylindrical chamber with the
pneumometrograph Figures 1, 4, 5 and 7.
The pneumometrograph consists of a cylindrical chamber R carrying a paddle
wind wheel, the axis of which carries on its head a worm screw operating on gear
wheels situated in a plane normal to that represented in Figure 7. The said
cylindrical chamber is connected with the aperture g¹ through which the air flows
in, and with the aperture 9 which allows the air to flow out. In the latter is to
be observed a small valve t. This valve opens and closes with the aspirations, thus
setting in alternate motion the lever s, which operating by means of the clicks n and n¹
on the ratchet wheel q and numbering the aspiration performed by the patient under
treatment.
The device shown in Figures 9 and 10 is applied for minimum aspirations. It
differs from the described pneumometrograph in substituting a cylinder, presently
to be described for the wind wheel, the worm and the gear wheels shown in
Figure 8, the whole arrangement being as shewn in Figure 9. In the space C
left free, is placed the device shown in Figure 10, consisting of two cylindrical
glass chambers separated by a diaphragm and closed with metallic ends provided
with leathern valves and the whole being secured by three small rods
with nuts at the ends. The two chambers are in communication with each other
by a glass tube f and hang upon a fulcrum which permits them to swing over the
space of the pneumometrograph Figure 9. The side T Figure 10 connected with
the emission opening g is provided with two apertures communicating with the
tubes a and a¹. The side T connected with the admission opening g' is provided
with two apertures communicating at right angles with the tubes 6 and b¹. The
aperture a is connected with the aperture m by means of a rubber connector.
The aperture 6 is similarly in communication with the aperture s opening on the
cylindrical side of the chamber P; the aperture a¹ is connected with m and the
aperture 6 with s¹.
Upon the brass plate e and within the upper quadrant, in the spaces left clear
by the taps, are fixed four smaller taps Figure 1, the object of which is also to
establish communication with the inside of the cubic chamber.
l
To the same front glass side of the chamber, and with no communication with the
inside of it, are externally placed, the manometer m and the pneumodinamometer.
These devices may be regarded as reciprocals for they can be transformed one into
the other. They consist of a small U shaped glass tube communicating upwardly
and by means of small taps either with the external air or with the inside of the.
chamber, through small india rubber pipes fixed to the taps.
At the centre of the rear glass side of the cubic chamber are fixed two brass discs n
and o giving passage to a rectangular threaded screw p Figure 4 which is secured
to a diaphragm T made of glass having the same thickness as that of the chamber
sides, fastened to the screw between two other discs Figure 4. This screw is turned
by means of a handle q Figures 2, 3, 4 and 5 placed outside.
The cubic chamber is scaled on the top glass with divisions representing cubic
centimeters, see Figure 3, by sliding the diaphragm the capacity of the cubic
chamber may be reduced at pleasure.
The back glass of the cubic chamber shows another scale see Figure 2, also
in cubic centimeters, which serves to measure the capacity of liquids occasionally
introduced in it.
"6
On the lateral side of the said cubic chamber, is written on the internal surface
the
word Pulvidensimeter " see Figure 4. This word is reflected no less than
fourteen times upon the opposite side, both sides being slightly inclined and for
a certain portion made mirror like (Figure 5 B¹), the letters represent a sloping
scale in reverse sense on the two sides, so as to allow an easy numeration of them,
the letters being reflected and alternately seen one large and one small one.
To the cubic chamber are attached one on each side, two pumps r and s
Figures 1. 2 and 5, in thick glass externally scaled in cubic centimeters.

page_text: By working the corresponding double arm handles, the pistons are moved over the
scales any required distance. The pistons are of simple make and leather finished.
At the two ends of the double arm lever handlet Figures 2 and 3. the two piston
rods are connected by knuckle joints. The stroke of the pistons may be prolonged
or shortened by pulling out or pushing in the toothed rack u Figure 4 which carries
the fulcrum of the lever. The rack is held between two locking pieces and vi
Figure 2 attached to a U shaped spring and they hold the rack through its whole
length. These rails open apart under the action of the hand levers a Figure 3
to let the toothed rack pass. The rack the U shaped spring and the rails are
contained within a small brass box Figure 1 fixed by screws on the wooden stand
of the cubic chamber.
The pump of which the detailed section view is to be seen in Figure 11, is
an ordinary two cylinder single acting pump the position of the valves may be seen
in the said figure. P is a cylindrical glass chamber having two supports / and h¹
to which are screwed the ends m and m². The piston Q is leather finished and
in the head of the piston rod is formed an eye k to which is jointed the lever handle t
as shown in Figures 2, 3, 4 and 5.
Upon the stand of the cubic chamber and by the side of it is the commutation
tap P with three passages all of brass work see Figures 1 and 5. In the sectional
plan view Figure 16 the commutation tap carries two tubes c and c' which can be
placed in communication with the opposite chamber P. The tube c¹ can be placed
in communication with the tube rat right angles to it and the tube c can be placed
in connection with the tube r¹ also at right angles which starts from underneath and
turns out bent as shown in Figure 1. In this figure the plug of the tap marked P¹.
Over the barrels of the pumps are fixed two small wooden stands y and z
Figures 1, 2 and 3. Upon the stand y by a sliding bracket the heater a¹ is supported
over the spirit lamp 6. The cylinder M Figure 5 in some cases is similarly
supported. On the top of the heater is fixed a tap c with the automatic drop
measured Figure 3 and the small scaled glass funnel e¹ or the latter only as shown
in Figure 1. Upon the same stand y a brass standard in two parts and adjustable
in height as seen in Figure 5 supports the so called choniogen f¹ which consists
of an india rubber syringe at the extremity of which is fixed at right angles a
brass mouth-piece supported by a cushion on the adjustable standard Figures 1, 3, 5.
The heaters shown in Figures 1, 2, 3 and 5 marked A in Figure 12, consists of a
metallic cylinder with ends bb carrying tubes extending in opposite directions. On
the top of the said heater is secured as already stated a tap adapted to establish
communication with the interior of the heater as represented in Figures 1 and 2 and
the funnel e consisting of a small graduated glass funnel which can be substituted for
the drop measure d' Figure 3, which is a simple graduated crystal tube provided
at each end with metallic rings one adapted to be screwed on to the tap m of the
heater A Figure 12 and the other to be closed with a suitable metallic screw stopper
which by being inserted more or less tightly will let more or less air to pass and
more or less of the liquid to fall into the heater. The whole device is supported
by a sliding arrangement and can thus be drawn out when desired.
On the same stands are horizontally fixed two filters g¹ and h¹ consisting of two glass
tubes filled with cotton mounted at the rear end with brass caps having central holes
covered with net work Figures 1 and 2 and at the front end with similar caps having
two small central brass tubes.
Upon the same stands are two lamps and m³ carried by jointed brackets
Figures 2 & 3. The lamp shown in Figure 13, is made of thin metal-plate and
is provided with a thick glass bull's-eye y which condenses the light of the lamp. It
contains the fittings for the wick and oil and the whole device is hinged upon two
pivots and adapted to be carried farther from or nearer to the apparatus."
On the front side of the stand z Figures and 3 is placed the cylindrical gas
purifier n of glass with brass ends. The device shown in Figure 14 is somewhat
different and consists of a cylindrical vessel shaped glass chamber p with a metallic
cover g which is secured to one of the metallic bands holding the cylinder. The
2

page_text: 7"
cover g carries three mouth pieces. The upper one is in connection with. the glass
tube which rests at the bottom on three pegs and is fitted at both ends with net
work; the middle one is freely in communication with the interior and the lower
mouth piece s carries a U shaped tube z the other end of which is covered with net
work and is secured by means of three pegs on the metallic cover. The purifier n¹
Figures 1 and 3 is closed at the bottom and at the front side presents three holes
covered with net-work. The first or upper hole is connected inside with a glass tube
of such a length as to nearly approach the other end and this tube is filled with
sulphuric pumice stones. The second or middle hole remains free and the third
or lower hole carries a U shaped tube with a brass coller at the further end which is
within the purifier. This tube is filled with potassic pumice stones.
At the rear of the purifier and on the same stand z is fixed by means of a band the
so called "Nephogen p¹ Figure 2. This device represented by Q Figure 15, consists
of a glass flask secured at the bottom by a metallic band screwed on a suitable
support. The mouth of the flask is closed by a metallic screw-stopper carrying two
tubes and of which is metallic and fixed on the stopper and of glass and passes
through the stopper to which it is secured ending near the bottom. The device shown
in Figures 2 and 3 differs by having a graduated glass flask the brass bottom of
which is screwed on. It can be provided either with a simple stopper or with one to
which are fixed two small pipes, the one S shaped and the other straight, both ending
inside of the flask.
On the adjoining drawings are further to be observed:
1st. The gasometer M Figure 5 which can also be used as a smoke collector or as
an aspirator, as a hydraulic projector or as an artificial respirator for small anatomic
lungs. It consists of a cylindrical graduated glass vessel having brass bottom
screwed on and brass cover fitted with three taps.
2nd. The instrument N Figure 4 consists of a circular bundle of tubes bound
together on the rear side, but in such a manner as to leave free passage across the
centre to another couple of tubes P of which one is straight and the other has a third
of the backward length bent down at right angles.
3rd. The other details refer to simple masks and to the mouth piece. The latter
contains two pipes of which one is connected with an india rubber pipe and the
other is applied to the mouth of the patient. This tube is fitted inside with an india-
rubber valve which opens for aspiration. A set of india rubber pipes to be used for
the communication with the different devices is also shown. Ainong them is to bo
specially noted: The pipe Q named esophagea-sounding pipe, consisting of two pipes
sewed together for three quarters of their length. It remains divided at one end, and
at the other it presents four holes on each side: R is the tube of respiration for
gases; it carries at one end, and perpendicularly to the vertical axis, a small glass
vessel screwed on by the bottom. This pipe branching at one end forms two smaller
ones, each carrying inside a valve, one acting for aspiration and the other for
expiration.
The mode of using the apparatus is as follows:-
:-
Within the cubic chamber and by means of communications established through
india rubber pipes with the different organs of the apparatus any required aeriform or
liquid ambients is composed.
Thus making for instance by means of a front tap connection between the cubic
chamber and the heater which has the spirit lamp placed under it and allowing to fall
into it liquid from a minim measure or a small funnel, the patient will breath in the
vapour or medicamental exhalation developed in the heater through the mouth piece
which will have been already jointed to a pipe connected with another of the front
taps of the cubic chamber. At the same time the pneumodinamometer, which will
have been also connected by an india rubber pipe with one of the smaller taps or
faucets of the cubic chamber, will indicate the power of the respiration. The
thermometer by which flows the air expelled from the cubic chamber will show its
temperature. The pneumometrograph will show the volume of medicated air coming
out of the cubic chamber at each respiration which are registered by gear wheels

page_text: worked by a worm screw placed on the axis of a wind wheel. As to the operation for
minimum aspiration; suppose the cylinder at its place in the pneumometrograph and
the chamber P to be full of water the said chamber will then lean on one side in
consequence of its own weight. Further supposing that air be drawn in through the
opening a into the opposite chamber P¹ then the opening b, being connected with s,
the air will carry with it the water, owing to the difference of pressure degree by
degree into the chamber P¹ according to the indication given on the scale which
chamber P will when thus filled lean on the other side and so on alternately. The
device will thus oscillate and by means of the pawls q and q¹ placed at the ends, it
causes the wheels y and y' symmetrically disposed on the pneumometrograph Figure 9
to indicate the volume of air drawn in, while by means of the lever sand of the
wheels and q it will show the number of aspirations performed.
The filters connected with other taps of the cubic chamber allow the penetration
into it of pure air which dilutes the medicines. The pulvidensimeter constantly
illuminated by the side lanterns, enables the operator to see the disappearance of a
more or less number of the fourteen images, reflected on the mirror according as the
charge of medicines is lighter or heavier. The charge has the effect of clouding the
air contained in the cubic chamber. Further by sliding forward and backward
the diaphragm situated under the scale of the top glass of the same chamber the
operator will be enabled to regulate the capacity of the same chamber according to
the purpose of the medication.
When gas medication is required, of the air contained within the chamber, it is
sufficient to connect one of the taps with one side of the bifurcation, the pipe leading
the other to the middle hole of the purifier, and connect the lower hole of the same
with the gasometer and the upper one with another tap of the cubic chamber. The
patient will then inhaling by means of the masks connected with the pipe R, breathe
in the gas from the chamber and expire it out into the purifier. This apparatus
retains the carbonic acid and the aqueous vapours, and only allows the oxygen to flow
back into the chamber; thus the oxygen going to and fro is ultimately fixed in the
lung. A small glass attached to the pipe serves to collect the aqueous vapour of the
respiration which deposits itself within and around the same tube.
When dry powder medicated air is required the chamber is to be connected with
the choniogen and by impressing on it some hand strokes, the thin powder which it
contains, will enter little by little into the chamber. This powder which is regulated
in quantity according to the disappearance of the images reflected by the pulvi-
densimeter is inhaled by the patient as before described.
If smoke medicated air is needed then the prescribed substances are burnt under
the cylinder M, which having no bottom acts as a flue and will have to occupy the
place of the heater. This cylinder being then connected with the chamber through
one of its upright taps, allows the smoke collected to flow in and the quantity is
regulated as usual by the pulvidensimeter.
The compressed air necessary to the production of fog, when such a treatment is
required will be obtained by the punips fixed on either side of the cubic chamber.
These are to be connected by means of a T formed pipe to the rear hole of the
instrument N and to the rear hole of the straight tube of the nebulizator, the vertical
tube of which dips into the graduated flask or nephogen. The fog then developed
within the centre of the wind dial, is surrounded by a bundle of ten compressed air
conductors which will carry it up to a distance of two meters, without loss and
allowing the sealed flask to show the quantity of liquid transformed into fog.
The vehicle employed in all the aforesaid manoeuvres is air having the same
pressure as that of the external atmosphere, but when the pumps, which are graduated
to indicate the volume of air contained therein, are set to produce within the cubic
chamber, either current, compressed or rarefied air, their degree being shown by the
manometer connected with the cubic chamber by a rubber connector then medications
will result having for vehicle a current of compressed or rarefied air. To obtain in
the chamber either compressed or rarefied air, it suffices to connect the suction and
delivery of the pumps, with the commutation tap which in its turn communicates with

page_text: the cubic chamber, and it is enough to turn its spigot from the horizontal to the
vertical position to cause the pump to deliver into the chamber and their aspiration
being from the external air, while by replacing the spigot to the horizontal position,
rarefaction is caused within the chamber and ejection of compressed air from the
pumps into the external atmosphere.
By working on the same plan within the cylinder M having the bottom closed and
acting in this case as an artificial respirator through one of its taps, the lung of a
lamb may be exhibited breathing artificially if kept hanging internally on another
tap; it expands when the air rarefies within the cylinder and contracts when com-
pressed air enters the same.
But the cubic chamber might equally be filled with water, the volume, being
Then the pumps
indicated by the scale written on the rear crystal of the chamber.
throwing their pressure upon the water level compel the same to find its way out
through a pipe connected to one of the front taps at a pressure determined by the
manometer and enter one end of the esophagus-sounder, while the other end com-
municating with the cylinder M which acts as an aspirator and within which the
pumps contemporaneously produce rarefaction, forces the water back from the cavity,
to which it is being carried by the cubic chamber. This manoeuvre serves to produce
within the cavity a vortex of determined volume and pressure and also to introduce in
the stomach some poisoned liquids which being driven out again, may just causticate
the diseased surroundings, without poisoning the organism.
Thus the "atimometer now described serves for the treatment of all the normal
and pathological cavities of the human body having external communication.
The importance of the present invention will then be generally recognised, when
considering that a complete measurement of the dose is obtainable by it, as is needed
to compose aeriform or liquid ambients, both natural and artificial to be inhaled or
passed in to the cavities of the human body with the object of curing diseases locally
and in a surgical way.
The success obtained on patients who have exhausted all other means hitherto
known is the best proof of the novelty and usefulness of the invention, and legitimates
the great and favorable impression the "atiometer "has made upon the scientific
men of the world.
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 :-
--
The apparatus for administering medicines which I call atmiometer consisting of a
chamber with appliances for disseminating medicaments in measured quantity in air
or other ambient and conducting the medicated ambient into the cavities of the body
substantially as described.
Dated this 20th day of March 1887