Monday, November 28, 2016

1864: Seigle and Adams steam powered Inhaler

Figure 1 (1)
The first steam powered inhaler was described in a paper published in 1862 by Dr. H. Walenburg of Germany. (1, page 464)

It was described as "an instrument by means of which he could produce medicated spray in combination with steam and through the motive power of that principle." according to George Beatson in an 1880 article in the Glasgow Medical Journal. (1, page 464)

Regardless of his invention, he did not get credit as the inventor of the steam powered inhaler, and this may have been because he didn't obtain a patent for his product.  (1, page 464)

Two years later, in 1864, Dr. Emil Seigle of Stuttgart did take out a patent for a steam powered inhaler, thus giving him credit for the invention.  (1, page 464)

However, to his credit, it's possible that, because the design of the Seigle inhaler was "entirely different" from that of the Walenburg inhaler, Seigle was unaware of Walenburg's paper.  (1, page 464)

Seigle's Inhaler was a significant improvement in nebulizer design because it was the first nebulizer to create a mist completely on its own, without any manpower. (1, page 464)

Dr. Scutter said the Seigle Inhaler "was far preferable" to the other options of the day "for its simplicity and because it is automatic. The best reason for preferring it, however, is, that its price is such as to bring it within the means of any patient, as it is furnished through the druggists for $5.00, and its construction is so simple, that it is readily operated by any one." (3 page 32)

Like the Mathieu and Bergson inhalers, the Seigle design used the Bernoulli Principle to create a mist. Yet the older designs required a stream of air to create the mist. Without electricity, this required manpower. A flow had to be produced by blowing into a tube, by cranking a peddle, by squeezing a bulb syringe, or by depressing billows.

Dr. Seigle used steam instead of air. This eliminated the requirement of manual effort to create the stream. From figure 1 we can see that what he "did was connect Bergson's spray tube with a glass boiler, using steam for producing and conveying the spray instead of air." (1, page 464)

Figure 2 (1)
There apparently were other similar devices for using steam to produce a medicated spray, but these other devices were not as simple in design and ease of use as the Seigle Inhaler.  (1, page 464)

It was nice because the patient could simply sit it on a table and inhale the mist without much effort. It may have been this reason Seigle's inhaler was considered the first of its kind, even though it was probably not.

Yet the original Seigle inhaler (pictured in Figure 1) had its flaws, including the fragile glass boiler, which occasionally overflowed, and "the water flowing over through the stream escape is projected forcibly in the face of the patient... it required much persuasion on the part of the physician, and considerable nerve on the part of the patient, to face Seigle's Patent Inhaler after one or two experiences of this nature." (2, page 218)

The device was updated many times, and ultimately was accepted by the medical community and recommended to some patients who could afford it. (1, page 465)

Dr. Adams with "Face Protector"  (2)
One of the most significant improvements on the device was made by Dr. Adams in 1868, who improved the boiler system so that it was no longer made of glass. He introduced his new design in the Glasgow Medical Journal in 1879. (1, page 465)

He discussed his new design ten years later in his 1889 article "On an improved apparatus for spray inhalations," (2, page 317)

Future designs of the Seigle inhaler were based on the Adams design, mainly because...
...they gave off a steady, uniform stream of spray, warm in character and so fine as to cause little irritation, while being self-acting, they neither fatigued the patient nor required an assistant. In this way they became extensively used. (1, page 465)
Figure 2 is nice in that it allows you to visualize how the Seigle and Adams inhaler worked by means of the Bernoulli Principle. You can see how the steam rises, flows through the vertical tube rapidly, and a negative side stream pressure is created that draws medication up from the medicine reservoir. The example shown is actually the Adams Inhaler, although the same concept was used with the Seigle Inhaler and other similar designs.

The Seigle's inhaler was later improved and re-marketed, or as Dr. Adams wrote "pirated," by Dr. Seigle and re branded as "Dr. Seigle's Patent Steam Spray Inhaler, with Boiler as suggested by Dr. Adams." (1, page 465) (2, page 317)

The principle used to create the Seigle Inhaler was used "on an extensive scale" at the Hospital for Diseases of the Throat and Chest in the United Kingdom.  Here a room was designated for the purpose of inhalations, up to twelve patients were able to inhale different medications at the same time. (4, pages 85-86)

The steam was conveyed from a boiler in the basement of the hospital, and it traveled through pipes "fixed horizontally round three sides of the inhaling room, and from this horizontal pipe there project at regular intervals, and at right angles, secondary tubes which correspond with the horizontal tube of a Seigle Inhaler.  Bottles containing different solutions are connected with each terminal tube."  (4, pages 85-86)

This was a nice design, allowing the physicians at the hospital to treat up to twelve patients, each with a different inhaled medicine, simultaneously.  (4, pages 85-86)

The principle used by Seigle and Adams was a simple one that allowed many patients to inhale a medicated mist.  Most often the patient would receive this therapy at a physician's office or hospital, and the physician, a nurse, or an attendant would prepare the medicine.

However, for those who could afford it, the devices could be purchased for a nominal fee, and the medicinal recipes prepared and inhaled in the privacy of their own homes.

References:
  1. Beatson, George, "Practical Papers on the Materials of the Antiseptic Method of Treatment," Vol. III, "On Spray Producers," Coats, Joseph, editor, "History of the Origin and Progress of Spray Producers ", Glasgow Medical Journal, edited for the West of Scotland Medical Association, July to December 1880, Vol. XIV, Alex and Macdougall, pages 461-484
  2. Adams, "On an improved apparatus for spray inhalations," The Retrospect of Medicine," W. Braithwaite, editor, Vol. LXXX, July-Dec., 1879, London, published by Simpkin, Marshall, and Co, pages 317-321 Inhaler
  3. Scudder, John M, "On the use of medicated inhalations, in the treatment of diseases of the respiratory organs," 2nd edition, 1867, Cincinnati, Moorz, Wilstach & Baldwin
  4. Mackenzie, Morell, editor, "The Pharmacopoeia of the Hospital for Diseases of the Throat and Chest," 4th edition, 1881, Philadelphia, Plesley Blakiston
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