Monday, March 27, 2017

1930s: Spiess-Drager (Apneu) Nebulizer and Inhalatoriums

Figure 1 (4, page 4)
The modern nebulizer is based on the work of Professor Spiess, who was working for Drager in Frankfurt, in 1902.

His nebulizer used a flow of oxygen from a compressed nebulizer to atomize solutions placed in a reservoir cup.

The system essentially consisted of the nebulizer, which was connected to a compressed air or oxygen tank.  The flow was set between 5 and 12 liters per minute.  (3, page 7)

The product was connected to a rubber mouthpiece by a rubber hose.  The system used the Venturi principle to atomize the solution to be inhaled.

The inhaler, sometimes referred to as the Spiess-Drager, Apneu, or collision inhaler, was used to study the effects of various inhaled medications.  The medicine most commonly used was Glycerin (a mixture of epinephrine, water, and glycerin) to patients with chronic bronchitis, chronic laryngitis, croup related pneumonia, interstitial pneumonia, and tuberculosis.  (3, page 7)

It was, in effect, the first nebulizer/inhaler device to utilize an oxygen tank, and was the first such device that allowed physicians to give oxygen and nebulized therapy simultaneously.  (4)

W.E. Collision, in his 1935 book "The Inhalation Therapy Technique," described the history of this inhaler. He said:
In 1902 Professor Speiss of Frankfurt introduced his inhaler, which incorporated the use of oxygen and atomized liquids.  His method was extensively used throughout Germany and during the Great War.  This apparatus was introduced into England by Mr. P.S. Douglas-Hamilton and myself in 1924 and was exhibited at the British Medical Association Exhibition (which was held in Bath in the following year), and in subsequent years until 1932, when the Collision inhaler was exhibited for the first time at the Association's Exhibition at the Imperial Institute of London. (4, page 4)
The London Inhalatorium... afforded
a comfortable treatment room
to those being treated."  (2, page 134)
Since most people with lung disorders could not afford to bring this equipment to their homes, this inspired London physicians to open up an inhalatorium in Grosvenor Place.  This created a comfortable, and affordable, setting for patients to inhale medicine with oxygen. (2)

Other medicine inhaled by the device was  epinephrine (adrenaline), menthol, eucalyptus, terpentine and insulin. (2).

The treatment would last about 10-15 minutes.

This spawned an inhalatorium fad of sorts.  Other inhalatoriums opened, and similar collision nebulizers were introduced to the market.  One such copycat was Hirth's Jet Nebulizer.

Asthmatics might also enjoy the pleasures of an inhalatorium.  They may only visit when having trouble breathing, or they might visit 3-4 times a day as a preventative measure.

The Spiess-Drager Inhaler, and the inhalatoriums it spawned, provided a unique opportunity for inhaling medication.  This was a nice set up for the time.

References:
  1. Green, Henry-Lionel and W.R. Lane, Particulate Clouds: Dusts, Smokes, and Mists, Second Edition, Spon Ltd., London, 1964. (linked to from Inhalation.net, "Atomizers for Droplet Aerosol Generation," accessed Oct. 8, 2012)
  2. Sanders, Mark, "The London Inhalatorium," Inhalatorium.com, page 134, http://www.inhalatorium.com/page134.html accessed 10/9/12
  3. Bisgaard, Hans, Chris O'Callaghan, Gerald C. Smaldone, editors, "Drug Oxygen Delivery," 2001, New York, Marcel Dekker, page 7
  4. Collision, W.E., "Inhalation therapy technique," 1935, London, William Heinemann

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