1869: Lewin's Inhaler

Mathieu's Nephogene (from Lewin) (2)

There were many problems with the Nephogene (nebulizer) created by Mathieu.  The greatest concern was that the spray produced was so forceful most of the mist created pounded into the oral cavity and produced a cough, according to Jacob Cohen in his book "Inhalation: its therapeutics and practice."

This made it certain little of the spray made it to the lungs.  Of course Cohen made sure to mention that this device was not first devised to deliver respiratory medicine, but to spray medicines on any part of the body.  

The person to fine tune the device to make it more appropriate for the inhalation of respiratory medications was Lewin of Berlin.  Cohen described the device as such: (1, page 190)

Lewin, of Berlin, has constructed an apparatus with an ordinary suction pump (syringe) which forces the liquid into a reservoir, the air within which is thus compressed, and in its turn becomes a propelling force, driving the fluid, on the opening of a valve, out of a very fine aperture, whence it impinges on a convex button, and becomes thus broken into spray. This apparatus once set in action will continue to work for a considerable time without further pumping. (1, page 190)

Lewin's glass nebulizer (1)

Yet another problem with inhalers prior to Lewin was that they were all mostly made of medal.  This meant that certain medicines couldn't be used if they interacted with metal. Lewin aimed to correct this problem by using a "strong glass reservoir" instead of metal." It was also graduated with markers so the operator knew how much water to put into it.   (1, pages 194, 195)

It was covered by a "strong metal cap with three openings: one for the introduction of the liquid and the subsequent attachment of the condensing syringe; one affords exit to the capillary extremity of a slender tube which reaches to the bottom of the glass; and the third is covered by a spring safety-valve, through which the compressed air may escape after a certain pressure has been produced."  (see figure 19) (1, pages 194, 195)

To work it a "finger is placed upon the capillary extremity of the exit-tube until the air in the reservoir has been sufficiently compressed by a few strokes of the piston, when the finger is removed, and the fluid rushes out with great force and breaks upon a gilded metallic convex button secured in a glass drum, perforated to admit the stream, and attached by a support to the side of the instrument. The drum is not furnished with a waste-pipe, but is so inclined that the excess of fluid will flow over its edge into any convenient receptacle." (1, pages 194, 195)

So there were various advancements made by Lewin both to his nebulizer and to that of Mathieu's.  Yet his most significant contribution was the use of material that wouldn't react with the medicine that might be used in it.

Yet tthere were still flaws with it. It was made of glass.  It was bulky.  It was expensive.

Either way, these nebulizers provided another option for physicians and patient. They were also another step in the evolution of nebulizer therapy.  (1, pages 194, 195)

References:

1. Cohen, Jacob Solis, "Inhalation in the treatment of disease: it's therapeutics and practice," 1876, Philadelphia, Lindsay and Blakiston, part II, "Inhalation of nebulized fluids, or sprays:  nebulized medicaments and the apparatus for their production," pages 184-212

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1859: Mathieu's Nephogene

Mathieu's Nephogine (Nebulizer) (1)

Modern nebulizers work by means of the Bernoulli Principle, where air is forced through a narrow tube, a negative side stream pressure is created, and medicine is sucked into the flow through a small opening in the tube, thus producing a fine spray or mist.  This concept was first used in a nebulizer in 1859 by M. Mathieu of Paris.  

A nebulizer is any device that creates a mist.  The first nebulizer was introduced in 1858 by M. Sales-Giron, and it required an operator to work a pump similar to a bicycle pump to generate a flow that caused the solution to spray onto a hard surface to produce a mist.  

Similar to Danielle Bernoulli's realization that the same mist produced by forcing water onto hard a surface could be produced by his Bernoulli Principle, Mathieu discovered the Bernoulli Principle would be ideal for creating an effective nebulizer.  He got the idea from the concept of treating ailments of the mouth and throat with a spray produced by squirting water out of a syringe.  (2, page 188)

On May 9, 1859, at the Paris Academy of Medicine,  he introduced his product, which he called the Nephogene (nebulizer), to the Medical Academy at Paris.  It was not a pulverizer or atomizer because it didn't pulverize nor atomize, it simply broke the solution into "a cloud or nebula"; it thus nebulized. (2, page 188)

The nebuliezr is described here:  (1, page 462-463)

"In it the subdivision of the medicated fluids is brought about, not by checking the jet against a solid body, but by forcing the fluid to escape at high pressure, along with a blast of compressed air, through a tube with a small opening. Fig. 2 shows Mathieu's original instrument. In it the air is compressed in the brass ball, A, by means of the pump above it, whilst the fluid to be atomised is put  into the glass ball, B. As soon as the instrument is set in motion the two stopcocks are opened, when; the medicated fluid escapes drop by drop into the tube c, and there meets the blast of compressed air, which forcibly projects it outwardVin the form of a very fine but cold spray." 

Another version designed by Mathieu can be seen in figure 18, and thus described here:

"This apparatus (Fig. 18) is composed of a glass reservoir c, in which the liquid to be employed is poured through the little funnel G. On compressing the air in the pump B, by motion of the lever A, the fluid is forced through a small groove in one of the plates forming the joint D, and by turning the screw H, the smooth plate is more or less compressed against the groove, thus regulating the delicacy of the stream. A stream as fine as the finest hair can be thus secured if the instrument be properly constructed. This capillary stream against the upper portion of the cylindrical metallic drum E, whence it is diffused in a very fine spray. A waste-pipe f, conveys the excess of fluid back into the reservoir. The force with which this little apparatus works is evident on removing the drum, when the stream will be projected up for several feet, then falling like a fountain. It is said that at a few inches distance the stream can be projected into the skin, thus forming a mode of endermic medication." (2, 193-194)

Before 1862 all the nebulizers produced were either based on the Sales-Giron or Mathieu design.  It was in 1862 the mechanisms of Mathieu's idea was greatly improved upon by a German named Dr. Bergson when he introduced the Bergson Apparatus and Inhaler in 1867.

Reference:  

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. Cohen, Jacob Solis, "Inhalation in the treatment of disease: it's therapeutics and practice," 1876, Philadelphia, Lindsay and Blakiston

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