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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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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1862: The Bergson Apparatus and Inhaler

Figure 1

In 1858 Dr. M. Sales Giron invented the first nebulizer to produce a fine spray by blasting a jet of water onto a hard surface, and in 1859 Dr. Mathieu invented the first nebulizer utilizing the bernoulli principle. In the following years various nebulizers were introduced to the market, all improving, in one way or another, either the Sales-Giron or Mathieu models. Yet this all changed in 1862 due to an invention by Dr. Bergson called Bergson Tubes.(3, page 463)

The concept that Bergson used was not new to the world. Similar "tubes" were used in fire trucks to draw water out of the truck's reservoir, through the hose, and spray water onto the fire. Similar tubes were also used for various other industries to spray solutions, such as for the perfume and disinfectant industry. (2, page 196-197)

So the recommendation was made by Dr. Nathanson to Dr. Bergson, who was from Germany, that he try to implement this idea to producing a nebulizer. Thankfully, Dr. Mathieu had already started on such a project. (2, page 196-197)

Dr. Scutter said he used Dr. Sales-Giron's Nebulizer "in my practice with excellent results," yet noted that a lot of cranking was required by the operator to generate only a small amount of mist. (1, page 31)

So perhaps all the work required to get only a little mist was the reason why Dr. Bergson decided to concentrate his efforts on improving the Mathieu nebulizer.

In 1862 Bergson introduced to the market what he referred to as the "Hydrokomion" or "Water Dust Apparatus." It was "an important modification of Mathieu's idea," (3, page 463) and would result in the Bernoulli Principle being mist producing concept of most nebulizers from that point on.

The Bergson Tubes resulted in a major improvement in the Mathieu design. Scudder described them this way: (2, page x)

"The apparatus, as constructed by Bergson, consists of two tubes at right angles, placed with their extremities together, and so joined that the extremity of the perpendicular tube should stand in front of the axis of the horizontal tube, as seen in the accompanying diagram. (see figure 1)

"If two tubes are thus arranged, and the vertical tube placed in a vessel containing a liquid, and then a current of air be blown from the mouth through the horizontal tube, the transverse current will carry over with it, as it were, the top of the column of air in the vertical tube, which, of course, will force up a current of the liquid to occupy the space of the air; and this continuing, the liquid will at length reach the top, and be blown by the transverse current into a coarser or finer spray. The fineness of the spray, and, consequently, its facility of ingress into the respiratory tract, will depend upon the minuteness of the extremities of the tubes, principally upon that of the tube dipping into the liquid. If the fluid is to be nebulized by the breath alone, the opening of the horizontal tube must not be too small, otherwise force enough cannot be produced. If the current is produced by means of a bellows, as the Davison's injecting syringe, the opening of the horizontal tube can be smaller.

"For the production of a continuous stream, an air reservoir must be attached to the syringe, and, for this purpose, Dr. Bergson adopted the arrangement of a rubber bellows worked with the foot, connected to the horizontal tube by rubber tubing, in the continuity of which is placed a globular elastic ball as an air reservoir. (Fig. 6.)

The Bergson nebulizer was therefore designed as such (refer to figure 3):

"a, reservoir for fluid; b,.waiter ; c, vertical tube ; d, horizontal tube ;  f, flexible tubing ; g, air reservoir ; h, rubber bellows to be compressed by the foot; i, joint connecting the Bergson tubes; k, nebula or spray; I, rim or cap of reservoir to which the nebulizing tubes are attached.   

The nebulizer worked pretty much as the description above describes, except the flow used to generate the mist was created by depressing the foot bellows.  When the bellow (h) is pressed, air is forced through the tube (f) "the air in the middle ball (g) is compressed and is forcibly blown through the horizontal tube (d).  When the air flows over the opening of the other tube," the negative pressure draws in the medication in the reservoir (a).  A mist is then created.  (3, page 463-4)

This product was a nice improvement, although it still took a lot of work to produce a mist.  Plus the tubes were made of glass, the product was clumsy, and it was costly and fragile. There was still room for improvement.

References:

1. 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
2. Cohen, Jacob Solis, "Inhalation in the treatment of disease: it's therapeutics and practice," 1876, Philadelphia, Lindsay and Blakiston
3. 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

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1738: The Bernoulli Principle

The market for a device to create a spray was looming.  Perfume marketers yearned for a device to spray their products onto ladies.

The medical industry yearned for a product to spray medicine into the airways of respiratory patients.  Yet no such product would be possible without knowledge of the Bernoulli Principle.

We are not concerned about the perfume industry here, yet there are two times in the history of aerosol therapy that the perfume market actually helped the medical industry.

The first time was during the mid 19th century, and the second was in the mid 20th century.  The first produced the nebulizer, the second our modern inhaler.

As far as the inhalation of medicines, the medical industry already had one very good method, and that was the inhalation of smoke and steam.  The problem was that there were two different types of medicine: volatile and non-volatile.

Volatile medicines could be ignited and thus inhaled.  Tobacco, for example, is volatile and can be stuffed into a pipe and burned.  Strammonium and Belladonna were volatile, and could be placed on a brick, stone or plate, ignited, and the smoke inhaled.  This knowledge was known since the ancient world.

By the mid 19th century the search was on for a device that would turn a solution into a spray.  It was believed that such a device would break down the solution into atoms, and in this way the solution could be inhaled.  This breakdown was thus referred to as atomization, pulverizing or nebulizing, and the devices created were often referred to as atomizers, pulverizers or nebulizers.

Yet no such machine would have been invented if not for the discovery of the Bernoulli Principle. Daniel Bernoulli observed that when water hits a rock it creates a mist that can be inhaled. He published a book in 1738 where he described that a similar effect could be created by forcing water through a narrow tube.

His concept was based on the fact that the faster water flows through a tube, the less the lateral pressure will be.  A decreased lateral pressure is also referred to as a negative side stream preassure.  If there is a hole in the side of the tube, the negative pressure will force water into the stream.

This same concept was used in creating the first nebulizers, only using air.  Air is forced through a tube, and a hole in the tube is connected to a container with a solution in it that contains the medication.  The fluid is basically sucked in due to the negative sidewall pressure, and turned into a spray or mist. (1, page 61)

This concept is illustrated in figure 1.  In this figure steam is used to create the flow and the negative side stream pressure.  As the steam flows through the tube the negative side stream pressure causes the solution in the cup to be sucked into the stream, and thus a spray is developed.

References:

1. Clark, William F., Paul J. Mathews, Kenneth A. Wyka, "Foundations in Respiratory Care," 2002, Delmar Thomson Learning