US3083707A - Device for treatment of pulmonary diseases - Google Patents

Description

April 2, I933 Filed Feb. 13, 1956 H. w. SEELER 3,083,797

DEVICE FOR TREATMENT OF PULMONARY DISEASES 2 Sheets-Sheet l 12 156 W IL I 1 17 --I '78 22 g INVENTOR.

H/S ATTOENEYS LN w JIEZ 21-15.]

April 2, 1963 H. w. SEELER DEVICE FOR TREATMENT OF PULMONARY DISEASES Filed Feb. 13, 1956 2 Sheets-Sheet 2 INVENTOR. HENZV W SE'ELEE HIS fl TTOF/VEYS' 3,083,707 Patented Apr. 2, 1963 3,083,707 DEVICE FOR TREATMENT OF PULMONARY DISEASES Henry W. Sealer, 3142 Atherton Road, Dayton 9, Ghio Filed Feb. 13, 1956, Ser. No. 565,015 11 Claims. (Cl. 128-29) This invention relates to a device for treatment of pulmonary diseases and more particularly to a breathing apparatus for supplying a vaporized medicament to the lungs of a patient, although not necessarily so limited.

The breathing apparatus to which this invention pertains is essentially a pressure control apparatus which periodically interrupts a flow of gas under pressure to the lungs of a patient. As the patient attempts to inhale, the control mechanism operates automatically to allow the gas to flow into the patients lungs as an aid to inhalation. When the gas pressure in the lungs reaches a preselected maximum value, the control mechanism operates automatically to cut oil the supply of gas permitting the gas pressure in the lungs to drop to atmospheric pressure, the patient exhaling naturally.

One object of this invention is to provide a breathing apparatus operable from a low pressure source of breathing gas. The source may be. for example, an electrically or manually operated air compressor. A gas pressure of 35 mm. mercury is sufficient to operate the breathing apparatus, hence, the need for costly cylinders of highly compressed oxygen or the like is eliminated.

Another object of this invention is to provide, in combination with the breathing apparatus, a medicament nebulizer assembly, the operation of which is governed by the breathing apparatus. As a means for conserving medicament, the nebulizer assembly in this combination is operative only during the inhalation cycle of the breathing apparatus so that medicament is never released to the atmosphere until it has passed into the lungs of a patient undergoing treatment.

Still another object of this invention is to provide a novel valve assembly in combination with the breathing apparatus which permits exhalation of gas directly into the ambient atmosphere, by-passing the breathing apparatus. Contamination of the breathing apparatus parts with exhaled medicament is thus prevented. As a further consequence, the breathing apparatus is able to provide fresh gas for inhalation immediately upon initiation of the inhalation cycle, with no recycling of exhaled air.

Other objects and advantages reside in the construction of parts, the combination thereof and the mode of operation. as will become more apparent from the following description.

In the drawings, FIGURE 1 is a perspective view of the pulmonary treatment device including the medicament nebulizer assembly.

FIGURE 2 is an enlarged sectional view taken substantially along theline 22 of FIGURE 1.

FIGURE 3 is an enlarged sectional view taken substantially along the line 3-3 of FIGURE 1.

FIGURE 4 is a sectional view taken substantially along theline 44 of FIGURE 2.

FIGURE 5 is an elevational view oriented 90, of the portion of the pulmonary treatment device shown in FIGURE 4, with parts in section taken substantially along the line 5-5 of FIGURE 4.

FIGURE 6 is an elevational view of the portion of the pulmonary treatment device shown in FIGURE 4, with parts in section taken substantially along the line 6-6 of FIGURE 4.

FIGURE 7 is a sectional view taken substantially along the line 77 of FIGURE 2.

FIGURE 8 is an end elevational view of the portion of the pulmonary treatment device shown in FIGURE 3 with parts in section taken substantially along the line 8-8 of FIGURE 1.

FIGURE 9 is a sectional view taken substantially along the line 9-9 of FIGURE 2.

FIGURE 10 is an enlarged sectional view taken substantially along the line Iii-10 of FIGURE 1.

Referring to the drawings in detail, FIGURE 1 shows the general arrangement of the elements of the pulmonary treatment device. Thereference numeral 20 indicates a pressure regulator apparatus adapted to receiver gas from a source of gas under pressure (not shown). Connected to thepressure regulator apparatus 20 by means of a herdble conduit orhose 22 is ahousing 24 for an exhalation valve assembly which functions to separate fresh gas for inhalation from exhaled gas. Thevalve housing 24 is provided with abreathing tube 26 for insertion in a patients month. When desired, the breathing tube may be replaced with a face mask (not shown).

Attached to thevalve housing 24 by means of aconduit 28 is a medicament nebulizer 30 for introducing medicament into the gas stream for inhalation by the patient. Gas under pressure is provided for operation of the nebulizer 30 through a hose orconduit 32 connecting to thepressure control apparatus 20.

Pressure Control Apparatus Thepressure control apparatus 20 is housed in a substantially cylindrical housing formed by two mating substantially cup-shaped housing members 36 and 38, as shown in FIGURE 2. Disposed radially within the housing and separating the cup-shaped members 36 and 38 is aresilient diaphragm 40 provided with anannular rib 42. Theannular rib 42 is seated in an annular groove provided therefor in the end wall of thehousing member 36 to provide a sealing gasket between thehousing members 36 and 38. Thehousing members 36 and 38 are held in compressive engagement with the diaphragm by screws (not shown) or other suitable means.

Thediaphragm 40 divides the housing into two substantiallycylindrical chambers 44 and 46. Thechamber 46 communicates with the ambient atmosphere through a port 49 provided in the wall of the housing member Mounted in thechamber 44 is anapertured block 47 functioning, as will be described subsequently, as a valve seat. Anoutlet port 48, seen best in FIGURE 4, traversing theblock 47 connects to the ambient atmosphere through aconduit 50 seated in theblock 47 and penetrating the wall of thehousing member 36. A clapper valve 53 closes theconduit 50, permitting a passage of gas only out of thechamber 44, not into thechamber 44. This construction is best seen in FIGURE 4.

Aninlet port 52 extends angularly through theblock 47 to communicate with a channel 5 4 through which a gas under pressure may be supplied to thechamber 44. Thehousing member 36 is provided with aspigot 56 providing thechannel 54 for connection to a source of gas under pressure.

A.gate valve 58 operated by a ring-lever 60 is provided for restricting the gas flow into theinlet port 52. The ring-lever 60 girdles thespigot 56 and is rotatably seated thereon. Awasher 62 held in compressive abutment with the ring-lever 69 by anelastomeric band 64, also seated on thespigot 56, provides a substantially air-tight seal to prevent leakage of gas around the ring-lever.

As best seen in FIGURE 9, the ring-lever 60 is provided with anannular cam surface 66 which engages apin 68 traversing the wall of thespigot 56 and carrying thegate valve 58. Thepin 68 is held in compressive engagement with thecam surface 66 by means of aspring 70 engaging the internal wall of the spigot. Ahandle 72 secured to the ring-lever 60 provides for manual rotation of the ringlever to adjust the position of thegate valve 58 so as to adjust the How of gas into theinlet port 52.

Aspigot 78 integral with thehousing member 36 pro vides for connection of theconduit 22 to the pressure control apparatus. Theconduit member 22 communicates eventually with the lungs of a patient, forming a closed volume with thechamber 44.

Aslide valve plate 74 best seen in FIGURE 6, is provided in thechamber 44 for closing selectively either theoutlet port 48 communicating to the ambient atmosphere or theinlet port 52 communicating to the source of gas under pressure. Thevalve plate 74 is pivotally mounted upon apin 79 secured to thehousing member 36 with a lJ-shaped bracket 81. Depending upon the location of thevalve plate 74, the pressure in thechamber 44 may either equal that of the ambient atmosphere, or be greater than that of the ambient atmosphere. Apressure gauge 76 is threadedly connected to thehousing member 36 for measuring the pressure in thechamber 44.

Traversing axially thechambers 44 and 46 is a rod 80 having an enlarged substantiallysquare end portion 82 seated in acylindrical bearing member 84, in the base portion of thehousing member 36. The opposite end of the rod 80 projects through the base portion of thehousing member 38, themember 38 being provided with a bearing member 86 in the wall thereof for accommodating the rod 80.

The portion of the rod 80 traversing thechamber 44 has a diameter greater than the corresponding portion traversing thechamber 46, thereby providing for a shoulder 88 for engagement with thediaphragm 40. Thediaphragm 40 is secured to the rod 80 with a pair of washera 90, one seated upon the shoulder 88 on one side of the diaphragm and the other secured by a pin 92 traversing the rod 80 on the other side of the diaphragm 40'.

In response to pressure changes in the closed volume including thechamber 44, the rod 80 is urged to move axially by thediaphragm 40. An axial displacement of thediaphragm 40 is promoted by providing an annular arched portion 94 therein adjacent the cylindrical wall of thehousing 20, the arched portion 94 straightening as the diaphragm moves axially. To obtain maximum effective pressure area for thediaphragm 40, a thin metallic or plastic disc 96 is placed on each side of the diaphragm, each disc 96 being sandwiched between one washer 90 and thediaphragm 40.

The axial motion of the rod 80 anddiaphragm 40 is utilized to govern the motion of thevalve plate 74 through a. novel toggle mechanism shown in FIGURES 4 and S. Slidably engaging the rod 80 within thechamber 44 is asleeve 98, the sleeve being seated upon the enlarged square end portion of the rod 80, as shown in FIGURE 5. Pivotally secured to thesleeve 98 are two oppositely directed, radially extendingshafts 100 which slant upwardly toward thediaphragm 40 from thesleeve 98. The free outer ends of theshafts 100 are journalled for reciprocating movement into L-shapedbracket members 104, there being one such bracket member for eachshaft 100. Eachbracket member 104 is secured to thehousing member 36 by any suitable means.

Ahelical spring 108 extends around eachshaft 100 compressively abutting thesleeve 98 at one end of theshaft 100 and the L-shapedbracket member 104 at the other end of theshaft 100. Due to the angular disposition of theshafts 100, thesprings 108 cooperate to urge thesleeve 98 and, as a consequence, the rod 80, towards the base of thechamber 44.

An actuator arm .110 projects radially from thesleeve 98 through aslot 112 in thevalve plate 74 to seat in anaxially extending channel 114 provided therefor in theblock 47. Theslot 112 in thevalve plate 74 is elongated axially, to permit lost axial motion of theactuator arm 110 within thevalve plate 74.

The pressure control apparatus is depicted in the drawings at an instant when the pressure within bothchambers 44 and 46 is that of the ambient atmosphere. If gas under pressure is delivered to thechamber 44 through theinlet port 52, the gas pressure within thechamber 44 will rise. The increasing gas pressure displaces thediaphragm 40 axially, so as to enlarge thechamber 44 and, as a consequence, the rod is drawn axially away from the base of thechamber 44. The rod 80 carries with it thesleeve 98 of the toggle mechanism. As thesleeve 98 is carried axially in thechamber 44 away from the base thereof, the shafts are pivoted into parallel alignment, while simultaneously the actuator arm traverses theslot 112 of thevalve plate 74. At the instant the toggle mechanism reaches the neutral or dead center position wherein theshafts 100 are parallel, the actuator arm engages thevalve plate 74. The motion of theactuator arm 110 as the toggle mechanism approaches dead center is thus lost motion relative to thevalve plate 74.

With continued rise in pressure, thesprings 108 of the toggle mechanism drive thesleeve 98 axially by a snap action along the rod 80 toward thediaphragm 40, where thesleeve 98 engages astop 116 which limits the axial motion thereof. Thestop 116 is secured to the base of thehousing member 36 at such an elevation in thechamber 44 that when thesleeve 98 engages thestop 116, thevalve plate 74, driven by theactuator arm 110 will cover theinlet port 52 in theblock 47, thus shutting off the incoming gas.

Proper positioning of thevalve plate 74 over theinlet port 52 is insured by placing astop 118 secured to theblock 47 by abracket 120 for engaging thevalve plate 74 as it covers theinlet port 52. Thevalve plate 74 is firmly seated against theblock 47 by a leaf spring 122, or the like, supported by thebracket 120.

As the valve plate is pivoted from a position covering theoutlet port 48, as shown in the drawings, to the new position covering theinlet port 52, gas flows out of the closed volume including thechamber 44, through theoutlet port 48, reducing the gas pressure within thechamber 44 to atmospheric pressure, and, as will be described subsequently, permitting a patient undergoing treatment to exhale. The falling pressure in thechamber 44 returns thediaphragm 40 to its equilibrium position, but does not reset the toggle mechanism. Thesleeve 98 remains in abutment with the washer 90 of the diaphragm assembly.

In order to reset the toggle mechanism, the patient must inhale briefly, closing the clapper valve 53 to close theconduit 50 and lowering the pressure in thechamber 44 below atmospheric pressure. This causes thediaphragm 40 to move axially, driving the toggle mechanism toward the base of thechamber 44. As the toggle mechanism approaches the dead center position, theactuator arm 110 crosses theslot 112 in lost motion in thevalve plate 74 and, as the toggle mechanism passes the dead center position, thesprings 108 snap thesleeve 98 to the base of thechamber 44, moving thevalve plate 74 to the position covering theoutlet 48 in theblock 47. Gas flows in theinlet port 52 and a new inhalation cycle is thereby initiated.

It is desirable that the inhalation cycle be initiated with a minimum of effort on the part of the patient. Accord ngly, thesprings 108 in the toggle mechanism are made ust strong enough that they properly position thevalve plate 74. The reduced pressure in thechamber 44 necessary to actuate the toggle mechanism is then minimized, so as to be readily created by a patient. The control apparatus herein disclosed is a demand responsive mechanism, in that the inhalation cycle is started only after the patient demands air.

Afiat spring 124, shown in FIGURES 2 and 7, is employed for controlling the maximum inhalation pressure developed in thechamber 44. A threadedannular flange 126, concentric with the rod 80, is provided on the end of thehousing member 38. Threadedly connected to theflange 126 is acap member 128, carrying adisc 130, to which is secured theflat spring 124. Thecap member 128 is adjusted by rotation, so that theflat spring 124 engages the rod 80 at substantially the instant the toggle mechanism is driven to the neutral point during the inhalation cycle. Clearly, in order to terminate the inhalation cycle, thediaphragm 40 must first overcome the restraining or biasing force of theflat spring 124 before driving the toggle mechanism away from the neutral position. The maximum pressure obtained in thechamber 44 is determined by the resistance offered by thespring 124.

By rotating thecap member 128 so as to move thespring 124 closer to thediaphragm 40, the restraining force exerted by thespring 124 can be increased, since it becomes necessary to displace the spring 124 a greater distance to terminate the inhalation cycle. Thecap member 128 thus represents a pressure adjustment. Apointer 132, integral with thecap member 128, cooperates with suitable indicia (not shown) on thehousing member 38 to provide a means of presetting thespring 124 for a particular maximum pressure value.

For occasions when the patient undergoing treatment has apnea and is therefore unable to initiate the inhalation cycle, a manual actuator is provided for starting the inhalation cycle. Seated within a hollowcylindrical projection 134 in thecap 128 is abutton 136 loaded with a helical spring 138, compressively engaging the disc 1311 at one end thereof and thebutton 136 at the other end thereof. This structure is shown in FIGURE 2.

Projecting into thecap member 128 is a shaft 14% of diameter smaller than the rod 80 slidably seated in thebutton 136. As thebutton 136 is depressed, the shaft 149 is thrust through asmall aperture 142 placed therefor in the center of thefiat spring 124, to engage the rod 8t), so as to drive the rod 80 and thediaphragm 40 axially toward the base of thechamber 44. This resets the toggle mechanism, positioning the valve plate 7; over theoutlet port 48 and opening thegas inlet port 52 so as to initiate an inhalation cycle.

In the event thebutton 136 is not released, anoverride spring 144 is provided, allowing the pressure control apparatus to operate as a resuscitator. Theoverride spring 144 is strong in comparison to the toggle mechanism, but weak as compared to thefiat spring 124. After initiation of the inhalation cycle, theoverride spring 144 yields to the axial movement of the diaphragm 4t} and the rod 80, allowing the toggle mechanism to operate thevalve 74. After the termination of one inhalation cycle, a new inhalation cycle is initiated as soon as the gas pressure in thechamber 44 drops sufficiently that thespring 144 can reset the toggle mechanism. Since thespring 144 is weak in comparison to the fiat spring 12-1, the maximum positive pressure developed during resuscitation is not significantly greater than would occur during normal demand responsive operation.

The Exlialazion Valve Assembly The pressure regulator supplies an intermittent gas pressure of variable amplitude to theconduit 22 which communicates with thevalve housing 24. As best seen in FIGURE 3, the valve housing is formed with two mating substantiallyconical members 152 and 154, separated by aflexible diaphragm 156. Thediaphragm 156 is provided with anannular rib 158 at the perimeter thereof which seats in a complementary annular groove in the Wall of theconical member 154. The diaphragm serves as a sealing gasket between the twomembers 152 and 154 which are held in compressive engagement therewith byreleasable clasps 162.

Theconical housing member 152 is provided with aspigot 164 for connection to theconduit 22 communicating with the pressure regulator apparatus and theconical housing member 154 is provided with aspigot 166 for connection to thebreathing tube 26 leading to the pa.- tients lungs. Thediaphragm 156 therebetween provides for a check-valve between thehousing members 152 and 154 resisting a flow of gas from the breathing tube to theconduit 22; but offering only small resistance to a flow of gas from theconduit 22 to the breathing tube.

Thediaphragm 156 is provided with an annular flange 168, the diameter of the flange 163 being approximately half the diameter of therib 158. The flange 168 projects into the conical housing member [54 to seat a circular check-valve 170. The check-valve 178 has astem 172 projecting normally from the center thereof through an aperture in the center of thediaphragm 156. Anannular channel 174 in thestem 172 engages the central portion of the diaphragm as a means of securing the valve to the diaphragm. A pair ofapertures 176 are placed in thediaphragm 156 intermediate the annular flange 168 and thestem 172 to provide for a passage of gas through the diaphragm.

When there is a pressure diiierential across the diaphragm such that the pressure in theconical housing member 154 is greater than the pressure in thehousing member 152, the valve 171) seats firmly= upon the flange 163 and no air can pass through the diaphragm. When the pressure diilercntial is reversed, thevalve 170 is displaced from the flange 168 to permit gas to flow through the diaphragm.

intermediate the annular flange 168 and theannular rib 158, thediaphragm 156 is provided with an annular arched portion 177 which permits an axial displacement of the diaphragm in response to a pressure differential across the diaphragm. Theconical housing member 154 is provided with an annular wall orflange 178 engaging thediaphragm 156 intermediate the annular arched portion 177 and the annular flange 168 of the diaphragm. Theannular flange 178 of thehousing member 154 cooperates with the arched portion 177 of the diaphragm to provide an annular channel 189 in theconical housing member 154. The annular channel 181 communicates with anexhalation port 182 integral with theconical housing member 154.

When a pressure differential develops across the diaphragm 1.56 such that the pressure within thehousing member 152 is greater than or equal to the pressure in thehousing member 154 and greater than the pressure in the annular channel 189, the diaphragm is driven axially toward theannular flange 178 of thehousing member 154 to close 011 the channel 139 therein, and hence to close oil theexhalation port 182. When the pressure differential is reversed so that the pressure in thehousing member 154 or the channel 183 is greater than that in thehousing member 152, thediaphragm 156 is displaced axially away from theannular flange 178 to open theannular channel 180. This permits gas to be exhaled into theexhalation port 132. Theport 182 connects to a lowresistance exhalation chcclevalve 184, which prevents inhalation through theport 182.

The valve assembly in thevalve housing 24, permits a passage of gas to a patients lungs isolating the exhalation port during the inhalation cycle. During the exhalation cycle, exhaled gases are vented directly to the ambient atmosphere through the exhalation port. In this manner. the valve assembly functions to separate exhalation and inhalation gases.

The Medicament Nebuiizer Assembly The medicament nebulizer 30 connects to the conicalvalve housing member 154 through aconduit 28. As shown in FIGURE 8, the medicament nebulizer comprises a vertically oriented substantiallycylindrical housing 186, in which is mounted a vertically extendinghollow tube 188. Thehollow tube 188 cooperates with agas inlet jet 190, to provide a conventional atomizer for vaporizing a medicament placed in the housing. Thegas jet 190 is supplied with gas under pressure through thehose 32 connecting to a spigot 192 threadedly connected to thehousing member 36 of the pressure control apparatus. Through anaperture 194 in thehousing member 36, thehose 32 connects directly to the incoming gas regulated by thegate valve 58.

As a means of conserving medicament, a pressure sensitive hose clamp assembly, as shown in FIGURE 10, is utilized to regulate the gas flow to the nebulizer 30 in response to pressure variations produced by the pressure control apparatus.

The hose clamp assembly includes a shallowcylindrical housing 196 having abase portion 198 and enclosed by atop portion 200. Aflexible diaphragm 202 extending radially in thehousing 196 divides the housing into twochambers 204 and 206. Thediaphragm 202 is provided with anannular flange 208 along the perimeter thereof which is secured to the wall of thehousing 196 by a suitable means. Anaperture 210 traverses the wall of thehousing 196 to thechamber 206, so as to maintain thechamber 206 at atmospheric pressure.

Thediaphragm 202 is adapted to move axially in thehousing 196 by providing anannular arch 212 therein. A thin metal orplastic disc 214 engages the central portion of thediaphragm 202 within thechamber 206, to prevent bowing or stretching of the diaphragm.

Thelegs 216 of aU-shaped bridge member 218 encircling thehose 32 slidably penetrate the top 200 of thehousing 196. Thelegs 216 are secured in any suitable manner to thedisc 214. A helical spring 220 encircles thelegs 216 within thechamber 206, compressively en gaging thedisc 214 at one end thereof and the top 200 of thehousing 196 at the other end thereof.

Abolt 222. threadedly engages the arcuate portion of theU-shaped bridge member 218. Thebolt 222 is provided with a taperedtip 224 which pinches thehose 32. When the pressure in bothchambers 204 and 206 is that of the ambient atmosphere, thespring 222 is sutficiently strong to cause the taperedtip 224 to fully close theflexible hose 32.

Through a conduit orhose 226, thechamber 204 of the hose clamp assembly communicates with theconduit 22. When the pressure in theconduit 22 is substantially that of the atmosphere, thehose 32 is closed and no medicament is vaporized. As the pressure in theconduit 22 rises during the inhalation cycle of the pressure control apparatus, thediaphragm 202 in the hose clamp assembly is displaced axially against the spring 220 actuating thebridge member 218 to open thehose 32. The opening in thehose 32 may be adjusted by rotating thebolt 222. This permits vaporization of medicament, which travels into thebreathing tube 26 through thevalve housing member 154. At the termination of the inhalation cycle, the pressure in theconduit 22 returns to atmospheric pressure and, as a consequence, theflexible hose 32 is pinched closed and vaporization of the medicament ceases.

Mode of Operation Thebreathing tube 26 is provided with aresilient end plate 230 adapted for insertion in a patients mouth between the lips and teeth. The patient retains the breathing tube by biting on a pair offlanges 232 projecting from theend plate 230.

As the patient undergoing treatment first demands air, the clapper valve 53 closes theoutlet port 48 and the gas pressure in thechamber 44 decreases. Thediaphragm 40 actuates the toggle mechanism to shift the position of thevalve plate 74 opening thegas inlet port 52 and closing thegas outlet port 48.

A gas under pressure flows to thechamber 44 through theinlet port 52 and thence through theconduit 22 to the patient's lungs, forcefully filling the lungs. With increasing gas pressure in theconduit 22, the hose clamp assembly is operated to open thehose 32 leading to the nebulizer 30. Vaporized medicament is released to the gas stream, flowing therewith into the lungs of the patient.

When the gas pressure in the lungs,conduit 22, andchamber 44 reaches the maximum pressure as determined by the setting of thecap 128, which positions theflat spring 124, the toggle mechanism is actuated to shift the position of thevalve plate 74, closing thegas inlet port 52 and opening theoutlet port 48. The high gas pressure in thechamber 44 forces open the clapper valve 53 and gas flows out of thechamber 44 and theconduit 22 reducing the gas pressure therein to substantially atmospheric pressure.

The reduced gas pressure in theconduit 22 operates the hose clamp assembly to close off thehose 32, thus cutting off the supply of medicament to the lungs. Simultaneously, the high gas pressure in the lungs operates thediaphragm 156 in thevalve housing 24 so as to open theexhalation port 182 and gas is permitted to flow out of the lungs in normal exhalation.

As soon as the patient again demands air by attempting to inhale, the cycle described above begins anew.

The time duration of the inhalation cycle is controlled by regulating the flow of gas into thechamber 44. The flow of gas is increased or decreased by adjusting thegate valve 58 with thehandle 72 projecting from the pressure control apparatus. The maximum pressure developed in the patients lungs is regulated by adjusting thecap 128 positioning theflat spring 124, which biases the movement of thediaphragm 40. The amount of medicament delivered to the gas stream by the nebulizer may be regulated by adjusting thebolt 222 in the hose clamp assembly.

The patient may exhale at any time during the inhalation cycle by developing a lung pressure greater than the pressure in theconduit 22. This operates the valve assembly in thehousing 24 to close 01f theconduit 22 and open theexhalation port 182. As the patient exhales, thechamber 44 will rapidly build up to maximum pressure actuating the toggle mechanism to open theoutlet port 48. The pressure control apparatus will thus be in proper position to initiate a new inhalation cycle when the patient next attempts to inhale.

It is highly desirable in a device such as this that provision be made for sterilizing the components subject to contamination. It is apparent that, in the present device, only the breathing tube and exhalation valve assembly are subject to contamination from the patients breath since the pressure control apparatus is isolated from the patients exhalation breath by the operation of the exhalation valve assembly.

The releasable clasps 162 of thevalve housing 24 provide for quick disassembly of the valve housing so that thehousing member 154, thediaphragm 156, thecheckvalve 170, thebreathing tube 26, and theexhalation valve 184 may all be separated to facilitate sterilization. Thehousing member 152 of the valve housing is not subject to contamination.

Although the preferred embodiment of the device has been described, it will be understood that within the purview of this invention various changes may be made in the form, details, proportion and arrangement of parts, the combination thereof and mode of operation, which generally stated consists in a device capable of carrying out the objects set forth, as disclosed and defined in the appended claims.

Having thus described my invention, I claim:

1. A device operable from a source of gas under pressure for use in the treatment of patients having pulmonary disorders, said device comprising, in combination, pressure responsive means connected to the source of gas under pressure for regulating the flow of gas therefrom, a conduit communicating with said pressure responsive means and terminating in an adapter for fitting the mouth of a patient for conveying gas to the lungs of the patient, said pressure responsive means operating to permit a flow of gas from said source to said conduit in response to a gas pressure less than that of the ambient atmosphere created by inhalation demand of the patient and operating to stop the How of gas from said source to said conduit while simultaneously connecting said conduit to the ambient atmosphere when the gas pressure in said conduit obtains a predetermined maximum value relative to that of the ambient atmosphere, and pressure sensitive valve means positioned between said adapter and said conduit for closing said conduit and simultaneously providing a passage from said adapter to the ambient atmosphere whenever the gas pressure in said adapter exceeds the gas pressure in said conduit.

2. A device operable from a source of gas under pressure for use in the treatment of patients having pulmonary diseases, said device comprising, in combination, a pressure regulator connected to the source of gas under pressure for regulating the flow of gas therefrom to establish a breathing cycle, an adapter for delivering the gas to a patient, a conduit connecting said pressure regllator with said adapter, exhalation valve means responsive to a gas pressure ditterential between said conduit and said adapter interposed therebetween, said exhalation valve means providing a first passage between said adapter and said conduit and a second passage between said adapter and the ambient atmosphere, said valve means having two positions, a first position opening said first passage while closing said second passage, and a second position closing said first passage while opening said second passage, a nebulizer operating from the source of gas under pressure supplying a vaporized medicament to said conduit, and means responsive to the gas pressure in said conduit for regulating the flow of gas from said source to said nebulizer, the construction and arrangement being such that gas is permitted to flow from said source to said nebulizer to deliver vaporized medicament to said conduit only when the gas pressure in said conduit exceeds a predetermined value above that of the ambient atmosphere.

3. A device operable from a source of gas under pressure for use in the treatment of patients having plumonary diseases, said device comprising, in combination, control means connected to the source of gas under pressure for regulating the flow of gas therefrom to establish a breathing cycle, conduit means communicating with said control means for conveying gas therefrom to the lungs of a patient, nebulizer means communicating between the source of gas under pressure and the conduit means for supplying a vaporized medicament to the conduit means, means responsive to the gas pressure in said conduit means for regulating the nebulizer means such that gas is permitted to flow from said source to said nebulizer to deliver vaporized medicament to said conduit only when the gas pressure in said conduit exceeds a predetermined value above that of the ambient atmosphere, and valve means providing for exhalation by the patient to the ambient atmosphere and preventing exhalation by the patient into said conduit means.

4. A pressure control apparatus for regulating the flow of gas from a source of gas under pressure into a closed volume, said apparatus including a housing defining a gas receiving chamber communicating with and forming a part of said closed volume, pressure sensitive means communicating with said chamber, means providing a gas inlet to said chamber communicating with the source of gas under pressure, means providing a gas outlet from said chamber communicating with the ambient atmosphere, a valve member, disposed in said chamber for alternately covering the gas inlet and the gas outlet, valve operating means responsive to said pressure sensitive means for actuating said valve member so as to close the gas inlet when the gas pressure in said chamber obtains a predetermined maximum value and to close the gas outlet when the gas pressure in said chamber obtains a predetermined minimum value, and yielding means for manually actuating said valve operating means so as to close the gas outlet when the as pressure in said chamber is greater than the minimum valve, said yielding means yielding when the gas pressure in said chamber exceeds a predetermined maximum value.

5. A pressure control apparatus for regulating the flow of gas from a source of gas under pressure into a closed volume, said apparatus including a housing defining a gas receiving chamber communicating with and forming a part of said closed volume, pressure sensitive means communicating with said chamber, means providing a gas inlet to said chamber communicating with the source of gas under pressure, means providing a gas outlet from said chamber communicating with the ambient atmosphere, pressure operated valve means disposed in said gas outlet for closing the gas outlet when the gas pressure in said chamber is below that of the ambient atmosphere, a pivotally mounted valve member for closing alternately the gas inlet and gas outlet, and valve operating means responsive to said pressure sensitive means for pivoting said valve member between the gas inlet and the gas outlet so as to close the gas inlet, opening the gas outlet when the gas pressure in said chamber obtains a predetermined value above atmospheric pressure and to close the gas outlet opening the gas inlet when the gas pressure in said chamber obtains a predetermined value below atmospheric pressure.

6. A pressure control apparatus for regulating the flow of gas from a source of gas under pressure into a closed volume, said apparatus including a housing defining a gas receiving chamber communicating with and forming a part of said closed volume, a pressure sensitive diaphagm disposed in one wall of said chamber, a rod carried by said diaphragm traversing said chamber, means providing a gas inlet to said chamber communicating with the gas under pressure, means providing a gas outlet from said chamber communicating with the ambient atmosphere, a pivotally mounted valve plate having a slot therein, said valve plate closing alternately the gas inlet and the gas outlet, reciprocably mounted means operated by said diaphragm for positioning said valve means, said reciprocably mounted means comprising a toggle mechanism including a sleeve slidably mounted on said rod for reciprocating motion thereon about the dead center position of said toggle assembly, resilient means biasing the toggle mechanism away from dead center so as to urge said sleeve to occupy one of two extreme positions on said rod, and an actuator arm carried by said sleeve projecting into the slot in said valve plate for pivoting the valve plate between positions covering the gas inlet and the gas outlet, the slot in said valve plate providing for lost motion of the actuator arm therein whereby the actuator arm pivots the valve plate only as the sleeve carrying the actuator arm moves away from the dead center position of the toggle assembly.

7. A pressure control apparatus for regulating the flow of gas from a source of gas under pressure into a closed volume, said apparatus including a housing defining a gas receiving chamber communicating with said forming a part of said closed volume, pressure sensitive means communicating with said chamber, means providing a gas inlet to said chamber communicating with the source of gas under pressure, means providing a gas outlet from said chamber communicating with the ambient atmosphere, a single valve element for closing alternately the gas inlet and the gas outlet, and valve operating means powered by said pressure sensitive means for shifting the position of the valve element alternately between the gas inlet and the gas outlet, said valve operating means including a lost motion mechanism whereby limited lost motion of the pressure sensitive means is permitted prior to actuation of said valve means.

8. The combination with a medicament nebulizer 0peratcd by a source of gas under pressure connected thereto by a flexible hose, said medicament nebulizer delivering gas to a gas stream of variable pressure, of means responsive to the gas pressure of said gas stream for regulating the operation of the nebulizer, said means including a housing defining a gas receiving chamber, means connecting said chamber with the gas stream, pressure sensitive means communicating with said chamber, and hose pinching means operated by said pressure sensitive means for pinching said hose an amount determined by the gas pressure in the gas stream.

9. A device operable from a source of gas under pressure for use in the treatment of patients having pulmonary diseases, said device comprising, in combination, control means connected to the source of gas under pressure for regulating the flow of gas therefrom to establish a breathing cycle, conduit means communicating with said control means for conveying gas therefrom to the lungs of a patient, nebulizer means communicating between the source of gas under pressure and said conduit means for supplying a vaporized medicament to said conduit means, means responsive to the gas pressure in said conduit means for regulating the nebulizer means such that gas is permitted to flow from said source to said nebulizer to deliver vaporized medicament to said conduit only when the gas pressure in said conduit exceeds a predetermined value above that of the ambient atmosphere, and valve means providing for exhalation by the patient to the ambient atmosphere, said valve means including a housing partitioned by a flexible diaphragm disposed in said conduit, said diaphragm having an aperture located centrally therein, pressure sensitive valve means secured to said diaphragm for closing said aperture when the gas pressure in the patients lungs exceeds that delivered by said pressure regulating means and for opening said aperture when the pressure differential is reversed, means asso ciated with said housing providing an exhalation passage from said conduit to the ambient atmosphere intermediate the patients lungs and said diaphragm, and means cooperating with said diaphragm to close said exhalation passage when the pressure delivered by said pressure regulating means exceeds that in the patients lungs.

10. A pressure control apparatus for regulating the flow of gas from a source of gas under pressure into a closed volume, said apparatus including a housing defining a gas receiving chamber communicating with and forming a part of said closed volume, pressure sensitive means communicating with said chamber and with the ambient atmosphere, means providing a gas inlet to said chamber communicating with the source of gas under pressure, means providing a gas outlet from said chamber communicating with the ambient atmosphere, a valve member for alternately covering the gas inlet and the gas outlet, means responsive to said pressure sensitive means for operating said valve member so as to close the gas inlet when the gas pressure in said chamber obtains a predetermined maximum value relative to that of the ambient atmosphere and to close the gas outlet when the gas pressure in said chamber obtains a predetermined minimum value, and means for regulating the time required for the gas pressure in said chamber to reach the predetermined maximum value, said means including a gate valve, an annular ring encircling said gas inlet, radially disposed pin means slidably penetrating said annular ring and supporting said gate valve in said annular ring for reciprocal movement across said inlet between opposite extreme positions, said gate valve fully closing said inlet in one extreme position and opening said inlet in the opposite position, annular cam means rotatably journalled on said annular ring and having an internal cam surface of varying radius engaging said pin means for adjustably moving said gate valve across said inlet, and resilient means biasing said pin means against said cam surface.

11. A device operable from a source of breathing gas under pressure for use in the treatment of patients having pulmonary diseases, said device comprising, in combination, control means connected to the source of gas under pressure for regulating the flow of gas therefrom to establish a breathing cycle, conduit means communicating with said control means for conveying gas therefrom to the lungs of a patient, said conduit means excluding atmospheric gases from the breathing gas, nebulizer means communicating directly between the source of gas under pressure and the conduit means for supplying the vaporized medicament to the breathing gas in said conduit means, and means responsive to the gas pressure in said conduit means for regulating the nebulizer means such that gas is permitted to flow from said source to said nebulizer to deliver vaporized medicament to said conduit only when the gas pressure in said conduit exceeds a predetermined value above that of the ambient atmosphere.

References Cited in the file of this patent UNITED STATES PATENTS Re. 24,193 Emerson Aug. 7, 1956 2,268,172 Sinnett Dec. 30, 1941 2,391,877 Cahan Jan. 1, 1946 2,473,518 Garrard June 21, 1949 2,535,844 Emerson Dec. 26, 1950 2,593,046 McKee Apr. 15, 1952 2,598,525 Fox May 27, 1952 2,617,414 Hol lman Nov. 11, 1952 2,693,178 Gilroy Nov. 2, 1954 2,774,346 Halliburton Dec. 18, 1956 2,814,291 Holmes Nov. 26, 1957 2,843,120 Thauer et al. July 15, 1958 2,908,270 Stanton Oct. 13, 1959 FOREIGN PATENTS 1,063,122 France Dec. 16, 1953 77.740 Denmark June 28, 1954

Claims (1)

1. 4. A PRESSURE CONTROL APPARATUS FOR REGULATING THE FLOW OF GAS FROM A SOURCE OF GAS UNDER PRESSURE INTO A CLOSED VOLUME, SAID APPARATUS INCLUDING A HOUSING DEFINING A GAS RECEIVING CHAMBER COMMUNICATING WITH AND FORMING A PART OF SAID CLOSED VOLUME, PRESSURE SENSITIVE MEANS COMMUNICATING WITH SAID CHAMBER, MEANS PROVIDING A GAS INLET TO SAID CHAMBER COMMUNICATING WITH THE SOURCE OF GAS UNDER PRESSURE, MEANS PROVIDING A GAS OUTLET FROM SAID CHAMBER COMMUNICATING WITH THE AMBIENT ATMOSPHERE, A VALVE MEMBER, DISPOSED IN SAID CHAMBER FOR ALTERNATELY COVERING THE GAS INLET AND THE GAS OUTLET, VALVE OPERATING MEANS RESPONSIVE TO SAID PRESSURE SENSITIVE MEANS FOR ACTUATING SAID VALVE MEMBER SO AS TO CLOSE THE GAS INLET WHEN THE GAS PRESSURE IN SAID CHAMBER OBTAINS A PREDETERMINED MAXIMUM VALUE AND TO CLOSE THE GAS OUTLET WHEN THE GAS PRESSURE IN SAID CHAMBER OBTAINS A PREDETERMINED MINIMUM VALUE, AND YIELDING MEANS FOR MANUALLY ACTUATING SAID VALVE OPERATING MEANS SO AS TO CLOSE THE GAS OUTLET WHEN THE GAS PRESSURE IN SAID CHAMBER IS GREATER THAN THE MINIMUM VALVE, SAID YIELDING MEANS YIELDING WHEN THE GAS PRESSURE IN SAID CHAMBER EXCEEDS A PREDETERMINED MAXIMUM VALUE.

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