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Saturday, September 29, 2012

19th century nebulizers provides us with the definition of nebulize:  "to reduce to fine spray; atomize."  And thus a nebulizer, then, would be any mechanical device that can "atomize" a solution and reduce it to a fine spray."  Quite often we refer to this spray as a mist.  So a nebulizer is any device that can create a mist. 

Turning a solution into a mist is a good means of getting medicine down into the lungs, where it's needed and can be of use.  Nebulizers were basically believed to break a solution into atoms, and thus the first nebulizers were often referred to as atomizers.  The process of creating a mist was thus termed atomization.   

Some of the first nebulizers were described by John M. Scutter in his 1867 book "On the use of medicated inhalations in the treatment of diseases of the respiratory organs.  The book was one of the first specifically dedicated to inhalation therapies, including devices to deliver it and the medications.  If the respiratory therapy profession existed back then, it would have been a must read. 

Nebulizers basically work based on the Bernoulli Principle.  The idea comes from the observation that when water hits a rock it creates a mist that can be inhaled.  Daniel Bernoulli published a book in 1738 where he described that a similar effect could be created by forcing water through a narrow tube. The faster water flows through a tube, the less the lateral pressure will be.  Thus, in nebulizer air is forced through a narrow tube, and fluid is entrained into the narrow opening.  The fluid is basically sucked in due to the negative sidewall pressure, and turned into a mist to be inhaled. (2, page 61)

So anyway, the following are the first nebulizers according to Scutter.  I will allow him to do the describing. (see pages 26-36):

Elsberg's Nebulizer
1.  Elsberg's Nebulizer:  "The simplest instrument is that known as "Elsberg's Nebulizer," which consists of two hard rubber tubes pointed at the extremities, the openings being small, and so hinged that they can be placed at right augles, the openings being immediately opposite, as in Fig. 3. One arm of the apparatus being placed in the medicated fluid, blowing through the other causes the fluid to rise in the tube, and it is carried off" in a fine spray. Rimmel's Rafraichisseur, which is the same in principle, has been employed for some years for distributing perfumes, and may be purchased quite cheap. The principal objection to this method is, that it requires a second party, and the breath cannot but prove offensive to many patients."

Sales-Giron's Nebulizer
2.  Sales-Giron Nebulizer:  "The second form of apparatus consists of a cylinder in which works an air tight piston, like the barrel of a syringe. Fluid being placed in it, is forced through minute openings in the nozzle, as a delicate spray.  Fig. 4, represents the instrument of M. Sales Giron, which I have used in my practice with excellent results. When inhalations are much used, I have no doubt they will be manufactured by our hard rubber manufacturers, at a price to bring them within the reach of all"  This nebulzier required lots of work to get a mist, and sometimes may have required two people if the person needing the medicine was too sick.  For this reason it probably wasn't very marketable.  This nebulizer of often listed as the first nebulizer, and for that reason I wrote about it in greater detail here.

3.   Dr. Mackenzie's Nebulizer:  "The apparatus of Dr. Mackenzie is a very good one. The piston is drawn back by a wheel and rack at its upper part, and is forced down by a circular spring which surrounds the cylinder. The apparatus is filled with liquid by a funnel in its top, and all the spray, except that which is inhaled, passes back into the apparatus. He claims the following advantages for  it:  1. Its simplicity, requiring only a few turns of a handle to set it in operation. 2. The extremely fine state of subdivision which it effects. 3. The uniform pressure exerted. 4. The fact that the Waste liquid returns into the apparatus. 5. The ease with which it can be taken to pieces and cleaned."

Dr. Seigle's Inhaler
4.  Dr. Seigle's Inhaler:  "The third form of apparatus is that of Dr. Seigle, and is preferable to the others, 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."  The inhaler (or nebulizer) is designed so that steam provides the flow that makes the bournoulli principle work, and in this way the operator doesn't need assistance to create a mist.  The device simply sits on a table and the patient can enjoy the mist, and hopefully relief in breathing.  I will describe this inhaler in greater detail in a later post. 

So these are your basic nebulizers of the 19th century.  It's basically what you had to deal with until the 1930s when electricity became available. 

  1. Scudder, John Milton, " On the use of medicated Inhalations in the treatment of diseases of the respiratory organs," 1867, Cincinnati, 2nd edition, Moor, Wilstach, and Baldwin
  2. Wyka, Kenneth A., Paul Joseph Mathews, William F. Clark, "Foundations of Respiratory Care,"

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