US1213302A - Apparatus for producing artificial respiration. - Google Patents

Description

W. E. TULLAR.

APPARATUS Fos PIIonucING ARTIFICIAL IIEsPIIIIITIoN.

APPLICATION FILED AUG-5. 196- 1,213,302. Patented Jan. 23,1917.

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D STATES PATENT OFFICE..-

WILLIAM L. TULLAR, or CHICAGO, ILLINOIS, AssIGNoR TO TI-Ii: REsIIRAToRY APPARATUS COMPANY, or CHICAGO. ILLINOIS, A CORPORATION or ILLINOIS.

APPARATUS FOR PRODUCING ARTIFICIAL RESPIRATION.

Laissez.

Specification of Letters Patent. Patented Jan, 23, 1917,

Application mea August 5, 191e. serial No. 113,'35'2.

To all whom t may concern;

Be it known that I, lVILLIAM E. TULLAR', a citizen of the United States, residing at Chicago, in the county of CoolI and State of Illinois, have invented certain new and useful Improvements in Apparatus' for Producing Artificial Respiration, of which the following is a specification.

This invention relates to an apparatus for producing artificial respiration whereby air or oxygen or mixtures thereof may be forced into and carbon-dioxid or other waste products withdrawn from the lungs of a patient alternately, the purpose being to simulate and thereby stimulate spontaneous breathing where respiration has ceased Owing to asphyxiation or other causes.

More specifically the invention relates to an improved form of the apparatus disclosed in my copending application, Serial No. 40.559, filed July 19', 1915.

Medical authorities differ as to the 'advisability of applying suction to the lungs of a patient to withdraw carbon-dioxid and other waste products therefrom in the method of inducing respiration by artificial means and in any event it is extremely desirable that the degreeV of suction exerted on the lungs may be varied at will or that the suction be eliminated in particular cases.

It is the principal object of my invention to provide an apparatus for producingartificial respiration in which the degree of suction exerted by the apparatus on the lungs of a. patient may be varied or the suction may be entirely eliminated without interfering with the operation of that portion ofthe mechanism provided to supply oxygen-containing gas to the lungs of a patient.

A further object of my invention is the provision in an apparatus of the above-described character of means Vfor regulating the speed of operation, means for simultaneously varying' the effective capacity of the oxygen-containing-gassupplying and wasteproduct-witlidrawing means and means for varying the proportion of oxygen in the oxygen-containing gas supplied to the patient.

Other Objects and advantages of my in-V vention will be apparent as it is better unders'toodv by reference to the following specication when read in connection with the accompanying drawing in which- V p Figure 1v is a vertical section throughA an apparatus according to my invention;l `ig. 2 is a plain view, partially in "section, ofthe structure illustrated F ig. l; Fig'. 3 is a horizontal vsection onthe line 3 3 of Fig'. 1; Fig, 4: is a. vertical section on thevline of Fig. 2 and Fig. 5 is a section on the line 5-5 of Fig. 1. l

Referring to the drawing, 1 indicates a suitable frame at either end of which the cylinders Zandl 3 are pivotally mounted by means 'of trunnions 2 and 3', the cylinder 2 constituting means for supplying oxygencontaining gas to the lungs of a patient and the cylinder 3 constituting means for withdrawing waste and other products from the lungs of a patient. Within the cylinders 2 and 3, each of which is freely open to the atmosphere at one end as indicated at 4', are pistons '5 connected by rods 6 to the oppositely directed arms 7 of a member 8 pivotally mountedfat l9 on the frame 1 and provided with an operating handle 10. Obviously when the member 8 is rocked on its pivot 9 the vpistons 5 are reciprocated in the Cylinders 2 and 3. y

Each ofthe cylinders 2 and l3 are provided with valved inlets and outlets, preferably controlled by disk 'valves 11 of mica or other suitable material, each retained in position by wires 12. These valves are extremely light and sensitive and are, therefore, oper.- able by the lungs of a patient even when in exhausted condition'.

The upper end of the cylinder 2 comprises a head la chambered to provide three ducts or passages, one of which is adapted tojreceive a supply of oxygen from a suitable source through a tube 15, another to receive air through an inlet 16 and the other' constituting an outlet leading to the pipe 17 which delivers the oxygen-containing gas to the mouth and nose-piece of usual construction. The oxygen and air-receiving ducts deliver the gas through `inlets 18 to the cylinderQ and the inlets 18 are, therefore, provided with disk valves 11 so arranged that the valves are opened when the piston 5 moves downwardly inthe cylinder 2. The duct leading to the pipe 17, is provided with a similar valve but oppositely disposed so that it opens as the piston' 5 moves upwardly in the cylinder 2, the valves in the inlets 18 being closed at this period ofthe operatiom In order lthat oxygen and air may' be mixed in any desirable propority of the cylinder. less air to the cylinder 3 as the piston 5 tion I provide a rotatable valve 19 secured to a sleeve 2O surrounding the rod 6 and cooperating with the inlets 18 to the cylinder 2 so that as the valve 19 is rotated the inlets 18 are proportionately opened or closed. An operating member 21 is secured to the upper end of the sleeve 20 and an indicator 22 is mounted on the cylinder head 14 to cooperate with the operating member 21 and indicate the position of the rotatable valve 19.

It will be understood from the foregoing description that I am enabled to allow oxygen or air alone or mixtures thereof in any proportion to enter the cylinder 2 and that this m'xture will be forced from the cylinder 2 through the pipe 17 to the mouth and nose-piece during the operation of the apparatus.

The inlet 23 at the lower endV of the cylinder 3 is connected by a pipe 24 to the mouth and nose-piece and the disk valve 11 is so disposed that it is opened when the piston 5 is traveling upwardly in the cylinder 3. Carbon-dioxid and other waste products are thereby drawn through the pipe 24 into the cylinder 3. rIhe outlet 25 in the bottom of the'cylinder 3 is also provided with a valve 11 but arranged to open when the piston 5 travels downwardly in the cylinder 3 whereby the products withdrawn from the lungs are driven from the cylinder. Because in particular cases it may be undesirable to subject the lungs of a patient to suction I provide means whereby the degree of suction may be varied or the suction entirely eliminated while the means :tor supplying oxygen-containing gas remains in operation. The best way of accomplishing this purpose is, as I have discovered, to vary the effective capacity of the suction cylinder 3 since obviously the degree of suction is proportionate to the e'ective capac- By admitting more or rises therein the effective capacity of the cylinder may be varied at will and any degree of suction between that possible with the apparatus and no suction at all may be readily provided. I, therefore, arrange a duct or bleedcr 26 at the base of the cylinder 3 and opening into the interior thereoil and to the atmosphere. A valve plug` 27 is disposed in suitable valve seat and is provided with an opening 28 which, when disposed in alinement with the duct 26, allows air to pass into the cylinder 3 as the piston 5 rises therein. The valve plug 27 is held in proper position in its seat by a screw 29 engaging a groove 30 in the plug 27 and an operating rod 31 is connected to the plug 27 and to an arm 32 at the upper end of the cylinder 3.

The arm 32 ccperates with a scale 33 on the cylinder head which indicates the position of the opening 28 in the valve plug With respect to the duct 26. By operating the arm 32 the effective capacity of the cylinder 3 and hence the degree of suction may be varied as desired. When the valve plug 27 is turned to a position in which the opening 28 registers with the duct 26 substantially novsuction will be produced in the pipe 24 whereas if the opening 28 in the valve plug 27 is so disposed as not to register with the duct 26 the suction produced by the cylinder 3 in the pipe 24 will be at a maximum. When no suction is produced by the cylinder 3 in the pipe 24 the patient exhales by con traction of the lungs thro-ugh the pipe 24 to the cylinder 3 and thence directly to the atmosphere through the outlet 25 and the duct 26. As previouslystated the dish valves 11 are so sensitive that no effort on the partof the patient is required to operate them.

The lungs of persons of dii'erent sizes vary in capacity and it is desirable, therefore, that the quantity of air or oxygen supplied be carefully measured and remain constant throughout the operation of the apparatus. This result is accomplished by the provision of a sector 33 pivotally secured at f 34 to the member 8 and slotted at 35 to engage a pin 36 on an arm 37 projecting from the frame 1. As the member 8 rocks the sector 33 reciprocates vertically. The sector 33 is provided, with a plurality of steps 38 adapted to selectively engage a member 39 slidably mounted on the i'rame 1 and provided with an indicator 40 cooperating with the scale 41, indicating different capacities of the cylinders 2 and 3. A T-shaped member 42 is slidably mounted in a depending portion 43V of the member 39 and is adapted to selectively engage teeth 44 formed on the underside of the frame 1. A collar 45 is secured to the upper end of the T-shaped member 42 and the spring 46 is disposed between the collar 45 and a shoulder formed on the depending portion 43 of the member 39. Pivotally mounted at 47 on the member 39 is a manuallyoperable lever 48, the end 49 of which is disposed in engagement with the collar 45 and by operating the lever 48 the T-shaped member 42 may be depressed against the spring 46 to free it from the teeth 44 so that it may be adjusted to engage one or the other of the steps 38 on the sector 33.

To limit the speed of operation of the apparatus so that the patient can not be injured I provide a cylinder 50 pivotally secured to lugs 51 depending from the frame l and adapted to contain a fluid such as castor oil which has the advantage of not varying in viscosity to lany extent at usual temperatures. A piston 52 is disposed within the cylinder 50 and connected by a rod 53 to an arm 54 on the member 8 so that as the provided Withfa restricted; opening 55, which allows.- the. iiuid'` to pass from: one' side. to the other ofl thepiston 52` as it reciprocates.

` Thertluidfbeingiincompressible it WilLbe apparent that the'` speedA of; operationv of the piston 525 and hencel ofthe member 8- de.-

pend's on the rate. ofioiv of the Huid-through:

theA restrictedv opening: rllhe` size of the opening 55 is des-ignedto allow the flow of fluid with' suiiicient rapidity to permit the apparatus to be operated at a speed; snflicientto -supply yoXygen-containingv gas 2v and Withdrau7 Waste: products from the` lungs ofapatient. at the normal rate-of breathing It Will beunderstoedirom theforegoin-g that I have'perfectedf an apparatus in Which the effect-ivefcapacity of the Waste-product- Withdratving: means is variableV independ ently ofthe. eifectivefoapacity ot theoxygencontainingfgas-supplying. means-soA that suction may befexertedin varying: degrees upon the lungs of a patient or. may beeliminatedy entirely;

My apparat-us further provides means Jor simultaneously varying the `effective capacity. ofthe cylinders 2: and Sfwhereby. theappa` ratus is adjusted toY the lungcapacity off apatient.

Finally my machine provides means tolimit the' rate of speedl at which; itmay beV operated andy means to vary the proportion of oxygen in theoxygen-containingv gas supe plied. L have, therefore, provided: ani apparatus of the greatest utility and; Wide appli.- cation as means for resuscitating` patients- Where respiration has-f ceased..

It will be apparent that vanious changes may be madef 1n they form, construction. and

arrangement of theparts without departing from the spirit anch scope.- of the invention or sacriiicingany 'ot its material: advantages, the form hereinbeforedescribedbeing merely a; preerredembodiment thereof..

L claimt l'. In an apparatus of the: character described, thecombination of means for supplying oxygen-containing gas to and; With.-V draaving 'Waste and other productsl trom! thel lungs of a patient.` an outlet from and an inlet to each of saidy mea-ns, a` disk ont relatively light material loosely maintained in bodily movable relation. toy eachv ofsai-d outlets and.v inlets, and adaptedtoalternately close said outlets and inlets, thel Weight of said disks being such that they are. readily operable by the lungs ot' the patient to permit spontaneous breathing through the apfparatus,` and means whereby said Waste? product withdrawing. means may be rendererl inoperative While. said oxygen-com tainingfgasfsupplying means continues opera-tion.

2. In. an.` apparatusl et the, character cle-- scribed, the combination of means for supplying oxygen-containing gas to and WithdrawingWasteandl other products from the lungs of a; patientan outletfrom and an inlet to each of said means, Valves in said inlets and outlets, means whereby said Waste-product-Withdrawing means may be rendered inoperative While said oxygen-con-A taining-gas-supplying means continues in operation, and means for preventing the operationk of said iirst-mentioned means beyond a predetermined rate of speed.

3; In an` apparatus of the character described, the combination of means for supplying oxygen-containing gas to and Withdraiving Waste and other products from the lungs of' a patient, an outlet from and an inletto each of saidr means, a disk of relatively light material loosely maintained in bodily movable: relation toeach of said inlets and outlets, and adapted to alternately close said inlets andoutlets7 the Weight of said disks being such that they are readily operable by the lungs of the patient topermit spontaneous breathingthrough the apparatus, meansv whereby saidv Waste-prodiuct-Withdraiving means may be rendered inoperative-While said oXygen-containing-gassupplyingmeans continues in operation, andl means for varying the eective capacity of` said first-mentioned means.

4. In. an apparatusy of the character described, the: combination of means for supplying oxygen-containing gas to and Withdrawing-Waste and other products fromv the lungs of a patient, an outlet from and an inlet to each of said;1neans, a. disk: of relatively light material loosely maintained' in bodily movable relation to; each ofV said inlets and outlets, and adapted to. alternately close saidV inlets andy outlets, the Weight of:

said disks being such that they are readilyr operable-by the lungs ot the patient to. permit spontaneousbreathing through, the ap,- paratus, meanswhereby saidf Waste-productivithdraiving means may be rendered inoperative While said' oXygenfcontaining-.gase supplying; means continues inV operation, and means iior varying the proportion of oxygen* in the oxygen-containing gas. supplied-l 5. In an apparatus of the character described, the combination of means for supplying` oxygen-containing gas to and Withdra-ivingwaste and other products from the lungs of a. patient, an outlet from and an inlet to-.eachz oi' said mea-ns, `al-ves i-nsaid inlets and outlets, means whereby, said Waste-product-Withdraiving means may be rendered inoperatiafe Whi le said oxygen-con,- taining-gas.-supplying means continues in operation., means for preventing the operation of said first-mentioned means beyond a predetermined rate of speed, kand means for vary-mg the eiiectiy/'e capacity ot said first-` mentioned means.

G. In an apparatus of the character described, the combination of means for supplying oxygen-containing gas to and withdrawing waste andother products from the lungs of a patient, an outlet from and an inlet to each oit' said means, a disk of relatively light material loosely maintained in bodily movable relation to each of said inlets and outlets, and adapted to alternately.

close said inlets and outlets, the weight of said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus, means whereby said waste-productwithdrawing means may be rendered inoperative while said oxygen containinggassupplying means continues in operation, means for varying the eii'ective capacity oit' said first-mentioned means, and means for varying the proportion of oxygen to the oxygen-containing gas supplied.

7. In an apparatus of the character described, the combination of means for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, an outlet from and an inlet to each of said means, valves in said inlets and outlets, means whereby said waste-product-withdrawing means may be rendered inoperative while said oxygencontaining gas supplying means continues in operation, means for preventing the operation of said first-mentioned means beyond a predetermined rate of speed, and means for varying the proportion of oxygen-containing gas supplied.

8. In an apparatus for supplying oxygencontaining gas to and withdrawing waste and other products from the lungs of a patient, the combination of a. plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, afdisk of relatively light material loosely maintained in bodily movable relation to each of said outlets Vand inlets, to alternately close said outlets and inlets, the weight of said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus, and means whereby one of said cylinders may be rendered inoperative while the other remains in operation.

9. In an apparatus for supplying oxygencontaining gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, valves in said outlets and inlets, means whereby one of said cylinders may be rendered inoperative while the other remains in operation, and means for preventing the operation of said pistons beyond a predetermined rate of speed.

10. In an apparatus for supplying oxygencontaining gas to and withdrawing waste and other products from the lungs of a patient, the combination oi' a plurality of cylinders, pistons therein, means for actuating the lungs of the patient to permit spontaf neous breathing vthrough the apparatus, means whereby one of said cylinders may be rendered inoperative while the other remains in operation, and means for varying the eective capacity of said cylinders.

11. In an apparatus for supplying oxygencontaining gas to and withdrawing waste and other products from the lungs of a pa-v tient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, a disk of relatively light material loosely maintained in bodily movable relation to each of said outlets and inlets, and adapted to alternately close said outlets and inlets, the weight of said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus, means whereby one of said cylinders may be rendered inoperative while the other remains in operation, and means for varying the proportion of oxygen in the oxygen-containing gas supplied.

12. In an apparatus for supplying oxygencontaining gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, valves in said outlets and inlets, means whereby one of said cylinders may be rendered inoperative while the other remains in operation, means Jfor preventing the operation of said pistons beyond a predetermined rate of speed, and means for varying the eiiective capacity of said cylinders.

13. In an apparatus for supplying oxygencontaining gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, a disk of relatively light material loosely maintained in bodily mov'- able relation to each of said outlets and inlets, and adapted to alternately close said outlets and inlets, the weight of said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus,

means whereby one of said cylinders may berendered inoperative Whileltheother re:-

mains iny operation, meansfor varying the effective capacity of said cylinders, and means for varying the proportion of oxygen in the oxygen-containing gassupplied.

14. In an apparatus for supplying oxygen-containing gas to and withdrawing Waste and other-products from thelungs of a patient, the combination. of ay plurality of cylinders, pistons therein, means for actu` ating said pistons, an .outlet from and an inlet to each of said cylinders, valves in said outlets and inlets, means whereby. one of said cylinders may be rendered inoperative While the other remains in operation, means for preventing the operation of saidpistons beyond a predetermined rate of speed, and means for varyingthe proportion of oxygen in the oxygen-containing gas supplied.

15. In an apparatus of the character described, the combination of means for supplying oxygen-containing gas to and Withdrawing Waste and other products from the lungs of a patient, anV outlet from andan inlet toV each of said'means, al disk of relatively light material loosely maintained in bodily movable relation toeach of said outlets. and inlets, and adapted to alternately close said outlets and inlets, the Weight of said inlets being such that theyiare readily operable by the lungsof the patient to permit spontaneous breathing through the apparatus, and means for varying ythe* ei'ective capacity of said Waste-product-Withdraiving means independently` of the effective capacity of said oxygen-containing-gas-supplying means. Y

16. In anapparatus of the character described, the combination of means for supplying oxygen-containing gas to and Withdrawing Waste and other products from the lungs of a. patient, an outlet from and an inlet to each of said means, valves in said outlets and inlets, meansV for varying thefetfective capacity of saidWasteproduct-withdrawing means independently` of the ei'ective capacity of said oxygen-containing-gas-supplying means, and means for preventingthe operation of said first-mentioned means beyonda l predetermined rate of speed.

17. In an apparatus Vofthe character described, thevcombination of means for supplying oxygen-containing gas to and Withdrawing Waste and other products from the lungs of a patient, an outlet from and an inlet to each of saidmeans, a disk of relatively light material loosely maintained in bodily movable relation to eachof said'outlets and inlets, and adapted to alternately close :said outletsV and inlets, the Weight of said disks being such-that they are readily operable by the lungs ofthe patient yto permitl spontaneous*- breathing through the`` appara-tus,` meansgforvaryingthe effective capacity of said Waste-productfwithdrawing means' independently of theel'ective capacity of said oxygen containing gassupplying means, and means for simultaneously varying the effective capacity of saidv first-mentioned means.

18. In an apparatus of the character described, t-he combination of means for supplying oxygen-containingy gas to and Withdrawing Waste and other products from the lungsof a patient, an outlet from and an inlet to each ofsaid means, a disk of relatively'light material loosely maintained in bodily movable relation to each of said outlets and inlets, and adapted to alternately closesaid outlets and inlets, the Weight of saidl disks being such that they are readily operable by t-he lungs of the patient to permit spontaneous breathing through the apparatus, means for varying the effective capacity of said W-aste-product-Withdrayving means independently of the effective capacity of said oXygen-containing-gas-supplying means,.and

means for varying the proportion of oxygen in the oxygen-containing gas supplied.

19; In an apparatus of thecharacter described, the combination of means for supplying oxygen-containing gas to and Withdrawing Waste and other products from the lungs of av patient, an outlet from and an inlet to each of said means, valves in said outlets and inlets, means for varying the effective capacity of said Waste-product- Withdrayving means independently ofv the effective capacity of said'oXygen-containing- 100 gas-supplying means, means for preventing the operation of said rst-mentioned means beyond a predetermined rate-olil speed, and means for simultaneously varying the effective capacity ci' said first-mentioned means. 105

20. In an apparatus of the character described, the combination' of means for supplyingoxygen-containing gas to and Withdrawing Waste and other productsk from the lungs of a patient, an outlet fromand an inlet to each of said means, a disk of relatively light material loosely maintained in bodily movable relation toeach 'of said outlets and inlets, and adapted to alternately close said outlets and inlets, the Weight of said disks being such that they are'readily operable by the lungs of the patient to permit spontaneous breathing'through the apparatus, means for varying the eiiective capacity of said Waste-product-Withdrawing means independently of the effective" capacity of said oxygen-containing-gas-sup plyingV means, means for simultaneously varying the effective capacity of said' firstmentioned means, and means for varying the proportion of oxygen in the oxygen-containing gas supplied. Y

21. In an apparatus of the character described, the combination of means-forl supplying oxygen-containing gas to and Withdrawing waste and other products from the lungs of a patient, an outlet from and an inlet to each of said means, valves in said outlets and inlets, means for varying the effective capacity of said waste-productwithdrawing means independently of the effective capacity of said oxygen-containinggas-supplying means, means for preventing the operation of said first-mentioned means beyond a predetermined rate of speed, and means for varying the proportion of oxygen in the oxygen-containing gas supplied.

22. In an apparatus for supplying 'oxygen-containing gasv to and withdrawing waste and other products from the lungs of a patient, the combination of' a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, a disk of' relatively light material loosely maintained in bodily movable relation to each of said outlets and inlets, and adapted to alternately close said outlets and inlets, the weight of said. disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus, and means for varying the effective capacity of the waste-product-withdrawing cylinder independently of the effective capacity of the oxygen-containing-gas-supplying cylinder.

23. In an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, valves in said outlets and inlets, means for varying the effective capacity of the waste-product-withdrawing cylinder independently of the effective capacity of the oXygen-containing-gassupplying cylinder, and means for preventing the operation of said pistons beyond a predetermined rate of speed.

24. In an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, a disk of relatively light material loosely maintained in bodily movable relation to each of said outlets and inlets, and adapted to alternately close said outlets and inlets, the weight of' said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing Athrough the apparatus, means for varying the effective rcapacity of the waste-product-withdrawing cylinder independently of the effective capacity of the oxygen containing gas supplying cylinder, and means for simultaneously varying the effective capacity of said cylinders.

inlet to each of said cylinders, a disk of rela- Y tively lightmaterial loosely maintained in bodily movable relation to each of said outlets and inlets, and adapted to alternately close said outlets and inlets, the weight of said disks being such that they are readily Operable by the lungs of the patient to permit spontaneous breathing through -the apparatus, means for varying the' effective ca pacity of the waste-product-withdrawing cylinder independently of the effective `capacity of the oxygen-containing-gas-supplying cylinder, and means for varying the proportion of oxygen in the oxygen-containing gas supplied.

26. In an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, valves in said outlets and inlets, means for varying the effective capacity of the waste-product-withdrawing cylinder independently of the effective capacity of the oXygen-containing-gassupplying cylinder, means for preventing the operation of said pistons beyond a predetermined rate of speed, and means for simultaneously varying the effective capacity of said cylinders.

27. In an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, a disk of relatively light material loosely maintained in bodily movable relation to each of said outlets and inlets, and adapted to alternately close said outlets and inlets, the weight of said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus, means for varyingthe effective capacity of the waste-productwithdrawing cylinder independently of the effective capacity of the oxygen-containinggas-supplying cylinder, means for simultaneously varying the eective capacity of said cylinders, and means for varying the proportion of oxygen in the oxygen-containing gas supplied.

28. In" an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, pistons therein, means for actuating said pistons, an outlet from and an inlet to each of said cylinders, valves in said outlets and inlets, means for varying the effective capacity of the waste-product-withdrawing cylinder independently of the effective capacity oi' the oxygen-containing-gas-supplying cylinder, means for preventing the operation of said pistons beyond a predetermined rate of speed, and means for varying the proportion of oxygen in the oxygen-containing gas supplied.

29. In an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination or' a plurality of cylinders, an inlet and an outlet from each of said cylinders, pistons in said cylinders, means for actuating said pistons whereby suction is produced in one and pressure in the other cylinder, a disk of relatively light material loosely maintained in bodily movable relation to each of said inlets and outlets and adapted to alternately close said inlets and outlets, the

weight of said disks being such that they are readily operable by the lungs of the patient to permity spontaneous breathing through the apparatus, a bleeder to the suction cylinder, and means for controlling said bleeder to vary the effective capacity of the cylinder.

30. In an apparatus 'for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, an inlet and an outlet from each of said cylinders, pistons in said cylinders, means for actuating said pistons whereby suction is produced in one and pressure in the other cylinder, a disk of relatively light material loosely maintained in bodily movable relation to each of said inlets and outlets and adapted to alternately close said inlets and outlets, the weight of said disks being such that they are readily operable by the lungs oi' the patient to permit spontaneous breathing through the apparatus, a duct leading to the interior of the suction cylinder and communicating with the atmosphere, a valve in said duct, and means for operating said valve to vary the eiiective capacity of the cylinder.

3l. In an apparatus for supplying oxygen-containing gas to -and withdrawing waste and other products from the lungs of a patient, the combination of a plurality of cylinders, an inlet and an outlet from each of said cylinders, pistons in said cylinders, means for actuating said pistons whereby suction is produced in one and pressure in the other cylinder, a disk of relatively light material loosely maintained in bodily movable relation to each of said inlets and outlets and adapted to alternately close said inlets and outlets, the weight of said disks being such that they are readily operable by the lungs of the patient to permit spontaneous breathing through the apparatus, a duct leading to the interior of the suction cylinder and communicating with the atmosphere, a valve in said duct, means for operating said valve to vary the effective capacity of the cylinder, an indicator scale secured to the exterior of the suction cylinder, and an indicator secured to said valve-operating means and cooperating with said scale.

82. In an apparatus of the character described, the combination of a supporting frame, means for supplying oxygen-containing gas to and withdrawing waste-products from the lungs of a patient, an inlet to and an outlet from each of said means, valves in said inlets and outlets, means for actuating said first-mentioned means, and means for limiting the movement of said actuating means comprising a toothed sector, a member slidably mounted on said frame, a plurality of teeth on said frame, a member pivotally mounted on said slidably mounted member, and means actuated thereby and adapted to selectively coperate with the teeth on said frame whereby said slidably mounted member is adjustably disposed with respect to said toothed sector.

33. In an apparatus for supplying oxygen-containing gas to and withdrawing waste and other products from the lungs of a patient, the combination of a supporting frame, a pair of cylinders, pistons therein, means for actuating said pistons, an inlet to and an outlet from each of said cylinders, valves in said inlets and outlets, and means for varying the stroke of said pistons comprising a sector pivotally connected to said actuating means and provided with a plurality of stepped teeth, a member slidably mounted on said frame, a plurality of teeth on said frame, a member pivotally mounted on said slidably mounted member, and means actuated thereby and adapted to selectively coperate with the teeth on said frame whereby said slidably mounted member is adjustably disposed with respect to said sector.

WILLIAM E. TULLAR.

Witnesses:

WM. O. BELT, W. T. WESTERBERG.

Copies of this patent may be obtained for five cents each, by addressing the Commissioner of Patents, Washington, D. C.

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