1910s, Mask, Photograph

Mask, Bohr’s, 1916

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Mask_Bohr_1916

From: The respiratory exchange of animals and man by August Krogh, 1916, page 40.

“Masks of rubber which can be fitted on the face and enclose the mouth and nose are far more convenient than mouthpieces, but it is extremely difficult to avoid leakage.  Bohr constructed masks which were specially fitted to each person on whom it was intended to experiment.  These masks (fig. 13) consist of a funnel-shaped piece of tinplate coated on the edge with a substance used by dentists and know commercially as Stent’s composition.  This substance becomes soft at a temperature of about 50 degrees, and can then easily be moulded on the face of a person and can be made to fit absolutely airtight when greased with lanolin, causing at the same time a minimum of inconvenience. These masks are much used in Danish laboratories for all experiments which have to last more than a few minutes at a time.”

1900s, Photograph, Spirometer

Spirometer, Home-made, 1904

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Spirometer_Home-Made_1904

From: Building of Vital Power: Deep Breathing and a Complete System for Strengthening the Heart, Lungs, Stomach and All the Great Vital Organs by By Bernarr Macfadden, 1904, page 152.

“In order to secure a perfect spirometer , all you need is to invent some method that will enable to you to measure the quantity of air you expel.  In making the second device here illustrated, provide yourself with two large tin cans that will hold from a gallon and a half to two gallons.  One should be less in diameter than the other, and the narrow can should fit snugly within the other.  The narrow can should be open at one end and closed at the other.  At the closed end should be a little opening with a thin spout, as shown in illustration No. 4.  These cans or buckets can be bought at a hardware store but any tinsmith will make them for a very small sum of money.

“If your lung capacity is large, the cans should be made to hold a gallon and a half to two gallons.  If small, cans of a gallon or more will be sufficiently large.

“Illustration No. 4 shows the two cans necessary to make the apparatus.  The can on the right is of the lesser diameter and shows the small spout attached.  To complete your device, purchase two or three feet of small rubber tubing that will fit tightly over the spout.  Now fill the can of the larger diameter about three-quarters full of water. Place the can with the spout to which the rubber tubing is attached, inside the larger can.  You will then have a device such as appears in Illustration No. 5, which shows the lung tester ready for use, with a rubber tube coiled on top of the can.  You will notice, however, that this lung tester in Illustration No. 5 is provided with a measuring rule.  If you have no method of measuring such as is described in the foregoing, you can provide your spirometer with a measuring device in the following manner:

“Procure some surgeon’s adhesive tape, or some thickly woven white cloth on which you can use a pen.  Now paste this cloth or tape around a narrow piece of cardboard of nearly the length of the taller can, such as is shown here in illustration No. 5.  This cloth should be slightly longer than the smaller piece of cardboard around which it is pasted.  The free end of this cloth should be fastened with glue, or in some other way tightly secured to the top of the can with the spout, as is shown in the illustration.  You are thus provide with a measuring rule which will rise and fall with the can attached to the tube, as the air is blown in or escapes from the can.”

1920s, Diagram, Spirometer

Spirometer, McDowall, 1928

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Spirometer_McDowell_1928

From: Proceedings of the Physiological Society, October 13, 1928.  Article “A new volume recorder” by RJS McDowall.

“The principal is an old one, being that of the spirometer and other similar apparatus with a fluid seal, but by improvement of the design friction is reduced to a minimum, while the curvature of the bell permits a large excursion of the lever.  The center of the curvature of the bell and of the weight is at the fulcrum, and if the center of gravity of the lever system is also exactly at the fulcrum the lever and bell are balanced in all positions, and for all practical purposes the entrance of equal amounts of air into the bell is recorded by equal excursions.  The apparatus cannot leak.  It is made by C.F.Palmer.”

1920s, Mouthpiece

Nose clip, Mouthpiece and Mask, 1920

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NoseClip_Mouthpiece_Mask_1920

From: The Newer Methods of Blood and Urine Chemistry, by  By Rutherford Birchard Hayes Gradwohl, Abraham Jacob Blaivas, 1920, Page 369.

“The mouthpiece is made of soft pure gum rubber, and consists of an elliptical rubber flange having a hole in the center 2 cm. in diameter, to which on one side a short rubber tube is attached.  On the opposite of the hole, at right angles to the rubber flange, are attached two rubber lugs.  The rubber flange is placed between the lips, and the lugs are held by the teeth.  The rubber tube of the mouthpiece is connected to the tube carrying the valves.  The nose must be tightly closed if mouth breathing is used.  This is accomplished by a nose clip, which consists of a V-shaped metal spring, the ends of which are provided with felt pads.  A toothed ratchet is attached to the ends of the spring, and serves to hold the spring tightly clamped on the nostrils in the proper position.”

“Some individuals experience great distress when made to breathe through the mouth.  For these it is best to use a face mask.  Unfortunately at the present time no mask is entirely satisfactory.  Perhaps the best is sold by Siebe, Gorman & Co. which is pictured in the cut.  After being placed in position the face mask should be tested for leaks, which can be done by putting soap around the edges.”

1920s, Douglas Bag, Photograph

Douglas Bag, 1920

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Douglas_Bag_1920

From: The Newer Methods of Blood and Urine Chemistry, by  By Rutherford Birchard Hayes Gradwohl, Abraham Jacob Blaivas, 1920, Page 373.

“The Douglas Bag.  The Douglas Bag is made of rubber-lined cloth, and is capable of holding from 50 to 100 liters.  It is especially useful for investigations during exercise, since it is fitted with straps so that the bag can be fastened to the shoulders (Fig. 73).  It is then connected with the valves, the mouthpiece of which is placed between the lips.  Respirations are commenced with the three-way valve turned so as to allow the expirations to pass directly outside.  After respiratory equilibrium is established, the three-way valve is turned during an inspiratory period so that the succeeding expirations may pass into the bag.  The time required to fill the bag comfortably is determined with a stop-watch.  The air which has been collected in the bag during the period is thoroughly mixed and passed through a meter, the temperature and barometric pressure are noted, and a sample analyzed in the Haldane gas apparatus.  The bag should be emptied completely by rolling it up when nearly empty.”

1920s, Photograph, Spirometer

Spirometer, Tissot, 1920

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Spirometer_Tissot_1920

From: The Newer Methods of Blood and Urine Chemistry, by  By Rutherford Birchard Hayes Gradwohl, Abraham Jacob Blaivas, 1920, Page 372.

“The Tissot Spirometer is shown in figure 72.  We have found the 100 liter size to be very serviceable in the clinic.  This instrument is mounted on a platform having rubber wheels, and can be moved about the wards with ease.  The bell of the spirometer is made of aluminum and is suspended in a water-bath between the double walls of a hollow cylinder made of galvanized iron.  The height of the bell is 72 cm and the diameter is 42 cm.  An opening at the bottom of the cylinder connects through a three-way stopcock with the rubber tube leading from the expiratory valve of the mouthpiece.  The bell is counterpoised by means of a weight. In the original Tissot spirometer an automatic adjustment permitted water in amount equal to the water displaced by the bell to flow into a counterpoise cylinder as the bell ascended out of the water.  The bell, being heavier out of the water than when immersed, is accordingly counterpoised in any position, although Carpenter has shown that this refinement is unnecessary.  An opening at the top of the spirometer permits the insertion of a rubber stopper, through which are passed a thermometer, a water manometer, and a stopcock with a tube for drawing the sample of air.  The scale on the side of the instrument gives the volume of air.

“During an observation the subject sits in a reclining position or lies on a couch. When the bell of the spirometer is placed at zero, the mouthpiece adjusted in the mouth, and the nose clamped, respiration is started, the expirations passed through the stopcock, which is turned so as to allow them to pass to the outside air.  After a few minutes the stopcock is turned so that the expirations are passed into the spirometer for a definite length of time.  At the end of the period the cock is again turned, and after the barometric pressure, temperature, and volume of the gas has been noted, the composition of air is determined in the Haldane gas analysis apparatus.”

The diverse, quirky and mostly forgotten history of Pulmonary Function testing