A POWDER BLOWER FOR 
THE STOMACH. 
MAX EINHORN, M. D. 
BY 
Heto Yortt i&etifcal Jtoutnal 
for April i, 1899. 
BBPBINTBD TBOM THB Reprinted from the Neio YorTc Medical Journal 
for April 1, 1899. 
A POWDER BLOWER FOR THE STOMACH.* 
MAX EIXHORF, M. D. 
Ouk deeper knowledge of gastric pathology and the 
better therapeutic results attained nowadays must be 
ascribed to the new special methods of diagnosis as well 
as of treatment of the local conditions of the stomach. 
Methods of direct treatment of the affected organ 
always merit consideration. Several years ago I devised 
a spray apparatus for the local application of medica- 
ments to the mucosa of the stomach. This method has 
since acquired numerous followers here and abroad. By 
means of the spray, however, only soluble drugs can be 
applied, but not substances which are either soluble with 
great difficulty or not at all. In order to facilitate the 
introduction of the latter I have devised a powder 
blower for this purpose. The stomach powder blower f 
(Fig. 1) consists of an ordinary, not too flexible rubber 
tube {A), twenty-eight inches and a half long, the dis- 
tal end of which connects by means of a hard-rubber 
* Demonstrated at the Society of German Physicians of the City of 
New York, January 27, 1899, 
f The stomach powder blower can be obtained at J. Reynders & Co., 
303 Fourth Avenue, New York. 
CoPTEIGHT, 1899, BY D. APPLETON AND CoVPANT. 2 
A POWDER BLOWER FOR THE STOMACH. 
piece with an air-snction bulb (J5), the proximate end 
of which is attached to a hard-rnbber piece (C). The 
latter is hollow and pierced with several small openings 
Fig. I.—The stomach powder blower. A, the tubing part; B, connection with 
the bulb ; O, hard-rubber end with screw thread for capsule. 
Fig. 2.—(Natural size.) The capsule-shaped powder receptacles. 
Fig. 3.—The small spoon tor putting the powder into the capsule. 
at the side for the passage of air, and provided with a 
screw thread for the capsule. The capsule (D) has 
numerous holes, and is made in three different sizes 
(three, three and a half, and four centimetres long), 
(Fig. 2). It is filled with the necessary quantity of 
powder, by means of a very small spoon (Fig. 3), and 
screwed on to G. 
Method.—Insufflation of the stomach with powder 
can naturally only be done when the organ is empty. 
It should therefore he performed in the fasting condi- 
tion, and, in cases in which the stomach is not empty in 
the morning, after previous lavage. Proceed as follows: A POWDER BLOWER FOR THE STOMACH. 
3 
According to the quantity of medicament required, one 
of the capsules, D, E, or F, is filled with the powder and 
screwed on to the apparatus. The tube is moistened 
with warm water and inserted into the stomach. The 
bulb is then compressed three or four times in quick 
succession. By holding the ear over the gastric region 
of the patient during insufflation the entrance of air 
(consequently also of the powder) is distinctly heard. 
In cases in which there is much mucus in the pharynx 
and oesophagus its entrance into the holes of the capsule 
may be prevented by covering them with vaseline in a 
thin layer. The latter forms a protecting covering and 
prevents liquids from coming in contact with the pow- 
der. When the apparatus is in the stomach and the 
Fig. 4.—A rubber bag with the strings tightened and within the end of the 
stomach powder blower. 
Fig. s.—The bag opened; the white spots showing the powder. 
bulb compressed, the air opens up the vaseline layer over 
the holes, and the powder can now escape. 
The following simple experiment shows that the 
powder does not collect merely at one spot, but rather 4 
A POWDER BLOWER FOR THE STOMACH. 
spreads over the entire surface of the gastric mu- 
cosa: 
Take a rubber bag (seven inches long and six inches 
wide), insert the end of the stomach powder blower 
filled with powder, and draw the strings together (Fig. 
4). Then compress the bulb two or three times and 
remove the insufflator from the bag. If the latter is 
now opened, the powder is found equally distributed 
upon the entire inner surface of the bag (Fig. 5). 
This shows that the air 
disseminates the powder 
as fine dust over all 
parts of the inside of the 
bag. In the stomach 
the conditions are not 
different from those in 
the bag, and the insuffla- 
tion of the interior of 
the gastric cavity with 
the powder will thus be 
complete. 
The correctness of 
this view can also be 
proved by the Eontgen 
rays. The stomach is 
insufflated with bismuth 
powder and the patient 
exposed to the X rays. 
Fig. 6.—Fluoroscopic picture of the stom- 
ach of Miss C. after powdering it with 
bismuth. Pronounced gastroptosis. 
On examining the gastric region with the fluoroscope the 
entire stomach is visible as a shadowy figure. This can 
occur only if the bismuth powder covers the entire inner 
lining of the stomach. 
Dr. Willy Meyer has been so kind as to place at my A POWDER BLOWER FOR THE STOMACH. 
5 
disposal the use of his excellent X-ray apparatus, and 
I take this opportunity to thank him most heartily for 
his courtesy. 
The following drawing is an exact sketch of the 
stomach of a patient (Miss C.), as it appeared when flu- 
oroscoped after insufflation of bismuth powder (Fig. 6). 
The indications for powdering the stomach are mani- 
fold: In ulcus ventriculi, bismuth; in gastric haemor- 
rhages, antipyrine; in gastralgia, orthoform; and in 
erosion, protargol can be directly insufflated. Insuffla- 
tion of the stomach with bismuth powder appears also 
to he of great help in X-ray examinations of this organ. 
The points just mentioned, and others, will have to he 
carefully investigated in a large number of cases in 
order to ascertain their real value. At present my in- 
tention has been merely to describe this method of pow- 
dering the stomach. At some later period I hope to 
publish the results therewith obtained. 
20 East Sixty-third Street. PRACTICAL DIETETICS, 
With Special Reference to Diet in Disease. 
W. GILMAN THOMPSON, M. D., 
Professor of Materia Medica, Therapeutics, and Clinical Medicine in the Univer- 
sity of the City of New York ; Visiting Physician to the Presbyterian 
and Bellevue Hospitals, New York. 
Large Bvo. Eight Hundred Pages. Illustrated. 
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