ON THE 
INHALATION. OF ATOMIZED FLUIDS, 
By H. BEIGEL, M.D., L.R.C.P. 
/V 
(FROM THE LONDON LANCET.] 
ON THE TREATMENT OF 
CHRONIC DISEASES OF THE LUNGS 
BY THE 
INHALATION OF ATOMIZED FLUIDS. 
By MORELL MACKENZIE, M.D. 
[FROM THE LONDON MEDICAL TIMES AND GAZETTE.] 
A NEW MODE OF TREATING 
DISEASES OF THE CAVITY OF THE AOSE. 
By J. L. W. THUDICHUM, M.D., M.R.C.P. 
Lettsonian Professor of Medicine of the Medical Society of London. 
[FROM THE LONDON LANCET.] 
Jourtlt €rtiti0W. 
PUBLISHED BY 
OODMAN & SHURTLEPF, 
13 & 15 TEEMONT STREET, BOSTON. CIRCULAR. 
Having devoted much attention during the past three years to constructing 
Apparatus for the Atomization of Liquids, and having been successful, — we 
believe, from testimony of the most eminent medical authority, — in produ- 
cing more simple, reliable, and convenient instruments than any hitherto 
constructed, we are led to publish, in connection with a description of them, 
two articles from foreign authors of high standing, in which they show the 
great advantage of employing Atomized Liquids in diseases of the Throat 
and Lungs. 
We have also introduced an article “ On a New Method of Treating Diseases 
of the Nasal Cavity.” A description of the Apparatus required for its employ- 
ment may be found on page 28. For much valuable information, enabling us 
successfully to adapt the apparatus for Atomization to its uses, we are indebted 
to the Physicians of this city specially engaged in the treatment of diseases 
of the Lungs and Throat, who have openly signified their good opinion of the 
merits of this form of inhalation, and who urged us to enter upon the manu- 
facture of the instruments we now offer to the profession. 
Since we commenced their manufacture, several important improvements 
in these instruments have been awarded Letters-patent, and are not found in 
any other apparatus for atomization. 
Having had much experience in the manufacture of Apparatus of the kinds 
described, we can assure purchasers that they are made with the utmost care, 
with view to complete efficiency, convenience, and durability, and every one 
is warranted. 
A Gold Medal has lately been awarded us by the Middlesex Mechanics’ 
Association, for Atomizing and Surgical Instruments, as will be seen from the 
following report signed by a leading New-England Surgeon and Physician : — 
“1503. Codman & Shurtleff, Boston, Mass; One Case Surgical Instru- 
ments and Atomizers. — “ The Committee have no hesitation in awarding foi this 
superb exhibition the highest, premium. **)#'** The various other instruments for 
Inhalation of Atomized Liquids, mid for Local Anaesthesia, were all apparently fault- 
less, both in design and workmanship. The exhibitors are regarded as more especially 
deserving the highest token of merit for having produced nothing except of their own 
manufacture. GOLD MEDAL, 
(Signed) '“OILMAN KIMBALL, M.D., Chairman.” 
The parts of each kind being interchangeable, physicians at a distance 
requiring new tubes or other parts, ci.n be sure that they will be adapted to 
the apparatus previously purchased, j 
Doubtless many of our patrons, nn; they the opportunity, would make the 
inquiry of us, — Which kind of Atomizing Apparatus is, all things considered, 
the best? Our reply would be, that, for most uses, the Steam Apparatus is 
to be preferred, — 
1st Because, being self-acting, it produces an even and continuous flow . 
of spray without inconvenience or labior. 
2d. The warmth of the spray produced by it is often ah advantage. 
On the other hand, the Air Apparatus is ready for use at the moment: the 
Steam Apparatus requiring a few moments for the raising of steam. 
In ordering, the cuts should be referred to, to prevent possibility of mis- 
understanding. To save collection expenses, funds should always be sent 
with the order, either in a post-office order, or registered letter, or if by mail, 
express or otherwise, carriage paid. For safety of funds addressed to us by 
either of the first two methods we will be responsible. 
If funds sent exceed the amount of the order, the excess will he returned 
with the goods. 
If no funds are sent, we shall forward the articles by express, with bill for 
collection, with collection expenses added, or we may decline to fill the order. 
For such testimony in regard to the value of our Apparatus as will he most 
highly esteemed, we refer to pp. 24, 25, and 26. 
CODMAN & SHTJKTLEFF, 
13 & 15 Xremont Street. 
Boston, March, 1869. From the London Lancet. 
ON THE INHALATION OF ATOMIZED FLUIDS. 
BY H. BEIGEL, M.D., E.R.C.P. 
The application of medicaments is effected in a two-fold manner, 
viz.: either directly on being applied immediately to the suffering 
part, or indirectly by being received into the circulation of the blood; 
so that through this agency, which reaches all parts of the body, it 
may also affect those parts on which we intend to act. Where a 
direct influence is possible to the physician, he will never think of 
attempting to reach his aim by circuitous routes. The straight way 
in medicine is also the best and most effectual, and those branches of 
our art which could pursue this direct track have enjoyed quick and 
conspicuous progress. We need only call to our mind surgery, 
ophthalmology, midwifery, and partly also, the treatment of skin 
diseases. 
But it is not very long since, that even in such cases as catarrh of 
the conjunctiva, simple ulcers, scabies, &c., very many compound 
medicines were ordered,—a kind of therapeutics which disappeared 
with the development of local treatment. Many parts of the body 
will certainly, by their position, ever exclude a direct proceeding in 
the matter just spoken of; as, for instance, the basis cranii, the 
heart, the pancreas, spleen, kidneys, &c., because no natural duct 
leads us to them. But the natural ways leading to others, which are 
therefore within our reach, have not been sufficiently appreciated. 
This was the case with the organs of respiration. The cavum oris 
and the pharynx were too easily accessible to be overlooked; but 
the glottis was considered a stoppage for any further advance, and 
the trespassing on which is almost impossible. One thing remains 
remarkable: It has always been observed, that one of the most 
important occurrences in life, respiration, proceeds in the most im- 
mediate manner; that the inhalation of different gases produces very 
marked effects upon the organism; and although man was, and 
usually is, so ready to imitate easily explicable phenomena of Nature, 
and to use them for his benefit, nevertheless the attempts to gain 
influence upon the body, and particularly upon the organs of respira- 
tion, through breathing an artificially-created atmosphere, were very 
rare. 
Grecian, Roman, and Arabian physicians recommended inhalations, 
but never attempted to use anything but vapors and fumigations; so 2 
Inhalation of Atomized Fluids. 
that a non-volatile chemical body could not come into contact with 
the organs of respiration. But at all times the urgent necessity of 
immediate application of medicaments in the organs of respiration 
was so rnueh felt, that Mascagni, a very renowned physician, once 
said, “if ever a specific should be devised against consumption, it 
would be such as to be introduced into the organism through the 
windpipe.” Besides this inhalation, some physicians of later date 
made use of blowing pulverized medicaments into the larynx in dis- 
eases of that organ. Aretaeus made use of a tube for blowing, which 
method in our times has been renewed with great benefit by Trous- 
seau and other physicians. In many Continental spas, arrangements 
were made to create an atmosphere suffused with mineral water, 
which the patient was recommended to inhale. But, inasmuch as 
the mineral water was turned into vapor, it need not be said that the 
so-called “ vaporatoria,” or inhalation saloons, were filled merely with 
common water vapors. 
In 1849, Auplian, of Euzet-les-Bains, originated the idea of atom- 
izing the mineral water, by throwing a jet of the liquid against the 
wall of the inhalatory. After a short time, the same system was 
adopted in Lamotte-les-Bains. But Sales.Giron first constructed 
at Pierrefonds an apparatus through which the fluid was subdivided 
into a fine vapor, which was inhaled by the patients with great benefit. 
His chief merit consists in his transferring this method from the 
vaporatory of the spas, to which it was hitherto restricted, into the 
hands of every physician, by devising a portable inhalation apparatus. 
Thus a long-cherished wish of physicians was realized, and from that 
time a new era in the local therapy of the organs of respiration com- 
mences. This apparatus of Sales-Giron consists of a vessel filled 
with the fluid which is to be atomized. Above this vessel an air- 
pump is placed, which compresses the air above the surface of the 
water. The pressure is indicated by manumetre. The water escapes 
through a fine opening of a tube, and strikes against a small metal 
disc, where it is turned into very minute vapor, which is inhaled by 
the patient. When Sales-Giron placed the results obtained in his 
vaporatory, and some years later his portable apparatus, before the 
Academie de Medecine, of Paris, great sensation was caused. At 
first, it was questioned whether the atomized fluids reached the larj-nx, 
the trachea and the lungs. Different opinions arose, and various 
experimenters arrived at different results. Meanwhile the new 
method gained more partisans. At last the Academie de Medecine 
took the investigation into their own hands; and, on Jan. 7th, 18G2, 
Poggiale, the reporter of the elected committee, in a deeply interest- 
ing, extensive, and brilliant discourse, gave a substantiated statement 
of the case, based upon experiments. This statement was entirely 
in favor of the new method; and it was experimentally proved also 
by other authorities, that not only the vapor, but the chemical bodies, 
which, by being atomized, are incorporated into it, reach not only the 
trachea, but the cells of the lungs. 
Some time after, (in 1859,) Matthieu constructed an apparatus 
which he called nepliogine, and exhibited it before the Academie de 
Medecine. But the greatest simplicity in the construction of the Inhalation of Atomized Fluids. 
3 
inhalation apparatus was attained by Dr. Bergson. lie placed two 
glass tubes with very fine openings at one end, at right angles to each 
other; the other end of one tube dips into a vessel filled with the 
fluid which is to be subdivided, while the other is fastened to a 
caoutchouc tubing, about a yard in length. At the middle of this 
tubing is attached a rubber ball, and the end extends into a ball also, 
so that the one in the middle represents an air reservoir, and that of 
the end a pair of bellows. If the latter is pressed by the hands of the 
patient, the air in the upper ball is compressed, escapes through the 
fine opening, and causes a vacuum in the other tube; the fluid of the 
vessel then ascends through aspiration, and is turned into fine mist 
when leaving the capillary opening. (See figure 3, page 18.) 
Upon this principle, which is as excellent as it is simple, Siegle has 
based his inhalation apparatus; putting aside the bellows, which 
fatigued the hands of the patient very much, and substituting a vapor 
kettle, into which one of the tubes descended. The vapor issuing 
forth effects the same purpose as the bellows, and the patients-inhale 
comfortably. One inconvenience which all the apparatus had in 
common was, that the cloud of vapor containing the subdivided fluid, 
not only rushed into the mouth of the inhaler, but moistened also his 
face. With indifferent medicaments tl is was only disagreeable; but 
with liquids of a more acrid or caustic nature,—as for instance nitrate 
of silver,—it was not only disagreeable, by reason of leaving black 
spots on the face and forehead, but even injurious as a caustic for the 
eyes. (See note.) 
If we set asid-i the effect, praised by Demarquay, Leiblinger, and 
others, in conjunctivitis and keratitis, likewise the effect upon the ear, 
upon ulcers, &c., and only consider the effect upon the organs of 
respiration from the mouth and pharynx with its arches, the uvula, 
the glands through the larynx and trachea, with its ramifications to 
the lungs, we meet with a great number of diseases upon which the 
local therapy just spoken of exercises a great influence. But as the 
respiration is performed more or less powerfully and deeply, the 
atoms of the pulverized fluid reach the more or less distant organs of 
that function. From this fact it becomes self-evident that it will be 
necessary to respire feebly, if the influence should be directed upon 
parts situated in the mouth or pharynx; more powerfully and some- 
times strenuously, if it should be our intention to act upon the larynx, 
trachea, or lungs. And further, as the lungs admit the greatest 
amount of air when the sitting position is assumed, it is manifest that 
we should place the patient in that position if we intend a deep 
penetration of the atomized cloud, whilst we should allow him to 
stand if we merely intend to act upon organs not so far distant. I 
do not intend to allude to such individuals as are excited and nervous 
at the aspect of every, even the most innocent instrument. Suffice 
it to say, that the inhalation apparatus do not enjoy an exception. 
But there are persons—happily not frequently met with—whose 
respiratory channels are so sensitive, even in a healthy state, that 
they cannot bear inhalations, either with pure water or any other 
NOTE.—The use of the Shield (described with Fig. 15, p. 17, and Fig 6, p. 19,) serves to 
surmount these inconveniences most perfectly. Inhalation of Atomized Fluids. 
4 
fluid, at the first attempt, and several sittings are necessary to accus- 
tom them to the process. All cases of high sensitiveness which I 
have hitherto observed were patients with laryngeal diseases; whilst 
with others, and particularly with those suffering from diseases of the 
lungs, inhalations agreed very well. 
The temperature of the atomized cloud, of course varies 
portion to the distance from the spout of the apparatus, and must be 
regulated according to the nature of the special case. For some 
patients, it is even necessary to have the fluid to be atomized, 
warmed. When the apparatus is in order, and ready to act, the 
patient stands or sits, and inspires more or less powerfully and deeply, 
according to the requirement of the case. The advice which has 
been given, that the patient should put out his tongue and keep his 
nostrils closed, when inhaling, is, in my opinion, superfluous and 
useless. 
It would exceed the limit allowed me were I to attempt to treat 
on all the diseases against which atomized fluids in general, and 
especially inhalations, have been beneficially used. Demarquay has 
applied them in many cases, pharyngitis-granulosa, ulcera-syphilitica, 
iaryngetis-chronica and syphilitica, phthisis, &c., and reports that 
cure or improvement has often been obtained in a few days. Other 
authors, Zdekauer, Fieber, Schnitzler, Gerhardt, Lewin, Walden- 
burg, McKenzie, Gibb, and others, report favorable success by inha- 
lations in cases of whooping-cough, asthma, inveterate bronchitis, 
aphonia, tuberculosis, gangrena pulmonum, pneumonia, bronchiectasis, 
emphysema, &c. 
The number of the cures effected, as well as the time in which the 
cure took place, is far more favorable than in similar cases which 
were treated internally, and my own experience induces me to agree 
with that statement. The inhalations form a real specific in certain 
cases of hemoptysis, in cough which is a result of eccentric irritation 
of the larynx, or trachea, in hoarseness and aphonia as consequences 
of acute or chronic inflammation of the mucous membrane of the 
larynx. The cure is sometimes effected with amazing rapidity, after 
many other medicaments have been applied without effect. Of 
many cases which I have observed, I shall here mention a few 
only. 
Case 1. A. B ,- an unmarried lady, consulted me at the end 
of last year for hoarseness, from which she had suffered for several 
years, and which was the more unpleasant to her, as she sang well, 
and a great deal, previous to that affection,—a pleasure the depriva- 
tion of which gave herself and her friends great concern. The voice 
was coarse and without timbre; the larynx was painful only at the 
beginning; now it is indifferent to external pressure. Laryngoscopy 
can easily be affected, and shows only a slight unnatural redness of 
the mucous membrane of the larynx, and of the vocal ligaments. 
No other inconvenience exists. In course of the affection a great 
many medicines were tried, and all without any effect. I applied 
inhalations of alum (ten grains to the ounce of water.) After three 
applications a striking improvement was observed, which, after five, 
was so complete, that I discharged the patient, advising her not to Inhalation of Atomized Fluids. 
5 
sing yet; but after a week she could no longer resist, therefore 
resumed singing, and sang as before the affection. 
Case 2. C. D , a merchant from Lima, advised by his physi- 
cians, left that country and came to England. Ilis suffering consisted 
in a severe attack of a very troublesome cough, which came on every 
eight or ten days, and lasted for a day or two, and then ceased. 
During that time the sputa were tinged with a good quantity of pure 
blood. After each attack the patient felt very exhausted. When he 
came under my observation, he was very pale and emaciated ; his 
voice was coarse. The result of physical examination was infiltra- 
tion of the left apex; otherwise the conditions were normal. Three 
days after the examination he had a severe attack; he coughed 
frequently and very severely, and was not ten minutes without 
coughing. The sputa consisted more of blood than mucous, and 
were very copious. The quantity of blood he ejected during the 
day was about two tea-cups full. I ordered immediately an inhala- 
tion of tincture of sesquichloride of iron. The cough did not de- 
crease ; but the sputa, after the first inhalation, was not tinged. The 
patient inhaled twice a day, and had, altogether, thirty inhalations. 
The intervals between the attacks were, in the meantime, much pro- 
longed. Blood never appeared during the cough, which altogether 
disappeared when extract of hyoscyamus was substituted for the 
above-mentioned liquor. The appearance of the patient had very 
much improved; and after six months’ stay in this country he again 
returned to Lima, whence he has repeatedly written, assuring me of 
his perfect health. 
Case 3. E. F , a vocalist, had caught a severe cold, in conse- 
quence of which he was very often attacked with considerable pain 
in his throat of a choking character; he felt, besides, a burning 
sensation in the larynx, and his face was covered with perspiration. 
Each attack lasted about ten minutes, when it disappeared and re- 
turned several times in the course of the day. There was no typical 
appearance to be observed. The larynx was indifferent to external 
pressure. The result of laryngoscopy was negative. Blistering, 
internal application of the acetate of morphia, cannabis indica, opium 
and iron, were had recourse to, but without any effect. I applied 
acetate of morphia by means of inhalation, (half a grain to an 
ounce of distilled water,) and the effect was, a perfect cure after ten 
applications. 
In conclusion, I shall proceed to make a few remarks on the 
medicaments I use for inhalation. Generally speaking, every 
chemical body which is soluble can be atomized, and therefore 
inhaled. The largest number of remedies contained in the Materia 
Medica can therefore be used for the local therapy of the respiratory 
organs. But it must be borne in mind that, besides the local effect, 
the medicaments are much more readily absorbed through the 
mucous membrane than they are by internal application,—a fact 
which must be taken into consideration, when the dose is to be 
decided on. 
The following medicaments are those mostly recommended and 6 
Inhalation of Atomized Fluids. 
found beneficial by practitioners engaged in treatment by inhalation, 
and which I can recommend from my own experience:— 
1. In inhalatory treatment of the respiratory organs, nitrate of 
silver deservedly occupies the first place. Its dose is three to five or 
ten grains, in one ounce of distilled water. It is particularly service- 
able in inflammatory conditions of the pharynx and the larynx. The 
strength of the solution, the frequency of the sitting, and the duration 
of the same, must be adapted to the nature of the particular case, 
It need scarcely be mentioned that proper care must be taken if 
strong solutions are inhaled. 
2. Much milder in its effects is nitrate of alumina, which, as far 
as I am aware, was first used by myself in inhalations. I prepared 
it from a simple solution of the metal in nitric acid, working the 
crystals in distilled water repeatedly, condensing the solution by 
evaporation and recrystalizing. It rendered good service, not only in 
inflammation, but also in nervous affections of the larynx and trachea. 
The dose is three grains in an ounce of distilled water. 
Very useful medicaments are the following:— 
3. Tannin,—three grains to eight or ten grains in an ounce of 
water. 
4. Alum,—four grains to ten or fifteen grains, ditto. 
5. Solution of sesqui-chloride of iron,—one minim to five or ten 
minims, ditto. 
6. Corrosive muriate of mercury,—four grains to one or two ditto. 
7. Acetate of lead,—a grain and a half to eight grains ditto. 
8. Sulphate of zinc,—half a grain to five ditto. 
9. Common salt,—which has long been considered a most useful 
agent in the treatment of diseases of the respiratory organs. On the 
supposition that it was present in the atmosphere near the sea and 
saline springs, physicians have been in the habit of sending thither 
patients affected with chest diseases; and to give the full benefit of it 
to those who were not able to travel, it had always been the object 
of physicians to create an artificial sea air. But it is only since the 
invention of the inhalation apparatus that this object could be fulfilled. 
The application of common salt for the purpose of inhalation is 
therefore very extensive, and produces very marked effects. I make 
use of it in doses of from five to ten and twenty grains to an ounce of 
water; and one ounce is effective, particularly in diseases of the 
lungs and windpipe. In nervous affections, particularly of the 
larynx, and also the asthma, narcotics have been used especially. 
10. Tincture of opium,—one to ten minims in an ounce of water, 
and the preparations of opium. 
11. The salts of iodine, bromine, chlorine, and some others. 
Authors report the good effects of arsenic, in the shape of Fowler’s 
solution, and in a dose of half to five minims in an ounce of water. 
Lastly, besides the different mineral waters, there must be men- 
tioned :— 
12. Pure or distilled water, cold or warm, or even as hot as the 
patient can bear it. It renders, in many cases of inflammation and 
paralysis of parts of the larynx, good service. Treatment of Chronic Diseases of the Lungs. 
7 
From the London Medical Times and Gazette. 
ON THE TREATMENT OF CHRONIC DISEASES OF 
THE LUNGS BY THE INHALATION OF ATOMIZED 
LIQUIDS. 
MOREL!. MACKENZIE, M. D. 
The author, after an elaborate description of the various instru- 
ments invented for the purpose of introducing medicine by means of 
inhalation, enters into an account of the apparatus invented by Dr. 
Siegle, of Strasbourg, and himself, which he describes. Dr. Siegle’s 
simple apparatus is an excellent one, and the author stated that he 
had often used it with great advantage. After enumerating the 
physicians and physiologists wTho had worked at the subject on the 
Continent, the author analyzed the experiments which had been per- 
formed by Demarquay, Fournie, Brian, and others, on rabbits and 
dogs. He then related his own experiments, which had been carried 
out in conjunction with Dr. Duchesne, of Woodford. After detail- 
ing various experiments performed on pigs and dogs, Dr. Mackenzie 
sums up the results. 1st, Demarquay’s and Brian’s experiments \m 
dogs; 2d, his (Dr. Mackenzie’s) on pigs and dogs; 3d, an experi- 
ment performed by Demarquay, in the presence of numerous wit- 
nesses, on a woman with a tracheal fistula, in which it was shown 
that the inhaled liquid penetrated to the trachea, though there was 
a great obstruction at the upper opening larynx. This experiment 
which has been previously unsuccessfully performed by Fournie, has 
since been repeated by Lieber, Schnetzler, and others, with result, 
similar to those obtained by Demarquay. 4th, the fact first shown by 
Bataille, and since by Moura Bourouillou, the author, and others, 
that after the inhalation of a colored atomized solution the sputa 
remained tinged long after the employment of the laryngoscope 
could detect any traces of the material used. On the one hand there 
was an immense number of positive proofs of the penetration of atom- 
ized liquids: on the other hand there were a few experiments per- 
formed, with negative results. It was scarcely necessary to remark 
that any experiment might be performed—the most simple chemical 
test employed—in a manner to insure failure. 
But a few experiments of this sort could have little weight 
against the mass of evidence on the other side. The author stated 
that the greatest benefit from this system of therapeutics might be 
expected and had resulted, in bronchitis, asthma, and haemoptysis, 
lie brought forward twenty-two cases treated between October, 
1863, and January, 1864. There were ten cases of bronchitis, six 
of phthisis, two of haemoptysis, three of asthma, and one of whoop- 
ing-cough. The author did not believe that in phthisis the treatment 8 
Treatment of Chronic Diseases of the Lungs. 
would have a positively curative effect, but was beneficial in cutting 
short intercurrent bronchitis. Of the twenty-two cases detailed, only 
two were unable to make use of this curative process. Of the ten 
cases of bronchitis, eight were cui-ed, one relieved, and one obtained 
no benefit. The average duration of the time required for curing 
these cases, though most of them were severe, and of long standing, 
was only fifteen days and a quarter. The shortest time was six 
days, (a severe case) ; the longest forty days. The duration of 
treatment was not in proportion to the severity of the disease, one 
mild case requiring twenty-eight days to get well. Of the six pa- 
tients laboring under consumption, two were unable to use the inha- 
lations on account of the irritation which they caused. Of the re- 
maining four cases, while the physical signs did not undergo any 
material alteration, the local symptoms (expectoration, pain and 
cough) were greatly relieved. The general health was much im- 
proved in two cases, Nos. 11 and 15, slightly in a third, and not at 
all in a fourth. In two cases of haemoptysis, one severe and the 
other slight, the atomized liquids rapidly stopped the bleeding. In 
three cases of asthma, one a very severe case, which had obstinately 
resisted the ordinary treatment, this system of therapeutics soon gave 
relief. In one case of whooping-cough (in an adult) the inhalations 
gave immediate relief, and quickly effected a cure. The author 
stated that during the past year he had used atomized liquids in more 
than eighty cases of diseases of the lungs, and that he had found the 
plan of treatment no less successful than was detailed in this paper. 
The various instruments referred to in the communication were 
brought before the society, and likeAvise diagrams illustrating their 
action and method of employment. Dr. Gibb said that the subject 
of the author’s paper was one of the highest importance, and in 
which he took the greatest interest. In the earlier part of his pro- 
fessional career, he (Dr. Gibb) had looked forward to the time when 
some means might be devised for introducing fluid in a minute state 
of division into the interior of the bronchial tubes, which would prove 
more certain in its effects than the vapor inhaled from certain sub- 
stances. From the evidence brought forward by the author, illus- 
trated by experiments of his own .and Continental investigators, he 
had not the slightest doubt that any atomized fluid reached the mi- 
nutest bronchial tubes and air cells; and from his own experience of 
the inhalation of fluid thus atomized or pulverized, he was quite sat- 
isfied such was the case. With Siegle’s atomizer, he. had caused the 
inhalation of a solution of the iodide of silver, for a few minutes 
only, in a case of rapid phthisis in the second stage of the disease, 
with profuse expectoration and laryngeal mischief. The effect of 
this was, a general feeling of warmth throughout every part of the 
chest, and subsequent diminution of the expectoration. This feeling 
of warmth so generally diffused, convinced him that the atomized 
fluid had reached the minutest bronchi. As a palliative in some 
cases of phthisis, and as likely to diminish the amount of expectora- 
tion, the inhalation of atomized fluids would prove useful; but it 
never could be relied upon as a curative agent in this disease. With 
regard to bronchitis, the chronic form especially, asthma and hannop- Treatment of Diseases of the Cavity of the Nose. 
9 
tysis, his own experience agreed with that of the author, and showed 
that in many cases the greatest amount of relief could be obtained. 
Indeed, he had been surprised at the good results which sometimes 
followed,—in the two former, especially. As furnishing an addition- 
al and most useful therapeutic agent, in the treatment of laryngeal 
and chest diseases, the inhalation of certain atomized fluids must be 
regarded as one of undoubted value, and he (Dr. Gibb) gladly bore 
testimony in its favor. 
From the London Lancet. 
ON A NEW MODE OF TREATING DISEASES OF THE 
CAVITY OF THE NOSE. 
LETTSONIAN PROFESSOR OF MEDICINE OF THE MEDICAL SOCIETY OF LONDON. 
J. L. W. THUDICHUM, M. D.; M. R. C. P., 
The treatment of diseases of the cavity of the nose has hitherto 
been attended with very great difficulties, owing to the circum- 
stance that the cavity is large, complicated by many sinuosities, inter- 
rupted by many thin, bony and membranous projections, and there- 
fore little accessible, and for the most part not accessible at all, to 
instruments by which growths might be removed, or topical remedies 
applied. The removal of excrescences from the lower and median 
nasal canal was yet the most successful of surgical operations, al- 
though it was frequently left incomplete, or remained unavailing, 
owing to the speedy return of the polypi. But the topical applica- 
tion of remedies for the treatment of acute and chronic affections of 
the nasal cavity, which is certainly the principal therapeutic require- 
ment, and in many eases prevents the formation of polypi, could oidy 
be attempted by mechanical contrivances which were so objectionable 
to the patients, that, after longer or shorter trials, they had to be 
abandoned. I have had under my own care, several important cases 
of affection of the nasal cavity, in which the mere possibility of 
cleansing the cavity of the nose would have been a great boon to the 
patients; others, in which I have no doubt the application of reme- 
dies, such as we are in the habit of using in conjunctivitis, would 
have effected a speedy recovery from painful and troublesome condi- 
tions. The only mode of cleansing the cavity of the nose, which 
was then known in medical science, was by injections with a syringe ; 
but, owing to the velocity with which the injected fluid touched the 
walls of the nose, this process always created much irritation, pain, 
sternutation and lachrymation, and the patients mostly opposed the 
entrance of the fluid by expiratory efforts, which, indeed, were the 
only means they had of preventing the fluids from running down 
the choanm and reaching the larynx. The mere effect of pure water 
upon the Schneiderian membrane being highly irritating, two causes 10 
Treatment of Diseases of the Cavity of the Nose. 
combined to defeat the object of injections of water; and when med- 
icines which might be supposed to have a beneficial effect upon the 
di- eased Schneiderian were dissolved in the water, they, although 
perhaps better tolerated than pure water, could not be kept sufficient- 
ly long in contact with the affected parts to exercise upon them even 
such slight medicinal action as their necessarily diluted state per- 
mitted. There was a third application that could be made,—namely, 
the introduction of medicines in the form of fatty or mucilaginous 
ointments. In one case in which I endeavored to benefit a chronic 
ozasna—a residue of scarlet fever—by topical applications, a solution 
of sulphate of zinc in intimate mixture with lard, had a most decided 
effect, the patient being much improved, though not cured. But this 
application of ointment to the surface of the lower canal of the nose, 
and to a part of the median canal, (which are the only portions that, 
as a rule, can be reached, even by clever manipulation,) is the most 
objectionable of any, so far as its accompaniments of irritation and 
pain are concerned, sternutation and lachrymation being not rarely 
long continued after it, and the peculiar pain producing a reluctance 
on the part of the patient, which it is difficult to overcome in young 
and old people. All these applications, then, were partial, imperfect, 
irritating and consequently unavailing to effect the desired end. 
Many cases of superficial ulceration ended in caries, embittering the 
life of the patients, and through the odor making intercourse impos- 
sible and family relations troublesome; other cases of chronic inflam- 
mation ended in deformity of the external nose and the formation of 
polypi in its cavity, and produced a constant false resonance of the 
voice; a number lasted throughout a lifetime, the nose being a con- 
stantly weak part, and capable of prostrating the patient at any 
opportunity which dust and wind might afford; others had conse- 
quences even more severe, and the specific ulcerations of the cavity 
of the nose only too frequently terminated in that sinking of its 
bridge, which is the most painful proclamation of disease with which 
a patient can become afflicted. Then there were the convulsive 
affections produced by local irritation in the nose—those cases of fab- 
ulous sneezing in which hardly any remedy availed, even in diminish- 
ing the number of spasms in time, because the centre and seat of the 
irritation could not be reached by medical agencies. Truly danger- 
ous were some cases of bleeding from the nose, in which the broken 
blood-vessel could not be reached by either styptics or mechanical 
compression, and could not be made to contract by contact with that 
most powerful of haemostatic agents, ice or ice-cold water. Not a 
few cases of this kind terminated fatally, or required the most des- 
perate measures to prevent the fatal end, such as plugging of the 
nose and choanae with sponges or tinder; and these not rarely left a 
condition of anaemia in which other accidental diseases could put a 
stop to life with comparative ease, or which continued Avithout the 
supervention of other diseases, enfeebling and considerably shorten- 
ing the rest of the life of such patients. 
All these difficulties, and many more which might be mentioned, 
are removed at one stroke by the discovery of Professor Weber, of 
Halle: that when one side of the nasal cavity is entirely filled Treatment of Diseases of the Cavity of the Nose. 
11 
through one nostril with fluid by hydrostatic pressure, while the 
patient is breathing through the mouth, the soft palate completely 
closes the choanae, and does not permit any fluid to pass into the 
pharynx (a physiological fact thus far already discovered by E. H. 
Weber, of Leipzig, before 1847, and published in Muller’s Archiv, 
1847, pp. 351-354) ; while the fluid easily passes into the other 
cavity, mostly round and over the posterior edge of the septum 
narium, in some persons also through the frontal sinuses, and escapes 
from the other open nostril, after having touched every part of the 
first half of the cavity of the nose, and a great part, certainly the 
lower and median canal, of the second half. By means of the ap- 
plication of this principle to the treatment of diseases of the nose, it 
is possible easily and frequently to wash the nasal cavity, to disinfect 
and deodorize it, to remove the sordes which accumulates so easily in 
it, and to apply to its surface a great number of beneficial medicinal 
substances, so as to prevent acute affections from extending, and to 
incline them towards a speedy recovery: to stop haemorrhages, allay 
irritations, and subdue in a remarkable manner, chronic affections of 
the Schneiderian membrane, so as to reestablish a perfectly healthy 
surface and normal condition of the organ of smell. 
The Apparatus.*—A rod of iron or brass, thirty inches in length, 
is fastened upright into a heavily-loaded foot, so as to form a firm 
stand. On this rod slides a nut which can be fixed at any height by 
means of a screw, and carries an arm and ring, in which is cemented 
a high cylindrical glass vessel of a capacity of from one to two pints. 
The glass vessel is open above, and its cavity contracts within the 
ring in which it is fastened, here directly to pass into a small-bore 
muzzle, to which a suitably-sized flexible india-rubber tube, thirty- 
six to forty inches in length, is fastened. To the other end of the 
india-rubber tube a stop-cock is fixed; upon this a little cup-shaped 
collar, and upon this the cylindrical perforated muzzle of gutta-percha 
or of prepared india-rubber. If now the glass vessel is filled with 
fluid, and the little stop-cock immediately underneath the nozzle is 
opened, the fluid will escape at the fine openings of the nozzle; and 
if the nozzle accurately fits the nostril, and the fluid is allowed to 
flow, the fluid will enter and fill the cavity of the nose, as will be 
more specially described hereafter. Great care must be taken to 
ensure an adequate fitting of the nozzle to the nostril of the person 
who is to be operated upon, as, if fluid escape by the side of the 
nozzle, it makes the operation difficult and troublesome. It is there- 
fore necessary to have several sizes of nozzles, to be fixed upon the 
stop-cock at will. In order to avoid all possible chances of infection, 
and ensure cleanliness, I lay it down as a desideratum, that every 
person using the apparatus should have his or her own nozzle, to be 
used exclusively by that person. In dispensaries and hospitals, 
where this cannot be so easily effected as in private* practice, the 
utmost care should be exercised to clean the nozzles from any semi- 
solid matter which easily becomes firmly adherent to them. As the 
current is always directed outwards through the openings, there is 
* For the description of apparatus as manufactured by us, see page 23. 12 
Treatment of Diseases of the Cavity of the Nose. 
hardly any chance of the interior of the nozzle becoming unclean or 
infectious. Yet it will be well to give to each patient, particularly if 
he he the subject of specific disease, his own apparatus. Even the 
suspicion that a patient might, by accident, blow into the tube and 
endanger his successor, will thus be avoided. 
Of the fluids to he employed for rinsing the nose.—Pure warm 
water, when introduced into the nose by means of the apparatus, 
causes, in most persons, a very disagreeable sensation, ending in 
lachrymation and sternutation (or tears and sneezing), with subse- 
quent copious discharge of watery mucus from the nose. If the 
quantity of water run through the nose be large, the “ cold ” pro- 
duced thereby, including the change in the sound of the voice, may 
last for some hours. To avoid this objectionable symptom, it is best 
to employ solutions of common salt, or other salts, of sugar or milk 
for rinsing the nose. In the course of practice, cases will arise in 
which all these solutions offer advantages. For general use, a solu- 
tion containing one ounce of common salt in a pint of water, is satis- 
factory. Some persons will bear less salt; others will tolerate more. 
Of this solution, having a temperature rather lower than that of the 
blood, from one to four, or if desired, any number of pints, may be 
allowed to flow through the cavities of the nose. It does not easily 
produce sneezing, rarely lachrymation, and hardly ever any subse- 
quent symptom of cold in the head. The saline solutions which, 
next to common salt, offer the greatest advantages, are those of the 
common phosphate of soda, and phosphate of ammonia and soda. 
They can be used by themselves, or mixed with the common salt. 
Their alkalinity has a beneficial effect upon the irritated Schneiderian 
membrane, and dissolves or loosens any deposits of mucus or pus, 
which so frequently dry and harden upon the surfaces of the nasal 
cavity. 
Of the fluids to he employed for deodorizing the nasal cavity.—For 
this purpose I have employed dilute solutions of permanganate of 
potash. This agent has done me such excellent service in removing 
the fetor of the mouth in cases of typhoid fever, that I was induced 
to apply it for the removal of the fetor of ozasna, and with the most 
striking and immediate success. A solution of from one grain to ten 
grains in a pint of water is a good proportion, according to the 
severity of the case. The solution tastes alkaline, and acts as a 
feeble escharotic upon healthy and particularly upon vascular and 
erythematous parts. When the margin of the nostrils is excoriated, 
the permanganate colors the excoriated part brownish; but the effect 
of this is rather beneficial than otherwise, as the excoriated and 
colored part dries easily, and after the shedding of the faint brownish 
pellicle, appears healthy. 
Mode of applying these and other fluids to the nose by means of the 
apparatus.—The fluid, of the proper composition and temperature, is 
filled into the glass vessel. All air in the india-rubber tube is now 
replaced by fluid, the escape of the air upwards being facilitated by 
gentle manipulation. The glass vessel is raised and fixed in the 
position which will give the desired pressure. A little fluid is now 
allowed to escape from the nozzle, to make sure that all air is ex- Treatment of Diseases of the Cavity of the Nose. 
13 
pelled. The patient (or healthy person, if it is only desired to show 
the physiological experiment) is seated in front of a basin, with his 
head and face slightly bent over it, the apparatus standing by his 
side. He is told to breathe through his mouth exclusively, and to 
abstain from swallowing. The nozzle, previously selected as of proper 
size, and connected with the apparatus, is now inserted into one 
of the nostrils, and held there by the patient’s hand of the same side. 
The little stop-cock (or tube) is now opened, and after a few seconds 
a continuous and rapid stream of fluid is seen to flow from the op- 
posite nostril into the basin below. Persons who have control over 
themselves will always bear the experiment as here described; but 
young persons, nervous females, and children, become confused, begin 
to cry, or to swallow and breathe through the nose. In such cases 
the level of the fluid in the glass should be very little above the level 
of the introitous into the external ear, so that the fluid runs very 
slowly, or only drops out of the free nostril. The hand of the 
operator should be-upon the india-rubber tube, to close it by com- 
pression the moment he sees bubbles come through the nostril, or 
perceives that the patient swallows or becomes confused. It is al- 
ways well to let the fluid pass at first under slight pressure, in order 
to allow sordes within the nose to be loosened and crusts of dried 
matter to be softened. When this has been effected, it is useful 
suddenly to raise the glass vessel and produce a rapid stream, which 
will then scour the impurities away. In some cases I have done this 
repeatedly with success. The loosening of crusts and lumps of 
inspissated mucous is always attended with some irritation, and also 
with retardation and diminution of the current of fluid. The sudden 
increase of the pressure is the surest means of causing the least 
inconvenience to the patient, and effecting in the quickest manner the 
purpose of the operator. It is also well to reverse the current now 
and then, as sordes are much better detached in that manner. If 
only one nostril is diseased, or the principal seat of the disease, I 
allow the fluid to enter by the opposite side, and to leave by the 
affected nostril. I then change the current, and filling the affected 
nostril, allow the current to leave by the healthy one. Thus, half a 
dozen or a dozen changes may be usefully instituted. It is really 
surprising what an amount of sordes will sometimes be removed from 
the nose by the rinsing process. Any one who has seen it once, will 
easily conceive the manner in which, by means of these constant 
accumulations, nasal diseases become chronic, incurable, and lead to 
fearful suffering and death. When water has been allowed to run 
through the nose, it takes two minutes and a half, before the sense of 
smell returns to its integrity. When saline solutions have been used, 
it takes about a minute and a half; but after the alkaline solutions a 
minute suffices to allow the perception of odors to be clearer than 
before the application. If the special excitant of the olfactory, as 
the perfumers term it, the neutralizer and stirrer-up of smell, ammo- 
nia, is applied immediately, even in less time than a minute will be 
sufficient. 
There are cases of chronic coryza, with some blenorrhagia, in 
which the affection of the Schneiderian membrane prevents patients 14 
Treatment of Diseases of the Cavity of the Nose. 
from satisfactorily performing their business, which requires a full 
command of the organ of smell. Chemists, perfumers, wine mer- 
chants, provision merchants, and others, may belong to this category. 
In cases of this kind the topical treatment is beneficial. After the 
application of alkaline solvents in particular, the sense of smell is 
clearer. 
I hope that the advance which we are making in the treatment of 
diseases of the nose, may be shared by its physiology. There is no 
greater enjoyment of Nature’s triumphs, and no greater safeguard 
against noxious things of all kinds, than a healthy nose. 
Of the medicinal solutions which may he applied to the cavity of 
the nose.—Although the solutions before enumerated act in a measure 
as alteratives, resolvents, and escharotics, and, therefore, rarely con- 
stitute a sufficient medical application by themselves,, yet they are 
more frequently used for preparing the nose for the application 
of more energetic and specifically acting solutions. To this latter 
class belong the solutions of alum, sulphate of zinc, and sulphate of 
copper—the best astringents; the solutions of nitrate of silver, and 
bichloride of mercury—the most suitable alteratives; and the solu- 
tions of chloride of calcium, in which suboxide or oxide of mercury 
is suspended in a finely subdivided state, together with the bichloride 
solutions—the best specifics. Of stimulating solutions, a mixture of 
eau de Cologne with water or salt water, is sometimes useful. 
The probable concentration of these solutions can be surmised 
from the circumstance that the sensibility of the healthy nasal cavity 
stands about midway between that of the eye and the mouth. When 
the nasal cavity is completely filled with fluid, the specific sense of 
smell cannot any longer be exercised; even the solution of eau de 
Cologne is not perceived to be such when it once fills the nose. The 
sense of smell being thus entirely obliterated by the fluid contained 
in the nose, the reflex effects which substances may exercise by 
means of this sense are entirely absent; and the only impingement 
which the fluids can produce is upon the filaments of sensitive nerves 
coming from the fifth pair. It is owing partly to this circumstance 
that comparatively strong medicinal solutions are borne by the nasal 
cavity without great secretion. Another circumstance favoring the 
application of stronger solutions is the ready manner in which the 
healthy service of the nose defends itself against irritating, chemical- 
ly-impinging substances by means of a copious flow of mucus. 
Excoriated or ulcerated parts lack this power of rapid secretion; 
and hence they are affected by medicinal solutions much more than 
the healthy parts of the surface of the nasal cavity. What is here 
stated is the general result of experience and experiment; but, at the 
same time, I must insist that the application of medicinal solutions in 
each case should be begun with the greatest caution, as individuals 
differ greatly in point of irritability of the nasal cavity. In the 
beginning, therefore, very dilute solutions of medicinal substances 
should be used, and their strength be increased gradually, after their 
effect has been well exhausted, by the use of greater quantities, 
applied by a quick flowq or the use of smaller quantities in a slow 
current distributed over a longer time of contact. Treatment of Diseases of the Cavity of the Nose. 
15 
Solution of alum.—Half an ounce of roughly-powdered crystallized 
alum is dissolved in a small quantity of hot water, and the solution 
made up to one quart by means of cold and tepid water in such a 
manner as to ensure that the temperature of the solution should be 
below, but near to, blood-heat. In superficial ulceration or blenorr- 
hagic conditions this solution is well borne. Ulcerated parts, which, 
before its application were red, mostly appear as white patches after 
its application, thus showing that the effect of the alum on the ulcer- 
ated surface has been considerable. When I was desirous to manage 
with smaller quantities of solutions, I have sometimes mixed a little 
permanganate solution with that of alum. 
Solution of sulphate of zinc.—From a scruple to a drachm of the 
sulphate of zinc, dissolved in a quart of warm water, together with 
half an ounce or an ounce of sulphate of soda or sulphate of magne- 
sia, gives a suitable fluid. 
Solution of Sulphate of copper.—Of this sulphate also from a 
scruple to a drachm, mixed with half an ounce or an ounce of soda 
sulphate or magnesia sulphate, can be dissolved in a quart of warm 
water. 
Solution of acetate of lead.—Of this crystallized acetate from a 
drachm to two drachms, together with half an ounce or an ounce of 
crystallized acetate of soda, may be dissolved in a quart of warm 
water. 
Solution of nitrate of silver.—Of this salt not more than from half 
a grain to a grain should be dissolved in each ounce of water. A 
quart of water, therefore, in which previously from half an ounce to 
an ounce of nitrate of soda has been dissolved, may receive from 
sixteen to thirty-two grains of the nitrate. In particular cases the 
solution may be made stronger. The nitrate of potash is not so good 
as the nitrate of soda, because it has slightly irritating qualities. 
When it is necessary to use it in an emergency, when soda nitrate 
cannot be had, the solution should be more diluted. 
Solution of bichloride of mercury.—The greatest caution is neces- 
sary in the use of this agent, as it has a tendency to produce excoria- 
tions on healthy surfaces. The first solution to be employed should 
be one containing five grains of corrosive sublimate in a quart of 
water, in which an ounce of common salt is also dissolved. 
Solution of chloride of calcium with suspended oxide or suboxide 
of mercury.—These fluids are the common phagedmnic waters, or 
black and yellow wash, to which common salt has been added. Two 
drachms of calomel, twelve fluid ounces of lime-water, one ounce of 
common salt, and twenty ounces of warm water, yield the black 
solution. One scruple of corrosive sublimate, one ounce of common 
salt, twelve fluid ounces of lime-water, and twenty fluid ounces of 
common warm water, yield the yellow wash. These mixtures must 
be well agitated in the glass vessel while being allowed to run 
through the nasal cavity. 
Sedative solutions.—Of prussic acid forty minims to the quart of 
warm salt water, of tincture of opium two drachms, may be taken, 
These drugs may be added to some of the above solutions of metallic 
salts. But if this is desired, it is better to substitute a solution of 16 
Treatment of Diseases of the Cavity of the Nose. 
morphia for tincture of opium. The prussic acid is incompatible 
with the copper, silver, and precipitated mercury solutions: it goes 
conveniently with the alum and common salt solutions. 
Styptic or haemostatic solutions.—Amongst these, ice-cold salt 
water, containing an ounce of salt to a pint of ice-water, takes the 
first place. When this, after having been continued for a considerable 
time, is insufficient to stop the haemorrhage, a fluid ounce of the 
tincture of the sesquichloride of iron may be added to each pint of 
ice-cold salt-water. 
Stimulating solutions.—One ounce of eau de Cologne upon ten 
ounces of salt-water, is a useful stimulant. Strong spirit of wine 
may be taken in place of the eau de Cologne. 
I have now fully, and for some readers, perhaps, somewhat too 
explicitly described a number of medicinal solutions which may with 
advantage be applied to the treatment of nasal diseases by the method 
in question. I was desirous to impress upon the memory of the 
reader the fact that I recommend only such solutions as are brought 
up to a certain specific gravity by salts which do not decompose the 
medicinal agents. There may be cases in which it is desirable to 
swell the Schneiderian membrane by watery fluid and produce 
endosmosis, and others in which highly concentrated solutions may 
beneficially be used to effect exosmosis and shrivel Schneider’s mem- 
brane. These adaptations, and the various accommodations of the 
fluids and their degrees of concentration, I must leave to the skill and 
ingenuity of those who make use of this method. They will also 
probably multiply the resources of the rhinotherapeutic pharmacy, 
and thereby add to the success and certainty of this interesting 
method of treatment. Description of Apparatus. 
17 
DESCRIPTION OF APPARATUS FOR TREATMENT OF 
DISEASES OF THE THROAT AND LUNGS 
BY- MEANS OF ATOMIZED MEDICATED LIQUIDS. 
DIRECTIONS POR USING ACCOMPANY EACH OP THE DIPPERENT POR'MS 
OP APPARATUS. 
Fig. 15. The Complete Steam Atomizer 
(patented). The name complete is used 
in connection with this apparatus with 
particular reference to the quality of its 
performance, as under no circumstances 
does it throw out little jets of hot water 
to frighten or scald the patient. The 
word is also appropriate when used to 
describe the apparatus itself, as it is the 
result of much care in arrangement, 
and of expense in the machinery em- 
ployed for its construction. On account 
of its convenience, durability, portability, compactness, and cheapness (in the 
best sense of the word), we think it adapted to come into almost universal 
use by physicians for their patients, and by patients at their homes. 
It consists of the sphere-shaped brass boiler A, steam outlet tube B, 
with packing-box C formed to receive rubber packing through which the 
atomizing tube D passes, steam tight, and by means of which tubes of various 
sizes may be tightly held against any force of steam by screwing down its 
cover while the packing is warm; the safety-valve E, capable of graduation 
for high or low pressure by the spring and screw in its top, the non-conducting 
handle F, by which the boiler may be lifted while hot, the medicament-cup 
and cup-holder G, the support H, base I I, the glass face-shield ./, with 
oval mouth-piece connected by the elastic band K with the cradle L, whose 
slotted staff passes into a slot in the shield-stand M M, where it may be fixed 
at any height or angle required by the milled screw N. 
The shield-stand is formed into a handle just above the waste-cup 0, and 
its base is formed to receive and hold this cup. It has also a sliding arrange- 
ment and set-screw, by which it may be fixed any desired distance from the 
atomizing tubes. 
The boiler is supplied with water through the opening into which the 
safety-valve is screwed. 
All of its joints are hard soldered, and cannot be separated by any heat 
short of redness or any pressure attainable with the lamp. Every one is 
carefully tested by very high steam pressure, and no accidents can happen to 
frighten the patient or injure the apparatus, should the water in the boiler 
become entirely exhausted. 
The spirit-lamp P is of brass, and is provided with means of graduating 
the flame, and with an extinguisher. 
The waste-cup, medicament-cup, and lamp, are held in their places in 
such a manner that they cannot fall out when the apparatus is carried or used 
Fig. 15. 18 
Description of Apparatus. 
over a bed or otherwise. The apparatus is contained in a box x 4 x 8 
inches; it can be carried from place to place by the practitioner without re' 
moving the atomizing tubes or the water; it can be unpacked and put in 
position for use in one minute, and repacked in the box in as short a time. 
Price of this Apparatus as represented in the cut, including two Glass Atom- 
izing Tubes, extra packings, and Shield Band, with directions for using, 
packed in box for transportation $6 00 
In neatly made, strong, Black Walnut box, with handle, additional 2.50 
Extra Face Shields, any size, including Elastic Band, each 50 
Glass Atomizing Tubes, each, 50 cts.; Silver do., $2.00; Silver and Platinum, 6.00 
Fig. 2 represents Dr. H. K. Oliver’s Hand 
Instrument, as described in a paper on Atomiz. 
ation, contributed by him to the “ Boston Med- 
ical and Surgical Journal” of March 8, 1866. 
a, Elastic Bulb with Valves, serving as a bellows 
to produce the spray within the jar. b, The 
Bergson Atomizing Tubes, the upright arm be- 
ing formed in part by a rubber tube, which dips 
into the medicament placed in the bottom of 
the jar. c, Opening for the admission of air. 
In this instrument the receptacle for the medi- 
cament and the shield for the protection of the 
face are united in one piece, while the spray 
is rendered exceedingly fine by being thrown forcibly against the side of 
the jar. 
Price, with two Atomizing Tubes, securely packed, accompanied with 
directions for using, $4.00. Price of Atomizing Tubes alone, 50 cents 
each. With Double Bulbs, instead of a Single one, $5.50. 
The Apparatus represented 
in Fig. 3 is essentially the same 
in form as that of Dr. Andrew 
Clarke, of England, but of 
improved construction. It con- 
sists of the Elastic Bulb r, 
which, with its valves, serves 
to force air into the Elastic 
Chamber g, which, alternate- 
ly expanding and contracting, 
supplies a steady stream of air to the Atomizing Tubes i, one branch of 
which dips into the vial containing the medicament. The stopper is of elastic 
rubber (patented), and fits perfectly the atomizing tubes and the vial. In 
addition to its other uses, this instrument constitutes a perfect Douche for 
bathing and making medicinal applications to burns, sensitive eyes, inflamed 
surfaces, painful sores, and for perfuming or disinfecting the sick-room. 
Price, with two Glass Atomizing Tubes, securely packed, $4.00. Price 
of Atomizing Tubes alone, 50 cents each. When of Silver, $2.00; when 
of Silver and Platina, $5.00. 
Fig. 2. Description of Apparatus. 
19 
Fig. 4. Freezing Ap- 
paratus for producing 
Local Ancesthesia. 
This form of appar- 
atus — similar to that 
represented in Fig. 3, 
with exception of Atom- 
izing Tubes, which are 
of metal,— is all that is 
required for producing 
Local Anassthesia by 
freezing with Ether, as 
employed by Dr. Rich- 
ardson, of London, or 
witli Rhigolene, as de- 
scribed by Dr. H. J. Bigelow, of Boston, in the “Boston Medical and 
Surgical Journal ” of April 19, 18GC. 
The Metallic Tubes which accompany this Apparatus are equally effi- 
cient for inhaling purposes, except for liquids liable to be vitiated by con- 
act with metal, for which glass or silver, or silver and platinum tubes should 
be used. Price of Apparatus, with Silver Plated Freezing Tubes, $5.00. 
Price, with two Glass Bergson Atomizing Tubes, and vial (fitted), thus com- 
bining in one the two apparatus for freezing and atomizing, represented in 
Figs. 3 and 4, $0.00. Price of Silver Plated Freezing Tubes alone, $2.00. 
Fig. 5 represents Siiurt- 
leff’s Atomizing Apparatus, 
(patented). It is similar to 
Dr. Clarke’s {Fig. 3), but 
has the shield b in addition. 
When used for inhalation the 
end of the shield is taken 
into the mouth, and serves 
both to protect the face and 
to depress the tongue, so that a direct and powerful current of spray may 
reach the throat. 
For making external applications the shield may be used to direct the 
spray upon a small surface only, or it may be disconnected, and the appa- 
ratus used without it. 
As all superfluous spray is turned to liquid by striking the inner walls 
of the shield, and is returned again to the vial by a suitably-formed orifice 
through the rubber stopper, this apparatus is very economical of the medi- 
cament, — a matter of some importance, when expensive liquids are 
employed. 
Extra shields of uniform or of various sizes will be furnished, if required, 
and can be connected with the other part of the apparatus without loss of 
time by passing them into the elastic rubber band which secures them to 
the upright standard. 
At f is a joint controlled by a thumb screw on which the shield swings 
when the vial is filled or emptied. 
COOMAN fc tHUHTLKEf 
BOSTON. 
Fig. *■ 
COOMAN L SHURTLEFP, 
BOSTON. 
Fig. 5. 20 
Description of Apparatus. 
Price, with two Glass Atomizing Tubes, securely packed, $4.50; price of 
Atomizing Tubes alone, 50 cts. When of Silver, $2.00. When of Silver 
and Platina, $5.00. Price of Glass Shield, including an Elastic Band, 
each 25 cents. 
(For other Tubes adapted to the Bulbs, see Figs. 8, 9, 10, 11, 12, 13 
and 14.) 
The rubber of Apparatus, Figs. 3, 4 and 5, is white and of the best quality. 
The Air Chamber or Reservoir Bulb l is covered with a netting of silk to 
prevent undue expansion, and to give the Chamber such rigidity as to afford 
a powerful current of spray. The valves are of a material and form to 
render them uniform and perfect in action in all positions, and each one 
is carefully fitted and ground to its seat. 
Rhigolene, of best quality, in strong 12-ounce bottles, per bottle, $1.00. 
Ether, of suitable quality, at market price.* 
Tubes adapted to Bulls represented in Figures 3, 4, and 5. 
o and f, (Figs. 8 and 9), conical end of air Tube 
for connecting with the rubber Tube of the Bulbs. 
r and o, (Figs. 8 and 9), Regulator (patented) for 
controlling the quantity and quality of the spray. 
Fig. 8. The Silver Plated Freezing 
Tube usually furnished with the Appa- 
ratus, Fig. 4. Price, with Regulator 
$2.00; when of Silver, $4.00; and when 
of Glass, without Regulator, $1.00. 
Fig. 9. Metal Tube, for throwing 
spray downwards into the larynx, or, 
when inverted, upwards into the 
posterior nares. It is also well 
adapted to freezing. 
Price, Silver Plated, with Regulator, $2.00; when of Silver, with Regu- 
lator, $5.00 ; when of Silver and Platina, with Regulator, $12.00. 
Figure 13. Glass Tube, for 
throwing spray downwards into 
the larynx or, when inverted, 
upwards into the posterior 
nares. 
Price, without regulator, $1. 
Pig. 9. 
Fig. 13. 
•Note.— Experience during the time in which Rhigolene and Ether have both been used 
for Local Anaesthesia, seems to have decided that Rhigolene is preferable to Ether, as being 
much quicker in action and more economical on account of lesser first cost, and smaller quan- 
tity required. Fears entertained, at first, of danger from its supposed great inflammability, 
have not been, we believe, in any instance realized. Description of Apparatus. 
21 
Figure 14. Glass Tube, for 
throwing spray upwards 
through the posterior nares. 
Price, without regulator, 
$1.00. 
Fig. 11 represents a very useful 
(patented) modification of the tube 
Fig. 9. By means of a nicely-made 
joint at b, the horizontal part may 
be turned to throw spray up or down, 
or in any direction at a right angle to 
the body of the tube, — the induc- 
tion end of the liquid-bearing tube 
being always downwards. It is particularly adapted to use in the throat, 
as the spray may be readily directed, either into the larynx or posterior 
nares. When Fig. 9 is used for the posterior nares, it is first charged with 
liquid and then inverted, and the operator is restricted to the use of as 
much liquid oply as the tube will contain; while with that represented in 
Fig. 11 the current of spray may be continued as long as desirable in any 
direction. This quality renders it in some cases superior to other, tubes 
for Local Anaesthesia. . 
Price, Silver Plated, with Regulator, $3.00; Silver, with Regulator, $6.00; 
Silver and Platina, with Regulator, $15.00. 
Fig. 10. Denial Tubes, w and z, the 
bifurcated portion of the Tubes (pat- 
ented), designed to deliver spray on both 
sides of the gum at the same moment, 
x and a, conical end of air Tube over 
which the rubber Tube of the bulbs is 
passed when used, r and b, Regulator 
(patented), to control amount of liquid. 
These Tubes are for use for Teeth 
Extraction, for painless removal of Den- 
tal Pulp, and other operations in Dental 
Surgery. With the Bulbs (represented in 
Figs. 3 and 4) they form the most desir- 
able Apparatus yet devised for these uses. 
For testimony in regard to the value of 
this Apparatus, see p. 26. 
Prices. — Either of those represented 
I in Fig. 10 (one being for use for Superior 
and the other for Inferior Teeth), Silver Plated, with Regulator $3.00; the 
COOMAN I. SHURTLEFF, 
BOSTON. 
Fig. 14. 
COOMAN L SHURTLEFF, 
BOSTON. 
\Fig. 11. 
Fig. 10. 22 
Description of Apparatus. 
two, $6.00; when of Silver, either, $6.00; the two, $12.00. One Bifurcated 
Tube, for use for either jaw, having the bifurcated portion straight instead of 
curved, and therefore not as convenient,—Silver Plated, $3.00; Silver, $6.00. 
I Reversible Bifurcated Tube, -with joint as de- 
scribed in connection with Fig. 11, answering 
the same purpose as the two in Fig. 10. 
Price, Silver Plated, with Regulator, $5.00; 
Silver, with Regulator, $10.00. 
To all the Metal Tubes, for Local Anajsthesia, as suggested by Dr. Bigelow 
and others, we have attached a Regulator (patented), which, without mate- 
rially increasing the cost, adds greatly to their value, as it enables the 
operator to secure such an amount of liquid as will freeze in the least pos- 
sible time when the Tubes are used for Local Anaesthesia, and will afford 
the finest spray when used for inhalation. It is also very useful in pre- 
venting the passage of foreign substances into the Tubes. Many Silver and 
other Metallic Tubes are so made as to be nearly worthless on account of 
the manner in which the orifices are formed, and of the unsubstantial 
method of joining the two branches. Those of our manufacture have 
orifices formed in solid metal turned and drilled in a lathe, and the two 
branches are soldered firmly together in immediate contact, or connected 
by double braces for those formed on a right angle. Those described as 
Silver, or as Silver and Platinum, are made in the same manner; the latter 
have both Nozzles and the liquid-bearing Tube of Platinum, and are there- 
fore not liable to be acted upon by any liquid. All our Glass Tubes are 
well annealed and remarkably strong. The two branches are so united 
that they cannot possibly get into a wrong position relatively to each other, 
and therefore always work well in the hands of the most unskilled. 
The price of the double Bulbs being $3.00, any of the Tubes before 
described may be selected to form such an Apparatus as may be desired, 
and the price readily ascertained. The Bulbs are also very useful as 
Inflators for Pessaries, Barnes’ Dilators, and for other purposes. For 
extensive operations, we make a larger Freezing Apparatus with compound 
jets, which we will describe, if desired, by letter. 
Foot Bellows. We make a neat, substantial and durable Foot Bellows, 
with elastic air chamber, covered with netting, and supplied with six feet of 
tubing. It may be used with any of the atomizing tubes. Price, $8.00. 
Fig. 12. Description of Apparatus. 
23 
DISEASES OF NASAL PASSAGES, 
DESCRIPTION OF APPARATUS FOR TREATING 
TIIE METHOD OF DR. THUDICHUM. 
Fig. 6. Nasal Douche, or Appara- 
tus for treating diseases of the Nasal 
Cavity, by the method of Professor 
Thudichum. a, Reservoir, b, Lead- 
ing Tube c, Nozzle, fitting the nos- 
tril in such a manner that liquid can- 
not pass outward, nor air into the 
nostril. r>, Joint formed by inserting 
a short glass Tube within the rubber 
tubing, at which Nozzles of different 
sizes, or for different patients, may be 
connected without loss of time. Price, 
with two Nozzles, securely packed, 
$2.50; extra Nozzles, each, 25 cents. 
“ Cheap Nasal Douchesimilar to Fig. 6. Price, with two Nozzles, se- 
curely packed, $2.00; Extra Nozzles, each, 25 cents. 
Fig. 7. Dr. Oliver’s form of Apparatus for 
Nasal designed for office use. a, Black- 
walnut Stand, b, Conical Reservoir, c, Lead- 
ing Tube. d, Nozzle, e, Joint, r, Ring, hinged 
to Stand, to support the Reservoir. 
Price, with two Nozzles, packed for transpor- 
tation, $3.50; extra Nozzles, any size, each, 25 
cents. 
In using either kind of Douche described, the 
Reservoir is placed higher than the head, and 
the rubber Tube is grasped near the Nozzle, 
between the thumb and finger, so as to control 
the current. The Nozzle is then depressed 
enough to allow a little of the liquid to escape, 
thereby expelling air from the Tube. It is then 
pressed gently into the nostril, and the grasp 
slightly relaxed, when the current will enter and fill the whole cavity of the 
nose and escape by the opposite nostril, the head at this time being 
thrown slightly forward over a basin, and the mouth kept open. 
Allen’s Nasal Douche. Instead of 
the reservoir furnished with other 
forms of Douche, this has a stopper, 
so made, that when inserted into a 
bottle of suitable size, such as can 
be found in every bouse, and the 
bottle inverted, the liquid will pass 
down the tube while air enters 
through another smaller tube in 
such a way as to form no inter- 
ruption to the egress of the liquid, 
un account ot ns cneapness ana portability, it will be found a desirable 
form of the Douche. 
Price, with 24-inch tube and one nozzle of best form, $1.20; with 36-inch tnbe, $1.50 
Also, Traveller’s Nasal Douche and Syphon Douche, each . . 1 50 to 2.00 
Fig, 6. 
Fig. 7. 
Fig. 16. 24 
Opinions of Physicians and Surgeons. 
We also make little Stop-cocks of hard rubber, which are thought by 
some to add to the value of the Douche. If required, they are inserted in 
the Tube at the joints d or e. Price, additional, $1.75. 
It will be noticed that the forms of Apparatus represented in Figs. 6 and 7, 
though different in detail from those described by Prof. Thudichum, are the 
same in principle. Though very simple, and comparatively inexpensive, 
we know, both from observation and report, that they answer perfectly the 
purpose intended. 
Directions for using accompany each of the different forms of Douche 
Apparatus. 
OPINIONS OF PHYSICIANS AND SURGEONS. 
Boston, May 2, 1866. 
Gentlemen,—I have used the three kinds of Apparatus for Nebulizing, prepared 
by you, and 1 have found them perfectly safe in their arrangements, and useful for 
throat and lung complaints. 
Yours, respectfully, H. I. BOWDITCH. 
18, Arlington St., Boston, May 11, 1866. 
Messrs. Codman & Shurtleff: Gentlemen, — Your Steam Atomizing Appara- 
tus furnishes an easy and valuable method of making local application to the fauces, 
larynx, and lungs. 
EDW. H. CLARKE. 
The following is an extract from a note from Dr. Henry J. Bigelow: — 
“ I have thus far found nothing better for freezing with Rhigolene than the tubes 
made by you after the pattern I gave you, and which I still use with your other 
apparatus.” 
Messrs. Codman & Shurtleff: Gentlemen, — Your Apparatus for Atomization 
of Liquids seems to have been carefully made, and I think it an efficient one where 
required for treatment of diseases of the Throat and Lungs. The Apparatus for Local 
Anaesthesia which you made for me answers the purpose perfectly. 
I am, very truly, your obedient servant, 
J. MASON WARREN. 
Boston, May 16, 1866. 
I have just had occasion to use one of your Apparatus for Local Anaesthesia, and it 
acted like magic. It is just the thing for Minor Surgery. 
April 29, 1867. 
I have thoroughly tested the Narcotic Spray Apparatus you sent me on trial, and 
believe it to be tlie best of any I have seen. 
I have been using one of your Steam Apparatus for about a year, and find it per- 
fectly adapted tor treating all diseases of the Throat and Lungs. 
Galveston, Texas, Sept. 27, 1867. 
Gentlemen,— I see that the impression prevails that Rhigolene is not suited to a 
warm climate, because it is thought that it boils at a temperature of 70 degrees F. 
The article which you sent me in January, and of which I have a small quantity 
remaining. I know has been subjected to 90 degrees, and often more, this summer, yet 
it has not lost in the least any of its efficiency. 
It produces congelation of the tissues where applied, almost instantly, and with an 
exceedingly small quantity. I am delighted with it, as well as with the excellent 
apparatus of Dr. Bigelow. It robs minor operations of all their terrors, entirely 
preventing pain j and this is a great consideration in an operation. 
I have ventured to freeze parts where the vitality is low, and never yet have I 
experienced the slightest trouble as to any secondary effects. Opinions of Physicians and Surgeons. 
25 
* “ It seems to me a singularly convenient and useful one.” 
* “ In completeness, elegance, and adaptability to the purpose for which it is designed, 
it is 1 think superior to any other ‘ Steamer ’ in "use.” 
* “ The little apparatus is the most complete for its price than any that have yet been 
manufactured, and the retail price so low, that expense is no longer an impediment to 
its employment by patients. 
* “ Our Boston friends, Messrs. Codmas & Shurtleff, have favored us with another 
modification of their model atomizer, and we must say that it is an elegant Instrument, 
and sufficiently cheap to bring it within the reach of every practising physician in the 
country: and their energy in this direction, in popularizing such useful apparatus, 
deserves commendation.” 
From Philadelphia Medical and Surgical Reporter of Nov. 28th, 1868: — 
*“We have received from the makers, Messrs. Codman & Shurtleff, a new instru- 
ment'for using atomized fluids, which appears to be very complete, simple, and durable. 
“The inventors claim that it cannot explode, unsolder, nor throw hot water jets 
instead of vapor. 
“If its future use warrants the expectations its appearance would lead us to form 
of it. it will prove very popular and very useful. 
“ For its thorough work aud durability, the price is very reasonable.” 
* “ Its operation is complete and satisfactory, and the ingenuity and artistic skill dis 
played in the design and manufacture, is a success truly.” 
* “I have not seen anything, either in workmanship or convenience, which surpasses 
it, and shall take great pleasure in recommending it as an admirable instrument.” 
* “ It seems to be as near perfect as such a machine can be, and I have no doubt will 
be much sought for by the profession.” 
From Boston Medical and Surgical Journal of Nov. 26th, 1868: — 
From the New England Medical Gazette of January, 1869: — 
“The ‘ Complete Steam Atomizer.’ as arranged by Codman & Shurtleff, seems 
the ultimatum ofconveuience. durability, portability, aud compactness for the purpose 
intended; and as to cheapness, we do not see how so perlect and extensive a piece oi 
machinery can be made for six dollars. 
“ Wherever frequent and continued medical inhalation is employed, this apparatus 
is invaluable. 
“ Their Hand Atomizer, for local application, is one which no physician should be 
without.” 
* “ It is the best constructed apparatus of the kind I have examined. 
“ Y our efforts in the practical atomization of remedies, are largely advancing this 
valuable means of treatment.” 
Massachusetts General Hospital, 
Codmas & Shurtleff's Complete Steam Atomizer has been used in the wards of 
the Massachusetts Genera) Hospital since its introduction. It is perfectly simple in its 
construction, yet substantial, compact, and safe. It atomizes steadily and completely, 
and gives entire satisfaction. 
BENJ. S. SIIAW, M.D. 
Resident Physician and Superintendent. 
Boston, February 15, 1869. 
* The Complete Steam Atomizer. 26 
Opinions of Dentists. — Postage. 
Who have used the Freezing Apparatus for their branch of Surgery. 
OPINIONS OP DENTISTS, 
The Apparatus for Dentists’ use was referred to by Dr. Stellwagen, at 
a meeting of the Pennsylvania Odontographic Society, reported on p. 316 
of Dental Cosmos, for January, 1867, as follows : — 
“ Dr. Stfllwagen then exhibited a Spray producer, of American Manufacture, 
having the tubes for the liquid and the air distinct and separate, which he thought 
made a more perfect Spray than the English Instrument, and with less Ether. 
“These Instruments have been employed with marked success in the Dental and 
Surgical Clinics of the Philadelphia Dental College.” 
“ I received the Instrument you sent, and it has proven all I could ask.” 
“ Messrs. Codman & Shut.tleff. —I inform you with pleasure that the Spray 
Apparatus of American manufacture, mentioned in the Cosmos of January, as brought 
before the Odontographic Society of this city, is of your manufacture, and has, 
within my own observation, been used by many, with very happy results.” 
Philadelphia, Jan. 24, 1867. 
“ It is very satisfactory The Double Tube is much superior to one 1 saw from * * * 
I wish you would send me another.” 
“ As T think I have given it a fair trial, I feel bound, in justice to its merits, and to 
my professional brethren, to add my testimony in its approval. The Tube which you 
let me have about two months ago (with regulating screw), I find to be an improve- 
ment.” 
“ Your Apparatus for Local Anesthesia, which we ordered some time ago, answers 
the purpose to our perfect satisfaction.” 
POSTAGE. 
The following will be sent by Mail, if so or-deyed, providing the amount necessary 
for prepayment of postage accompanies the order in addition to the price: — 
Apparatus, Fig. 3, complete 87 
Apparatus, Fig. 4, complete 84 
Combined Apparatus, Figs. 3 and 4, complete 1-05 
Apparatus, Fig. 6, complete 1-00 
Dentists1 Apparatus, consisting of bulbs, vial, and the 2 tubes represented in Fig 10 .90 
One Glass, Silver, or Silver and Platinum Tubes, for Apparatus Fig. 1 or for Fig. 15 .09 
Two Glass Tubes for Fig. 1 or for Fig. 15 12 
One or Two Glass Tubes for Fig. 2 06 
One Glass, Silver, or Silver and Platinum Tubes, for Fig. 3, or Fig. 5 06 
Two Glass Tubes for Fig. 3, or Fig. 5 09 
Silver, Silver-Plated, or Silver and Platinum Tubes, for Fig. 4, (also shown in Fig. 8) .12 
Silver, Silver-Plated, or Silver and Platinum Tubes, Figs. 9 and 11 12 
Dental Tubes, — either of those described in Figs. 10 and 12 15 
The two described in Fig. 10 21 
One or two Nozzles for either kind of Douche, Figs. 6, 7, and 16 06 
Three or four Nozzles for either kind of Douche, Figs. 6, 7, and 16 09 
Postage—Cents. Codman fy Shurtlejf, 13 Trcmont Street, Boston. 
27 
THE AUTOMATIC VACCINATOR. 
[Whittemore’s Patent.] 
FOR USING THE CRUST. 
MADE ONLY BY OURSELVES. 
A. Perforator having Its end 
counter-sunk or hollowed to re- 
ceive a small quantity of the crust. 
In using the Instrument, tlio 
forefinger is passed into tho King 
C, and the thumb pressed upon tho 
Lever B, by which the perforator 
i3 raised, and after reaching a cer- 
tain height is disengaged by the 
proper mechanism, when it de- 
scends with the forceof tho spring, 
and, slightly puncturing the skin, 
deposits tho virus. 
CODMAN Sr SHUATLEFF, 
BOSTON* 
A single, easy motion in one direction, is all that is required to 
operate the Instrument, — the skin being punctured and the matter 
deposited simultaneously. 
The pain attending its use is so slight as rarely to waken a sleeping 
child, while the operation is rendered much more certain than by other 
methods. sent (post-paid) on receipt of 
Price, c$1.00. Every one Warranted. 
The following, from sources that will be generally recognized and 
respected, is the only testimony we think it necessary here to present. 
I have examined and used the improved Vaccinator, which you were so kind as to 
send me. 
With a very long and extended knowledge and experience of the various methods 
of Vaccination, and the instruments employed in the performance of that simple oper- 
ation, I do not hesitate to say, that your Vaccinator is the best, and that with it, any 
one, without special dexterity, can vaccinate with great rapidity and certainty, and, as 
is of great importance, do a great deal of work iu a short time. 
Yours truly, HEMET A. MARTIN, M.D. 
Taunton' Lunatic Hospital, June SO, 1S07. 
I cannot speak too highly of your Vaccinator. 
I always charge it with a paste made of the powdered crust with Glycerine, 
which keeps perfectly well. Dr. NO ETON FOLSOM. 
VACCINE VIRUS always oil hand and sent by return train in 
answer to orders by mail or telegraph. 
We are able to supply Physicians and the Trade with Vaccine Virus 
of absolute purity and excellence. 
The Lymph we have furnished for the last four years has given such 
satisfaction, that we now offer it with the renewed and complete assurance, 
that no better service can be offered than that performed in this branch of 
our business. 
Vaccine Crusts, resulting from the dedication of perfect, unruptured vesicles, 
carefully selected and securely mounted in Gutta Percha, so as to be used without 
breakage or waste, $3.00 each. 
Quill Points, prepared so that the Lymph cannot chip o£T, well and carefully 
charged, in packages of ten points, $1.50 per package. 
Kach package i f Virus will be hermetically sealed, and packed very securely for 
preservation and easy transmission by mail, or otherwise, to any distance, and is abso- 
lutely warranted. 
Whenever its use fails to give perfect satisfaction, a fresh supply will be sent, on 
notification, within fifteen days. 
TERMS. , Codman & Shurtlef ’ 13 Tremont Street, Boston. 
28 
Tmm BPflOULUB. 
The accompanying cuts rep- 
resent an important improve- 
ment upon any form of Specu- 
lum hitherto iu use, lately 
devised by Prof. Horatio R. 
Storer, and exhibited by him 
to the Suffolk District Medical 
Society, on September 26th. 
It will be seen that by a sim- 
ple spring attachment at the 
side of the Cusco bivalve, (rep- 
resented at A,) the blades may 
at once be disjointed, swung 
around back to back, and there 
fixed by a turn of the nut al- 
ready existing upon the screw 
traversing the handles, with the 
effect of giving a retractor equal 
in working facilities to that of 
Sims’. 
Dr. Storer’s instrument is, in 
fact, a duplex one: as a specu- 
lum retaining the excellence of 
Cusco’s instrument, and as a 
retractor better for ordinary 
purposes than the complicated 
and more expensive instru- 
ments of Emmet, Bozeman, 
Fallen, and Bryant. 
The history of the invention, 
may be given in Dr. Storer’s 
own language, when describing 
it to the Society. 
“ A year ago I was discussing 
with my assistant, Dr. Stone, 
the features of Dr. Thomas’ 
Telescopic Speculum, and re- 
marked to him that while I was 
averse to the unnecessary mul- 
tiplication of instruments, 1 
thought it possible to improve 
upon the best yet in use, which 
I considered Cusco’s to be. 
Some six months afterwards I had occasion to remove stitches from the anterior vaginal 
wall, after an operation for vesical fistula, and happened to have no retractor with me. 
I therefore directed Dr. Stone to remove the screws connecting together the blades of 
Cusco’s instrument, and by reversing their relative position I had at once the retractor 
that I desired. By subsequently attaching a moveable spring peg in place of one of the 
screws, and rendering the other one a fixed point, immediate change from the speculum 
to the retractor, and back again, became possible by a slight touch of the finger.” 
This instrument, (many of which have already been sold,) is of our own manufacture; 
and from its combining the advantages of two separate and distinct mechanical principles, 
and thus making one instrument serve the purposes of two, will probably come into 
almost universal use. It has been styled by Dr. Storer the “Boston Speculum,” but will 
doubtless be known by his own name. .Price, $7.00. 
Dr. Storer’s other instruments — his intra-uterine Scarificator, clamp-shield, of great 
value in ovariotomy and removal of the uterus by abdominal section, porte-caustique for 
intra-uterine applications, hollow needle with jointed handle, wire rope for ecraseur, 
pessary for retroflexion, prolapsed ovary and tumors in Douglas’s fossa, may also be 
obtained of us. 
CODMAN & 9HURTLEFF, 
BOSTON. 
COOMAN It SHUATLEFF, 
BOSTON. COOMAN It SHURTLEFF, 
BOSTON. 
IDE. E- CUTTER’S 
Fig. 1. 
PESSARY, FOR RETROVERSION OF THE UTERUS. 
The modification in this Pessary consists in the single posterior support,—the hooked 
termination and the joint. It operates as follows: — 
Extending the vagina in its long diameter, and in the direction of its antero-posterior 
curvature, it does not distend it transversely, nor interfere with the normal tonic contrac- 
tion of its transverse fibres; in which condition of the vagina there can be no retroverting 
of the uterus. 
Its fixed point, by means of the elastic suspension, is the sacrum, and not the vaginal 
or pelvis walls. The suspension imitates the natural elasticity of the normal uterine sup- 
ports, and permits a limited degree of motion. The suspension cord runs in the furrow 
between the buttocks, which prevents lateral motion of the Pessary. Motion upwards is 
preventedjby the post-utero vaginal cul de sac; downwards, by the suspension; forwards, 
by the cervix uteri, and backwards by the promontory of the sacrum. 
The joint, in the crook obviates the necessity of removing the belt, — permitting the 
tubingjto be turned aside during defecation, at the same time serving as a handle, by 
means of which the vagina may be kept at its normal length, and the uterus in situ 
naturalis during the bearing-down efforts, which, under other circumstances, are likely 
to retrovert a replaced womb. 
There are three sizes of the Pessary,—4£, 5, and 6 inches in length. 
Price of either size, with directions for introducing $3.00 
CODMAN & SHURTLEFF, 
BOSTON. 
CODMAN 8. SHURTLEFF, 
BOSTON. 
Fig. 2. 
Fig. 3. 
Figures 2 and 3 represent, respectively, an Intra-Uterine, and a Prolapsus Pessary, 
which combine, with the usual features of such instruments, the advantages of convenient 
external support, and of the jointed hook, as in the other instrument. 
Price of either $3.00 30 
Codman & Shurtleff\ 13 Tremont Street, Boston. 
Laryngoscopic Lantern, or Light Concentrator. 
Invented by Dr. II. K. OLIVER, 
This is, as far as we know, the only 
Laiiyngoscopic Lantern made in the 
United States, — those in use here being 
ail imported from Europe. To nearly all 
of these instruments there is the objec- 
tion that they are adapted to a par- 
ticular kind ol'lamp or gas fixture. The 
invention of Ur. Oliver obviates this 
objection, — his Lantern being, by a 
number of very simple contrivances, 
easily fitted to any kind of lamp or 
fixture. 
The want of a portable Light Con- 
centrator, of universal adaptability, has 
been greatly felt by Laryngoscopists 
when called upon to examine cases away 
from their office. It has also, as we 
know from personal experience, ob- 
structed the desirable extension of the 
study and practice of laryngoscopy, 
inasmuch as general practitioners and 
students have found it necessary, in 
order to provide themselves with a 
Light Concentrator, to purchase also 
the fixture or lamp to which it was at- 
tached. 
Ur. Oliver’s Instrument isdesigned 
for direct light, — a method preferred by 
many Laryngoscopists to reflected light. 
The lens, however, is of sufficient diame- 
ter for use with tne frontal reflector, if 
thought desirable. 
Auto-laryngoscopy being by general 
acknowledgment an important means of 
acquiring skill in the use of the laryn- 
goscope, there is attached to the Lan- 
tern a small mirror, which, by a very 
simple mechanism, has nearly all the 
movements usually afforded by the ball 
and socket joint. 
This Light Concentrator will be found 
useful not only in laryngoscopy, but in 
the examination of the external ear. 
In the same box in which the Lantern is packed, is a rack for three sizes of laryngeal 
mirrors, copied from London mirrors imported by Ur. Oliver, with which they bear 
favorable comparison. 
Description. — The Lantern is made up of three main portions, the front piece A, and 
two wings which hinge upon the front piece, and by which the diameter of the lantern 
may be increased beyond the diameter of any of the glass chimneys in ordinary use. 
These wings may be locked together at the desired point, as at a, a" The height of the 
flame from the part of the lamp suited for a support to the Lantern varies considerably, 
of course, in different lamps and gas stands; and inasmuch as the lens must be on a level 
with the flame, the tube containing it is attached to a slide B, which, moving in grooves 
in the front main piece, may be raised or lowered, as found necessary. The lens is also 
movable within the tube, in’order to admit of its being retained at its focal distance from 
the flame, when the diameter of the Lantern is changed. The movement is made by the 
sliding of a knob on each side (6) in an elongated opening in the tube. The Lantern is 
made firm upon the lamp by passing a bit of cord back and forth between the instrument 
itself and hooks (of), which are strung upon a cord tied around any suitable place in the 
lower part of the lamp. This arrangement is simple, extremely efficient, and universally 
practicable, — the latter point being difficult of attainment by any other mechanism. 
At c is seen the little mirror for use in auto-laryngoscopy. 
• OBMAN & 9HURTLEFF, 
BOSTON. 
Price, — Laryngoscopic Lantern $4 00 
Auto-Laryngoscopic Mirror, additional 1 00 
Set of three Laryngoscopic Mirrors 4.50 
All the above fitted in Case 10.00 
Laryngeal Mirrors, separately, any size 1.50 
B3T Concise rules for use furnished with each Instrument. 
For full description of the Lantern and method of its employment, see article con- 
tributed to the Boston Medical and Surgical Journal, of October 8tn, 1868, by Dr. Olivkb. Codman & Shurtleff, 13 Tremont St., Boston. 
31 
ID Ft. CHAPMAN’S 
Spinal and Lumbar Ice and Hot Water Bags, 
For making dry, hot, or cold applications to the spine and other 
parts of the body. 
THE DOUGLASS PATENT ARTIFICIAL LIMBS. 
We have been appointed Agents for these very excellent Limbs, and will 
forward descriptive pamphlets, on application. 
RUBBER URINALS, 
For Males or Females. 
Figure 1. 
These Urinals 
valves, which pre- 
with tightly closing 
of the greatest ser- 
flicted with incon- 
Tliey are adapted 
on the person, and 
are provided with 
vent overflow; also 
stop cocks, and are 
vice for persons af- 
tinence of urine, 
for constant wear 
are quite durable. 
Figure 2. 
rPRIOES. 
Male, for (lay or night, .... $6.00 
Male, for day only (Figure 1), . . . 5.00 
Female, for day only (Figure 2), . . 4.00 
IF A C T O FI -5T. 
. " c have over and connected with our Store, a Factory, with steam-power, where 
instruments of every description are made to order, or sharpened, polished and re- 
paired, and where old instruments may often be rendered nearly as good as new. 32 
Codman & Slmrtleff\ 13 Tremont St., Boston. 
Ball and Socket, hard or soft Pads single, $4.00 
“ “ “ “ double, 7.00 
Ratchet, hard or soft Pad single, 4.00 
“ “ “ double, 7.00 
Spiral-Spring Pad single, 4.00 
“ “ “ double, 7 00 
French Style, or long Pad , single, 4.00 
“ “ “ double, 7.00 
L. B. White’s Patent Lever, hard Pads singlb, $7.00 to 10.00 
“ “ “ “ “ “ double, 10 00 to 20.00 
Hard Rubber single, 8.00 
“ double, 10.00 
Moc-main or Varicocele 
Trusses for Prolapsus Ani 
Dr. Banning’s, with separate attachments, for either kind of 
Hernia or Prolapsus, and lor spinal and abdominal support, $10.00 to 20.00 
TRUSSES, FOR ADULTS. 
CHILDREN AND YOUTHS’ TRUSSES 
Ratchet, hard or soft Pads single $3.00 
“ “ “ “ double, 5.00 
French, soft Pads single, 3.00 
“ “ double, 5.00 
“ cheap style, soft Pads single, 2.00 
“ “ “ “ double, 3 00 
UMBILICAL TRUSSES AND BELTS. 
Umbilical Trusses $5.00 
“ Belts, with adjustable Pads 5.00 
“ “ Children’s 2 50 
ABDOMINAL SUPPORTERS. 
Chapin’s , $4.00 
Boston 4.00 
London 5.00 
Philadelphia, with pads giving support on lateral muscles 7.00 
Fitch’s 4.00 
Banning’s, with attachment for either kind, for Hernia, or for Prolapsus 
Uteri, Prolapsus Ani, or Spinal Curvature 
Mrs. Betts’, with Prolapsus Pad 7.00 
The above-described Trusses and Supporters are nearly all of our own 
manufacture, and will be found of the first class as regards quality, adaptation, 
and workmanship. The prices are those for which we adapt them to the 
patient. Physicians sending measures, and taking the trouble and responsi- 
bility of fitting patients, will receive them at a discount of 38j per cent, from 
these prices. 
SILK ELASTIC ABDOMINAL BELTS. 
For use during pregnancy, and when abdominal support is required, $10.00 
All kinds of apparatus for club feet, weak ankles, bow legs, malformations, 
&c., made to order to meet requirements of each case. 
SPINAL SUPPORTERS. 
83“ DIRECTIONS for measuring for Trusses, Supporters, Crutches, Apparatus for 
Deformities, &o., will be sent, if requested. 
Shoulder Braces, Suspensory Bandages, &c., &c.  
DIRECTIONS FOR MEASURING. 
tigjUT* Indicate the measure around the limb in inches, 
>pposite the dotted lines of the cut. 
For Stocking to cover the entire limb, measure at 
iBCEGH. 
For Stocking to reach to G measure at A B C E G. 
For Stocking to reach to D, measure at A B C D. 
For Knee-cap, measure at D E F. 
For length of (Stocking, measure from I upwards. 
WE HAVE ALWAYS OH HAND 
Sizes to reach to II — 
Of best Silk. 
Of Cotton. 
To reach to G — 
Of best Silk. 
Of Cotton. 
To reach to I) — 
Of best Silk. 
Of medium Silk. 
Of Cotton. 
Sizes to reach from D to F 
(Knee-caps) — 
Of best Silk. 
Of medium Silk. 
Of Cotton. 
To reach from A to B 
(Anklets) — 
Of best Silk ("only). 
Unusual sizes and forms for special eases made to order. 
Also, Elastic Abdominal Belts, for Obesity, Pregnancy, 
Weakness, &c. 
Physicians ordering the above for patients, will receive them at a discount 
from retail prices. 
Having a Factory, with steam-power and experienced workmen, we can 
promptly make to order, or sharpen and repair, Surgical and Dental instru- 
ments. 
CODMAN & SHURTLEFF, 
13 & 15 Tremont Street, Boston. APPARATUS FOR PARACENTESIS THORACIS, 
Approved by Dr. HENRY I. BOWDITCH, 
Accompanied with Directions kindly furnished by him. 
CAMMANN’S STETHOSCOPES, Articulated and Disarticulating. 
OTOSCOPES. 
LARYNGOSCOPES, simple Throat Mirrors. 
OPHTHALMOSCOPES —Greefe’s, Liebreich’s, Anagnostakis’s. 
iESTHIOMETERS. 
Dr. MILLER’S INTRA-UTERINE SCARIFICATOR. 
(See Boston Medical and Surgical Journal, March 21st, 1857.) 
DEWEE’S EVAPORATOR. 
SPLINTS AND FRACTURE APPARATUS. 
BIGELOW’S TOURNIQUET. 
SAYRE’S SPLINTS FOR HIP-JOINT DISEASE. 
HYPODERMIC SYRINGES, great variety. 
RENTE’S INTRA-UTERINE CAUSTIC INSTRUMENTS. 
HOLT’S DILATOR. 
BARNES’ DILATOR. 
UNIVERSAL SYRINGES. 
INHALERS. 
FEVER THERMOMETERS. 
GALVANIC BATTERIES AND APPARATUS. 
MEDICINE TRUNKS AND POCKET MEDICINE CASES. 
AMPUTATING, TREPHINING, POCKET AND OTHER INSTRUMENTS, 
in sets, or single. 
THE VARIOUS INSTRUMENTS OF DR. H. R. STORER, FOR THE TREATMENT 
OF UTERINE DISEASES. 
Apparatus for Club-Feet, Weak Ankles, Boiv-Legs, 
Spinal Curvature, Ac., made to order. 
Crutches, the best patterns, all sizes, always on hand. 
Mespirators, to prevent coughing on entering cold or warm air, also 
to prevent inhalation of dust. 
Teeth Forceps, Pluggers, Scalers, Excavators, Opera- 
ting Chairs, Spittoons, Mineral Teeth, Gold and Tin Foil, 
and all other Instruments, Implements, and Materials used in the practice of 
Dentistry. 
Skeletons, articulated and disarticulated. 
Skulls, articulated, disarticulated, and sawed, showing sinuses, internal 
and median ear. 
Manikins, Anatomical and Pathological Models,Charts, 
Ac., on hand or imported to order. 
Price-Lists of Manikins, Models, Skeletons, &c., furnished on application.