Respirator

“ A definite increase in the volume of the lungs is the consequence of frequent repetition of this supplemental respiration. The air-cells which are as a rule inactive, and which are reserved for cases of excessive respiratory strain, arise from their inaction; their walls, which are usually collapsed, and even stuck together, separate and give entrance to the air which can not find room in the confined space sufficient for ordinary breathing. ”

“ Besides the heart and the great vessels the chest contains the lungs, the chief organ of respiration, which, with the rest of the respiratory system, will now be treated. The nose and mouth, through which the air first enters the body, have already been spoken of. From them the air passes through the larynx to the trachea, thence to the bronchi, and so to the lungs, where the supply of oxygen for the tissues is taken from the air by the hemoglobin of the blood. ”

“ Protection of the respiratory organs can to some extent be obtained by so-called respirators worn over the mouth and nose. Often they consist simply of a moist sponge or folds of cloth, or again may be complicated air-proof affairs enclosing mouth and nose, or the whole face like a mask, or even the head like a helmet ”

“ But more wonderful yet is its effect on the disorders of the respiratory organs. Under anything like favorable circumstances the lungs are, indeed, the most curable part of the human body. With every inspiration the balm of pure air can be brought into contact with the thousand times thousand air-cells of the respiratory apparatus, [2] and, as we breathe about twenty times per minute, the panacea can be applied twenty-seven thousand times in twenty-four hours. ”

“ The respiratory murmur may be lessened in certain morbid conditions, such as emphysema and congestion of the lung, and may completely disappear in pneumonia or broncho-pneumonia, a fact which is even of greater significance. ”

“ The construction of respirators is extraordinarily varied. One form is illustrated. They must be light, and in order not to obstruct breathing seriously they are often provided with valves—closing during inspiration and opening during exhalation. ”

“ It accelerates the respiratory process, as the amount of air inhaled at one inspiration does not contain oxygen enough to supply the wants of the organism at the ordinary rate of breathing, and is therefore especially distressing to diseased (wasted) lungs, whose functions are already abnormally quickened, and can not be further stimulated without overstraining their mechanism. ”

“ Where the dust cannot be avoided, the use of steam or electric fans, to deflect the dust away from the workman, has been found successful; and in many cases, free ventilation of the workshops has greatly diminished the mortality. Where none of the above measures suffice, the use of respirators ought to be insisted on. Breathing through the nostrils ought to be carefully maintained, as thus the dust is to a large extent stopped before reaching the lungs. ”

“ The impulse which comes from within, from the so-called respiratory centers, so excites the respiratory muscles that they cause the chest to execute the strongest breathing movements with the greatest ease, ventilating every portion of the lungs, filling every air-cell to its utmost capacity. ”

“ We know that the respiratory system is constructed for the circulating: that the form, the extent, the complication of the respiratory apparatus depend entirely upon the quantity of blood that is to be regenerated, and the degree of perfection with which that regeneration is to be accomplished. ”

“ The purity of the blood is influenced by the condition of the lungs. When the bronchial tubes and air-cells have become partially impervious to air, from pressure upon the lungs, from fluids in the chest, from tumors, or from the consolidation of the cells and tubes from disease,—as inflammation, or the deposition of yellow, cheesy matter, called tubercles,—the blood will not be purified, even if the air is pure, the lungs voluminous, and the respiratory movements unrestricted, as the air cannot permeate the air-cells. ”

“ In addition to the effect on the circulation, the respiratory movements keep up the nutrition and efficiency of the lungs, which in old age undergo a kind of atrophy, and also maintain the elasticity of the chest-walls, which are apt to become stiff through disuse, and so interfere with the movements of the lungs and pleura. ”

“ The respirations are more or less increased in frequency, the increase, other things being equal, being in proportion to the amount of damage of the pulmonary organs, or, in other words, the extent to which the respiratory function is compromised by the lesions. ”

“ We can also now understand why, when the vessels of the lungs become congested and oppressed, and in those who are affected with serious diseases, it should be so dangerous and fatal a symptom when the respiratory organs become implicated. ”

“ Simple diffusion through the narrow bronchial tubes could not possibly bring oxygen into the lung sacs fast enough to supply the requirements of the blood flowing through their walls. The situation is met by active lung ventilation; that is, by forcibly changing the air in the lungs at frequent intervals. The way in which this is done is, as we all know, by breathing. Breathing is nothing but a bellows movement of the chest by which air is alternately expelled and allowed to enter. ”

“ The lungs are the essential organs of respiration or ventilators of the body. They are two in number, separated from each other by the heart, are placed in a semi-distended state in the air-tight thorax, which we have seen they, together with the heart and great blood-vessels, completely fill. The lungs ultimately consist of air-cells, surrounded by dense plexuses of capillaries and nerves. The air-cells communicate with the exterior through the bronchial tubes, trachea, larynx, throat, and nose. ”

“ The free and equable expansion of the lungs by full inspiration, necessarily takes place; this maintains their healthy structure, by keeping all the air-passages open and pervious; it prevents congestion in the pulmonary circulation, and at the same time provides more completely for the necessary chemical action on the blood, by changing, at each act of respiration, a sufficient proportion of the whole air contained in the lungs,—all objects of great importance, and all capable of being promoted, more or less, by the means in question. ”

“ Part 21 The explanation of the admission of air and respiration in those animals in which a lung is found, and especially in those in which it is full of blood, is to be found in the fact that it is of a spongy nature and full of tubes, and that it is the most fully charged with blood of all the visceral organs. All animals with a full-blooded lung require rapid refrigeration because there is little scope for deviation from the normal amount of their vital fire; the air also must penetrate all through it on account of the large quantity of blood and heat it contains. ”

“ Lungs' Respiration.—'The number of respirations is increased at the beginning of the stay, but returns to the normal number after a longer time, and probably the depth of the inspiration is also increased.' This is in accordance with our observations. The greater expansion of the chest, and the frequency with which patients and others volunteer the statement that they can breathe deeper, confirms the opinion that the depth of respiration is increased; more bulk of air being taken in to give to the lungs an equivalent amount of oxygen, greater depth of breathing must needs follow. ”

“ Some blow fresh air into one of the nostrils by means of bellows, while the other nostril and the mouth are kept firmly closed. But, as far as my experience goes, by this treatment the air is much more likely to get into the stomach than into the lungs. If it is necessary to induce artificial respiration, it is better to alternately press the arms of the patient firmly to his chest and then to raise them above his body, or, what is even more simple, squeeze together every two or three seconds both chest and abdomen with the hands. ”

“ In the above cases, death often may be prevented by prompt recourse to artificial respiration. To accomplish this, place the patient on his back with the head lower than the body; grasp the arms near the elbows and draw them upward and outward until they are stretched above the head, on a line with the body. By this means the chest cavity is enlarged and an inspiration produced. To produce an expiration, carry the arms downward, and press them against the chest, thus forcing the air out of the lungs. ”

“ We must, however, distinguish between respiration by the lungs, called external respiration, and respiration by the cells, called internal respiration.
The purpose of respiration is indicated by the changes that take place in the air while it is in the lungs. Air entering the lungs in ordinary breathing parts with about five per cent of itself in the form of oxygen and receives about four and one half per cent of carbon dioxide, considerable water-vapor, and a small amount of other impurities. ”

“ The numerous canal-like ducts in the lung, into which it passes, have each a blood-vessel lying alongside, so that the whole lung is thought to be full of blood. The inward passage of the air is called respiration, the outward expiration, and this double movement goes on continuously just so long as the animal lives and keeps this organ in continuous motion; it is for this reason that life is bound up with the passage of the breath outwards and inwards. ”

“ Why air introduced into the pleural cavity through a wounded lung, should have such wholly different effects from that entering directly through a wound in the chest, was to me a complete mystery until I heard of the germ theory of putrefaction, when it at once occurred to me that it was only natural that air should be filtered of germs by the air-passages, one of whose offices is to arrest inhaled particles of dust, and prevent them from entering the air-cells. ”

“ The lungs, the organs of respiration, are two pinkish gray structures of a light, spongy appearance, that fill the chest cavity, except the space taken up by the heart and large vessels. Between the lungs are situated the large bronchi, the œsophagus, the heart in its pericardium, and the great blood-vessels. The base of the lungs rests on the dome-like diaphragm, which separates the chest from the abdomen. This partly muscular and partly tendinous partition is a most important factor in breathing. ”

“ The person having weak lungs should spend as much time as he conveniently can out of doors. He should provide the most ample ventilation at night and have a sleeping room to himself. He should practice deep breathing exercises and partake of a nourishing diet. While avoiding prolonged chilling and other conditions liable to induce colds, he should take advantage of every opportunity of exposing himself fully and freely to the outside atmosphere.
Summary.—The purpose of respiration is to bring about an exchange of gases between the body and the atmosphere. ”

“ In ordinary breathing the emission of air immediately follows the intake; expiration begins the moment inspiration ceases, and the respiration is completed. The elasticity of the lungs causes the diaphragm to rise and the walls of the chest to return to their natural position. ”

“ Fig. 1, A pair of bellows with two separate bags, so contrived that by opening them, when applied to the nostrils or mouth of a patient, one bag will be filled with common air, and the other with the mephitic air extracted from the lungs; and, by shutting them again, pure atmospheric air will be introduced into those organs, and that drawn out, consequently discharged into the room. Thus, the artificial breathing may be continued, while the other operations on the surface of the body are carried on ”

“ All rough usage should be avoided, especially twisting or bending of limbs, and the patient must not be allowed to remain on the back unless the tongue is pulled forward. In the event of respiration not being entirely suspended when a person is lifted out of the water, it may not be necessary to imitate breathing, but natural respiration may be assisted by the application of an irritant substance to the nostrils and tickling the nose. Smelling-salts, pepper and snuff may be used, or hot and cold water alternately dashed on the face or chest. ”

“ In the room heated by a German stove and consequently where there cannot be a free ventilation, every individual is breathing the identical air that has circulated through the lungs of every other individual in the same place—through the air-cells of the scrofulous, the scorbutic, the asthmatic, the consumptive, &c.—air that is not only deprived of its oxygen, but loaded with animal effluvia of a very questionable character! ”

“ The organs of respiration have their only protective apparatus, filter, or dust-catcher, in the nostrils. When the breath is taken through the mouth, there is nothing from mouth to lungs to strain the air, or to catch the dust and other foreign matter in the air. ”

“ Whilst one person is carrying out artificial respiration in this way, others may, if there be opportunity, busy themselves with applying hot flannels to the body and limbs, and hot bottles to the feet, but no attempt should be made to remove the wet clothing or to give any restoratives by the mouth until natural breathing has recommenced. ”

“ Respiration is more frequent in females and children than in adult men. In diseases, particularly those of the lungs, it is more increased in frequency than the action of the heart. In health, the smallest number of inspirations in a minute by an adult, is not less than fourteen, and they rarely exceed twenty-five. Eighteen may be considered an average number. The quantity of oxygen taken into the lungs at each inspiration is about eight cubic inches, one half of which disappears in every act of respiration. ”