US 2280992 A
Description (OCR text may contain errors)
April 28, 1942. R. M. WRIGHT ETAL.
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APPARATUS FOB.4 TREATING NASAL ORGANS Filed Jan. 8, 1940 [Irl- TL April 28, 1942.
l ENTORS ATTORNEY.
Patented Apr. 28, 1942 APPARATUS FOR TREATING NASAL ORGANS Russell M. Wright and Carl Voorhies, Detroit, Mich.
Application January 8, 1940, Serial No. 312,810
(Cl. 12S-297) 2 Claims.
too inflamed to effect normal drainage of the sinus chambers it Was usually necessary to open a drainage passage therefrom by packing the upper end of the nasal openings with medicated swabs containing styptics effective to shrink the membranes lining the openings to the sinuses.
Thereafter under normal circumstances the sinuses would slowly permit drainage of the secreted pus, fluid and other foreign matter trapped in the affected sinuses, which are normally hol- W air chambers, and which under a clogged condition cause much pain to the sufferer. The aforementioned method of treatment is somewhat long drawn out for a conventional office call as the patient must usually remain in the physicians office during the interval the nose remains packed and While the medicine for shrinking the inflamed membranes is taking effect. i Thereafter the packing is removed and an antiseptic or germicidal solution is sprayed or introduced into the sinuses, and then a healing and soothing oil or balm is used to cover the tender surfaces before the patient leaves. This procedure is disagreeable to handle, very susceptible ofspreading the ailment, and causes the patient much suffering. Therefore a system of treatment which would obviate the above objectionable factors, be relatively more sanitary, economical to administer, cause less suffering to the patient in the treatment, and be readily portable for use in any oinceor home would nd ready acceptance. Accordingly, to this end, the apparatus of the present invention contemplates the provision of means for selectively administering a nasal tube charged With a heat-tempered medicated solution under regulated pressure, or producing a regulated vacuum in the nasal chambers to introduce a medicated solution in one nostril and draw out the mucus, pus and other foreign matter in a circuit through the sinuses and out the other nasal chamber.
provision of an apparatus providing means for treating certain ailments of the human body which are relatively inaccessible Without surgery and deep seated and that are reactive to a system of treatment which comprises the introduction of a medicament to the affected part and the withdraw of the combined used medicament and infected matter in solution into a trap joined in circuit with a vacuum producing means and thereafter selectively reversing said system circuit to provide means for the introduction of a heat-tempered medicated solution in a low-pressure spray form to envelope the affected parts with a protective coating of a healing and soothing balm; the provision in an apparatus as above described of control means for selectively reversing the system circuit from a pressure producing system to a vacuum producing means, and separate control means for independently regulating the amount of vacuum and/or pressure produced; the provisionof means in an apparatus as above described comprising yieldable valve means for limiting to a predetermined amount the extent of vacuum or pressureproduced, including dial gauges for viewing the degree of positive or negative pressure in the system; the provision in an apparatus as above described of means comprising a sanitary filter trap in the vacuum branch of the system circuit for the removal of bacteria and lighter foreign particles not retained by the trap but carried in suspension in the vacuum line back into the apparatus and their separation fromthe apparatus before deposition in the valve parts or conduits thereof, including removable filter means for periodically readily cleansing and renewing the lter trap; another object of this invention is the provision of means in an apparatus as above described comprising an air heater and sterilizer, having a xed maximum operating temperature, in series with the pressure branch of said system and affording a heat tempering and purifying member for the introduction of pure treated air and/or medicated spray to the affected part.
` Other objects of the invention include the provision of apparatus having its component parts so constructed and arranged that it may be compactly mounted substantially in its entirety as a unit upon a removable panel board forming a section of a housing cabinet; the provision in an apparatus as described of a unit pump and driving means therefor loosely disposed in said cabinet connected through flexible conduits to said system circuit; the provision in an apparatus as Among the objects of this invention is the above described of muler means on the air intake side of said vacuum and/or pressure branch of the system circuit for quiet operation of the apparatus when inducting or discharging a iiuid medium into or from the atmosphere, namely,
Further and other objects and advantages of the invention reside in the novel combination and arrangement of parts and will become apparent as disclosed in the attached drawings, which form a part of this specication, and are `limited in scope only by the extent of the appended claims.
Like numerals have been used to designate similar parts throughout the several views, and in which:
Fig. 1 is an elevational View of a panel board for mounting the attached instruments and controls shown upon a reduced scale; and
Fig. 2 is a rear elevational View of the back of they panel shown in Fig. 1, and is drawn on a much larger scale; and
Fig. 3 is an end elevational View of the apparatus, shown in Fig. 2, taken substantially on the line 3 3 thereof, and includes a sprayer attached to the pressure side of the system.
Fig. 4 is a similar end elevational View taken from the opposite side of the view shown in Fig. 3, substantially on the line 4 4 of Fig. 2, and includes an associated combination of medicament Vial and mucous trap vial lmeans in the vacuum Fig. 6 isa sectional elevational View of the spring-tensioned regulatable pressure valve of Fig. 3.
It will be noted that substantially the entire components of the apparatus of the present invention are nicely and compactly arranged upon the rear face of a panel board, with the exception ofthe energizing means comprising a vacuum-pressure pump, and as such may be mounted as a unit in a cabinet for office use, or may be housed in a portable case for traveling, only a source of electric power being necessary to plug into for energizing the driving means of the pump. Likewise, since the initial diagnosis of most nasal disorders includes a careful examination and illumination of the sinuses, a pencil-like light having a strong concentrate-d beam is used, and because these ear or nose lights operate at a reduced voltage below that of the standard power supply, a convenient outlet or socket is incorporated in the panel layout for the operators ready use as will be hereinafter described.
Now having reference to the drawings, and particularly to Figs. 1 andy 2, the assembly and other component parts of the apparatus are shown. A mounting board or panel, generally designated I0, of rectangular outline and. preferably composed of Bakelite, plastic, wood, or other dielectric material, has a plurality of holes II in the corners thereof for mounting the panel in a cabinet or portable case and a series of stamped or cored openings in the central portion of the panel body for the reception of the dial gauges, valve controls and other component parts of the apparatus. As previously mentioned, the system circuit comprises a vacuum branch and a pressure branch, and since the common means to the two branches of the circuit` is an energizing means which includes a powered pressure-vacuumpump, the system description will begin there and extend progressively through each branch of the circuit to the respective outlets therefor.
A pump unit I2, which energizes the circuits, is a compact combination vacuum-pressure pump and electric motor driving means coupled thereto and all housed within a small cylindrical shell. That is to say, the pump is of the conventional vane type which has a pressure side and a suction side from which extend flexible conduits I4 and IB, respectively. This pump unit, which has its own rubber tipped feet to stand on and requires no mounting means, may be located at any convenient location in the cabinet behind the panel board Ill and controlled from the face of the panel by a snap-on switch Il secured therethrough which is connected in series with the motor current wire and a source of electric power, not shown. A jeweled bezel I8 with an electric light in line therewith is also mounted through the panel I0 adjacent the switch I'I and being connected across the switch provides a visual tell-tale means for determining when current is flowing through the switch and the pump motor is on.
The conduit I4, leading from the pressure side of the pump'IZ, extends to a short pine line 2t which is threadedly secured by any suitable nipple means to one port of a two way, spring seated, valve cock 22, which is also mounted on the rear of the panel ID and operated from the front face thereof by a handle 23. A second port vof the valve cock 22 also has a pipe line 25 threadedly secured thereto through a similar nipple means. The remaining port of the valve cock 22 has a relatively smaller pipe line 2S similarly threaded thereto and its free end is rolled up into a hollow cylindrical formation to provide a muiiler 2l in which are a series of atmospheric openings 23 in adjacent convolutions thereof, for a purpose to be hereinafter described in the operation of the system. Since the two-way valve cook 22 may be adjusted by the handle 23 to only a pressure or vacuum setting, not including the off position, i. e., to provide communication between pressure line 2 and pipe line 25, or between the muiiler 21, pipe line 26 therefrom and pressure line 2Q, respectively, it will be hereinafter referred to as the control means for convenience of reference purposes in differentiating between this control and separate adjustable valve means which regulate the degree of pressure or vacuum in the branches of the system circuit.
The pipe line 25 is in fluid tight communication with one port of a cross or four-way fitting 33 which is threaded into the end of an ad- `instable valve 32 which is secured to the rear face of the panel I0 by any suitable fastening means. A rotatable knob Srl on the front of the panel board has an operating shaft extending therefrom for effecting regulation of the valve 32. Another relatively smaller pipe line 35 is vthreaded by a conventional nipple means on one end thereof into a second port of the tting 30 andv extends to and in communication with a pressure gauge 36 mounted by any suitable fastening means 31 and projecting through an opening in the panel board for viewing from the front face of the panel the extent of pressure in the system circuit. From the remaining port of the tting 30 a pipe line 38 is in communication with a heater and stemlizer All, preferably in the form of a cartridge or bomb, with a base 4I supported by a bracket 42, coninected through threaded fastening means 43 to the rear faceof the panel l0. The heater and sterilizer 40 may consist of a heating element comprising a wire having a predetermined resistance, and hence `a fixed operating temperature, in the hollow interior of the shell which is enveloped on its outer periphery by` an insulating material to prevent radiation and heat losses therefrom. The heater is` connected in series with a switch 45 located adjacent thereto and mounted through the panel I for control from the; front face thereof. Above the switch 45 is a `jeweled bezel 46 having a light in line therewith and connected across the switch for visualizing when current is flowing through the switch` and the heater 40 is functioning. A further pipe line 48 is in communication with the outlet ,from the heater and extends to a flexible conduit U forming an outlet from the apparatus `for connection to any desired equipment or instruments for use on the patient,lone embodiment of which will be hereinafter described., The location of the heater or sterilizer 40 in; this order in the pressure branch of the circuit, after the control 22, the adjustable valve 32 and just before transmission to the patient, is preferred not only as concerns conservation of heat losses from the tempered fluid but more particularly because the operating temperature of the heater was found to introduce problems of heat expansion of the metal and operation of the aforementioned valve parts and the fluid tightness of other component soldered joints and seals, which is entirely obviated by the illustrated circuit; however this is not intended as a limiting location because obviously a choice selection `of various available metal alloys or fibers for the `valves and controls would reveal materials not readily affected by heat.
Now having reference to Fig. 6, there is shown a sectional plan View of the adjustable valve 32, for regulating the degree of compression in the pressure branch of thesystem circuit, and which is provided with means for limiting the maximum pressure obtainable to a predetermined value. The rotatable knob 34, in Fig. 1 or Fig. 3, has an axial shaft extending through the panel Ill into one end of a rectangular hollow sleeve` 52 disposed on the interior bore of the valve body 32. The opposite end of the sleeve 52 is fitted over a complementary shaped stud 53 integral` with a screw member 54, which is threaded into the body of the valve and adapted to be moved forward or back by the knob 34. Upon the opposite axial end of the screw member 54 one end of a spring 55 is secured, which has the other end attached to a piston 56 movable in acylinder bore 51 of reduced diameter. An opening 58, which is preferably in theform of a slot, as best shown in Fig. 3, exhausts to the atmosphere from a point in the cylinder bore 51. The spring 55 is adapted to transmit rotary movement of the knob 34 to effect forward movement and retraction of the piston 51 to control the degree of pressure in the circuit;` and it will be obvious that, by a proper `selection of the spring pressure desired, any force` on the opposite side of the piston greater than the force required to collapse the spring will move the piston axially inward in its cylinder until the exhaust slot 58 is uncovered to relieve the excess pressure in the system, after which it will again automatically `close the opening. By so limiting the maximum pressure obtainable in the system any possibility oi accidentally applyingan injurious amount `to the patient by an inexperienced operator is avoided.
The description of the vacuum branch of the system circuit is much the same as the initial component parts of the pressure branch of the circuit. Now having reference to Figs. 1, 2 and 4, there is shown a flexible conduit I6, leading from the suction side of the pump l2, that extends to the free end of a short pipe line 60 which is threadely secured by a nipple on the opposite end thereof to one port of a two-way valve cock 62, similar to valve cock 22, and also secured to the rear of panel I0 and operable from the front face thereof by a handle E3. One port 64 of the two remaining ports of the cock 52 is open to the atmosphere, and the remaining port has a pipe line 65 extending therefrom to another four-way or cross fitting 31; The valve cock 62 which selectively communicates the vacuum branch of the circuit with the energizing means is similar in operation to member 22 and will hereinafter be referred toas vacuum control 62, for convenience of reference purposes in distinguishing from its associated adjustable valve which regulates the degree of vacuum in the circuit in accordance with the setting of control 62.
The four-way fitting 6l is threaded in the end of an adjustable valve 69, also mounted on the rear of the panel l0 similarly to valve 322, and which has a rotatable knob l0 on the front face of the panel for effecting adjustment movement of the Valve. A relatively smaller pipeline 12 is threaded by a nipple means into a second port of the fitting 52 and provides the feed line for a vacuum gauge 13 mounted through the panel l0, which is secured thereto by fastening means 14, for viewing the dial indicating the degree of vacuum in the circuit from the front of the panel, all as similar to the pressure gauge 35 previously described. A by-pass pipe 15, which has one end sealed into a third port of the fitting 61, is shunted around the metering means of the valve 59 into the interior of the valve body, and functions in a manner as will be described in connection with operation of the valve 69. From a fourth port of the fitting 61 a pipe-line `f6 extends into the interior of `a filter trap 18.
The filter trap 'I8 may comprise an inverted glass bowl 19 threaded into a cover member 85 which is supported by the pipe line` 16 extending thereinto a substantial distance. Another pipe line 82 is sealed to the cover member 80 and is in communication with the interior of the filter trap. The free end of pipe line 82 is encased by a flexible conduit 84 which is the outlet, or more correctly, since this is a vacuum line, the inlet to the apparatus for connection to any selected surgical apparatus or instruments for use on the patient, one embodiment `of which will be hereinafter described. .The filter trap 18 is designed so as to be covered on the interior, especially adjacent the opening of pipe-line 82 thereinto, with a piece of absorbent tissue, such as filter paper or cleansing tissue, whereby any foreign matter or infectious germs evacuated from the patient which is carried by a liquid trap adjacent the administering instrument and entrained in the vacuum line, may becaught by the filter trap and prevented from reaching the interconnected controls and valves of the apparatus forming the system circuit.
In Fig. 5 is shown a sectional plan view of the adjustable valve B9 which regulates the extent of vacuum in the vacuum branch of the circuit, and
that is provided with means for limiting the maximum vacuum obtainable. This valve is very similar to pressure valve 32 before .described but has an important distinction in the means arranged to limit the degree of vacuum produced. The rotatable knob '|0 in-Figs. 1 or 4, has an axial shaft projecting through the panel and extending into one end of a rectangular hollow sleeve 86 freely disposed in the interior bore of the valve body 60. The opposite end of the hollow sleeve is slidingly tted over a complementary shaped stud 8'| integral with a screw member 88, threaded into the body of the valve and arranged to be projected forward and retracted by the knob 10. A spring member 89 is secured to the QDpOsite axial end of the screw 88, and is arranged for connection with a piston 90 movable in a cylinder bore 9| of reduced diameter in the valve body. An opening 93 through the peripheral wall of the valve, between the piston 90 and the screw 80, communicates with the atmosphere. As in the description of the pressure valve 32, the spring 89 is adapted to transmit rotary movement of the knob 10 to effect forward movement and retraction of the piston to control the degree of vacuum in the circuit, and the spring is preselected to accommodate the desired break down point in the vacuum line. However it will be noted that, since a vacuum is being drawn through the tting 61, on the end of the valve, as the extent of vac* uum is increased by movement of the piston in the valve body until the vacuum overcomes the resisting force of spring 89 an opening such as 83 would have no vacuum relief function, in the manner that the slotted opening 58 of valve 32 provides a pressure relief as in Fig. 6. Accordingly, the by-pass tube 'I5 is shunted around the piston 90; now when the measure of vacuum in the circuit overcomes the selected spring tension the piston will be drawn forward and seated upon the end of the cylinder bore 9|, as shown, to uncover the entrance to the by-pass tube and communicate the atmospheric opening 93 with the main line thus breaking the Vacuum, and after the vacuum has fallen to a safe amount will automatically close and recharge the system. It may be noted here that under a badly congested condition of the sinus passages, for example, where impeded by a polyp, or jelly-like matter, which should be removed with a snare, the reading on the vacuum gauge would increase to a degree harmful to the patient due to the congestion, if no means were relied upon other than the operator to watch the dial gauge, but in view of the safety vacuum relief means incorporated in the valve structure such a possibility is obviated. Furthermore, with the present invention the operator by observing the reading on the dial gauge increase until the safety relief vacuum is reached may be advised of the presence of such blocking matter and have an opportunity to remove the same as mentioned above before completing the treatment.
The operation of the apparatus is as follows: the heater is energized by the switch 45 and the tell-tale light d6 glows to indicate that current is flowing through the unit. After the heater reaches its operating temperature the pump I2 is energized by the switch and the associated tell-tale light |8 indicates its functioning. The control handles 63 and 23 are both turned to indicate either a vacuum or pressure setting in accordance with the function selected. The valve 32 or 69 is adjusted by the `regulator knob 34 or |0 to secure the desired reading on fifi the gauges 38 .or 13, respectively, in accordance with the setting of the control handles 23 and 63. Assuming that the apparatus has been set to function in a pressure producing manner, air will be inducted through the atmospheric opening 64, into the control 62, through the channels 60 and |6 to the suction side of the pump and compressed uid will flow from the pump through the pipes |4, 20, into the control 22, the pipe 25, and through the pressure adjusted valve 32 into the heater and sterilizer 40 from the pipe 38. From the heater 40 the pipe 48 conveys the tempered compressed fluid to flexible conduit 50 which forms the outlet from the apparatus. As
shown at the right hand side .of Fig. 3, there is illustrated va simple form of sprayer which may be connected to the pressure line 50. This instrument comprises a testtube or vial |00, with an apertured sealing cover |02 closing the open top thereof. A hollow tube |03 extends diametrically through the cover |02 and has a nozzle |64 on one end thereof for insertion in the nasal columns. Upon the other end of tube |03 is a thumb valve |06 for communicating the pressure line 50 secured adjacent thereto with the nozzle` Intermediate the valve |06 and the nozzle |04, in the tube |03 is an aspirator tube |08 having its upper end bonded into the interior bore thereof substantially on the axis and facing in the direction of uid flow. The lower end of the aspirator tube extends deep down into the test tube |00. Obviously when the system circuit is functioning in the manner above mentioned, and the thumb valve |06 is depressed,
the medicament or styptic carried in the vial or test tube will be drawn from the reservoir by the aspirating'eifect produced around the upper end of tube |08 and sprayed from the nozzle |04 in an atomized form to whatever part of the anatomy desired, in this case the nasal column.
Now if the styptic has been deposited in the nasal columns, the entrance to the sinuses, and accomplished its openingfunction, and it is desired to ush out or irrigate the sinus chambers,
an apparatus such as .shown in the upper left hand side of Fig. 4 is used. This apparatus consists of two test tubes or vials` ||8 and secured together by the bracket H2. The test tube ||0 may be open to the atmosphere and partially lled with a ger-micidal or flushing solution, .and have a discharge outlet at the .bottom thereof to which is attached one end of a flexible tube H4, containing a petcock ||5 intermediate its ends, and a nozzle I6 depends from its lower end for insertion into one nasal opening of the patient. The other test tube has an apertured cover memberv tightly closing the open upper end thereof and from Vwhich extends a tube H8, having one end deep down in the test tube, and the other free end supporting a nozzler H0 for insertion into the other nasal opening of the patient. A T-shaped hollow pipe |20 has one arm of the T in communication with the interiorof the test tube and the opposite free end |2| of the arm open to the atmosphere. The depending leg of the T is inserted in the suction line 84 of the vacuum producing system circuit. Now if the system is cycled so that the control handles 23 and 63 are set to a vacuum reading and the regulator knob '50, of the vacuum valve 69, is adjusted to produce the desired degree of vacuum, as visualized by the gauge 13, a vacuum will be drawn through the atmospheric opening |2 i, the line 84, filter trap 18, adjusted valve 69, pipe line E6, control 62 .and into the suction side I6 of the pump I2. The exhaust of the pump will now be handled through the pressure side of the pump and on through and out of the pressure branch of the system as previously described. It will be noted here that in this vacuum producing cycle of the system the ccntrol *52 has the atmospheric opening 64 closed from communication therewith and hence draws through the opening I2I, of the T shaped pipe V20, and line 84; while thecontrol 22 is set so that the port supporting the pipe line 26 is in communication with the muiiler 21 for a quiet exhaust to the atmosphere.
It will be obvious that if the bracket IIZ, and the tubes Ii and III supported thereby, are grasped in the hand of the operator, the nasal nozzles I I6 and I I9 inserted in the nostrils of the patient, the petcock II opened, and the thumb of the operator placed over the opening I2I, the vacuum line will be closed to the atmosphere and be drawn in a circuit through the medicament fed by `gravity into one nostril through the sinuses and out the other nostril. Most of the mucus and pus or foreign matter evacuated from the patient will be deposited and trapped in the test tube III before being carried into the interconnected lines and valves of the system. Any smaller particles or germs which are light enough to be entrained in the Vacuum line will be caught by the filter trap 'I8 next in series in this branch of the circuit. It will be further noted that since the exhaust from the apparatus, when it is functioning in a vacuum producing manner, may be through the pressure branch of the system, any extraneous impurities can be passed through the heater and sterilizer 4!) and thus neutralized or killed, whereby they will not be transmitted further on the next cycle of the apparatus, to the same or another patient.
Other combinations in which the apparatus of the system circuit may be arranged to produce variations of the straight vacuum or pressure producing functions may be illustrated. For eX- ample, when the apparatus is caused to operate in a full vacuum producing manner by setting the handle 23, of the control 22, so that the exhaust or pressure side of the pump is passed through the pipe line 25, instead of through the mulller 21 to the atmosphere, and through the sterilizer or heater 40 to the outlet conduit 5|), instead of dissipating this pressure tothe atmosphere it may be put to useful Work. Obviously now the pressure gauge 3B will record a pressure in the exhaust line and the metering valve 69 by its regulator knob 'I0 may be adjusted to suit; thus` the system will be producing full vacuum effect and minor pressure characteristics at the same time, or any ratio of the same, under separate and independently controllable metering means. Accordingly, the said exhaust pressure available in the conduit may be conveyed to an apertured cover member |24 secured in the test tube I I0, as shown in Fig. 4. Under this arrangement instead of the medicament solution normally contained in the test tube I I0 being fed by gravity, there will be a pressure behind the solution to positively force the matter through a badly blocked condition of the nasal passages or sinuses, if such be the case.
From the foregoing description it will be apparent that among other things a novel and useful apparatus and method have been provided for accomplishing the first mentioned objects of this invention; however, it is to be understood that since only one embodiment of this invention has been disclosed it is not intended to be limited to the specific construction herein disclosed but to cover all modifications fairly within the spirit of the broad invention and limited in scope only by the extent of the appended claims.
What we claim is:
1. The improvement in an air pressure system for treating sinus disorders having pump actuated pressure and suction branches including dispensing and evacuating nozzles insertable in the nasal organs, which consists in providing said pressure branch with a medicament tube having means thereon supporting said dispensing nozzle, and in providing said suction branch with a sampling tube with means thereon supporting said evacuating nozzle, which also consists in providing a single supporting panel upon which said system branch means are mounted into a unitary system, closure means on said sampling tube including a valve adapted to be operated by the thumb of the operator for initiating an evacuating action, bracket means connecting said medicament and sampling tubes as a unit and in such manner they may be held in the palm of the hand of the operator used to thumb said valve, said suction branch of the pressure system on said panel unit connected through elongated exible hose means with the closure means on the sampling tube, valve means in the pressure and suction branches of said system, and in the provision in said valve in the pressure branch of a muiiier tube controlled port open to the atmosphere for quietly exhausting air when the suction branch of the system is operative.
2. The improvement in an air pressure system for treating sinus disorders and having pressure and suction branches and including dispensing and evacuating nozzles insertable in the nasal organs, suction and pressure creating means comprising an air pump having its outlet connected to the pressure branch and its inlet connected to said suction branch, and manual valve means for selectively rendering either branch of said system operative, which consists in providing individual pressure regulators for each branch each of which consists `or manual means for regulating the fluid pressure in its respective branch, spring pressed venting means in said pressure and suction regulators adapted to open its respective branch to the atmosphere for dissipating pressure or suction respectively when a predetermined safe maximum is exceeded, in providing a port open to the atmosphere in said valve of the suction branch which port comprises the air inlet for said pump when the pressure branch of the system is operative, and in providing the valve in the pressure branch of said system with an apertured, cylindrically-coiled tube controlled port open to the atmosphere and constituting a muier for quietly exhausting air when the suction branch of the system is operative.
RUSSELL M. WRIGHT. CARL VOORHIES.