The machine which is used to give general anaesthesia is generally called as Boyle's machine even though there are many other names for that machine.This presentation tries to trace the development of the Boyles machine from 1846.

1. evolutionof Boyle’s apparatus
It is a misunderstanding that Boyle actually invented the Anaesthetic
machine, this is incorrect. On a visit to New York he was persuaded by
James. T Gwathmey who was a reservist American Army officer, to try
his machine for delivering gases. It did provide an airtight mask with a
pressure escape valve. After persuading the board of Governors at St
Bart's, he imported two machines.
He was to eventually to modify the machine to make it more gas tight.
It was given the name "Boyles Nitrous oxide Ether outfit" since
then the elders of the anaesthetic environment will still refer to this
machine as a "Boyles Machine"

3. before theinvention of anaesthesia…
surgerywas an agony…a nightmare….

4. Surgery in medieval times..
Often religion based..

5. Entry of nitrous oxide…

6. administration ofanaesthesia
was not so complicated…..

7. Anaesthetic arnamentorium 1850…

8. Giving anaesthesia became an art
rather than based on any
scientific fact..

9. Inventor and revealer of anaesthetic inhalation
by whom, pain in surgery was arrested and
annulled… before whom , in all time, surgery was
agony…. since whom, science has control of pain
October 16,1846
W.T.G.MORTON

10. Cotton ball soaked in sulfuric ether..
a mouth piece and an exhalation port
housed in a glass bottle

11. Codman & Shurtleff Inhaler
A mouth piece, shut-off valve,
Attachment to bottle with ether/chloroform
Air entering port

12. Hager Inhaler -1850 -1860
Used with ether
Can force air into the chamber

13. Joseph Clover administering anaesthesia
with his apparatus
See his hands on the patient’s pulse….

14. Clover ether apparatus

15. Mask designed to
administer ether

16. A well-made antique anesthesia nitrous
oxide gas and ether inhaler as introduced, in
the early 1900s, by Sir Frederick Hewitt
(1857-1916), anesthetist to King Edward
VII. The Hewitt's improved large
bore inhaler is a modification of
Clover's portable regulating inhaler.
HEWITT’S APPARATUS

17. WORKING PRINCIPLE OF HEWITT’S APPARATUS

18. JUNKER’S CHLOROFORM BOTTLE

19. ANAESTHESIA APPARATUS –U.K- 1890

20. MAGILL’S ANAESTHESIAAPPARATUS

21. MAGILL’S ANAESTHETIC APPARATUS -1920

23. The apparatus includes a "Boyle Bottle"
ether vaporizer (right) and a Junker
chloroform vaporizer (front). Each is held in
a warm water bath, and is connected to a
vacuum flask (thermos) that holds hot water.
A thermometer registers the temperature
inside the flask. A hand pump was used to
blow air first through the ether and/or
chloroform vaporizers, and then through the
vacuum flask on its way to the patient
Shipway Apparatus

24. Dr.Elmer.I.Mckesson- invented the
McKesson Intermittent Flow Apparatus in
1910. In the same year, he also formed a
company to manufacture it. This was the
first anesthesia machine to have an
automatic cut-off regulated by the patient's
breathing. The air stream flowed only while
the patient inhaled, and stopped when the
patient exhaled, preventing waste. The
machine could administer nitrous oxide,
oxygen and ether, either singly or in
combination. A small rubber rebreathing
bag also allowed some of the patient's
exhaled carbon dioxide to be reintroduced to
the air stream

25. E.M.O VAPORISER

26. E.M.O apparatus with bellows-
Ether with a water jacket and a
temperature compensating
mechanism.

27. HEIDBRINK MILITARY MODEL

28. Dr. Charles K. Teter (1875-1959) and his brother Dr. William C. Teter (1873-
1954) were both dentists who specialized in oral surgery and anesthesia. In
1902, they patented an apparatus to deliver nitrous oxide, oxygen and ether. It
may have been the first machine to include all three of these agents. This
became the standard combination for all anesthesia machines made over the
next two decades. The model shown here is the Teter Regulated Pressure
Apparatus, introduced around 1912.
TETER APPARATUS

29. The Heidbrink Anesthetizer was among the
earliest machines to allow for the
administration of controlled concentrations
of nitrous oxide and oxygen, and was very
popular for dental anesthesia. Heidbrink
applied to patent the 'Anesthetizer' in 1912.
HEIDBRINK ANESTHETIZER

30. COTTON-BOOTHBY APPARATUS-1911
Dr. Frederic J. Cotton (1869-1938) and Dr. Walter
Boothby (1880-1953) were colleagues at the Boston
City Hospital when they developed this apparatus for
nitrous oxide-oxygen-ether anesthesia.

31. • provided an uninterrupted flow of anesthetics and oxygen,
• a visible indication of the rate of flow for both the nitrous oxide (N2O) and
oxygen.
• means to quickly and easily add ether vapor to the gas mixture.
• estimating the flow rate: pass each gas separately through water in a glass
mixing chamber. The rate of bubbling of the gases through the water was
used to estimate the flow and proportion of each gas.
• The gases directed into the ether chamber could be made to pass over the
surface of the ether or bubble through it.
• The gases could also be directed to fully bypass the ether chamber.
The process of estimating the flow rate of gas by bubbling it through a liquid is
commonly referred to as the “bubble bottle” or "bubble-through" method. Its
influence can be seen in anesthesia devices developed by others, including those
developed by Dr. James Gwathmey (1862-1944) of the United States, and Dr.
Henry Boyle (1875-1941) of the United Kingdom. Drs. Frederick J. Cotton and
Walter Boothby introduced this apparatus in 1911.

32. The Gwathmey-Woolsey Nitrous Oxide-Oxygen Apparatus was developed to
administer ether as well as nitrous oxide and oxygen. Introduced in 1912, its design was
partially rooted in guidelines for nitrous oxide-oxygen anesthesia recommended by
physicians Frederic Cotton (1869-1938) and Walter Boothby (1880-1953), designers of
the Cotton-Boothby Apparatus. The most notable similarity between this apparatus
and the Cotton-Boothby is the water-sight flowmeter, or ‘bubble bottle,’ which was first
developed to estimate the rate of flow for both nitrous oxide and oxygen.
GWATHMEY-WOOLSEY
APPARATUS

33. CONNELL 1936 MODEL
Dr. Karl Connell (1878-1941) introduced a line of closed circuit, multiple-gas
anesthesia machines in the 1930s. These were among the first to have a built-in
carbon dioxide absorber. This series of machines also had ball-bearing gauges,
called flow meters, to accurately display the rate of gases flowing to the
patient. Incorporating the suggestions of several leading anesthesiologists of
that era, the machine's safety features included glass domes to make the action
of the valves controlling the flow of air and gas visible, and conducting wires
inside the rubber breathing tubes to reduce the possibility of explosion. These
machines also introduced solid stainless steel cabinetry. This model could
deliver carbon dioxide, oxygen, ethylene, nitrous oxide and cyclopropane. Ether
and helium could also be added.

34. nitrous oxide (N2O) delivery device that could
be carried by midwives into the homes of the
women they cared for. Minnitt and King
adapted a McKesson device, likely the
Nargraf, to create a machine that could be
used by the patient to self-administer a
mixture of air and N2O. The Minnitt
Apparatus was introduced in 1933 and
approved by a British oversight authority, the
Central Board of Midwives, in 1936
MINNIT APPARATUS-
FOR LABOUR ANALGESIA

35. Dr. Henry E. G. Boyle (1875-1941), a leading English anesthetist, invented a nitrous
oxide, oxygen and ether anesthesia machine in 1917. It was based on the design of the
Gwathmey Apparatus, using a "bubble through" or "sight feed" vaporizer. The
gases were routed through two perforated tubes in a glass mixing chamber
containing water. The rate of flow could be estimated by observing the force of the
resulting bubbles. This became widely known as the Boyle Bottle. The Boyle machine
continued in production for over 50 years, while the Boyle Bottle became a standard
feature of British anesthesia machines.
BOYLE’S APPARATUS

36. FOREGGER -GWATHMEY
MACHINE WITH 2
SIGHT FEED TUBES
RICHARD VON FOREGGER-
ANAESTHESIA EQUIPMENT MAKER
1872-1960

37. A CLOSE UP VIEW
OF WATER SIGHT FEED
FLOW METER
The flow meter system to the left would have
had a plain glass jar, filled with water to the
level of the bar. Below that bar, each flow
meter down-tube is perforated at intervals
with holes. In use, increasing gas flow would
depress the water in the tube causing gas to
escape from increasingly low holes. These
levels were calibrated in units of flow which
would be read from a card attached to the
bottle. The chloroform vaporiser bottle is
coloured green while the ether bottle is clear.
It is not known why the glass is coloured
green,as the recommended colour for bottles
for storing chloroform is brown. The chains
would have been attached to the filler corks
to prevent accidental loss.

39. 1942

40. CONNEL FLOW METER-1936
 CO2,OXYGEN AND ETHYLENE

41. CIRCLE ABSORBER-1929

42. WATERS TO & FRO CANISTER

43. COEXTER ANAESTHESIA MACHINE -1940

44. BOYLE’S MACHINE -1940

45. MARRET’S ANAESTHESIA APPARATUS
1942
1950
This machine is the first industrial prototype
of Marrett’s portable machine. The
vaporiser is an integral metal chamber in a
water bath, fed by a dropper from two
internal chambers with separate ports on
top, with knobs to control flow rate for each
agent and cut-off levers. It was used with
oxygen, cyclopropane, nitrous oxide, carbon
dioxide, ether and trichloroethylene. It was
designed for carrying and has a fold-flat
handle on top.

46. COPPER KETTLE VAPORISER-1952
Dr. Morris originally designed the vaporizer for the
administration of chloroform. Because it worked with any
volatile liquid, it was soon used to administer ether, and
later halothane. Effective and safe use of the system
required thoughtful attention and a strong understanding of
the math and science behind the machine.

47. WORKING PRINCIPLE OF
COPPER KETTLE

48. The Heidbrink Company introduced the
Kinet-O-Meter machine in the mid-1930s. It
was influential enough to attract the
attention of competitors. Before the end of
that decade, the Heidbrink Co. had been
acquired by its rival, The Ohio Chemical
and Manufacturing Company. For three
decades, Ohio kept the well-respected
Heidbrink name and continued to make the
Kinet-O-Meter, in many configurations and
with numerous modifications. Even after
Ohio was in its turn acquired by other
companies, this widely-used machine
continued to be known as "the Heidbrink".
Shown here is the Model 4000, also called
the “Compact” Model, introduced around
1963
KINET-O-METER -1963

49. Ohio No8 vaporiser
OHIO ANAESTHESIA MACHINE
MID 1960s

50. Boyles apparatus -1970
CO2 flow meter
Trilene and Ether bottles

51. BOYLES APPARATUS -1975
 Halothane vaporiser
 Metal soda lime canister
 Cyclopropane flow meter
 Attached B.P apparatus

52.  ETHER AND TRILENE BOTTLES
 PLUNGER
 ‘ U’ TUBE
 COPPER TUBE IN ETHER
 CHROME PLATED TUBE IN TRILENE
 TRILENE LOCK
BOYLE’S BOTTLES -1980

53. CYLINDERS -1846 -60

54. This cylinder would have been used for the
anaesthetic gas ethyl chloride. It is made of
brass and was made in Paris, France. The
cooling effect of the volatile liquid was used
to produce local anaesthesia. The contents of
the cylinder would be sprayed on the site
that needing anaesthetising and the area
would be cooled by the evaporation of the
liquid.

55. The manufacturer of the N2O once held in
this gas cylinder (or tank), the S.S. White
Dental Manufacturing Company of
Philadelphia, was the dominant supplier of
dental and medical supplies throughout the
19th century.

56. Pin Index Safety System was introduced in
1952

57. Dr. Jay A. Heidbrink may have first
described this valve in a patent that he filed
in 1929 for a ventilator. ‘Heidbrink Valve’
has become a common name for valves of
similar design that can be found on many
manufacturers’ anesthesia machines.

58. WORKIKING PRINCIPLE OF HEIDBRINK VALVE

59. HEIDBRINK OXYGEN
FLOW METER -1912

60. LUCY BALDWIN
ANALGESIA APPARATUS
-1955 -65 (BOC)

61. Rowbotham’s vaporiser
Goldman vaporiser

62. Variable bypass, incomplete vapourisation,
flow-over without wicks, low resistance in-
circuit, non-agent-specific (but intended for
Halothane), no temperature compensation,
no interlocks. Glass bowl originally an
automotive fuel filter chamber.
Economical if taken from place to place
(unused agent can be put back in the bottle,
no wicks. Used in-circuit. Output decreased
due to cooling after induction. Patient
hyperventilation if light caused increased
output.
Mk1 in 1959 with easily bumped 3 position
levers, Mk2 in 1962 changed lever to click.
GOLDMAN VAPORISER

63. OXFORD MINIATURE
VAPORIZER-1960
Variable bypass, flow-over with metal mesh
wicks, low resistance, multiple agents, not
temperature compensated, light weight.
Chamber only contains 50ml of agent.
Cooling limits maximum output to 2-4%
with halothane.

64. CYPRANE FLUTEC MARK II
VAPORIZER

65. WORKING PRINCIPLE OF FLUTEC MkII

66. FLUTEC Mk III

67. SIEMENS SERVO VAPORIZER - 1980

68. Evolution of vaporizers
Continue….

69. MAQUET I-FLOW-2010
 Where is the flow meter..?

73. WHO IS HE?
tail piece….!

74. What is this?

75. dr.r.selvakumar
professor of anaesthesiology
k.a.p.viswanatham govt medical college
trichy