To commemorate the Centennial Year of the American Association for Thoracic Surgery,
and the 55th International Conference of the American Society of Extracorporeal Technology,
CardioQuip is pleased to present this historical artifact.

Booth 917
Boston Hynes Convention Center and Sheraton Hotel
April 29 – May 2, 2017
Boston, MA, USA

Robinson Pneumothorax Apparatus

Made circa 1920 by The George P. Pilling and Son Company, Philadelphia, Pennsylvania
On loan from the Coryell Museum & Historical Center, Gatesville, Texas

Even before Dr. Robert Koch's discovery of the tubercle bacillus Mycobacterium Tuberculosis in 1882, the disease commonly known as "consumption" had been studied since at least the 11th century. Prior to the development of streptomycin in 1946, though, treatments for tuberculosis ranged from crude to gruesome — and all were largely ineffective.

This portable device, designed by Dr. Samuel Robinson (who later served as the 4th president of the AATS), was used to induce pneumothorax in a tuberculosis patient. After a thoracotomy incision, a trocar needle was passed into the intrapleural space, and gas — typically nitrogen or air — was pumped into the cavity, forcing the lung to collapse. The idea was to close the pockets of infection and force the lung to rest, giving the lung a better opportunity to heal. The concept was suggested by Dr. James Carson in 1833, and implemented in the 1880s by Dr. Carlo Forlanini in Italy, and Dr. John Murphy in the U.S., who used the newly-invented fluoroscope to improve the procedure. Artificial pneumothorax devices were built and improved by Brauer, Robinson, Cutler, Bethune, Davidson, and many others. Pneumothorax treatment was used extensively between 1900-1950, and was at least moderately successful in about 50% of cases.

Robinson's device was manufactured in the early 1900s by Codman & Shurtleff (now part of Johnson & Johnson), and by Pilling (now part of Teleflex). The device on display was used by doctors in Gatesville, Texas circa 1920-1950, and was restored to working condition earlier this month by CardioQuip's lead design engineer. In fact, two of the Gatesville doctors who once used the device were his great-grandfather, Dr. M. W. Lowrey (1875-1946), and his grandfather, Dr. E. E. Lowrey (1913-1999), who also developed and manufactured the first anatomically correct plastic human skeleton in the 1950s. The red residue in the manometer is from the dyed alcohol that was used as a level indicator. The trocar needle on display was made for the British military circa WWII by John Weiss & Son.

Although tuberculosis has been largely eradicated in the West, it remains the number one cause of death by infectious disease in the world, predominately in Africa and Asia. Worldwide, an estimated one in three people are infected with Mycobacterium Tuberculosis, though only a small percentage develop symptoms.

Published April 2017

Additional Resources

Listing of the Robinson Apparatus in the 1913 ASTA Journal:

Listing of the Robinson Apparatus in the 1932 Pilling catalog:

Pneumothorax needles in the 1932 Pilling catalog:

Earlier (circa 1910) and later (circa 1930) models of the Robinson Apparatus:

Tubing connection schematic:

Glassmaker's mark (Whitall Tatum & Co.) on the underside of the bottles:

Bibliography

Robinson, Samuel, and Floyd, Cleaveland. Artificial Pneumothorax as a Treatment of Pulmonary Tuberculosis. The Archives of Internal Medicine, Vol IX, 1912. 

The George P. Pilling & Son Co. Pilling Instruments and Equipment for Surgeons and Hospitals. 1932 ed. p.250

Post, John F. Coryell Memorial Healthcare System Extended History, 1936-2002. Accessed 4/8/17. 

Barr, Michael. The Wizards of OS: The Story of Medical Plastics Laboratory. Waco, TX: Davis Brothers Publishing Co., 2013. 

Felton, Chuck. Cresson TB Sanatorium Remembered: Personal Stories. Accessed 4/8/17.

Murphy, J. B. Surgery of The Lung. The Journal of the American Medical Association, Vol. 31 No. 4, 1898. 

Truax, Charles. The Mechanics of Surgery. Chicago, IL: C. Truax & Co., 1899. p.211

Artificial Pneumothorax in Treatment of Tuberculous Pulmonary Processes. The Journal of the American Medical Association, Vol. 47 No. 15, 1906. 

Balboni, Gerardo M. The Treatment of Pulmonary Tuberculosis by Artificial Pneumothorax, According to the Method of Forlanini: With a Report of Twenty-One Cases. The New England Journal of Medicine, Vol. 167 No. 22, 1912.

Vrooman, C. H., and Wittich, F. W. Apparatus for Producing Artificial Pneumothorax. The Journal of the American Medical Association, Vol. 62 No. 12, 1914. 

McGoldrick, Thomas A. Artificial Pneumothorax in The Treatment of Pulmonary Tuberculosis. The Long Island Medical Journal, Vol. 9, 1915. 

V. Mueller & Co. Surgeons' Instruments, Office and Hospital Equipment. 1916 ed. p.238

Lilienthal, Howard, and Gerster, John C. A. A Treatise on Regional Surgery, Volume 3, Section XVII: Thoracic Surgery. Binnie, John F., editor. Philadelphia, PA: P. Blakiston's Son & Co., 1917. 

Otis, Edward O. Pulmonary Tuberculosis: A Handbook for Students. Boston, MA: W. M. Leonard, 1917. 

Gamble, Shelby G. Collapse therapy in the treatment of pulmonary tuberculosis with special reference of artificial pneumothorax.University of Nebraska Medical Center, 1937

Lockhart, Bill; Serr, Carol; et al. The Dating Game: Whitall Tatum & Co. Summer 2006. Accessed 4/22/17.

Ott, Katherine. Fevered Lives: Tuberculosis in American Culture since 1870. Cambridge, MA: Harvard University Press, 1996. 

Texas Medical Center Library, Pneumothorax apparatus. 

Virginia Commonwealth University Library, Robinson Pneumothorax Apparatus. 

Oregon Health & Science University Library, Cutler-Robinson Pneumothorax Apparatus. 

Medical College of Wisconsin, Dr. Samuel Robinson's Apparatus for Artificial Pneumothorax. 

Tom Kirsch, Consumption. 

Dorothy Sharrar, Object Acquisition # 77-363.1 Pneumothorax Apparatus.