Exceedingly Rare First Model, The 1862 Model, of Tobold's Laryngoscope. Sold!
Patents, click on any image to see larger image!
The exceedingly rare medical instrument offered here is an early device for indirect laryngoscopy used to examine the larynx (voice box). The Tobold laryngoscope, also referred to as "Tobold Lamp" in the literature, was invented in 1862 by the German physician Dr. Adelbert von Tobold. Tobold described and pictured his laryngoscope or lamp in his seminal book, LEHRBUCH DER LARYNGOSKOPIE UND DES LOCAL-THERAPEUTISCHEN VERFAHRENS BEI KEHLKOPFKRANKHEITEN, BERLIN, 1863, [1], (textbook of Laryngoscopy.)
Dr. Adelbert von Tobold (1827-1907) was a prominent specialist in laryngeal diseases at the University of Berlin and an early pioneer in the field of laryngology. Tobold has been described as, "the first physician to directly visualize the larynx."
After the 1862 model of his laryngoscope which he introduced in his book [1] and pictured on page 6 and 19, he introduced a second laryngoscope, a smaller model in 1869; the instrument offered here is the first model introduced in 1862, the very model pictured on page 6 and 19 in his book [1].
The laryngoscope consists of a lacquered brass tube containing an optical condenser utilizing three lenses to focus the light (lenses are shown in picture 6), and an articulated arm holding the mirror.
The second model was a smaller simplified instrument and only used two lenses. To see the second model of the Tobold laryngoscope, click here!
A second model laryngoscope with a tag attached listed H. Windler, Berlin, as the manufacturer. That laryngoscope sold on eBay on January 27, 2016. It is very likely that Windler also manufactured the first model as Windler was founded in 1851.
The student lamp with Argand burner Tobold's laryngoscope is attached to, was imported or manufactured by German immigrant Charles Frederick Albrecht Hinrichs, New York. (More on the Argand burner under the heading "History" below).
The student lamp is based on Carl A. Kleeman's patent issued on March 10th, 1863, with the number 37,867. The lamp has a little brass plaque applied below the burner with the patent date and the Inventor's name, see pictures 6 and 13.
The device's articulated arm has three sections which attach to the main shaft or column of the student lamp on one end, and at its far end, the arm is holding the mirror which reflects the bundled light from the laryngoscope into the mouth of the patient.
The articulated arm allows the physician to position the focused light vertically and horizontally for an optimal view of the patient's larynx.
Interestingly the woodcut print showing the use of the laryngoscope in Tobold's book [1] on page 19, Fig.IV, shows a much longer arm than his laryngoscope actually has. If the arm would be that long, the student lamp with attached laryngoscope and mirror would tip over!
The early Kleemann lamp with the applied plaque with the patent date of 1863 is rare and difficult to find. This early lamp has a heavier weighted base than the later model with the 1873 patent. There are other differences; the finial below the burner housing is smaller and different than the finial of the Kleemann lamps usually found, see picture 13. If you compare this finial with the drawing shown above in the patent papers to the Kleemann patent, you can see that it has the exact same shape. To see an image of a lamp with the patent date December 30, 1873 in comparison, click here!
The larynx was viewed indirectly with a small hand-held mirror at he end of a curved handle (not shown in any of the pictures). To view the larynx in the small mirror, the physician would look through the small hole in the center of the reflector or mirror at the end of the articulated arm as shown in the picture below on the left. This reflector or mirror with the small hole is reflecting the focused light into the mouth of the patient.
The hand-held mirror is missing, there is a space in the fitted domed case to place a long thin object and a clip to fasten it, see picture 7.
Tobold's contributions extended beyond the laryngoscope itself; he also developed one of the first simulators, using a plaster-of-Paris model of the voice box attached to a skull, for students to practice the different procedures with his laryngoscope. He also designed a specialized steel and glass syringe used to spray anesthetics or medications directly into the larynx. This tool remained a standard medical instrument into the early 20th century.
Tobold's 1862 laryncoscopes were sold in the US by, G. Tiemann & Co., Manufacturers of Surgical Instruments, 67 Chatham St, N.Y., USA, see picture 9, which shows the label attached to the inside of the domed lid of the case for the laryngoscope.
An indication that the second model, the model of 1869, was also made by the same manufacturer can also be drawn by comparing the cases of the two models. On May 12, 2002, one of only three known Tobold laryngoscopes of the second model was sold at auction at Flint's Auctions Ltd., in England. One of the pictures shows the domed case of that second model sold at that auction. The black canvas covering the case shows stylised pattern of metal bands nailed to a wooden case,
click here to see the image. Please compare the case with its stylized metal bands shown in that picture with the stylized metal band of the domed lid shown in picture 10 of the case with the instrument offered here in comparison.
Condition:
This exceedingly rare first model of Tobold"s" laryngoscope is in exceptional condition and probably the only extant example of Tobold's first model of 1862. The condition is exceptional due to the fact that the instrument was protected by its domed wooden case.
The domed case originally contained the laryngoscope, the articulated arm, the rod holding the mirror, the mirror, and the little hand held mirror. This is just the writer's guess as the mirror and the rod holding the mirror and the little hand held mirror are missing. At the right side of the case seems to be a space to slide in a mirror with 3 inch diameter. The space is very narrow and it is possible that the mirror or reflector with the hole in the center was not a concave mirror but instead just a flat mirror (?) to fit there. The replacement mirror offered her is an age appropriate concave mirror. The rod to attach it to the articulated arm is machined to a perfect match, even the ornamental ball at the lower end was machined to match the ornaments of the articulated arm.
As far as the little hand held mirror is concerned, the length of the handle of the mirror could not be very long as the case would restrict its length to about 7.5 inches.
The Hinrich's student lamp with Argand burner has a few small dents at its base but is all original. There is even a tubular wick in the burner. The lamp has the patent date of March 10, 1863. The burner of the original 1863 lamp is different from the Hinrich's lamps usually found on eBay and other online market places. These early Argand burners do not have a patent date stamped into the outside as later burners do. The glass chimney has ground ends and is original to the lamp.
All in all, this Tobold laryngoscope, the first model, is a beautiful, and maybe, a one of a kind instrument.
As far as the writer can see, there is nothing missing and no repairs have been made to this exceedingly rare medical instrument. As mentioned before, the tubular wick which is impossible to find, is still in the lamp.
There is no reason why this lamp could not be filled with kerosene oil and lit up and used... The overall height is 19¾ inches.
History:
While dentists have relative easy access to the teeth they treat, Otolaryngologist's work presents obstacles as the nasopharynx, ora-pharynx, hypo-pharynx and especially the larynx are increasingly difficult to access as they are increasingly deeper down the human throat.
Especially laryngologists and otolaryngologists struggled in the early days to see anything while trying to do their examinations and treatments. There were simply no strong enough artificial light sources available, just the sun-light.
The history of indirect laryngology is complex; the vocal pedagogist Manuel Garcia (1805-1906) is credited with having done it first. In 1854, he became the first man to view the functioning glottis and larynx in a living human, or at least, he was the first to document it. Garcia developed a tool that used two mirrors for which the sun served as an external light source. Using this device, he was able to observe the function of his own glottic apparatus and the uppermost portion of his trachea. He presented his findings at the Royal Society of London in 1855.
Anecdotal evidence provides that Ludwig Türck, professor of laryngology in Vienna, decided to try Garcia's mirror in examining patients in the wards of the Allgmeine Krankenhaus in 1857. He was unsuccessful, and by the fall of that year he abandoned his efforts. Johann Czermak, professor of physiology at the University of Pest, Hungary, borrowed Türck's mirrors and continued experimentation over the winter of 1857-1858 with artificial light. He was able to accomplish what Türck couldn't, and by the early spring of 1858 he presented his findings to the Viennese medical community, claiming to be the first physician to visualize the living larynx. It is believed that Türck failed because the summer and early fall of 1857 was marked by inclement weather, hence, there was not enough natural light.
Only four years later, Tobold devised his Laryngoscope, described and pictured it in his seminal book [1], and marketed his idea.
Before Edison's invention of the incandescent light bulb in 1879, the predominant problem was clearly the lack of light.
The Argand burner:
The Argand lamp or burner is a revolutionary kerosene oil lamp invented in 1780 by Swiss chemist François-Pierre-Aimé Argand.
It represented the first significant improvement in lighting technology in thousands of years, producing a flame up to 10 times brighter than contemporary candles or standard kerosene oil lamps, while emitting much less smoke and being much more efficient.
The lamp's superior performance was due to its scientifically constructed burner, which optimized airflow for more complete combustion. Unlike traditional flat wicks, the Argand lamp or burner used a cylindrical, or tubular hollow wick held between two concentric metal tubes, see picture 14.
This design allowed air to flow both around the outside of the flame and through the center of the wick, providing a "double air supply" that fed more oxygen to the flame. A tall, narrow glass chimney was placed over the burner to increase the upward draft and steady the flame, resulting in a cleaner, smokeless light.
Because of its complexity and the high cost of manufacturing, the lamp with Argand burner was initially a luxury item for the wealthy. Famous Adopters were Thomas Jefferson who described the light as equal to "six or eight candles" and ordering several for Monticello.
Tobold's laryngoscope, for good reasons, used a student lamp with an Argand burner.
Tobold failed to patent his laryngoscope in the United States and Boekel took advantage of this fact.
Julius Boekel of Philadelphia, Pennsylvania, was granted a patent for a Laryngoscope on June 15, 1886. The patent is published above for the reader's convenience.
Boekel's laryngoscope had additional features to Tobold's invention. Boekel's optical condenser only used a single lens to focus the light. Additionally, he equipped his laryngoscope with a reflector to reflect the light emitted backwards to the front where it was needed. An additional improvement was the suspension of the mirror with the small hole at the end of the arm by a ball clamped between two plates. This allowed the mirror with the small hole to be adjusted in any direction; Tobold's mirror with the small hole could only be adjusted horizontally and vertically by adjusting the height of the rod holding the mirror.
Tobold's optical three lens condenser was overkill. While simple condensers may use only one or two lenses, a three-lens configuration typically provides a higher numerical aperture (NA) and better control over optical aberrations, features needed in cameras and other critical applications but not needed for simply gathering and focusing diverging light from a source into a parallel or converging beam in a laryngoscope. Boekel realized this fact and used only one lens, hence using a condenser with less loss of light.
Boekel's laryngoscope was clearly superior but was too late to be a success. In 1879, seven years before Boekel received his patent, Edison invented the incandescent light bulb, and by 1882 Edison opened his first power plant in New York City, the Pearl Station power plant, which was a DC (Direct Current) power plant. Outside major cities electric power was only available by running an Edison DC power generator which was expensive.
These Edison generators which were available in 10 sizes, were powered by gasoline engines or water wheels. The smallest generator could power 25 light bulbs, the largest generator 500 light bulbs. It was Tesla and the Westinghouse Electric Co., which eventually brought power to American homes with Tesla's AC (Alternating Current) system.
In 1886, the year Boekel was issued his patent for his laryngoscope, Westinghouse's Niagara Power Plant, the first commercial AC power plant in the US went online providing power to thousands of residences.
Literature:
(Click on any title to see the online version of the book or publication if there is one.)
[1]
LEHRBUCH DER LARYNGOSKOPIE UND DES LOCAL-THERAPEUTISCHEN VERFAHRENS BEI KEHLKOPFKRANKHEITEN, Dr. Adolph Tobold, BERLIN (1863), VERLAG VON AUGUST HIRSCHWALD.
[2]
Die chronischen KEHLKOPFS-KRANKHEITEN mit specieller Rücksicht auf laryngoskopische Diagnostik und locale Therapie. Von Dr. ALBRECHT TOBOLD, Sanitätsrath und Docent an der Berliner Universität.
[3]
CHRONIC DISEASES OF THE LARYNX, WITH SPECIAL REFERENCE TO LARYNGOSCOPIC DIAGNOSIS AND LOCAL THERAPEUTICS, BY ADELBERT TOBOLD,LECTURER IN THE UNIVERSITY OF BERLIN, TRANSLATED FROM THE GERMAN AND EDITED BY GEORGE M. BEARD, A. M., M.D., LECTURER ON NERVOUS DISEASES IN THE UNIVERSITY OF NEW YORK (1868), W. M. Wood & Co., 61 Walker Street, New York, Robert Hardwicke, London.
Inventory Number 02677;
Sold!
Prices realized in the past:
- On May 12th, 2002, one of the 1869 models, the second model, sold at Flints auctions Ltd., Thatcham, RG19 4EP, United Kingdom, lot 53, for £1,000.00. click here to read about it!