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April 10, 1948


JAMA. 1948;136(15):984-985. doi:10.1001/jama.1948.72890320006007

The respirator1 in widest use consists of a box in which one places the patient in order to subject his body to alternating positive and negative (or zero and negative) pressures. These changes in pressure cause air to pass in and out of the lungs, as the respiratory system of the patient is in communication with the air outside the box. The patient's head protrudes from the end of the respirator, while a foam rubber diaphragm, placed around his neck, provides an air-tight seal. This arrangement permits full use of the respiratory capacity, i. e., expansion of the chest and descent of the diaphragm.

A need for the use of the respirator and a contraindication to the use of the rubber diaphragm about the neck were recently demonstrated in a patient treated in the neurosurgical department of the Cleveland Clinic.

REPORT OF CASE  A young woman of 24 had quadriplegia,