WO1986001728A2

WO1986001728A2 - Injection device with sensor

Info

Publication number: WO1986001728A2
Application number: PCT/DE1985/000313
Authority: WO
Inventors: Wolfgang Wagner
Original assignee: Wolfgang Wagner
Priority date: 1984-09-07
Filing date: 1985-09-07
Publication date: 1986-03-27
Also published as: JPS62500429A; WO1986001728A3; IN165367B; EP0213139A1

Abstract

A cannula which, by the special features of its design, and when used in conjunction with a measurement arrangement, makes it possible, before or during suction-type injection of liquids into the body of a patient to assess and record the state of exchange of materials primarily for kidney sufferers and especially diabetics. Essentially, however, the idea of the invention concerns an injector which, after or during the determination of tissue sugar, relates the measurement values to a pre-set dosage and dose correction, and if necessary - in the case of frequently-required corrections - automatically adjusts the programming of the dosage. This is done chiefly in a suction-type injector which draws the skin into the cannula by means of the underpressure and thus, by controlling the return of the air to the suction vessel, accurately assesses the duration of the measurement and injection. In addition to the arrangement of the sensor cannula as regards its shape, location and type of sensor coatings, electrical or optical measurement probes, the special feature of the improvement in the suction-type injector concerns its handling qualities, simple operation and ability to meet compliance requirements. The type of underpressure production, dosage and special characteristics of the operating controls are directed to this end.

Description

Injection device with sensor

A s p a n t e l l u n g:

The invention also relates to the field of medical technology, more particularly to injection technology. In particular, it has the task of improving the treatment of diabetics who require insulin. The metabolism of the patient should be made known to him frequently and as regularly as possible, in order to make it easier for him to maintain his diet and to compensate for changes in lifestyle from a rigid norm by adapting insulin treatment. The treating physician should be able to gain insight into the patient's diet and to adapt his dosage suggestions for insulin. From this resolution, there is the task of creating an injector that can be used by people with disabilities by automating its functions, and which favors more frequent daily applications. For this purpose, the injector should be as small and handy as possible, safe in its functions, without health hazards and, if possible, in its use associated with little annoyance. The handling - also with regard to the refilling of insulin or cannulas should be as simple as possible, the costs should be as low as possible. The use of suction injection, in which the skin is lifted into the cannula by means of negative pressure and a firm connection between the injector and the skin is ensured until the suction cup is re-ventilated, is particularly favorable for solving the task of combining the sugar measurement with the injection. But especially with regard to the suction injection technology, adjustments to the measuring technology and further improvements with regard to storage, mixing and metering of the insulin, but also the generation and use of the negative pressure are required. The more than fifty years of attempts to use suction injection in noteworthy situations show that only a complex treatment, in which all functional parts and the human (especially psychological) constitution are coordinated, lead to an advantageous and commercially usable solution. Compared to the now easier-to-use (but expensive) long-stroke disposable syringe with built-in cannula, a fully automatic injector has to be pocket-sized, easy to use, reliable, easy to use and inexpensive. With regard to the cannula diameter, the minimum must be kept in order to avoid additional injury and nuisance. Compared to the conventional syringe, additional essential advantages must be offered, such as those in dose adjustment under sugar measurement and including the control, exercise and upbringing options are suitable for increasing compliance. Metabolism examinations directly at the bedside via automated sampling have long been known, and measurement data are also stored (for example Hudspeth, CL, Richardson, Ph. Cl., Inter alia in DE 24 37 467). For example, the insulin infusion device Biostator from Miles has made it possible to continuously supply insulin while monitoring the blood glucose concentration in recent years. The relatively extensive equipment can only be used at the bedside. The "implantable electrochemical sensor", as stated by Leblanc jun., Among others (DE 26 45 048), is inserted into a vessel within a casing and serves to monitor the ion activity. It shows hydration by drip infusion. It is also proposed to take blood samples for analysis via a lying probe (Clemens, Anton Hubert, E. Myers, R. Weston, DE 27 20 482) and to control the separate supply of glucose and insulin. The closest to the invention presented here, Ash St. R., La Fayette, Loeb MP, with its "arrangement for the administration of insulin as required" (D 30 50 155). A coated sensor is attached directly to an insulin-supplying cannula for joint insertion under the skin. Instead of a specific ferment reaction with glucose, which is more susceptible to faults, the osmolarity of the blood is measured and deducted from any water withdrawal from the body with simultaneous salt determination. The measurement results are arithmetically coordinated with a dosing program. The insulin pumps, which are particularly useful for adolescents and metabolically unstable, and which are worn on the body with the so-called permanent cannula, serve to supply a controllable minimum amount of insulin with the possibility of arbitrarily changing additional doses before meals by the patient himself (e.g. Hearten, R. and Cress H, DE 25 13 467). A Blood glucose meter is not available here. Loeb MP and Olson AM (DE 32 41 313) specify a curved syringe to be carried on the body with catheter application. For implantation in the body, several pumps are also described with tanks, for example Cummins RD and Park 0, DE 33 43 708). One is concerned with the wireless transmission of dosing instructions to such a device (Prestek K. and Franzeski M. DE 30 35 670) as well as with the function control via measurement data from the inside of the body, whereby a blocking device is also provided if an insulin infusion limit value is exceeded (Fischell R and Ellentuch, DE 32 47 232). The title The Development Of A Needle-Type Glucose Sensor For Wearable Artificial Endocrine Pancreas "(Yamasaki. Y. Journal of Osaka Univ., Voll-2, Sept. 1984) should not hide the fact that these are dogs in Anesthetic implanted button probe with a complicated layer structure and the inventive idea of the cannula coating is not mentioned.

The wire-coated sensors from Wilkens E. and H.G., Daniel R.u.a. and Gough A. u. a., which are cited in more detail in the description of the sensor cannulas. Overall, however, such "catalytic sensors" pose considerable problems in the sense of electricity-generating cells, precisely because their permanent use in humans is sought. Optical systems are also not without problems with regard to the competition between substances (e.g. the polarization level of rotating amino acids), but only practical in the miniaturized form of body access through the cannula. Müller A. dealt with in-vivo measurements (DE 2944113) through the auricle. Permanent measurement values obtained in this way could certainly be used to improve the dose correction in suction injection.

The measurement over the Cannula. Sepharose-Concanavalin A has been used for some time to bind cardiac glycosides and other sugar derivatives. On the other hand, it is known that sugars are non-conductors and, in higher concentrations, increase the electrical resistance of an electrolytic solution; why in sugar chemistry resistance measurements are used to track down sugar (a fact that I owe to the personal communication from Prof. Dr. Mauch Berlin). The plaster-adhesive skin fixation during the injection also has precursors, but still without skin lifting.

The suction injection - that is, the injection under a skin pulled up under the influence of suction within a suction bell - which was already on November 7, 1933 by M. Demarchi (U.S. Pat. 1, 934, 046) and described by G. N. Hein (U.S. Pat. 2, 743, 723 dated May 1, 1956) and by W.R. C.Geary (US Pat. 3, 122, 138 on February 25, 1964) and in several own applications since 1974 (GB 1494325, 1494646, 1513463, 1517289, DE 25 51 991.25 51 992,

25 51 993.30 19 589, Australia 510, 272, US. 4.139, 008, 4.169, 474, 4.284, 077, 4.393, 870, Can.1189412 and many others) was not used due to technical imperfections in humans , although human skin is well suited for suction injection because of its special elasticity and finer hair. GHHein already specifies a device that safely prevents premature penetration of the skin before the injection, but the more important removal of the skin and cannula after the injection has been neglected. The methods of generating negative pressure are also still unsatisfactory, although one-hand operation is of course a prerequisite for the self-treatment of diabetics. The dosing systems are also still unsatisfactory; one of stone (DE 14 91 840) specified injection device uses the principle of a drug supply through the metering syringe plunger through a valve in the same from a storage bottle, but the need for separation between the outside air and the storage bottle content is not taken into account. Needle-free injection by means of overpressure is prohibited for long-term use due to the considerable tissue damage. In general, too little attention has been paid to the need to prevent patients from cleaning device components.

Advantages of the invention:

It is advantageous for the insulin-injecting diabetic as well as for the insulin pump wearer if he or she does not suffer additional self-damage by scratching the skin of the fingertip, which is particularly rich in pain points, and without the cumbersome procedure of layering a drop of blood on a test strip and colorimetrically reading the same, during insulin injection or can choose to experience its metabolic state before actuating the syringe plunger. Even a subsequent reflex photometry in the cannula tip or a color indicator strip removed from the cannula lumen can be used due to the patient's dietary behavior. By recording the measurement results and the insulin doses administered, the patient and doctor can give an account of the therapy situation and communicate more easily. For the individual measurements - be it via the sensor covering of the cannula. as a power source or by measuring conductivity changes under the influence of glucose - by means of the constantly renewed cannulas there are no sources of interference, such as protein or electrolyte accumulation on the measuring probe, as they complicate continuous use. Suction injection offers the special part in connection with the metabolically controlling sensor cannula that the duration of skin contact is automatically increased; In addition, it is advantageous for the measuring arrangement to have a comparative electrode of secure adhesion in the edge of the suction cup near the cannula / which does not have to be attached separately. The milling of the cannula shaft into a kind of skeletal cannula, which receives the drug delivery channel and the sensor, saves the cannula from thickening due to the sensor coating, which would negate an essential advantage due to the painfulness of the puncture. which the modern fine triangular loop cannulas and suction injection bring with them. By dividing the cannula shaft into the metal skeleton part and an attached sensor part - which can also be applied to hoses inserted into the channel-shaped cannula shaft - it is possible to separate between two electrically divided parts with their own lead paths and thereby gain a further reference electrode. A tube inserted into such a half-open cannula can have a small amount of clearing when the skin is pierced, in order to be expanded thanks to its elasticity under the pressure of the injection liquid. In this way, a faster injection can be made possible (or such a solution of more liquid solutions or of suspensions as depotinsulins often represent). A further advantage can result from the fact that foreign substances stored on the tube surface come into contact with tissue fluid or blood through capillary suction, but the introduction of such foreign substances into the body can be avoided. The automatic dosage adjustment to the metabolic situation determined in each case precludes incorrect calculations and estimates as well as incorrect operation by the patient and allows different ones to be taken into account

Insulin sensitivity. In addition, an automatic program allows the doctor to correct a gross incorrect dosage or to adapt it to new living and nutritional conditions without medical assistance. The use of immediate-acting old insulin and depot insulin next to each other enables a short-term metabolic correction in addition to long-term care of the body, similar to insulin pumps. However, the nuisance caused by a device worn on the body and especially by the cannula inserted into the abdominal cavity or in the subcutaneous tissue and fixed there with that in diabetic patients is eliminated increased risk of wound infection. Programming by means of switching rings that are rotatably arranged in blocks on the housing simplifies the overview. The selection of profile numbers allows the entire program line to be printed in the patient file without complicated technical aids. Lockability of the programming and the possibility of restricting compensation options and program changes by the patient are indispensable prerequisites for avoiding serious incidents due to misconceptions, idiosyncraticness and unintentionality of the patient or willful interventions by third parties. In the field of vacuum generation, advancing it to the phase of industrial packaging of the cannula appears advantageous, particularly when the higher expenditure of the triggering device for a storage container which maintains the negative pressure and is surrounding the cannula is relocated to the injector which is used again and again. Surface changes in the storage potty during skin suction can be

Convert touch elements of the injector into control impulses, so that the direct skin contact of a push button for switching purposes can be omitted. The solution of vacuum generation via air dilution within a heated chamber is particularly suitable for electrically operated dose delivery. The use of several chambers increases the independence from the power grid and thus the freedom of design in the daily routine. The advantages of a demand-controlled permanent vacuum can be used within a handy device by a gas jet pump in connection with a household carbon dioxide cartridge, after problems due to the high gas outlet pressure and the valve icing during gas release have been eliminated by a special lock valve. Finally, considering the low vacuum requirement, the vacuum generation in a spring-operated be considered cylinder-piston pump, if the feeding of the air from the suction bell prevents the piston and cylinder from the finest quartz grains from the skin pores from being affected in their surface quality. The vacuum preparation is expediently bound to the movement of a closure cover for the suction bell, the mechanism for changing the cannula also being actuated. Bowden cables allow space-saving power transmission. The one-sidedness of the detection of a suction piston by means of a lateral raster device with the risk of the piston tilting is counteracted in that the suction piston is already held approximately in the raster position by magnets and spring lock. The effort required to trigger the suction cup is reduced considerably. A delay in the pumping movement also occurs, which can be used to close a pressure relief valve. The latter is used to derive the. air compressed due to the skin approaching the cannula in the suction cup to save suction. If the thinning of the upper skin layers by shortening the skin allows the cannula shaft to be shortened, stacking the cannula in a tube or tube contributes to further space savings. The height of the stacking cannula can be further reduced by the fact that, with appropriate securing against rotation in relation to the lateral medication entry points, for example by one-sided flattening of the cannula magazine, which still ensures tight sealing of the lateral cannula opening, the liquid channel, which comes into cover with the medicament outlet opening of the device runs down as a channel in or on the wall of the cannula housing before it enters the cannula shaft. An articulated connection between the stacking cannulas - which can be a thread - permits cannula transport by train, a spring mounted in the magazine or a sealing body in front of a compressed gas line a conveyance by pressure. The side entry of medication via an annular groove of the cannula body facilitates the loading of the cannula shaft with several types of medication, as well as the cannula removal by means of a claw-like lid device. The cannula arrangement in a row also facilitates the removal of the cannula after use, whereby the space of the previously unused cannula can be taken up in a space-saving manner. The displacement of the cannula after the injection before it is removed brings about a valve closure of the medicament flow channel. The distance between the skin and the cannula at the moment the suction cup is re-ventilated by returning a suction cup previously held in place by a grid or by a central pin inside the suction cup prevents dangerous skin cuts if the device is accidentally removed after use tangentially to the skin. Advantageously, the cannula magazine as a whole, for example under suction in the suction bell onto a septum connected to the magazine, can be lowered counter to the injection of the skin and raised again when it is ventilated again.

Progress is also indicated in the field of function control, in particular from running safety between skin suction, drug injection and re-ventilation of the suction cup. A central pin inside the suction cup near the cannula conveys the condition of the skin lift. The three release pins distributed around the edge of the suction cup in other examples have also been improved by a more clever arrangement of the rooms and by the fact that their resilience to the skin is lifted or weakened after it has been raised. The distance between the skin and the cannula after the injection to avoid cuts is ensured by springing back of the suction cup, which is still blocked during the injection. The suction cup is only ventilated again after loading Injection is terminated (in the mechanically controlled examples) if a previously tensioned spring mechanism is only activated after the sliding parts controlling the dosage have hit the dose-limiting obstacle. The spring mechanism is to be equated with a magnetic attraction of the ventilation valve, whereby a fluttering of the valve is prevented by means of a special locking mechanism when a permanent suction is applied. The central pin advantageously occupies a center point of an elliptical suction bell, while the cannula takes the other in order to keep the seals around the central pin and cannula and the suction bell rim at the necessary distance. The use of a swelling pin for lifting a gas capsule into the opening mandrel saves a relatively heavy screw cap and a force-requiring operation. In the area of the medication storage and supply, a uniform medication flow to the metering device is ensured. A refill process to build up a residual supply to a usable dose saves expensive hormone, especially if a lock allows the replacement of the storage container only when the used one is almost completely empty. In the field of dosing, the dosing accuracy is increased towards the cannula by avoiding longer connection hoses with an air boiler function. If the dosing device was installed as a short-stroke piston or cuff in the end of the medication supply hose from the container just in front of the cannula and actuated from outside the hose, then in other solutions, the task can be performed in an electromagnetic manner by applying pressure periodically from outside the hose so that moving parts in the hose are eliminated. Only a pin bearing a ring bar inside the hose as a counter-pressure bearing is useful. Short shaking movements to fill up The addition of Zirlkchlorid as an additive to depot insulin is required to obtain an injectable suspension. The control of a discharge valve in connection with a flow measurement is considered from the point of view of saving space. Piezzoelectric or switch mediated differences in the lifting speed or a motor return, which is used to drive a manual transmission, save considerable weight for further power drives for several metering devices. The use of auxiliary liquid instead of the medication for dosing (using the displacement effect) saves or facilitates the cleaning of the dosing device. If the auxiliary liquid is placed behind the piston of a stage syringe, the higher viscosity of the auxiliary liquid prevents it from being added to the medication. Considerable space for the auxiliary liquid can be saved if a locking piston pushing up the separating piston is used, so that the same limited amount of auxiliary liquid always oscillates between the metering device and the step syringe.

The invention also includes a number in the illustrated or in a new combination. Essential advantages for solving the task, which are apparent from the following text in conjunction with the drawings.

Solution of the task:

The object is achieved in that a cannula serving the input of liquids is at the same time designed as a sensor which, after the cannula has been introduced into the body of a mammal, changes in physical and chemical states in the body of the latter

Changes mammals in measurement signal changes, which are fed to a measuring instrument for evaluation in order to make the physico-chemical changes in state immediately or later recognizable. For this purpose, the sensor itself can serve as an electrical voltage source Je (for example in the case of the so-called catalytic sensor), the voltage changes or current output of which are used for processing the measurement signals; However, the sensor can also change its conductivity for externally supplied electrical currents under the physical-chemical influence of the state of the body and thereby supply measurement data to the measuring instrument. For this purpose, at least one layer is usually applied to at least parts of the cannula shaft, which produces the sensor property. According to the main application of the invention, it reacts to the body mainly with the glucose of the body in order to react with it as a kind of electrical cell or through the addition of glucose or its reaction - or synthetic products (such as glycogen, starch or lower carbohydrate chains) the electrical conductivity via the cannula or past the cannula depending on the glucose concentration of blood or tissue (depending on the position of the cannula within a blood vessel or in the subcutaneous tissue or in the abdominal cavity) to change. By removing a part of the cannula shaft behind the cannula tip while maintaining its end face, the wall of the shaft can be supplemented by plastics, the sensor properties of which are primarily electrical Isolation to the cannula shaft were taught. It is also possible for the liquid to be dispensed via a tube with sensor properties on the surface, the clearing of which is placed in a tight connection to the bore of the syringe attachment or, where such is not available, to the infusion tube in such a channel-shaped hollow cannula shaft without the free end thereof must be emptied via the tip of the cannula itself (this can be useful if the cannula shaft is very short, in order to guarantee the injection of medication under the skin). If such or a similar sensor cannula appears to be usable for the dialysis of patients with impaired kidney function (with quantitative recording of metabolic products retained in the body or of the water and salt balance), the application in connection with insulin pumps also appears with the possibility of recording measured values over a long period of time lying cannulas particularly advantageous. Characteristically, the subdivision of the cannula shaft into at least two compartments that are electrically insulated from one another can be suitable for saving an additional comparative electrode outside the cannula. Power is supplied and discharged via lines which are expediently connected to the measuring device in places within the infusion tube (embedded in and insulated by its wall). When using the sensor cannula for a single injection, there is a new possibility according to the invention that the sensor coating of the cannula is irreversibly changed under the influence of metabolic products, in particular of sugar or more specifically glucose, and the measurement parameters are obtained from the extent of these changes. In particular, glucose can be on the cannulas covering (for example, to plant carbon or fermentative) and by enriching the sugar as an electrical non-conductor, the conductivity of the sensor coating chosen as a good conductor is reduced depending on the sugar supply, taking into account the time function. Another solution is the miniaturization of optical measurements and their relocation in the area of the cannula. For this purpose, light is directed through at least one optical fiber or directly through the cannula shaft against an optical indicator zone, and the light, which is reflected by the change reflected under the influence of metabolic products, is measured and evaluated. Another solution without color indicators uses polarized light, and the property of some metabolites (including glucose) to change the polarization level of such light depending on its concentration. According to the invention, the polarized light is deflected back by a medium of different density, which is preferably introduced in the area within the cannula tip, after contact with the metabolic product and compared with a reference beam or a calibration standard by means of suitable detectors. Adherence to the time required for measurement and injection is best ensured when using suction injection, i.e. when the skin is lifted into a suction cup surrounding the cannula by vacuum and held until the suction cup (automatically controlled) is re-vented . If the suction injection is used, the edge of the suction bell (for example coated with silver chloride-silver or using a contact gel or a double-sided adhesive electrode ring) can be used as a reference electrode. Instead of lifting the skin through suction, this can also be achieved by plastering. The completion of the measurement and the calculation ganges to adjust the dosage to be administered can serve as a trigger signal for the dosing pump. This eliminates the intrinsically advantageous injection initiation by contact pins or by earth leakage of the cannula within the raised skin. (But also the dependence of an "earth fault", as a contact with the body as a transmitter, which is dependent on the proximity of external electrical fields). If the measuring device fails, the injection is triggered according to the invention by means of a power cut through the skin. The compensation of a poor metabolic setting within a medically programmed framework via additional altinsulin doses calculated as cheap or through the calculated favorable deduction of depotinsulin doses belongs to the essential embodiment of the invention. From medical experience in patient management, the task arises of being able to limit the amount of an arbitrary additional dose of old insulin before planned meals. On the other hand, situations arise in which automatic programming is expedient, which allows automatic programming without the involvement of the doctor (insofar as this does not block this possibility in the case of unsuitable patients using the device provided for this) to correct incorrect programming gradually and to program (if necessary without Involvement of a doctor) to adapt to changing nutritional and living conditions. The measured values and the doses administered as well as the type of influence on the set program can be printed out in the device according to an embodiment of the invention. In addition or instead of the printer, an electronic storage device for the measured values (and the doses) can also be provided, which can be viewed externally by the doctor on a screen and converted into clear curves. Even when using a continuous infusion cannula, the poss of a single measurement (to determine the initial metabolic state) may be useful. An inventive step is also the programming by means of rotatable switching rings which are put together into program blocks, since they record the simultaneous overview of the starting point of the programming. A print-type-like majesty of the program symbols and their arrangement in a transverse program line as a whole allows the intended program to be printed in the patient register or otherwise without special technical facilities. The blocking against rotation of the switching disks beyond the set locking step by lateral jamming by means of a screw to be operated by key is facilitated by lateral profile formation on the support rings below the switching rings. There is a spring back play between the carrier ring and the locking ring when contact is made with the control unit, so that setting values which have been changed, for example, by the automatic program, can be made visible on the device display. Prewarning signals that can be influenced by the patient are provided for the impending depletion of medication (or also cannulas) and, under computer control, a replenishment of an almost exhausted medication supply to a final dose, which allows the storage container to be almost completely emptied. A lock (electromagnetic or mechanical) can force the patient to refill, but the patient should be able to shift the time by refilling a larger amount of medication.

For cases in which, for example for conductivity measurements, the possibility of coating only the cannula surface would arise (in order not to have to enlarge the cannula diameter in order to increase the injury), the cannula must penetrate into the

Skin from the side of the dosing pump the delivery of a small NEN drug (for example in the form of a single volume-reduced basic cycle of the metering device) is provided to prevent a capillary suction of blood or tissue fluid and a power line in the bypass over this. (Provided the medicine is practically a non-conductor). When using the finest tubes and capillaries inside the cannula lightening, the injection is expediently started before the measurement is completed in order to keep the time of the injector contact within limits. The injection pressure is limited because of the risk of tissue damage. The computer can initiate a limited immediate correction even after a basic rate has been injected. The device for suction injection itself was further developed according to the invention, not least for its downsizing, which only allows it to add the measuring and control unit for the sensor cannula without losing the necessary handiness. Since the vacuum requirement of the suction bell is relatively low and the human hand is capable of considerable force concentration, a piston-cylinder pump remains an economical method for storing energy in a spring. However, a sand filter between the vacuum pump and suction bell must be switched into the suction channel to prevent the destruction of the piston cylinder surface by the finest quartz grains, as they are torn out of the fine skin pores by the suction. Such a pump is operated in a space-saving manner via Bowden cables. The tensioning process for the spring is expediently connected to the pivoting movement of the cover over the suction bell. The suction piston is locked from the suction bell by weakening the breakaway force of the spring by means of a clamping device or the liability of Permanent magnets. In this way, the risk of canting is mitigated if the suction generation is triggered on one side eccentrically from the suction lock. The delay caused by this Ent relief mechanism favors the conclusion of a spring-loaded over pressure valve, which compensates for the air pressure compression that occurs when the suction cup is placed on the skin and when the suction cup is raised against the cannula. The raising of the suction cup rim against spring pressure and the release of the locking of the return movement of the suction cup during its re-ventilation result in a distance between the cannula and the skin after the injection. The same task can also be solved by a central pin, which is lifted centrally in the suction cup (due to the proximity of the cannula, in the center of an elliptical suction cup), sealed against it during skin suction and pressed against the skin under spring action during the re-ventilation of the suction cup. The spring tension for solehe associated with considerable effort

Auxiliary functions are conveniently effected when a lid flap is closed (with a reminder for the device not being ready for use), so that the pressure on the skin of the central pin which triggers the vacuum pump can be reduced. In general, the possibilities were tested to deflect the pressure of release pins, which initially protrude from the area around the edge of the suction cup, after activation of the vacuum source from the skin. This is done by the action of wedge bevels on a spring-loaded ring, which releases the pin movement upwards with little friction after passing the wedge bevels. A return movement until the spring-loaded ring acts on the wedge bevels takes place via an elastic one

Collar following the suction cup rim. This allows the vent movement while securing the skin end of the suction cup, whereby the suspension the release pins provide the stability for the suction cup rim so that no outside air penetrates under the suction cup rim during suction. In the case of storage pots which maintain the vacuum and in which the required suction is already prepared in industrial production, the release of the same after transfer during storage is transferred to a release mechanism in the device by means of the holding function of a cover shortly before the injection. Since the jamming effect of the skin compared to a valve pin in a tube parallel to the cannula has proven to be unreliable, this mechanism has been improved in that, starting from the valve pin, a resilient bow protrudes from the suction bell towards the skin. The temple ends lie on the edge of the suction curl. When the potty is pressed manually against the skin, the bracket is stretched and then suddenly all of a sudden bent in the opposite direction, the ends being pulled from the edge of the suction cup and lifted into the suction cup. The valve pin pops up and with its tip breaks the membrane over the end of its tube after it has been stretched out a little. The air pressure between the vacuum accumulator and the suction bell is thus equalized. Since the suction bell may only be re-ventilated when the injection is complete, a spring mechanism was tensioned on the device before use, which is triggered by the injection mechanism as it expires. In the case of the simpler electronically delayed triggering, a ventilation valve is proposed, the double-acting magnet of which draws the valve membrane onto the ventilation channel during suction generation (the fixation then provides the negative pressure) in order to keep the valve membrane away from the ventilation channel during the re-ventilation. The

In this way, the magnet does not have to work against a return spring. In a mechanical company For example, using a permanent vacuum source, the vent valve is opened by actuating a valve tappet in the last phase of syringe emptying within a contracting bellows, supported by the attraction of permanent magnets, which also prevent valve flutter by changing the opening and closing positions. Finally, when preserving a larger vacuum storage space in constant connection to the suction cup by actuating the vacuum generator, the resuscitation mechanism can be replaced for the duration of the injection by a nozzle, through which air gradually penetrates into the suction cup after the suction has been switched off. In the field of dosing, the quantitative conveyance of the medication via three valves closed in a specific sequence also appears advantageous, for which purpose hose rings are preferably filled with an auxiliary liquid via metering chambers delimited by edge rings on a pin in the medication tube near the cannula attachment of electromagnetically operated pumps. Piezoelectric actuating elements surrounding the hose can also be used as metering valves. Operating a metering pump to convey a (usually more viscous) liquid, such as paraffin, prevents pump parts from coming into contact with the medication and saves cleaning. The auxiliary liquid can also be introduced behind the plunger of a stepped syringe, the effect of a metering hydraulic system with powerful and slow advancement of the plunger of the stepped syringe. The piston can out

Wax or be surrounded by a wax-like coat, which avoids the costly grinding fit. A special coupling valve consists of a slide valve with springback in the device part and a kind of slidable sleeve over a side opening for the access of auxiliary liquid into the staged syringe, the sleeve being forced to on the step syringe is moved into the device. In this way, an air-free coupling of both liquid systems is guaranteed. The space required for the auxiliary liquid can essentially be saved if only a quantity exceeding the individual metering stroke and the leakage loss is injected via the metering device between the separating piston and a supporting piston, and the supporting piston is guided to the separating piston above the medicament and is then blocked from movement. The auxiliary liquid swings on this

The way between the metering pump and the intermediate piston chamber and the separating piston and the supporting piston move alternately. In the field of vacuum generation, a type of lock valve following the channel on the opening mandrel of a pressurized gas cartridge is also important, in which a small-sized poppet valve inside the plate of a larger poppet valve is first opened with less effort. The gas, which is under high pressure, then accumulates in a chamber, which is closed by a slide valve behind the seat valves. As a result of the pressure equalization in the chamber, the large seat valve can then be opened easily. The gas flow then reaches the gas jet pump via the open slide valve. The gas capsule can be lifted into the opening mandrel by means of a swelling pin (made of agar-agar, for example) while absorbing water. An automatic cannula change is facilitated by a stacking cannula, whereby in the case of a vertical arrangement within a magazine tube or hose, the preceding cannula shaft lies in a hollow in the body of the subsequent cannula and the medication is supplied laterally via an annular groove in the cannula body with a bore opening into the cannula shaft. At the end of the chamber in the body for the reception of the adjacent cannula shaft, an elastic septum of let terem can be perforated centrally. to To enable storage in curved magazines, there can also be an incision between two cannula body halves, around which the bending can take place when the material is elastic. The drug supply can also be via vertical channels or

Channels are made along the cannula body. Gluing or thread-like attachment between the cannula bodies can enable transport by train, which preferably originates from the claws at the end of the receiving tube inside the suction cup cover. Pressure effect on the stacking cannulas can originate from a compression spring which is tensioned by the thrust effect of used cannulas when they are manually pushed in the circuit from the receiving tube over the end of the magazine tube. This

Thrust movement is important for the advancement of a stacking cannula into an open position in alignment with the drug exit points in the magazine. A leaf spring actuated by means of a switching pin on the cover can serve as the switching mechanism.

The raising of the central pin in the suction bell can also allow a cannula to be lowered by means of a ball grid, which in this other solution example takes place under the action of compressed gas on a sealing piston in the magazine hose. (Fig.18, Fig.19).

Flattening or oval shape of the magazine and cannulas can serve as a rotation lock and allow the effectiveness of the joint elements between the cannulas as well as a better contact and sealing of the medicinal channels (Fig. 27).

In order to mix the insulin components in the area of a peristaltic pump, which is operated by means of a spiral spring, at least one pin fastened on a disc is placed on the axis thereof by means of a gearwheel Like unevenness of the opposite surface of the disc carrying the rollers of the hose pump moves that a jerky, repetitive evasive movement of the hose pump is caused against a spring. The dosing accuracy in the case of small circumferential dimensions is increased in that two hoses are guided in parallel over two hose pumps acting in the same way; further characterized in that the hoses can only expand within the pump between the grooves of the discs carrying the rollers and in that the reunited hose section, for example, between the pump and the cannula to reduce the wind boiler function is surrounded with a solid jacket. An even better solution results from the introduction of a small piston pump directly in front of the cannula socket, which causes the medication to be dispensed in preprogrammed pump cycles either via the guide of a spring-operated disc or by repeated actuation of an electromagnet. The storage of the piston pump within the medication tube when actuated from the outside via the mediation of a cross plate on the pump plunger saves cleaning and facilitates the replacement of the metering system in accordance with the overall object of the invention. The replacement of a fitting piston with an elastic sleeve, the hollow of which is pressed against a contact surface, for example of a pierced plug laterally welded to the tube, by means of the plunger for dose delivery, is particularly advantageous with regard to the production costs, while the end of the plunger passed through the bore of the plug is widened and, in push-pull, closes the plug bore to the cannula attachment cone. In a particularly advantageous manner, a special pump housing can be saved if the stopper (114) directly into a hose extension vulcanized, whereby the hose extension can only expand to a limited extent within an axis bushing of the injector (Fig. 92). The drive of the dosing device also takes over the function of the vibrator for mixing the medication and avoids the permanent squeezing of the tube by the pump rollers, which remains problematic even if, as in the example shown, the tube is always clamped by the rollers at the same place practically through the process the rolls in one direction with the addition of the metering distances is very likely to be avoided. Grooves of the carrier disks for the metering rollers enclosing a hose each reduce the expansion of the hoses within the pump, which is additionally compensated for by spring tension at the end of the hoses emerging from the pump. (Fig. 66). Two pairs of rollers can also be arranged radially one above the other in such a way that they enclose the hoses between them (FIG. 74). The pulling effect of the rollers can also be countered by fixing the pair of tubes via a crossbar between the tubes, which is interrupted in the manner of a rope ladder for a fixed ring gear (FIG. 75). In the field of drug storage in the storage vessel, a slightly contracting thin-walled membrane, i.e. a simple pouch, was considered as a simplification (Fig. 66). For the transport of medication, this can be arranged within a further rigid-walled pouch when compressed gas is stored between the pouches (FIG. 35). However, since the medication feed by means of the pressure effect in the container means dosing free of air bubbles (air can penetrate from the cannula even if there is negative pressure in the hose system or there could be a suction effect through the cannula

Towards body tissues) are much easier, improvements have been made here and in such a way that this pressure on the drug supply is made uniform from the beginning to the end of the drug supply exhaustion. This is caused by screwing the lid down against the medicinal bellows in relation to the liquid cans to be dispensed (Fig. 78). This results in a rough dosing similar to the use of a step syringe, which, however, is supplemented by the piston pump for fine dosing. In a second example with a pressurized gas cushion (Fig. 82), this is caused by the delayed release of carbon dioxide gas when dilute hydrochloric acid acts on a carbonate, the latter being able to be protected on rolled-up polyethylene film by a pectin film that has gradually been broken down by hydrochloric acid. A pressure relief valve constantly prevents excessive pressure rise. The bellows-receiving storage cylinder can expediently be a component of the device, while the bellows with the medicinal liquid is exchanged in each case. For the production of carbonic acid in an amount which is necessary to expel 50 ml of liquid at a residual pressure of 1 atm 375 mg of sodium bicarbonate and 815 mg of 20% hydrochloric acid are required. If calcium carbonate were used, 446 mg would be required. For bonding to a film, the more heat-resistant calcium bicarbonate is preferable, since it can be blown heated over the film or sprinkled on a polyethylene film heated to 100 to 120 degrees Celsius.

The prewarning before the drug supply is used up results in the solution from a gradually lowered screw cap - which can be tracked in a cylinder slot along a metering scale - from the attachment of a removable obstruction against the descending screw cap at the point of the lower limit for a sufficient single dose before the supply is exhausted (Fig. 78). It can also be - especially within the difficult to see compressed gas storage bottles (Fig. 82) - between the bellows and the container lid a thread is attached, which actuates a warning device when tightening, as they can be purchased inexpensively as electronic melody in greeting cards. Finally, medication consumption can also be electronically monitored (Fig. 93) and read off (Fig. 94). A pre-warning margin can be selected and the function of the injector can be blocked if the remaining amount falls short of the single dose. The function control has been improved in many ways. In the case of spring-mechanically operated solutions, such as the peristaltic pump, the control mimic for triggering the injection or re-ventilation is pretensioned at the same time as the cannula-carrying vacuum reservoir is inserted; it is therefore not cumbersome to operate a special lever, but as actuators there is at least one pin which projects downward beyond the cannula attachment piece. To check the skin contact of the edge of the suction cup, there are three pins in bays outside of the sticky-note design

Suction cup edge in one example (Fig. 86), which enables the trigger pins to be brought closer to the device center without reducing the adhesion due to a smaller skin contact area. Pins stored inside the suction cup must be sealed towards the suction cup roof (Fig. 22). In the example shown, such pins first cause a ring to rotate against its suspension in order to then be able to step upwards with little friction (Fig. 80). By turning that ring If the pins move from the opposite direction, they engage with openings in the ring and the lowering caused by manual pressure can open the valve between the suction bell and the vacuum accumulator. In the example described, the negative pressure is generated in three chambers of equal size, which are arranged in a ring around and above the suction bell (Fig. 83), specifically by means of the expulsion of air by means of electrical heating wires via the lighting network. The chamber heating is switched off via a temperature sensor (e.g. bimetallic switch) or a short-term switch after the maximum temperature has been reached, and the chambers are then cooled. Spring-loaded valve flaps allow the hot air to escape from the chambers via the suction bell, which also serves as a side effect of cleaning them, while pins from above each lever one of the valve flaps out of their seats for air pressure compensation between the chamber and the suction bell. Since a wide hat-brimmed edge around the edge of the suction cup is useful anyway in order to prevent a stretched injector from tilting on the skin and thus preventing unwanted air from entering the suction cup, the higher space requirements of the heating chambers are less important than the savings of the industrially evacuated one Storage potty around the individual cannula. The division of the ring-shaped jacket space around and above the suction bell into three individual chambers allows the injector to be used three times after each heating. The vacuum potty-preserving pots have also been significantly improved. A membrane-like cover around the cannula opening cone allows a loosening of the cannula into the skin after loosening a support on the cannula or on the pin (Fig. 66, Fig. 89) caused by injection molding. In other examples, the suction bell is formed by a rubber-elastic sleeve of the injector (FIG. 78) into which the vacuum accumulator is pushed in a sealed manner becomes. Such a memory of the two-chamber system, in which a distinction is made between the storage space and the suction bell chamber and the cannula emerges uncovered, then resembles a memory of the single-chamber system in which the cannula is located as a whole and to the tip behind the end membrane. The dead space around the exposed part of the cannula shaft can be reduced by saving it by filling it with an annular piston. There is no need for a special valve between the suction bell and the vacuum accumulator if an expandable membrane is used as the partition between the annular piston and the vacuum accumulator, such as is used as a household foil (e.g. "Frapan") (Fig. 78, Fig. 85) . In this case, however, the ring piston must be held against the vacuum accumulator before use. According to the invention it can have a transverse groove in which a retaining collar or cover extensions from retaining tongues extend from the lower edge of the vacuum reservoir into this transverse groove and thus prevent the inward movement of the annular piston under vacuum influence before use. In sections of the annular transverse groove between these retaining tongues, retaining pins or lamellae snap into the injector and, after removal of the retaining collar or the suction cup cover, hold the annular piston in place until the injection is triggered. From a manufacturing point of view, the more complex transverse groove can be replaced by producing an annular piston with an open ring notch in the same shape with the vacuum accumulator. The latter is then transported via a conveyor carousel to an adhesive device, for example an ultrasound head, and connected with a circular, stretchable film. Then the ring piston is placed under a vacuum reservoir and the edges of the circular film are glued to the edge of the vacuum reservoir. According to the invention, this edge is broadened like a hat brim and can also have a linear sealing contact with the suction cup sleeve of the injector. The transverse groove or the ring notch can be designed horizontally or obliquely in alternating sectors, on the one hand to support the locking effect of the cover tongues or cuff pins, and on the other hand to facilitate the unlocking of the retaining pins or lamellae of the injector (Fig. 85). Since the cover of the vacuum accumulator is held rigid in this solution example, the cannula is approached in use except by raising the skin due to the flexibility of the suction cup cuff. The increase in the range of motion between the skin and the injector can serve to release the negative pressure effect on the skin within the suction bell, but can also trigger the metering device for injection on a subsequent switching path. In the example in FIG. 66, the correct vertical movement of the injector against the skin is a prerequisite for the trigger actuation that the suction bell cuff can only be lifted simultaneously with the lifting of a cylinder segment which has a tightly fitting ring to the outer surface of the cylindrical receptacle for the vacuum accumulator, which jams against the wall of the receptacle when the movement is one-sided. In this way it is ensured that the injection is only triggered after the suction bell has come into contact with the skin safely and under vacuum. In the example in FIG. 82, the rotary pumps are only activated after the negative pressure effect on the skin has been determined, as in previous patent applications. In this case, however, a button serves as a "suction switch", which controls changes in shape of the vacuum accumulator. In the examples shown, these changes in shape concern the cover and the cannula opening cone. This can - as described - membra be nosy and lower before injection. A circumscribed elastic part is pulled in under the influence of the negative pressure in the reservoir; after the vacuum is reduced by balancing with the suction cup space, this membrane will rise slightly. However, the usable performance is low. Therefore, a slide valve working with low friction was provided as the switching element. The associated button is first advanced by means of a pneumatic piston against the elastic membrane, which is operated by a bellows, which is compressed when the vacuum accumulator is inserted into the injector and remains pressed together until a re-ventilation takes place via the slide valve mentioned. The expansion of the bellows, which is optionally reinforced by an additional spring, actuates the switching element for the further functions of the device (Fig. 76). A slight edge projection of a welded-on cover membrane can offer resistance to a resilient holding device, as a result of which a more expensive transverse channel in the piston can be avoided. On the other hand, a device that acts laterally on the cover in a wedge shape can be useful for removing the vacuum accumulator after use (FIG. 70). Even the single-chamber system becomes economically viable again if the elaborate trigger mechanism for the suction cup cover carrying the membrane is transferred to the injector itself (Fig. 87). A stretchable elastic membrane spans a bottom ring within half of the vacuum accumulator, which in turn has a high guide cylinder which is loosely inserted into that vacuum potty. An inner part of that bottom ring is glued to another ring-shaped cover ring, which rests with its edge on the lower edge of the vacuum reservoir and, after the latter has been evacuated, prevents the bottom ring from being lifted until an edge streak occurs strip that cover ring along a predetermined breaking line is removed by pulling it down. In accordance with the intended purpose, this only takes place after pins or latching segments take over the supporting function for the bottom membrane from the injector at a height above that inner guide cylinder at its edge through material-thinning wall thinnings of the vacuum storage potty. In the single-chamber system, the entire cannula is protected behind the cover membrane, whereby the disadvantage of blunting the tip of the cannula when passing through the membrane is less significant in the case of the rubber membrane used previously in the highly elastic plastic film. The fact that after the opening of the membrane closure through the cannula connecting piece into the storage suppressive effect can be used to make the negative pressure visible laterally by collapse of an elastic ball. If a blood vessel is hit by the longer cannula predetermined for deeper injections, the ball fills up with blood after loosening the clamp (210). In such a case, the incorrect injection into the blood vessel can be prevented by stopping the injection (Fig. 87). The unicameral system has the largest vacuum storage space in terms of the overall size of the vacuum storage pot. Sterility of the cannula is guaranteed even without external packaging. The function control for the ventilation of the suction bell was improved in that in each case an easy-to-operate slide valve is first closed with energy storage for the return of the valve lifter before actuating the metering device. The valve actuation mechanism is blocked until the metering mechanism has completely run off, which is activated by deflecting a moving locking element on a steep flank of the link guide on the housing (Fig. 69, Fig. 77, Fig. 81). In this way, the risk of re-ventilation before the administration of the entire amount of liquid liquid is countered and the additional risk that during the withdrawal of the cannula tip through the upper layers of skin there is also injected intracutaneously. The mixing of the medicinal components can also be brought about by mechanically coupling the buzzer of the electronically controlled warning device to the hose parts leading around the pump in such a way that its vibrations are communicated to the inside of the hose (Fig. 91), even just before the injection . An edge ring (223) on the cylinder (5) that maintains negative pressure serves both for better attachment of the boundary membrane (6) and for a more favorable seal to the injector (FIG. 85). In the area of the dosing, the dosage is weighed by means of a kind of magnet-clocked rocker, provided the medicinal tube is sufficiently resistant (e.g. made of silicone), whereby the type of clamping prevents the inflow from the reservoir from squeezing the tube (for example, inside a dosing screw, the turns of which are also present) are successively narrowed over the hose by flattening it (Fig. 99). The possibility of allowing the expansion of a body as a pressure transmitter (be it a magnetic stroke or a piezo effect) to act in stages on a hose part as a means of metering, also allows an inflow leg to be shut off in the hose chamber, thus saving a valve (Fig. 101). The possibility of changing the speed of the magnetic stroke or piezo expansion (by sudden switching of individual lamellae) and using it to switch to a different type of medicine has already been discussed above (Fig. 98) Hose ring constriction (Fig. 102) or piezoelectrically pressurized orifice plates around an elastic pin in the hose in the manner of a photo camera central lock can be accomplished) in connection with a critically high flow rate or a constant medication pressure from the storage container or the utilization of the electric field or the nuclear magnetic resonance for measuring the flow form possibilities that lead to Reduction of the dosing mechanism can be considered. At any rate, the use of piezo elements in their lengthwise expansion seems to be possible only because of the high voltage required, only in connection with the power grid (thermal vacuum generation is only a temporary dependency). In any case, it can only be decided at a considerable cost in accordance with the current state of the art which combination of functional parts realizes the injector to which the task is based.

Brief description of the exemplary embodiments:

FIG. 1 shows a top view of a filled injection syringe with a sensor cannula in connection with a measuring device.

FIG. 2 shows in longitudinal section a storage potty which maintains negative pressure and has a sensor cannula in conjunction with a hand-operated metering device and a measuring device.

FIG. 3 shows a longitudinal view of an insulin pump in connection with a sensor cannula and measuring device.

Figure 4 shows in longitudinal section and on the right in cross section the detail of a cannula connection piece in connection with a hose coupling piece.

Figure 5 gives a block diagram for data storage and reading in a device according to Figures 1 to 3. Figure 6 shows a refinement of the block diagram of Figure 5.

FIG. 7 shows a circuit diagram of the reader of a device as in FIGS. 5 and 6.

Figure 8 shows in natural size, with the exception of a shortening of approximately 40 mm, the housing cylinder with a discharge hose, bellows and receiving pipe socket for the insertion cylinder in a longitudinal section.

Figure 9 shows the insertion cylinder, which can be inserted from below into the housing cylinder of Figure 8, with a maximally filled injection syringe in longitudinal section. Figure 10 shows a cross section through the iron plate closing the insertion cylinder upwards, the position of the six permanent magnets and the trigger tube for the re-ventilation valve being shown interrupted is.

FIG. 11 shows in longitudinal section parts of a housing cylinder similar to that in FIG. 8 with deviations in the design of the re-ventilation valve. Figure 12 shows in a reduction on a scale of about 1: 5 a water jet pump with line connection suitable for the operation of the device in a longitudinal view. Figure 13 shows a longitudinal section through an injector which is operated by means of a CO2 compressed gas capsule for a medicinal product with an automatic cannula change.

Figure 14 shows a cross section at height A - B of Figure 13.

FIG. 15 shows a cross section at height CD of FIG. 13.

FIG. 16 shows a longitudinal section through the detail of one of the two liquid coupling valves for FIG. 13. FIG. 17 shows a cross section through the gas jet pump of FIG. 13.

Fig. 18 shows on the left in longitudinal section and on the right in cross section a detail at the end of the cannula magazine on a scale of 5: 1 for FIG. 13.

FIG. 19 shows a side view of the cover flaps on one side of FIG. 13; to the right of this is a vertical section and below it a cross section at height A - B.

Figure 20 shows in vertical section along D - E of Fig.13 details of the control of the triggering and the change of the dosage. Below is a cross section.

Figure 21 shows on a scale of 2: 1 details of Figure 20. Below you can see a cross-section along A - C. On the right, the position of the release spring of the trigger can be seen in two details rotated by 90 degrees.

FIG. 22 shows a partial top and bottom view in longitudinal section and in the middle in cross sections A - B and C - D details of the control mechanism. FIG. 23 shows in longitudinal section the counting and locking mechanism of the device according to FIG. 13 and the following. Below this is the cross section at height A - B. Figure 24 shows on a scale of 5: 1 the detail of the implementation of the lifting movement in the rotation of the counter. Figure 25 shows the grooves in the guide bushing in a 10: 1 scale. FIG. 26 shows a cannula magazine and variations of stacking cannulas on the left in a longitudinal section, which encloses a cross section on a scale of 5: 1, and FIG. 27 on the right in longitudinal section likewise on a scale of 5: 1.

FIG. 28 shows a metering pump for auxiliary liquid on a scale of 10: 1 on the left in longitudinal section and on the right in two cross sections of different heights.

FIG. 29 shows in longitudinal section an electrically operated injector with step syringes for two different medicines.

Figure 30 shows a cross section at height A - B of Figure 29.

FIG. 31 shows a circuit diagram in TTL for FIG. 29, 30. FIG. 32 shows in longitudinal section a variant of FIG. 29, which has a motor with a manual transmission for two metering peristaltic pumps.

Figure 33 gives the TTL circuit diagram for Figure 32. FIG. 34 shows a medicine supply bottle with compressed gas within a bellows in longitudinal section. FIG. 35 shows a longitudinal section through a medication bag inside a pressurized gas bag. Fig. 36 gives a schematic top view of a suction injector as a preferred embodiment, the inventi. The storage of stacking cannulas of two different constructions is shown in longitudinal section in the magazine tube.

FIG. 37 shows a longitudinal section through the suction injector, which follows the line AB in FIG. 36. A cross-section through the suction bell (height indicated by an auxiliary line) and a cross-section below the suction piston can be seen on the right. FIG. 38 shows a longitudinal section along the line A - B of FIG. 36 through the injector.

FIG. 39 shows a top view of the suction cup roof together with cylinder (304) with cannula magazine along the line D - E.

FIG. 40 shows a schematic longitudinal section along the line F - G to explain the piston guide mechanism via the movement of the suction cup cover in the waiting position before the injection.

Figure 41 largely corresponds to Figure 40, but shows the stage after the injection. Figure 42 shows the stage after the lid is closed. FIG. 43 shows a variation of the trigger mechanism for the suction piston with the line of the longitudinal section as in FIG. 36; the suction cup is shown in side view.

Figure 44 shows a schematic longitudinal section of a connection possibility between the old and new storage bag for partial replenishment of the old one. Figure 45 shows a longitudinal section at the top, including a cross section of two metering pumps for the injector according to Fig. 26 ff and a locking of the storage bag. Figure 46 shows in longitudinal section on a scale of 5: 1 the detail of a metering pump in connection with one of the magnetically operated metering pumps.

FIG. 47 schematically shows the course of a peristaltic dosing movement in a variation of the pump arrangement in order to save dosing pumps. Figure 48 shows in a longitudinal section on a scale of 5: 1 a stacking cannula according to Figure 25.

Figure 49 largely corresponds to Figure 48 and represents a cannula variation.

FIG. 50 shows a special sensor in longitudinal section and below in cross section along line A - B cannula with partial shaft replacement by plastic on a scale of 5: 1.

FIG. 51 shows a cannula variation with an inner coating in longitudinal section and on a scale of 5: 1. FIG. 52 shows a cannula, which corresponds to the configuration of FIG. 50 with an inserted sensor tube or thread with an intact shaft. FIG. 53 shows a cannula, which corresponds to the representation of FIG. 50, with a tube being inserted into the split shaft. Figure 54 shows in longitudinal section on a scale of 10: 1 a sensor cannula for reflex photometric measurement. Figure 55 shows in longitudinal section on a scale of 10: 1 egg sensor cannula for optical measurements with optical fibers only up to the base of the shaft.

Figure 56 shows in longitudinal section on a scale of 10: 1 the variation of a stacking cannula corresponding to Figures 48, 49 within a device bore with light supply via a swivel segment.

Figure 57 shows the top and bottom in cross section of the switching ring arrangement on a device cylinder for a device according to Fig. 25 ff. Figure 58 shows a functional diagram for the electrical control and programming.

Figure 59 shows a table with the compilation of example programming and their effects. FIG. 60 shows a processor-controlled program sequence for an injector according to FIG. 25 ff. FIG. 61 shows a refinement of block 6 from FIG. 60; FIG. 62 is a continuation of FIG. 61. Figure 63 is a continuation of Figure 62. Figure 64 is a continuation of Figure 63. Figure 65 is a continuation of Figure 64. Figure 66 shows an example of an injector with two parallel and identically operated peristaltic pumps as a metering device, with a storage bag of great wall flexibility and a vacuum storage pot 42-not submitted 43 -

Figure 77 shows a highly schematic of four functional stages A to D of a mechanism for re-ventilation by means of a slide valve. Figure 78 shows a longitudinal section through an injector with a metering device integrated within a hose according to a type of piston-cylinder pump, a screw cap with a mechanism for automatically reducing the size of the medicine-storing container and a suction bell rim with elastic lips, which belongs to the injector and also to the one Trigger device for the bottom cylinder of a vacuum potty which is to be assigned to the injector and which takes over the holding function of a potty-specific support device removed before use in the injector.

Figure 79 shows in cross section A - B of Figure 78 a trigger mechanism.

Figure 80 shows a schematic longitudinal section of Figure 79 in rollup.

Figure 81 shows a highly schematic of three functional stages A - C in Fig. 78 of a mechanism for re-ventilation by means of a slide valve. FIG. 82 shows a longitudinal section through an injector with an electromagnetically operated hose-integrated pump similar to that of FIG. 78, wherein a film roll as chemical carrier for the gradual formation of compressed gas in conjunction with an overpressure valve ensures uniform medication feed and a device for the thermal generation of the vacuum for the suction bell is available in three separately activated storage chambers.

FIG. 83 shows a cross section in the direction A - B through the vacuum storage chambers and suction bell of FIG. 82. Figure 84 shows a schematic unrolling of the Mechanism for opening the valve flaps to the vacuum chambers.

On the left (I) in Fig. 84 is shown part of the schematic roll-up of the groove guide for the cam of the shift cylinder of Fig. 82 to explain the sectoral rotation thereof after lowering the medicine container against the pump housing.

The triggering function is explained below (III) in cross section A - B in FIG. 82. Figure 85 shows a variation of a vacuum storage potty similar to that in Figure 78. On the left half of the picture, the bottom cover locking in the transverse groove can be seen, in the right half of the picture after removal of the latter, the locking of the ring piston by a locking plate of the injector.

FIG. 86 shows a schematic cross section through the suction cup sleeve of an injector with a cross section lobed like a cloverleaf and the position of the trigger pins outside the suction cup.

FIG. 87 shows a longitudinal section of a vacuum potty according to the single-chamber system with a removable cover for the suction bell, with a schematic illustration of a locking mechanism for the insert cylinder carrying the base ring, which belongs to the injector, and a device for checking the cannula seat with regard to its blood vessel contact. FIG. 88 shows the process steps for producing a vacuum storage potty according to FIG. 85 in a highly schematic manner.

FIG. 89 shows a vacuum potty of the type used in FIG. 66 inside the guide cylinder in the stage of the skin being pulled up by air pressure compensation in a longitudinal section. Figure 90 shows on a scale of 2: 1 a schematic roll-up of the two opposing profile strips for deflecting the valve tappet in an injector according to Figure 78 in a functionally clarifying approach to each other. Figure 91 shows a schematic longitudinal section of a mounting bracket as a rigid connection between an electrical buzzer and a ring around a metering pump as a device for mixing medication.

FIG. 92 shows in longitudinal section a drug-carrying bellows, which is emptied via a hose with this integrated metering pump without a special pump housing. FIG. 93 shows a block diagram of a prewarning device with regard to the depletion of medication for injectors as described in FIGS. 37, 78, 82.

Figure 94 gives the circuit diagram for Fig. 93. Figure 95 shows in longitudinal section a locking device of the drug supply until the supply is exhausted. Figure 96 shows a variant of the metering hydraulics in longitudinal section.

FIG. 97 shows a top view above, below and in the middle a longitudinal section in section line A - B of the top view and below likewise in a longitudinal section in section line C - D of the top view a metering device which is pressurized by the electric magnet (546).

Figure 98 shows in longitudinal section a helical metering device similar to that in Figure 97. FIG. 99 shows a metering device in longitudinal section, by means of a piezo pressure transmitter under photoelectric and switch-controlled influence control, particularly for use with a narrow outflow flow path. Figure 100 shows in cross section a hose throttle valve in connection with an electronic flow measurement.

FIG. 101 shows in longitudinal section a dose changeover by means of a gearbox, that is to say a metering device for two medicaments by means of a motor.

Figure 102 - also shown in longitudinal section - fulfills the same task by means of different pulling speeds of a piezo pressure sensor. FIG. 103 shows in longitudinal section in two functional stages the movement of the cannula magazine to and from the skin by means of suction.

Figure 104 shows a longitudinal section of two functional stages of an injection with skin lifting by plaster.

FIG. 105 shows the polarization-photometric metabolic control through the top of the skin raised in a suction cup.

FIG. 106 shows the basic experiment on influencing the conductivity of a membrane with Sepharose concanavalin A by glucose.

Detailed description of the exemplary embodiments:

FIG. 1 shows a top view of a filled injection syringe (233), on which a clamp (227) is placed, from which contact terminals (228) emanate from the sensor covering of the cannula (326). Lead wires (234) lead from the contact terminals to the housing with the measuring device (288) and the reading device (289) with printer. The cable (240 connects the measuring device to the contact patch (228) for the skin, which serves as a reference electrode.

Figure 2 shows a device similar to that of Figure 1. The injection cannula (326) -with the sensor covering is, however, within a storage potty which keeps the oppression (as was shown in Canadian Patent No.1189412 of June 25, 1985 in FIGS. 3 and 4 and in application 0 103 664 of the European application). In contact with the cannula coating, the cast lead wires (234) during manufacture lead to plug sockets (235) in the cover. The valve pin (229) lies within its guide tube (230), which has been moved into the center of the storage pot (here in an elliptical shape, into one of its centers) and, as a further innovation, has a leaf spring resting on the suction cup edge (231). This has a convex curve towards the skin and is attached in the center to the valve pin, the pointed end of which is at a distance from the stretchable cover film (232). The cannula is next to the valve pin but not in projection on the leaf spring. The contact patch is through the ring-shaped adhesive electrode (239) on the suction edge of the bell with its cast-in contact line (236 (236) to the socket. Before the injection, the plugs of the lead (236) and the cable (240) to the measuring device (388) are inserted into the sockets (235) Injection syringe (233) filled in this way is attached to the cannula socket, the protective film ring (237) is removed from the adhesive electrode (238) on the edge of the suction cup, and if the storage potty is pressed against the skin for injection preparation, the valve pin is raised The spring absorbs tension and finally flips upwards with its ends leaving the edge of the suction cup. The valve pin is shot up explosively and breaks with the tip of the cover film (after it has been stretched out), which leads to air pressure compensation and lifting of the skin into the suction cup. (The extension of the cover foil prevents the valve opening from closing the suction cup securely through the skin). The protective film ring (237) must be removed from the edge of the suction cup before use. The measuring device (288) can also preferably be worn on a resilient link bracelet (241) and the adhesive electrode can then be replaced by a contact pad (242) below the measuring device. Similar to that of FIGS. 78 or 82, the metering device contains a pump which can be actuated intermittently by hand locking via the handle bar (180). The same is built into the hose (44) and is held by the container cylinder (19) with slotted walls by means of the screw connection (578). The medicinal bellows (731) is attached to the tank cylinder by means of a fastening ring (579). The loading festigunnsring serves the compression spring (500) as a counter bearing to move the plunger (110) back and thus cause the medication to be expelled. After the storage potty adheres to the skin, the measurement result can be awaited and also one of corrected dose calculated by a computer can be administered intermittently.

FIG. 3 shows the combination of the sensor and dose compensation device (ie the computer) with a commercially available insulin infusion pump (245). The measuring device (288) and reading (289) and computer (246) are attached to the housing of the infusion pump. The lead wires (234) connected to the parts of the sensor cannulas are insulated for a distance within the wall of the supply hose (236) and then with their own insulation to the sockets (235) in the housing of the control unit (175). FIG. 4 shows in longitudinal section and on the right in cross section the detail of a cannula connection piece in connection with a hose coupling piece. The cannula connector (47) is in close contact with the plug cone (570) of the supply hose (236). The retainer clip with the sliding contact (254) inside has not yet snapped into the annular groove (581) towards the cannula, from which contact with the cannula shaft (79) is made via the wire (577). The cable (240) leads a distance from the sliding contact, isolated in the wall of the supply hose, to the measuring device. Another wire leads from the sensor covering through the cannula shaft to the internal contact (253) inside the bore of the cannula socket. There it comes into contact with the conductive surface of the plug-in cone and thus via the lead wire (234) with the measuring device.

A measurement value storage device is preferably useful for the device according to FIG. 3 in order to display the behavior of the measurement values when the device is lightly loaded by the device for the patient for the doctor by a display device (255) in numbers and possibly as curves on a screen do. FIG. 5 shows the block circuit diagram of such a device. Process hardware was used as hardware controlled system described in order to store and evaluate measured values and to take account of self-indicators and key parameters of the system itself. The core of the system is a CPU. EPROM / ROM is used as the firmware for the operating system, and RAM is used to store non-volatile but variable data (e.g. master parameters) as an intermediate value memory. FIG. 6 describes the basic structure of a circuit which is able to store measured values at regular time intervals (for example of 15 minutes), which are read out by a processor system with suitable interfaces.

A. Measured value recording: During the last measured value reading process, all memories and the address counter are set to "zero". The first timer pulse describes the current measured value in the memory cell of the address (000) and increases the address counter by one via the clock input. The second timer pulse repeats this procedure with the next address (001) etc.

B. Read measured value: The state of the enable line is changed via the interface with the result that the AD converter is disconnected from the data bus and the timer is stopped. Now after activating "Reset" the memory content can be read via the data bus by counting up the address counter. The data word (00) serves as the end of the data. After the reading process, the initial state described under A must be restored.

Figure 8 shows in natural size, with the exception of a shortening of approximately 40 mm, the housing cylinder with the discharge hose, bellows and receiving pipe socket for the insertion cylinder in longitudinal section. The device is particularly suitable for operation by means of a continuous suction source. Water jet pumps or vacuum cleaners can serve as such. The housing cylinder (701) with the base ring (702) carries the pipe socket (703) with the bayonet groove guide (704) for fastening the insert cylinder (FIG. 9). The bellows (705) is included means of a holder ring (706) screwed tightly to the base ring (702) and by means of the fastening ring (707) to the piston (708), the guide sleeve (709) of which prevents tilting. In the central bore of the piston (708) is the sliding tube (710) in a loose sliding fit, which is sealed by screwing to the tent-like membrane (711), which is screwed tightly to the piston (708) by means of the ring (712). The sliding tube (710) continues at the top in the discharge hose (713), which lies in spirals under the cover cap (714) thanks to the pre-tensioned tension and leaves this to a water jet pump or another suction source via the mounting bushing (715). The carrier ring (716) for the Dauermag netstifte (718), which are magnetically connected at the top by the iron ring (718), is attached to the piston (708) by the very stub (719). In its central bore, the carrier ring (716) allows the sliding tube (710) to pass through, the lower end of which is slotted for better air passage. The trigger tube (721) for the valve tappet with seal also slides into a sliding fit through a peripheral hole, which slides slightly under spring pressure for better air flow as an octagon in the capped valve bore. The channel (722) leads laterally out of the valve bore to an upwardly open slot in the guide sleeve (709) in order to let the outside air in through the cap bore (722).

Figure 9 shows the insertion cylinder in longitudinal section. (724) with a shoulder for the seal (725), the two bayonet pins (726) and the suction cup opening (727) downwards. Inside the insertion sleeve with piston thickening upwards the sliding sleeve (728) is arranged, which is pressed by the weak compression spring (729) against the iron plate (730) glued onto the insertion sleeve. while holding the syringe (233) up on its flange. The often unnecessary cover cap (732) for the suction bell is made of rubber-elastic material, while the remaining parts - apart from the sliding tube (710) and trigger tube (721), which can also be made of metal - are expediently made of a little fragile acetate plastic, Delrin or the like are made. A sliding contact (254) in the insertion cylinder is directed against the cannula shaft, a contact spring (576) against the cannula connection piece of a suitably contacted sensor cannula. (Instead of the conductive coating on the plug-in cone (570, as in Fig. 4), the outer surface of the needle hub is conductive). The lead wire (234) and the cable (240) connect the injector to the measuring device.

To prepare the injection, the syringe is filled from the bottle in the usual way, then provided with the sensor cannula and inserted with the tip forward through the opening in the iron plate (330) of the insertion cylinder so that the flange of the syringe cylinder is inserted through the oval Hole (see Fig. 10) of the iron plate. Appropriately - especially when the syringe insertion cylinder is inserted with the syringe plunger down into the pipe socket (703) of the housing cylinder - the syringe is then rotated axially on the plunger by approximately 45 ° to prevent it from falling out. By rotating the insertion cylinder while it is being fixed in the pipe socket (703) until the bayonet pins stop, the seal (725) is pressed against the bottom ring (702) and thus becomes effective between the housing cylinder and the insertion cylinder. It is advisable to store them within a clean linen cloth. The suction injector is best constantly connected to a permanent suction source, for example a water jet pump, as shown in FIG. To the For this purpose, a conically widened end of a water hose is preferably shortened until it can be pushed tightly over the part of the household tap with the outlet opening, where it is clamped by means of a band clamp (738), which holds the holding arm (739 ) wearing. This in turn has the axis (740) to the clamping jaws (741) which can be locked by means of a wing screw. The tube (743) of the water jet pump can be inserted into this at any height and clamped using the wing screw (742). Since the mouth of the jet pump can be aligned as desired and the water jet is first passed through a Verwirbelungsvorrich device (744), the tap can be easily used, air being sucked in through the nozzle (745) with the discharge hose (713). For the injection, the patient has to take the injector hanging on a hook or on a shelf from the drape and point the suction cup against any part of the body (as long as it does not prove unsuitable for the injection due to its sensitivity and nature, such as the skull area , Anus and palms or palms) after he has opened the tap and thus actuated the jet pump according to the arrangement of Fig. 12. The suction then lifts the skin into the suction cup and holds it there, then the membrane (711) with the smooth-running sliding tube (710) and finally the piston (708) with the bellows (705) and thus initially the In the injection syringe (233) pressed against the compression spring (729). After the sliding sleeve (728) stops on the bottom of the insertion cylinder (724) and the cannula has penetrated the raised skin, the syringe plunger is lowered to the stop and the syringe is emptied. On the last millimeters of the distance of the carrier ring (716) carried by the piston (708) whose magnetic pins are attracted by the iron plate (730), which favors the raising of the trigger tube (721) and thus the opening of the re-ventilation valve, so that the outside air can penetrate through the channel (722), which means that the vacuum under the membrane (711 ) the syringe lifts under the action of the compression spring (729) while the skin retracts from the suction cup, while bellows with piston (708) continue to be held down by the magnetic force. The patient can determine this when the housing cylinder (701) is transparent or through the side longitudinal slot (733) in this case, if necessary, by touching it with his finger before placing the injector. If the screwing of the insertion cylinder (724) is loosened while turning the pins (720) in the bayonet groove guide (704), the iron plate (730) moves away from the magnetic pins and the bellows expands again due to its inherent elasticity, and the check valve is opened his compression spring closed.

It is still the pressure pin (574) to be added, which is attached to the sliding sleeve (728) and when lowering f butts against the contact (254) and approaches the cannula shaft. In this way, contamination of the cannula section that later penetrates the skin is avoided. FIG. 11 shows part of a device similar to that of FIGS. 8 to 10, which shows a variant of the re-ventilation valve and its automatic operation. The housing cylinder (701) is separated by a gap (746) with a wall bevel in an upper and lower part, which are held together by the fastening sleeve (747). The piston (708) is connected to the bellows (705) and contains in its central bore the sliding tube (710), which has a notch (748) at the top and the inner lumen of which continues upwards into a small bellows (749). This in turn continues into the discharge hose (713), which is sealed in the cover plate (749) by means of a fastening bushing (715). In a transverse bore of the piston (708), two pins (750) with rounded end caps are slidably mounted, whose elastic sealing caps (751) within the bores (752) can cover the edges at the entrance to the smaller bores (753). Channels (722) lead from the smaller bores (753) upwards for re-ventilation. The lower end of the sliding tube (710) widens and extends to a pot (754). When the bellows (705) is relaxed, the small bellows (799) stretch, the pins lie inward over the wall slope of the gap (746) during the upward movement within the depth of the notch (748) and the sealing caps (751) become the small holes pressed tight. When the suction cup is closed, the piston (708) can sink under suction; after contact with the cover plate (30) of the insertion cylinder, the pot (754) and thus also the sliding tube (710) is raised, the bevel of the notch (748) pushing the pins (750) outwards, precisely at the stage of the piston lowering , in which their ends fit into the gaps (746) of the

Can avoid housing cylinder, whereby an upward movement of the piston is prevented until after removal of the insertion cylinder, the sliding tube (710) can move down again, which is further favored by the elasticity of the small bellows (799). The moment of deflection of the pins (750) outwards at the lowest piston position is also the one at which the elasticity of the sealing caps (751) is overwhelmed, so that their edges are torn off their seats in front of the entrances to the small bores (7 (753) This causes the airflow past the piston (708) into the interior of the bellows FIG. 13 shows a longitudinal section of an injection device which, by means of a CO2 pressure gas capsule (256) via the gas jet pump (257), generates the negative pressure for the suction bell (173), which is maintained there by the check valve (323). The compressed gas is removed via the mandrel (258) with a channel, which is tightly screwed to the valve block (259). From the cover bridge (260), two coupling valves connect to the valve block, then a control shaft with cannula magazine (262), a front and rear metering spindle (263) with thread for the associated metering nuts (264) - as shown in Fig. 14 can be seen in cross section, slide valve (265) and displaceable pump housing (111) for the piston of the metering device which is fixed on a rod. All of the above-mentioned components and others belong to the part of the device to be reused, while in the housing (226) of the insert (269) to be disposed of, this CO2 compressed gas capsule (256) is placed above the perforated receiving tube (269) for the swelling pin (270). , contains the elastic bag (271) with an auxiliary liquid and the syringe barrel (272) made of siliconized glass. The latter ends at the top in the valve tube (273) over which the sliding sleeve (274) lies. The separating piston (275) between the medicinal and auxiliary liquid has the wax jacket (276) and ends in the hook-shaped outlet pipe (277) which extends laterally and extends from below into a bore in the cannula magazine (316). Insert part and device part are screwed together using the fastening spindle (279). The spring-loaded ring (281) on which the pipe socket (282) with the hinge joint (322) can act by means of a rotary movement of the holding arm (341) with the hinge joint (322) for the suction cup cover (342) serves to tighten the counter nut (280) . The angle arm (283) with power transmission between the locking bar (283) in the control shaft and the is used to determine the metering pump Above the cylinder of the pump housing (111) against the compression spring (284) displaceable sliding cylinder (285) which is guided in the outer cylinder (286). In incisions in the locking bar, the wedge (287) for the dose change and the holding slot for the pulling loops (288) are pivotable about a longitudinal axis. Since after the lip seal (290) a pipe-like tube (289) expanded like a pipe is brought into contact with the end of the used cannula by means of the holding arm when the lid is closed. Above you can still see the compression spring (291) for the cover slide (292) and the receptacle sleeve (293) for the bag (256) with the Hi 1 fs liquid. From the gas channels, one can see the cross channel (294) after the external sense valve - which is described in more detail in Figure 19 - which is behind the blocking ball of the check valve (295) via the channel (296) through the cannula (297) within a stopper membrane in the carrier sleeve (293) leads into the gas storage space (429) of the insert part. The channel (299) leads to the gas jet pump (257) via the check valve (298) arranged parallel to the check valve (295), which continues the compressed gas line via a nozzle into the hose connection (431) to the end of the cannula magazine.

FIG. 14 shows a partial cross section through the injector according to FIG. 1 along the section plane A - B there. There are the elliptical suction cup (51) with the central pin (433) and the cannula magazine (316) inside, the step syringe cylinder (272), the outer cylinder (286) of the dosing pump for the auxiliary liquid, the dosing spindles (263) with dosing nuts (264) and the locking bar (283).

Figure 15 shows in cross section in the section guide A - B of Fig.19 the ceiling I slide (292) with its compression spring (291) and the bolt (449) of the flap hinge. In addition, the U-bend of the transverse cannula magazine (316) is made visible. Figure 16 shows a liquid section in longitudinal section tion device in the approach of the slot to the cover bridge. The liquid outlet opening (442) in the top-ventilated intake cylinder (443), which is closed by the spring-loaded sliding sleeve (444), corresponds to the liquid inlet opening (262) in the valve tube (273) of the stepped syringe cylinder (272). This is closed by the sliding sleeve (274) and is only moved towards the opening when the shoulder of the receiving cylinder approaches, the cover of the valve tube also displacing the sliding sleeve (444). FIG. 17 shows a cross section of the gas jet pump (257) with the gas inflow channel (446), the suction nozzle leading to the suction bell and the so-called non-return valve (448).

FIG. 18 shows the cannula changing mechanism on the right in longitudinal section on a scale of 2: 1. The grid ball (432) is pushed by the central pin (433) into its bore (434) inside the receiving cone (435) for the housing (575) of the insertion part through a side slot in the cannula magazine and into the middle notch (436) of the cannula body. The latter can only be lowered via the gas pressure, which is dammed up behind the cannula magazine for a short time, when the central pin is fully raised. Its lateral flattening (437) allows the grid ball to withdraw from the cannula. The cannula descends to the spring-loaded pawl (438). If the central pin is lowered again, it displaces the grid ball again, since it can move into the upper notch of the lower one and into the lower notch of the upper cannula. If the pawl in the lid is actuated by the switch pin (356), the cannula can be transferred from the lip seal into the cannula damming tube. Since a slight lifting of the central pin when the lid is closed again allows a gap in the central pin to pass through the grid ball, the subsequent cannula is deeper. The tubule (439) in the cannula body comes up in the same position the pawl is in register with the drug outlet opening (440) from the syringe. The illustration on the right in cross section shows the oval shape of the cannula and cannula magazine (262) and the lip seal (441) above the locking mechanism described for the central pin (433)

FIG. 19 shows the flap hinges with the flaps (shown in broken lines) on the front on a longitudinal section near the surface. A rectangular slot (452) is left in the center of the flap to allow the metering nuts to move freely. The "lock valve" is shown on the left in a lower level. The gas channel (294) from the CO2 compressed gas capsule leads into the overpressure chamber (455), which is closed by the large valve plate (456). In the central bore, a small valve cone sits on the narrow-ended pin in front of a stop plate (457). The pin continues in the slider valve cylinder (458) and has a ping groove. The gas from the overpressure chamber (455) is introduced laterally into the slide valve cylinder and, after the cap pin (461) has been lowered, is passed on via the annular groove to the transverse channel under the action of the wedge bevel of the slide (462). Previously, after the small valve cone had been pushed open while the slide valve was still closed, gas accumulated in the overpressure chamber, which allowed the large valve plate to be pushed open by means of the pressure plate. On the right under (II) in a vertical section along the section line A - B of the longitudinal section, the closed flaps (445) with the app hinges (450) are shown, the support arms (463) of which touch and the left of which the bolt (449 ) wearing. The open flap is shown in dashed lines on the left. Under (III) the left flap can be seen in a top view at the height of the slot (452) with the dosing nut. Below this under (IV) is a cross section through the lid bridge shown. The influence of the cover slide (292) over its wedge bevel (464) by means of the bolt (449) can be clearly seen. Figure 20 shows a vertical section through the control shaft, the two dosing lockers In (263) with dosing nuts (264), the fastening rod (465) for the axis (466) of the wedge (287) for the dose change with the knob spring ( 467) in its scenery (72). Below you can see the spring-loaded pin (468) for manual switching between the set doses. The trigger (469) has the profile nose (470) for engagement in the notch of the locking bar (283). to which it is pressed by means of the leaf spring (471), whereby it can be rotated about the axis (472). On the right you can see the return spring (472) of the stud carrying the nub spring, which is secured against rotation by the guide pin (473) sliding in the slot. In the lower control shaft above the suction bell, the carrier plate (474) transmits the movements of the central pin (433) to the half-channel (475), which is adjacent to the outer cylinder (286) and is divided into two legs, to the cover slides. Below this, the connection tab (476), which is vertically displaceable relative to the central pin, is shown for the rotationally secured fastening of the metering spindles (263). The partial cross-section under Figure 20 makes the position of the parts even clearer.

Figure 21 shows the trigger for the liquid injection in detail on a 2: 1 scale. The support of the profile nose (470) on a projection of the locking bar (283) is shown in cross section below. In the longitudinal section above you can see the overhaul spring (477), which is sliding against the fork opening (483) (as shown in a view in the direction of arrow A to the right and rotated 90 degrees below). The trigger slide (484) at the end of the central pin causes the upper one to be raised Wedge bevels against the overhaul spring, the evasive movement of the trigger (469), whereby it lies with its fork in the notch (485) under the influence of its leaf spring (471). If the central pin returns against the skin after the injection, the upper bevel of the notch (485) pushes the overhaul spring back and the trigger slide can overtake the trigger within the fork opening (483).

Figure 2. shows in a vertical section through the control shaft - which forms the space between the insert part and the metering pump - above the trigger on a scale of 2: 1 the mechanism for the metering stage selection. It can be seen that the pin (468) for switching the dosage can be raised with its bearing bush on the locking bar (283), while the counter pin (499) is fixed with its stronger compression spring. On the cross bolt (501) it can be lowered in the guide of the wall slot (500). The pin (468) moves downwards under the action of its spring and the N-opposing spring (467) causes an axis pivoting of the switching cylinder and thus also the one at an angle due to its movement within the link guide (72) of the switching cylinder (which was drawn out on the left) attached to this wedge for dosing. The change of the dosage level selection can thus be carried out without triggering the dosage.

The cross-section below clearly shows the angular displacement between the switching cylinder and the wedge (287) as well as its position above the dosing nut (264). The interrupted wedge display shows its position after the switchover. FIG. 2 shows the control arms extending from the half-channel and the cover slide with counting and locking device in partial representation in longitudinal section and in the representation in the middle in the transverse direction cut and under this in a top view. A vertical section is shown on the right. The end roller (486) of the control arm of the central pin acts on the wedge bevel of the slide (487) when the same is lifted, displacing it to the left. The spring-loaded locking pin (488) takes the valve opening slide (489) with it, which lowers the cap pin (461) by means of its wedge bevels and thus opens the valves after the CO2 gas pressure capsule. The profile guide (490) of the cover plate (492), by deflecting the guide pin (491) for the raster pin, causes it to be displaced against its spring. This unlocks the two sliders (487, 489) from each other. As can be seen particularly clearly on the vertical section on the right, the edge rod (493) emanating from the central pin has a lateral switching knob (494) which, when raised, comes to rest for a stroke in an incision in the valve opening slide and thus its return movement under effect the compression spring (495) prevents. In the highest position of the central pin, its switching knob leaves that incision in the valve opening slide, so that the latter can return to the starting position with the valve closed. The slide (487) can only return to the starting position under the influence of the compression spring (496) when its wedges have left the end roller (486) after lowering the central pin and the wedge bevel of the slide. This backward movement takes place only under the action of the compression spring (291) by the movement of the cover slide (292) - which is shown in Fig. 13 via the action of the wedge bevels on the end roller (498). The cover slide, in turn, is only activated when, by lifting a dosing spindle (263) because of the connection of the same, the cross pin (266) has been raised via a locking step in the oblique slot (267) via the connecting bracket (476) (Fig. 13, 19). With the Raising the connecting strap but also the trigger rod (60) of the ventilation valve (324) attached to it is raised against its suspension and the suction bell is re-vented.

FIG. 24 shows the counter mechanism for the number of doses in longitudinal and above in cross section. The stick (502), which extends from the half-channel in the extension of the central pin, actuates the counter transport by lifting the pinion (504) within the switching socket (503), the four switching cams (505) of which are guided within the four axial control grooves (406) become. Raising and lowering cause equal rotation of the high and narrow gear (507), which protrude from it onto the flat and wide gear 508), which serves as a counting wheel and carries a number scale. The counter wheel is mounted on the pin (512) with a fine thread, which is gradually raised in its threaded bushing until the cam (509) - after emptying a cannula magazine - hits the locking pin (511) on the locking slide (510) sprung to the left The lock can be released by pressing the same (after renewing the cannula magazine). If the insulin supply is exhausted, the cam (509) hits the locking bar (513) on the locking slide. The lock is released by unscrewing the large gear (508) using the socket wrench (514). The number of revolutions takes place according to a table attached to the device, to which the number of uses is assigned to the height of the two adjustable insulin doses. Figure 25 shows in longitudinal section on a scale of 5: 1 the mechanism of the counter transport with pinion (504), switching cam (505) on this, switching socket (506) and small gear (507).

Figure 26 gives a 5: 1 scale of a winding of the inside of the switching socket (506), the arrows indicating the path of a switching cam (505). Figure 27 shows a longitudinal section on a scale of 1: 1 Cannula magazine (262). The cannula damming tube (289) at the bottom has been schematically and dashedly converted into one that returns used cannulas to the magazine. A magazine cross section within the upper magazine sheet on a scale of 5: 1 with a flattening continues to the right in the sheet and shows in longitudinal section the position of stacking cannulas with a curved back (515), which is also shown in cross and vertical section. The pressure spring (516), by thinning the magazine wall, causes the pressure against the medicine outlet opening. At the edge of the cannula magazine, a sliding contact (584) to the electrical line (364) is shown, thread bridges (583) couple cannulas. FIG. 28 shows a metering pump in a longitudinal section on a scale of 5: 1, in which the drug flow is from bottom to top. Such a pump can be used in devices according to FIG. 13, but also according to FIG. 78 or 82. It consists of an outer bulb (518) which is sealed against the cylinder (519) by means of the seal (517); further from the inner piston (520), which is displaceable in the inner bore of the outer piston and can be closed against the conical bevel (523) by means of the sealing ring (521) by lifting the inner piston on the piston rod (524). When the piston rod is lowered to the valve opening after the metering stroke has ended (upwards), the inner piston finds resistance on the compression spring (581), which rests against the stop bush (518) screwed into the outer piston. The two pistons can thus be lowered together with the flow of liquid. Dosing is carried out by lifting the piston rod (524) after the valve on the sealing ring (517).

The cross-sectional view to the right of the longitudinal section shows the liquid passage channels (525, 526). To start up an injector according to Fig. 13 to 26, a protective cover film is first pulled off over a slide-in part, which is replaced as a whole. Water is conveniently poured past the CO2 gas pressure capsule from a prepared syringe. The insert part is then placed under the cover bridge (260), the fastening spindle (279) is inserted into the wall channel (460) of the insert part (see Fig. 14) and this is screwed to the device part when using the holding arm (341) as a lever arm. The cannula (297) to the gas storage space (480) penetrates the associated seal and the air-free liquid coupling to the bag (271) and to the syringe barrel (272) is accomplished. After a predetermined time the Quellsti ft (270) has taken up so much water that it has raised the CO2 gas pressure capsule against the mandrel (358), the latter having penetrated the soft iron seal. A cannula magazine is then inserted from above. Until the tube with the drug outlet opening (440) in the wall of the cannula magazine (see Fig. 14) is completely seated, the central pin (433) must be raised briefly to allow the magazine to pass the grid ball (527). The dosage levels are now set on the dosing screws by height adjustment on the spindles under comparison with a scale - for example for morning and down. Then the compression spring (284) is tensioned by pulling down the drawstring (288) with inserted fingers. The piston (168) is lowered and fills with auxiliary liquid from the bag (272) via the feed line (528) and the slide valve (Fig. 13). If the flaps (445) are pressed together, the cover slide is moved to the left against its compression spring (291). The piston of the slide valve (265) is lowered and the discharge channel (529) to the syringe barrel Approved. Via the sockets (235), from which the lines (364) to the sliding contacts (584, Fig. 27) for the cannula contact extend, the connection to the measuring device follows first. The counter wheel for the function lock after cannula or insulin reserve exhaustion must be turned back, otherwise the movement of the central pin in the switch socket (503) is blocked (Fig. 24). When the suction cup cover (342) is swiveled away, the last cannula closing the magazine - a shaftless cannula body at the beginning of the magazine - is removed via the cannula damming tube (289). If the suction cup is pressed against the skin, the slightly protruding central pin is raised before the suction cup edge is touched and the gas flow to the gas jet pump (257) is released. The grid ball (527) returns to the flattening of the central pin (Fig. 18). The cannula thus comes in deeper under the influence of the influence of the gas line between the back cheg valve (295) and the sealing body (585) at the end of the cannula magazine and the skin, the previous Broken cavity connection is restored between the cannula shaft and the medicine outlet opening (440). During the further raising of the central pin, which can take place on the slide (487) due to the special nature of the wedge profile design (Fig. 24) without resistance due to the skin being raised, the latter actuates the trigger (419, Fig. 20, 21). Thus, the sliding cylinder (285) is moved by means of the compression spring (284) together with the piston (268) on its piston rod (524) as far as the wedge (287) comes to its stop. the dosing nut (264). The auxiliary liquid is brought via the slide valve behind the separating piston (276) and with it also displaces the medication located underneath, which empties into the tissue via the cannula. The conical narrowing of the syringe barrel is selected so that it abrades the wall of the wax jacket (276) compensates without any liquid transfer. Because of the higher viscosity of the auxiliary liquid, in the event of an accident, medication would rather be pushed up into the medicament than the auxiliary liquid downwards. The play of the dosing spindles on their connecting plate (476) was included in the dosing distance. When the dosing spindles are raised, the slide valve is also raised and its cross pin extends beyond the short vertical distance in the oblique slot (267). The sliding coupling tappet and the actuation of the ventilation valve (324) allow the sliding coupling (269). It is caused by the right movement of the cover slide under the flap opening. If the patient wants to make a dose correction after reading the measurement result by turning the dosing screw during skin contact, he keeps the two flaps pressed together until he wishes to be re-vented.

FIG. 29 shows a longitudinal section of an electrically operated injector with step syringes for two different medicines. The two stage syringe cylinders (272) are inserted into the container cylinders (820). The separating pistons (275) lie above the medicinal liquid, above them inside protective bellows (854) and the threaded spindles (856) are secured against rotation. Be shifted in height. the latter by the internal thread of the small gear wheels (839), which are driven by the large gear wheels (859) via the electric motors (855). The cover plate (819) holds the gear wheels on the housing. While these motors are behind the cutting plane, the stepped syringes continue with their own cannula connection piece in the suction cup (173). Around the edges of the three trigger pins (853) are arranged, the pressure contacts must be closed in order to Switch on the compressor (830), which is located behind the suction bell. The contact rods (858) for the cannulas are actuated by plugging them onto the respective cannula connection piece. The central sensor pin (829) conveys through contact with the lift what initiates the injection process. It is generally sufficient to choose a type of earth fault contact here, without additional effort for a switch actuation. The switching wheels (832) for preselecting the dose are arranged on both sides of the switch housing (839) with the control unit.

FIG. 30 shows a top view of the injector of FIG. 29. In addition to the gearwheels, the fastening screw and holder (878) can be seen. You can also see the switch button (864) for motor return to raise the threaded spindles before removing the syringe barrel, the program changeover switch (864) and the pressure switch (874) for the ventilation valve (875) with the ventilation channel (870). The location of the bat t er ie (845) is also given.

FIG. 31 shows a circuit diagram in TTL for FIGS. 29 and 30. Section (A) designates the energy supply, (B) the selection of the dosing program, (C) the check of the start requirements, (D) programming of the dosing, (E) the recovery the starting conditions. By attaching a cannula, one of the contact rods (858) is actuated and the associated contact is closed and compared in part C by means of the two AND gates (1) TTL SN 7408 and the. EXOR gate TTL SN 7486. From there, the line leads to the AND gate (2) TTL SN 7408, which interrupts the circuit to the 830 compressor. If the AND gate on the suction cylinder is closed three times (by placing it on the skin), the flip-flop TT1 SN 7474 switches via the Transi. stor (1) the compressor (830) running in reverse, ie sucking. There is now a vacuum in the suction bell in the suction bell, the skin is lifted into this and in turn actuates the contact rod (829) and thus the NAND gate TTL SN 7400 from position low to high. In part D for stepper motor selection, depending on the position of the bistable relay via transistor (2) or (2), the stepper motor is closed via the NOR gates TTL NN 7402

Dosing spindle 856 or 856 brought from low to high when bistable relay and compressor are switched on. The cam contact (856, 856) - shown in Fig. 29 - is actuated with every revolution of the metering wheel (859,859) and leads to the TTL SN 7490 decimal counter. The counter is compared with the pre-selection switch using the TTL SN EXOR gate 7486 with assigned diodes IN 4148 until the current flow is switched from high to low at point E. From low at E the counter gate is set to zero via AND gate (3). The compressor is switched off via the AND gate (4) and the flip-flop is tilted into the rest position via the AND gate (5). Using transistor (3), Hilfeldes switch-on reset ensures that the bistable relay layer changes its switching position by switching the device on and off at button (874). The solenoid ventilation valve (368) is actuated by means of transistor (4) via monoflop TTL SN 74121 using the transistor (4), air entering the suction cylinder. For re-ventilation, the air inlet into the suction bell can also be released via the ventilation duct (870) by actuating the pressure switch (874) by manually opening a seat valve.

FIG. 32 shows in longitudinal section a variant of FIG. 29. The structure of the device is as follows:

The square shafts are located between the end plate (2) and the intermediate wall (884) of the housing (1) (885,886) in their bushings (887, 888, 889, 890). The square shafts are secured against falling out by clamping rings; the shaft (885) is connected to the drive shaft of the electric motor (855) and this in turn to the compressor (830). The first large gear wheel (893) sits on the square shaft (885) and is carried by it, the other gear wheels run on the bearing bushes except for the last large wheel (815), which is attached to the square shaft (886) and now slows down transfers the rotary motion to the metering disks (816,, 325). This is done via a shifting pinion (800) which can be moved on the square shaft (886), which through the bearing bush (890), which also acts as an S tappet sleeve while being fixed by a pawl (801) which engages in an annular groove, here in a drawn position in engagement with the inside toothed socket (802). This socket is firmly connected to the metering disc (816), the rollers of which act on the medication tube and its disc bearing by means of its rollers and can displace the medicament to the associated cannula attachment nozzle. If the plunger of the axle beech (890) is pressed, the shift pinion moves to the right and comes into engagement with the internal toothing of the shift socket (820), which is firmly connected to the metering disc (325). It is now dosed from the other storage vessel via the hose (44). After pulling the start lever (803), the centrifugal governor, whose weight-loaded swivel wing (804) is retracted from the strut of the partition (884), is mediated by. Square shaft driven by the engine. For this purpose, the electrical start contact (197) is activated when the start lever is actuated. The pot-like, hollowed-out socket with the wing arms on the square shaft, which includes the fastening head of the wing arms, is shifted to the left against its adjustable spring. This spring mechanism If the number of revolutions of the motor decreases by switching it off, the rotation of the wing arms on the housing strut is blocked in a short time. The metering takes place under control counting via the switch cam (856) and the electronic control unit (175). The sealed housing is connected to the suction bell via the suction channel (809) and has the ventilation nozzle (869). Start lever (803) and plunger sleeve (890) are sealed to the housing by bellows. Spring-loaded contact pins (858) are located next to the two cannula connecting pieces. The sensor (829) is located between the cannula connection piece and is actuated by the skin pulled up by the vacuum. There are three release pins (853) near the edge of the suction cup to start the engine. The program is selected via contacts, which are activated with the end positions of the plunger sleeve (890). The energy supply is not shown.

Figure 33 shows a simplified electronic circuit diagram. The specified voltage should be at the contact points labeled 5 V and the voltage of the switch-on reset at the contacts labeled R. For the sake of clarity, the wiring has been omitted, as have the diodes against the reverse currents. The manual actuation of the switch-on reset after setting the program preselection switch for dosing causes the voltage 5 V to be slowly built up on a capacitor in order to bring the circuit into the zero position. The bistable relay bie B is on program I or II and can be changed manually using the program change button. The pressure contact (858 or 858) is closed by placing the cannula on the cannula attachment cone and compared in part C using the two AND gates (1) TTL SN 7408 and the EXOR gate TTL SN 7486. The line leads from there to the AND gate (2) TTL SN 7408, which interrupts the circuit to the compressor (830). If the AND gate on the suction cylinder is closed three times (by placing it on the skin), the flip-flop TT1 SN 7474 switches on the reverse compressor, that is to say suction, via the transistor T (l). There is now negative pressure via hose (809) in the suction cup (173); the skin is lifted in this and touches the sensor pin (829) and thereby actuates the NAND gate TTL SN 7400 from position low to high. In part D for dosing program selection, the motor for dosing is switched from low to high via the NOR gate TTL NN 7402, depending on the position of the best-stable relay via transistor (2 or 2), when the bistable relay and compressor are switched on. The cam contact (856) is actuated with each revolution of the gear wheel (815) and leads to the TTL SN 7490 decimal counter. The counter is compared with the pre-selection switch using the TTL SN 7486 EXOR gate with the assigned IN 4148 diodes to the point E the current flow is switched from high to low. From low at E, the counter is set to zero via AND gate (3). The compressor is switched off via the AND gate (4) and the flip-flop is tilted into the rest position via the AND gate (5). Using the switch-on reset, transistor (3) ensures that the bistable relay does not change its switching position when the device is switched on and off using button 821.

Figure 34 shows a side cross-section of a medication pressure bottle, the upper wall boundary of which is drawn into the bellows (831) in such a bowl-like manner that the bottle neck together with the hose (44) wrapped around the hose attachment nipple (838) fits into the bowl recess (822), which fits the Stacking of such bottles allowed. A clamp closure (823) prevents the medication from escaping into the tube under gas pressure in the bellows. FIG. 35 shows, in a lateral longitudinal section, a variation of the container consisting of a less elastic outer shell (827) which is filled with compressed gas. In its. Inside there is another membrane-like container (408) with liquid, which is only emptied through the hose (44) when the clamp closure (823) is removed. The hose is surrounded by a fastening plate (838), sealed to this, for insertion into an injector. FIG. 36 shows a schematic top view of a suction injector as a preferred embodiment of the invention. In the cannula magazine (262), which is designed as a spirally wound hose, the storage of stacking cannulas of two different constructions is shown in longitudinal section. (The cannulas mentioned, which allow an automatic cannula change, are described in more detail in FIGS. 48, 49). The dosage is intended for two drugs, programmed and correctable depending on the measurement results. The cutting planes for the following figures are given. Shown are the cylinder (304) for receiving the suction piston, the insertion cylinder (334) with the dosing devices and medicine storage containers, the hinge joint (322) for the holding arm of the suction cup cover, the central holding tube (314) for the cannula magazine, the guide cylinder (313 ), the tube (319) for the compression spring with the Bowden cable returning the suction piston, the protective tube (320) for the exciting end for those compression springs and the guide tube (321) for the strong Bowden cable for tensioning the tension spring of the suction piston. The banderole (400) corresponds to a magazine end before use. It holds the cannulas by means of the pin (403) inserted through the wall of the tube, which are under the action of the tensioned compression spring with the sealing bodies (370) at their ends in the magazine. FIG. 37 shows the suction injector in longitudinal section A - B of FIG. 36 with the suction bell cover already open before use. The suction cylinder (301) with the sealingly ground suction piston (302) in its interior is held at its lower edge by the bottom cylinder (303) and at its upper edge by the cylinder (304) for the tensioning piston (405). The tension spring (306), which extends between the suction and tensioning pistons and is attached to them, is in the tensioned state. The suction piston is in the vicinity of the annular piston (307), which is somewhat displaceable along the central pin (308) fixed on the bottom cover of the bottom cylinder and whose concentrically arranged permanent magnets (309) which are fixed in the form of a pin on an annular skirting board on the bottom cylinder with one fixed iron ring (310) there in contact. The upper ends of the permanent magnets (309) are embedded in a soft iron ring (311), which is tightly attached to an elastic-membrane septum (312). This septum airtightly divides the cylinder space into a larger upper and a smaller lower part and is interrupted by the sliding check valve (323) in its supply line. the sand filter (393) is inserted. The septum is also sealed around the central pin by screwing. The central shaft has a spindle-shaped swell at its end with a flat curve rise at the top and a steeper slope at the bottom. The spiral spring (325) acting inwards with its Kraftwir direction just lies against the lower portion of the curve, and the screen angle (327) is locked by its compression spring in a slide of the sleeve (369) which is attached to the suction piston. The central telescopic tubes (328) between the suction and tensioning pistons are pulled apart. The central locking plunger (329) is down after its spring has been extended drawn. As a result, the locking members (330) cannot withdraw from the niche slope of the roof attachment (331) under the action of the tension spring (306). The downward movement of the tensioning piston is therefore blocked. The tappet of the ventilation valve (324) with the sand filter (393) is pressurized from the ring piston. The suction cup (351) is arranged within the guide cylinder (313) against three compression springs (354) so that the movement downwards is limited by the raster spring (353) for cannula control by means of the switching knob (355) of the switching pin (356) becomes. An elastic sealing sleeve (352) is stretched between the lower edge of the suction bell and the guide cylinder. In addition to the three bores for receiving the compression springs (354), which are counteracted by the locking mechanism (357) of the suction cup cover (342) and the compression spring (335) under the fixed housing (315, Fig. 39), the suction bell also contains the downward one funnel-shaped opening (359) for the switching pin, the guidance of which with a certain elasticity of the holding arm (341) for the suction cup cover the vertical approach of the

Receiving tube (358) allowed for changing the cannula. A small tube (459) which can be displaced against a compression spring on this receiving tube has claws (361) which act on the cannula by means of slits in the receiving tube at its lower end. In the opposite direction to the claws described, spring claws (360) originate from the ends of the receiving tube, which, after pushing back the spring-loaded tube (459) by pressing against the central holding tube (314), latches into the ring groove of the cannula last used after this had been depressed in the cannula magazine due to the momentary retrieval of the raster spring (353) by the switching pin (356) under the influence of the compression spring (Fig. 36). The lowering of the tube (459) when closing the lid also causes the un cannulas inserted in the receiving tube are pushed further down by the claws (361). When the suction cup cover is opened, the switching knob (355) in turn passes through the raster spring (353), whereby the next cannula in the cannula magazine can step deeper. This then lies with the lower edge of her body of the detent spring, while the annular groove (381), which is in hollow connection to the cannula shaft, comes to rest through the bore in the cannula magazine for the angling (340) of the medication tube. The previously used cannula is removed with the lid opening lying in the receiving tube, where the spring claws (360) prevent it from falling out. The bayonet coupling (362) can be seen on the holding arm (341) under the suction bell cover (342).

In the cross section above the suction cup, in addition to the position of the cannula magazine (316) in the central holding tube (314), the three compression springs (354) and the passage (359) for the switching pin can be seen. In both slots (363) the two tubes with the bend (340) for the drug supply and in the central holding tube the two electrical lines to (364) from the sliding contacts on the cannula to the control unit.

The cross-section on the right explains the position and function of the spiral spring (325) under the final piston expansion of the central pin (308).

FIG. 38 shows a schematic longitudinal section along section line C - D of FIG. 36 to supplement the device structure. In Zy cylinder (304) for the tensioning piston (305), this has been depressed under the influence of the tension spring (306). The suction piston (302) in the suction cylinder (301) is in turn engaged by the spiral spring on the central pin (308) and under the action of the permanent magnets at the bottom via a septum with a check valve (323) and an annular piston (307). Down in the insertion cylinder (334) are the two dosing devices (337, 338), one of the two elastic tubes with the bend (340) is recognizable. The slide-in cylinder is held by the rail (336) on a ring around the suction cylinder and pressed by the strong compression spring (335) under the fixed housing (315) with the control unit and electric battery down. The two medical supply containers are inside the slot. and thus also against the suction cup cover (339). FIG. 39 shows a schematic plan view of this suction cup cover (339). A winding of the tube of the cannula magazine (316) can be seen above the insertion cylinder. The tubes with the bend (340) enter the suction bell through the sealing sleeves (370) next to the central holding tube (314).

A slide is shown as a lock (357) for the suction cup roof.

FIG. 40 shows in a schematic longitudinal section along the section line E - F on FIG. 36 the position and function of the parts for the preparation of the suction pump function by pivoting the suction bell cover by means of the holding arm (341). Immediately before the injection, this was swiveled out of the position (shown in broken lines) with a suction cup cover closure by 180 degrees around the hinge joint (322) to cover the suction cup in continuation of the functional stage shown in FIG. 37. Due to the tensile effect of the Bowden cable with the sheathing (344), which is passed on after bending over a loop in the protective tube (320) and is finally connected to the hinge joint at the end of the lever arm (345), the compression spring (332) in the cylinder barrel ( 319) have been brought under tension by lifting the lower guide piston (349), without the latter being able to pass on its moment of motion via the Bowden cable with the jacket (345), which is fastened to the centrally drilled upper guide piston (349). The upper guide piston had already been lowered when the tensioning piston (305) was lifted when the cover was closed. The tensioning piston was lifted while pulling on the strong Bowden cable in the jacket (346) from the end (347) of the lever arm over the guide tube. (321) When the tensioning piston was raised within the roof attachment (i.e. close to its upper end position), the locking members (330) were pushed into the niche-like projection of the roof attachment by lowering the locking tappet (329) when pulling the telescopic tubes (328), causing the return movement of the tensioning piston remains locked under the influence of the tension spring (306) (as shown in Fig. 37). By self-winding the string-like end (348) in continuation of the strong Bowden cable, the opening movement of the holding arm (341) was released. FIG. 41 shows a partial representation of the functional stage after the injection and after the tensioning piston has been reset. The suction cup cover (342) is still folded away. After opening the electromagnetic valve (324) for venting the suction cylinder (301), the suction piston (302) was brought closer to the upstanding tensioning piston under the action of the tension spring (306). After relieving the tension of the tension spring (306), the locking plunger (329) was raised under the action of its spring, so that the locking members (330) dodged into the ring notch of the locking plunger under the action of the lower wedge in the recess of the roof attachment. Now the compression spring (332) was able to relax by pushing the tensioning piston (305), which had already been depressed under the influence of the suction piston and the tension spring (306), completely downwards by means of the Bowden cable in the casing (345) . Finally, the suction piston came under the influence of the permanent magnets (309) and the bending spring (325) snapped onto the central pin (308). At the same time, the grid angle (327) and thus the suction piston were locked in relation to the grid ball K 366). The lowering of the ring piston (Figure 27) had caused the grid ball to escape into its niche intended for this. Under the action of the compression springs (354) was now the suction bell (353) in her leadership cylinder (313) lowered against the skin. At the same time, the ventilation valve (324) also opened due to the impact of the ring piston against its valve tappet and the suction bell was re-vented through the hole for the grid ball (366). (Fig. 37, when the tensioning piston is at a low level as in Fig. 38). FIG. 42 shows the schematic functional sequence for the suction piston tensioning mechanism at the stage when the suction bell cover closes. The tensioning piston ((305) has been pulled up on its bracket (531) via the strong Bowden cable in the sheath (346) while stretching its string-like end (348) into its upper latching position when the cover is closed. The tension spring (306) was tensioned in the process The Bowden cable in the casing (344) was relaxed and the lower guide piston (349) was lowered with the relaxed compression spring, whereby the upper guide piston (350) was also pushed down by the Bowden cable in the casing (345) in the cylinder tube (319) The extended telescopic rail (343) can serve to extend the holding arm (341) for closing the suction bell cover .. Figure 43 shows in longitudinal section a detail of a variant of the trigger mechanism for the suction piston, which makes it possible to avoid the septum and the movable ring piston. Instead of the raster ball 366), a plunger (406) is sealed by a bellows, which engages on the left with a notch in the suction piston (305) The bending spring (325), in turn, brakes the upward movement of the suction piston under the action of the tension spring (306) on the piston-like expansion of the central pin (308). The ventilation valve (324) is opened by resting the suction piston against the spring-loaded valve tappet and thus also connecting the suction bell to the outside air via the duct (532) via the sand filter (594). The bore for the check valve (323) runs parallel to the tappet (406). If the suction cup is lifted, its trough (365) in the area of the tappet tip, which enters into this under the action of the wedge bevels of the notch in the lifting suction piston. Now the suction bell is locked, the vacuum that forms in the suction cylinder when the check valve (323) is opened and sucks the air out of the suction bell through the air duct (533). The ventilation valve (323) has closed and is only opened again by returning the suction plunger with ventilation of the suction cylinder via the electromagnetic valve (not shown), while the re-ventilation via the air duct 533) is until then closed by the check valve (323). FIG. 44 shows schematically a longitudinal section through the detail of the suction cup area of a device and the function of refilling a storage container for medication in a device according to FIG. 37. The central holding tube (314) is pushed down in its seal (534) in the suction bell cover. The medication supply tube in question is pulled at its bend (340) out of the bore of the central holding tube and inserted into a bore of the socket (535), while the other bore of the socket is connected to the medication supply tube of the new storage container by inserting the cone at the end the hose (44).

The two metering pumps are shown in a longitudinal section in FIG. 45. The medication tube (44) leads from the storage bag (408) to its sack-like extension between the pump cylinder (111) and the metering pump pins (337, 338) and continues into the tube with an angled bend (340), which via the transverse bore in the central holding tube (314) connects to the cannula shaft via the cannula body. In the cross section shown below along the line A - B of FIG. 45, in addition to the metering pump pins (337, 338), the arrangement of the liquid pumps (409, 410, 411, 412)) can be seen In FIG. 46, the enlargement on a 5: 1 scale allows the construction of a metering pump according to FIG. 44 to be seen more clearly. Three ring-shaped notches each represent a metering chamber (416) on the pump pin. The hose ring (415) assigned to this is fixed in height in a trough-shaped bulge in the axle bushing (116). When the hose ring inflates, it displaces the liquid from the metering chamber and its surroundings and then blocks the liquid flow, whereby it lies against the groove edges. The liquid flow to the cannula leads via the channel (417). The liquid pump in FIG. 46 represents a variant. Only one of the three liquid pumps for the auxiliary liquid assigned to a hose ring is shown. The lifting magnet (413) and the return spring (414) act on the bellows (418) after the adjacent pulse sequence, which leads to the injection at I, while a medication return is effected at II.

47 shows two liquid pumps for actuating a metering pump as double-acting piston-cylinder pumps in conjunction with a solenoid (413) and return spring (414), the two cylinder ends being connected to at least one hose ring (415) via hose connections stand. The middle hose ring is connected to each of the two opposite cylinder ends by a hose. Fig. 47 also illustrates the pump function. In the basic position A, both pistons are lowered under spring action. The top hose ring is relieved of liquid, while the lower and the middle hose ring are inflated by excess liquid. In position B the top magnet received an impulse, which inflated the top hose ring and relieved the middle one. In position C, both magnets are excited, which relieves the pressure on the lower hose ring and inflates the other two. The pulse sequence -, + -, ++ has the effect that a certain quantity of medication goes from top to bottom The cannula is displaced and the liquid flow is blocked.

FIG. 48 shows a 3: 1 enlargement of a stacking cannula (318) made of rubber-elastic material such as Perbunan. Special sealing elements, in particular around the medication inlet channel or in the cannula magazine, are not required for their use. The upper and lower chamber are connected to each other via an articulated waist. The upper chamber for receiving the shaft of the attached cannula can be designed to be relatively narrow, since bends in the magnesium tube are compensated for at the waist. The silver-plated strip (382) extends from the bottom surface to the cannula shaft as a conduit. The enzyme coating (383) is indicated on the cannula shaft. The cannula bodies can be glued together at their edges before use, which guarantees sterility of the cannula shafts.

Figure 49 shows another stacking cannula in longitudinal section. The cup-shaped cannula body (317) is divided by a partition (318) into a lower chamber for fastening the cannula shaft (379) in its base plate and into an upper chamber for receiving the cannula shaft of the subsequent cannula. The upper chamber is closed off by a membrane (380) drilled in the center. Within the lower chamber, the cannula shaft bends at an angle to an annular groove (381) surrounding the cannula body, into which it opens. The annular groove has a steep surface at the bottom, which holds the claws (361) of the cannula receiving tube, and gently slopes upwards to facilitate the transport of the cannula downwards, the claws having to leave the annular groove. The distance of the annular groove up to the same has a strip with silvering, while the cannula shaft itself is platinum-plated in order to pass on weak currents to the contact spring in the central holding tube for the cannula magazine without voltage distortions. The cannula body is made of cast plastic material such as polyvinyl chloride. The required ring seal within the central holding tube (314, Fig. 37) was not shown. The enzyme coating (383) is shown. The current is transferred via the silver chloride-silver layer of the detent spring (353) for changing the cannula, while the undersurface is electrically insulated to prevent skin contact. On the other hand, the use of a contact gel, as is customary with cardiac current leads, is necessary in order to ensure the comparison electrode for measurements from the silver-plated edge of the suction cup. A ring-shaped adhesive electrode (Fig. 94) that glues on both sides can also be used, which is glued to the edge of the suction cup and is well conductive to the silver layer. By means of such an adhesive connection, the application safety can be increased as long as considerable reaction times are required until the measurement is completed, since the maintenance of the negative pressure in the suction bell is even better guaranteed. The annular groove (582) in Fig. 49 serves for the determination by the locking spring (353). FIG. 50 shows the variation of a lowering cannula in oblique view at the top in longitudinal section and at the bottom in cross section on a 5: 1 scale. The cannula shaft is ground behind the area of the still closed tip (541), so that the cannula bore as a trough (542) would be open. The shaft wall was closed to the cannula shaft by the plastic insert (543) with insulation zones (544).

FIG. 51 shows a different variation of the sensor cannula in longitudinal section and below in cross section. Inside the shaft there is an almost capillary thin tube (545) or a thread, the surface of which can have sensor properties. As in the others, in addition to blood, tissue fluid can also be caused by the capillary effect (or can be sucked in by suction from the drug supply tube) for the determination of the measured value.

FIG. 52 shows a longitudinal section through the shaft end of a cannula, in which the wall in the tip region is thinned from the inside and coated with the sensor covering (383), so that the latter cannot be stripped off when the skin is pierced. The stability of the cannula shaft is maintained by the thicker part. A wire (577) for current dissipation can be seen inside the shaft.

FIG. 53 shows in longitudinal section a sensor cannula similar to that of FIG. 50. However, a tube (545) or thread with sensor properties is inserted into the open recess (542) of the shaft.

Since the handling of the glucose-specific enzyme coatings exceeded the present possibilities of the inventor, an electrolyte-containing gel with sugar-specific adsorbent as doping was provided as a coating for changing the electrical conductivity on the platinum cannula in connection with the measuring device (e.g. the adduct Sepharose -Concanavalin A from the Pharmazia FreiburgBreisgau).

FIG. 54 shows a photometric version of the sensor cannula, for example for glucose determination, the light source (560) and the optical detector (561) and the cannula being shown in longitudinal section. Within the cannula attachment piece (47) which surrounds the cannula shaft (379), at least one fiberglass thread (885) leads later in the clearing of the shaft (379) to the cannula tip, which is applied with an indicator layer (886) under curvature or inclination. At least one other fiberglass thread runs back from that indicator layer through the shaft. The contact ring (587), from which fiberglass bundles lead to the light source with polarization filter (583), and others lead back to the detector, lies around the end of the medicament to be supplied with the cannula attachment cone. If the cannula is inserted into the tissue, the In reacts indicator layer with the tissue glucose with discoloration depending on the glucose concentration. The attenuation of the returned light signals can be evaluated according to a calibration comparison to the measured value. Two fiberglass threads can also lead to two indicator layers of different quality and back, the latter possibly being sensitive to different measuring times for different concentration ranks. Such optical indicator layers for glucose determination are, for example, paper impregnated with glucose oxidase and peroxidase, to which 3.55.5 tetramethyl 1-benzidine-dihydrochloride or 4-aminoantipyrine dihydrochloride and sodium 3,5-dichloro-2-hydroxy-benzenesulphonate is added as colorant.

Figure 55 shows a longitudinal section of a sensor cannula, in which instead of a color indicator, a crescent-shaped mirror (588) is attached in the tip area of the interior of the shaft (the mirror can consist of evaporated silver, which is coated with silicon dioxide to protect it against oxidation The free light beam to the mirror is shown in dashed lines, where it is reflected back through the tissue fluid from the other side of the mirror and a fiber of the optical fiber bundle meets the detector. The rotation of the plane of polarization by the glucose is evaluated in the computer Figure 5.6 shows another embodiment of the invention according to Figure 55. In order to avoid the problematic and complex optical coupling between the optical fibers in the cannula connection piece and those of the device, the light rays are emitted from the sparkling wine disc (589) directly through the center bore of a stacking cannula (317, for example) in the cannula shaft projected in and received from there again in the device part and forwarded to the detector in optical fibers (885). The cannula bore is closed at the bottom by the window membrane (590), which allows the light rays to pass through, but not the medicine. The latter is injected laterally from the annular groove (381) from the medication outlet opening (440) through the holding tube (314). After the injection, the centering cone (594) is pulled out of the central bore by lowering the sector disk (589) and the passage of the next cannula to the medication outlet opening is released by pivoting about the (only indicated) axis in the manner of a transport carousel (211). The mirror (588), like that of FIG. 55, is vapor-deposited from silver or aluminum.

FIG. 57 shows in a side view and below in a cross section a part of the switching rings for the electronic programming of an injector as described in FIGS. 36-44. On the switch strip (371) of the switch housing cylinder there are two adjacent pressure contacts for a switch ring (372), which are actuated one after the other in a wave-shaped design of the inner limit of the switch rings, depending on the direction of rotation, in the opposite order, whereby the ball grid ( 373) the adjustment is only guaranteed in whole switching steps. With binary coding, the individual parameters, such as tissue sugar values or insulin quantities for dosing can now be recognized in their respective target or actual values, displayed and evaluated arithmetically. In practice, 20 switching steps already seem sufficient. At the time, the hourly intervals with a break between 0 and 5 a.m. (whereby a day-night reversal can be compensated by changing the timer), with the tissue sugar levels in mg /% 20.30.40 ... to 100, then 120, 140, 160 ... to 300, then 350 and 400, switching levels 0, 1, 2, 3 for the insulin quantities in units 4,8,12 ... 80 and for the multiplication constants (K1 for depot insulin and K2 for altinsulin). to 19. As a reference line for the reading, edge projections on the fixed intermediate rings (374) and wire bracket (375) on the switching cylinder, or in its place a transparent plastic strip with an optical magnification effect, which can be turned away from the reading area so that they are raised designed numbers for program archiving can be printed. Protruding edges (376) make it easier to turn the shift rings and prevent over-turning in one direction. Adjacent switching rings, which are functionally assigned, can each have a pin (377) with a hook-like bend, which abuts against the edge (376) and thus causes the switching rings to be carried along automatically. It is recommended 4 programming blocks (I-IV), each with the same composition, for four pre-programmable administration times, each with a pre- and post-deadline that can be pre-selected after hours, as well as a supplementary block (V) that is available as often as required after injections, for the additional administration of quickly effective old insulin all to compensate for diet or setting errors, whereby it is the responsibility of the doctor to adjust the depotinsulin dosage in a reasonable manner.

FIG. 58 shows a table with the compilation of example programs and their effects on insulin treatment. They were patients with morning insulin doses in the lowest to the highest doses corresponding to a very different response to this therapy. No determinations were made about the schedule, the tolerance range of the target sugar levels was set at 90 - 120 mg% with an ideal value of 120 mg%. The measured actual values for glucose are also simplified with one time 180 mg% and another time with 50 mg%. Only the correction factor K2 for depot insulin was varied according to the estimate and a correction with old insulin was not included. the columns of the dose correction, which is carried out by the computer, are shown for clarification. The result of the correction, which consists of an increase in the case of the sugar level of 180 mg% and a decrease in the case of the sugar level of 50 mg%, can be seen from the last two vertical series of numbers. Theoretically, patient 2 would have to receive 56E depot insulin at a blood sugar level of 180 mg%, but this is not possible due to the maximum dose being exceeded, but instead leads to supplementary program V with old insulin. The same patient receives no insulin at all with a sugar level of 50 mg%. A patient who is particularly at risk from hypoglycaemia must be advised to measure and inject before meals in order to avoid additional old insulin administrations. On the other hand, another may intend to have a more abundant meal to take time, postpone the injection to a time after a meal and thereby obtain additional units of old insulin.

If programming should also be carried out by the doctor and therefore a blocking of the rotation of the switching rings by the pressure of a screw-operated screw (384) is provided, which is favored by ribs (385, Fig. 57) on the flat sides of the switching rings the patient has a number of duties to cooperate and influence, which is also evident from the description of the functional overview. FIG. 44 shows such a functional overview, from which any trained specialist can easily derive an electronic block diagram.

Below are the functional organs with rectangles and circles, such as timer (386), suction cup (173) with cannula in the earth fault through the skin pulled up by means of negative pressure, reminder and warning device (387) with the functions of acoustic and optical signal and vibrator to show the To facilitate operation for the disabled (all separately on hand switches 1/0), the electrical measuring device with the measured value display and printer (389), measuring display and printer for dispensing insulin units (390) and for old insulin units (391) as well as the metering pumps (337, 338 ). The setting ranges of the switching rings can be found above it in rhombuses, and the measurement data of the actual glucose values and their arithmetical processing in rhombuses and rectangles with broken lines. The timer gives the respective time of day via line (a) to the alarm clock for comparison. A computing element determines how much time before the alarm time and afterwards a signal from the measuring device (388) towards the pumps via line (b) takes effect. The path of line (d) from the cannula to the measuring device (388) and its display and printer is always clear. If the measuring device fails, the patient can still call up a standard dose via hand switch (390) in line (c). The set wake-up time is shown on line (e) the warning device (387) activated. If the planned time for treatment has already been exceeded, the follow-up program is selected; this is also possible if program I is switched off on the hand switch (391). If program II is also switched off by hand, there is no dosing. The choice between two programs at the same time increases the adaptability between lifestyle and treatment. After programming the time (read from left to right), the setpoint program for the tissue sugar level with the desired ideal value in the middle and the limit values above and below (until no dose correction is to be achieved) follows the line (g) until the dashed vertical lines arrows arbolize this computational determination of the permitted deviation in comparison with the pre-programming. The fourth, lowest rhombus denotes the (dangerous) outermost low value, from which a stop signal is sent to both pumps via line (h) under registration. If the sugar values are higher, line (i) continues in the direction of the dosing programs. If the measured sugar falls below the uncorrected approved value, the amount of the deduction of depot insulin units is determined by arithmetical determination of the deviation from the ideal value and multiplication by the factor Kl determined by removing the lower rhombus from the standard dose, and after deduction from the Standard dose according to line (k) are made via line (l) display, registration and dosage. Altinsulin delivery is switched off via line (m). With measured sugar values within and above the permitted tolerance, the line (s) leads to the activation of the program for the old insulin, whereby any preprogrammed administration of old insulin according to the arithmetical comparison between excessive value and target or ideal value after multiplication by the factor K2 over line (p ) is encouraged to register and dose. If the preprogrammed maximum dose is exceeded, the addition is made via line (q) The program is reserved so that it can be recalled and used within the time limits programmed there using the warning device. Via line (u) the electromagnetic valve at (368) is opened for re-ventilation. Revitalization also takes place via line (v) after measuring the tissue sugar level alone without delivering insulin (for example outside the specified time limits or at the patient's will). The patient can use the pressure switch (392) to interrupt the course of the command in the direction of the injection after the skin has been sucked in during the measurement. If he lets go of the pressure switch after taking note of the measured values, the fuel is injected (somewhat delayed). However, if he presses the pressure switch a second time after a short time, the injection is finally stopped with re-ventilation. Additive counting of the quantities delivered by the individual pump controls the medication consumption and can be queried via the lines (w, x). After pre-programmed volume consumption, registration and alarm are carried out via the lines (r, s). The cannula consumption is also reported and registered via a counter after contact counting at the contact (392) in the area of the suction bell according to the actuation by the switching pin (356) via line (t). With regard to the construction of the sensor cannulas, the invention is based on the following writings and the literature drawn therein:

I. Implantable Glucose Sensor, E. Wilkens and M. G. Wilkens: J.Bieo med. Eng. 1983, Vol. 5, October, 309-315.

2. Problems in Adapting a Glucose Oxidase Electrochemical Sensor Into an Implantabel Glucose-Sensing Device, Daniel R. Thevenot, Diabetes Care, Vol.5 No 3, May-June 1982, 184-189. 3. Progress Towards an Implantable Glucose-Sensing Device, David A. Gough, John K. Leypoldt, and John C. Armour: Diabetes Care, Vol. 5 No 3, May-June 1982, 190-198,

There is also an electronic delay of a new printing process with continuous transport of the registration tape in order to keep the printed data legible. It is more advantageous (because of the energy saving) to run up the registration strip according to the elapsed time each time it is used. An automatic program is also provided in order to clear up obvious incorrect programming on the part of the doctor, which repeatedly necessitates synchronous dose corrections. Such an automatic program is also advantageous if the patient's life circumstances change without the need for medical help. Even in the short term, the sensible patient must be able to change the insulin doses within the free spaces defined by the doctor. Using the button (586), which can be locked by the doctor, the patient can add additional insulin for injection, either pulse-wise or intermittently, if he carries it out the next minute after the command. The doctor can limit the absolute amount of the total replacement dose within an already restricted scope. A special switching ring is provided for the commands limiting a patient's choice. For example, its position means 1 = blocking the automatic program (see below) for old insulin, 2 = blocking the automatic program for depot insulin, 3 = blocking the entire automatic program, 4 = limiting the additional dose to 15 cycles, 5 = limiting to 10 cycles, 7 = blocking the additional doses, 8 = limitation of the additional doses to 15 cycles and blocking of the automatic program for old insulin, 9 = limitation of the additional doses to 10 cycles and blocking of the automatic program for old insulin, 11 = blocking of the additional doses and the automatic program for old insulin, 12 = limitation of the additional dose 15 cycles and blocking of the automatic program for depot insulin, 15 = blocking of the additional doses and automatic program for depot insulin, 16 = limiting of the additional doses to 15 and blocking of the entire automatic program etc. A decoding disc (595) is on the device cover brought, which is expediently rotatable itself as a switching ring. “Automatic program” is to be understood as the device which corrects incorrect programming for the dosage adjustments. If a correction dose is called up four times in succession in the same time block because of excessive measurement values, the depotinsulin dosage is increased by 1 cycle for the time preceding the measurement times. If the programmed correction dose reaches the set maximum value without full compensation (becomes an additional injection from the block

V prompted), the depotinsulin dosage of the previous time block is increased by 2 cycles. The increase takes place within each block at every occasion after measurement. If the lower limit for dose correction is undershot with any use of the device, the depotinsulin doses are reduced by 1 cycle for the time block preceding the measurement time. If the lower limit for the dose stop is reached, there is a reduction by 2 cycles, insofar as the supplementary program in the past two hours

V was not pressed.

The patient's involvement is required to activate the automatic program for the old insulin. When the program key (597) is pressed, the time block allocation is overridden and block V is selected if no depot insulin injection has taken place in the last 6 hours. The patient should eat a meal with 3 bread units of easily absorbable carbohydrates about 15 to 20 minutes before the button is pressed and is asked to carry out the control measurement within 15 to 20 minutes after the altinsulin dose, the amount of which corresponds to the pre-programmed correction program. If the measured (actual) value exceeds the ideal (target) value by more than 40 mg%, the dose correction factor (K2) is increased by 1. If the actual value falls below the setpoint by more than 20mg%, the Dose correction factor (K2) reduced by 1. In all corrections, the display prompts the patient to occasionally repeat the program test. The status of the actual program setting (in any deviation from the starting position readable by the switching ring position) can be made visible on the assigned display fields by a slight rotary movement on the switching rings. The doctor can make the changed program values visible through the switching ring position by resetting the switching rings after resetting to the zero position (with simultaneous actuation of both contact pins on the switch strip (371) arranged, the extent of mobility is limited by the locking pin (275), which extends from the edge ring into a slot on the carrier ring, to a distance below the distances between the individual locking steps of the ball grid (373) A shaft top of the inner profile of the switching ring hits the contacts (598, 599) of a contact strip on the housing.Cylinder (315) and closes the contact to the control unit when the knurled ring turns. The return spring (600) between the edge ring and the switching ring interrupts it again.

When activating the automatic program for old insulin, a distinction must be made as to whether the adjustment of the correction factor for program V to the metabolic conditions is intended (and this type of correction was shown above) or whether the pre-programmed amounts of old insulin in the individual blocks should be changed. The correction of the latter additional doses of old insulin to the depot insulin doses (in exceptional cases also the sole administration of old insulin) is carried out automatically if the patient uses the injector again 15 to 20 minutes after an injection (insofar as a correction is not blocked). Description of the program flow

The main program (HP) loop queries whether the cannula has skin contact (1) so that a measurement (6) can begin to determine whether the wake-up time (2) of an active time block has been reached, so that the user (by wake-up signal) Attention must be drawn to whether the user wishes to shift (8) the time blocks (3), whether (4, 5) one of the storage containers has been replaced, so that the storage counter is set to the value of a new container (9, 10) got to. (Fig.60)

The operation (12) of the internal clock and the Stellringkon contacts (13) is so time-critical that it interrupts the main program if necessary. (Fig. 61) Figs. 62-65 are a refinement of block (6).

After the measurement (14) it is decided (15, 16) whether the automatic program (17) should be effective for old insulin. If this is not the case, the time is not in any time window (20) of the programs I - IV and the user does not press the key (21) "program V" within the next 15 s (23) or program V has been selected , but the lock-up period has not yet passed (22) since the last injection, the process is terminated by venting (18, 19). (Fig. 62)

If the choice (24) between two programs is possible, the position of the program selector is queried if a decision has not already been made on the same day. If the measured value is not within the tolerance window, the insulin doses are corrected (27, 28). If the measured value is exceeded, function blocks 27, 31 to 35 follow. In addition, the automatic program for depot insulin either 29, 30 or 31 to 35 becomes effective if it has not been blocked by a doctor (29, 31). (Fig. 63) The injection takes place after 15 s (41) if the user does not press the "Wait" button. Pressing this button (392, Fig. 59) twice (37) leads to an abort (42, 43) without injection. With the "+" and "-" buttons to make visible.

For this purpose, the edge ring (316) which is respectively supported on the switching ring (372) is rotatably arranged with respect to the former, the extent of the mobility by the locking pin (275), which extends from the edge ring into a slot on the carrier ring, a distance below the distances of the individual locking steps of the ball grid (373) is limited. The sliding contact (226) on a shaft top of the inner profile of the switching ring strikes when the

Edge ring on the contacts (598, 599) of a contact strip on the housing (315) and closes the contact to the control unit. The return spring (600) between the edge ring and switching ring interrupts it again. When correcting the programming of the Altinsulin, a distinction must be made as to whether the dose correction is adjusted to the metabolic conditions via program V (as described above) or the preprogrammed amounts of Altinsulin of the individual blocks. The correction of the latter is expediently carried out automatically if the patient uses the injector again 15 to 20 minutes after an injection in the manner described above.

Figure 66 shows in longitudinal section an example operated with spring force, in which a hose roller pump is used as a metering device. On the housing cylinder (1) is on the closing plate (2) on the fastening tongue (3) Be a mounting plate (4) as a counter bearing for an interchangeable cylindrical vacuum reservoir (5). The latter has a membrane cover (6) around the cannula opening cone, which is located in the center of the pin (7) and continues in the cannula shaft with its free end (8), which is surrounded by the ring coke (9). The boundary membrane (10) divides the potty into the vacuum storage space (11) and the suction bell (12) and has the predetermined breaking grooves (13). On the fastening plate (4), the support ring (15) is fastened via four screw pins (14). Parallel to this and to the mounting plate on the opposite side of the housing cylinder via the base (16), the base plate (17) is fastened by means of the plug lock (18), which plate carries the container cylinder (19) with a side slot for the Introduction of the medicine storage bag (20). Via the angle arm (21), a cam engages in the longitudinal groove (22) of the sliding sleeve (23) from the base plate in order to rotate it. prevent. A driver pin of the metering disc (25) causes its rotary movement in its spiral groove (24). There are evenly distributed clamping pins (26) on the circumference of the metering disc, between which spring steel tongues (27) are locked on the trigger pin (28). The drive of the metering disc (25) by moving the sliding sleeve is transferred via the pipe segment (29) to the disc with the latch (30) and to the coil spring (31). The latch (30) acts on the locking gear (32) on the Rohrmanschet te (33). The pinion (34) attached to the latter actuates the counter, whereby it engages in the ring gear of the counting wheel (35), which lies behind the image plane and is held by means of the pressure spring (36) against a support plate (77) on the housing cylinder. Federed pins on the counter wheel (38), the compression spring (39) of the support wall (37) is based, cause frictional contact with the Pinion the rotation of the counting wheel (38), whereby an armature on the support plate (77), via the actuation by a switching pin on the counting wheel (35), only allows rotation by one of 100 teeth on the counting wheel (38) after the respective counting wheel 35) made a full turn. After the drug supply has almost been used up, one of the spring-loaded pins, which has a different center-to-center distance, engages in a bore of the pinion and also blocks the rotation of the metering disc (Fig. 68). About the pipe sleeve (33), the force of the spiral spring (31) is transmitted to the carrier disks (40) for the axes of the two rollers (41). The latter are pressed against the hoses (44) by two balls each in tubular bushings (42), the fluted ring (43) serving as a counter bearing. The latter has a gap at the bottom for the passage of the two hose legs. In this section, the hoses up to the T-piece (46) with the cannula attachment piece (47) are covered by an expansion-resistant jacket (45). Tension springs (48) stretch the hose ends where they come out of the pump. The pump unit can be moved along the sliding sleeve on the pipe sleeve (33) against the compression springs (49). (The pins for this purpose, which extend from the carrier disks (40), are not shown in the associated transverse slots in the pipe sleeve). The sliding movement is effected by four vibrating pins (50), which are arranged on an annular prism profile on the outside of the carrier disc (40) (Fig. 8). The vibrating pins are embedded in the disk (51), which can be rotated independently of the pipe sleeve and engages with a cam in the spiral groove of the axle shaft (52). At the free end of the axle shaft is the foot plate (53), at the other end a Nockensti ft (53) which engages in the longitudinal groove of the sliding sleeve and prevents the axis rotation. The spiral spring (55) serves to drive the disk (51). FIG. 67 shows in cross section along the line A - B of FIG. 66 the mechanism of the metering adjustment. Three spring steel tongues (27), which start from rotating on the pipe segment (29) discs, lie between clamping pins (26). One of the spring steel tongues rests on the trigger pin (28) for dosing after it has passed the wedge profile bar (56) of the triggering mechanism for re-ventilation (Fig. 69). Two of the spring steel tongues shown are in a kind of blind zone of the rotating sector of the metering disc (25), as it results from the need to support the coil spring on the housing cylinder (1) and from the possibility of producing the grooves in the sliding sleeve (23).

FIG. 68 shows in cross-section along the line C - D the dose counter, which indicates the drug consumption, and the blocking device for preventing injector use after the drug supply has been exhausted. The pinion (34) for driving the counting wheel (35) is fastened on the tubular sleeve (33). A cam pin (180) on this actuates the spring-loaded locking armature (57) after each revolution, which causes the large counting wheel (38) to rotate further by a tooth width under the influence of the friction of the recoilable pins by means of leaf springs. One of these pins is at a different distance from the gear center and is pushed by the compression spring (39) into a bore of the pinion (34) as soon as the counter wheel (38) has completed a complete revolution, which corresponds to the supply depletion. FIG. 69 shows in a tangential cut along the line E - F of FIG. 66 the triggering mechanism for the re-ventilation and for the dose delivery after the shaking process. The spring steel tongue (27) has overcome the wedge piece of the wedge profile bar (56) at the time shown. The latter was returned by the compression spring (64). The slot guide (65) with the grooved pins prevents it from sliding sideways under the action of the leaf spring (63), which allows the locking rack (62) to engage in the locking teeth of the small gearwheel, causing it to rotate. The turning of the large gear (58) connected to the small gear causes its saw teeth to engage the push pin (59) in a groove of the trip bar when the trip bar is raised (as shown).

To the right of Fig. 69 is enlarged to a scale of 2: 1, part of the disk (51), which carries the vibrating pins, is drawn out in detail to represent one of the four openings (67) into which the round tip of the release pin (28) is located could avoid the influence of the inclined position of the spring steel tongue in order to be returned to the surface of the pane via a slope after the steep flank. In this way, the movement of the metering disc was released up to the stop of the next spring steel tongue. Figure 70 shows a simplified cross section along the section line "G - H of Fig. 71, the three pressure buffers (81), which are guided both by a spring steel bracket (82) to the wall of the vacuum storage container and by the compression spring (83) against its protruding edge A swivel lever (84), which clamps a wedge between the mounting plate (4) and the cover membrane (6), is used to remove the potty fastened in this way, the latter being clearer on the partial longitudinal section shown below the cross section.

FIG. 71 shows in cross-section along the line J-K, in which the center of the vacuum storage container towards J is included, the mechanism for triggering the vibrating device and the triggering mechanism for re-venting the vacuum storage container.

The support ring (15) is designed here as a variant of a guide cylinder leading upwards to facilitate the introduction of the vacuum storage pots and has a lateral slot (68). The flattened ramrod (69) extends through this. In the figure, the broad side is shown, with the lower edge of the wall of the vacuum storage potty (5) resting, while the probe angle (85) extends to the rear (which is why it is shown in broken lines according to its later position). The ramrod continues into the drum (71) via the passage (70). This points the recessed link guide (72), into which the fixing bolt (73) of the end plate (2) protrudes. The bearing for the drum is omitted for the sake of clarity of the drawing, as is the mounting of the grid wedge (75) for blocking the vibrating pins (50). A cap (76) resilient around a hinge is placed on the grid wedge, which allows the vibrating pins to pass when the disk is turned to the right to tension the coil spring (55), but not when it is turned to the left. The grid wedge has an oblique slot (77) for receiving a wire bracket (78), the square axis of which can be rotated within the articulated bore (79) of a slot in the spring-mounted retaining bolt (80). The release notch (86) in the shaft above the drum is turned according to the position of the fixing bolt in the link guide from the transverse stem (87) of the grid wedge, which increases when the drum is raised with its rotation along the backdrop. If the vacuum potty is pushed all the way up, the stylus swivels by 90 degrees and comes to rest on the edge of the pin (7) in order to lie on the cannula shaft. This prevents the drum from lowering. The ramrod also rotates and is now turned on its narrow side to the side of the wall of the potty to lower past it. The trigger mechanism for the re-ventilation consists of the trigger rod (60) with its compression spring and the rotation-preventing bridge bridge (88) between the mandrel (89) guided in a bushing and the fastening underneath the drum (71). In contrast to the illustration in Fig. 69, the push rod (59) is not yet in the locking position within the release rod (60).

FIG. 72 shows in cross section along the line L - M of FIG. 66 the position of the hose (44) between the rollers (41) and the grooved ring (43). A section through the metering disc (25) in the direction of the arrow shows its profile cavity for. the receptacle of the two hoses.

FIG. 73 shows the vibrating mechanism of FIG. 66 in a roll-up, four vibrating pins (50) on the disk (51), with their rotation relative to the spline profile (56) of the metering pump, causing their jerky displacement against the pressure springs (49). To start up the device according to FIGS. 66 to 73, the plug lock (18) is pulled. Then the axle shaft can be pulled out of the sliding sleeve. The injector is dismantled into a right half with end plate (2), mounting plate (4) and Sehraubsti ften (14) together with the support ring (15) and the pump unit including the grooved ring (43) can be removed from the pipe sleeve (33) . After the ring (43) has been bent out, the hoses can be pushed into the profile cavities of the metering disc and the exiting hose ends can be hooked into the tension springs (49) at the beginning of the jacket hose (45). The medicine storage bag (20) is inserted through the slot in the container cylinder (19). The latter, with its attachment, belongs to the left half of the injector, which must be approached again by plugging the parts together. (The locking pin, not shown, must be inserted into its longitudinal slot in the pipe sleeve (33)). The cannula socket (47) is inserted through the hole in the mounting plate, and the plug lock (18) is closed. The dosage is then preselected by slightly lifting the spring steel tongues (27) and rotating them into the spaces indicated by numbering between two clamping pins (26).

By exerting pressure against the foot plate (53) at the end of the axle shaft (52) (for example against a table top), the disc with the vibrating pins (50) moves over the spline profile bar (56), the cap (76) allowing the vibrating pins to pass through in a springy manner up to the maximum tension of the spiral spring (55). The reversal of movement is blocked by the grid wedge (75). By exerting pressure against the sliding sleeve (23), the spiral spring (31) is tensioned without this movement being transmitted to the pump thanks to the latch (30). The spring steel tongues rub elastically evasively thanks to the inclination of their ends over the end of the trigger pin (28) and the Keilpro filleiste (56), whereby the spring steel tongue for the first dosage then pushing back the keel profile bar in front of the trigger pin is locked by the latter. Inward against the compression spring (64) the Keilpro fil bar can only be moved after the release rod (60) is raised and the notch of the movement of the push pin releases the movement of the large gear (58). This is done after inserting a pressure pot by lifting the ramrod up to its rotation by 90 degrees via the link guide (72) on the drum. The notch (86) overtakes the transverse pin (87) in order to finally stand above it on the shaft above the drum. If the support ring (15) is placed on the skin for application, the same is lifted when the pressure is exerted on the projecting ring piston (9) until the ringed predetermined breaking lines (13) of the boundary membrane (10) break while the suction cup rim is already covering the skin Suction cup closes. The negative pressure effective from the storage space lifts the skin into the suction cup, but at the same time the pen approaches the cannula shaft (stripped of its support) of the skin (Fig. 89). However, this also reduces the feeler angle (74) and the release notch (86) into which the cross pin (87) can move (Fig. 71). This takes place under the thrust effect of the vibrating pin lying against the cap (76). The wire bracket (78) under tension of the retaining bolt (80) then penetrates into the oblique slot (77) and causes the raster wedge (75) to return to the locked position before the passage of the next shaking pin. After the hose contents in the pump area have been mixed by the shaking movements, the trigger pin (28) passes over the steep flank of the opening (67) in the disk (51), as a result of which the locking of the spring steel tongues (27) is released for a short time and the injection is initiated. After the steep flank on the wedge profile bar (56) is exceeded by the next spring steel tongue, a sector rotation of the large gearwheel is released under the action of the compression spring (64) and due to the retraction of the push pin (59), the trigger bar lowers under spring action and the mandrel (89) breaks through the lid membrane of the vacuum storage potty for re-ventilation ben. For the function of the wire bracket (7-8) described above, it should be added that during the lifting of the retaining bolt (80) in the final phase of the lifting of the ramrod (69) via frictional engagement on the Au plate plates for the compression springs from the locking slot with its movement its end arm, which is parallel to the wire bracket, is pulled down into the articulated bore (79) and is laterally pulled out of the oblique slot (77). The narrowing slot guide in the retaining bolt, which is not particularly shown, ensures that the retaining bracket is returned to the vertical when pressure is applied (Fig. 71). After changing the medicine storage bag, the counting device must be reset to the zero position. For this purpose, the counter wheels (35, 38) can be freed from the tooth engagement against the pressure springs assigned to them and rotated as desired.

FIG. 74 shows, in a highly schematic manner on a scale of 2: 1, rollers (41) acting in pairs against one another, the outer counter-rollers (90) in this example only being moved passively freely, which is facilitated by their rubber-elastic surface. Two rollers each are attached to a common swivel arm (91) by axles, the drive being carried out via a pinion running on a larger gear (92).

Figure 75 shows in natural size a schematic roll-up when looking at a metering pump (approximately in the direction of the arrow on Figure 74). It is demonstrated the possibility of hose routing in the case of a pair of hoses using pairs of rollers as in FIG. 74, specifically by the lateral outlet of the two hose legs, which rest firmly on the carrier disk (40) in that there is a type of gear between them, between them Tooth notches stretch rope-like bridge threads (94) between the two hoses (44).

FIG. 76 shows a variant of the example in FIGS. 66 to 75, the deviation relating to the type of starting mechanism for the metering. The schematic drawing The upper part of a vacuum storage container again has an elastically closed window (85) in the rigid lid membrane. According to the rotational position of the fixing bolt in the guide of the drum (71), the ramrod (69) points with its broad side towards the wall of the potty and has lowered past it. The bellows (96) which is stationary as a result of the axis (95) relative to the drum is fastened to the gallows (97) together and parallel to the pneumatic cylinder (98), the piston of which also represents the plunger of the push valve (99). The slide valve, which is open to the outside air, is connected to the bellows via line (100) and an open check valve. Via a closed check valve, the line (101) leads from the bellows into the pneumatic cylinder, which is connected via the line (102) to the opening of the pushing valve just closed here. The current position of the slide valve follows from the lifting of the valve joint with the elastic membrane of the window (85). It was raised because pressure equalization during the skin lift in the suction cup weakened the negative pressure that drew up the membrane. If the charging pin is lifted when a new potty is inserted, the bellows is compressed by the air escaping through line (101) and the pneumatic piston being actuated. The plunger is lowered into the window (85) and the overpressure in the pneumatic pump is released via line (102). The bellows cannot unfold and lower the drum by rotating and actuating the trigger for the metering (75) until the line (100) is ventilated again by slightly lifting the valve tappet through the window membrane. FIG. 77 shows in a highly schematic manner in the functional stages A - D a variation of the mechanism for re-venting the suction bell, as is expedient for devices which, like that in FIG. 76, cannot be re-aerated by the destruction of the lid membrane of a potty. Here, the slide valve (99) can be moved as a whole on a rail (103) against the compression spring (104). The valve tappet (106) with wedge profile for example by actuation a spring steel tongue (27, Fig. 66) has a separate compression spring (105). The ventilation hose (107) leads from the slide valve into the suction cup space, which is easiest to do if the suction cup is part of the injector (Fig. 78). A rocker-type locking slide (108) is actuated along a backdrop on the valve lifter. In stage A, the valve lifter is on the left and the slide valve is closed and left-handed for the state during the injection. In stage B the slide valve is shifted to the right and still closed. In stage C, the slide valve is still held in the right position by the locking slide, while the valve tappet is moved to the left under the action of its spring and is thereby opened. During this sliding movement of the valve tappet, the return movement of the slide valve as a whole is triggered by its spring (104) by actuating the locking slide. In stage D, the state of stage A is restored.

Figure 78 shows a longitudinal section of an injector, the metering pump of which consists of a pot-shaped elastic sleeve (109) which is immovably mounted on a plunger (110) which has a groove-like groove on its surface for the passage of the medicine. The plunger is supported with its lower end inside the cannula attachment piece (47) with its upper end in the neck end of the pump housing (111). The plunger ends at the top in a plate (112) drilled through for the passage of medication, which expands the hose (44) at this point, which bridges the distance between the medicine storage bag (20) designed as a bellows and the neck closure of the pump housing. The sleeve (109) is directed with its cavity against the ring plate (113) fastened to the pump housing. The latter continues in a downwardly conically tapered elastic and centrally pierced stopper (114). The plunger carries the annular valve plate (115) below the plug. The pump housing is inserted into the central axle bushing (116), around which the parts for the actuation of the pump are rotatably arranged, and which extend outwards continues in the housing cylinder (1). On its bottom, the wheel (117) is mounted on a ball bearing, with its upward annular Kei lprofilleiste (56), which is similar in function and design of the vibrating device in Figures 66 and 73. Instead of the pin with a glide increasing ball at the end here three rollers evenly distributed over the circumference (of which only one is shown) are attached via axle pins below the outer lower edge of the cupcake-like double-walled cylinder (119), the inner wall of which is on the axle bushing is movable, but not rotatable. The compression spring (121) is mounted between the edge ring of this double cylinder and the ring plate (120) attached to the axle bushing: from the upper edge of the double cylinder, three angular pieces distributed over the circumference extend through slots in the axle bushing to the side above the plate (112), to engage there with elongated locking slots of the edge segments of the locking sleeve (123) with head grooves. The latter transmits the impact movements of the rollers (118) onto the plate from above. The ring plate (124) is also firmly connected to the axle bush. On a ball bearing, this rotatably connects the wheel (125) with a spline, which is directed downwards. Against this, three rollers are directed on the outer cylinder (126), which is vertically displaceable against the subsequent inner wall of the housing cylinder. The compression spring (127) acts against its ring plate and is supported against the bottom of the housing cylinder (1). The wheel (125) is composed of parts of different 'edge diameter. The upper part carries a ring of ratchet teeth on the outside, in which the latch (128) engages. The latter is attached to the narrow-ring disc (30), which can be rotated around the outer surface of the ring plate (.124). About the bridge angle (129) this rotation of the spiral spring (31) is communicated, which can be tensioned without the wheel (125) being rotated. After the reversal of movement, the spiral spring movement is shared by the pawl the wheel (125) and by this over the between wheel (125) and wheel (117) attached Cylinder segment (130) with the two wedge profile. The pendulum movement of the outer cylinder (126) is transmitted from below to the plate (112) via three U-brackets (131) mounted in bores in the axle bushing. The Behälterzy cylinder (19) is screwed onto the mounting plate (4) with an internal thread and carries a guide bush (132) for the square rod (133). The lower pinion (134) attached to this engages in the correspondingly designed ring gear of the lower part of the wheel (125), while the upper pinion (135) is displaceable on the square bar and between the protruding disks (136, 137) of the cover (138 ) engages in the ring gear. The lid has an external thread and is hereby screwed into the internal thread of the container cylinder (19). The bore (140) serves to ventilate the interior of the container above the bellows. For the penetration of the upper pinion by d eft container r cylinder is provided in this slot (141). Screw bolts (142) which can be displaced along a scale in the slots of the container cylinder allow the remainder of the medication, which corresponds to a corresponding dose level, to be determined before the start of use of a new bellows, by preventing the cover (138) from being lowered further by its stop on the screw bolt.

In Fig. 78, the left half of the image corresponds to the state before, the right half to the state during the use of the injector for injection. The support ring (15) continues in a cylinder, which has a sliding ring (143) to the receiving cylinder (144) for the vacuum potty (5). The ring (145) fastened on the intake cylinder serves to fasten the rubber-elastic sleeve (147) which carries the edge of the suction cup. It also contains the guide slots for the trigger pins (148) and is used to attach the trigger mechanism for suction on the skin. For this purpose, three locking lamellae (149) are inserted into the notch (150) of the ring piston (left side of Fig. 78). By rotating the ring disc (151) by lifting the angular and bayonet-shaped release pins when lifting the edge the cuff (147), the locking lamellae are moved similarly to the lamellae of the central lock of a camera from the indentation of the annular piston, which is favored by a beveling of the indentation, and the annular piston moves upwards under the influence of the negative pressure between the skin and the vacuum storage space for pressure equalization. The size membrane (10) is rectified. The edge of the suction cup, which is initially pressed against the skin by the pressure from the suspension of the release pins, is raised a further distance with the support ring. The upper edge of the cylinder (151) actuates the rocker (152) against its compression spring, the pin (153) being pulled out of a lower wedge profile strip of the lower wheel (117) and thus triggering the rotation thereof and the metering. Figure 79 shows the holding mechanism for the support ring (15) of the vacuum storage potty in cross section. The mode of operation of the release pins (148) is illustrated in the longitudinal section in FIG. 80. The control ring (154), which is fastened by means of three cap screws (155) on the ring (146) in slots, is held in the end position A by means of the compression springs from the fastening points (145) on the ring. As can be seen on the schematic roll-up under the cross section, the bayonet-shaped kinked release pins (148) have a slant in the control ring. When the trigger pins are raised, the control ring is first displaced to the left in stage B while the compression springs are tensioned. During further raising in stage C, the control ring lies against the release pins, so that the return action of the compression springs on the release pins is not effective. The first phase of their return is effected by the elasticity of the cuff to which they are attached. The locking slats (149) are held against the locking function side by the cap screws (155). A second axle pin (158) rotatably attaches it to the control ring (154).

FIG. 81 schematically shows a mechanism for re-ventilation to FIG. 78 through the hose (156). This runs in the slot (157) of the cylinder of the support ring. The associated slide valve (99) is arranged by a sector th delay mechanism actuated. With the movement of the hand lever (161), which, as a spring-elastic tongue that can be rotated about the dose indicator disc (159) by means of a tube segment, the valve tappet (106) of a slide valve is displaced against its pressure spring (105) in such a way that the ventilation opening to the hose (156) is closed because the pump cylinder is attached to the dose indicator disc. The hand lever must now be lowered in order to be able to pass the steep flank (162) of the link ring under the mounting plate (4). For this purpose, the driver pin (163) dodges into the driver bore (160), whereby the return movement of the valve tappet remains locked until the hand lever has passed the steep flank again after returning to the O position. The driver pin then leaves the driver bore thanks to the elasticity of the hand lever and the compression spring (105) can reopen the slide valve to re-vent the suction bell. There is a rigid connection between the dose indicator disc (159) and the latch (Fig. 78) via the bridge angle (129). In FIG. 81, stage A denotes the state after the hand lever has returned and when the slide valve is open again. Stage B denotes the state shortly before the hand lever returns to the O position with the slide valve still closed. To start up an injector according to FIGS. 13 to 15, the square rod (133) is first detached from the lower pinion (134) and pulled out of the guide bushing (132). The container cylinder (19) can now be unscrewed from the mounting plate (4). By turning the bellows, the connection between the locking sleeve (123) and the elbow (122) can be released and the pump housing (11) with the needle hub (47) can be pulled up out of the axle bushing. The lid (138) is screwed out of the container cylinder. A new pump housing is inserted and the locking with the elbows is carried out by rotating the locking sleeve that is adhesively connected to the bellows in a thread-like manner. The upper pinion (135) is pushed between the washers (136, 137) of the cover and then onto the square rod after the container cylinder (19) has been screwed back onto the mounting plate. The four The square rod is inserted back into the guide bush after the container cylinder (19) has been screwed onto the mounting plate (49). A vacuum reservoir is now removed from the sterile packaging and pushed into the receiving cylinder (144) by means of pressure against the bottom cover (165), guide grooves (166) ensuring the correct radial setting, since cams (167) in the guide cylinder correspond to them. The release pins (148) must be pressed briefly before the locking slats pass. After the locking slats snap in, the bottom cover is removed, but in any case before the injection. By turning the hand lever (161), the slide valve is closed to re-vent the suction bell and after slightly depressing the hand lever, this is selected according to the dose to be selected when counting the locking steps of the

Move the stem (153) further along the ratchet profile strip. The set dosage can be checked by means of the position of a marking on the dose indicator disc on the scale on the container cylinder. If the support ring (15) is placed on the skin, it can only be lifted towards the receiving cylinder due to the otherwise jamming that occurs when the thrust direction is strictly vertical. Raising the edge of the suction cup on the cuff (147) causes the release pins (148) to be raised and thus the locking slats to withdraw from the indentation of the annular piston (9), which is lifted up with the skin. The edge of the suction cup continues to be raised until the rocker (152) is actuated and the injection is initiated. This takes place in liquid impulses of equal size in accordance with the pumping movement of the cuff (109). If this is pressed with its edge against the ring plate (113), it seals off a quantity of liquid below its edges by sealing against the same as well as against the inner wall of the pump housing, a certain amount of which is measured according to the movement distance of the valve tappet. ejected in the direction of the cannula because the valve plate (115) has moved away from the lower plug surface. Figure 78 shows this moment. The rollers (118) are deep in the depression of their wedge profile, while the counter rollers pressed down by their wedge profile strips. The valve plate (115) is removed from the stopper by lowering the tappet (110) and the edges of the sleeve (111) approach that of the ring plate (113). As the sleeve is lowered further, a certain quantity of liquid is expelled towards the cannula. Before the cuff lifts off the ring plate in the opposite direction, the valve plate has closed the plug opening again (with the appropriate roller guide). Figure 81 shows a longitudinal section of an injector with an electromagnetic hose-integrated metering pump similar to that in Fig. 78, whereby a roll of tightly layered and chemical-coated film ensures a gradual release of gas in the container under the control of a pressure relief valve and thus an even medication feed! the negative pressure is generated by three electrically heated chambers that can be opened before the injection. FIG. 83 shows a cross section at height A - B of FIG. 82, which shows the distribution of the boilers (172) and their transverse walls (174) and the distribution of the heating wires (178). In Fig. 82 you can also see the loops (191) on the cannula connection piece inside the suction bell with the rubber-elastic edge and the inner lip (180), above it large (168) and small valve pistons (169) of the metering pump with plunger (110) ' and perforated plate (112) within the hose. The resilient clamping jaws (171), which are moved by the spring-back lifting magnet (170), lie around the plate (112). The insulating jacket (177), which also partially encloses the hose (44), lies between the boiler and the lifting magnet. The medication container (19) is fastened via the locking bolt (195) and the locking screw (194). In the cover (138) there is the pressure relief valve (181) and inside the bellows (20) with the medicine and the roller (182) for gas generation. The brackets (190) serve to secure against rotation, while the switching cylinder (188) with ball bearing toward the container can be rotated with its pin according to the groove guide (193). Cable connections (176) lead from the control unit (175) to the solenoid, to the heating wires, to the start contact (197) and to the sensor cannula. The resistance heating wires (178) are stretched out between insulator rings (179). The bellows (20) of the medicine is located inside the housing cylinder (19), which is screwed on by means of a sealed cover (138). Between the mounting plate (4) and the hose there is a seal (196) in the passage for them. The bellows (20) contains in its central, bowl-shaped depression a rolled-up solid body package (182) for generating compressed gas. Tension springs (183) which extend obliquely through the chambers are fastened to retaining pins of valve flaps (184) which are guided through bores in the suction bell slope. Eccentrically outside the sealing rings of the valve flaps, these are each reached by a vertical tappet (185), which is sealed in front of the switching ring (186). You will encounter release tongues (187) which extend downwards from the holding cylinder (188) and which can only actuate a plunger quickly after every third lowering of the switching cylinder through the switching ring. The prerequisite for this is that the three trigger pins (148) are simultaneously raised within the suction cup. (Fig. 84) To put the injector into operation, the clamps (190) are bent open and the container cylinder including the pump unit up to the cannula nozzle including an insulating jacket against the effects of heat are pulled out of the switching cylinder. The locking screw (194) is loosened after the container cylinder has been unscrewed from the mounting plate and the cannula has been pulled out of the suction bell by its shafts (191). After loosening the locking bolt (195), the bellows, mounting plate hose and pump housing (111) and insulating jacket are replaced in their entirety, the clamping jaws (171) around the plate (112) being closed before the pump unit is pushed back into the switching cylinder and the Locks are made. Via the plug of the mains connection, the boiler is heated for a predetermined time, whereby heated air escapes into the lock space in the sow via the valve flaps lifted off by excess pressure against the tension springs. Figure 84 illustrates the. Rotation of the shift cylinder via a cam (19) left in guide grooves (189).

The schematic A roll-up in the area of the switching ring (186) shows that only when all three cones are lifted by the spring-loaded release pins (148) under the action of the compression spring, a shifting of the switching ring to the left can occur. After this rotation, the three release tongues (185) can penetrate into the elongated holes with wedge bevels while lowering the shift cylinder, causing the shift ring to rotate back against its spring. The fact that the three trigger tongues and the nine elongated holes have the same spacing, but the valve tappets are arranged irregularly underneath the elongated holes - despite brief torque, it is possible to open one valve flap after the other. The clamps (190), which are embedded in the fastening plate, release the necessary play between the medication container and the rest of the injector. In the last phase of the downward movement of the switching cylinder, the start contact (197) for the automatic dosing is actuated. After dosing is completed by means of the pre-programmed pump pulses, the suction bell is re-ventilated by opening the solenoid valve (368) by means of a pulse from the control unit. No reheating is required for the next two uses. Tightening the rope (139) triggers the electronic alarm under the lid when the medicine supply is almost exhausted.

FIG. 85 shows in longitudinal section a vacuum storage potty according to the two-chamber system, as can be used in the injector according to FIG. 78. One of the three guide grooves (166) is drawn in, which, prior to passage past the blocking lamellae, forces the potty to rotate into a certain angular position. The cams (167) secure this angular position in the end seat of the potty. FIG. 86 shows in cross section through the suction cup area of an injector that the suction cup edge can also be cloverleaf-like in order to bring the three trigger pins (148) closer to the center of the injector without having to seal them upwards. FIG. 88 shows a longitudinal section of a vacuum potty according to the single-chamber principle and a locking pin (204) which emits from the injector and whose function corresponds to a locking lamella. The boundary membrane (10) is supported by the bottom ring of the Stützzyli ders (205), which has a caliber jump inwards in its upper wall to leave space for the passage of the thin-walled bagging (206). The inner edge of the base ring of the support cylinder (205), the boundary membrane (10) and the center of the base cover (165) are glued together by means of the annular welding edge (207). The edge of the bottom cover is supported against the lower edge of the vacuum reservoir (5) and has at least one annular predetermined breaking line, which can be detached by pulling on a tab if the support cylinder is supported on the edge of the injector by the locking pins (204). of the injector until triggering for skin suction. As an illustrated extension of the invention, the disposable potty includes the funnel for connection to the elastic tube (209) starting from the cannula attachment piece, which ends in a ball and to which negative pressure is transmitted through the cannula shaft. The clamp (210) is raised to check for negative pressure, the ball being drawn in. After the skin has been sucked in, the clamp can be raised again to check whether the ball is filling with blood. During the injection, the clamp prevents medication from flowing into the ball. FIG. 88 shows a roughly schematic diagram of a manufacturing process for a vacuum storage container as in FIG. 19. In stage A, the potty and ring piston are injection molded side by side with the mold halves being pulled apart vertically (215, 216). In stage B, for example, using three sector-overlapping transport carousels (211, 212, 213), the boundary membrane (lθ) produced by means of a knife cut is approached to the ring piston and welded to the ring piston using an ultrasound head (214).

The transport carousel (212) brings the combined parts under a printing press to attach the bottom cover (165) and then under the opening of the vacuum storage container. The combined parts are placed in the evacuation chamber (217) when vacuum is generated by a compressor using the ultrasound head (218) welded in the area of contact between the boundary membrane and the edge ring (219).

FIG. 89 shows a vacuum storage potty of the type shown in FIG. 66 inside the sliding sleeve (23) in the state of skin suction.

In a scale of 2: 1, FIG. 90 shows the profile strips (225) on the two wheels (117, 125) in FIG. 78 in a schematic roll-up, wherein they are approached to clarify their mutual functional interaction. FIG. 91 shows, in a highly schematic manner, the attachment of an electrical buzzer, the warning device about the impending supply depletion, via the carrier (221) with a ring around the outlet of the two hose legs from a metering pump according to FIG. 66. With the vibrations of the buzzer, the hoses and the carrier disks (40) for the rollers of the metering pump are also set in vibration, so that the vibrating device is dispensed with.

FIG. 92 shows in longitudinal section a variation of the metering device from FIG. 78 in detail. The hose (44) leading down from the bellows (20) extends underneath the plate (112), which is interrupted from the edge in a sector-like manner, by the plunger (III). A further, stronger bulge of the hose replaces the pump housing and is replaced by the axle bushing (116) After passage of the bore in the stopper (114), the end of the plunger is formed by a valve cone (115), while a kind of bellows (109) serves as the metering chamber, and the tube at the enlarged end comprises the carrier plate of the cannula attachment cone (47), which can be added to the insert part.

FIG. 93 shows the block diagram of the control of the injector, as shown in FIGS. 82 and 83, consisting of a central processing unit (CPU), memory unit and input / output port. FIG. 94 describes the program flow chart for a control unit according to FIG. 93.

The function of the four buttons is as follows:

Key 1 switches the contents of the supply counter to the display the first time it is pressed.

The second time you press, the safety reserve appears in the display. Only now do keys 2 and 3 have a function. Key 2 increases the safety reserve. Key 3 reduces the safety reserve of the storage container. Key 1 switches the display off when pressed three times. Button 4 is closed when changing the insulin reservoir. In the waiting position, the processor queries the four buttons and the switch (start contact 197). When the buttons are pressed, the processor operates the display and, if necessary, changes the size of the safety reserve as described above. The switch (197) triggers the injection. Then the stroke counter is loaded with the value of the dosing specification (there are, for example, memory modules for 2 to 20 piston strokes of four units of insulin each) and determines the frequency of the dosing pulses and thus the amount of medicinal liquid administered. After the injection is complete, an impulse is given to the magnet for the magnetic valve (368) to re-energize the suction cup so that the device can be removed from the skin again. The supply counter is updated and compared with the safety reserve and the dosing specification. If the safety reserve is undershot, the warning device is actuated, but the device remains functional. If the dosage falls below the prescribed level (ie the drug supply has dropped below the single dose to be dispensed), the warning device is triggered and the device function remains blocked until a new drug supply container is inserted and button 4 is closed. Figure 95 shows in longitudinal section a locking device of the medical supply until the supply is exhausted. Within the housing cylinder (1), which is open at the top, there is a bellows, as the pharmaceutical storage container (131), the medication tube (44) of which is located within the medication pipe (316) with the Au ring (601). This rests on the mounting plate (4), within which the transverse locking pins (330) lie on the outside against the spring-loaded locking bolts (329) with their domes, while the inner domes are locked in an annular groove of the medication tube. The hose (44) continues down into the pump stem (337) with the cannula hub; in the area of the hose rings (415, Fig. 45-47) it is surrounded by the axle bushing (116) of the device tes. At the top, the bellows is fastened by means of resilient louvres inside the slide-in cylinder (200) and can be detached through lateral cylinder slots. If the bellows is pushed together with it into the housing cylinder after it has been fixed in the sliding cylinder, the uncovered part of the hose around the pump pin comes into contact with the hose rings. The lock pin (330) will snap into place (as shown). After the drug is almost used up, the lower edge of the sliding cylinder lowers on the locking bolts and lowers them. The locking pins can now retreat from the annular groove of the medication tube when the cable (139) is pulled for the electronic warning device (387) and the bellows together with the tube can be pulled out again.

Figure 96 shows a variant of the metering hydraulics. The separating plunger (275) is mounted above the medicament within a graduated syringe cylinder (272), and auxiliary liquid is stored above it, which is provided by a cover plunger (801) as a disposable part. This is the device component of the support piston (802), which contains the cylinder bore with the large (168) and small (169) valve pistons, which fluid in the room with Hil emptied a hole. There is a seal between the bellows with auxiliary fluid, which is filled up after the leakage of the support piston, and the valve tappet. The valve pistons are actuated by the solenoid (413) by means of the valve stem via the swivel lever (803). The end of the valve lifter engages in two arms out of phase in oblique grooves (804) of a disk. The latter is attached to the threaded rod (905), which is mounted in the threaded bush (805). When the valve tappet and the valve piston (168, 169) are lowered, a dose unit of auxiliary liquid is pumped from the bellows into the liquid space between the separating piston and the supporting piston for metering. Since the support piston is held down by the threaded spindle, the separating piston and thus the medication is displaced through the cannula. When the valve lifter is raised (its fork meets different slants of the disk in different phases), the disk is rotated and the threaded spindle is lowered by the amount that corresponds to the displacement of a dose unit. The corresponding amount of auxiliary liquid runs back into the bellows. Figure 97 Continued on page 120.

Figure 97 brings up a top view, below and in the

In the middle a longitudinal section in the section line A - B of the top view and below likewise in a longitudinal section in the section line C - D of the top view a metering device which is pressurized by the electric magnet (546). This magnet sits above the short lever arms, which each belong to two plates (535) that can be folded in the hinge (547). Lever arms and plates do not cross, not even at the end shown below, where the hose (44) is led out to the cannula. When the flap is opened, as shown, the outflow of medication is undershot due to the hose being clamped between the short lever arms. At the point where the medication tube is introduced, plates and short lever arms cross over each other like scissors, which is why the inflow is unobstructed there. The hose lies in a loop between the plates. If the plates are brought closer to each other under magnetic effect, the hose is first squeezed off at the inflow point (when the short lever arms are suspended) and then in the area of the loop between the plates. The returning hose leg is passed through the opening (549) to the outer surface of the top plate in order to avoid a flow inhibition. The compression spring (549) is used for resetting. Figure 98 shows the hose (44) in turns on a spiral ring which is embedded on the outside on an elastic rubber pyramid. The counter spiral is in engagement above the hose windings and is arranged within a keg-shaped cup. When lowering the same under magnetic effect, the two spiral rings are first stamped closer to each other at the top than at the top until the hose is clamped off. The tube is emptied downwards (towards the cannula). When the conical beaker is raised by the pressure spring (549), the overbeaker (553) is first raised, the lower edge of which, the hose is pinched off. FIG. 98 shows a further longitudinal metering device for the pulse operation. Piezoelectric pressure transmitters (564) operated with electrical voltage are mounted at the top against a fixed housing part and rest on an elastic jacket ring (556). This contains in front of the rigid attachment piece (557) for the discharge pipe a hose friction (558), from which the hose continues via a lateral flattening of the jacket ring to a shut-off valve. The latter is released at the opening of the lid of the injector in order to stop the outflow of medication even when there is no voltage in the area of the piezo elements. The surface of the lens-like flattened hose friction is firmly connected to an adhesive plate (567), which in turn is fastened to the lower surface of the pressure sensor (564) by means of the locking slides (568). From the light source (560) on the left, optically conductive fibers lead through the jacket ring and are directed towards the wall of the partially transparent hose bladder. Opposite the light source, light-guiding fibers (below the zone deformed by pressure) run in turn to the optical sensor (561), which is electrically connected to the control unit (175) as well as the piezoelectric switches (562, 563). Command lines (555) lead from the control unit to the piezoelectric voltage-pressure transducers. Under the control of the height-adjustable switch (562), piezo elements receive voltages via their command lines via the control unit, which lead to their expansion and to the blocking of the medicinal inflow in the inflow area of the tube expansion. The metering pulses are now converted into the excitation and expansion of larger parts of the pressure sensor (564), whereby the jacket ring is flattened and narrowed in the lumen and the hose swelling is reduced until the switch (563) reports the set low point of the pressure sensor. After changing the voltage for re-expansion, the hose opens filling. Due to the sudden withdrawal of the pressure sensor, a vacuum first occurs inside the hose expander (due to the greater inertia of the fluid dynamics). The decrease in density and its disappearance due to the filling is reported back to the control unit via the optical sensor and the next dosing pulse is directed to the pressure transmitter before medication can flow freely from the medication container to the cannula. The outflow speed can be regulated by the speed of the connection of individual sections of the pressure transmitter (as a data word in the control unit) (or distribution of the pressure effect on the time curve). This means that subcutaneous injections can also be made via finer capillary lines within the cannula without causing tissue destruction due to sudden excess pressure. In such a case, the outflow channel is particularly narrow (as it is aimed at in favor of a pain-free injection), the arnei release (in slow cycles) is initiated before the measurement of the metabolic parameters is completed. A certain base rate is then already applied before the further delivery is possibly interrupted according to a calculated correction.

FIG. 100 shows a rough schematic of the connection of a throttle valve (565) shown in cross section to a control unit, which is at the same time designed as an inductive flow meter and accomplishes the valve control in accordance with the flow rate reported via the measuring electrodes (566). Such measuring devices are widely described in the patent literature. So by G. Geisler, A. Seebode in DE 33 14 954, K. Walter, F. Hofmann, W. Stelz, Ronald, Venlo in DE 24 10 407 or from E. Prince, G. Leiser in DE 27 44 845. FIG. 101 shows in longitudinal section a switching device from one metering device to another when only a single motor is used. The electric motor (855) has a central bore in its drive shaft (603) for receiving the shift rod (604). The force transmission bushing (605) acts only clockwise to convey the ratchet gear (607) via its pawl (606). The ratchet wheel is firmly connected to the shift pinion (800) which can be freely rotated around the bearing bushing (887). The gear wheel (859) is driven by the shift pinion on the threaded rod of a step syringe (for example), since it engages with it. The ratchet gear (608) is permanently mounted on the shift rod and is driven by the pawl of the small power transmission bush (609) when turning to the left. The movement of the ratchet wheel (608) is transferred to the drum (71) with the link guide (72) in which the fixing bolt (73) causes an increase and decrease on rotation. This axis shift is transferred to the shift pinion and determines its position in relation to the gearwheels. To switch to the other metering program, the motor only needs to turn half a turn through S tr om to perform pol un g. This means a considerable saving in space and weight.

In FIG. 102, a device for changing the dose when using magnets or piezo pressure transmitters as a metering drive is shown at the top in a side view and at the bottom in a plan view. There is an elastic connection (612) between the short end of the swivel lever and the pressure transmitter (564). The pivotably arranged cap (613) stands above the spring-loaded plunger (614), the spring lifting the plunger against the hose extension in a metering chamber after each pump cycle. He stays in contact with the cap. However, if a rapid pull impulse from the pressure transducer comes into effect, the cap leaves the tappet and a spring tensioned by means of a pressure lever (616) transports the cap by swiveling the plunger of the other dosing device.

Figure 103 shows in longitudinal section a variation of the mechanism for the vertical movement of the cannula magazine before and after the injection in the two functional states A and B. The cannula magazine (316) can be easily moved together with the central holding tube without a seal in a socket of the suction cup cover. The end of the central holding tube widens to form an annular plate (536) which is sealed to the suction cup roof by an elastic membrane (537). Stage A shows how the skin was pulled up into the suction cup under the influence of suction and at the same time the ring plate (536) was lowered so that the skin and cannula meet. In stage B, the skin and cannula have moved away from each other again after the suction bell has been re-aerated, thanks to the elasticity of the skin and membrane. FIG. 104 shows in longitudinal section a variation of an injector, in which a jacket (538) for protecting the cannula is present instead of a suction cup. The jacket is designed as an ellipse, in one center of which the central holding tube (324) is arranged to be vertically displaceable, while in the other center a central pin (433) carries an annular plate (536) which has a bore for the passage of the central holding tube and the like Provided with a double-sided adhesive film (539). At the top in stage A, the central shaft (similar to the example in Fig. 13) was raised with the ring plate and skin, while the central holding tube was lowered with the cannula. Conversely, in stage B below, the eccentric support tube was raised and the central pin lowered so that the skin and cannula separated. A vacuum application is avoided. Between A and B, the adhesive film (539) with the hole for the cannula passage can be seen in a plan view, which is expediently surrounded by the adhesive electrode ring (617) between the two protective films (540) in a card-shaped arrangement. FIG. 105 shows a longitudinal section of the skin raised into a suction cup by means of negative pressure, polarized light being thrown through the top of the skin onto an opposite detector. The measured values determined in this way could be used for dose correction. It still has to be confirmed to what extent the slowly changing sugar values in the tissue are suitable for assessing the current metabolic state. FIG. 106 shows the basic experiment on the left in a side view and on the right in a top view, which was commissioned to change the electrical conductivity at boundary membranes. A filter paper was clamped onto the electrolytically defined silver chloride-silver plate in the side seal and Sepharose-Concanaval A was filled in between. The other side of the membrane was rinsed with saline of various concentrations and measured against the calomel electrode (611). 600 V alternating current was used and significant differences in measurement results were confirmed.

Claims

P a t e n t a n s r u c h e:

1. Device for injecting liquids under the skin, characterized in that a sensor is arranged at least in the vicinity of the cannula, which allows to prepare metabolic changes in the body for information without additional injury.

2. Device according to claim 1, characterized in that the cannula itself is designed as a sensor to prepare metabolic changes in the body for information.

3. Apparatus according to claim 1, characterized in that the cannula shaft behind the bevel and the ring closure of the same is opened gutter-shaped, the missing wall being replaced by a plastic insert which has sensor properties.

4. The device according to claim 1, characterized in that between the cannula shaft and plastic insert special insulation zones are provided with regard to conductivity.

5. The device according to claim 1, characterized in that a tube with sensor properties is introduced in at least part of its surface in tight connection with the drug-supplying channel within the trough-shaped shaft.

6. The device according to claim 1, characterized in that at least one thin tube which has sensor properties is introduced into the bore of a cannula.

7. The device according to claim 1, characterized in that there is a hollow within the cannula shaft at least the tip part, in which a sensor coating is introduced.

8. The device according to claim 1, characterized in that there is both an internal contact with a conductor within the cone of the attached cannula and an external contact on a connecting piece to the cannula, the latter reaching over as a sliding contact on the cannula extension tongue-like.

9. The device according to claim 1, characterized in that a cannula at the end which is opposite the cannula shaft has an opening for receiving the shaft of another similar cannula, the medication being supplied laterally.

10. The device according to claim 1, characterized in that cannulas are stacked one above the other in a tubular container with the inclusion of one cannula shaft of an adjacent cannula in the shaft-carrying body with the medicinal supply

11. The device according to claim 1, characterized in that the cannula has a cannula body which is divided into an upper and lower chamber, the upper chamber serving to receive the shaft of a similar cannula.

12. The apparatus according to claim 1, characterized in that the cannula body has an annular groove on the side.

13. The apparatus according to claim 1, characterized in that the upper cannula chamber is closed by a septum with a central hole.

14. The apparatus according to claim 1, characterized in that the cannula between the upper and lower chamber has an annular notch which serves as an articulated connection.

15. The apparatus according to claim 1, characterized in that the cannulas are stored within a tube.

16. The apparatus according to claim 1, characterized in that a circuit occurs in the suction cup cover via a cannula changing mechanism, in which used cannulas take up the space of unused cannulas in the container hose.

17. The apparatus according to claim 1, characterized in that at least one sealing body is slidably disposed within the container hose to separate unused from used cannulas.

18. The apparatus according to claim 1, characterized in that between two sealing bodies in the container hose there is an elastically compressible body with spring action, which serves to store a moment of movement for the cannulas.

19. The apparatus according to claim 1, characterized in that a sealing body is present behind the last unused cannula in the cannula magazine, but the cannula body itself can also act as a sealing body, and in that compressed gas is introduced through the end of the cannula magazine in order to forward the cannulas push.

20. The apparatus according to claim 1, characterized in that there is a thread-like connection between the cannula bodies, which to enable transport via Zugwirderen.

21. The apparatus according to claim 1, characterized in that there is an airtight detachable connection between each upper and lower chamber each different cannulas.

22. The apparatus according to claim 1, characterized in that the cannula and cannula magazine differ in cross section from the circular shape.

23. The device according to claim 1, characterized in that the drug inlet opening in the cannula is located on a flattening of the cannula body.

24. The device according to claim 1, characterized in that the cannula body has a conduit vertically shifted in its wall approximately parallel to the cannula shaft in order to spare a lower chamber for the insertion of the cannula shaft of the adjacent cannula into the cannula body.

25. The device according to claim 1, characterized in that the two ends of the tube for cannula storage are united by means of a band.

26. The apparatus according to claim 1, characterized in that the cannulas are prevented from falling out of the hose by at least one removable obstacle transversely to the conveying direction of the cannulas before the connection of the hose storing them to the injection device.

27. The apparatus according to claim 1, characterized in that a leaf spring is provided at the end of the central holding tube for the cannulas, which dislodges the cannula passage, but releases it through a bore when a switching mechanism acts on it.

28. The device according to claim 1, characterized in that the leaf spring is actuated at the end of the central holding tube by a switching pin in connection with the holding arm for the magazine tube.

29. The device according to claim 1, characterized in that a receiving tube is available for receiving used cannulas, on which a spring-loaded sleeve is displaceable with spring bends for cannula transport in one direction.

30. The device according to claim 1, characterized in that a loop (192) is fastened to an extension cone (224) continuing in the cannula shaft, which loop allows the cannula to be removed from the suction bell after use.

31. The device according to claim 1, characterized in that for the attachment to a cannula there is a clip which can be plugged on in a conductive manner towards the cannula shaft and via which a line connection to a measuring device exists.

32. Apparatus according to claim 1, characterized in that the measuring device is worn on an elastic bracelet, whereby a contact pad with electrically conductive properties to the skin is held by means of the same.

33. Apparatus according to claim 1, characterized in that the cannula is connected to the drug-carrying hose of an infusion pump, to which a measuring device is added.

34. Apparatus according to claim 1, characterized in that the cable to the measuring device extends in places within the discharging hose, which can also serve as insulation.

35. Apparatus according to claim 1, characterized in that an electronic storage unit is present, which measurement data can later be displayed outside the device via a reader.

36. Apparatus according to claim 1, characterized in that there is a plate with skin-adhesive nature within an injection device, which leaves a space to let a cannula pass when this plate is moved up by a mechanism and thereby lifts the skin.

37. Apparatus according to claim 1, characterized in that this plate lies within a jacket which ensures that the surrounding skin is kept away.

38. Apparatus according to claim 1, characterized in that a mechanism is present to move the holder of the cannula against the skin

39. Apparatus according to claim 1, characterized in that two double-sided adhesive films are present in a card-like arrangement between two protective films, the interior being intended for attachment to the plate, the outer annular for attachment to the edge of the jacket.

40. Apparatus according to claim 1, characterized in that in connection with a suction injection device, in which the skin through

Vacuum is lifted into the cannula inside a suction cup.

41. Apparatus according to claim 1, characterized in that the cannula is arranged within a storage potty receiving a vacuum and a lead wire extends from its shaft, which can be connected to a cable to the measuring device via a socket on the storage potty.

42. Apparatus according to claim 1, characterized in that a valve pin within a guide tube is displaceable in a storage potty with suction bell, the upper end of which is closed by an extendable cover film, while the valve pin projects beyond the edge of the suction bell before use and has a kind of leaf spring , which resists the curls of the sauna and is suitable for making the upward movement of the pen more sudden.

43. Apparatus according to claim 1, characterized in that on the cover membrane (6) opposite edge of a vacuum-maintaining cylinder (5) this is widened to an edge ring (223).

44. Apparatus according to claim 1, characterized in that in the vicinity of the suction cup there is a surface support to prevent the device from tipping over during the injection or measurement.

45. Apparatus according to claim 1, characterized in that the holding device for the cannula carries at its end an annular plate inside the suction bell, which is connected to a membrane which is sealed towards the suction bell roof, in order to absorb suction within the suction bell with the cannula lower and return to the higher starting position by spring force after the suction bell has been re-vented.

46. Apparatus according to claim 1, characterized in that the suction cup is arranged displaceably against springs within a guide sleeve in order to be held by a raster device until the interior of the suction cup is re-vented.

47. Apparatus according to claim 1, characterized in that a central pin within the suction cup is moved against the skin after completion of the injection and before completion of the re-ventilation of the suction cup in order to remove it from the area of the cannula tip.

48. Apparatus according to claim 1, characterized in that a valve during the reduction of the suction cup space by the approach and penetration of the skin prevents air compression in the suction cup.

49. Apparatus according to claim 1, characterized in that at least a sand and dust filter is provided between the suction bell chamber and the space in which a suction piston moves in a cylinder for generating negative pressure.

50. Apparatus according to claim 1, characterized in that the spring for the suction piston is tensioned by means of a Powden cable upon actuation of the holding arm for the suction bell cover.

51. Device according to claim 1,. characterized in that the lever arms connected to the joint of the holding arm for actuating the Bowdenzüqe for the piston movement have such an angular position that an overstroke is effected in such a way that the spring action holds the holding arm in an end position.

52. Device according to claim 1, characterized in that a telescopic rail is attached to the holding arm for the hose with cannulas in order to facilitate the actuation.

53. Apparatus according to claim 1, characterized in that in a suction pump, the suction piston of which is moved by a spring, this piston is additionally prevented during its rest position by a device with increased friction from its initial movement.

54. Device according to claim 1, characterized in that in a suction pump, the suction piston of which is moved by a spring, this piston is prevented from moving during its detent position by magnetic action.

55. Apparatus according to claim 1, characterized in that the suction piston is held in position by means of a / plunger before the suction generation, which is sealed within a type of bellows to this and to its bearing bore.

56. Apparatus according to claim 1, 2 and 3, characterized in that within the space in which a negative pressure is maintained during the injection, an opening for re-ventilation is provided which is connected to an electromagnetic valve.

57. Apparatus according to claim 1, 2 and 3, characterized in that the electromagnetic valve consists of an elastic membrane with a disc made of magnetizable material in the center, which is urged by an electromagnet depending on the direction of current flow in its winding against a ventilation opening, this close or attract the magnet to open it.

58. Apparatus according to claim 1, 2 and 3, characterized in that a valve is present between the suction cup space and the suction cylinder space, which is opened when the suction piston returns to its position in front of the suction device for re-venting the suction cup

59. Apparatus according to claim 1, 2 and 3, characterized in that a control unit which supplies the signals determined by the sensor cannula in a measuring device and this to a printer and a display device and establishes a signal connection to at least one programming unit and commands to at least one dosing device forwards.

60. Apparatus according to claim 1, 2 and 3, characterized in that the medicinal injection takes place automatically via a pre-programmable metering device and the dose to be dispensed can be related to the measured values determined via a computing and control unit.

61. Apparatus according to claim 1, 2 and 3, characterized in that a metal ring on the edge of the suction cup serves as a comparison electrode for the measuring unit.

62. Apparatus according to claim 1, 2 and 3, characterized in that an annular adhesive electrode is provided for attachment to the edge of the suction cup.

63. Apparatus according to claim 1, 2 and 3, characterized in that the switching elements for programming the drug dosage are assigned to periods clearly summarized in blocks.

64. Apparatus according to claim 1, 2 and 3, characterized in that switching rings are provided with regular indentations on the inner edge, which act on contact for programming.

65. Apparatus according to claim 1, 2 and 3, characterized in that switching rings are arranged displaceably in rows around the housing cylinder, which are arranged in series over a wave-shaped design of their inner surface two consecutively arranged contacts on a switch strip when rotated by one raster switch position so make each other actuate that the matrix for the switch position can be determined from the sequence of actuation.

66 Apparatus according to claim 1, 2 and 3, characterized in that a type of switch pin of another switching ring can strike from at least one switching ring in a hook shape without being able to be moved past it.

67. Apparatus according to claim 1, 2 and 3, characterized in that the numbers on the outer edge of the switching rings are raised and are placed in series for programming so that the program data can be printed on a copy carrier.

68. Apparatus according to claim 1, 2 and 3, characterized in that the switching rings have a type of ribs on the sides facing each other in order to facilitate the blocking of the rotary movement by increasing friction

69. Apparatus according to claim 1, 2 and 3, characterized in that a locking device to be actuated by means of a key holds the switching rings in their program position.

70. Apparatus according to claim 1, 2 and 3, characterized in that at least one counting unit is present for which the data storage on the amount of medication dispensed by the associated metering device, week data is processed in such a way that a warning or Wake-up device is actuated

71. Apparatus according to claim 1, 2 and 3, characterized in that a counting unit is present which detects the consumption of the cannulas of a magazine via at least one counting contact and actuates a warning or wake-up device via data processing according to a predefined number of cannulas

72. Apparatus according to claim 1, 2 and 3, characterized in that the contact in the central holding tube for the cannulas, which serves the data transmission between the cannula shaft and measuring unit, also serves as a contact switch for the counting unit on the cannula consumption.

73. Apparatus according to claim 1, 2 and 3, characterized in that a contact switch in the effective range of the switching pin for changing the cannula passes on the counting data on the cannula consumption to the counting unit.

74. Apparatus according to claim 1, 2 and 3, characterized in that the function of the printer is delayed for a predetermined time after receipt of data from the measuring unit with continuous movement of the registrar.

75 .. Apparatus according to claim 1, 2 and 3, characterized in that the switching rings within the respective spring-locked catch position for setting an adjustment level for rotation have somewhat spring-back play, in order to apply the current setting values effective from the electronic memory to the assigned reader To query switch actuation.

76. Apparatus according to claim 1, 2 and 3, characterized in that the display device prompts the refill of the almost exhausted medicament supply from a new storage container, the medication delivery tubes being connected to one another as intended and the difference quantity necessary for filling an expected programmed dose is pumped back into the almost empty storage container.

77. Apparatus according to claim 1, 2 and 3, characterized in that the medicament storage container is only unlocked electromagnetically for removal from the device when the medicament supply is emptied to a predetermined extent

78. Apparatus according to claim 1, 2 and 3, characterized in that a multiple approximate daily dose for decanting via the dosing device in the almost empty storage container is determined and pumped back via the control unit on the patient's command.

79. Apparatus according to claim 1, 2 and 3, characterized in that at least one time programming unit is provided, which forwards at least one appointment in each case in comparison with a timer to a wake-up device and also the period for calling up a specific, albeit after variable pharmaceuticals according to the chemical parameters determined, between changeable but always definable time limits.

80. Apparatus according to claim 1, 2 and 3, characterized in that at least one programming unit is provided, which determines the deviations from measured chemical parameters downwards and upwards in a changeable but determinable manner for the individual case, within which no adjustment of the dosage of an intended normal dosage is permitted.

81. Apparatus according to claim 1, 2 and 3, characterized in that within a programming unit for at least one type of medicine according to the assignment to a dosing device, a normal dose for certain periods can be fixed and their correction according to at least one graded selectable correction factor in conjunction with the deviations of the determined chemical parameter from the normal value determined as desired.

82. Apparatus according to claim 1, 2 and 3, characterized in that at least one programming unit for a special dosing program within changeable but definable dose limits within definable time limits can be selected in the event of exceeding changeable parameters that are defined for the individual case.

83. Apparatus according to claim 1, 2 and 3, characterized in that the wake-up device comprises both acoustic and optical signal generators and a vibrator as signal generators, which can be individually blocked individually by the patient, the activation and deactivation being recorded by the printer can.

84. Apparatus according to claim 1, 2 and 3, characterized in that switches and delay devices are provided which enable the patient to delay the injection until he has become conclusive about the measurement results, or to abort, the latter being recorded by the printer.

85. Apparatus according to claim 1, 2 and 3, characterized in that there is a programmable automatic function which can be closed with regard to its function and which allows the preset dosing program to be changed in the event of multiple clear measured value deviations with corrections which suggest a dose incorrect setting.

86. Apparatus according to claim 1, 2 and 3, characterized in that in the case of multiple additions of old insulin in accordance with the preset dosage, the depotinsulin dosage of the injection date preceding the respective time of the measured value collection is increased in stages, while a drop in depot insulin is noted as the future dose when the measured values are undershot.

87. Apparatus according to claim 1, 2 and 3, characterized in that for the correction of the dose setting for old insulin with the participation of the patient, a pro gram automatic is effective, which makes a gradual adjustment of the old insulin doses in the dosing program in the event of increased or decreased control measured values after a regular injection term.

88. Apparatus according to claim 1, 2 and 3, characterized in that for the correction of the setting of the correction factor for old insulin with the participation of the patient, a programmable automatic function which can be closed with regard to its function is effective, which according to increased or decreased measured values during measurement control according to one of Patients can determine the setting of the correction factor in stages at a certain minimum distance from an insulin injection and prior administration of old insulin. 92a. Device according to claim 1, 2 and 3, characterized in that the plunger of the stage syringe is provided with a kind of wax jacket, the abrasion of which is coordinated with the conical narrowing of the cylinder.

93. Apparatus according to claim 1, 2 and 3, characterized in that as a metering device, a pin is located within the in front of a rigid-walled derivative of the medicament within the tube, which has an inflow channel to the rigidly-walled pipeline, and with hose rings between a drug-carrying tube and one feston sheathing are available, which are partially filled with auxiliary liquid from an electrically operated pump, one after the other, in such a way that the medical inflow is partially interrupted and liquid is displaced in certain quantities in one direction in a distal motion.

94. Apparatus according to claim 1, 2 and 3, characterized in that the pin consists of elastic material.

95. Apparatus according to claim 1, 2 and 3, characterized in that a hose ring is mounted around an inside the medicinal hose, a hose ring being located between that hose and a rigid wall, which is filled with auxiliary liquid via an electrically operated pump , which stops the flow of medication in the tube.

96. Apparatus according to claim 1, 2 and 3, characterized in that a pin within the medicament-carrying hose is held by aperture-shaped lamellae which are narrowed via piezoelectric voltage converters as pressure transmitters for throttling through flow.

97. Apparatus according to claim 1, 2 and 3, characterized in that two double-acting cylinder-piston pumps sn are electrically operated, that the middle of three hose rings is at the same time in cavity connection with an outlet of both cylinders.

98. Apparatus according to claim 1, 2 and 3, characterized in that at least one electromagnet acts on the short lever arm on plates connected to the same by means of a hinge, the drug-carrying hose thus between short and resilient lever arms crossing between the plates and between two lever arms that do not cross one another are guided further to the cannula, so that the same medications are conveyed by pulsed actuation.

99. Apparatus according to claim 1, 2 and 3, characterized in that over an elastic cone with a spiral edge strip, on which the drug-carrying hose is mounted, a conical jacket with a spiral inner strip, the lowering via an electric drive, acts on the hose so that the upper turns of the hose are squeezed earlier than the lower ones and a peristaltic dosing movement takes place, which is blocked when the conical jacket is reset by the action of a barrier lying under a hose turn.

100. Apparatus according to claim 1, 2 and 3, characterized in that an elastic jacket ring is present, in the cavity of which a hose extension is stored, the feeding leg of which is guided flat over the edge of the jacket ring, the hose extension being connected to a plate on the cover side, which is connected to the pressure transducer mounted above it, so that when it approaches, the supplying hose leg is first disconnected and then the tube extension is partially emptied through the cannula, a light source interacting with a sensor to control the filling status of the tube extension while the stroke height of the pressure transducer is controlled by piezoelectric switches.

101. Device according to claim 1, 2 and 3, characterized in that measuring alktrodes are present on the drug-carrying hose, the measurement data of which are transmitted via electromagnetic changes in state depending on the flow rate to a control unit which commands an electrical shut-off valve, and the medicinal liquid is under pressure from the reservoir.

102. Apparatus according to claim 1, 2, and 3, characterized in that the ends of the medicinal tubes are designed to be bent at an angle to the tube ends, which are connected with conical bores of the central sleeve tube for the cannula magazine.

103. Apparatus according to claim 1, 2 and 3, characterized in that a central pin displaceable within the suction bell actuates a raster device which acts on the position of the cannula within the cannula magazine.

104. Apparatus according to claim 1, 2 and 3, characterized in that a height-adjustable central pin inside the suction bell protrudes before the suction generation and for triggering the same of the suction bell edge.

105. Apparatus according to claim 1, 2 and 3, characterized in that there is a valve combination following a compressed gas capsule, which consists of two seat valves, the smaller of which is opened first, and a spool valve

Overpressure chamber towards the seat valves creates a gas pressure build-up, which facilitates the opening of the large seat valve.

106. Apparatus according to claim 1, 2 and 3, characterized in that a swelling pin is mounted inside a tube under a compressed gas capsule, which presses the compressed gas capsule into the mandrel with the trough for gas extraction when liquid is added.

107. Apparatus according to claim 1, 2 and 3, characterized in that a holding arm with a pitot tube for receiving used cannulas serves as a lever arm. to connect a slide-in part for medicine replenishment to the device using a fastening locker.

108. Apparatus according to claim 1, 2 and 3, characterized in that side flaps are present, the closure of which causes a spring tension, which is used to control device functions, and at the same time indicates the functional state.

109. Suction injector according to claim 1, characterized in that a cylindrical pump housing (111), in which a plunger (110) is inserted, is interposed in the vicinity of the cannula without interruption by hose sections with the possibility of an expansion unimpeded by its internal material properties or from the outside is, which operates a sealing element (109,168) and and a valve closure (115, 169) in alternating cycles, where at the force of a plate (112) perforated by passages for the medicinal liquid on the tappet via a clamping device (113, 171) and a The linkage (122, 126) is operated by a motor, the number of pump strokes of the plunger being determined for the respective injection by means of the mechanism for preprogramming the dosage, the latter being triggered as soon as the skin in the suction cup is raised.

110. Suction injector according to claim 1 and 9, characterized in that the sealing element on the plunger consists of a sleeve (109) which is directed against a stopper (II4) through the central bore of which the plunger passes to the cannula and by means of a projection (115 ,) of the tappet closes this hole in counteracting the sealing pressure of the sleeve against the stopper.

111. Suction injector according to claims 1 and 9, characterized in that the pump housing (111) itself is formed by the hose (44), the expansion possibility of which is limited by the non-compliance of the internal material properties or by a fixed casing (116) from the outside.

11 2. Suction injector according to claim 1 and 9, characterized in that the motor is formed by a spiral spring (31) which acts on two wheels (117, 125) rotatable around the pump housing, the latter each having an annular profile strip facing one another ( Fig.23) are located on which to the axis of the pump housing rotating secured ge resilient (121, 127) rods (122, 126) communicate their stroke movements to the plate (112) on the valve lifter within the hose (44). 113. suction injector according to claim 1 and 9, characterized in that the motor is formed by a lifting magnet (170), the spring-back pendulum movements on the plate (112). are transmitted within the hose (44), the number of pulses for each injection in the unit (175) being able to be preset. 114. Suction injector according to claim 1, 2 and 9, characterized in that the medicament storage container (20) consists of a bellows over which a cover (138) is arranged so as to be vertically displaceable, this displacement being carried out via a force transmission mechanism (132 to 137) with the movement for the pump is coupled in accordance with the presettable dosage so that the amount of medicinal liquid displaced by the cover corresponds to the amount dispensed by the pump

1 15. Suction injector according to claim 1, 2 and 9, characterized in that the medicament storage container consists of a bellows which is charged with gas-forming chemicals within a gas-tight container, the type of storage of the chemicals relative to one another resulting in a delayed and gradual release of gas, and wherein a pressure relief valve is present on the container in order to keep the pressure on the medicinal liquid approximately constant.

1 16. Suction injector according to claims 1 and 15, characterized in that a bicarbonate compound is applied to the film to generate gas pressure, which is exposed to the action of hydrochloric acid in layers in thin layers in the gas pressure container.

117. Suction injector according to claim 1, characterized in that there is a cable between the medicament storage container in the direction of the lid, which after tightening due to the reduction in the medication storage container is tightened shortly before the supply is exhausted and triggers a warning device

118. Suction injector according to claim 1, characterized in that within the unit (175) for the electronic control of the presettable dosage a program can be provided in order to actuate the warning device adapted to the changeable individual dosages before the supply is exhausted and to detect the function of the injector block as soon as the delivery of the next single dose is no longer guaranteed. 119. Suction injector according to claim 1 and 14, characterized in that an adjustable obstacle (142) is present in order to prevent the lid (138) from further lowering shortly before the medication supply is exhausted and thereby to block the function of the injector.

120. Suction injector according to claim 1, 2 and 9, characterized in that the suction source is the maintenance of negative pressure in a part of a capped cylinder (5) adjacent to the suction bell. is used, there being a scanning device (69 to 74) on the injector for the surface changes caused by the release of the negative pressure after skin contact on that cylinder, which controls the progress of the functional sequence of the injector. 121. Suction injector according to claim 1 and 20, characterized in that this scanning device consists of a button (74), which is secured as an angular arm on a drum (71) which of a ramrod (69) of oblong flattened cross-section against a spring with the edge of a vacuum-maintaining cylinder (5) is raised, the drum being rotated by the action of a link guide (72) in the same on a fixing bolt (73) such that the load stick leaves its seat on the cylinder wall and a notch in the Switch pin (66), which continues the drum axis, comes to rest above a raster wedge (75) and the feeler bracket (74) swings in to the cover membrane (6) of the vacuum-maintaining cylinder (5), which, after being lowered, causes the support to stop lowers the pin (7) around the cannula shaft from the boundary membrane (10) towards the suction cup, with the notch in the switch pin in the vertical acc that link guide is lowered and operates the grid wedge for further activation of the functions of the injector.

122. Suction injector according to claim 1 and 20, characterized in that a bellows (96) by a ramrod (69), which rests on the wall of a vacuum-maintaining cylinder (5) when it is lifted by inserting the cylinder (5) into the injector is, the air via a check valve via line (101) penetrates into the pneumatic cylinder (98) and lowers the piston and thus the tappet of the slide valve (99), which thereby in the window (85) of the elastic membrane on the otherwise solid cover membrane of the cylinder (5) penetrates, with the window membrane being raised as a result of the reduction in the negative pressure in the cylinder (5) after pressure equalization towards the suction cup closed by the skin, but that slide valve is reset, after which the opened slide valve and the line (100) the bellows is re-aerated, so that the drum (71), which is rotatably attached to that, according to its guide on the fixing bolt (73) lowers and triggers the locking pin (75) and thus the other functions of the injector. 123. Suction injector according to claim 1, characterized in that the injector carries a locking device (148, 149, 154, 155) for the floor cover K 9.165), the latter having a fastening device (165, 207, 208) for those which are intended before Use of the injector is removed after the injector locking device has been activated.

124. Suction injector according to claim 1 and 23, characterized in that the locking device of the injector is formed by locking lamellae (149), of which parts with eccentric attachment with an axis (155) on a ring fixed to the injector (146) with the rotation a control ring (154), with which it connects an axle pin (158) in each case, is moved in and out of the notch (150) in the region of the annular piston (9) of a cylinder (5) under negative pressure.

1 25. Suction injector according to claims 1, 23 and 24, characterized in that the control ring (154) for actuating the locking lamellae (149) is rotated from three pins (148) in the suction bell area against a spring which, in addition to actuating the release of the locking lamellae, within it Passages are raised through the control ring 1 26. Suction injector according to claim 1, characterized in that the rotation of the control ring (154) of three pins in the suction cup area releases through openings for release tongues (187) above the control ring, so that when one of them drops the other functions of the injector are triggered.

1 27. Suction injector according to claim 1, characterized in that the trigger pins (148) for the further functions of the injector are located within indentations a cloverleaf-shaped suction cup rim outside the suction cup space. 128. Suction injector according to claim 1, characterized in that the suction bell is at least partially formed by the injector, into which the cylinder (5) which maintains the vacuum is inserted in a sealed manner relative to the suction bell. 129. Suction injector according to claim 1, characterized in that the injector is equipped with spring-loaded pressure buffers (81) which act on a cover membrane (6) projecting beyond the wall of the vacuum-maintaining cylinder (5) in order to fix it. 130. Suction injector according to claim 1 and 23, characterized in that the locking device of the injector consists of locking pins (204) which, through wall pockets (206) of the vacuum-maintaining cylinder (5), blocking the movement of the support cylinder (10) supporting the limit membrane (10) 205) act, while on the latter, the central membrane is attached with a central portion through which a central through-drilled bottom cover (165) is attached. while the edge supported on the wall of the cylinder (5) is removed along a predetermined breaking ring (208) before the injection. 1 31 Suction injector according to Claims 1 and 30, characterized in that a tube (209), which is closed by the clamp (210), forms a small ball from the attachment funnel for the cannula attachment piece of the injector, which projects somewhat beyond the cover membrane (6) of the cylinder (5) which maintains the vacuum leads to the check of the negative pressure as well as the position of the cannula to blood vessels. 132. Suction injector according to claim 1, characterized in that the suction source is a boiler (172) which is heated by frictional electricity, the heated air escaping through valves (184) and the negative pressure can be maintained up to a valve opening between the boiler and Suction cup area for suctioning the skin. 133. Suction injector according to claims 1 and 32, characterized in that the boiler is divided (174) into several chambers with separate valve equipment for each individual chamber.

134. Suction injector according to claim 1, 32 and 33, characterized in that the boiler (172) is designed as a double-walled cylinder, the lower part of which surrounds the suction bell chamber. 135. Suction injector according to claim 1, 2 and 9, characterized in that a switching mechanism is provided for re-venting the suction bell chamber, which provides for the tension of a spring (64, 104, 105) before the motor causing the dispensing of the medicinal liquid, a locking member (59, 99 , 159) is held in place by a grid (58, 62, 108, 160, 161, 163) until this locking member on the steep flank (162) of the fixed housing backdrop releases the movement through that spring (64, 105) after the medicinal liquid has been dispensed .

136. Injector according to claim 1 and 35, characterized in that this mechanism for re-ventilating the suction bell chamber contains a mandrel (89), the trigger rod (60) is raised against a spring with the insertion of the vacuum-maintaining cylinder (5), after actuation of that Switching mechanism to pierce the cover membrane (6) of that cylinder (5).

137. Suction injector according to claims 1 and 35, characterized in that this mechanism for re-venting the suction bell chamber contains a slide valve (99) which creates a connection to the outside air via the hose (156), the tension of that spring (105) being moved by the pressure effect of a Tongue (82) is caused on the wedge slope of a valve lifter (106), and wherein the housing of the slide valve (99) is displaced against the compression spring (104) and a locking mechanism (108) prevents the valve lifter from returning to a valve open position until that Sliding valve after passage of those wedge bevels through the tongue under the action of the spring (105) causes the locking mechanism (108) to be released and thus the valve tappet to return under the action of the spring (105). 138. Suction injector according to claim 1 and 35, characterized in that the tension of the spring (105) for returning the valve tappet via a resilient hand lever (161) with the sliding valve (99) closed against the spring (105) with counter-bearing on the at Drug ejection with moving disc (225) is caused, after which, by lowering the hand lever into a sudden narrowness of the guide link on the housing, the driver pin (163) engages in the driver bore of the disc (225) and that driver pin only comes back again after the hand lever returns over the steep flank of its guide link on the case by high springs of the hand lever releases the movement of the spring (105), which causes the suction bell to be re-vented through the hose (156) by moving the valve tappet. 1 39. Suction injector according to claim 1, characterized in that a loop (192) is attached to an extension cone (224) continuing in the cannula shaft, which allows the cannula to be removed from a suction bell after use.

140. Suction injector according to claim 1, characterized in that on the cover membrane (6) opposite edge of a vacuum-maintaining cylinder (5) this is widened to form an edge ring (223).

141. Apparatus according to claim 1, 2 and 3, characterized in that counting wheels are present, which are rotated via the back and forth movement of a pinion in accordance with the number of uses and whose blocking by a stop causes the devices to be blocked.

[Claims 142-146 not filed]

147. A method for producing a cylinder (5) which maintains negative pressure, characterized in that two mold halves (215, 216) of an injection mold are produced and shaped next to one another under pressure-retaining cylinders and annular pistons (9) and are then formed by means of transport mechanisms (211, 212 , 213) the ring piston is first fed to a boundary membrane (10) and is glued to it, then the fastening device (165) is attached to the ring piston and finally the ring piston with fastening device and boundary membrane in a sealing chamber with a cylinder (5) with a fixed cover membrane ( 6) as a second part, the air is largely removed from the sealing chamber by means of a pump and then both parts are adhesively combined with the boundary membrane as a connecting surface, so that after removing the vacuum-maintaining cylinder potty, the fastening device of the annular piston prevents it from moving into the cylinder.

1 48. Device according to claim 1, characterized in that means for monitoring the medication depletion are present in order to actuate a warning device and to block the function of the device when the delivery of a sufficient dose is no longer guaranteed.

14 9 Device according to claim 1, characterized in that means are provided in order to set the dosing device, at least the tube section near the cannula, for the mixing of the pharmaceutical components into vibrations.

150 Device according to claim 1, characterized in that the re-ventilation of the suction bell is carried out through a nozzle.

151 Device according to claim 1, consisting of a housing cylinder (1), a base ring, a bellows extending from its vicinity to a piston, a stirring connection for connection to an insertion cylinder including a seal between the housing cylinder and insertion cylinder for receiving an injection syringe, characterized in that that a re-venting valve is present and a device for pre-locking the piston return movement to redeploy the bellows after its interior has been connected via a discharge hose to a suction source and the suction cup has been closed by the patient's skin. 152 Device according to claim 1, characterized in that a tent-like membrane is provided between a central slide tube and the piston in order to enable a backward movement of the slide tube and the syringe even after the piston has been ascertained

153 Apparatus according to claim 1, characterized in that the Se ins chubzy lin de r contains a sliding sleeve which, by means of a spring, lifts the syringe a predetermined distance from the area of the suction cup rim, but under pressure from the piston moved under suction but against the suction cup is lowered.

154 Device according to claim 1, characterized in that a piston ring is attached to the piston, which carries Mag te, which are directed against the iron cover plate of the insertion cylinder with which they can come into contact.

155 Device according to claim 1, according to claim 1, characterized in that pins are mounted in a transverse bore in the piston which are moved by means of a bevel in a gap in the housing cylinder and the notch of the sliding tube and serve to block the piston movement. 156 Suction injector according to claim 1, characterized in that the injector consists of a collapsible medication storage bag as a liquid container and as a means for regulating the medication flow through the tube according to a preselectable variable dosage from a carrier disc (40) which has two opposing rollers (41 ) carries and encloses the hose (44) in a grooved chamber un against a ring-shaped thrust bearing (43) with those roles len and has a sector-shaped passage, which hose outside of this passage is surrounded by an expansion-resistant jacket (45) up to Cannula (8) within the suction cup, a coil spring serving as a power source for the movement of that carrier disc, and movement via a ratchet wheel with pawl (30) in the relaxation direction of that coil spring, and as a means of presetting the dosage before use resilient to ngen (27) serve as stops, which prevent the carrier disk from being able to be determined along a scale, in that they bear against a switching pin (66) which is briefly withdrawn after a sector movement of the disk (51) through a profile link (67), after that of separate spiral spring (55) driven disc (51) of the vibrating device carries pins at regular intervals, which engages in the ring-shaped wedge profile strip (76) along the carrier disc and sets it in axial transverse impact movements as soon as the skin within the suction bell is sucked into the cannula was raised.

157 Device according to claim 1, characterized in that when the insertion part approaches the suction bell, a pin abuts against a contact spring which thereby comes into contact with the cannula shaft 158 Suction injector according to claim 1 and 2, characterized in that at least two tubes are arranged in parallel on the carrier disc and are reunited before the cannula attachment.

159 Suction injector according to claim 1 and 2, characterized in that a device (48, 88) is present which ensures a fold-free hose storage within the fluted chambers (228). 160 Suction injector according to claim 1 and 2, characterized in that opposing pairs of rollers press the hose together.

161 Suction injector according to claim 1 and 6, characterized in that a tension spring (48) extends as a safety device from the hose outlet from the passage of the annular counter bearing (43) to the housing. 162 Suction injector according to claim 1 and 6, characterized in that rope-like threads unite between the hoses (44) via the fixed bridge web (88) of a gear wheel. Summary

Automatic injection device

The invention relates to a device for automatic injection, in particular for the injection of insulin in the treatment of diabetes.

The centerpiece of the invention is a so-called sensor cannula. When a sensor cannula according to the invention is inserted under the skin, the body fluid has an electro-chemical influence on the sensor coating. Embodiments of the sensor cannula are proposed both as an active and as a passive component. A photometric sensor cannula is also described.

The signal detected by the sensor cannula is sent to a computer for evaluation. The computer, in turn, controls a dosing unit which releases the calculated dose to a syringe cylinder from a storage container for injection.

The advantages of the invention can be seen in the fact that the injection of insulin can also be adapted to individual lifestyle habits, that the measurement of the glucose concentration and the injection of the required amount of insulin is carried out with a single puncture, and that all further functional sequences are largely automatic . Automatic injection device

Claims

1. Medical device for the automatic injection of liquids under the skin of humans or animals, in particular for the injection of insulin in the treatment of diabetes. The injection device consists of: a) the actual injection syringe, which in turn essentially consists of a syringe cylinder and piston and a storage container, b). Means for determining the concentration of the respective blood values (or the deviation from the normal values) of the living beings to be treated (human or animal), here in particular means for determining the blood glucose concentration of diabetes patients to be treated, c) means for calculating the the injection - in the case of the measured blood values which deviate from the normal values - the amount of liquid required, here in particular means for calculating the amount of insulin required for the treatment of the measured blood glucose content, d) means for the dosage and amount of liquid to be provided in the syringe barrel, here in particular means for the dosing of insulin, e) means for introducing the liquid under the skin of the living being to be treated, and is characterized in that a cannula serving for the introduction of liquids is at the same time designed as a sensor transducer which is intended to be inserted after the cannula has been inserted the body of the living being the concentration of questionable Body components, especially metabolic states (e.g. glucose content), are determined within the body by means of physico-chemical changes in state.

2. Injection cannula according to claim 1, that the sensor surface of the cannula acts in conjunction with the body fluid of the living being and by means of a counter electrode as an active electrochemical element.

3. Injection cannula according to claim 1, characterized in that the sensor surface of the cannula under the action of the body fluid of the living being changes its electrical resistance in a legal and reproducible manner, and a voltage proportional to this resistance, or the temporal change in this voltage or a current intensity proportional to this resistance, or the change over time of this current intensity is available for evaluation.

4. Injection cannula according to claim 1, that a sensor is present on the cannula that detects the needle

Concentration of the body fluid in question is determined by means of light guides carried in or on the cannula by photometric means.

5. Injection device according to the preamble of

Claim 1, which contains a means for generating a negative pressure on the body surface to be treated (so-called. "Suction cup") and is characterized by Auxiliary units, with the help of which it is ensured that a) the injection liquid is ejected under the skin only after the negative pressure has been built up, and that b) the ventilation is not carried out until the injection has been completed, and automatically, and the suction cup rim at which Measurement serves as a counter electrode.

6. Injection device according to claim 1 or 5, g, e k e n n z e i c h n e t d u r c h a computer module, with the aid of which the dosing and the 'injection of the liquid takes place automatically after (pre) programming and starting the program.

7. Means according to claim 1 (in particular 1c) for calculating the amount of liquid required for the injection, characterized bya) its input-side measuring unit for recording and processing the signals emitted by the sensor cannula, b) a program unit (with timer) for the (Pre) programming of commands, c) a computer unit for evaluating the data given by the sensor and the program unit and d) a command unit for forwarding the computer results as commands to the dosing device.

8. (pre-) programming unit according to claim 7b, characterized by the adjustability of a predetermined "normal" dose, Automatic injection device

The invention relates to a medical device for the automatic injection of liquids under the skin of humans or animals, in particular for the injection of insulin in the treatment of diabetics. The injection device consists of the actual injection syringe, which in turn essentially consists of a syringe cylinder and piston, means for determining the concentration of the respective blood values or the deviation from the normal values of the living beings to be treated (human or animal). , here in particular means for determining the blood glucose concentration of diabetes patients to be treated, means for calculating the amount of liquid to be administered for the injection - the amount of liquid to be administered for the measured and deviating from the normal values - here in particular means for calculating the the amount of insulin required for the treatment of the measured blood glucose content, means for dosing and medicine to be provided in the syringe barrel, here insulin, means for introducing the medicine under the skin of the living being to be treated and possibly means for generating a negative pressure on the body surface to be treated.

The purpose and aim of a perfect insulin treatment is, among other things, to enable diabetics to lead an individual lifestyle that is not linked to a rigid scheme, and in particular to provide a varied diet. It seems particularly favorable to combine the sugar measurement with the injection.

The method of "suction injection" is advantageously used here, in which the skin is lifted into the cannula by means of negative pressure and a firm connection between the injector and skin is ensured until the suction bell is re-vented.

Various embodiments of injection syringes are known from the history of medical technology.

Since the core of the invention can be seen in a "sensor cannula" located on an injection syringe, to round off the prior art, the developments in the sector of glucose measurement that have been carried out particularly intensively in recent years may be mentioned.

The main focus of research in this regard is on the field of enzyme symbology, where reliable biochemical methods for determining the sugar concentration are sought (e.g. DE 28 17 363 and DE 32 28 551). These are mere measuring methods, as they are in principle everywhere, e.g. B. in laboratory applications or, ideally, also in implanted insulin donors. The following work on scientific papers on glucose sensors may be mentioned: Implantable Glucose Sensor, E. Wilkens and MG Wilkens: J. Biomed. Eng., Vol 5, Oct. 1983, pp. 309-315; Problems in Adapting a Glucose-Oxidass Electrochemical Sensor Into an Implantable Glucose-Sensing Device, DR Thevenot: Diabetes Care, Vol 5, No 3, May-June 1982, pp. 184-189; Progress Towards an Implantable Glucose-Sensing Device, DA Gough, JK Leypoldt, and JC Armor: Diabetes Care, Vol 5, No 3, May-June 1982, pp. 190-198. Unfortunately, reliable endurance tests are still pending, so that e.g. Currently permanent implants cannot be thought of. For the previously possible applications, two separate operations and therefore two separate punctures under the skin are always required, namely firstly to measure the glucose content or to take a blood sample and secondly to inject insulin.

Metabolic examinations directly at the bedside using automated sampling have long been known, and measurement data are also stored (e.g. Hudsped, C.L., Richardson, Ph. Cl. And others in DE 24 37 467). For example, the insulin infusion device Biostator from Miles has made it possible to continuously supply insulin while monitoring the blood glucose concentration in recent years.

Because of its size, the apparatus is not transportable and can therefore only be used at the bedside

In recent years, implantable electrochemical sensors, e.g. B. from Leblanc jun '(DE 26 45 048) has been specified. Here, a vessel is inserted inside a casing, which serves to monitor the ion activity. The liquid is supplied by drip infusion.

It is also proposed to take blood samples for analysis using a lying probe (Clemens, A.H. Myers, E., Weston, R .: DE 27 20 482).

The arrangement according to the invention comes closest to the invention by Ash, St. R., Lafayette, Loeb, MP with its "arrangement for the administration of insulin as required" (DE 30 50 155). Here, an insulin-supplying cannula becomes a sheathed sensor directly for common use leadership attached. Instead of a more sensitive fermentation reaction with glucose, the osmotic pressure of the blood is measured and deducted from a possible lack of water in the body while determining the salinity. The measurement results are arithmetically coordinated with a dosing program. Such a permanent implantation of the sensor and the so-called permanent cannula has so far not been able to establish itself, since problems of infections in the insulin patients who are particularly at risk of infection could not be overcome.

The insulin pumps, which are particularly useful for adolescent and metabolically unstable diabetics and are worn on the body with the so-called permanent cannula, are used to supply a controllable minimum amount of insulin with the possibility of arbitrarily changing additional doses that the patient can set himself before meals. (See e.g. R. Haerten, H. Kresse: DE 25 13 467.) Here is one

Measuring device for determining the blood sugar level not available.

M. P. Loeb and A. M. Olson indicate an arched syringe to be carried on the body under catheter application (DE 32 41 313).

Several metering pumps with storage vessels are also described for the implantation into the body (e.g. R. D. Cummins, O. Park: DE 33 43 708).

Furthermore, one deals with the wireless transmission of metering instructions to such a device (K. Prestek, M, Franetzki: DE 30 35 670), as well as with the function control via measurement data. the inside, too a blocking device is provided when an insulin infusion limit is exceeded (Fischeil, R. Ellentuch: DE 32 47 232).

The total implantation of the insulin sensor, insulin storage container and dosing device has not yet reached the stage of animal testing. Apart from the immense costs for such devices, it has been shown that the biochemical processes on the sensor converter do not have the long-term constancy required for implants.

The title "The Development of a Needle-Type Glucose Serisor for Wearable Artificial Endocrine Pancreas" (Yamasaki, Y .: Journal of Osaka Univ., Vol 2, Sept. 84) should not hide the fact that these are dogs button probe implanted in anesthesia deals with a complicated layer structure and the inventive idea of the cannula coating is not mentioned,

The wire-coated sensors from Wilkens E. and H. G., Daniel R. u. a. and Gough A. u. a., which will be quoted in more detail in the description of the sensor cannulas. Overall, however, such "catalytic sensors" pose considerable problems in the sense of electricity-generating cells, precisely because their permanent use in humans is sought. Optical systems are also not without problems with regard to the competition of substances (e.g. amino acids rotating in the polarization plane), but only practical in a miniaturized form of body access through the cannula.

The suction injection (ie: the injection under a suction under a suction cup drawn skin), which was already described on November 7, 1933 by M. Demarchi (U.S. Pat. 1,934,046), and by GN Hein (U.S. Pat. 2,743,723 dated May 1, 1956), by WRC Geary (U.S. Pat. 3,122,138 of February 25, 1964) and on the part of the inventor since 1974 in several own patent applications (GB: P 14 94 325, P 14 94 646, P 15 13 463, P 15 17 289; DE: P 25 51 991, P 25 51 992 , P 25 51 993, P 30 19 589; Australia: P 510, 272; USA: P 4, 139, 008, P 4, 169, 474, P 4, 284, 077, P 4, 393, 870; Canada: P 11 89 412, etc.) has been developed so far due to technical reasons

Imperfections in humans are not known applications, although human skin would be well suited for suction injection because of its special elasticity and finer hair. G. H. Hein already specifies a device which reliably prevents premature penetration of the cannula into the skin before the end of the suction process, but the more important removal of the cannula from the skin after the injection process has been neglected. The methods of generating negative pressure are also still unsatisfactory, although one-hand operation is of course a prerequisite for the self-treatment of diabetics.

Particularly with regard to suction injection technology, adjustments to the measuring technology and further improvements with regard to storage, mixing and metering of the insulin, but also the generation and application of the negative pressure are required.

Finally, it can be criticized about the suction cups that have become known so far that, after the injection has been completed, the patient either has to forcefully lift the suction cylinder off the skin, with the risk of cutting wounds through the tip of the cannula, or that he has to operate a ventilation valve. There could also be an opening in the discharge hose to the peristaltic pump, which the patient must keep closed with the finger before and during the injection, or the patient would have to switch off the permanent suction source after the injection (e.g. to close the tap to a water jet pump). However, all of this is not reasonable for the group of people who are to benefit from the suction bell, especially since it has so far not been possible to control whether and when the injection is complete.

The dosing systems are also still unsatisfactory; an injection device specified by Stein (DE 14 91 840) does indeed use the principle of a medication supply through the metering syringe plunger through a valve in the same from a storage bottle, but the need for separation between the outside air and the storage bottle content is not taken into account.

Needle-free injection by means of overpressure is forbidden for long-term use because of the considerable tissue damage.

In general, too little attention has been paid to the necessity of avoiding patient cleaning of device components.

The over fifty-year attempts to use suction injection to a significant extent show that only a complex treatment, in which all functional parts and the human constitution are coordinated, lead to an advantageous and also commercially usable solution. When the prior art is critically examined, it can be seen that the methods for treating the insulin-requiring diabetics are in need of improvement.

The invention aims at extensive automation of the various functions of the injection device, so that the application by laypersons is easier and more reliable. In particular, the sugar measurement required in the individual lifestyle of the diabetic should be coupled with the respective injection.

The patient's metabolic status should be made known to him frequently and as regularly as possible, in order to make it easier for him to keep to the diet and to compensate for any deviations in lifestyle from a rigid norm by adapting the insulin treatment. The treating physician should be able to gain insight into the patient's diet and to adapt his dosage suggestions for insulin.

Based on this intention, the object of the invention can also be formulated to create an injector, the handling of which is also possible for the disabled through automation of its functions, and which favors more frequent daily applications. For this purpose, the injector should be as small and handy as possible, safe in its function, without any health risks and in its use with little annoyance. The handling - also with regard to the refilling of insulin or cannulas - should be as simple as possible, the costs should be as possible be small.

This object is achieved in that one of the introduction of liquids (especially In sulin) under the skin is also designed as a sensor transducer, which, after the cannula has been introduced into the body of the living being, is used to determine the concentration of the constituent parts of the body, in particular metabolic states (e.g. glucose content) within the body by means of physico-chemical changes in state notes.

In order to implement an automatic injection apparatus according to the invention, a measuring and evaluation unit and a dosing device are installed between the sensor surface and the cannula.

The sensor itself is designed so that it represents an electrical voltage source, and its voltage changes or current output serve for measurement signal processing, or the sensor changes its conductivity for externally supplied electrical currents under the physical-chemical influence of the state of the body and thereby delivers Measurement data to the measuring instrument.

For this purpose, at least a layer (or several layers) is usually applied to parts of the cannula shaft, which produces the sensor property. According to the main application of the invention, this sensor coating on the cannula shaft mainly reacts with the body's glucose in order to react with it as a kind of electrical cell or through the addition of glucose or its reaction or synthesis products (such as glycogen, starch or also lower carbohydrate chains) Conductivity via the cannula depending on the glucose concentration of blood or tissue (depending on the position of the cannula within a blood vessel or in the subcutaneous tissue or in the abdominal cavity. As an alternative to the electrochemically active cannula described so far, the photometric sensor cannula is characterized by a coating which changes under the influence of metabolic products such that the degree of change in the sensor coating is measured by means of signals fed in and out via optical fibers and with the concentration of the metabolic products can be related.

By removing a part of the cannula shaft behind the cannula tip with its grinding surface, the wall of the shaft can be supplemented by plastics, which sensor properties have been introduced primarily in electrical insulation from the cannula shaft. It can also be used for dispensing liquid and with sensor shafts on the surface, the clearing of which can be placed in such a groove-shaped hollow cannula shaft in a tight connection to the bore of the syringe attachment or - where such is not available to the infusion tube - without the free end necessarily being over the Empty the tip of the cannula itself (with a very short cannula shaft, however, this can be useful to guarantee the drug injection under the skin).

If such or a similar sensor cannula also appears to be usable for the dialysis of patients with renal dysfunction (with quantitative recording of metabolic products retained in the body or of the water and salt balance), the use of the insulin pumps appears for a long time if the possibility of recording the measured values appears with lying cannulas particularly advantageous. Characteristically, the subdivision of the cannula shaft into at least two compartments that are electrically insulated from one another can be suitable for saving an additional comparative electrode outside the cannula. Power is supplied and discharged via lines which are expediently connected to the measuring device in places within the infusion tube (embedded in and insulated by its wall). When using the sensor cannula for a single injection, there is a new possibility according to the invention that the sensor coating of the cannula is irreversibly changed under the influence of metabolic products, in particular of sugar or more specifically glucose, and the measurement parameters are obtained from the extent of these changes.

In particular, glucose can be bound to the cannula coating (for example, to biochar or fermentatively) and the conductivity of the sensor coating chosen as a good conductor can be reduced as a function of the sugar supply, taking into account the time function, by enriching the sugar that isolates as non-conductor. Adherence to the time required for measurement and injection is best guaranteed when using suction injection, i.e. when the skin inside a suction cup surrounding the cannula is drawn into it and held until the suction cup (automatically controlled) is re-aerated .

When using suction injection, the edge of the suction cup (for example using a contact gel) can be used as a comparison electrode. The completion of the measurement and the calculation process for adjusting the dose to be administered can serve as a trigger signal for the metering pump. This eliminates the on and for advantageous injection initiation by earth fault of the cannula within the raised skin. (The dependence of an "earth fault", which is actually the contact with the body as a transmitter, on the proximity of external electrical fields would have made it necessary to guarantee the triggering by means of the electrical connection using the skin as a conductor, which principle in the event of failure of the Measuring device is also used according to the invention.)

The compensation of a poor metabolic setting within a medically programmed framework via additional altinsulin doses calculated as cheap or through the calculated favorable deduction of depotinsulin doses belongs to the essential embodiment of the invention. From medical experience in patient management, the auxiliary device arises to be able to limit the amount of an arbitrary additional dose of old insulin before planned meals.

On the other hand, situations arise in which automatic programming is expedient, which allows automatic programming without the involvement of the doctor (insofar as this does not block this possibility in the case of unsuitable patients by means of the device provided) and the programming of errors (and if necessary also without assistance) of a doctor) to adapt to changing nutritional and living conditions. The measured values and the administered

Cans and the type of influence on the set program are printed out in the device. In addition or instead of the pressure, an electronic storage device for the measured values (and the dosages) can also be provided, which is external to the doctor via an egg a visible screen and can be transformed into clear curves. Even when using a continuous infusion cannula, the possibility of a single measurement (to determine the metabolic position) can be useful.

An inventive step is also the programming by means of rotatable switching rings which are put together into program blocks, since they record the simultaneous overview of the starting point of the programming. A print-type-like majesty of the program symbols and their arrangement in a transverse program line as a whole allows the intended program to be printed in the patient register or otherwise without special technical facilities.

The locking against rotation of the switching disks beyond the set locking step by applying lateral pressure by means of a screw-operated screw connection is facilitated by the lateral profile formation on the support rings underneath the switching rings. There is a spring back play between the carrier ring and the locking ring when contact is made with the control unit, so that setting values can also be made visible on the device display, even if the program automation has changed.

Prewarning signals that can be influenced by the patient are provided for the impending depletion of medication (or also cannulas) and, under computer control, a replenishment of an almost exhausted medication supply to a final dose, which allows the storage container to be almost completely emptied. A magnetic lock can force the patient to refill, but this can be postponed by refilling a larger medication quantity is repaired. In cases where, for example for conductivity measurements, it would also be necessary to coat a part of the cannula volume (so that the cannula diameter does not have to be increased to increase injury), a small amount of medication must be dispensed by the metering pump before the cannula penetrates the skin (For example in the form of a single volume-reduced basic cycle) is provided in order to prevent capillary suction of blood or tissue fluid and a power line in the bypass via this.

The device for suction injection itself was further developed according to the invention, not least to reduce its size, which only makes it possible to add the measuring and control device for the sensor cannula to it without losing the necessary maneuverability. Since the vacuum requirement of the suction bell is relatively low and the human hand is capable of considerable force concentration, a piston-cylinder pump remains an economical method for storing energy in a spring.

A sand filter is provided in the suction channel between the vacuum pump and the suction bell in order to prevent the destruction of the piston-cylinder surface by the finest quartz grains, as are torn out of the fine skin pores by the suction. Such a pump is operated in a space-saving manner via Bowden cables. The tensioning process for the spring is expediently connected to the pivoting movement of the cover over the suction bell. The suction piston is locked from the suction bell while weakening the breakaway force of the spring by means of a clamping device or the adhesion of permanent magnets. In this way, the risk of tilting is mitigated if the suction generation is triggered on one side eccentrically from the suction bell. The delay caused by this relief mechanism favors the closure of a spring-loaded pressure relief valve, which compensates for the air pressure compression that occurs when the suction cup is placed on the skin and when the suction cup is raised against the cannula. The raising of the suction cup rim against spring pressure and the release of the locking of the return movement of the suction cup during its re-ventilation cause a distance between the cannula and the skin after

Injection. This process can also be solved by a central pin, which is lifted centrally in the suction cup (due to the proximity of the cannula in the center of an elliptical suction cup) and is pressed against the skin during spring suction and during the re-ventilation of the suction cup. The spring tension for such auxiliary functions associated with considerable expenditure of energy is expediently closed when one is closed. Cover flap (with memory function for inadequate availability of the device) causes so that the pressure of the central pin serving as the trigger of the vacuum pump on the skin can be alleviated.

In general, the possibilities were tested to deflect the pressure of release pins, which initially protrude from the area around the edge of the suction cup, after activation of the vacuum source. This happens through the action of wedge bevels on a spring-loaded ring, which is low-friction after passing the Wedge bevel releases the pin movement upwards.

A return movement until the spring-loaded ring acts on the wedge bevels takes place via an elastic sleeve following the edge of the suction cup, which triggers the trigger movement while securing the skin end of the suction cup, whereby the suspension of the release pins provides the stability required for the suction cup edge, so that no outside air penetrates under the suction bell rim during suction development.

In the case of storage pots which maintain the vacuum and in which the required suction is already prepared in industrial production, the release of the same after transfer during storage is transferred to a release mechanism in the device by the holding function of a lid just before the injection. Since the jamming effect of the skin compared to a valve pin in a tube parallel to the cannula has proven to be unreliable, this mechanism has been improved in that, starting from the valve pin, a resilient bow protrudes from the suction bell towards the skin. The temple ends lie on the edge of the suction cup.

When the potty is pressed manually against the skin, the clip is stretched and then suddenly all of a sudden bent in the opposite direction, the ends being pulled from the edge of the suction cup and being lifted into the suction cup. The valve pin flies upwards and its tip breaks through the membrane over the end of its tube after she was stretched out a little before. The air pressure is thus equalized between the vacuum accumulator and the suction bell.

Because the suction cup cannot be re-vented until the injection is complete, a Open the spring mechanism before using the device, which is triggered by the injection mechanism when it runs out. In the case of the simpler electronically delayed triggering, a ventilation valve is proposed, the double-acting magnet of which draws the valve membrane onto the ventilation channel during suction generation (the fixation then provides the negative pressure) in order to keep the valve membrane away from the ventilation channel during the re-ventilation. The magnet does not need against one in this way

To work return spring. In a mechanically operated example using a permanent vacuum source, the re-ventilation valve is opened by actuating a valve tappet in the last phase of syringe emptying within a contracting bellows, supported by the attraction of permanent magnets, which also prevent valve flutter by changing the opening and closing positions . Finally, when preserving a larger vacuum storage space in constant connection to the suction cup by actuating the vacuum generator, the re-ventilation mechanism can be replaced by a nozzle for the duration of the injection, which air gradually penetrates into the suction cup after the suction has been switched off.

In the field of dosing, the quantitative transport of the medication via three valves closed in a certain order still appears advantageous, for which purpose preferably by means of edge rings. Dosing chambers on a pin in the medication tube near the cannula attachment of electromagnetically operated pumps are filled with an auxiliary liquid. Piezoelectric actuating elements surrounding the hose can also be used as metering valves. The operation of a metering pump to convey a (usually more viscous) liquid such as paraffin prevents pump parts from coming into contact with the. Medicines and save cleaning. The auxiliary liquid can also be introduced behind the plunger of a stepped syringe, the effect of a metering hydraulic system with powerful and slow advancement of the plunger of the stepped syringe. The plunger can be made of wax or be surrounded by a wax-like shell - avoiding shrinkage during manufacture under an ultrasound field - thereby avoiding the costly grinding fit.

A special coupling valve consists of a slide valve with springback in the device part and a kind of sliding sleeve over a side opening for the access of auxiliary liquid into the syringe, the sleeve being inevitably moved into the device when the syringe is inserted. In this way, an air-free coupling of both components is guaranteed.

In the field of vacuum generation, another type of lock valve following the channel on the opening mandrel of a compressed gas cartridge is important, in which a small-sized poppet valve inside the plate of a larger poppet valve is first opened with less effort. The gas, which is under high pressure, then accumulates in a chamber, which is closed by a slide valve behind the seat valves. As a result of the pressure equalization in the chamber, the large seat valve can then be opened easily. Passed through the open slide valve the gas flow then to the gas jet pump.

The gas capsule can be lifted into the opening mandrel using a swelling pen (e.g. from AgarAgar) while absorbing water.

An automatic cannula change is facilitated by a stacking cannula, whereby in the case of a vertical arrangement within a magazine tube or hose, the preceding cannula shaft lies in a hollow in the body of the subsequent cannula and the drug supply is carried laterally via an annular groove in the cannula body with it in the cannula shaft opening hole takes place.

At the end of the chamber in the body for receiving the adjacent cannula shaft, an elastic septum can be perforated centrally by the latter. To enable storage in curved magazines, there may also be an incision between two cannula body halves around which the bend can take place. The medication can also be supplied via vertical channels along the

Cannula body. Gluing or thread-like attachment between the cannula bodies can enable transport by train, which preferably originates from the claws at the end of the receiving tube inside the suction cup cover.

Pressure effect on the stacking cannulas can originate from a compression spring which is tensioned by the thrust effect of used cannulas when they are manually pushed in the circuit from the receiving tube over the end of the magazine hose. This pushing movement is important for the advancement of a stacking cannula into an open position in coincidence with the drug exit points in the magazine. A leaf spring actuated by means of a shaft pin on the cover can serve as the switching mechanism. The raising of the central pin in the suction cup can also allow a cannula to be lowered by means of a ball grid, which in this other solution example takes place under the action of compressed gas on a sealing piston in the magazine hose. Flattening or oval shape of the magazine and cannulas can serve as a rotation lock and allow the effectiveness of the joint elements between the cannulas as well as a better contact and sealing of the drug-carrying channels. For better skin distance after the injection, the central holding tube, sealed with the cannula magazine, can be fastened to a plate under the suction cup roof, an elastic septum spreading from the plate attached to it. The latter is lowered against the skin under suction with the magazine and raised again when the suction bell is re-vented.

In the area of the dosing, with appropriate resistance of the medication tube (e.g. made of silicone), the dosing is considered by means of a kind of magnet-clocked rocker, whereby the type of clamping prevents the inflow from the storage vessel during the squeezing of the tube (for example, also within a dosing screw whose Windurrgen are successively narrowed over the tube by flattening them.The flow measurement (for example with the medication outlet valve timed (which can also be done by means of tube ring constriction or piezoelectrically pressurized orifice plates around an elastic pin in the tube) in conjunction with a critically high flow rate or a constant Drug pressure in the reservoir or the use of the electrical field formation during the flow form possibilities that can be considered to reduce the dosing mechanism. The use of suction injection, in which the skin is lifted into the cannula by means of negative pressure and a firm connection between the injector and the skin is ensured until the suction cup is re-vented, is particularly favorable for solving the task of combining the sugar measurement with the injection.

A comparison of over fifty years of attempts to use suction injection to a significant extent shows that only the complex treatment according to the invention, in which all functional parts and the human (especially psychological) constitution are coordinated with one another, is advantageous and also lead commercially usable solution.

According to further embodiments of the invention it is provided that for mixing the insulin components in the area of a peristaltic pump, which is operated by means of a spiral spring, on the axis of the same by means of a second spiral spring, at least one pin fastened on a disc so over a gear-like unevenness of the opposite surface of the the pulley of the peristaltic pump is moved, which causes a jerky, repetitive evasive movement of the peristaltic pump against a spring.

The dosing accuracy in the case of small circumferential dimensions is increased in that two hoses are guided in parallel over two hose pumps acting in the same way; further characterized in that the hoses can expand within the pump only between the grooves of the discs carrying the rollers, and in that the hose section, for example, reunited between see pump and cannula is surrounded with a solid jacket.

An even better solution results from the introduction of a small piston pump directly in front of the cannula connection piece, this in preprogrammed pump cycles either via the guide of a spring-operated disk or by dose. repeated actuation of an electromagnet causes the drug delivery. The storage of the piston pump within the medication tube when actuated from the outside via the mediation of a cross plate on the pump plunger saves cleaning and facilitates the exchange of the metering system in accordance with the overall object of the invention.

The replacement of a fitting piston with an elastic sleeve, the hollow of which is pressed against an abutment surface, for example of a pierced plug that is laterally welded to the tube, by means of the plunger for dose delivery, is particularly advantageous with regard to the production costs, while the end of the plunger passed through the bore of the plug is widened and, in push-pull, closes the plug bore to the cannula attachment cone.

In a particularly advantageous orphan, a special pump housing can be spared if the stopper is inserted directly into a hose extension, the leaning of the hose against the surrounding injector housing or some other internal strengthening of the wall, for example by inserting a fabric, practically prevents the wind boiler function. The possibility of demoulding undercuts in rubber injection molding technology makes this solution easier. Such a design of the metering device also takes on the function of the vibrator for mixing the medication and avoids the permanent squeezing of the tube by the pump rollers.

The installation of a hose between the grooves of the carrier disks for metering rollers that are included in the casing reduces the expansion of the hoses within the pump, which is additionally compensated for by spring tension at the end of the hoses emerging from the pump. Two pairs of rollers can also be arranged radially to one another in such a way that they enclose the hoses between them.

A fixation of the pair of hoses via a crossbar between the hoses interrupted in the manner of a rope ladder for a fixed ring gear can counteract the tensile action of the rollers.

Uniformity of pressure on the drug supply from the beginning to the end of the depletion of the Arzflei supply is achieved by unscrewing the cover against the bellows in contact with the drug in relation to the liquid doses to be dispensed. As a result, a coarse dose is achieved, similar to the use of a step syringe, which, however, is supplemented by the piston pump for fine metering.

In a second example with a pressurized gas cushion, this is brought about by delayed release of carbon dioxide gas on exposure to dilute hydrochloric acid on calcium carbonate, the latter gradually being broken down on rolled-up polyethylene film by one of hydrochloric acid Pectin film is protected. A pressure relief valve constantly prevents excessive pressure rise.

The storage cylinder receiving the bellows can expediently be a component of the device, while the bellows is exchanged with the medicinal liquid in each case. 375 mg of sodium bicarbonate and 815 mg of 20% hydrochloric acid are required for the production of carbonic acid in an amount which is necessary to expel 50 ml of liquid at a residual pressure of 1 atm. at

Using calcium carbonate would require 446 mg of this. For binding to a film, the more heat-resistant calcium bicarbonate is preferable, since it can be blown heated over the film or sprinkled on a polyethylene film heated to 100 to 120 degrees Celsius.

The prewarning before the drug supply is used up results in the solution from a gradually lowered screw cap - which can be tracked in a cylinder slot along a metering scale - from the installation of a removable obstacle against the screw cap coming down at the point of the lower one. Limit level door a sufficient single dose before the exhaustion. It can also - especially within the difficult to see compressed gas storage bottles between the bellows and container lid, a thread is attached, which actuates a warning device when tightening.

Finally, drug consumption can also be electronically monitored and made legible. A pre-warning margin can be selected and the function of the injector can be blocked if the remaining amount falls short of the single dose. The function control has been improved in many ways.

In the case of solutions operated by the spring, such as in the case of the peristaltic pump, the control mimic for triggering the injection or re-ventilation is pretensioned at the same time as the insertion of the cannula-carrying vacuum reservoir; So it is not cumbersome to operate a special lever, but as actuators there are pins which project downwards from the cannula connection piece. To control the skin contact of the suction cup edge, there are three pins in bays outside the clover leaf-like suction cup edge, which makes it possible to move the trigger pins closer to the device center without reducing the adhesion due to the smaller skin contact area. Pins stored inside the suction cup must be sealed towards the suction cup roof.

In the example shown, such pins first cause a ring to rotate against its suspension in order to then be able to step upwards with little friction. The rotation of that ring engages pins moved from the opposite direction with openings in the ring and the depression caused by manual pressure can open the valve between the suction bell and the vacuum accumulator.

In the example described, the negative pressure is generated in three equal-sized chambers, which are arranged in a ring around and above the suction bell, specifically via the heating and expansion of the air by means of electrical heating wires via the lighting network. The chamber heating is switched off via a temperature sensor (e.g. bimetal switch) or a short-term switch after the maximum temperature has been reached, and the chambers are then cooled. Spring-loaded valve flaps leave the

Escape hot air from the chambers via the suction bell, which also serves as a side effect of cleaning them, while pins pry one of the valve flaps out of their seats for air pressure compensation between the chamber and the suction cup.

Since a wide hat-brimmed edge around the edge of the suction cup is useful anyway to prevent a stretched injector from tilting on the skin and thus preventing unwanted air from entering the suction cup, the higher space requirement of the heating chamber is less important than the saving of the industrially evacuated storage potty around the single cannula.

The division of the ring-shaped jacket space around and above the suction bell into three individual chambers allows the injector to be used three times after each heating. The vacuum accumulators have also been significantly improved. For example, a membrane-like cover around the cannula opening cone, after loosening a support for the cannula or the injection-molded pin around the part of the cannula shaft lying in the reservoir, allows the cannula to go deeper into the skin.

In other examples, the suction cup is formed by a rubber-elastic sleeve of the injector, into which the vacuum accumulator is pushed in a sealed manner. Such a memory of the two-chamber system, in which a distinction is made between the storage space and the suction cup space and the cannula emerges uncovered, then resembles a memory of the single-chamber system, ie the cannula as a whole and. to the top behind the end membrane. The dead space around the exposed part of the cannula shaft can be reduced by saving it by filling it with an annular piston. There is no need for a special valve between the suction bell and the vacuum accumulator if an expandable membrane is used as the partition between the annular piston and the vacuum accumulator. In this case, however, the ring piston must be held against the vacuum accumulator before use. According to the invention, it has a transverse groove for this purpose, into which holding tongues from a lower collar or from cover extensions extend from the lower edge of the vacuum reservoir into this transverse groove and thus prevent the inward movement of the annular piston under vacuum influence before use. In sections of the annular transverse groove between these retaining tongues, retaining pins or lamellae snap into the injector and, after removal of the retaining collar or the suction cup cover, hold the annular piston in place until the injection is triggered.

From a manufacturing point of view, the more complex transverse groove can be replaced by producing an annular piston with an open ring notch in the same shape with the vacuum accumulator. The latter is then transported via a conveyor carousel to an adhesive device - for example an ultrasound head - and connected with a circular, stretchable film. Then the annular piston is brought back under a vacuum reservoir and the edges of the circular film are glued to the edge of the vacuum reservoir. According to the invention, this edge is broadened like a hat brim and can at the same time have a linear sealing contact with the suction cup sleeve of the injector.

The transverse groove or the ring notch can be designed horizontally or obliquely in alternating sectors, on the one hand to support the locking effect of the cover tongues or cuff pins, on the other hand but to make it easier to unlock the injector retaining pins or blades.

Since the lid of the vacuum accumulator is held rigid in this solution example, it is used during use

Cannula approach except by lifting the skin due to the flexibility of the suction cup cuff. The enlargement of the movement path between the skin and the injector can serve to release the negative pressure effect on the skin within the suction bell, but can also trigger the metering device for injection on a subsequent switching path.

In the second example shown as a whole, the correct vertical movement of the injector against the skin is a prerequisite for the trigger actuation that the suction bell cuff can only be lifted simultaneously with the lifting of a cylinder segment which has a tight-fitting ring to the outer surface of the cylindrical receptacle for the vacuum accumulator , which jams against the wall of the receptacle when the movement is one-sided. In this way it is ensured that the injection is only triggered after the suction bell has come into contact with the skin safely and under vacuum.

In the first example shown as a whole and equipped with rotary pumps, they are triggered only after the negative pressure effect on the skin has been determined. In this case, a button serves as a "suction switch", which controls changes in shape of the negative pressure accumulator. In the examples shown, these changes in shape concern the lid around the cannula opening cone. As described, this can be membrane-shaped and can lower itself before the injection. A circumscribed elastic part is pulled in under the influence of the negative pressure in the reservoir; after the vacuum is reduced by balancing with the suction cup space, this membrane will rise slightly. The usable performance is low. Therefore, a slide valve working with low friction was provided as the switching element. The associated button is first advanced by means of a pneumatic piston against the elastic diaphragm, which is operated by a bellows, which is compressed when the vacuum accumulator is inserted into the injector and remains compressed until a re-ventilation takes place via the slide valve mentioned. The expansion of the bellows, which is optionally reinforced by an additional spring, actuates the switching element for the further functions of the device.

A slight protrusion of the edge of a welded-on cover membrane can offer resistance to a resilient holding device, as a result of which a more expensive transverse channel can be avoided. On the other hand, a wedge-shaped device that acts laterally on the cover can be useful for removing the vacuum reservoir after use.

The single-chamber system becomes economically viable if the elaborate trigger mechanism for the suction cup cover carrying the membrane is transferred to the injector itself. A stretchable elastic membrane spans a bottom ring within the vacuum accumulator, which in turn has a high guide cylinder, which is loosely inserted into that vacuum potty.

An inner part of that bottom ring is glued to another ring-shaped cover ring, which with its Edge rests on the lower edge of the vacuum storage potty and after evacuation of the latter prevents the bottom ring from being lifted until an edge strip of that cover ring along a predetermined breaking line is removed by pulling it down. In accordance with the intended purpose, this only takes place after pins or latching segments take over the supporting function for the base membrane from the injector at a height above that inner guide cylinder at its edge through material thinning wall thinnings of the vacuum storage potty.

In the single-chamber system, the entire cannula is protected behind the cover membrane, whereby the disadvantage of blunting the tip of the cannula when passing through the membrane is less of an issue with the previously used rubber membrane but with the highly elastic plastic film. The fact that after the opening of the membrane closure through the cannula attachment into the storage vacuum takes effect can be used to make the depression visible laterally by collapse of an elastic ball.

If a blood vessel is hit by the longer cannula predetermined for deeper injections, the ball fills up with blood after the clamp is released. In such a case, the incorrect injection into the blood vessel can be prevented by stopping the injection.

The unicameral system has the largest vacuum storage space in terms of the overall size of the vacuum potty. Sterility of the cannula is guaranteed even without external packaging. The function control for the re-ventilation of the suction bell has been improved in that a slide valve which can be actuated easily is initially stored under power for the return of the valve lifter before actuation of the

Dosing device is closed. However, the valve reset mechanism is blocked until the metering mechanism has completely expired, which is activated by deflecting a moving locking element on a steep flank of the link guide on the housing. In this way, the risk of re-ventilation before the administration of the entire amount of medicinal liquid is countered and the additional risk that during the withdrawal of the cannula tip through the upper skin layers, medication is also injected there - ie intracutaneously.

The mixing of the medicinal components can also be brought about by mechanically coupling the buzzer of the electronically controlled warning device to the drug-carrying hose parts around the pump in such a way that its vibrations are communicated to the inside of the hose. also just before the injection. An edge ring on the cylinder that maintains negative pressure serves both for better attachment of the boundary membrane and for a cheaper seal to the injector.

The advantages that can be achieved with the invention are manifold. Starting from the fact that a diabetic by means of the (insulin) syringe according to the invention without additional self-damage by scratching the skin of the skin, which is particularly rich in pain points. Finger finger and without the cumbersome procedure of stacking a test strip and calorimetrically reading the same, during the insulin injection or, if desired, even before actuating the syringe plunger. By recording the measurement results and the insulin doses administered, the patient and doctor can give an account of the therapy situation and communicate more easily. With the individual measurements - be it via the sensor coating of the cannula as a power source or the measurement of changes in conductivity under the influence of glucose - by means of the constantly renewed cannulas there are no sources of interference, such as protein or electrolyte accumulation on the measuring probe, as they make long-term use difficult.

In connection with the metabolically controlling sensor cannula, suction injection offers the particular advantage that the duration of skin contact is automatically controlled; it is also advantageous for the measuring arrangement to have a reference electrode of secure adhesion in the suction cup rim near the cannula, which does not have to be attached separately.

The milling of the cannula shaft into a kind of skeletal cannula, which receives the medication guide channel and the sensor, saves the cannula from thickening due to the sensor coating, which would negate an essential advantage due to the painfulness of the puncture, which is lost when using suction injection technology and modern ones fine triangular cut cannulas.

By dividing the cannula shaft into the metal skeleton part and an attached sensor part - which can also be applied to tubes inserted into the channel-shaped cannula shaft - it is possible to distinguish between two electrically divided parts with their own leads and thereby gain a further reference electrode. The automatic dosage adjustment to the metabolic situation determined in each case precludes incorrect calculations and estimates as well as incorrect operation by the patient and allows different insulin sensitivities to be taken into account. In addition, an automatic program allows the doctor to correct a grossly incorrect programming or to adapt it to new living and nutritional conditions without medical assistance.

The use of immediate-acting old insulin and depot insulin next to each other enables a short-term metabolic correction in addition to long-term care of the body, similar to insulin pumps. However, the nuisance of a device worn on the body and above all of the cannula inserted into the abdominal cavity or into the subcutaneous tissue and fixed there with the increased risk of wound infection in diabetic patients is eliminated.

Programming by means of switching rings that are rotatably arranged in blocks on the housing simplifies the overview. The selection of profile numbers allows the entire program line to be printed in the patient file without complicated technical aids. Lockability of the programming and the possibility of the patient restricting compensation options and program changes are essential prerequisites for avoiding serious incidents due to misconceptions, idiosyncrasies and inconsistency of the patient or willful interventions by third parties. It appears in the field of vacuum generation

Advancing to the industrial packaging phase of the cannula is particularly advantageous, especially when the higher effort of the triggering device for a cannula preserving the negative pressure surrounds it

Storage pots for single use is placed on the injector that is used again and again. Surface changes in the storage potty during skin suction. can be converted into control impulses via touch elements of the injector, which has the advantage that the direct skin contact of a push button for switching purposes can be omitted.

In the embodiment of the invention with electrically operated dose delivery, it appears to be particularly advantageous to use the electrical supply at the same time for generating negative pressure via the air dilution within a heated chamber.

On the other hand, according to further refinements of the invention, the advantage of a demand-controlled continuous vacuum within a handy apparatus can be used by a gas jet pump in connection with a household carbon dioxide cartridge.

Finally, in view of the low vacuum requirement, the advantages of vacuum generation by means of a spring-operated cylinder-piston pump can also be considered. The filtering of the air from the suction bell prevents the surface quality of the pistons and cylinders from being affected by the finest quartz grains from the skin pores. The vacuum preparation is expediently linked to the movement of a closure cover for the suction cups, the mechanism for changing the cannula also being actuated. Bowden cables allow space-saving power transmission. The one-sidedness of the detection of a suction piston by means of a lateral raster device with the risk of the piston tilting is counteracted in that the suction piston is already held approximately in the raster position by magnets and spring lock. This considerably reduces the effort required to trigger the suction cup. There is also a delay in the pumping movement, which can be used to close a pressure relief valve. The latter is used to discharge the air compressed by the skin approaching the cannula in the suction cup in order to save suction.

If the thinning of the upper skin layers by shortening the skin allows the cannula shaft to be shortened, the cannula stack is carried in a tube or

Tube to further save space. The height of the stacking cannula can be further reduced by the fact that, with appropriate securing against rotation in relation to the lateral medication outlet points - for example by flattening the cannula magazine on one side, which still ensures tight sealing of the lateral cannula opening - the liquid channel, which comes into congruence with the drug outlet opening of the device, as a groove runs downwards in or on the wall of the cannula housing, before it enters the cannula shaft. An articulated connection between the stacking cannulas - which can be a thread - allows cannulas to be transported by pull, a spring embedded in the magazine or a sealing body in front of a compressed gas line to be transported by pressure. The side discharge of medication through a ring furrow of the

The cannula body facilitates the loading of the cannula shaft with several medication locations, as well as the removal of the cannulae by means of a claw-like lid device. The cannula arrangement in a row also facilitates the removal of the cannula after use, whereby the space of the previously unused cannula can be taken up in a space-saving manner. The displacement of the cannula after the injection before it is removed brings about a valve closure of the medication flow channel.

The distance between the skin and the cannula at the moment the suction cup is re-ventilated by returning one previously held in place by a grid

Suction cup or by a central pin inside the suction cup prevents dangerous skin cuts if the device is accidentally removed after use tangentially to the skin. Advantageously, the cannula magazine as a whole - for example under the action of suction in the suction bell on a septum connected to the magazine - can be lowered counter to the skin prior to the injection and raised again when it is ventilated again.

In the field of function control, in particular the securing of processes between skin suction, medical injection and re-ventilation of the suction bell, progress over the prior art is also indicated. A central pin inside the suction cup near the cannula conveys the state of the lift. The three trigger pins distributed around the edge of the suction cup in other examples were also improved by a more clever arrangement of the rooms and by the fact that their rear is lifted or weakened after lifting the skin.

The distance between the skin and the cannula after the injection to avoid cuts is ensured by the resilience of the suction cup, which is still blocked during the injection. The suction bell is only ventilated again after the injection has ended (in the mechanically controlled examples), if a previously tensioned spring mechanism is only activated after the sliding parts controlling the dosage have hit the dose-limiting obstacle. The spring mechanism is to be equated with a magnetic attraction of the ventilation valve, whereby a fluttering of the valve is prevented by means of a special locking mechanism when a permanent suction is applied. The central pin advantageously occupies a center point of an elliptical suction cup, while the cannula occupies the other. The use of a swelling pin to lift a gas capsule into the opening mandrel saves a relatively heavy screw cap and a krafterforder.de operation.

It proves to be expedient to replace the sealing piston previously used with a bellows, which is held in a contracted state after the injection, in order to avoid fluttering of the re-ventilation valve and to enable a visual inspection of the injection process, preferably a ring made of permanent magnets to favor the opening of the re-ventilation valve and to keep the bellows in a lowered position by magnetic contact with an iron plate on the insertion cylinder with the syringe, until the insertion cylinder is removed, which can be facilitated by screwing it out of a bayonet catch. A resilient mounting of the syringe barrel within the insertion cylinder causes the cannula tip to be distanced from the skin before the injection and a withdrawal from the skin after the injection, especially since the central tube acting on the syringe plunger is stored in a tent-like membrane above the holding piston of the bellows after re-ventilation allows an upward movement.

In the area of drug storage and delivery, a uniform drug flow to the dosing device is ensured. A refill process to build up a residual supply to a usable dose saves expensive hormone, especially if a magnetic lock only allows the storage container to be replaced when the used one is almost completely empty.

In the field of dosing, the dosing accuracy is increased by avoiding longer connecting tubes to the cannula. If the dosing device was installed as a short-stroke piston or cuff in the end of the medication supply hose from the container just in front of the cannula and actuated from outside the hose, the task in an electromagnetic version can be advantageous in a milking movement due to pressure periodically exerted from outside the hose Be solved so that moving parts in the hose are eliminated. Only a pin with a ring bar inside the hose is useful as a counter-pressure bearing. Short shaking movements to shake up zinc chloride as an additive to depot insulin is required to get an injectable suspension. The control of a discharge valve in connection with a flow measurement is considered advantageous from the point of view of saving space.