GB2222251A - Device for metabolism control - Google Patents

Abstract

A device for the control of metabolism e.g. in diabetes mellitus by automatic measurement of blood sugar at given place on the body consists of a relatively flat housing with central suction cups resilient against the skin, on which the spring pressure for the drive of two suction pumps is produced by a single electric motor connected to gearing, whereby the skin is lifted by influence of at least two pump strokes.

Description

DEVICE FOR THE CONTROL OF METABOLISM ESPECIALLY OF THE DIABETES The invention relates to the field of the medical technology, more especially to the field of the diagnosis of metabolism and the injection therapy, mainly for the diabetics. The Patent Publications W086/01728 and Euro No 0221005 as well as the Applications Euro No 85904428.1 and Euro No 881037 75.8 from 1988 are consequently continued herewith.

The scope of the invention remains: to create a handy device which permits to diabetics automatically to measure himself the blood sugar avoiding a painfull puncture of the finger-tip. Thereby, the patient shall be encouraged to measure his blood sugar more frequently and he shall be provided for insulin, if he needs it, according to the evaluated datas of metabolism.

All considerable datas-including such relating to conditions for use and to the influences of the patient to the function of the device-are printed out during the daily battery supplying, all this with the aim to warrant a prompt survey over the illness and the live costumes to the patient and the physician. The present invention serves for the amelioration in warranting a skin contact with the device even for periods of a desired or non-desired interruption of the vacuum effect to the skin (p. e. by a sealing leak at the area of the suction cup rim as a result of an intense hearness of the skin).

This aim is solved according to the invention by pressing the skin, which is elevated into the suction cup by means of negative pressure, against the rim area of the suction cup wall from the inside-supported by a undercutting of the skin-in such a manner to sink a pressing-on ring inside of the suction cup; a mechanism, which can be enhanced -especially with regard to less elastic skin areasby projection and moving levers, which can be tilted around an axle positioned near to the inner rim of the suction cup, in such a manner to prevent a sliding back of the skin out from the suction cup by an increase of friction. The shape of the levers and of their sectoral wing like projections may be chosen so as to urge the blood ir, the skin vessels to the summit, i. e. to the puncture place, whith the consequence of favourizing the blood exit there, all this by the influence of pressure towards the skin surface in a sequence from inside to outside. The levers may be supplemented by an air cushion, which also causes those to descend in connecting the inside of that cushion (or membrane under a solid wall) with the outern air by a valve, after this cushion being connected with the suction source, while the skin has been sucked in. As suction source is used again the simple cylinder-piston-pump, which is driven by a (traction) spring, which serves as a power capacity (for space saving and a more equal distribution of capacity, consisting of a row of spiral springs, which communicate by means of sprocket gears with a sprocket chain according to the operation of a typewriter). The spring tension is effected by a small electric motor, wjose rotaion of which belatedly transferred over a gear unit to a drive spindle for the suction piston.

Thereby, the air inside of the pump cylinder is let out to outern air by a valve, while air only is let in filtered against sand from the suction cup.

Before the suction piston is started by removing an arrest with a turning back of the motor,-the bolt nut serving for the promotion of the spindle is opened so that the wedge pins, which constrict it, are retired from the marginal area of the bolt nut.

Before or while the suction cup stands in a gas exchange with the pressure reduced inside of the pump, a drive gear driven by the electric motor shifts by severing itself from the contact with the tooth less wheel of the axle spindle (16) and changing over a face-to-face connection towards a slidable spindle (the thread coupling was enabled by a readily biasing of the latter) and drives by this manner a large gear wheel (40), which moves the pump spindle of a second cylinderpiston-pump over a gear cross connection (20,22) against traction springs and tensioning these. Thus, a second suction pump is provided for function, so that the preliminary skin apiration may be effected by two fractional"impacts".

Thus it is also possible to replenish the vaccum inside of the suction cup again and again, mainly, when the skin inside of the suction cup is to be exposed to a repeated pressure change for the blood migration. But in a variation, a single pump may be provided, which is again and again restored for a new functional readiness while a valve closure provides for the inclusion or conservation of negative pressure inside of the suction cup. A combina tion of one or two suction pump may also be considered, of course with a under pressure storing inside of the housing of the device (of course to be sealed).

For the further functional switchings for the transport of the punction style a second electric motor is used (Fig. 2) and a self-changing gearing as far as the functions are positively (or forced) driven, is introduced and combined with the mechanism of the functional change, steered by the inversion of the rotor direction. For that aim an axis is driven on by said electric motor, on which a pinion is slidable, secured against rotation, and rolls in mesh with several gear wheels, the rotation of which is transferred by flexibles or cardan shafts to drive wheels and disks at the area above the suction cup serving the style transport. Flexible or cardan shaft are to be chosen because the suction cup is vertically slidable in the central opening of the housing and is approached to the skin by a predeterminable spring pressure. For the chosen example, the shifting of the gear pinion is brought about in mounting it at the end of the pump spindle, which is driven by the motor and thereby moved along the the drive gears, one after the other, for the transfer of the different functions. The interspaces between the drive gears are chosen in such a way that the gear pinion has quitted the last driven drive wheel before it contacts with the next one. This contact is rendered possible thereby that the gear pinion is bisept or divided in two halves, which are biased one against the other. If one half-in the case of a shifting to the left the left half, the right half in the case of the shifting to the rightrotates and touches the still-standing toothing of the next drive wheel, it is shifted against the described biasing spring and approached to the other pinion half. Thereby, omitting its axle seat, secured against rotation, its motion is slowed-down at that drive wheel. The latter, again, is brought in a light rotation as far as the teeth of pinion engage into the thooth spaces of the drive wheel, which abuts. The two halves of pinion disengage by the spring effect again and both have now gained an axle seat secured against rotation. (That guarantee for rotation is given by a radiar marginal ledge abuting to each pinion half). But if the drive wheel is stopped abruptly on one of the arresting ledges, one of the cross pins, situated outern inside of relating annular notch of the drive wheel, overcomes the radial border ledge or stop bridge and the pump or worm spindle may bear nearly a total additional rotation, before it again exercises by the impact to the stem-like radial border ledge a turning moment to the pinion. The latter then has lost the tooth contact with the drive wheel because it was shifted far away. By the employment of ratched gears and pawls may be effected, that some drive wheels are only driven in one direction.

Instead of an advance of a gear spindle, the migration of the gear pinion may be also effected by wedge guidance on its outer faces collaborating with disk segements which project from the drive wheels; self-evident, the auxiliary means may be exchanged one against the other for a pinion shifting. Generally, it is possible to tap the rotation of the drive wheele on both of its ends (p. e. for the operation of two different functions).

To save space the axle bush may also rotate around the transport spindle, if another speed is proper by a additional gear as drive wheel.

The change from a positive or forced switching over of the gearing to a steering activated from outside and therefore variable is suitably effected immediately before the worm or transport spindle is moved back into the direction of the initial position. A thread-less final piece may be used to admit rotations without spindle feeds. The summit of reached dislocation of the transport spindle now make possible any activation of the last operation function. With the motion inversion by pole changing of the electric motor a light biasing of the worm ore transport spindle is effectiv and brings the latter to roll into mesh, which is now maintained until the initial position is reached (Fig. 2).

A variation of this mechanism is described with the supplement of the device by an injection tool (138, Fig. 9). For the purely diagnostic version the possibility of a repeated final operation during the spindle end position was used to sink the lancet about three puncture steps made suddenly by accumulation of spring pressure, to guarante a minimal injury for the blood winning.

The completion stage to a sensor steered injector dispense with such possibility of variation (for a simplification). After the thread-less final position of the transport spindle inside of its thread guidance, first, the drive wheel for the pump of the one insulin sort is rotated in the frequence adequate to the dose, after the change of the rotation direction of the spindle the pinion is hindered to rotate by a little delated working arrest of the drive wheel into counter direction (perhaps by trip pin and radial border ledge) and to the dosing motion and the rotation of the transport spindle continues in a turning out of a separated screwed up or in axle piece with the gear pinion on the end, whereby the drive wheel for the pump of the second insulin sort is finally taken along during the final position of the axle piece thread. The blocked pretension of the restoring spring for the transport spindle is effective after the repeated change of rotation direction was consecuted by screwing back of the axle piece the pinion being arrested (because the turning back of the second pump drive was locked also). By that, transport spindle is again rolled into mesh with the guiding thread and then the gear pinion is shifted back in its initial position by futher rotations of the transport spindle. Regarding to the dosing pumps, the solution of a"hose integrated", more preferably"the drug admission pipe concluding"dose chamber is taken up, which is filed on Japon as No 211352/86, from whose chamber a membrane bound gas pressure supply is replaced by drug fluid filled under pressure and then expelled through the neighbouring cannula by influence of the gas pressure bolster. The alterning valve operation for the fluid admission to the dose chamber and the flowing out was already changed to a rotary operation in the European Patent Application No 88103775.8 from 1988. The spherical gas bolster was replaced by diaphragm to facilitate the model building.

If the injury less glucose measurement by laser light reflexion would make strides, it could be incorporated into the demonstrated concept of device without difficulties; the combination with a needle-less injection over a pressure jet should then be considered.

As long as blood has to flow into a capillar ! aperture (suitably horizontal at the level of the blood drop which exits from the puncture blessure) the injury necessary for that will be bigger than such from a finest cannula for the drug injection.

The more expensive cannula can be replaced by a simple capillary which may be introduced under the skin using the rail of a central furrow or hollow (half) channel of the lancet, in the case an injection is desired with regard to the measuring result. Owing to the fact that the skin fold is lifted off from the support (bone, fascia etc.) the lancet may be prolonged and more acute-angled what facilitates its piercing into the skin. A cannula, especially a rotating one, of course, could be applied in this device to gain blood, also, the reflex optical ascertainment of metabolism could be replaced by an electrical one inside of the capillary measuring fissure, if the principles of the Patent Application WO 86/01828 are continued further on.

Neverless, the optical equipment is certainly very advantageous: by reflex photometry affected skin areas may be ascertained as such and excluded from the puncture. The same or a similar measuring assembly may also control the level of the skin knob as a prelimination for the measurement or injection. Also, the filling of the measuring chamber may be controlled best optically, p. e. by a raster (scanning) like splitting up of the measurement in multiple measurings: if the measuring results differ from a destinated limit so that measuring chamber is not sufficiently filled (the lancet prick should be deepened or the measuring result should be rejected), it does not matter whether blood or-after corpuscles are filtered out-plasma is measured after it was penetrated into the measuring fissure. Colour and brightness changes of the indicator layer also should not dif fer to much for a registration as full valid measurements and further treatment.

If a puncture style shows a guide face for the lancet (shaft) on or in the style body and a cap shell for the shifting of said lancet against said style body, a foil strip forming the upper limitation of the measuring fissure over the indicator layer, may be drawn along under the measuring or ray style or grip (preferably centrally introduced into a boring of said style body) by the motion of said cup shell; window like openings can be let open for the measuring rays; the indicator layer or zone may be cleaned by a wiping cushion anteceding to the measurement of metabolism.

Finally, the chamber base with the measuring layer can be performed by a second foil strip, which is moved under the measuring grip according to the first (and glidingly gluet with said) so that the indicator layer is positioned under that grip only when the skin control was effected before by said measuring grip. An additional reserve fold in connection with the fixation of these (p. e. transparent) foil strips at the capped shell or the body secures the timing and operation of that relative strip shifting one against the other.

Finally, as a novelty should be stressed out that the puncture styles adhere at at least one gluing tape from which they are shifted downwards for the introduction into the suction cup.

Also, the removing or the lids of the puncture style may be effected by a cross shiver at the same time above and below, which also serves for the exact guidance in height of the capped shell against the style body (which is fixed inside of the suction cup by a kind of holding clamp.

The space saving excentric guidance should yet be mentioned, in which an excentric pin of a disk projects in a cross slot of a shiver.

So far as the advantages of the invention are not already shown or are yet evident by the description of the drawings, these consist of the more simple and reliable handling gadgets by means of one single (that is the electric) energy source and of the further centralization of the functions without danger of poisoning by indicator substances.

The combination with earlier described features are numerous; here, the combination of the reflex-photometry with a laser light arrangement -the latter tangentially administered to the skin knob-should be mentioned as means for an investigation of the metabolism. This combination could permit a fixed or variable alternation between measurements by puncture (for gaining of referrence values) and injury-free measurements by light rays.

Detailled Description of th-e Examples: Figure 1 shows, in the middle in a top view, for the rest in a cross section in a natural size a device for a diagnostic use. The suction pump piston (l) is shown with the pump spindle (2) inside of the suction cylinder (4), the preceding being rotable in its boring and secured against traction by the ring fastener (3). Inside of the ballonet wall (5), which is steady, two of the four projections are visible joining with the sliding disk (6), the wedge guidance of whose has approached the bolt nut (7), which is composed of both halves in a wider boring of the ballonet wall so that the thread of that closes with the pump spindle. The latter finishes with the drive gear (8), which-fixed and secured against rotation-is connected with the pump spindle and rolls into mesh with the sliding gear (9).

That rolling into mesh is permanently maintened by this manner that the guiding side plates (10) hold together in connection both gears on both axle bushes also embracing the sliding gear, which is positioned on a joint sliding axis (ll) and there secured against rotation. That sliding axis is driven over the cogwheel (12), which is fastened there, by the gear rim with small diameter of the bull wheel (13). The large gear rim of the bull wheel (13), again, is driven by the lateral cam (14) of the toothed coupling gear (15), which latter approaches to the bull wheel (13) on the axle spindle (16) firmly attached to the latter until a lateral notch offers resistance to that lateral cam. If the toothed coupling wheel (15) is revolved in counter direction (counter-clockwise), the latter removes from the bull wheel (13) and leaves that axle spindle (16) displacing the slidable spindle (17) until its thread insertes with the inner thread of the tooth ed coupling gear. Finally, the toothed coupling gear moves with the lateral cam the thooth-less wheel (18)-the middle partial Fig. l- so that the latter is taken with and the revolution is transferred over the slidable spindle (17), which is spring biased-towards the left, to the cup wheel with front serration toothing (19) and from there over the both pinions (21,22) of the cross shaft (38) -the upper partial Figure-over a cup wheel with serration toothing, which works into the counter direction, to the shifting axle (24). The drive gear (8a)-left lower partial Figure-for the second pump spindle (25) is driven by the sliding gear (9a) (upper partial Figure). The pump spindle (25) is shown in a terminal position, in which the pull cable (26) is connected with the relatively relaxed spiral spring packets and this happens over the roller (27)-above shown behind the other pump cylinder (4)- and a roller with spoil (137, Fig. 8) lower positioned. That pull cable servs to retire the suction piston (l) from the position as shown in Fig. l, whereby suction is effective towards the suction cup space (Fig. 10). The bolt nut (7a) is opened around the pump spindle (25). Auxiliary tension springs for this aim are not shown, but the freeing of the fissure for both halves of the bolt nut (7a) is demonstrated by the shifting of the four projections connected with the disk (29).

The slit and tongue with connecting rod (30), whose both disks (6,29) operate in the opposite function of approach and and removing relative to the bolt nut by tapping the motion from the toothed coupling gear (15), is only schematically outlined by dashed and dottered lines (-.-.) with the appropriate bars.

On the middle Partial Figure the locking mechanism is shown for the removement of the suction piston caused by the spiral spring packets with chain (28). This consists of a excentric disk (31)-see al so the lower Partial Figure to the left-which is turned over the switch axis (32) by a gear (33) which only permits a motion by a coupling mechanism, if the back rotation of the drive gear (8)-before its contact release from the toothless wheel (18)turns the sprocket wheels (145, 146) and the sprocket chain (147) and by a particular toothed rim of the sprocket wheel (145) the right half of the bisect gear (33) with facing wedge flanges, whose both halves are urged one from another, the left half now revolving its disk (157) with axle-seat by a pin enganging with a notch of said disk of the bisept gear (33). The sectoral rotation of the cross shaft (32) releases the pump piston (l).

For the preceding locking of the pump, the excentric disk (31) was brought in a locking position by the crossarm (34) while it was outrun by the drive gear (8, the lower Partial Figure to the left). A spiral spring is placed around the cross shaft of the excentric disk (31) operating the latter, this as a variation of that locking mechanism, this spiral spring being provided with a final claw projecting downwards and wedge like increasing a little and overtaken by the gear rim of drive gear (8) stretched a little thereby, the cross shaft being turned so that the excentric disk is positioned behind the driving gear and there pressed on by the spring tension effect. An analogue mechanism (145a...) exists for the locking and release of the second pump piston, released, only if the coupling wheel-while sliding to the left-overcomes the ratched gear (158) turning the sprocket wheels. The drive power for both pumps is derivated of a single electric motor (35) and transferred from there over the pinion (36), which is shiftable on the motor axis, to the coupling wheel (15), the engagement of the gear teeth being secured by guiding side plates (37).

In the case of a counter-clocke-wise rotation of the motor-will say, if the cup wheel with front serration toothing (23) drives the shifting axle (24) turning back the rotation direction, by the cross shaft (38), the rotation is transferred over the small pinion (39) to the large gear wheel (40), which drives the drive gear (42) for the pump spindle over the shifting pinion (41) in connection with that by guiding side plates (lower Partial Figure to the right). The rearward position of the motor is made plain by the Fig. 2 (with dasheddottered lines).

The Figure 2 shows at a scale of 2 : 1 the control gear, above in the cross section, below in the side view from the left along the section line A-8, the diagram of which was omitted in the left middle part of the diagnostic device. The functions which are driven by the electric motor (43)-a little reduced in size in favour of the representation of the gears-are marked by Romain Numbers (I-IV) for a better understanding of the classing with the operating parts (Fig. 3) for the punction style transport. Interposed by the small pinion (45), which is turnable around the axis (46), the revolution is transferred over the large gear wheel (44), which is fixed on the motor axis, to the large gear (47), which rotates around the axle sleeve (48). That axle sleeve is supported by the strut (49) in a mann er to lead the transport spindle (50) through the latty without friction for the bush (51), which is rotable around it. The rotary double wheel (52) works to the counter double gear wheel (53, dashed in the left), the smaller gear rim of the latt-er driving the gear with female thread (54).

This gear wheel with female thread (54) affecting the transport spindle has annular grooves as ball bearings toward the housing wall and the supporting arm (55). Independent from its position, the driving gear wheels (as well as the electric motor) are drawn with dashed-dottered lines for a clarification of its function. The bisect pinion (56) driven by its both halves successively also propells the other drive gears (I-IV), which are fastened on their axes (the supporting flanges therefore are not all shown), if not several axes are driven by additonal pinions (Ia, IIIa, IVa), by flexible shafts, transport spindle (50) being shifted to the left until the thread less axle spatium moving past of all drive gears until the drive gear (IV) is reached, which rotates around the axis (46) and operates the smaller drive pinions (IV, IVa) with their own axle shaft bearings.

The gear shift collar (51) has a kind of coarse toothed rim or a pin for the rolling in to mesh of the inner coarse toothed rim or notch of both halves of the bisect pinion (55) with the aim to propell these; but both halves outflank between their inner toothed rim or notche an annular thooth less or smooth zone, around which a pressure spring is mounted urging both halves of the bisect pinion against axle stops into mesh. The side view, which is shown to the right of lower side view of the Fig. 2 shows a detail of the left half of the bisept pinion with the radial cam (60) against which the cross pin (59) leans to transfer its motion, if it turns to the left and permitting a freewheel for nearly one rotation, if it turns to the right.

The half-circle above to the right of the cross section marks the free space for suction cup and its functional equipment which serves to the punction style transport, while the chain of punction style and its transport wheel and curved transport skids was omitted.

The Figure 3 shows at a scale of 2 : 1 a top view on the functional mountings or fittings of the suction cup which serve for transport of punction stylo The transport disk (63) with deep indentation for the style transport is mounted at the level immediately over the sealing (62, Fig. 5) of the suction cup roof with its rotation axis on this roof and is operated by its spur gear rim by means of the laying on ratched wheel with pawl by pinion an this only during the shifting to the left of the gear pinion (Fig. 2) by function I from the gearing.

Thereby the chain of punction styles is shifted witt one style to the right collaborating with the indented counter disk (6) and supported by a drive of the transport wheels over Ia (not shown). The adhesive tape (65) for the introduction of the punction styles as chain is positioned above the plane of the transport disks (61,) at the margin of the curved conduit for the guidance of the punction styles. The mentioned drive can be transferred to the transport wheel for the punction styles by the two hubs of drive gear wheel On the post or pillar bracket fixedly inserted in the suction cup roof exists a vertical rail guidance (71) inside of which both shivers (72,79) are raised and descended. For the shiver (72) a cross slot serves for the raising and descending, in which the excentric pin (68) of a disk driven by the flexible shaft (III) insertes (see also Fig. 4); said shiver (72) being connected over the bridge angle (74)-the latter conducted by the prolonged axis of the disk (63)- with the tube segment (76) for the punction mechanism. The shiver (79) for the vertical motion of the optical measuring grip is moved over its transverse slot by the excenter pin of the disk (69), the axis of which is mounted in the frame (78) which is for its part fixedly connected with the shiver (72). From the frame (78) projects the beak for the pressure spring which works against the shiver (79). From the punction mechanism, in a top view (by omitting the cap screw) the cross spoke (75) is shown surrounding the screw bolt, which is stationary in the tube segment sleeve, leaning on to said tube segment. The rod (66) projects from the cap screw (Fig. 5). The sliding cylinder, which surrounds the cross spoke, bears the cross shiver with the slide fork (85).

The Figure 4 shows in a side view at the scale 2 : 1 the mechanism for the grip lowering. In addition to the shiver for the lifting and lowering of the bridge arm by the drive of the flexible shaft (III) the drive (IIIa) for the optical grip by the disk (69) is explained. The axle bearing of this disk (69) with the excenter pin effective in the slot of the shiver (79) stands on a fork projecting from the shiver (72) connected by a cross-shaft. The elevation of the shiver (79) takes place against the pressure spring at the beak by means of the flexible shaft (IIIa), while the lowering of that is favorized by said pressure spring. On the shiver (79) above is further positioned the crossbeam (80 for the fixation of the optical grip.

The Figure 5 shows at a scale 2 : 1 in a longitudinal section details from the cross section of the Fig. 3 for the explanation of the punction mechanism. The cross spoke (75/ is again ha which sleeve like surrounds the screw bolt fixed ly mounted on the the tube segment, the screw bolt lying on to the fixed tube segment (76) which has step formed insertions. The ends of the cross spoke transfer their abrupt sinking by influence of the pressure spring under the cap screw and of the vacuum under the cap shell. From the latter the rod (66) projects up to behind the vertical projection of one of the three spokes. The cross spoke is turned over the gear rim of the cap screw by the flexible shaft (IV). After the cross spoke is descended behind one of the steps regularly distributed over the circumference of the tube segment, the rod and therewith the cap screw can be operated for nearly one rotation until it again abuts at that project. The end of the cross spoke transfers its abrupt lowering by a inner notch to the segment cylinder, which is connected with the shiver mechanism (Fig. 6).

Below the suction cup roof is visible with the seal (62) ring in a partial view while the punction style is sunl < down into the elastic holding clamp (88). body (90) In the central boring (91) of this the measuring grip is shoved in from above. The style body is fixed by the insertion of the holding clamp (88) into the annular groove (86). Between holding clamps and style body space remains for the lowering of the caped shell (87), between upper annular ledges the slide fork (85) of the cross shiver is slid in, by which the punction style can be vertically moved. The lancet shaft (drawn with black) yet positioned inside of the body of the punction style is attached above at the roof of the capped shell (87). The foil strip (87) which lies under the central boring above of the basal plate with the whiping cushion (98) terminating in a basal niche of the style bottom are not drawn in, but can easily be understood from the continued elaboration of the style in Fig. 7.

The Figure 6 shows the shiver mechanism (II), above in the cross section in a waiting positon in front of the punction style, above in a transversal section after the cross shiver has been pushed forward, the shiving fork of the latter been sent away and the upper and the lower protection lid removed by telescopic stems (dahed outlined), favorized by cap naps. (The lid remains connected by threads with the ca-pped shell on the one hand, with the style body on the other).

Above is seen the production of the excenter motion by a disk with excentric pin in a shiver slot and a additional boring for the light permission through the cross shiver.

The Figure 7 shows at a scale of about 3 : 1, aboute in the longitudinal section and below in the cross section a punction style without a special base plate. The style body is rounded above and flattened at two sides with border ledges, which embrace to the left in the upper portion (aside of the sharped obliquity). Between the lancet shaft and the flattening to the left of the style body, initially portions of two foil strips are rested, strained over the central boring (91) and continuing inside of the style flattening to the right up to the roof of the capped shell (87), where they are fixed (the upper (97) directly, the lower (95) in a sliding sticking at the upper or with a soluble adhesive fold). The upper foil strip (97) ends (unfixed) to the left and bears there a wiping cushion with an upper transverse ledge and terminates to the right fixed at the capped shell. The lower foil strip bears to the left the indicator layer above of the wiping cushion and terminates fixedly attached on the style body after a reserve fold (97).

The style body below has nups (154), to render more difficult the lowering of the capped shell and a suddent reduction of circumference (89), in which a inner border ledge of the capped shell engages, to prevent the drawing up of the latter from style body.

To the right, two marginal inflections of the foil strip (95) are illustrated at the area of the indicator layer as a detail in the transversal section, which bounds a capillary fissure with the foil strip (97) laying above.

The Figure 8 shows at a scale of 2 : 1 in the longitudinal section three spiral spring packets (28), whose axis, each one connected with one spring, have top sproket wheels (100) and a sproket chain (147), all three spiral spring packets being embraced, here only two, whilst the third is coupled on over the gear pinion (102) with an inverse spiral spring winding. The chain connected spiral spring packets can be coupled off by the transverse pulling out of the gear pinion (102) in case that air overpressure inside the pressure chambers comprising the elastic drug supply balls is produced by the suction pump movement (Fig. 11, Fig. 12). The power transfer over the pull cable (26) and roller (27) to the pump spindle is outlined.

The Figure 9 shows at a scale 2 : 1 in the longitudinal section and below in the cross section a section cup without roof equipment.

Essentially an undercutting (114) of the suction cup rim is demonstrated with anti-sliding quality in this inner rim zone and the small hammers, which fall outwards in lateral joints (115), with the air cushion ring (117) above connected with the valve (Fig. 11) by the hose (118).

Below in the cross section, the distribution of the hammers is shown, lateral (but also dispensable) wing plates (116) are drawn, in slightly overlapping one against the other in reality. The holding clamps with the style body project downwards into the cannula cup. The air deviation above the skin effects p. e. by a fine channel in the measuring grip.

The details to the right show above a curved variation of a hammer, below a clamp as hammer with lateral breaking bending out (dotterd lnward of the ends for a joint.

The Figure 10 shows in a schematical longitudinal section an other solution of the lateral skin squeezing on by a elastic border ring (119) lightly elevated first whilethe skin is sucked on and then lowered by the blown up hose ring (118) so that the skin fold is squeezed on by that lower border ring lowered. To the left, half the skin elevation is demonstrated, to the right half the skin squeezing on. A further hose ring serves to demonstrate the possibility of a wavelike pressing on of the sl < in by pressure when the rings are blown up at a range from outwards to inwards.

The Figure 11 shows a valve mechanism from which the inlet hose (traced or inked in arrow) is connected with the air scoop (120) of the suction cup through a segmental rotor excavation; the air now is sucked out from the air cushion (117, Fig. 9); if the hammers are fastened on the lower face of the latter (p. e. by elastic threads) they are now elevated.

The valve rotation may be coupled'with the function IV-also modified by a retarding of rotation by a drive pinion-so that the connection to the suction pump is interrupted after a certain rotation and, later, the air cushion ring (or the hose rings one after the other as in Fig. 10) are blown up by the opening of the channel (s) to the outern air (dashed arrow). A flow back valve (121) is yet mentioned for the air outlet while the suction piston is led back and the flow back valve (122) for the prevention of an air entrance during the same phase of the pump function. The illustration can be comprehended as a longitudinal section or a cross section at natural size.

The Figure 12 shows a similar valve driven by rotor, but a additional drive wheel (VII) would be necessary to derivate pressurized air from the pump cylinder into the drug pressure container (123.

Inside of this, twice two each sperical drug bubbles or balls are stored with elastic walls'124'which have drug outlet cones for the hose attachment in the direction of the dose pumps. To the left the first drug bubble is nearly exhausted and its inner cannula (125) is entering into the adfixed reserve bubble to derivate the drug into the dose pumpe (V) after a sealing membran against the opening cone has been destroyed, to the right the drug yet streams from the first filled drug bubble to the dose pumpVI.

The Figure 13 shows at a scale of about 4 : 1, above in the partial side view, below in cross sections along the section lines A-B, respectively C-D, a variation of a lancet. One of its cutting faces has (without a exclusive necessity) lateral indentations (133). On different levels, a profile elevation (134) slightly ascending from below as edge zone is increasing to spread the stab for a better blood exit. A capillary can be shoved under the skin for the drug injection-also after the puncture-through the central fillet.

The Figure 14 shows at the scale of 2 : 1 a dose pump in the longitudinal section, which is operated by rotation of the valve ring (126) with the bridge notch (127). This bridge notch sealingly embraces the half cylinder with the nap formed dose chamber (128) and the central and transverse boring for the periodical communication with the derivation channel (130) through the centre between the valve ring on the one hand, and the feed line, which continues in the second half cylinder (132) inside of its wall, on the other. A pressurized gas supply, introduced in the inside of half cylinder (132, effects the replenishing of the dose chamber by the elastic membrane between the two half cylinder and thereby the ejection of fluid. If the fluid flows in by the overpressure, this membrane is pressed against a solid latice while the dose chamber being filled. The latice also may be replaced by a central boring in a closing wall. The rotation of the valve cylinder corresponds to the delivery of one dose chamber filling.

The Figure 15 shows at a scale of 2 : 1 a cross section of the detail of an amplificated control mechanism according to Fig. 2 for the possibility of a dosing adapt to the situation by means of two rotation pumps (Fig. 14, Fig. 9 dashed lines).

The gear (54) has transported the transport spindle (50) so far that its thread less sleeve (152) permits the continuation of the rotation of the gear (54) and therewith of the transport spindle. Thereby a screwed rod (103) is crewed out from a thread boring of the transport spindle after an idle rotation (because the cross pins (59) run back until they reache the radial cam and an analogous device on the side of the ratched wheel (104), which is only transferred during the rotation of the transport wheel (105) to the right now continued). After the desired dosing is completed the change of motor motion happens and therewith the rotation to left of the transport spindle. After the corresponding idle rotation (because the cross pins (59) run back until they reach the radial cam (60, Fig. 2) of the counter side and an analogous device on the other side of the ratched wheel (104) with the prevention for rotation of the gear pinion, which lies on the top of the screwed rod, the screwed rod is further screwed out by the rotation to the left and the gear pinion rolls into mesh area of the ratched wheel (106). After (analogically controlled) idle running the drive gear and the pump VI is driven by the gear. With a new change of the rotation direction, the gear pinion is again moved back by the screwing in of the screwed rod into the transport spindle. The back motion of the gear pinion along the transport wheel (105) is favorised by a restoring spring (108), which permits also by a shifting against the transport spindle, the change of its rotation direction to the left. The restoring spring was tensioned while the screwed rod was screwed out, it was locked by the latch (109), and it was disconnected or freed by the rotation of the release pinion (llO) only activated in the operation direction (analogous to the events at the arresting of the pump pistons (Fig. l)."Only in operation direction"means: that taking with of the operation axle (III) by the release pinion is prevented by a rathed and pawl mechanism. The revolution of the excentric locking wheel (112) to the left in a locking position to the guiding shiver of the pressure spring (108) happens by lateral friction at a disk (113) which turns with the axle on the end of the bisect pinion (55).

By the particular ledge formed bearing of the side face of the ratched wheel against the housing wall, that ratched wheel is again withdrawn from that disk while the rotation is continued, so that the produced friction is again abolished. The distances between the transport wheels (104,105) is chosen in a manner that the prevention for rotation of the bisect pinion makes possible the axle shifting of it by contact with each transport wheel, in each case locked to the rotation direction of the screwed rod.

The Figure 16 shows a schematic longitudinal section through a gearing device with self-shifting of the sliding pinion (114) along of its axis (115) parallel to the axle (116 ?) of the drive gears.

At the phase A the sliding pinion rolls to mesh with the drive gear of the left and is hindered to shift laterally by the disks (140), which have a bigger diameter than the drive gear which is flanked by those. But the wedge (144) yet approaches the sliding pinion and the disk to the right shows then a blank for its passage.

At the stage B, this has happened and a wedge (142) is shown at the flank of the sliding pinion which faces the wedge (141) in a short time.

At the stage C, the sliding pinion was-during that facing-shoved further to the right through a gap in the disk to the left (143) of the second drive gear; the sliding pinion now is with its one half rolled into mesh with that right drive gear, whilst it has quitted the rolling into mesh with the drive gear to the left. A wedge (121) on the disk to the right of the right drive gear performs the shifting to the right of the sliding pinion through the gap in the disk to the left, which is yet open in the stage D of rotation.

Principally, a sliding pinion can be shifted further to the right by the calculation of the facing of wedges which counteract one against the other. But this sliding pinion can also be brought back to the left by reciprocally working wedges.

The described device for the diagnosis (supplementary also for injection scopes) yet containes batteries and an electronic control unit, which not are shown. The space for that is held free in the middle area (Fig. l above) with a possible admission from above through flaps. Also the control contacts and linking wires between control unit and mechanic portions are omitted. These control contacts are positioned p. e. along to the pump spindle, in a plurality even along this distance and partially adjustable; p. e. activated by the touching of the respective drive wheel of the pump spindle. The period from the release of a suction pump motion until a control contact is reached, may indicate the tightness of the skin occlusion at the suction cup rim and may serve as signal for the release of the second suction pump.

Before the use of the device-at the performance or after having carried out a preceeding use or by a hand contact (button) on the housing and confirmed by a control lamp-the electric motor runs in a turning to the right with a tendency of motion of the drive wheel (8) to the left until the final position of the pump spindle in a locked tension (also possible according to the method of the Fig. 15). After this locking position is called back, the electric motor changesthe polarity and the drive gear (8) rotating to the left is shifted to the right, first on the axle spindle (16), then on the slidable spindle (17)-which could make away, first, to the right against its restoring spring up to the rolling into mesh with the gear wheel-up to the impact against the tooth-less wheel (18) turning the slidable spindle, the wheel being flanked against a shifting to the right. The further revolution to the left operates over the cup wheels with front serration toothing (20,23) the drive of the pump spindle (25) up to its locked final position. The tooth less wheel (15) is brought to turn again to the the right after pole changing of the electric motor. But this happens only, after the suction cup rim has contacted the skin and the suction cup has raised against its resilient springs (156, Fig. 10). Before, after an idle running distance, the drive wheel (8) again disconnects itself from the tooth-less wheel (18) shifting to the left by motor rotation to the right, the revolution to the right of sproket wheel (145) over the revolution of its slidable spindle is transferred by the sproket chain (146) running to the sproket wheel (147) to the second gear rim of the latter and drives the gear (33) which is locked by its ratchet portion in counter direction. The latter effects the rease motion of the excentric disk (31) over the switch axis (32) by a sectoral turning to the left, this release for the suction piston (l), being driven by the tension (spiral) spring packets. Through the flow back valve (122 and its connecting pipe (136, Fig. 10) negative pressure results in the suction cup and in the air cushion (117), which lifts up the skin. After a short delay-which can be coupled to the speed of the pump spindle (3) motion-the motor, which was meanwhile stopped, is operated in the same direction of motion. Thereby the drive wheel (8) passes the gear wheel (137) on the left, the turning of which, only effective in this direction (caused by its organization as ratched gear wheel), is transferred over the sprocket chain (138) from a gear wheel, which stands near to the housing wall in a rigid shaft connection with the gear wheel (137) to a gear wheel with shaft connection with the excentric disk (31a). For the power distribution, this yet happens before the wedges are operated, which press together the bolt nut (7). By this the second suction pump is now operated and its suction is effective in the suction cup through a corresponding valve arrangment (Fig. ll). The further motor drive causes the leading back of the suction piston (l) to the left whereby the spiral springs are tensioned, and the opening of the flow back valve (121) for the air escape. Motor pole change causes the shifting of the drive gear (8) to the right the latter revolving to the left.

Before the second pump piston is yet led back, the suction piston (l) is released by a short pole change. After this the second suction piston is led back in the tension arresting while the rotation to the left of the drive wheel (also after a renewed pole changing) is continued.

Accordingly, the pump strokes now may be always prepared and released anew until the energy is exhausted. At the same time (or alterning) with the described function of the electric motor (43) for the driving on of the suction pumps, the gearing for the electric motor (43) may be operated until the switching step IV. But if the energy supply is weaker, the functions for the lowering of the punction style are drawn forth to the even described processes (but a alterning intermediate arrangement may be efficient). The transport of a style (function I), but at the latest the removing of its lids or cover (function II) is only economically and hygienically tenable, if the skin puncture followes immediately. But such is omitted, if there difficulties arise during the sucking on of the skin.

On the function Ia also the power transfer over a single motion hub is in question, namely to the left and to the right, passing over the suction cup to the more horizontally beared transport wheel for the row of the punctions styles. For the functional step or stage II (the bisept pinion is drawn in Fig. 2 in this functional position) the feeding of the slide fork (85, Fig. 6) happens together with the removing of the lids, from this moment, the style being vertically guided on the capped shell. If not an other transmission ratio is chosen, the function II is only calculated for half of a turning (and therefore only drawn half as wide).

The precourse until the engagement or stop with the driving disk (135) in axle mesh is to be added at any rate. On the function III, at the same time the optical grip is sealingly lowered into the central boring of the capped shell and the latter for the occlusion of the suction cup roof inside of the sealing (62).

The connection of the device with anoptical measuring tool from above by a rail guidance or push-button fastener as well as the numerous necessary adaptions are not shown,-p. e. of the light guidance-because they deduce from prior art without particular invento : y tory effort.

Either through the transparent foil strip (97) or through a boring in the same, the light ray may now be directed against the skin. The comparison of the measuring results with prior measuring values or with such gained by at least one reference ray perhaps through a fiber glas bundle through the suction cup roof from an other skin area, permits to exclude coarse diseased skin alterations before the puncture. The device should then be operated at an other skin area.

Before the capped shell is sunk (II) for the puncture by lancet (if a punction style according to the Fig. 7 is used) a rise of the capped shell happens, after pole changing of the motor in short current impulses, until the optical measuring grip calls the light reflexion at the indicator layer. After a pole change, the full revolutions of the function IV for the abrupt lowering of the lancet into the skin now begin, coupled (with or without a prerunning of the revolution by respective lockable disks) with the activation of the ventilation valve (Fig. ll) for the air cushion117) rings with the arresting effect of those to the skin inside of the suction cup (Fig. 9, Fig. 10) and the blood pressing out effect until the filling of the capillary fissure is called back by the measuring grip (the temporal control of which can be supported by contacts for a revolution counting,.

As soon as the blood winning is optically affirmed (eventually also the regular blood distribution by screen distributed multiple measurements), the electric motor (43) changes again the pole and the capped shell is lowered by an impuls like segmental moving back controlled by the optical grip, whilst the style body is retained by the holding clamp (86, Fig. 5). This action happens after the exspiration of the preprogrammed period for the influence of blood or plasma to the indicator layer and the optical measuring there (where- by a"blank value measurement"may also be effected either before or during the puncture).

When the transverse inferior ledge at the wiping cushion has shoved in its front the indicator layer between mask and style body, supported by the tension effect from the right by the foil strip (97), so the indicator layer remains fixedly under the central boring because the foil strip (95) is fastened at the style body to the left, while the end of the strip (95) to the right slides along to the foil strip (97) while the wiping cushion is pulled passing the indicator layer before the measurement of metabolism. From the moment of the affirmed blood coating the arresting of the skin can be abolished by the reventilation of the air cushion and the device can be lifted from the skin after a signal. After the measurement is completed the measuring value is indicated on the photometer after a signaling procedure and the exit position is again restaured by the shifting of the bisept pinion to the right, whereby the optical measuring grip is retired and the punction style pulled out from the holding clamp (88) and, final, can also be further transported horizontally (function I).

The development of the diagnostic device to the diagnosing injector was demonstrated only by detail supplement in order not to overload the Application (WO 86/01728 offers as well as the successive Application rich further possibilities for combinations). For injections, a capillary or a fine can- nula can be introduced under the skin together with the lancet shaft or it may be shoved in later (137, Fig. 7). Lateral drug openings in the upper section and lateral exit channels in the punction style can render possible a drug loading of the dose pumps (138) also if the latter are positioned laterally. The latter may also be beared spring biased from outside inwardly to facilitate the tightening of the channels. The overpressure for the drug expell from the pressure containers (124, Fig. 12) out from the elastic walls (124, Fig. l2) of the drug bubles may be produced by gas producing chemicals, which are stored inside of the surrounding sealing pressure container, gas overpressure can also be preproduced. Also by a separate function VII, a valve can be steered during the leading back of the suction piston only for said pressure generation, if needed, while the spiral springs are partially relieved (Fig. 8).

The hight of the gas pressure could be ascertained by the release of the movement of the pump spindle after a certain distance; but it is anyway limited by the power of the electric motor.

Self-evident, also the motion of the membrane inside of the dose pumps could be optically supervised by functional control through fibre glass bundless (157, Fig. 14).

The disclosure is set forth by the following claims.

Claims (44)

1. Claims : What I claim is: 1. A device for the control of metabolism for human or animal by inquiry of measuring values over the situation of metabolism, which may include a mechanism for the correction of metabolism by means of injection, t h e r e b y c h a r a c t e r i z e d, that, at least inside of portions of the device, the necessary alteration of the atmospheric pressure is produced by at least one pump, the spring drive of which is brought in the necessary tensioned state by anelectric motor in connection with a gearing.
2. 2. A device according to claim 1, wherein a negative pressure, which is produced by at least one pump, is used for the elevation of the skin inside of a suction cup and wherein a squeezing mechanism is present, to guarantee the elevation of a skinjknob inside of a suction cup by pressing on their marginal area against the inner rim of the suction cup.
3. 3. A device according to claim 1, wherein at least one valve mechanism is present, to make effective the negative pressure during a single use inside of the suction cup, produced by several pump motions, which can also be brought about by more than one pump.
4. 4. A device according to claim 1, wherein a gearing is present, to effect the tens ioning of the springs for more than one pump by one single electric motor.
5. 5. A device according the claim 1, wherein the power transfer from the electric motor is effected by a spindle with bolt nut and a mechanism is present to open the latter in order to free the pump motion by the influence of said tensioning spring, after the influence of the spring to the pump has been arrested by means of a locking mechanism.
6. 6. A device according to claim I and 2, wherein the mechanism for a squezzing on of the skin inside of the suction cup consists of at least one body, which, after the skin is raised inside of the suction cup by means of negative air pressure, is lowered against the skin and exercises pressure against its outer rim in such a way that this is held fast on the inner rim of the suction cup as long as this pressure by sinking is exercised.
7. 7. A device according to claim 1 and 6, wherein that body consists of several radially arranged small levers, the turning axle of those is mounted over the rim area of the suction cup inside of it so that the exercition of pressure against the skin downwards additionally obtains a partial component working outwards.
8. 8. A device according to claim 1 and 7, wherein the small levers have plate like enlargements, which temporary exerte pressure against the skin surface.
9. 9. a device according to claim 1 and 6, wherein that body consists of a annular body.
10. 10. A device according to claim 1, wherein inside of the suction cup at least one membrane is arranged, which is temporarily risen in connection with a pump, but lowered against the skin entered in the suction cup entered skin after air is let in a space enclosed from it mediated by a valve mechanism, with the aim to exerte pressure against the skin what also may happen by the employment of at least one additional body.
11. 11. A device according to claim 1 and 10, wherein said membrane encloses a kind of annular cushion.
12. 12. A device according to claim 1 and 10, wherein at least two concentrically arranged hoses are connected with a pump mechanism by a valve mechanism, but at least one of those simultaneously not showing the same inner pressure.
13. 13. A device according to claim 1, wherein at least one gearing is present for the movement of the punction styles driven by a electric motor, the drive power of which is used not only for the drive of drive wheel for different functions, but also for the shifting of at least one gear pinion, whereby means exist ta shift that gear pinion after predestinated switching distance so that it rolls into mesh with different drive wheels one after the other.
14. 14. A device according to claim 1 and 13, wherein the means for the shifting of the gear pinion is a transport spindle, the drive of which simultaneously shiftes the gear pinion and drives it on.
15. 15. A device according to claim 1 and 14, whereby the gear pinion consists of two gear wheels, which are spring-biased one against the other and may be slided out of+gn axle seat in a middle position rotable around the axle.
16. 16. A device according to claim 1 and 13, whereby on the gear pinion and on disk segments of disks with bigger diameter the gear wheels flanking at a distance, if having the same axle seat, also on the counter wheel, lateral wedge-formed shivers are present, which, after a precalculated angle turning, effect the axle shifting of the gear pinion by mutual repel.
17. 17. A device according to claim 1 and 13, whereby the axle spindle is rotable around a thread-less axle distance without further sliding, from which it is again led back into the thread guidance after the rotation direction has been changed by influence of pressure, preferably exercised by a spring.
18. 18. A device according to claim 1 and 13, whereby between a gear wheel with free revolution around its axle and a disk rolling into mesh with said axle or rolled into mesh at the one side a cam or stop exists, on the other side a kind of arresting pin comes to rest after a predestinated turning sector, wherby also a springy overcoming of the stop can be provided if the axle or the gear wheel are stopped.
19. 19. A device according to the claim 1, whereby in a gearing, the control or drive gear can change over from a axle spindle to a separated running or slidable spindle, whereby the spindles lie on a commun axle plane and at least on of these springs being biased in the axle direction.
20. 20. A device according to claim 1, wherein a switching mechanism is present, whereby a switch pinion operates a release mechanism while it is overcome and turned with by a control or drive gear wheel which is moved past, whilst a locking mechanism prevents a rotation of the gear pinion while it is overcome in counter direction.
21. 21. A device according to claim 1, whereby the spring drive at least for one pump consists of at least one spiral spring, which transfers its power over a pull cable from a spoil.
22. 22. A device according to claim 1 and 21, wherein several spiral spring packets in a row are connected by a kind of sprocket gear connection one with the other, whereby also a sprocket chain can be used.
23. 23. A device according to claim 1 and 21, wherein between at least two spiral spring packets a gear wheel builds the connection, which can be pulled out from the alterning gear mesh for the coupling off from a part of the power drive.
24. 24. A device according to claim 1, whereby for the lowering of the punction style, a horizontally and herewith vertically to the lowering direction working shiver engages into the guiding profiles of the punction style, which shiver may also be used for the removing of at least one protecting lid.
25. 25. A device according to claim 1, whereby movements of the styles or grips are effected by a shiver, which is sloted transversely to the motion direction, in the slot of which the excentric pin of a disk engages, which is driven by a gearing.
26. 26. A device according to claim 1 and 25, whereby to a shiver for the lowering of the punction style a further shiver is connected so that the measuring grip-also simultaneous with the punction style-can be additionally lowered by one of these shivers.
27. 27. A device according to claim 1, whereby a kind of cross spoke can be turned on a stationary tube segment with abrupt insertions by a rod connected with a screw while a pressure spring is tensioned between said screw and said cross spoke so that an abrupt lowering of the cross spoke and of the shivers effected for the transport of the punction style, which is connected with said cross spoke.
28. 28. A device according to claim 1, whereby a punction style has a body, over its boring for the measuring grip at least one foil strip is strained, which is connected with the capped shell which partially surounds the style body so that the foil strip can be moved past the boringpreferably a central boring.
29. 29. A device according to claim 1 and 28, wherein the measuring chamber is built by a capillary fissure space between two foil strips.
30. 30. A device according to claim 1 and 28, whereby a foil strip bears a kind of wiping cushion at its end, which, according its purpose, is led past the indicator layer coated with blood, if needed also be used to shift the indicator layer in front of itself before cleansing of it-with or without an additional transverse strip of foil for the separation of the blood inside of the measuring fissure from the wiping cushion.
31. 31. A device according to claim 1 and 28, whereby a foil strip has a fold for motion and is connected with the style body so that, if its other end is directly or indirectly fastened on the capped shell, it can be pulled past the boring for a limited distance when said capped shell is elevated.
32. 32. A device according to claim 1 and 28, whereby a foil strip has an accumulation of material on its edges at the area of the indicator layer, which destinates the hight of the blood coating.
33. 33. A device according to claim 1 and 28, whereby the position of at least one foil strip to the boring in the style body is secured by a kind of mask guiding directed against the latter.
34. 34. A device according to claim 1, whereby a lancet shaft which is fastened on the capped shell of a punction style has a hollow channel in which a kind of capillary for the injection can be inlaid.
35. 35. A device according to claim 1 and 28, whereby at least one foil strip has at least one hole building, which permits a passage of measuring rays or blood without restraint.
36. 36. A device according to claim 1, whereby the lancet shaft of a punction style has marginal ledges-at least one and in this case not necessarily interrupted-from its point area increasing by degrees and abruptly interrupted, to facilitate the blood exit from the sticking channel to the skin.
37. 37. A device according to claim 1, wherein a optical control of the equality of the filling of the measuring chamber at the area of a punction style takes place by means of a distribution of the measuring plane to several measuring points.
38. 38. A device according to claim 1, wherein at least one dose mechanism is used, which consists of a capsule like excavated (half) cylinder with pressurized gas inside and-in an axis joining with it-of a second cylinder connected with the latter, both separated by a elastic membrane, wich is capable to move inside of a dosing mould centrally positioned in the boundary area, whereby fluid is conducted through a boring, at least here and there transverse, to the dosing mould and from there, it can be derivated again by an other boring or its other end, whereby a shell with valve function, which rotates around at least one of the cylinders, alternately frees the feed or intake and the discharge or outtake in and out of the dosing mould, whereby the membrane motion could be controlled by light rays.
39. 39. A device according to claim 1, which is connected with a tool to make visible essential datas, preferably in connection with the loading of the electric energy source and preferably by use of a printer.
40. 40. A device according to claim 1, whereby laser rays are used for the measurements of metabolism.
41. 41. A device according to claim 1, Mherby the injection under the skin ensues by means of over pressure jet through at least one nozzle.
42. 42. A device according to claim 1, wherein at least one valve mechanism is present, which permits a filling of pressurized air from a pump to a pressure container with elastic drug supply containers.
43. 43. A device according to claim 1, wherein a pressure container exists in which elastic supply containers with a kind of inner cannula are fixed, at least two, and exhausted by using said inner cannula to open a valve towards and of the next supply container, if the first one is nearly exhausted.
44. 44. A device according to claim 1, wherein an optical control of the equality of the skin in the punction area takes place, especially using the optical measuring grip.