Imagine the terror of not being able to breathe because your lung muscles are paralysed. You're gasping for air as the medical team slides you into something that looks like a coffin&nbsp;on legs. They seal you in up to your neck and a strange 'whooshing' sound starts somewhere in the room. Then, relief! Your lungs pull in fresh air and you find you're breathing again.

The coffin-like cabinet respirator—better known as the 'iron lung'—was the state-of-the-art in&nbsp;life support technology in the first half of the 20th century.&nbsp;The first&nbsp;iron lung&nbsp;was used at Boston Children's Hospital to save the life of an eight-year-old girl with polio in 1928.

What's An Iron Lung?

<ol><li>What kind of patients it treated? Patients with ACUTE POLIO</li><li>Why? Because patients with polio had symptoms of ACUTE MUSCLE PARALYSIS and if it affected the chest, the patient could not breathe.</li><li>How is the Iron Lung a solution to this problem? Because Iron Lungs helped the patient to "Breathe"</li><li>Who invented Iron Lungs? Philip Drinker and Louis Agassiz Shaw&nbsp;invented the first iron lung at Harvard School of Public Health</li></ol>

Frequently Asked Questions (FAQs)

The Smith-Clarke Baby cabinet respirator, with built-in pump was made at the request of a paediatrician, 1956-1970. It influenced the later development of incubators for babies.

Examples Of Iron Lung

Going into an iron lung was a bewildering process for patients, many of whom were delirious and in extreme pain.Life&nbsp;in an iron lung was difficult for both patient and carers. The numerous tasks involved in treating&nbsp;the patient included:<ul><li>blood transfusions</li><li>intravenous glucose feeds</li><li>inserting and replacing catheters</li><li>and endless adjustments to the body and equipment.</li></ul>In addition to medical care, itches were scratched, noses blown, hair combed, bodies washed&nbsp;and bedpans inserted and removed, all&nbsp;through the portholes as far as possible. (See image above)

WHAT WAS IT LIKE FOR THE PATIENT?

Once an effective&nbsp;polio vaccine&nbsp;was developed in the 1950s, the incidents of polio infection fell dramatically and only a very few machines were needed in hospitals. But patients dependent on them to breathe the old iron lungs were gradually replaced with modern ventilators.

Is It Still Used Today?

The iron lung was large, cumbersome and very expensive,&nbsp;but it&nbsp;saved the lives of thousands of polio victims.Imagine the terror of not being able to breathe because your lung muscles are paralysed. You're gasping for air as the medical team slides you into something that looks like a coffin&nbsp;on legs. They seal you in up to your neck and a strange 'whooshing' sound starts somewhere in the room. Then, relief! Your lungs pull in fresh air and you find you're breathing again.The coffin-like cabinet respirator—better known as the 'iron lung'—was the state-of-the-art in&nbsp;life support technology in the first half of the 20th century.&nbsp;The first&nbsp;iron lung&nbsp;was used at Boston Children's Hospital to save the life of an eight-year-old girl with polio in 1928.&nbsp;<h2> What was the iron lung for?</h2>Incidents of poliomyelitis (polio)&nbsp;began to rise to epidemic proportions across Europe and North America, reaching their peak in the United States in 1952, with 57,628 cases in one year.One of the worst symptoms of acute polio was muscle paralysis. If paralysis affected the chest muscles, the patient couldn’t breathe unaided and might die. Researchers looked to technology for a way to keep these patients alive.The solution came from a&nbsp;team at Harvard University. The&nbsp;'iron lung', as it was nicknamed, was&nbsp;a huge metal box attached to bellows in which the patient was encased. The continuous suction from the bellows kept the patient breathing.It soon became a feature of the polio wards of the mid-1900s. By 1939, around 1,000 iron lungs were in use in the USA.<h2> Who invented it?</h2><a href="http://historical.hsl.virginia.edu/ironlung/ironlung/pg3.cfm.html" dir="ltr">Philip Drinker and Louis Agassiz Shaw</a>&nbsp;invented the first iron lung at Harvard School of Public Health. It consisted of a huge metal box with a set of bellows attached at one end to pump air in and out. The whole body was enclosed in an airtight chamber, apart from the head. A tight rubber seal supported the neck and ensured that air did not escape.Mechanical breathing apparatus were not a new idea, but the huge scale of the polio epidemics motivated researchers to come up with a&nbsp;device. In 1931,&nbsp;<a href="https://www.polioplace.org/people/john-h-emerson" dir="ltr">John Haven Emerson</a>&nbsp;improved on the ‘Drinker’ design by improving access to the patient. He made the bed slide in and out of the cabinet and added portholes to the sides allowed access to the patient without loss of air pressure.&nbsp;Drinker and Harvard University felt that the Emerson respirator was too similar to the original and sued Emerson for infringing on their patents. In court, Emerson's lawyers demonstrated that all the technologies used by Drinker already existed&nbsp;and so could not be patented. <figure><img alt="Diagram from Philip Drinker's patent for an artificial respirator, 1933" height="475" src="https://www.sciencemuseum.org.uk/sites/default/files/styles/embedded_image/public/2019-04/drinker%20patent2.jpg?itok=1y0moZnc" width="675"><figcaption dir="auto">Diagram from Philip Drinker's patent for an artificial respirator. US Patent no. 1906 844, 1933.

United States Patent and Trade Mark Office</figcaption></figure>Emerson won the case and all the patents were declared invalid. The judge also agreed with Emerson that a technology that saved lives should be shared by everyone.A few years later, the Both Respirator was born of necessity. When a polio epidemic broke out in Australia in 1937, the cost of buying and transporting Drinker Respirators all the way from America was so high that the South Australian Health Department asked biomedical engineer&nbsp;<a href="http://adb.anu.edu.au/biography/both-edward-thomas-ted-12234" dir="ltr">Edward Both</a>&nbsp;to come up with a cheaper alternative.The Both respirator was made of plywood. It was not only cheap, but also&nbsp;easier to construct and transport. In some cases, the Both was in use within one hour of production. Lord Nuffield was so impressed with the Both design that he had around 1,700 machines built at his car manufacturing plant in the UK and donated them to hospitals around the world.<h2> Examples of different iron lungs</h2><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/2099451505.jpg?itok=UxktUydA" alt="" width="505" height="400"><figcaption dir="auto">Before the large scale manufacture of iron lungs, local hospitals had to improvise their own methods to help patients breathe when their lungs failed. This&nbsp;custom-built iron lung at Lansdowne Hospital in Cardiff, Wales&nbsp;was made by hospital engineers in the 1940s.&nbsp;

Science Museum Group Collection</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/1901340835.jpg?itok=cmOJMg8w" alt="" width="601" height="400"><figcaption dir="auto">Drinker iron lung respirator, by Siebe Gorman and Co. Ltd., London, 1930s.
Science Museum Group Collection</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/2018-10/emerson.jpg?itok=pOuwZwbK" width="519" height="400" alt="A patient in an emerson iron lung with a nurse standing beside the the machine"><figcaption dir="auto">The Emerson Iron Lung introduced portholes to give medical staff access to the patient without having to open the cabinet, 1960.

CDC Public Health Image Library</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/232608655.jpg?itok=06n_W0n9" alt="" width="515" height="400"><figcaption dir="auto">The Both iron lung was cheap to manufacture and light-weight so it could be easily transported, 1950-1955.
Science Museum Group Collection</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/505264449.jpg?itok=IGqWasYf" alt="" width="500" height="400"><figcaption dir="auto">The Smith-Clarke Senior iron lung. This later 'alligator' style model took up less space than the other designs because the bed did not need to slide out of the cabinet for access, 1953.
Science Museum Group</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/1770712649.jpg?itok=w3-zYx4B" alt="" width="266" height="400"><figcaption dir="auto">The Smith-Clarke Baby cabinet respirator, with built-in pump was made at the request of a paediatrician, 1956-1970. It influenced the later development of incubators for babies.
Science Museum Group Collection</figcaption></figure><h2> How did the iron lung work?</h2><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/embedded_image/public/2019-04/drinker%20patent1.jpg?itok=OgcQJvUr" width="337" height="525" alt="Philip Drinker's patent for an artificial respirator, 1933"><div> United States Patent and Trade Mark Office </div><div class="caption"><cite> United States Patent and Trade Mark Office </cite></div> The respirator worked by pushing air into the lungs by method of artificial respiration called External Negative Pressure Ventilation (ENPV). The bellows sucked air out of the box in which the patient was sealed. As the air pressure in the box fell, the patient’s lungs automatically expanded, drawing fresh air into the diaphragm. When the bellows allowed air back into the box, the air pressure rose and the patient's lungs deflated passively, pushing air out of them. The rhythmic ‘whoosh’ of air from the iron lung became the reassuring sound of patients breathing. Image: A page from&nbsp;Philip Drinker's and Louis Agrassiz Shaw's patent for an artificial respirator. US Patent no. 1906453, 1933.<h2> What was it like for the patient?</h2>Going into an iron lung was a bewildering process for patients, many of whom were delirious and in extreme pain.Life&nbsp;in an iron lung was difficult for both patient and carers. The numerous tasks involved in treating&nbsp;the patient included:<UL><LI>blood transfusions</LI><LI>intravenous glucose feeds</LI><LI>inserting and replacing catheters</LI><LI>and endless adjustments to the body and equipment.</LI></UL>In addition to medical care, itches were scratched, noses blown, hair combed, bodies washed&nbsp;and bedpans inserted and removed, all&nbsp;through the portholes as far as possible.When the portholes were inadequate, tasks such as physical therapy had to be completed in the few minutes that a patient could breathe on their own outside the iron lung.<figure><img alt="Boy in an iron lung, his smiling face is seen in a mirror attached to the machine, 1930s-1950s." height="532" src="https://www.sciencemuseum.org.uk/sites/default/files/styles/embedded_image/public/2018-10/Iron%20lungs%20for%20polio%20victims%2C%201930s-1950s%20%285%29_0.jpg?itok=ni32ejnW" width="675"><figcaption dir="ltr">Polio patient, United States, 1930s-1950s. <cite dir="ltr">AP / Steve &amp; Mary DeGenaro / Boston Children’s Hospital Archive / AARC’s Virtual Museum</cite><a class="| js-credit-link" href="https://rarehistoricalphotos.com/iron-lungs-polio-1930s-1950s/" dir="ltr"> Image source for Boy in an iron lung, his smiling face is seen in a mirror attached to the machine, 1930s-1950s. </a></figcaption></figure>One of the biggest problems for patients was boredom. A mirror could be&nbsp;attached above the patient’s head, so they could see what was happening around them. They could also read books suspended in front of their faces if someone turned the pages for them.In larger iron lung wards they had other patients nearby to provide companionship and psychological support but visiting hours for family were limited. <h3>Using dolls in polio rehabilitation</h3>Polio particularly affected young children, and it was especially difficult for them&nbsp;to understand what was happening to them.&nbsp;Lord Mayor Treloar Hospital in Hampshire specialised in the treatment of children affected by tuberculosis and polio. They used dolls to explain what would happen to them during treatment.<h2> Using dolls in polio rehabilitation</h2><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/1185422513.jpg?itok=r6XH2WxH" alt="" width="601" height="400"><figcaption dir="auto">Teaching doll in a model iron lung, 1930-1950.
Science Museum Group Collection</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/2018-10/lung%20doll.jpg?itok=EfWsDmMO" width="266" height="400" alt="A doll in a model of an iron lung"><figcaption dir="auto">Science Museum</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/2018-10/poliobed.jpg?itok=_d0Dedkd" width="266" height="400" alt="A doll in a model bed used to explain treatment to children with polio"><figcaption dir="auto">Science Museum</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/1193194065.jpg?itok=cXGD5fEc" alt="" width="266" height="400"><figcaption dir="auto">A doll in a bed complete with bedding and a small teddy bear.
Science Museum Group Collection</figcaption></figure><figure><img src="https://www.sciencemuseum.org.uk/sites/default/files/styles/carousel/public/973993250.jpg?itok=wD55tLn8" alt="" width="601" height="400"><figcaption dir="auto">Doll encased in a full body-length plaster cast, probably used to demonstrate to child patients their prospective treatment, 1930-1950.
Science Museum Group Collection</figcaption></figure><h2> How long did you spend in an iron lung?</h2>Most patients only used the iron lung for&nbsp;a few weeks or months depending on the severity of the polio attack, but those left with their chest muscles permanently paralysed by the disease faced a lifetime of confinement. ​​​​​​Therapists used several techniques to help patients regain strength in their chest muscles. By slowly extending the time outside the cabinet the patient could gradually build up the muscles to the point where they could spend most of the day outside the iron lung,&nbsp;returning to it at night to give&nbsp;tired bodies&nbsp;time to rest.The technique sounds&nbsp;straightforward, but in practice learning to breathe again was a difficult and frightening process, as one patient, Kenneth Kingery recalled:<BLOCKQUOTE>I’d have to strain my every fibre for a breath of air. And there was always a helpless terror – wondering whether they’d close the tank in time.</BLOCKQUOTE>As&nbsp;chest muscle strength returned some patients were transferred to rocking beds, which used gravity to help with breathing. As the head of the bed tilted&nbsp;upwards, gravity pulled the internal organs&nbsp;downwards, drawing air into the lungs. When it tilted the other way, gravity pushed the internal organs up on to the diaphragm, pushing air out of the lungs.<div class="caption"> Overslung rocking bed for aiding respiration, by the Cape Engineering Co. Ltd., Warwick, 1973.</div><figcaption class="caption"><cite>Science Museum Group Collection</cite></figcaption>

The iron lung was large, cumbersome and very expensive, but it saved the lives of thousands of polio victims. The iron lung was the state-of-the-art in life support technology in the first half of the 20th century. The first iron lung was used at Boston Children's Hospital to save the life of an eight-year-old girl with polio in 1928.

Health

The iron lung was large, cumbersome and very expensive, but it saved the lives of thousands of polio victims.

Imagine the terror of not being able to breathe because your lung muscles are paralysed. You're gasping for air as the medical team slides you into something that looks like a coffin on legs. They seal you in up to your neck and a strange 'whooshing' sound starts somewhere in the room. Then, relief! Your lungs pull in fresh air and you find you're breathing again.

The coffin-like cabinet respirator—better known as the 'iron lung'—was the state-of-the-art in life support technology in the first half of the 20th century. The first iron lung was used at Boston Children's Hospital to save the life of an eight-year-old girl with polio in 1928.

Incidents of poliomyelitis (polio) began to rise to epidemic proportions across Europe and North America, reaching their peak in the United States in 1952, with 57,628 cases in one year.

One of the worst symptoms of acute polio was muscle paralysis. If paralysis affected the chest muscles, the patient couldn’t breathe unaided and might die. Researchers looked to technology for a way to keep these patients alive.

The solution came from a team at Harvard University. The 'iron lung', as it was nicknamed, was a huge metal box attached to bellows in which the patient was encased. The continuous suction from the bellows kept the patient breathing.

It soon became a feature of the polio wards of the mid-1900s. By 1939, around 1,000 iron lungs were in use in the USA.

<a dir="ltr" href="http://historical.hsl.virginia.edu/ironlung/ironlung/pg3.cfm.html">Philip Drinker and Louis Agassiz Shaw </a> invented the first iron lung at Harvard School of Public Health. It consisted of a huge metal box with a set of bellows attached at one end to pump air in and out. The whole body was enclosed in an airtight chamber, apart from the head. A tight rubber seal supported the neck and ensured that air did not escape.

Mechanical breathing apparatus were not a new idea, but the huge scale of the polio epidemics motivated researchers to come up with a device.

In 1931, <a dir="ltr" href="https://www.polioplace.org/people/john-h-emerson">John Haven Emerson </a> improved on the ‘Drinker’ design by improving access to the patient. He made the bed slide in and out of the cabinet and added portholes to the sides allowed access to the patient without loss of air pressure.

Drinker and Harvard University felt that the Emerson respirator was too similar to the original and sued Emerson for infringing on their patents. In court, Emerson's lawyers demonstrated that all the technologies used by Drinker already existed and so could not be patented.

Emerson won the case and all the patents were declared invalid. The judge also agreed with Emerson that a technology that saved lives should be shared by everyone.

A few years later, the Both Respirator was born of necessity. When a polio epidemic broke out in Australia in 1937, the cost of buying and transporting Drinker Respirators all the way from America was so high that the South Australian Health Department asked biomedical engineer <a dir="ltr" href="http://adb.anu.edu.au/biography/both-edward-thomas-ted-12234">Edward Both </a> to come up with a cheaper alternative.

The Both respirator was made of plywood. It was not only cheap, but also easier to construct and transport. In some cases, the Both was in use within one hour of production. Lord Nuffield was so impressed with the Both design that he had around 1,700 machines built at his car manufacturing plant in the UK and donated them to hospitals around the world.

The respirator worked by pushing air into the lungs by method of artificial respiration called External Negative Pressure Ventilation (ENPV).

The bellows sucked air out of the box in which the patient was sealed. As the air pressure in the box fell, the patient’s lungs automatically expanded, drawing fresh air into the diaphragm.

When the bellows allowed air back into the box, the air pressure rose and the patient's lungs deflated passively, pushing air out of them.

The rhythmic ‘whoosh’ of air from the iron lung became the reassuring sound of patients breathing.

Image: A page from Philip Drinker's and Louis Agrassiz Shaw's patent for an artificial respirator. US Patent no. 1906453, 1933.

Going into an iron lung was a bewildering process for patients, many of whom were delirious and in extreme pain.

Life in an iron lung was difficult for both patient and carers. The numerous tasks involved in treating the patient included:

<ul><li>blood transfusions </li><li>intravenous glucose feeds </li><li>inserting and replacing catheters </li><li>and endless adjustments to the body and equipment. </li> </ul>

In addition to medical care, itches were scratched, noses blown, hair combed, bodies washed and bedpans inserted and removed, all through the portholes as far as possible.

When the portholes were inadequate, tasks such as physical therapy had to be completed in the few minutes that a patient could breathe on their own outside the iron lung.

One of the biggest problems for patients was boredom. A mirror could be attached above the patient’s head, so they could see what was happening around them. They could also read books suspended in front of their faces if someone turned the pages for them.

In larger iron lung wards they had other patients nearby to provide companionship and psychological support but visiting hours for family were limited.

Polio particularly affected young children, and it was especially difficult for them  to understand what was happening to them.  Lord Mayor Treloar Hospital in Hampshire specialised in the treatment of children affected by tuberculosis and polio. They used dolls to explain what would happen to them during treatment.

Most patients only used the iron lung for a few weeks or months depending on the severity of the polio attack, but those left with their chest muscles permanently paralysed by the disease faced a lifetime of confinement. ​​​​​​

Therapists used several techniques to help patients regain strength in their chest muscles. By slowly extending the time outside the cabinet the patient could gradually build up the muscles to the point where they could spend most of the day outside the iron lung, returning to it at night to give tired bodies time to rest.

The technique sounds straightforward, but in practice learning to breathe again was a difficult and frightening process, as one patient, Kenneth Kingery recalled:

I’d have to strain my every fibre for a breath of air. And there was always a helpless terror – wondering whether they’d close the tank in time.

As chest muscle strength returned some patients were transferred to rocking beds, which used gravity to help with breathing. As the head of the bed tilted upwards, gravity pulled the internal organs downwards, drawing air into the lungs. When it tilted the other way, gravity pushed the internal organs up on to the diaphragm, pushing air out of the lungs.

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The Iron Lung | Science Museum

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What's An Iron Lung?

Frequently Asked Questions (FAQs)

Examples Of Iron Lung

WHAT WAS IT LIKE FOR THE PATIENT?

Is It Still Used Today?

IDEAS ABOUT

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The Iron Lung | Science Museum

KEEP READING BELOW!

What's An Iron Lung?

Frequently Asked Questions (FAQs)

Examples Of Iron Lung

WHAT WAS IT LIKE FOR THE PATIENT?

Is It Still Used Today?

IDEAS ABOUT

MORE LIKE THIS

Ventilators Are No Panacea For Critically Ill COVID-19 Patients

7 scientists who helped change the world

How to Manage Panic Attacks

It's time to

READ

LIKE

A PRO!

Bite-sized knowledge
to upgrade
your career