The Iron Lung

Among the many terrible diseases that have been essentially eliminated from wealthy developed nations such as Australia is poliomyelitis (polio).  Poliomyelitis is defined as “muscle paralysis, wasting and deformity of limbs after infection by a common virus (poliovirus) that can damage the so-called motor nerves in the spinal cord”.[1]

The earliest epidemic of poliomyelitis in Australia was recorded in 1895 and the last in 1961 before the Salk vaccine and the Sabine oral vaccine were widely delivered.  Major epidemics occurred in 1937-38, 1947-48 and 1951-52.[2]

Patients with certain forms of poliomyelitis are unable to breathe unaided and must be given artificial respiration.  The 1937-38 epidemic was particularly severe and the ‘iron lung’ formed a vital part of the treatment regime available.  The basic mode of operation is to encase the patient’s body other than the head in a sealed chamber, called the ‘tank’.  A pump is then used to artificially raise and lower the pressure in the tank so that the patient’s chest expands and contracts inhaling and exhaling air through the mouth and nose as in normal breathing.

A successful ‘iron lung’ had been developed in the United States in 1929 by Dr Philip Drinker and Dr Charles McKhann.[3]  The problems with the Drinker respirators were that they were expensive and, being made of ‘iron’, very heavy and unwieldy.  While there were Drinker respirators in Australia, there was a need for a larger number of more practical less expensive machines.  A number of Australian inventors went to work and the most successful Australian model was the Both respirator developed and manufactured in Adelaide using plywood rather than steel.  Nevertheless, the name ‘iron lung’ continued to be used.  The plywood construction lowered costs and made the respirator quite portable.  They could be fitted with wheels.

The photograph shows the Both Respirator located in the ACHHA’s display at the Rockhampton Heritage Village.

This image clearly shows both the ‘tank’ enclosing the patient and the bellows machinery at the bottom right.  The tube connecting the two is also visible.  A flexible rubber seal surrounds the patient’s neck.

The ‘Both’ respirator took its name from its developer, a young Adelaide man Edward Thomas Both who set up a laboratory to develop scientific and medical apparatus at Adelaide University in the early 1930’s.  He and his wife and younger brother subsequently set up a company which became known as Both Equipment Limited. 

The device for creating the air pressure variation in the chamber is a large electrically driven cylindrical bellows on its own wheeled stand.  As the bellows expand, a negative pressure is created in the tank causing the patients chest to expand, inhaling air through the nose and mouth.  As the pressure increases the patient breathes out.  The two units were connected by a wide flexible tube and in some hospitals the machinery was kept on the veranda with the tube fed through a window to the chamber.

Although the Both Respirator was relatively inexpensive and could be made fairly quickly, there was still an issue with ensuring widespread availability during the epidemic.  Here Lord Nuffield (Sir William Morris) who started his career with a bicycle shop in Oxford, England enters the story.  In 1913 he made his first motor car, the Morris, and by the 1930’s had become an important philanthropist.  He was impressed by the simplicity of the Both machine and decided to manufacture and give away units to any hospital in the British Empire which requested one.  Until the war intervened, 800 units had been manufactured in the Morris Cowley works.

Because the respirator went on to be made in many locations including some hospital workshops, they are not all identical.  The Nuffield model was further developed over time and baby incubators and emergency respirators for transfer by plane were developed.  The Both factory in Adelaide was eventually sold to Drug Houses of Australia (DHA) which retained all of the workers.

The ACHHA’s respirator was one of those provided by Lord Nuffield Foundation.  The ACHHA’s records and a plaque on the machine indicate that the Hospital Board agreed to accept the machine and pay the transport costs at its meeting in December 1938.  The Morning Bulletin report stated:[4]

“Yesterday the Rockhampton Hospitals Board received a telegram from the Director General of Health and Medical Services (Sir Raphael Cilento) stating that Lord Nuffield was prepared to offer a free Respirator (“Iron Lung”) for the treatment of paralysis at the Hospital.”

Other photographs in the ACHHA collection at the Heritage Village show iron lungs in use in a hospital ward.  The display also outlines the procedures and difficulties associated with nursing patients dependent on an iron lung to keep them alive.

Proudly built by Online by Design.

© Australian Country Hospitals Heritage Association Inc 2008