The Iron Lung

Ingenious

Alana Sutherland s3108081

The earliest case of Polio or ‘Infantile Paralysis’ in Australia was in 1895, and with no warning it started to spread. By 1937 it had become a worldwide epidemic and three major outbreaks were to change the way the world approached artificial respiration and design in a medicinal sense. The most severe outbreak was undoubtedly from 1937-1938, and with only a few American respirators in Australia there was a sudden need for more. This process had to be quick as time was not a luxury anyone possessed, in turn factories were erected in England who then distributed all over the British Empire, including Australia.

Polio (Poliomyelitis) is a viral disease, when at its most severe, attacks the central nervous system causing permanent or temporary paralysis. Victims with ‘anterior’ poliomyelitis are unable to breath on their own and require artificial respiration to keep them alive. When The Iron Lung is in use the person is placed into the central chamber, a cylindrical steel drum, and a seal is formed allowing only the head and neck to remain free. The air tight compartment encases the rest of the body and pumps that control airflow periodically decrease and increase the air pressure within the chamber, particularly on the chest. When the pressure falls below that within the lungs, the lungs expand and air from outside the chamber is sucked in via the person’s nose and airways to keep the lungs filled; when the pressure rises above that within the lungs, the reverse occurs, and air is expelled. In this manner the Iron Lung mimics the action of natural breathing.

DETAILED DESCRIPTION SOURCED FROM ARCHIVES- OF IRON LUNG SEEN IN MUSEUMS VICTORIA MORELAND ANNEXE IN COBURG-

“THIS RESPIRATOR, COMMONLY KNOWN AS AN ‘IRON LUNG’ CONSISTS BASICALLY OF A WOODEN BOX, WHICH RESTS ON A MOBILE METAL FRAME. IT IS DESIGNED TO BE ATTACHED VIA A STEEL REINFORCED INLETHOSE, TO A BELLOWS AND ENGINE UNIT WHICH DELIVERS INTERMITTENT NEGATIVE PRESSURE TO THE BOX. TWO CONNTERWEIGHTS EXTEND BEYOND THE REAR OF THE BOX, WHICH PIVOT AND ALLOW FOR EASE OF MOVEMENT WHEN RAISING THE LID FOR BRIEF ACCESS TO PATIENT, THUS CAUSING MINIMAL LOSS OF PRESSURE. TO MAINTAIN CORRECT AIR PRESSURE, THE UPPER AND LOWER HALF OF THE BOX IS SEALED WITH A RUBBER SEAL AND TWO METAL CLAMPS. WITHIN THE BOX THERE IS A SLIDING WOODEN BASE FOR A MATTRESS. A METAL FRAME SUPPORTS A CANVAS HEAD SUPPORT. A RUBBER AND MEATL SEAL WHICH FITS AROUND THE NECK COMPLETES THE AIR-TIGHT CONTAINMENTS OF THE PATIENT. A WOOD AND PERSPEX FRAME FOLDS FORWARD FROM THE TOP OF THE BOX ALLOWING THE PATIENT TO READ FROM BELOW. AN ANGLED MIRROR IS ATTACHED HERE TOO, FOR THE PATIENT TO VIEW THEIR SURROUNDINGS. ABOVE THE BOX ALSO IS A PRESSURE GAUGE FROM WHICH POSITIVE AND NEGATIVE AIR PRESSURE WITHIN THE BOX CAN BE READ BY AN ATTENDANT. BENEATH THE BOX IS AN ADJUSTABLE METAL WHEEL FOR TILTING THE BOX, AND THUS THE ANGLE OF THE PATIENTS CHEST. THE BOX IS MADE OF WOOD, PAINTED RED AND BLACK- THE COLOURS OF ESSENDON FOOTBALL CLUB- REFLECTING THE INTERETS OF THE PATIENT WHOSE HOME THE RESPIRATOR WAS FOR MANY YEARS. IN A SIMILAR VEIN, NUMEROUS ADHESIVE STICKERS HAVE BEEN APPLIED TO THE BOX, ALTHOUGH UNFORTUNATELY THE PINUPS WITHIN THE BOX HAVE BEEN REMOVED.”

As recorded in ‘The Hammer’- Health and Medicine Museums newsletter-

“By 1994 there were 50 long-term patients, most at home using positive pressure ventilation. Since their transfer to the Austin and Repatriation Medical Centre in 1996, over 200 patients are now being supported in this way with only five now using tank ventilators, three at home. Several backup ventilators still exist while one ventilator painted in the red and black Essendon football colours by its last user has been donated to the Melbourne Museum.”

This particular Iron Lung was occupied by a patient at Fairfield Hospital in Melbourne who infact had Polyneuritis, a disease similar to Poliomyelitis in terms of the affect on respiratory muscles. Having a localized infectious disease helps one to understand and empathize with the entirety of Poliomyelitis, the strength patients drew on and the scars that remained. More often than not, patients were forced to leave the family home in search of full time specialized care. This only added to patients’ humiliation and thoughts of self worth, frequently resulting in severe depression. Patients with serious cases of Polio- permanent paralysis- found ways to contribute to society, in example through drawing and writing with the use of their mouth. It was evident that the mind became sharper and more intuitive without having use of the body, in the way a blind person’s sense of smell is heightened.

Many jobs were born from Polio, not only through the need for Medical staff, but for carers and other generous people wanting to make a difference. Adult Polio victims generally felt sexually frustrated and physically unattractive, so to relieve this burden they employed people, and this was done in a very understanding and beautiful manner.

The Iron Lung, a showcase of modern technology, shows great appreciation for the respiratory system, with several inventors designing the crucial Iron Lung and engineers developing the technologies to keep the Polio victims alive.

The Drinker Iron Lung

The Drinker respirator was developed in the late 1920s by Phillip Drinker at the Rockefeller Institute in the USA. The chamber of the Drinker respirator was a large, cylindrical metal tank. Somewhere along the line it was given the nickname ‘Iron Lung’ and this name stuck. The Drinker went into commercial production in the early 1930s.

The Both Iron Lung

Although operating on the same principle as the Drinker respirator, external negative pressure, the Both respirator was much more efficient and cheaper to produce. One of its positive aspects was that it was made of plywood, thus enabling portability due to its weight. It was infact called the ‘Both portable cabinet respirator’. The term ‘Iron Lung’ was used for the Both respirators though they were made from plywood, the designers themselves even referring to them as ‘Iron Lungs’.

The Boths, a husband and wife team, were approached by health authorities in South Australia in the hope that they could create a breathing machine to cope with the recent outbreak of Polio in Australia. At the time the only system that was reliable was the Drinker respirator, so the Boths based their design on this existing technology. They were able to produce enough machines to cope with the epidemic in South Australia, and soon the rest of the country. On top of the machines being copied in the workshops of several Australian hospitals, another Both factory opened in Sydney and the Both Iron Lung was still being produced into the 1950s.

Very few Iron Lungs are still used in Australia today, the last reported case of Polio occurring in 1961, just before the Salk vaccine and Sabine oral vaccine finally put an end to the debilitating disease. Those who still use their Iron Lung use it only at night, if only for its security and comfort, as many have spent much of their lives in the machine. Many opted for positive pressure ventilation in the form of a portable oxygen tank and mask to overcome any breathing difficulties.

To comprehend Polio one must lie in an Iron Lung and not move, not an inch, and imagine that sensation lasting until they die, even then that’s really only pretend. Those who cared for and bathed, shaved, fed and sung to a Polio victim are the only ones who come close to understanding the affect Polio had on the body, mind and soul.

+ REFERENCES

Museums Victoria Moreland Annexe- Archives

University Of Virginia

Historical Collections at the Claude Moore Health Sciences Library

www.historical.hsl.virginia.edu

The Hammer

Health and Medicine Museums newsletter

Issue number.24 March 2003 PDF Adobe Acrobat

www.archive.amol.org.au

Breathing Lessons (Video recording)-

The Life and Work of Mark O’Brien

Swanston Library Audiovisual Collection

Call no. Av.616.835