The Drinker iron lung

When polio paralyzed the muscles of breathing, patients suffocated, often within a few hours of the first signs of distress. Manual artificial respiration could not be kept up for long, and devices such as the pulmotor pushed air too forcefully and could injure the organs.

The respirator came out of industrial safety work. In 1926 the Consolidated Gas Company of New York set up a committee on resuscitation after gas poisoning and electric shock. Cecil Drinker, a physiology professor at the Harvard School of Public Health, pointed it to his brother Philip, a chemical engineer, and to Philip's colleague Louis Agassiz Shaw, and in the fall of 1927 the committee sent them $5,000. Shaw and Cecil Drinker had been sealing cats in airtight boxes, heads out through a collar, to measure their breathing. Drinker and Shaw then paralyzed cats with curare and kept them breathing by raising and lowering the pressure in the box with a hand-operated piston.

With more money from the gas company, a tinsmith and the Harvard Medical School machine shop built a version large enough for a person, and Drinker and Shaw tested it on themselves. The patient lay on his back in a sealed metal tank with the head outside and a rubber collar around the neck. Pumps lowered the pressure in the tank, the chest expanded and air flowed in through the nose and mouth; when the pressure rose again the patient breathed out. The first machine was little more than a galvanized iron box run by two household vacuum cleaners.

In October 1928 it was used at Children's Hospital in Boston on an eight-year-old girl with respiratory paralysis from polio. It kept her alive for five days, but she died of heart failure brought on by pneumonia; Drinker and the pediatrician Charles McKhann reported her as a fatal case in 1929. The next patient, a Harvard student, spent several weeks in the respirator and recovered enough to return to normal life.

A severe polio epidemic in 1931 raised demand, and major American hospitals soon owned at least one Drinker respirator. That year John Haven Emerson built a quieter, cheaper tank. Drinker threatened to sue over his patents, which were later declared invalid for lack of originality. In 1982 the anesthesiologist H. H. Bendixen wrote that polio mortality stayed high until positive-pressure breathing was added to the tank.