The last man with an iron lung is dead – that is the story of the metal box

In 1952, at the age of six, Paul Alexander contracted infantile paralysis, also known as polio, which left him paralyzed from the neck down. The disease prevented him from breathing on his own, so doctors placed him in a metal cylinder. Alexander would spend the rest of his life there.

But that didn’t stop him from pursuing a career: Paul Alexander later earned a law degree, practiced law and published his memoirs. On Tuesday, March 12, Alexander, the last man with an ‘iron lung’, died at the age of 78.

But what exactly is this steel colossus?

In 1936, 25-year-old American Fred Snite went on a world tour before taking over the company from his father, a wealthy financier. But everything turned out differently. He didn’t get to see the world: instead, he stared at the ceiling of the Rockefeller Memorial Hospital in Beijing for eighteen years.

Snite had polio. Since the 19th century, the United States and Europe have been plagued by the infamous polio every five to six years. If the virus affects the respiratory muscles, the disease can be fatal. But the young American was lucky. He was placed in China’s only ventilator: an iron colossus to which he owed his life.

When Chinese newspapers shamed the wealthy American for occupying the Chinese steel tank for so long, Snite’s father brought his son back to the United States. This life-threatening journey has gone down in history as “one of the most exciting medical odysseys of modern times,” Spiegel writes.

Snite could be happy though, as the Iron Lung was state-of-the-art for its time. 1926 is the birth year of the medical device that revolutionized the history of artificial ventilation. She saved the lives of thousands of polio victims.

The invention was not planned at all: initially, the engineer Philip Drinker of Harvard University Medical School in Boston had not thought about treating polio. The New York Gas and Electric Company even commissioned him to develop a resuscitation device for victims of gas poisoning and electrocution.

With $5,000 (about $66,000 today adjusted for inflation), Drinker revolutionized artificial ventilation. Together with engineer Louis Agassiz Shaw, he tested his invention on a cat (see info box). The experiment was successful and should be tested on humans in a second step.

Drinker volunteered, put himself on his own ventilator, started hyperventilating heavily and then knew: it was working. In 1929 his gas mask was presented to the public. The good news spread quickly: a device was finally available that could prevent the fatal outcome of polio.

Just two years later, iron lungs went into mass production after another serious epidemic raged in the United States, with 4,138 cases of the disease recorded in New York alone. 88 of them suffered from respiratory paralysis.

Ever since man received the divine breath of life, he has tried to hold on to it – even when the body resists it.

Some historical precursors of the life-saving metal lung sometimes seem to come from a theater of horror. But no one was tortured with these devices. On the contrary: they are all built to bring people back to life. For almost 300 years, resuscitation was performed using bellows. This brutal overprinting method was only gradually abandoned in the 17th century.

In 1838, the Scottish physician John Dalziel invented an airtight container that allowed a person to be ventilated using negative pressure: the patient sat in a wooden box that was sealed against ambient pressure and from which only the head looked out. Still slightly crooked in posture, it will develop into a prone tank in just 38 years.

The French inventor Woillez also integrated a bellows into his breathing apparatus developed in 1876. This was a cylinder made of zinc or sheet steel.

The great American inventor Alexander Graham Bell, known for his co-development of the first telephone, built a metal vacuum jacket in the 1880s. This invention was in response to the tragic death of his son, who died of a respiratory illness shortly after birth. The vacuum jacket served as a resuscitation aid for humans and animals.

In the case of respiratory arrest in newborns, Austrian Dr. Egon Braun a wooden fan. The child’s body was pressed against a small rubber membrane opening (E) in the otherwise closed wooden box using a device (C). The doctor blew into the tube (D) so that the child’s chest would be compressed by the increased pressure. He then released the air again, creating a suction that expanded the chest.

This process had to be repeated 20 to 30 times per minute. What seems to today’s viewer a scary element of a more or less tasteless horror show has saved 50 little lives.

Ferdindand Sauerbruch was one of the most important and influential surgeons in the first half of the 20th century. Thanks to the pressure difference method he developed, it became possible to perform operations on the thorax.

The Pulmotor was used in 1907 to revive injured miners, victims of gas poisoning and drowned people. This device also worked on the principle of alternating pressure ventilation. The Pulmotor obtained its driving energy from the oxygen in a compressed gas bottle, which also served as medicine.

In 1918, the South African Dr. W. Steuart created a machine that almost had the finesse of the Drinker Respirator. His device consisted of a locked wooden box, specially designed for polio patients. The bellows were driven by a motor and the speed of the air blasts could be controlled.

As an alternative to the tank masks, in which the entire body of the patient except the head was inside the machine, there was the Cuirass mask, named after the French name for the chest and back armor of cavalry soldiers, which was originally made of leather duration.

Amazingly, people were still living in an iron lung until the 21st century. In 2008, American Dianne Odell died after almost 60 years in the steel colossus: the power went out.