The machine invented by Phillip Drinker of
Harvard School of Public Health in
1926 was officially known as a Drinker respirator, or the Emerson tank after its main manufacturer, but the term "iron lung" quickly became the standard term for it. Drinker's first machine was a tin box with used
vacuum cleaner blowers attached through valves, and an end plate with a rubber collar for the user's neck. It took a long time to get it to provide adequate respiration for a paralyzed
polio patient, but in
1928, its first trial on an actual patient kept an eight-year-old girl alive for a week when she had been blue with
oxygen deprivation before the device was turned on. This was a revolution in care for people who couldn't breathe on their own.
However, at first there were neither enough machines nor medical personnel who knew how to use them during the polio epidemics of the 1930s. The National Foundation for Infantile Paralysis, formed in 1938, took as one of its goals supplying both people and tanks to all the hospitals with a need. Army planes flew them to epidemic locations. Hospitals often had to hire engineers to keep them running, since an iron lung might have to function for six months without stopping. Any kind of failure set off a built-in alarm and they could be hand-pumped in the event of power outages.
However, patients were essentially stuck in a box. Some were completely paralyzed; others could move their arms and legs, though the muscles for breathing were paralyzed, and some models did have armholes. The lucky patients had radios, or occasionally even a TV to keep them occupied; others had books in overhead racks but were forced to wait for someone else to turn the pages. It could also get a little unpleasant inside the box, since patients were not able to get out to a bathroom. For patients who couldn't breathe unassisted long enough to have the sheets inside changed, it was possible to exchange the bed linens through side vents, but the wrinkled results could dig into a paralyzed person's body. Many of the paralyzed patients had a tracheotomy, so they couldn't speak normally and had to click their teeth together, make popping sounds with their lips, or compress and release air between cheek and tongue (like urging a horse forward) to summon help. They also couldn't cough, sneeze, blow nose, rendering secondary infections a problem.
And the machines were noisy, with the sound of a rhythmic bellows pumping, wheezing and squeaking; one person described it as sounding like windshield wipers. Sleep might be difficult for the patient in an iron lung ward.
Patients could be transferred from one hospital to another still inside the iron lung (attached to a generator) in trucks, trains, or even planes. There were smaller portable iron lungs made, but they were too confining for long-term use, so most transferred people stayed in a full-sized one (requiring the use of transportation with wide enough doors for the machine to fit).
Sources:
Black, Kathryn. In The Shadow of Polio: A Personal and Social History. Reading, Massachusetts: Addison-Wesley, 1996.