page_title: Iron lung
section_title: Both respirator
hierarchical_section_title: Iron lung / Invention and early use / Both respirator
caption_attribution_description: English: A patient at the 110th Australian Military Hospital receiving treatment in an iron lung, 1943. Comment&#160;: This is now the Hollywood Private Hospital in Nedlands, Perth, Western Australia.
context_page_description: An iron lung, also known as a tank ventilator or Drinker tank, is a type of negative pressure ventilator; a mechanical respirator which encloses most of a person's body, and varies the air pressure in the enclosed space, to stimulate breathing. It assists breathing when muscle control is lost, or the work of breathing exceeds the person's ability. Need for this treatment may result from diseases including polio and botulism and certain poisons.
  The use of iron lungs is largely obsolete in modern medicine, as superior breathing therapies have been developed, and due to the eradication of polio in most of the world. However, in 2020, the COVID-19 pandemic revived some interest in the device as a cheap, readily-producible substitute for positive-pressure ventilators, which were feared to be outnumbered by potential victims temporarily needing artificially assisted respiration.
context_section_description: The Both respirator, a negative pressure ventilator, was invented in 1937 when Australia's epidemic of poliomyelitis created an immediate need for more ventilating machines to compensate for respiratory paralysis. Although the Drinker model was effective and saved lives, its widespread use was hindered by the fact that the machines were very large, heavy (about 750 lbs), bulky, and expensive. In the US, an adult machine cost about $2000 in 1930, and £2000 delivered to Melbourne in 1936. The cost in Europe in the mid-1950s was around £1500. Consequently, there were few of the Drinker devices in Australia and Europe.
  The South Australia Health Department asked Adelaide brothers Edward and Don Both to create an inexpensive "iron lung". Biomedical engineer Edward Both designed and developed a cabinet respirator made of plywood that worked similarly to the Drinker device, with the addition of a bi-valved design which allowed temporary access to the patient's body. Far cheaper to make (only £100) than the Drinker machine, the Both Respirator also weighed less and could be constructed and transported more quickly. Such was the demand for the machines that they were often used by patients within an hour of production.
  Visiting London in 1938 during another polio epidemic, Both produced additional respirators there which attracted the attention of William Morris (Lord Nuffield), a British motor manufacturer and philanthropist. Nuffield, intrigued by the design, financed the production of approximately 1700 machines at his car factory in Cowley, and donated them to hospitals throughout all parts of Britain and the British Empire. Soon, the Both-Nuffield respirators were able to be produced by the thousand at about one-thirteenth the cost of the American design. By the early 1950s, there were over 700 Both-Nuffield iron lungs in the United Kingdom, but only 50 Drinker devices.
caption: A Both cabinet respirator being used to treat a patient at the 110th Australian Military Hospital in 1943
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