
The first of these devices to be widely used however was developed in 1928 by Drinker and Shaw of the United States.

Stueart's box was sealed at the waist and shoulders with clay and powered by motor-driven bellows. Early prototypes included a hand-operated bellows-driven "Spirophore" designed by Dr Woillez of Paris (1876), and an airtight wooden box designed specifically for the treatment of polio by Dr Stueart of South Africa (1918). Successful use of similar devices was described a few years later. The first negative pressure ventilator was described by British physician John Dalziel in 1832. Mayow built a model consisting of bellows and a bladder to pull in and expel air. In 1670, English scientist John Mayow came up with the idea of external negative pressure ventilation. In Germany, fewer than a dozen of these breathing machines are available to the public. Iron lung from the 1950s in the Gütersloh Town Museum. Invention and early use Initial development

If a person loses part or all of the ability to control the muscles involved, breathing becomes difficult or impossible. When the diaphragm relaxes, the reverse happens and the person exhales. This, in turn, causes the pressure of the air inside the lungs to decrease (it becomes negative, relative to the atmosphere), and air flows into the lungs from the atmosphere: inhalation. This causes the pressure in the chest cavity to decrease, and the lungs expand to fill the space. Humans, like most mammals, breathe by negative pressure breathing: the rib cage expands and the diaphragm contracts, expanding the chest cavity. A lightweight variation on the cuirass ventilator is the jacket ventilator or poncho or raincoat ventilator, which uses a flexible, impermeable material (such as plastic or rubber) stretched over a metal or plastic frame over the patient's torso. The cuirass ventilator encloses only the patient's torso, or chest and abdomen, but otherwise operates essentially the same as the original, full-sized iron lung.

Smaller, single-patient versions of the iron lung include the so-called cuirass ventilator (named for the cuirass, a torso-covering body armor). Larger "room-sized" iron lungs were also developed, allowing for simultaneous ventilation of several patients (each with their heads protruding from sealed openings in the outer wall), with sufficient space inside for a nurse or a respiratory therapist to be inside the sealed room, attending the patients. Iron lungs can be either manually or mechanically powered but normally are powered by an electric motor linked to a flexible pumping diaphragm (commonly opposite the end of the cylinder from the patient's head). Įxamples of the device include the Drinker respirator, the Emerson respirator, and the Both respirator. Then, for the patient to exhale, the air inside the cylinder is compressed slightly (or allowed to equalize to ambient room pressure), causing the patient's chest and abdomen to partially collapse, forcing air out of the lungs, as the patient exhales the breath through their exposed mouth and nose, outside the cylinder. To cause the patient to inhale, air is pumped out of the cylinder, causing a slight vacuum, which causes the patient's chest and abdomen to expand (drawing air from outside the cylinder, through the patient's exposed nose or mouth, into their lungs).

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The iron lung is typically a large horizontal cylinder, in which a person is laid, with their head protruding from a hole in the end of the cylinder, so that their full head (down to their voice box) is outside the cylinder, exposed to ambient air, and the rest of their body sealed inside the cylinder, where air pressure is continuously cycled up and down, to stimulate breathing. Diaphragm (yellow) mechanically extends/retracts, varying cylinder air pressure, causing patient chest to expand (inhale) (top) and contract (exhaling) (bottom) Iron lung cylinder (black), patient head exposed through sealed opening.
