Breathing Under Pressure: How Philip Drinker Built the Iron Lung

The Girl in the Tank

In October 1928, at Boston Children's Hospital, an eight-year-old girl named Bertha Richards was placed into a long galvanized-iron cylinder until only her head stuck out through a rubber collar at one end^1,4. She had paralytic polio, and the muscles between her ribs had stopped working⁴. A pair of adapted vacuum-cleaner pumps attached to the tank were switched on, and her chest began to rise and fall again, moved by changes in air pressure around her body rather than by her own muscles^1,2.

The machine was doing what it was designed to do⁵. That did not mean the girl was out of danger.

Polio could damage the nerves controlling the diaphragm and chest wall, leaving patients fully conscious while they lost the ability to breathe on their own⁶. Before this device existed, there was not much to offer such a patient beyond nursing care, oxygen, and watching them struggle. A person could die of suffocation while perfectly aware of what was happening to them.

The idea behind the tank came out of a Harvard laboratory, not a hospital ward. Philip Drinker, an industrial hygienist, and Louis Agassiz Shaw, a physiologist and engineer, had been studying how pressure changes affected breathing, partly in connection with industrial gas poisoning^9,10. Their early experiments used anesthetized animals sealed inside a metal chamber with the head left outside through a collar. Lowering the pressure inside the chamber made the chest expand on its own; raising it made the chest fall. It was, in effect, breathing done from the outside in^10,11.

Turning that lab setup into something usable on a child took almost nothing exotic: an airtight iron box, a sliding bed, a rubber neck seal, and two household vacuum cleaners wired to alternately pull air out of the chamber and let it back in^1,2,3. Drinker and Shaw got outside money to build a human-sized version, reportedly a $500 grant from the Consolidated Gas Company of New York, the kind of unglamorous industrial sponsor that would later help place more machines in hospitals^12,5.

Back in the Boston ward, the respirator kept Bertha Richards breathing for roughly 122 hours, just over five days⁵. For that stretch, a mechanical box did the job her own body could no longer do. It was the first time anyone had managed that for a human patient.

She died anyway. The reported cause was cardiac failure linked to extensive bronchopneumonia, not injury from the machine; an autopsy reportedly found no sign that the respirator had damaged her lungs through overinflation or otherwise⁵. The tank had done precisely what Drinker and Shaw built it to do. It just could not touch the infection and paralysis underneath, and that gap, between keeping someone breathing and actually curing them, would define the iron lung for the next three decades.

Why a Breathing Machine, and Why Then

Polio epidemics were already a recurring American and European terror by the late 1920s, striking children in particular and sometimes leaving them unable to breathe without help^6,13. The disease's worst form attacked the nerves controlling respiratory muscles, which meant a child could be fully alert while suffocating in a hospital bed.

Drinker and Shaw's chamber was not originally conceived as a polio treatment at all. It grew out of research into industrial hazards, including coal gas poisoning, where victims also lost the ability to breathe on their own^6,9. The leap from gas-poisoning victims to polio patients happened because the underlying problem, a body that could not move air in and out of its own lungs, was the same.

Scale of the Crisis

• 57,628: polio cases recorded in the United States during the 1952 epidemic, the country's worst^2,13.
• 1,200: people using iron lungs in the United States by 1959¹³.
• $1,500: reported cost of a 1930s iron lung, roughly the price of an average American home at the time.
• 90% to 20%: reported drop in mortality among severe bulbar polio patients after positive-pressure ventilation replaced negative-pressure machines in parts of Europe.
• 39: people still using tank respirators in the United States by 2004, falling to about 10 by 2014⁶.

Who Was Involved

• Philip Drinker: Harvard industrial hygienist who co-built the respirator; later known for a disputed wartime asbestos-safety study⁹.
• Louis Agassiz Shaw Jr.: physiologist and engineer at Harvard who worked with Drinker on the chamber's design^10,11.
• Bertha Richards: eight-year-old patient from Waltham, Massachusetts, the device's first human subject in October 1928^4,5.
• John Haven Emerson: inventor who introduced a cheaper, sturdier iron lung in 1931 and later defeated Drinker in a patent lawsuit^6,5,7.
• Boston Children's Hospital: site of the first clinical use of the respirator^4,3.

What Sources Disagree On

Historical accounts split over whether to date the invention to 1927, when Drinker and Shaw built the first prototype, or 1928, when it was first used on a human patient; both appear in reputable summaries^10,13.

The exact date of that first clinical use is also inconsistent. Most modern sources give October 12, 1928, but one detailed account gives October 13, which may simply reflect different starting points, preparation versus the machine actually running^1,4,11.

After the Tank

John Haven Emerson's 1931 version replaced the original's blowers with a flexible elk-hide diaphragm, making it quieter, lighter, and reportedly half the price of Drinker's design⁵. Drinker and Harvard sued him for patent infringement; Emerson argued that lifesaving devices should not be locked behind a patent, and won by showing the underlying technology already existed before Drinker's claim^6,7.

By the 1940s and 1950s, rows of iron lungs filled polio wards, keeping paralyzed patients alive for the weeks it took their own breathing to recover, if it ever did⁶. The machines were heavy, loud, and hard to move, which pushed European clinicians during the 1952 Copenhagen epidemic toward positive-pressure ventilation delivered through a tube in the airway, a method that cut mortality sharply among the sickest patients and, within a year, had displaced the iron lung across much of Europe^6,8.

Timeline

1. 1927Drinker and Shaw develop a pressure chamber at Harvard, testing it on anesthetized animals^10,11.
2. October 1928First clinical use of the respirator on Bertha Richards at Boston Children's Hospital; she is ventilated for about 122 hours before dying of cardiac failure linked to pneumonia^4,5.
3. 1929A Drinker machine is installed at Bellevue Hospital in New York; Consolidated Gas Company donates 14 machines to New York hospitals¹².
4. 1931Drinker and Shaw receive the John Scott Medal; John Haven Emerson introduces an improved, cheaper respirator^12,14.
5. 1935-1940Emerson successfully challenges Drinker's patents in court, arguing lifesaving devices should be widely available^6,7.
6. 1952US polio cases peak at 57,628; Copenhagen epidemic drives adoption of positive-pressure ventilation^2,8.
7. 1959About 1,200 people in the United States are using iron lungs¹³.

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