Iron Lung History: Invention, Polio, and Its Final User in 2026

An iron lung machine is a large, airtight metal chamber that helps a paralyzed person breathe by mechanically changing the air pressure around their chest, rather than pushing air directly into their lungs. The patient lies inside with only their head outside the machine. For decades, it was the only thing standing between severe respiratory paralysis and death — and remarkably, the technology’s real-world use didn’t fully end until 2026, nearly a century after it was invented. Here’s how the iron lung machine works, where it came from, who actually needed one, and the story of the very last people who depended on one.

Picture a giant metal tube, roughly the size of a small car, with only a person’s head sticking out one end. That image sounds like science fiction, but for decades it was the difference between life and death for thousands of people paralyzed by polio and other conditions.

What the Iron Lung Machine Actually Is

An iron lung machine is a large, airtight metal chamber built to help someone breathe when their own chest muscles can’t do the job. The patient lies flat inside the tank with just their head poking out through a sealed, cushioned neck opening, while the rest of their body stays enclosed. A motor-driven pump inside the machine constantly changes the air pressure around the patient’s chest, cycling between a slight vacuum and normal atmospheric pressure.

How Negative Pressure Ventilation Works

Here’s the clever part: instead of pushing air directly into the lungs the way a modern ventilator does, the iron lung works by changing the pressure surrounding the whole body. When the machine lowers the pressure inside the chamber, the chest expands and pulls air into the lungs naturally, the same way breathing works outside the machine. When the pressure rises again, the chest gets pushed back in and air flows back out. Doctors call this negative pressure ventilation, since it recreates breathing from the outside in, rather than forcing air in directly.

How an iron lung machine cycles pressure to produce inhalation and exhalation, without ever touching the airway directly.

Where the Iron Lung Idea Came From

The core concept wasn’t entirely new when the iron lung became famous. British physician John Dalziel described an early negative-pressure breathing box in 1832. Decades later, Dr. Woillez of Paris built a hand-operated, bellows-driven device called the “Spirophore” in 1876, and in 1918, Dr. Stueart of South Africa built a clay-sealed wooden box specifically to treat polio patients.

The version that changed medicine forever came out of Harvard in the late 1920s. Philip Drinker and Louis Agassiz Shaw, both researchers focused on industrial hygiene, built a working metal chamber and successfully used it on a patient for the first time in 1928. You can hear the full story of how the iron lung was invented from the American Chemical Society’s podcast on the topic. Their early machine ran on an electric motor hooked up to two ordinary vacuum cleaner pumps. A few years later, engineer John Haven Emerson refined the design into a lighter, more reliable version that became the standard model used in hospitals for decades. In Australia, engineer Edward Both went a different direction entirely, building a plywood version that cost roughly one-thirteenth as much as the American machine — cheap enough that philanthropist Lord Nuffield financed about 1,700 of them for hospitals across the British Empire.

Why Polio Made the Iron Lung Necessary

Polio is a viral illness that can attack the nervous system, and in its most severe form, it can paralyze the muscles that control breathing. Before vaccines existed, polio outbreaks tore through communities every year, and doctors had almost no way to treat the disease itself. When paralysis reached the chest and diaphragm, a patient would slowly suffocate, since their body could no longer expand and contract on its own.

The iron lung changed that outcome completely. By taking over the mechanical work of breathing, it kept people alive long enough for their bodies to recover, which happened in many polio cases once the acute phase of the infection passed. For patients whose paralysis never fully went away, the machine became a long-term lifeline rather than a temporary bridge.

During the worst polio years in the mid-20th century, hospital wards lined with iron lungs became a common and unforgettable sight, especially in children’s hospitals. Some hospitals even built room-sized versions large enough to ventilate several patients at once, with space inside for a nurse to move between them while each patient’s head protruded through its own sealed opening in the wall.

Who Else Needed an Iron Lung?

Polio gets most of the attention, but it wasn’t the only reason someone might end up inside an iron lung. Anything that paralyzed or severely weakened the muscles used for breathing could make one necessary. That included:

• Guillain-Barré syndrome, an autoimmune condition that attacks the peripheral nerves and can spread to the respiratory muscles
• Spinal cord injuries that damage the nerves controlling the diaphragm and chest wall
• Muscular dystrophy and other progressive neuromuscular diseases
• Botulism, a bacterial toxin that can paralyze respiratory muscles
• Poisoning from certain drugs, including barbiturate overdose, which can suppress the drive to breathe

In these cases, the iron lung wasn’t always a permanent fixture — for some patients it was a bridge to get through a temporary crisis until their own breathing muscles recovered enough to take back over.

By the Numbers: Just How Deadly Was Respiratory Paralysis?

It’s easy to describe the iron lung as “life-saving” in the abstract. The numbers make it concrete. Before mechanical ventilation of any kind was available, the fatality rate for patients with severe respiratory paralysis could run as high as 80% to 90% — most died either by drowning in their own saliva, since their swallowing muscles were paralyzed too, or from a slow buildup of carbon dioxide in the bloodstream as their airways clogged.

During Copenhagen’s 1952 polio epidemic, a hospital team led by anesthesiologist Bjørn Ibsen tried something different: instead of relying on negative-pressure iron lungs, they used a tracheostomy tube and manually squeezed air directly into patients’ lungs — an early form of positive-pressure ventilation. The first patient treated this way was 12-year-old Vivi Ebert, who had bulbar polio. The approach worked so well that the hospital brought its fatality rate down from around 80-90% to roughly 11%. That single outbreak is widely credited with kicking off the shift toward the modern, positive-pressure ventilators used in every ICU today.

The decline of the iron lung itself also shows up clearly in the numbers. In 1959, an estimated 1,200 people in the United States relied on tank respirators. By 2004, that number had fallen to just 39. By 2014, only 10 people were still using one. A 2013 estimate from Post-Polio Health International put the number even lower, at six to eight — and by 2017, the organization’s own director said she knew of none, though a handful of press-documented users, including Paul Alexander and Martha Lillard, turned out to still be living in theirs.

What Life Inside an Iron Lung Was Actually Like

Living inside an iron lung wasn’t just physically demanding, it reshaped daily life entirely. Patients were essentially sealed away from normal physical contact with the world, able to interact with visitors mostly through their voice and whatever they could see through the machine’s small portholes. Simple things most people take for granted, like sitting up for a cup of tea, required careful monitoring, since even short breaks from the machine could leave a patient short of oxygen within minutes.

“That’s what keeps me healthy. That’s what heals me.”

— Martha Lillard, describing her iron lung, in a 2012 NBC News interview

Beyond breathing, severe polio sometimes affected the muscles needed for eating, swallowing, and speaking, so some patients had to relearn these basic skills after the worst of the illness passed. Despite all of this, plenty of iron lung patients went on to build full lives — some, like Lillard and Paul Alexander, even taught themselves glossopharyngeal breathing, a technique of gulping air using throat and mouth muscles that let them spend limited stretches of time outside the machine.

Other Types of Negative-Pressure Ventilators

The full-body tank is the version everyone pictures, but it wasn’t the only design. As the technology evolved, engineers built smaller, more targeted versions of the same basic idea:

• Cuirass ventilator — named after the torso-covering armor, this enclosed only the chest and abdomen in a rigid shell rather than the whole body
• Jacket, poncho, or wrap ventilator — a lightweight version using flexible plastic or rubber stretched over a frame around the torso
• Rocking bed (introduced around 1950) — tilted a patient head-to-toe to use gravity and the weight of the abdominal organs to help move the diaphragm
• Pneumobelt (introduced around 1959) — an inflatable belt worn around the abdomen that assisted exhalation

These alternatives were generally easier to live with than a full-body tank, but the trade-off was a less reliable seal — and a less reliable seal meant less effective ventilation.

The Decline of the Iron Lung

Everything changed with the arrival of the polio vaccines developed by Jonas Salk and Albert Sabin in the 1950s and 1960s. As vaccination spread and new polio cases plummeted, the need for iron lungs dropped along with them. At the same time, medicine was moving toward positive pressure ventilation, the technique used in virtually all modern ventilators, where air gets pushed directly into the lungs through a tube inserted into the airway. This approach was more precise, easier to manage at a patient’s bedside, and far more practical for hospitals treating a wide range of breathing problems, not just polio.

By the later decades of the 20th century, iron lungs had mostly disappeared from active use, replaced by compact, bedside ventilators that could do the same job with a fraction of the size and complexity.

The Iron Lung’s Unlikely 2020 Comeback

By the early 2000s, the iron lung looked like a closed chapter of medical history. Then COVID-19 hit, and hospitals worldwide faced a terrifying shortage of modern ventilators. In response, a few engineering teams dusted off the old negative-pressure concept.

In the United Kingdom, a team including the University of Warwick, the Royal National Throat Nose and Ear Hospital, the Marshall Aerospace and Defence Group, and Imperial College Healthcare NHS Trust developed a compact, torso-sized device called the “Exovent” as a cheaper, faster-to-produce alternative to a full ICU ventilator. In the United States, a company called Hess Services, based in Hays, Kansas, built a full-size modern iron lung prototype for the same purpose.

Neither project replaced modern ventilators at scale, but the fact that engineers reached for a nearly century-old design during a 21st-century crisis says something about how sound the original idea really was.

The Last People Who Ever Needed an Iron Lung Machine

Here’s a detail that rarely gets much attention outside of specialized reporting: iron lungs didn’t fully vanish until remarkably recently — and as of this writing, that chapter has just closed for good.

Before the two best-known “last” users, there was a generation of long-term patients who quietly kept the technology alive for decades. Martha Mason of Lattimore, North Carolina, spent 61 of her 72 years in an iron lung and wrote a bestselling memoir about the experience, titled Breath, before her death in 2009. June Middleton of Melbourne, Australia, was entered into the Guinness Book of Records as the person who spent the longest time in an iron lung — more than 60 years — before she died the same year, at age 83. Dianne Odell, another long-term polio survivor, had a spinal deformity that made switching to a modern ventilator medically unsafe for her; she died in 2008 after a power failure disabled her machine.

Paul Alexander, a Texas man who contracted polio in 1952 at age six, spent nearly 72 years depending on his iron lung. His father built him a mouth-operated alarm bell so he could call for help, and during power outages, neighbors would come by to hand-pump the bellows to keep him breathing. Alexander taught himself glossopharyngeal breathing — he called it “frog-breathing” — earned a law degree, became a practicing attorney, and built a large TikTok following late in life before he died in March 2024 at age 78.

That left Martha Lillard of Oklahoma, who contracted polio in 1953 at age five, as the last known American still relying on an iron lung. Lillard slept in hers nightly for over 70 years. She died on June 26, 2026, at age 78, from complications linked to post-polio syndrome and long COVID — bringing to a close the practical, real-world use of a technology invented nearly a century earlier, in 1928.

Why the Iron Lung Still Matters

Even though nobody depends on an iron lung today, its legacy runs through nearly every ventilator used in hospitals right now. It was the first machine that let people survive on mechanical support for breathing over the long term, proving that technology could take over a basic bodily function indefinitely. That single idea reshaped critical care medicine and paved the way for the ICU ventilators, anesthesia breathing systems, and home respiratory devices used across the world today.

The iron lung was bulky, loud, and far from comfortable, but for thousands of families during the polio era, it was the machine standing between their loved one and death. That’s a legacy worth remembering, even in an age where a virus like polio has been pushed to the edge of eradication in most of the world.

Frequently Asked Questions

Does anyone still use an iron lung today?

No. As of June 2026, with the death of Martha Lillard, there is no longer a known iron lung user in the United States. She was the last of the two final known users, after Paul Alexander died in March 2024.

Why don’t hospitals use iron lungs anymore?

Modern positive-pressure ventilators push air directly into the lungs through a tube, making them smaller, more precise, and usable for a much wider range of breathing problems than the bulky, single-purpose iron lung.

How is an iron lung different from a modern ventilator?

An iron lung uses negative pressure — changing the air pressure around the whole body to make the chest expand and contract. A modern ventilator uses positive pressure, pushing air directly into the lungs through a tube in the airway.

How did people in an iron lung use the bathroom?

Caregivers used bedpans, urinals, or other collection devices inserted through the machine’s small access ports, since the patient’s body remained sealed inside the chamber. Long-term patients and their nurses developed routines to manage this without interrupting ventilation.

How did people in an iron lung eat?

Because the patient’s head stayed outside the machine, they could chew and swallow normally, and caregivers helped position food and drinks for them. Patients with weaker swallowing muscles were often given soft foods or liquids, and a feeding tube was used in cases where eating safely wasn’t possible.

How long did people typically stay in an iron lung?

It varied enormously. Many polio patients used one for just a few weeks while their breathing muscles recovered from the acute phase of the illness. A smaller number, whose paralysis never fully resolved, relied on one for years or even decades — Paul Alexander and Martha Lillard both used theirs for more than 70 years.

Could an iron lung help during a modern ventilator shortage?

It’s been considered. During the COVID-19 pandemic in 2020, engineering teams in the UK and US built new iron lung-style prototypes specifically to address ventilator shortages. Neither replaced conventional ICU ventilators at scale, but both showed the underlying design still had practical value nearly a century after it was invented.

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This article is for historical and educational purposes and is not medical advice.