Notable Australian contributions to the management of ventilatory failure of acute poliomyelitis
ABSTRACT
When Australia’s 1937 epidemic of poliomyelitis created anurgent need for extra ventilating machines to compensatefor respiratory paralysis, Edward Both, an innovativeAdelaide biomedical engineer, invented a wooden-cabinetrespirator capable of being made relatively quickly insufficient quantity. His device, here called “the Both”,alleviated the problem at Adelaide’s Northfield InfectiousDiseases Hospital and others, and in late 1938 wasintroduced into England when Both was visiting there.Appreciating its merits, Lord Nuffield financed assembly-lineproduction at the Morris motor works in Cowley, Oxford.Then, through the Nuffield Department of Anaesthetics inOxford’s Radcliffe Infirmary, he had the Both distributedCommonwealth-wide, as a gift for treating ventilatoryfailure in polio - especially in children.For the 1937 epidemic in Victoria, and to the design ofMelbourne University’s Professor of Engineering, AubreyBurstall, nearly 200 of another wooden-cabinet respiratorwere ultimately built. Some were installed at the AcuteRespiratory Unit of the Infectious Diseases Hospital atFairfield, then others “all over Australia”. However, by theearly 1950s, the Both had replaced Fairfield Hospital’s“Burstall”, which had functioned as Victoria’s favouredrespirator since 1937. Dr John Forbes at Fairfield becamethe foremost Australian clinician for expertise with the Both.Before the advent of intermittent positive pressureventilation, the Both’s usefulness had seen it tried forventilatory failure in some non-polio conditions, but uptakeof that application was limited. Nonetheless, Nuffield’sphilanthropy with the (Nuffield-)Both ultimately furtheredprogress along the 20th century pathway to intensive caremedicine.
Crit Care Resusc 2006; 8: 383-393
