How man survived inside 'iron lung' for 70 years before dying last year

Paul Alexander, AKA 'the man in the iron lung', was able to live for more than 70 years inside the medical contraption prior to his death.

Polio may have been eradicated from most of the world nowadays, but in the not-so-distant past the disease caused devastation, with devastating epidemics occurring across the UK and US in the 1950s.

Polio patients being treated in 1948 (Bettmann/Getty Images)

What is polio?

Poliomyelitis - typically shortened to polio - is an infectious disease which is spread from person to person through contact with contaminated faeces. The majority of cases are asymptomatic however polio can cause flu-like symptoms such as muscle pain, headaches and sore throats.

In a small percentage of cases, polio can cause paralysis of the muscles, becoming fatal if this spreads to the muscles used for breathing.

Treatment for patients who lost control of their respiratory muscles included being placed inside a medical device called an iron lung.

An iron lung works by enclosing all of the patient's body (excluding the head) and using air pressure to mimic how a person's diaphragm and chest muscles would work through a process called External Negative Pressure Ventilation.

Over time iron lungs were replaced by ventilators that used something called a Positive Pressure Ventilation System, where air is pushed directly into a patient's lungs through a tube.

Patients would stay inside an iron lung until they were able to breathe independently, which in the case of Alexander would last for over 70 years until his death on 11 March, 2024.

Paul Alexander inside his iron lung (TikTok/@ironlungman)

Alexander had contracted polio at the age of six, with the disease causing lifelong paralysis of his entire body below the neck down.

Despite the setbacks of contracting polio and finding himself paralysed, Alexander was determined to keep on living his life, eventually attending university, studying to become a lawyer and publishing a memoir.

How did Paul Alexander survive inside the iron lung?

For the following 10 years after being paralysed, Alexander was unable to leave the iron lung - which meant that he was largely confined to a life indoors. However, he was eventually able to survive for extended periods of time outside of the device by practising a technique known as 'frog breathing'.

"The first day I was outside the house was extraordinary. It was a 100 percent improvement," Alexander recalled of the first day he was able to leave the iron lung, as per Rotary.

Also known as glossopharyngeal breathing, the technique uses the mouth and throat muscles to force air into the lungs. The method would help him on his journey to become a lawyer as he was unable to use the iron lung while taking his bar exam.

Prior to his death, Alexander explained what would happen in the event of his machine losing electricity, causing it to shut down.

"Say the electricity goes out - bad storm, no electricity. The iron lung does not work because it’s all run by electric pulses - so if the electricity goes out, it stops and I stop breathing," he said.

"To me, that’s life or death if it doesn’t start back up, it’s death, because I can’t breathe very long on my own without the iron lung."

Following Alexander's death aged 78, US woman Martha Lillard is the last living person to use an iron lung.