Episode 30: Incubator Babies - Part 1

Learn all about how baby incubators came to be from Germany, to Paris to Chicago. 

Transcript

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Hey everybody, I'm Shannon, and welcome to the They Hid What Podcast. On this podcast, I explore parts of history that have been kept hidden or swept under the rug. In this week's episode, I will be discussing incubator babies. Let's get into it. This story is a little jumbled in the beginning. There are a lot of similar people doing similar things across the globe. And I'm going to try and keep it as simple as I can. Let us begin with German gynecologist and obstetrician named Carl Sigmund Franz Krede. After years of schooling in Berlin, Karl became a doctor in 1842. Ten years later, in 1852, he became the director of the Berlin School for Midwives and the chief physician of the delivery department, as well as director of a gynecological department at the Berlin Charité. In 1856, Carl was made professor of obstetrics at the University of Leipzig. There, he established a clinic of obstetrics and gynecology and established a separate department of women's diseases at the maternity unit. Carl was pretty cool, but he was most famous for introducing the use of silver nitrate eye drops as an antiseptic for the prevention of neonatal conjunctivitis, or pink eye. During a three-year period, Carl treated 1,160 newborns with silver nitrate, with only 0.15% of the infant developing ophthalmalia, or the inflammation of the eye. In 1861, Carl invented an incubator that had warm water throwing through the double walls of a tub called a Varmavaner, and continued to use it in his work at the Lipsig Maternity Clinic for at least 20 years. He published the results of his incubator work in 1884. Going back a bit to 1850, Stefan Tarnier completed medical school and in 1856 began working at the Maternité Port Royale in Paris. Tarnay began research work on perperal fever, and the chief of the maternité was so impressed that he made Tarnay chief of clinic at the hospital. Tarnay began using the asepsis technique, which are procedures to prevent contamination and keep things sterile. He also started to isolate infected patients. As a result of his efforts, maternal mortality at the maternité dropped from 93 out of 1,000 deliveries to 23 out of 1,000 from 1870 to 1880, and then to 7 out of 1,000 in the next decade. Tarney also focused on the care of premature infants, first implementing policies to keep the infants in hygienic isolation in a separate contained unit. On December 29, 1869, Michael Cohen was born in a Prussian town called Kroczn, which is now Kroczn in Poland, to parents Frederik and Herman. Michael was the youngest of four children. We'll come back to Michael in a bit. Let's meet our third doctor, Pierre Constant Boudin. In 1975, he returned to the maternite as a fourth-year resident and worked under the supervision of Stefan Tarnay. Boudin helped Tarnay implement the use of the incubator and modified it by introducing a thermostat and a temperature-sensitive alarm that would alert caregivers if there was a problem. In 1880, claiming to be inspired by chicken brooders he saw at the zoo, Tarnay created his convuse, which he began using in the hospital in 1881. Tarnay's incubator was a two-tiered device. The bottom portion held a reservoir of water, which was heated by an outside boiler powered by an alcohol lamp. The upper portion held four newborn babies. In Tarnay's design, air circulated from the bottom of the incubator through vents above the infant. Despite this setup, there was still a risk that the incubator could fail or, even worse, overheat. Nurses had to refill the reservoir by hand so that the water couldn't boil and evaporate. Later, he and an intern, Alfred Ovart, swapped the reservoir with water bottles and changed the upper deck to hold only one baby. Tarnay had his staff feeding the babies through a tube. In 1883, Pierre Boudin published a report where he stated that Tarnay's invention reduced the infant mortality rate in half. The Tarnay of Ard incubator became an increasingly popular device in maternity wards in Paris through the 1890s. Upon arriving, Alfonso had changed his name to Cooney and encouraged Michael to do the same. Michael Cohen became Martin Arthur Cooney. In 1889, French inventor Alexander Leon made an egg incubator to fit 5,000 eggs. He put his invention on display in Marseille and people would pay to go and see the chicks hatch. The following year, 1890, Leon created a smaller version of this incubator to hold one infant child. This incubator had warm water circulated via a spiral water pipe heated by a boiler with a thermometer affixed to the side, which recorded a constant ideal temperature. There was also a fan blowing fresh air into and out of the incubator, creating ventilation, with a pipe that led outside and a disinfecting filter and glass display window. By May of that year, he received his first prematurely born baby to test out his invention. He added this incubator to the chicken exhibit and soon expanded his business to Nice, where he later formed what he called a charity, but was basically the same display of living beings in incubators. Leon hired nurses for six-month stints to care for the babies around the clock. By 1892, Pierre Boudin founded the first clinic for what he called nurslings. He didn't stop there. Boudin was a busy man, and in 1893 he designed several items for new mothers and their infants. Boudin designed a rubber nipple and developed a smaller version for infants that were born prematurely and unable to suckle. For women with premature infants, Boudin created an apparatus that pumped milk from the breast, making breast milk more accessible for infants who were unable to suckle. He, together with obstetrician Joseph Chavane, gave two presentations on the results of maternal education and the sterilization of milk at the French Academy of Medicine. Leon was pretty busy in 1893 as well. He hosted a reunion for the babies and mothers that used the incubators and took his show to be displayed in America. At the Chicago Columbian Exposition, there was an American doctor displaying incubators, but these were noted to be of poor design and didn't even display them with babies inside. In 1894, Alexander Leon reported saving 137 out of 185 babies using his incubator. He founded institutions in other cities in France, his most famous one was in Paris, and abroad in cities such as Barcelona. Leon installed incubator pavilions on numerous national and international exhibitions in France and elsewhere in Europe, and they used his proven format. By charging an entrance fee, the public ended up paying for the care of the children. The more people came, the more income. Thus, Leon inspired others to do the same. This idea didn't sit well with everyone. Some felt that Leon was being exploitative and compared the babies to the bearded lady at the circus. Leon forged ahead, though, and was invited to display his setup at the Industrial Exposition in Berlin in 1896. He received a patent for his invention, and his instrument maker Paul Altman manufactured it. As time went on, Alexander Leon just wanted to go home. He allowed others to use his invention while he returned to France. In 1895, Pierre Boudin, remember him, succeeded Professor Tarnay and became chairman of obstetrics at the Maternity in Paris at Port Royal, where he developed the first specialized infant care center, the Pavilion for Weaklings. Boudin also attended the exposition in Berlin and displayed Tarnay's invention, the Convuse. Somewhere along the line, Martin Cooney, formerly Michael Cohen of Prussia, met Boudin and was asked to demonstrate the invention with babies from the German charity ward. Martin Cooney called them Kinderbrnstadt or a childhatchery. Bouden had other things to focus on. He was heavy into maternal bonding and set up clinics to teach new mothers about nutrition and hygiene. He understood the importance of data gathering and analysis, and he used his data to focus his efforts on the root causes of infant mortality. He published extensively and improved his field. His book, The Nursling, published in 1900, can be thought of as the earliest textbook in neonatology and emphasized many core concepts that were ahead of their time, like used breast milk, temperature control, and the prevention of infection, among others. Pierre Boudin was very much in the mother and child corner and spent his life improving theirs. After meeting at the Berlin Exposition, the promoter of Queen Victoria's Diamond Jubilee, Samuel Schenckin, invited Martin Cooney to exhibit the incubators. Using his connections with Pierre Boudin, in August of 1897, Martin Cooney obtained babies from Paris to display in the machines. Cooney transported premature infants on a boat via the English Channel in baskets with hot water bottles to keep them warm. And I need to take a beat here and point out that Martin Cooney or Michael Cohen did not attend medical school. He was not a doctor. It's unclear how he came into contact with Pierre Boudin and how he gained that man's trust to travel the world with his inventions. Somehow he did it. And Cooney became known as the incubator doctor. What Martin Cooney really was was a very good showman. Now, back to the Jubilee. After setting up the incubators and importing the babies, Martin Cooney and Sam Shankin hired a head nurse, Louise Recht, to be in charge of the baby's care and hired British physicians to check the babies daily. Whether he was a doctor or not, Martin Cooney did like babies and wanted them to be given the best chance to survive. Cooney's display quickly became known for its professionalism and cleanliness. Upon intake, the infants were first bathed in lukewarm water and sometimes were given a drop of brandy. Ribbons of pink or blue were tied around the babies, which allowed visitors to identify the sex of the infant. The infants would be on show throughout the day in individual incubators, except for the two hours a day that encompassed the feeding times. Most were fed by either wet nurses or using bottles. However, some infants were administered breast milk spooned through the nose. The medical journal Lancet reported this machine to be better than Carl Griday and Tarnay's because those were difficult to maintain. This is a little funny since they weren't even Cooney's inventions. Cooney placed strict diet restrictions on his wet nurses. While under his employment, wet nurses were not allowed to smoke, consume foods such as hamburgers, which were found all over at these fairs and expositions, or drink alcohol, as Cooney believed doing so would affect the quality of their breast milk. Cooney also encouraged his nurses to take the babies out of the incubators and cuddle them in front of the audience. In addition to holding the infants, head nurse Louise would show a diamond ring to audiences before sliding it up onto the baby's arms to emphasize the tiny size of the infant. There was a walkway which was created in front of the incubators where visitors could look into the glass door and see the sleeping babies. These performances, however, triggered outcry from child protection groups, claiming Cooney objectified the infants for monetary gain. In 1897, an anonymous source in the medical journal The Lancet condemned the exposition as, quote, an unscrupulous way to make money. Cooney defended his sideshow, claiming his exhibits were the last resort for many premies, and that his practices survival rate was much higher, in fact, than many hospitals. Cooney was placed in the East Midway, but found that reporters were ignoring him. Omaha was also kind of remote at the time, so there wasn't much foot traffic. It was said that those that did visit the display didn't think the babies were small enough. It got to the point where Martin Cooney took on a sponsorship for beer in order to make money. His ad read, quote, Dr. Martin Cooney says nursing mothers cannot find its equal as a milk producer. It is also beneficial to the babies. Dr. Cooney claims, we take pleasure in stating we have used crug cabinet bottled beer constantly, and for milk producing qualities, we can cheerfully recommend it to all nursing mothers. Now this goes against his strict diet for the wet nurses, but money's money. 1898 was still a good year for Cooney because on November 3rd, he became a U.S. citizen. At the 1901 Pan American Exposition in Buffalo, New York, Cooney's exhibit was placed in the amusement section instead of the science wing. This further showed that overall, people viewed Cooney as a carnival barker and the babies as his freaks. However, following the exposition, the Children's Hospital of Buffalo bought several of the incubators. After every event, Cooney would approach hospitals with his incubators, and most of them turned him away. 1903 was a busy year for Cooney. He lost his head nurse Louise for a time and replaced her with May, who was trained as a registered nurse in Chicago. The two ended up marrying on September 26 of that year. Cooney also began setting up permanent incubator displays at Luna Park and Dreamland on Coney Island, and the Atlantic City Boardwalk, Chicago's White City Amusement Park, and the Minneapolis Wonderland Amusement Park. The reason he chose theme parks and boardwalks and expositions and fairs is because of the heavy foot traffic. He wanted people to understand that these infants deserved a shot at life and this is how they could get it. In the beginning, Cooney would have to approach hospitals and orphanages to acquire babies for his exhibit, but when he began to gain popularity, people would bring their premature babies to him. He never charged the parents of the children for any of the care that he provided. Again, Martin Cooney actually liked the babies. And he may have been inspired by Pierre Boudin to care for the mothers as well. After exhibiting in Topeka, Kansas, the Louisiana Purchase Exposition in St. Louis, Missouri, and the Lewis and Clark Exposition in Portland, Oregon, Martin Cooney and Sam Schenken formed the Infant Incubator Company to market and sell incubators. Nyshare Company in New York manufactured Leon's machines for the United States. In 1911, the Dreamland Amusement Park on Coney Island caught fire. Repairs were being done to the ride Hellgate using hot tar, and it's believed that it was the heat from the tar that caused the light bulbs within the ride to burst and ignite the freshly laid tar. The breeze that was in the air pushed the fire across the park, and the heat from the flames caused several hundred thousand light bulbs to burst, as well as igniting the shells from the shooting gallery. Dr. Solomon Fischel had just accepted his fifth baby into the incubator exhibit. After he laid down around 1.30 a.m., the fire broke out. He ran into the nursery and woke up the nurse on duty and the two wet nurses. The three of them carried the babies out, covering their faces to avoid smoke inhalation, and brought them to the home of a local doctor, John Price. They fed all five babies, then tucked them into bed, and later took them to a hospital. Now the New York Times published their story on the fire and reported that all of the babies had died in the fire. The president of the New York Society for Prevention of Cruelty fired off an angry letter stating that they investigated Cooney's display and determined that this type of work should only be done in hospitals. True as that statement may be, hospitals weren't caring for premature babies. One doctor noted that while in the last legs of his medical study, he was taught that if a baby was born premature, poured it in a warm basket and let it pass on its own. The options for parents were take it to Martin Cooney's sideshow or let the baby die. And which would you choose? This is where I'm going to end part one. Come back next week for part two, where I talk more about Martin Cooney's displays, his personal life, and more importantly, the babies. See you next time.