Doctor's Review: Medicine on the Move

December 17, 2017
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Before Wheelchairs

Before the invention of the wheelchair, paralyzed people were forced to roll with the punches

The simplest ideas usually yield the most impressive results. Indeed, adding three or four wheels to a chair meant major strides for millions of people whose compromised mobility would otherwise have left them languishing on the sidelines.

Though it may seem an obvious solution to the problem of injury or paralysis -- both temporary and permanent -- a functional wheelchair was many millennia in the making. Not surprisingly, the rise of the wheelchair roughly corresponds with the rise of humanism in the Western world. As people gradually began to believe in the rights of the individual, they moved away from feudal and medieval notion that this world was simply a place to stay and suffer for a while before heading on to more important business in the afterlife. For the physically disabled, the road to respect and mobility was to be built one brick at a time.

ANCIENT CHINESE SECRET?
The history of the wheelchair rightly starts with, well, the invention of the wheel. Fast-forward a few thousand years from the Neolithic period to sixth-century China and you may spot one of the oldest incarnations known to exist: a three-wheeled version, first depicted in a mysterious engraving on a sarcophagus. (Though, to be fair, the Ancient Greeks had already added wheels to a bed in order to accomplish roughly the same result.) During the aptly named Dark Ages in Europe, few wheelchairs seemed to be around. Those with physical or mental disabilities often ended up depending on the kindness of family, begging for their suppers or being run out of town by a torch-wielding mob. As the Medieval period wore on, the infirm fared marginally better, though religious rule and blind acceptance of the will of God usually left little room for technological or medical innovations in the minds of most.

It took a few run-down royal celebrities to bring some much-needed publicity to the predicament. The aging King Philip II of Spain might well have been the Christopher Reeve of his day, for his situation focussed the public's attention on the plight of the paralyzed. Philip's reclining "invalid chair" on wheels was a complex contraption with adjustable arm and leg rests. King Louis XIV also used a wheelchair -- known in France then as a "roulette" -- first after he had surgery to fix his bothersome anal fistula and later as an old man.

By the mid 1700s, there were plenty of artistic representations of people in wheelchairs, reflecting the slowly changing belief that even people with imperfect bodies, who weren't of royal lineage, were also deserving. Still, the product itself wasn't exactly a design inspiration -- handmade, bulky and improvised wheelchairs were the standard. People who needed a wheelchair simply had to create or commission one themselves. Back then (and, let's face it, today as well), people with the big bucks had access to the better chairs.

Independent-minded people in need of personal transport fared better in Germany, where a 22-year-old German watchmaker named Steven Farfler put his mind to the problem. Perhaps inspired by his watch gears -- and certainly fueled by the fact that he himself was a paraplegic -- Farfler had the unique idea of creating a wheelchair that could be moved by its user. In 1655, he introduced the first self-propelled model, a wooden box on wheels with hand cranks.

TAKING A BATH
James Heath, an inventor who lived in Bath, England, was responsible for the first popularly available wheelchair during the mid-18th century: the bath chair. This device had a steering wheel for the occupant and was able to be pushed by a friend or servant. It also incorporated a hook at the front in case only donkey- or pony-power was available. The two big wheels at the rear and the small one at the front made it quite maneuverable despite its size, so much so that it actually became a popular form of conveyance not just for invalids, but also for those delicate ladies who felt that walking was beneath them.

 

By the early 19th century, bath chairs were the rickshaws of England's urban elite, with legions of them for hire on the city streets. The bath chair was bulky, however, and the lot of those in real need of a wheelchair improved greatly once English inventor John Dawson came along. He was the first to create a commercially viable, user-friendly version in 1783, which he produced on a large scale for the benefit of all. During the Victorian era, Dawson's chair was the one to have.

Over in the United States, 1869 was the year when the first wheelchair patent was issued, for a wicker-backed chair that had large hind wheels and a pair of smaller front casters, as most of today's models do. Its design made it more maneuverable than earlier chairs, and it was widely seen as a godsend by those who needed one. Also, the trend towards mass production suddenly meant that a relatively effective, well-designed rolling chair was finally available to the immobile masses. A few more innovations came along, like metal wheels, followed by rubber wheels with pushrims -- those round handles on the outside of the wheels which allow people to move without getting their hands dirty -- and wheelchairs were finally able to offer their users the right combination of practicality and mobility.

That said, the basic wheelchair as we know it today burst onto the health scene in 1932, when a mechanical engineer from Los Angeles devised the first collapsible, steel-framed incarnation. Harold Jennings began the project upon the request of his disabled friend, a mining engineer named Herbert Everest, who was annoyed that he couldn't take his bulky wheelchair along with him in his car. The pair worked together to perfect it, patented their chair in 1937, then started a company called Everest and Jennings (E&J) to manufacture it. E&J would go on to have a stranglehold on the wheelchair market for decades, buying out competitors and charging exorbitantly high prices (even by today's standards!) until they were accused of price-fixing and slapped with an antitrust suit in 1977 by the US Department of Justice.

CANADIAN CONTRIBUTION
E&J usually gets the credit for developing the first motorized wheelchair, which it brought to the American and Canadian markets in the mid 1950s. Their electric device was propelled by a small, battery-powered engine, and it basically did to old-fashioned wheelchairs what automobiles did to horse-drawn carriages. Technically, however, the first motorized wheelchair came out of London in 1916, though it didn't exactly catch on -- perhaps due to its feeble 3/8-horsepower engine -- until E&J began mass producing a more powerful version beginning in 1956.

While paraplegics had the option of a muscle-powered wheelchair, quadriplegics, or those with limited upper-body strength, had to depend on others to get around. Inspired by the many disabled World War II veterans who returned home to bleak futures, the prolific Canadian inventor George Klein helped change all that by dramatically improving their mobility.

Klein's chair involved a powerful motor and was the first to incorporate a joystick for control, effectively offering quadriplegics their first shot at independence. Though Klein's work was backed by the Canadian National Research Council, no Canadian company could or would manufacture it. He decided to simply give the design away to Americans E&J -- a move some believed was crazy, but one which ultimately provided access to his creation.

Wheelchairs currently provide their users with a level of mobil-ity unheard of a century ago. These days, models range from basic four-wheel, muscle-powered varieties and portable, super-lightweight versions, to sports bikes and all-terrain vehicles, to elaborate high-tech devices that can be set into motion and directed with as little as a whisper -- something those pioneering Neolithic engineers surely never could have imagined.

 

This article was accurate when it was published. Please confirm rates and details directly with the companies in question.

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