In the middle ages premature infants were wrapped in the skin of a sheep, with the wool on, or put in a jar of feathers. Later they were enveloped in cotton. Sterne, in the middle of the eighteenth century, relates how the child of a physician was raised by the “same artifice that one used to make chickens hatch in Egypt. He put his son in an oven, properly constructed, heated regularly, the temperature of which was regulated by suitable instruments. In 1857 Denuce described a double walled bath tub, with water in the interspace for the rearing of feeble infants. In 1866 Crede of Leipzig, used an identical contrivance, although he did not publish it until 1884. In 1880 Tarnier had Odile Martin, a poultry raiser of the Jardin des Plantes, construct an infant incubator on the plan of a chicken incubator.

It was installed in the Maternité and could hold several children. Individual incubators were subsequently constructed of which that Auvard is the best of that period. It consists of an oblong, wooden box heated by cans of water, with an opening for air at the bottom, a vent at the top containing a wheel to indicate the movement of the air, and a glass, sliding cover. The child is supported on a shelf and a wet sponge is hung near by to keep up the moisture. Nearly all the incubators in this country are modifications of this form of apparatus. The objections to all of these instruments are that they are of wood, and therefore harbor infection; they are clumsy; they have unhandy heating methods; e.g., hot water bottles or cans that are to be emptied and filled frequently. They have no automatic heat regulation, little provision for moisture, poor ventilation and no provision for fresh, uncontaminated air, so that often the air in the incubator due to the high temperature is worse than that outside. Therefore, infection of the child occurs and many infants are better off out than in the box. Some of these instruments are still on the market. They serve but one purpose — to keep the infant warm, and that may be accomplished as well with a shoe box and hot water bottles. Rotch has constructed an incubator on wheels, containing a scale for weighing the infant and a very complicated system of ventilation. It has not attained general use. Winckel has constructed a permanent bath in which the child floats, this to avoid the rapid evaporation and imitate more closely the liquor amnii. The bath ought to be placed in an incubator. Some incubators are open at the top like a box others at the front, some are heated by hot water bottles, some by hot water systems connected with a boiler outside, some by hot air, others by steam. I think the system Lion is the best model. Paul Altmann and Gebrüder Müncke of Berlin, Kny Scheerer of New York, and perhaps others make instruments after this model varying in the details. I think it is the best form in which the apparatus can be made. The incubator which I present this evening is of this shape, but differs from all in the ventilating and heating systems. I have spent much time and labor for two years in perfecting it, and feel that it is now in condition to be recommended to the profession. There are four main problems in incubator work. First and easiest, the heating apparatus. Second, the ventilation of considerable difficulty but of most importance. Third, moisture of the most difficulty and of considerable importance. Fourth, portability and simplicity neither of which can be obtained unless at the expense of the ventilation. In addition to these the incubator must be aseptic. That is easily disinfected must be handy to work with and not exorbitant in price. To obtain all these qualities in one portable incubator is very difficult. The body of the incubator is a box twenty nine inches high, twenty two inches deep and twenty inches wide, it has two compartments … a lower, containing a water pan, and an upper for the infant in which lies on a cotton mattress swinging in a basket. The two compartments are connected by air flues only. There are doors at the front through which the infant is handled and a sliding door at the side, through which it is watched and fed. The lower front is removable for sterilizing and cleaning.