O’Dwyer’s Intubation Set Disrupts Diphtheria’s Dyspnea

Derived from the ancient Greek diphthera, or “leather hide,” Corynebacterium diphtheriae formed a leathery laryngeal pseudomembrane that often obstructed the airway. Diphtheria outbreaks devastated entire institutions like the New York Foundling Hospital (NYFH) on Manhattan’s Upper East Side. NYFH physician Joseph O’Dwyer, M.D. (1841 to 1898), developed an intubation set (lower right) to prevent lethal asphyxiation from diphtheria and to circumvent the need for pediatric tracheostomy, which was associated with a high mortality risk. The technique he invented in 1885 involved the operator placing a mouth gag in an awake, restrained child and digitally lifting the epiglottis while blindly intubating the larynx with a metal cannula (upper right). O’Dwyer meticulously elongated and reshaped the tube over a decade to prevent tissue erosion and expectoration with cough (left). Initially ridiculed but ultimately revered, the O’Dwyer Method laid the groundwork for future acceptance of tracheal intubation during general anesthesia. (Copyright © the American Society of Anesthesiologists’ Wood Library-Museum of Anesthesiology, Schaumburg, Illinois.)