by (Dr) Adrian Padfield
This is a short history of the Cape Engineering Co., named after ‘The Cape of Good Hope’, a pub in Warwick.
It sprang from my finding that Ron Walton, who later became managing director, lives not far away from me near Banbury. I knew that Captain GT Smith-Clarke, Chief Engineer of Alvis cars, also was involved with the company after his retirement from Alvis in 1950 because I’ve written his biography. TG ‘Gerry’ Turner, who was Alvis Home Sales manager, left Alvis soon after the end of WW2 to start Cape Engineering, setting it up in a factory built from five wartime aircraft hangars with a nucleus of employees ‘poached’ from another company; Warwick Productions, according to Ron.
Later he was joined by George S Webley ex manager, Alvis Fighting Vehicles, who during the war had managed the Alvis shadow factory in Stratford on Avon. Towards the end of WW2 in August 1944, Webley had actually engaged Ron as ‘assistant to the Technical Assistant’ at a weekly wage of 25/- plus 3/6 war bonus (a total of £1.37) in Stratford.
In the early ‘50s polio was epidemic and in April 1952 the Senior Administrative Officer of the Birmingham Regional Hospital Board (BRHB) was concerned about the quality and quantity of breathing machines for polio victims with respiratory paralysis.
He convened a subcommittee to look into improvement of the 48 Both/ Nuffield cabinet respirators (iron lungs) in the Region. The respirators were 13 years old and neither ‘patient friendly’ nor easy to operate; they had originally been designed in a hurry to cope with the 1937 South Australia polio epidemic.
The image shows an original wooden cabinet respirator designed and made by Edward Both (pronounced ‘both’) Access to the patient’s body was poor, limited to only two ‘portholes’ near the patient’s head. Nursing staff complained that the poor access made it difficult to nurse patients within the cabinets, which were also heavy and with no wheels very hard to move about needing two men.
The pump unit, providing the ‘negative’ pressure, had poor operating speeds for the patient’s respiration and was noisy and hard to operate manually if there was an electricity failure; not uncommon in the years after the war. There was no alarm if the pump failed or the cabinet leaked air. Edward Both came to London in 1938 and Lord Nuffield after consulting with his friend Robert Macintosh, Professor of Anaesthetics in Oxford, turned over part of the Morris Motors factory in Cowley to make improved copies.
Smith-Clarke (GTS-C) was co-opted onto the BRHB sub-committee. There is an entry in his 1952 pocket diary; 8th May: ‘Queen Elizabeth Hospital (Birmingham) [Ministry of Health] Iron Lung Committee 5-0’. Since 1935 he had been chairman of the Coventry & Warwickshire Hospital, then vice chairman when the NHS started in 1948 and, after retiring from Alvis in 1950, chairman of the Coventry HMC Group 20. At some time, during a ward visit, as part of his hospital rounds, he had been horrified at the distress and discomfort endured by a female patient being nursed out of the iron lung and particularly when the airtight collar was forced over her head on return to the cabinet.
In May 1952 GTS-C, together with JDF Williams the hospital physicist first completely dismantled a Both in a disused hospital air raid shelter. There were no working drawings of the respirator so GTS-C prepared drawings necessary for the parts required. He brought his drawings to Alvis, where patterns were created.
Arthur Varney and George Clarke set about getting sets produced to convert all the Coventry cabinet respirators. John Parkes, MD of Alvis, had the larger castings made and machined while GTS-C machined the smaller parts in his own workshop. It is a measure of their dedication to the task that modifications to first machine were completed in a matter of weeks by August 1952.
The details of the many modifications made to the Both cabinet respirator, are taken from the minutes of the Birmingham Regional Hospital Board in early 1953 where the report of a sub-committee was approved. These consisted of: large observation windows, multiple portholes and small cork holes for drips and catheters, fine adjustments to the pressure within, a tilting mechanism, illumination and warmth by electric light bulbs within the cabinet, a simple patient alarm and rubber wheels.
The pump speeds were made more useful and the pump was made quieter and easier to work manually, in the event of a power failure, by elongating the operating lever with a detachable extension for extra leverage. The modifications were approved by the Ministry of Health and Cape won the contract to produce kits. GTS-C then acted as adviser to Cape (he was paid £1000 pa; according to Ron partly because his Alvis pension was poor). An example is shown: .
This fourth image shows the modified Nuffield/Both with the improvements designed by GTS-C and manufactured by Cape: These made the ‘iron lung’ much more user friendly for both the patient and the nursing staff. GTS-C’s inventive mind then got to work and by the late autumn of 1953 a photograph in the Coventry Evening Telegraph showing Turner and Webley with the ‘new Coventry type iron lung’. A modified Both can be seen in the background.
The accompanying article describes the modifications made for the Both and the kits of parts the company had produced for 500 Both iron lungs around the country. It states that the new revolutionary iron lung was designed and developed by GTS-C and that the new apparatus will be made of glass fibre and stainless steel.
Money had been raised by public subscription which included £800 from the Coventry Coronation parade (that included Lady Godiva!). However, it was found that glass fibre was unsatisfactory and was not used in production models. It was constructed of aluminium alloy and stainless steel; a much improved neck seal was incorporated utilising a wrap-over collar, and the pump unit was extensively modified to provide an inspiratory/expiratory ratio of 1/1.5 and better speeds. Originally called the Coventry Mechanical Respirator.
The new iron lung became known known as The Alligator (possibly following its description by Dr Galpine in the Lancet). Junior and infant models were made. Later models had nameplates with ‘Alligator’ and ‘G Smith-Clarke’ signature. It was robust and very successful; Cape made them in batches of ten. The company made other non-medical equipment; Cape had a contract to make a mechanism that flipped out fins on bombs; resultant on Webley’s Ministry of Defence connections when working for Alvis.
After the Copenhagen polio epidemic when Dr Bjorn Ibsen, a local anaesthetist, started using intermittent positive pressure respiration (IPPR) because of the shortage of ‘iron lungs’, GTS-C designed and constructed a prototype IPPR ventilator.
It was superbly engineered and contained some unique design features, having an infinitely variable stroke volume between 200 ml and 1500 ml and a variable speed gearbox that allowed stepless speed changes to give breathing rates between 1-40 per minute.
The inspiratory and expiratory valves were opened by cams and closed by springs just like valves in car engines (DER Fox, a Cape employee, told me that the prototype used Morris Minor valves; I met him many years ago and still have his visiting card) and if electricity failed, it had a crank handle for manual operation.
In May 1956 GTS-C entered into an agreement with Cape Engineering Company Limited that they should have the sole permitted use his trademark; “G. Smith-Clarke” which he had registered in October 1955.
It was for use on the mechanical breathing machines manufactured by Cape to GTS-C’s design and he received £500.
Ron Walton joined Cape in October 1956 by which time the need for Both modification kits was fading out. The company were making 2 to 3 Alligators and about 10 Cape IPPR per week but fewer junior & infant Alligators. Some 150 Alligators were manufactured between 1954 and 1967 and about one third sold worldwide. In 1957 Ron made the journey to the 4th Polio Conference in Geneva in a large Austin van to demonstrate the Alligator .
Cape Engineering was acquired by E & HP Smith of Birmingham in 1962 but they put it up for sale in 1970 and Turner and Webley bought it back. Ron Walton progressed from works manager to works director and later managing director. The company became a group: Cape Warwick Holdings, in which Ron took a share-holding. It comprised several subsidiary companies: apart from the ‘iron lungs’, Cape Engineering made the foot operated suction pump devised by GTS-C and a pump for the cuirass used to aid the breathing of polio patients when they were out of the iron lung.
Ron was involved in the manufacture of cuirasses using glass fibre and set up a separate department for making other devices using this relatively new material. Cape continued making ‘iron lungs’ but also kidney dialysis machines; a subcontract under licence from Lucas. Other medical equipment included anti embolism stockings for which they also made the pumps. Another subsidiary, Microflow made air filters, Warwick Productions; large quantities of aluminium boxes, Pressoturn; bulk material handling and Capecraft which was the sales company for Cape Warwick but also made medical trolleys, X-Ray trolleys and full set ups for CSSDs particularly for new hospitals in the Middle East. In 1977, at a medical equipment exhibition in Dubai, they exhibited their ventilators.
Following the progressive trend, Cape made a semi electronic IPPR, the Cape 2000 but its biggest success was the Cape Waine anaesthetic machine. This had been suggested by Dr TE Waine, consultant anaesthetist at the Coventry hospitals. He approached Cape with the idea of combining the Smith-Clarke/Cape IPPR with an anaesthetic machine and the resulting large appliance was sold widely.
A full description of the Cape Waine may be found in the British Journal of Anaesthesia (1962) Vol. 34 pp 410-6.
Waine’s co-author, DER Fox, was originally Cape’s service engineer, visiting hospitals and becoming involved with anaesthetists. In the late 1950s, Dr Kelleher of the Western Hospital in Fulham that had many polio patients in cabinet respirators, came to Cape with a proposal to make a rotatable Alligator to aid postural drainage of the lungs, reduce the incidence of bed sores and enable physiotherapy. He was accompanied by Baroness Felicity Lane Fox after whom the St Thomas’ Hospital Respiratory Unit was later named.
Kelleher described the new version in The Lancet Vol. 278 pp 1113-6, 18th November 1961 and Cape made 11 of them.
Cape Warwick Holdings was bought by Thomas Tilling in 1976 and Ron Walton then was Divisional Manager. The company participated at a medical equipment exhibition in Dubai in 1977. Later Ron became Chairman of Penlon, also part of Tilling, and of Vessa who made electric wheelchairs. In 1983 a ‘dawn raid’ was made on Thomas Tilling by BTR, a conglomerate driven by its chairman Sir Owen Green.
With the introduction of the Sabin and Salk vaccines in 1957, the demand for more ‘iron lungs’ was diminishing but many patients still needed them. In the early ‘80s a more user friendly version was devised to allow flexibility for patients more physically able who lived at home. Portable Iron Lungs were designed for this purpose and twenty were built by Cape Warwick into which Cape Engineering had been merged after being closed by BTR. Cape Warwick suffered the same fate a few years later. By 1989 BTR had decided that making more cabinet respirators of any type was unprofitable.
In The Observer 19th May 1991 it was announced that ‘Profits fall leads firm to quit iron lung production’. The manufacturing rights were eventually sold to a small company DHB Tools in Leamington Spa. They had previously worked with Cape Warwick and even employed some of the workforce including the designer of the Portable Iron Lung, Dr John Wines.
In 1992 at the behest of Geoffrey Spencer (see following article), they made five improved Portable iron lungs called the Spencer-DHB for the Lane Fox Respiratory unit.
Cape (Warwick) Holdings was dissolved in August 2016 but now there is another Cape Warwick in Burton on Trent who make hospital sanitary ware &c.
Turner formed Red Triangle Autoservices in Kenilworth to provide services for Alvis owners when Alvis stopped making cars in 1967, taking over all the details of Alvis car production, documents and spares.
Partly derived from the forthcoming book: ‘Coventry, Alvis and the Iron Lung’, ‘A Biography of Captain GT Smith-Clarke’ by Adrian Padfield.
References: Waine TE, Fox DER. A new and versatile closed circuit anaesthetic machine with automatic and manual ventilation. British Journal of Anaesthesia 1962; 34:4 10.
Smith-Clarke GT, Galpine JF. A positive-negative pressure respirator Lancet 1955; 1: 1299.
Smith-Clarke GT. Mechanical breathing machines. Proceedings of the Institution of Mechanical Engineering 1957; 171: 52.
The following article by Geoffrey Spencer was first published in AOC Bulletin 457 in 1999: