The Couvreuse, or Mechanical Nurse

The Lancet 2:241-242, August 11, 1883

After two years' trial, the couvreuse has proved so decided a success that a brief description of this ingenious contrivance may be desirable. It was in 1878 that Dr. Tarnier, when visiting the apparatus devices by M. Odile Martin for artificially hatching and rearing chickens at the Jardin d'Acclimatation, suggested that a similar method might be applied with advantage to infants, especially in cases of premature birth. Two years elapsed, however, before any attempt was made to carry out this proposal; but in the course of the year 1880 a couvreuse was made, and brought to the hospital of the Maternité. This is a plain wooden case or box, measuring about 2 ft. 8 in. by 2 ft. 4 in., and 2 ft. 4 in. in height. The box has a double covering, the space between being filled with sawdust to retain the heat, and is divided into two parts. The lower half contains a reservoir, which holds about sixty litres of water, and is fed by a patent boiler that stands outside the box, and is warmed by an oil lamp; or hot water may be used without recourse to the lamp. The upper portion of the box forms a warm chamber, where a little basket or cradle is placed, large enough to hold two infants. From an opening at the side, this cradle may be withdrawn, while the top of the box has a double glass covering, so that the children and thermometer lying by their side can be constantly watched. If the water used in the first instance is cold, it takes a long time to attain the required temperature; but once this is done the lamp need only be relit three or four times during the course of the day. It is best to warm the apparatus while the infants are being fed or washed. The temperature within the couvreuse is generally maintained at 86° F., and though the contrast on withdrawing the child to be fed or washed is very great, amounting often to 30° F., colds are not so frequent as among the infants nursed in the ordinary manner. Altogether the experiment is considered so successful, that it is proposed to supply all the hospitals of France with a couvreuse, and there is every reason to anticipate good results from this measure. Nor is this all. A small portable couvreuse is about to be tried which could be carried by hand from house to house. After this we shall probably have perambulators constructed on the same model. In conclusion, we should remark that, though no very careful experiments have been made with respect to the ventilation within the couvreuse, yet this is evidently sufficient. Apertures are made in the lower portion of the box, the fresh air travels over the hot-water reservoir, and is thus warmed before it reaches the child. The very great difference of temperature within the couvreuse ensures a constant current of air, though the child is protected by its cradle and clothes from any draught.

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