Martin A. Couney

Martin Couney was born Michael Cohen (or Cohn) in 1869 in the town of Krotoszyn, which was then part of German Prussia and is now Poland.[1] Couney's cultural and professional background remain contested as Couney repeatedly changed the details about his personal background throughout his life. The ambiguity of his early life has long impacted his work and reputation. The mystery Couney enforced on his background was compounded by his lack of an official medical licence.[4] Couney stated he had studied in Leipzig and Berlin and that his medical licence was European, and therefore, that his doctorate was not applicable in America.[5][6] However, there is no record of Couney ever studying medicine in any European institutions.[7] There is some evidence to suggest that Couney immigrated to the United States in 1888 when he was 19 years old; however this casts doubt on his claims both of having completed a medical degree and of having studied under Budin, due to the inconsistencies in this timeline.[7]

In 1903, Couney married Annabelle Maye, a nurse employed in one of his 'Infantoriums'.[8] In 1907, Couney's daughter, Hildegarde Couney, was born six weeks premature, weighing just three pounds (1.4 kilos).[8] Couney's wife predeceased him in 1936.[9]

Despite the many unknowns of Couney's life, it is widely accepted that he was an apprentice under Budin in Paris, an established obstetrician, known as the founder of modern perinatal medicine.[7] In 1896, Couney entered his first exhibition as Budin's intermediary to exhibit Budin's Kinderbrutanstalt, or 'child hatchery', to spectators at Berlin's Great Industrial Exposition.[2] The exhibit was a success and in 1897, Couney was invited by exposition promoter Samuel Schenkein to host an exhibit at the Diamond Jubilee Celebration for Queen Victoria in London to present his first infant incubator show.[4]

Following the European success of Couney's displays and a move to the United States, Couney held the American debut of his incubator show at the Trans-Mississippi Exposition in Omaha.[5] Couney then began showcasing his Incubator shows in fairgrounds across the US, including the World's Fair in Buffalo, New York in 1901.[7]

Artificial incubator for premature babies designed by R. Mathieu. Note the sides of glass and the inclusion of thermometer and sponges in the model.

Originally, incubators were used by poultry farmers to hatch chicken eggs, with the original design being little more than a heated, enclosed box.[6] Stéphane Tarnier, a prominent French obstetrician in the nineteenth century, has been widely recognised as the first to implement incubators in the care of human infants.[10] At the time, his ideas were deemed unscientific. It was not until his assistant, Budin, exhibited the incubators at Berlin's World Fair that the incubators gained considerable attention.[10] Couney's alleged apprenticeship under Budin allowed him the knowledge and ability to promote and spread the medical importance of these machines.[10]

The importance of the infant incubators was noted early on in Couney's career by medical journal The Lancet during the Diamond Jubilee in 1897.[4] The Lancet editors visiting the infant exhibit noted that while the use of the incubators had "not yet become general in England", they further claimed that "any successful attempt to improve the construction of incubators and to render this life-saving apparatus available to the general public must be welcomed."[4]

Each Incubator at Couney's Infantorium measured around 1.5m high, with steel walls, framework and a glass front.[8] In order to fill the incubators with warm air, water boilers fed warm water into pipes that ran underneath where the babies rested and thermostats were placed inside the incubators to maintain and regulate temperatures.[8] Couney was also concerned with the entrance of impurities into the air of the incubators. In order to filter out impurities in the air, the air fed into the pipes was first filtered through wool suspended in antiseptic, then again through dry wool. The air was then cycled out of the incubators, constantly refreshing the infant's air.[8]

Nurse bathing an infant in the Baby Incubator exhibit

Couney's shows varied in name from fairground to fairground, including the 'Infantorium' and 'Baby Incubators'. Couney's slogan was 'All the world loves a baby' and he encouraged nurses to take the babies out and cuddle them in front of audiences.[2] The babies were placed in incubators with glass doors to allow visitors to see in and contained warm, filtered air.[8] At the Coney Island 'Infantorium', Couney worked in tandem with established doctor Julius Hess and he employed a team of nurses who lived onsite, taking care of the premature infants at all hours.[4] Couney is usually remembered for his Coney Island facility, but he also established a similar exhibit in Atlantic City which ran for 38 years, from 1905 to 1943.[8] Couney's facilities were known for their professionalism and cleanliness. Couney was influenced by one of his employed nurses, and later wife, Annabelle Maye who insisted upon the importance of strict hygiene and systematic procedure.[4]

In 1903, the average cost for the care of one infant at Couney's facility was $15 ($405 today).[8] The care costs of premature babies was expensive, however, Couney did not charge the parents of his patients for their care. Couney made up the costs of caring for the infants through the entrance fees during the exhibitions. The entrance fees covered not only the care of the infants, but also allowed Couney to pay his nurses a good wage and facilitated the frequent travel of the exhibit.[8]

Couney's reputation suffered after the 1911 Coney Island Fire.[4] Despite all of the infants being rescued, the incident highlighted the dangers of caring for infants in amusement parks.[12] Others decried the entire notion of infant incubators in fairgrounds. In the medical journal The Lancet in 1897, an article titled "The Danger of Making a Public Show of Incubators for Babies" lamented the proximity of infant incubators to animal exhibits and peep shows, concerned that the unsanitary conditions of the animal exhibits would endanger the babies.[4] It was also seen as inappropriate to house the infants so close to 'scandalous' peep shows, especially as the Infantorium shows attracted many families and children. The perceived dangers of 'preemie' fairground exhibits were accentuated by imposter shows, which began appearing in fairgrounds as a result of the profitability of shows such as Couney's Infantorium. These shows often did not adhere to the same cleanliness and professional standards as the well-known Infantorium. As a result, medical journals at the time condemned the shows as risky and dangerous for the premature infants.[4]

The support of Julian Hess, who came to be known as the father of American neonatology, during the 1933 Chicago World Fair improved Couney's reputation.[4] The exhibit ran for two consecutive summers, over 18 months from 1933–1934.[7] The facility cost $75,000 ($1.4 million today) to construct and was fronted by a huge sign bearing the words, “Living Babies in Incubators”.[7] By the end of the second summer, Chicago's health commissioner had become involved in Couney's efforts. It was not long after the end of the fair that Chicago became the first American city to officially implement policies for the explicit purpose of premature infant care.[6]

Throughout Couney's career, whenever a midway or fairground closed, Couney attempted to donate his incubators to local hospitals, though his donations were never accepted.[6] By the year of Couney's death in March 1950, incubators had been integrated into public hospitals.[12] Couney is now recognised as a pioneer of early infant care. His exhibits worked against the claims of the then popular eugenics movement and helped introduce the issue of premature births to the general populace. Due to the high fatality rates of prematurely born infants in the first half of the twentieth century, the topic was generally undiscussed. Couney's promotion of his Infantorium demonstrated that 'preemie' infant care could be successful, if expensive.[4]

• Coney Island
• Development of modern neonatology
• Wonderland Amusement Park (Minneapolis)

• Raffel, Dawn The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies (New York: Blue Rider Press, 2018)

• Dr. Martin A. Couney
• History Detectives: Sideshow Babies
• Babies On Display: When a Hospital Couldn't Save Them
• Former incubator baby dies at 96