If you were to visit New York’s Coney Island in the early 20th Century, you would have found no shortage wonderful amusements to occupy your time. You could swim in the ocean, enjoy an ice cream or a hot dog, or brave the death-defying mechanical rides of the island’s three giant amusement parks. If you were feeling more adventurous, you could take in such spectacles as a Boer War battle reenactment starring a thousand soldiers, a burning building being extinguished by firefighters, reenactments of the eruption of Mount Vesuvius and the 1889 Jonestown Flood, or sideshow attractions like Lilliputia,  a village inhabited entirely by little people. But amid this “anything goes” carnival atmosphere, one attraction would have seemed rather out of place. For a 25-cent admission fee, you could enter a sterile room attended by white-gowned nurses, in which dozens of tiny premature babies, weighing only a pound or two, lay swaddled inside glass-doored incubators. This strange exhibit was among the most popular on the island, drawing thousands of visitors every day to witness this miracle of modern medicine. But this was not some crass parody or even an advertisement for New York City hospitals; incredibly, for nearly half the Twentieth Century the Incubator Exhibit at Coney Island was among the only dedicated neonatal care facilities in the United States, taking in thousands of desperate cases that no other hospital could care for. This strange combination of hospital ward and carnival sideshow was the life’s work of a mysterious German immigrant named Dr. Martin Couney, who for nearly fifty years defied the Medical Establishment and helped give thousands of premature infants a fighting chance at life.

Premature births have plagued humanity since the dawn of time, but for thousands of years there was little that could be done but to swaddle infants in cloth, place them by the hearth, and hope. The first steps towards modern neonatal were taken in 1870s France, whose plummeting birth rate in the wake of the Franco-Prussian War prompted doctors to more closely examine the problem of infant mortality. In 1878, Dr. Stephane Tarnier had a chance encounter with a Monsieur Odile Martin, a zookeeper at Paris’ Jardin d’Acclimatation, who showed him the latest model of incubator for hatching bird eggs. Inspired, over the next two years Tarnier perfected a modified version of the incubator for use with premature infants. The device consisted of a wooden cabinet with a glass lid divided into two compartments, the upper one holding the infant and the lower one a pan of water heated by oil lamps to warm and humidify the air. A small chimney packed with chemically-treated cotton filtered the incoming air. Tarnier’s design was further improved by his protégé Dr. Pierre-Constant Budin, who added a mechanism to automatically regulate the internal temperature, reducing the need for the incubators to be monitored round-the-clock.

In 1896 Budin sent his apprentice, German student Martin Couney, to promote the incubators at the Great Industrial Exposition in Berlin. Born in 1869 in Krotoschen, Prussia, Couney, who had changed his name from Cohen to hide his Jewish ancestry, claimed to have studied Medicine in Leipzig before moving to Paris to study under Budin.

Budin’s incubators, billed as Kinderbrutanstalt or “child hatcheries,” proved such a hit that a promoter named Samuel Schenkein invited Couney to exhibit them at the Victorian Era Exhibition in London’s Earl’s Court the following year. There the exhibit caused a sensation, with Londoners flocking in their thousands to see infants so small few believed they could ever survive. At the time, premature births accounted for nearly 40% of infant deaths in England, leading the medical journal The Lancet to praise the exhibit and declare:

 “Any successful attempt to improve the construction of incubators and to render this life-saving apparatus available to the general public must be welcomed.”

However, the exhibit’s financial success caught the attention of less scrupulous promotors, and in February 1898 the Barnum & Bailey Circus opened their own copycat exhibit in London, leading The Lancet to run an article titled Danger of Making a Public Show of Incubators for Babies:

“This success, however, has not proved an unmixed blessing. It attracted the attention and cupidity of public showmen, and all sorts of persons, who had no knowledge of the intricate scientific problem involved, started to organize baby incubator shows just as they might have exhibited marionettes, fat women, or any sort of catch-penny monstrosity.”

“But if music-hall proprietors, caterers for refreshments at exhibitions, and public showmen…are going to start baby incubator shows [then] the question arises whether the attention of the sanitary authorities should not be directed to the dangers that may result. The most obvious way to avoid all difficulties is to obtain the loan of fully developed and healthy babies. The general public would scarcely detect this fraud, and these shows might easily degenerate into a disguised form of baby farming.”

But while the medical authorities saw only the potential for baby snatching and mistreatment, Couney saw in the Earl’s Court Exhibition a workable if unorthodox model for promoting the use of incubators. Though over 400 babies were admitted to the exhibit over the run of the Exhibition, none of the mothers had been charged a single penny, admission fees from the curious public being more than sufficient to cover expenses. It was a system that would serve Couney and his tiny wards well for the next 50 years. Believing that Americans would take to the sideshow format even better than the British, in 1898 Couney emigrated to the United States and took his incubator show on the road, first setting up shop in a county fair midway in Omaha, Nebraska. While Couney’s exhibit, tucked between a Wild West Show and a Camel Ride, failed to attract the attention he had hoped for, the experience allowed him to perfect the system of care he would later become famous for. In contrast to the carnival atmosphere surrounding him, Couney ran the incubator exhibit with obsessive care and military discipline, ensuring that every surface was kept sparkling and sterile and dressing his employees in starched white hospital uniforms. A staff of nurses, physicians and wet nurses to feed the babies lived permanently onsite, with Couney even hiring a cook to make nutritious meals for the wet nurses to keep their milk as healthy as possible. If a nurse was caught smoking, drinking alcohol, or even indulging in a hot dog or soda, she would be summarily fired. Infant care was similarly regimented. Upon admission, each baby was given a bath and a small dose of brandy, swaddled with a pink or blue ribbon, then placed on display. Throughout their stay they received round-the-clock care, being fed by the wet nurses every two hours.

Despite his insistence on cleanliness and order, Couney still had something of the showman about him, instructing his staff to swaddle the infants in clothes several sizes too large to emphasize how small they were. One of his nurses, Mrs. Louise Recht, would often show off to visitors by slipping her diamond wedding ring over the infants’ wrists. Couney’s approach was unorthodox in other ways. While most physicians recommended keeping premature infants isolated for fear of infection, Couney encouraged his nurses to hug and kiss their wards, believing contact and affection would help them thrive.

Couney’s next ports of call were the 1901 Pan-American Exposition in Buffalo, New York and the 1904 St. Louis World’s Fair. The year before he married one of his nurses, Annabelle Maye Segner, and in 1907 their first child, Hildegarde, was born prematurely and had to be nursed back to health in one of Couney’s incubators. The incident spurred Couney to continue his work, and later in life Hildegarde would train as a nurse and join her father’s business. By this time Couney’s incubator sideshows had finally caught on, and he was fast becoming a very wealthy man. Indeed, the daily cost of caring for each baby at the St. Louis fair was around $15 – equivalent to $405 dollars in today’s money – yet the exhibit never had any difficulty covering expenses. By 1903 Couney had made enough money to establish permanent exhibits at the Luna Park and Dreamland amusement parks on Coney Island, while in 1905 he built another in Atlantic City.

But while the public couldn’t get enough of Couney’s tiny babies, the medical establishment was rather more skeptical. In 1904 large numbers of infants died at a rival incubator show at the 1904 World’s Fair, while in 1911 the Dreamland amusement park burned to the ground. While the infants in the incubator exhibit were saved from the flames, the incident prompted the President of the New York Society for the Prevention of Cruelty to Children to declare that infant care should only be performed in hospitals. While Couney wholeheartedly agreed, despite his best efforts incubators and neonatal care was slow to catch on in the United States. Part of the problem was a simple lack of resources with which to provide premature infants with round-the-clock care. As journalist A.J. Liebling wrote in 1939:

“There are not enough doctors and nurses experienced in this field to go around. Care of prematures as private patients is hideously expensive… six dollars a day for mother’s milk… rental of an incubator and hospital room, oxygen, several visits a day by a physician, and fifteen dollars a day for three shifts of nurses.”

Couney’s work was also tainted by his lack of professional qualifications. While he often styled himself as a doctor, there is little evidence that Couney actually obtained a medical degree. This led many medical professionals to dismiss him as little more than a carnival showman and a charlatan.

But there was another, more sinister reason for the lack of interest in incubators: Eugenics. The Eugenics movement, which sought to improve society through a program of selective breeding and the sterilization or extermination of those deemed genetically inferior, saw premature infants as “weaklings” and “runts” not worth saving. So pervasive was this attitude in American society that in 1917 Chicago doctor Harry Haiselden produced a film titled The Black Stork arguing for the euthanasia of “defective” children, and  Better Babies contests awarding gold ribbons to the fittest-looking children were often held next door to Couney’s incubator exhibits. The Eugenics movement disgusted Couney, who when challenged by critics would often rattle off a long list of historical figures who were born prematurely but went on to accomplish great things, including Mark Twain, Napoleon Bonaparte, Victor Hugo, Charles Darwin, and Sir Isaac Newton.

While doctors and eugenicists could debate Couney’s credentials or the value of his work, what they could not argue with were his results. Over his 50-year career, Couney’s incubator exhibits enjoyed a success rate of 85%, nursing infants weighing as little as 23 ounces back to health. And Couney was not without allies. In 1914 he met Dr. Julius Hess – widely considered to be the father of American neonatology – and the two became lifelong friends. In his groundbreaking 1922 textbook Premature and Congenitally Diseased Infants, Hess became one of the first physicians to acknowledge Couney’s pioneering role in the history of infant care. He also bankrolled Couney’s exhibit at the 1933 Century of Progress exhibit in Chicago. As before the show drew massive crowds, and to celebrate his success, in 1934 Couney held a “homecoming” for the babies who had “graduated” from his incubators the year before. Of the 58 babies cared for in 1933, 41 returned with their mothers, the joyous event being broadcast live across the nation. Six years later, Couney’s decades of work finally paid off when the first dedicated neonatal unit opened at Cornell Hospital in New York. That same year, Couney exhibited his incubators at the 1939 New York World’s Fair, but unlike previous years the high operating costs nearly bankrupted him, and he was forced to start winding down his permanent exhibits. In 1943, after 40 years of operation, the incubator exhibits at Coney Island and Atlantic City closed their doors for the last time. Martin Couney died in 1950 at the age of 81.

While Martin Couney is rarely remembered today, his contributions to medicine cannot be overstated. Between 1896 and 1943 his incubator exhibits took in around 8500 premature infants and succeeded in saving nearly 7500. In the face of an apathetic and hostile medical establishment, his unorthodox mix of pioneering medicine and carnival showmanship brought hope to desperate parents and gave thousands of children abandoned by society a fighting chance at life.

But there are those who will never forget. Kathy Meyer was born eight weeks premature in 1939, and when her parents realized they couldn’t afford her hospital care, a doctor recommended she be taken to the Coney Island facility. In a 2016 interview, the now 77-year-old Meyer recalled:

“I was a sickly baby. If it wasn’t for Couney, I wouldn’t be here today. And neither would my four children and five grandchildren. We have so much to thank him for.”

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