First appeared in Doctor's Review-History of Medicine, February 2007, Vol. 25, No. 2

The simplest ideas usually yield the most impressive results. Indeed, adding three or four wheels to a chair meant major strides for millions of people whose compromised mobility would otherwise have left them languishing on the sidelines.
Though it may seem an obvious solution to the problem of injury or paralysis-both temporary and permanent-a functional wheelchair was many millennia in the making. Not surprisingly, the rise of the wheelchair roughly corresponds with the rise of humanism in the Western world. As people gradually began to believe in the rights of the individual, they moved away from feudal and medieval notions that this world was simply a place to stay and suffer for a while before heading on to more important business in the afterlife. For the physically disabled, the road to respect and mobility was to be built one brick at a time.

Ancient Chinese secret?
The history of the wheelchair rightly starts with, well, the invention of the wheel. Fast-forward a few thousand years from the Neolithic period to sixth-century China and you may spot one of the oldest incarnations known to exist: a three-wheeled version, first depicted in a mysterious engraving on a sarcophagus. (Though, to be fair, the Ancient Greeks had already added wheels to a bed in order to accomplish roughly the same result.) During the aptly named Dark Ages in Europe, few wheelchairs seemed to be around. Those with physical or mental disabilities often ended up depending on the kindness of family, begging for their suppers or being run out of town by a torch-wielding mob. As the Medieval period wore on, the infirm fared marginally better, though religious rule and blind acceptance of the will of God usually left little room for technological or medical innovations in the minds of most.

It took a few run-down royal celebrities to bring some much-needed publicity to the predicament. The aging King Philip II of Spain might well have been the Christopher Reeve of his day, for his situation focused the public's attention on the plight of the paralyzed. Philip's reclining "invalid chair" on wheels was a complex contraption with adjustable arm and leg rests. King Louis XIV also used a wheelchair-known in France then as "roulette"-first after he had surgery to fix his bothersome anal fistula and later as an old man.

By the mid-1700s, there were plenty of artistic representations of people in wheelchairs, reflecting the slowly changing belief that even people with imperfect bodies, who weren't of royal lineage, were also deserving. Still, the product itself wasn't exactly a design inspiration­handmade, bulky and improvised wheelchairs were the standard. People who needed a wheelchair simply had to create or commission one themselves. Back then (and, let's face it, today as well), people with the big bucks had access to better chairs.

Independent-minded people in need of personal transport fared better in Germany, where a 22-year-old German watchmaker named Steven Farfler put his mind to the problem. Perhaps inspired by his watch gears-and certainly fuelled by the fact that he, himself, was a paraplegic-Farfler had the unique idea of creating a wheelchair that could be moved by its user. In 1655, he introduced the first self-propelled model, a wooden box on wheels with hand cranks.

Taking a bath
James Heath, an inventor who lived in Bath, England, was responsible for the first popularly available wheelchair during the mid-18th century: the bath chair. This device had a steering wheel for the occupant and was able to be pushed by a friend or servant. It also incorporated a hook at the front in case only donkey- or pony-power was available. The two big wheels at the rear and the small one at the front made it quite maneuverable despite its size, so much so that it actually became a popular form of conveyance not just for invalids, but also for those delicate ladies who felt that walking was beneath them.

By the early 19th century, bath chairs were the rickshaws of England's urban elite, with legions of them for hire on the city streets. The bath chair was bulky, however, and the lot of those in real need of a wheelchair improved greatly once English inventor John Dawson came along. He was the first to create a commercially viable, user-friendly version in 1783, which he produced on a large scale for the benefit of all. During the Victorian era, Dawson's chair was the one to have.

Over in the United States, 1869 was the year when the first wheelchair patent was issued, for a wicker-backed chair that had large hind wheels and a pair of smaller front casters, as most of today's models do. Its design made it more maneuverable than earlier chairs, and it was widely seen as a godsend by those who needed one. Also, the trend towards mass production suddenly meant that a relatively effective, well-designed rolling chair was finally available to the masses.