Paul Alexander, who lived much of his life in an iron lung after contracting polio at the age of six, has died at the age of 78.

The Texas resident was paralysed from the neck down by the disease and went on to become an inspirational figure, graduating from law school, writing a memoir and painting using a brush that he held in his mouth.

In an update on a fundraising page that was set up to raise money for his medical and accommodation bills, organiser Christopher Ulmer announced: “Paul Alexander, ‘the Man in the Iron Lung’, passed away yesterday.

“After surviving polio as a child, he lived over 70 years inside of an iron lung. In this time, Paul went to college, became a lawyer and a published author. His story travelled wide and far, positively influencing people around the world. Paul was an incredible role model who will continue to be remembered.”

The announcement quoted Alexander’s brother Philip, who said the money already raised would be used to pay for his funeral bills. “It is absolutely incredible to read all the comments and know that so many people were inspired by Paul. I am just so grateful,” Philip was reported as saying.

While Alexander spent much of his time in the mechanical respirator – which used pressure to artificially pump air into his lungs – he was not completely confined to it. He taught himself to breathe by gulping air and forcing it down his throat, allowing him to represent clients in court, travel on a plane and attend disability rights protests. Alexander told the Guardian in 2020 that this breathing technique was like riding a bicycle, but he could only do it while awake. In his last years, however, Alexander had been almost permanently confined to the 300kg machine.

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Iron lungs saved thousands of children during polio epidemics, but were only meant to be used for short periods. Once vaccines were administered in the late 1950s, they largely disappeared, and other breathing devices were inserted directly into the throat became more commonplace. Alexander said he preferred not to have invasive surgery and continued to live in the iron lung, becoming one of the last people in the world to do so. Doctors never expected him to live so long.

Alexander rose to prominence over the years, after attention in the media for the extended time he had spent in the iron lung. ​H​e was recently recognised by the Guinness World Records as the “longest iron lun​g patient”.

In his Guardian interviews, Alexander said he had become an activist by chance. “You have to understand, back then, there were no cripples … Wherever I went, I was the only one. Restaurant, movie theatre … I thought: ‘Wow, there’s nobody else out here. I’ll just pave the way,’” he said. “I kind of thought of myself as representing a group. I fought for that reason. ‘What do you mean, I can’t go back there? I want to go back there!’ ‘You can’t do that.’ ‘Oh yes I can!’ I was always fighting.”

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