The History of Oxygen Therapy

Compressed Air Therapy

One of the first known attempts to use changes in ambient pressure to treat disease occurred in 1662 when a British Clergyman, Henshaw, built the “Domicilium,” a sealed chamber in which ambient pressure was adjusted via valved organ bellows. Henshaw would treat acute illness with increased pressure and chronic illnesses with decreased pressure.

In the 19th century, “pneumatic institutes” were developed in Europe that could accommodate up to 10 people and could attain pressures of two or more atmospheres. These “spas” rivaled the popularity of mineral water spas of the era.

While the above two uses were, at best, scientifically and medically questionable, in 1879 a French surgeon named Fontaine built a mobile operating room that could be pressurized. Performing surgery under pressure had two benefits. First, it increased the potency of the inhaled nitrous oxide, providing deeper anesthesia, and it improved the oxygenation of the patient.

For most of the rest of the 19th century and the first half of the 20th century, hyperbaric facilities used primarily compressed air and treated only the complications of prolonged exposure to increased pressure (decompression illness-“the bends“) in divers and casion workers. However, in the 1950's, the medical usefulness of using compressed oxygen began to become recognized and hyperbaric oxygen therapy was born.

Compressed Oxygen

In 1955, a physician named Churchill-Davis began to look into the effects of hyperoxia in potentiating the effects of radiation therapy in cancer patients.

Then, in 1956, a Dutch surgeon named Boerema published a paper describing how he used hyperbaric oxygen to prolong patient tolerance of circulatory arrest during cardiac surgery.

In the early 1960's papers appeared that touted the use of HBO in gas gangrene and carbon monoxide poisonings. Because of these early promising results, researchers began to use HBO to treat many diseases, often with out good scientific basis. These experiments were often poorly done and produced questionable results.

In a response to the indiscriminate and overzealous use of hyperbaric oxygen therapy, the Undersea Medical Society, in conjunction with Medicare and private insurers, convened a committee and published a report in 1977 that listed the disease state that were and were not appropriate for HBO. Since then, this committee report has been updated on a regular basis and has become the standard reference on which disease states are appropriate for hyperbaric oxygen therapy.

The above information was obtained from: Kindwall, Eric. A history of hyperbaric medicine. In: Kinwall, Eric P. and Whelen, Harry T. Hyperbaric Medicine Practice, 2nd Edition, Best Publishing Company, Flagstaff Arizona. 2002.