A brief history of hyperbaric oxygen therapy
You may not have heard much about hyperbaric oxygen therapy. You may even think it’s a newly discovered medicine that is untested and unproven. You would certainly be wrong in thinking this as the science and practice behind what we do at Wesley Hyperbaric has been around for centuries.
Looking back as far as the 1600s we can see that the use of chambers to treat conditions by changing air pressure has been practiced. Back then it was a very new science, but a science none the less. As we have had advances in understanding and technology, we have seen how the use of hyperbaric oxygen therapy has become a go-to treatment for certain conditions.
Let’s take a brief journey through the past to understand where hyperbaric oxygen therapy began and how we arrived at where we are today.
The very first steps in hyperbaric oxygen therapy were taken by a British clergyman and physician called Nathaniel Henshaw. He believed that putting a patient under pressurised conditions would leave to therapeutic benefits to certain conditions of the lungs and even to aid better digestion. He created a chamber, which is called his ‘Domicilium’ and the air pressure was driven with organ bellows. At this point in time, this was very simple – there was only a change in pressure within the chamber and no form of pure oxygen was used, in fact at this time air has not been broken down into its constituent gases. With time and further discovery, this initial invention would improve.
1830’s and 40’s
Despite the work of Robert Boyle who gave us Boyle’s Law in the 1600s. There was still much to be understood about decompression and the effects on the human. Robert Boyle had conducted experiments on small animals to understand the behavior of gasses and how the animals reacted to the changes in pressure. But it wasn’t until the 1840’s that we would be affected by decompression illness when workers such as miners, divers and tunnel construction workers were being affected by air pressure in their working conditions.
Diver’s in Portsmouth, England were affected when working to clear the wreck of HMS Royal George which has sunk in 1787 and now was proving to be a hazard to the ever growing English naval fleet. Royal engineer William Pasley decided to test his new equipment – a hard hat diving bell on this project. Men would work underwater in this diving bells and be subject to pressure changes.
Similarly, during the 1830’s bridge construction workers, miners and tunnellers would use a sealed box filled with compressed air, called a caisson, to work underwater or at great depths. This allowed them to work safely with a supply of air. The workers became known as Caisson workers, or just ‘caissons’.
As the amount of work increased and more and more workers were using these Caissons, there was an increase in reports of illnesses such as dizziness, cramping, sharp pains in the joints and abdomen and even death. The understanding for this was not understood and it became known as mysterious malady. One strange mystery to them was that the symptoms seemed to disappear when the worker returned to the pressurised chamber. Of course, we now see these as classic symptoms of decompression illness or as it’s known to divers today ‘the bends’. The term ‘the bends’ was coined later on in the 1700s when similar workers working on the Brooklyn Bridge in New York were suffering from these symptoms, many workers have lost the ability to stand up straight and were left with a permanent bend to their stature.
It was 1878 when Paul Bert proposed that the caisson workers were affected by the pressure changing too quickly which then led to the illness.
Not too long after this understand recompression chambers were built at these construction project sites to help recompress workers suffering from this illness. Effectively creating what we have today in terms of a chamber created to aid suffering patients.
By 1877 the use of hyperbaric chambers was being used in medicine. A French surgeon called Fontaine developed a portable operating theatre which was within a pressured chamber. He believed that the increase in oxygen in the patient’s blood would help with anesthesia. This allowed for a higher level of oxygen to ensure lower rates of death under anesthesia.
By the start of the twentieth century, the Royal Navy has started to take interest in hyperbaric medicine to create a solution for its divers suffering from the bends.
In 1907 Dr. John Scott Haldane was working on experiments using goats and differing depths and helped develop the first dive table for use by divers. These tables are still used today by Wesley Hyperbaric to help safely treat patients.
During the early 1900s Dr. Orval Cunningham has been working with a patient suffering from cardiovascular disease and made a link between patients who lived at higher altitudes suffering more than patients living at sea level. He believed that putting patients under even greater air pressure differences would have great benefits. He created a chamber a 27-metre chamber and started to successfully treat many conditions.
But in 1921 he took a massive step and constructed the world’s largest chamber – a chamber fit for a king! It was built in Kansas City and was 20 metres in diameter and within it there were five floors, a smoking lounge, dining room, private quarters and the décor of a fine hotel.
With claims as big as the chamber itself he was soon under the spotlight of the authorities. With his unproven claims the authorities shut down the ‘hyperbaric hospital’ and it was demolished and sold off for scrap metal for use in the war effort.
The US military began conducting research about survivable pressures. Using hyperbaric oxygen to treat navy clearance divers with decompression sickness. The US Navy’s research has itself help develop its own dive tables. As the Royal Navy tables, these are used today for treating certain conditions in hyperbaric chambers.
By the 1960s hyperbaric chambers were being used in mainstream medicine. At Boston Children’s Hospital a chamber acquired from Harvard University was being used by Dr William F Bernhard to treat children suffering from cardiac conditions – this included the prematurely arrived son of John F Kennedy. The hospital undertook surgery on 120 infants using the chamber prior to the invention of the bypass machine.
As the research continued and further advancements were made a governing body was formed to help keep this going – in 1967 The Undersea and Hyperbaric Medical Society (UHMS) was founded. To this day they continue to add governance to hyperbaric medicine allowing the safe use of the medicine across the world.
UHMS helped develop a list of clinical indicators that have evidence that hyperbaric oxygen therapy can be used. As this is a wholly researched and proven list Medicare in Australia adopted this list to help patients get access to help from registered and accredited practitioners such as Wesley Hyperbaric.
As the years have gone by, the medical research has not stopped and there is an ever increasing list of conditions that hyperbaric oxygen therapy has been proven to benefit. The 1980’s saw research proving that the therapy has a massive impact on problem wounds and radiation tissue damage. These are some of the conditions that we see the most at Wesley Hyperbaric and we see a lot of success in the treatments.
So that brings us up to date on the medicine. As you have read, from the early days we have seen a lot of problems solved from industry being able to build, advances through military research and of course in the medical industry an ability to treat conditions that would have been life-threatening allowing organisations such as the Wesley Hyperbaric to give people a chance of getting over conditions and regaining their life.
But it doesn’t stop there. The most basic and early understood science such as gas laws still today form the basis for hyperbaric oxygen therapy, but as research continues and technology changes the future the medicine will continue to change and grow. Wesley Hyperbaric is playing a major part in this, conducting its own studies into conditions such as Xerostomia and pelvic irradiation damage, and prove how hyperbaric oxygen therapy can help.