Hyperbaric Oxygen Chamber History

The origins and development of Hyperbaric Medicine are closely tied to the history of diving medicine. The actual origins of diving are not known, however it was recognised as a distinct occupation as far back as 4500 BC.

The first records of actual diving equipment, used to extend the limits of underwater activity, are attributed to Alexander the Great in 320 BC, when he was reported to have be en lowered into the Bosphorus Straits in a glass barrel during the siege of Tyre .

Around the year 1500, Leonardo Da Vinci made sketches of diving vessel chambers, but did not develop them for practical use. In 1620, the Dutch inventor Cornelius Drebbel developed the first true diving bell. This vessel had the ability to be compressed to 1 atmosphere but had no supplementary oxygen. In 1691, Edmund Halley, after whom the comet is named, improved diving bell chambers by devising a method of replenishing the air supply.

The first attempt to use a hyperbaric chamber in medicine was made by the British physician Henshaw, in 1662. The chamber was fitted with a large pair of organ bellows, with valves paced so that air could either be compressed into the chamber or extracted from it. In the ‘domicilium' increased pressures were used for the treatment of acute disease, and reduced pressures for the treatment of chronic diseases.

In the Netherlands , the Dutch Academy of Sciences sponsored a prize in 1782 and subsequent years, for the design of an apparatus to study the effects of higher pressures in biology. There were no contenders, nor any recipients of the prize. It is ironic that the recent advances in Hyperbaric Medicine are based heavily on the work of the Dutch, almost two centuries later.

In the 1830's, France led the new fashion in Hyperbaric Medicine. Hyperbaric chamber exposures of between 2 and 4 atmospheres absolute were stated to increase the circulation to the internal organs, improve the cerebral blood flow, and produce a feeling of well being.

Junod (1834) first made these observations, and they were taken up avidly by his colleagues, Tabarie and Pravaz. In 1837, Pravaz built a large hyperbaric chamber using it to treat a variety of ailments. The chambers were promoted and used specifically for pulmonary diseases, including tuberculosis, laryngitis, tracheitis and pertussis, as well as apparently unrelated diseases such as deafness, cholera, rickets, metrorrhagia and conjunctivitis.

Fontaine (1877) developed the first mobile hyperbaric operating theatre, and by this time hyperbaric chambers were available in all major European cities. Interestingly, there was no general rationale for hyperbaric treatments, and as a result, prescriptions varied from one physician to another. In those days, no methods were available to estimate the partial pressure of oxygen in blood, which at 2 ATA of air is about double that at sea level. In comparison, if pure oxygen is breathed at 2 ATA, the partial pressure of oxygen in the arterial blood is twelve times higher than normal.

During the second half of the nineteenth century, hyperbaric centers were being advertised as comparable to health spas. Junod referred to his treatment as “Le Bain d'air comprime” (the compressed air bath). In 1855 Bertin wrote a book on this topic and constructed his own hyperbaric chamber. The literature on Hyperbaric Medicine up to 1887 was reviewed by Arntzenius and contains a remarkable 300 references.

During the 1850s many hyperbaric chambers were in use throughout Europe . “Pneumatic Institutes” flourished and mobile hyperbaric facilities were introduced. In 1879 a fully equipped mobile hyperbaric operating room was completed, so that surgery could be performed in hospitals, sanatoriums, and even in private homes. It was claimed that patients recovered from anaesthetic more rapidly when in the chamber (an observation of particular note nowadays, when the effect of Hyperbaric Medicine on both gas elimination and high-pressure neurological syndrome are of considerable interest). Cyanosis and asphyxia were reported to be less, or absent. Post-anaesthetic excitement and vomiting were markedly decreased. The chamber was recommended to facilitate the reduction of hernia, and for patients with asthma, emphysema, chronic bronchitis and anemia. Twenty-seven operations were performed within a 3-month period in this chamber. Success was so great that a large hyperbaric surgical amphitheatre which would hold 300 people was planned, but never actually came into being. Fontein had an accident whilst at the Pneumatic Institute which resulted in his death, the first physician martyr to Hyperbaric Medicine.