History of Hyperbaric Oxygen Therapy | Part II

Although the twentieth century was slow in terms of new innovations brought to the field of HBOT, it was still a century of rapid expansion.

The first half of the twentieth century was a period of stagnation for hyperbaric medicine. With HBOT being mostly relegated to treating pressurization injuries, very little new evidence was put forward pertaining to the field until 1921. Physician Orval J. Cunningham built a hyperbaric chamber in Kansas City. Cunningham built his chamber after observing the devastation wrought during the Spanish Flu Epidemic. He had observed higher mortality and morbidity rates in locations that were at higher elevation. This led him to believe that the increase in pressure given during hyperbarics would be beneficial in treating Spanish Flu.

He had observed some success, but Cunningham was all the more convinced of his efforts after a tragic event occurred at his facility. A mechanical failure caused his chamber to rapidly decompress; killing everyone inside. The conclusion Cunningham made was that his treatment was the only thing keeping these people alive and that they could not survive in a regular environment. Had Cunningham had the understanding and the education we have today, he would have known that the real reason behind his patients’ deaths was the rapid decompression itself. But, feeling emboldened by his observations, Cunningham would open the world’s largest hyperbaric chamber in Cleveland, Ohio in the year 1928.

Cunningham’s Sanitarium, as it was called at the time, was a 900-ton sphere with five stories and twelve bedrooms on each floor. The ENTIRE building was the hyperbaric chamber! And although Cunningham treated a plethora of different ailments, the sanitarium mostly specialized in treating diabetes. Cunningham at this time believed that many diseases such as diabetes and even cancer were caused by microscopic organisms that could not survive in an oxygen rich environment. Although he was wrong about the causes of diabetes and cancer, Cunningham was right about certain microorganisms causing ailments and that a high oxygen environment would kill them. He would spend his life not knowing he was correct, however. Cunningham would draw major criticism from the American Medical Association after repeated efforts to get him to submit empirical evidence were declined and ignored. The sanitarium closed and was sold for scrap metal nine years later.

HBOT experienced another period of stagnation until 1956, when a Dutch cardiac surgeon named Ite Boerema started using HBOT as an aid in cardiopulmonary surgery. He noticed a decrease in recovery time and a decrease in mortality rates as a result. Boerema’s colleague, Willem Brummelkamp, additionally noticed infection was inhibited by HBOT therapy. This was when the antimicrobial benefits that were originally “observed” by Cunningham twenty years prior would be documented and researched legitimately.

Although the twentieth century was slow in terms of new innovations brought to the field of HBOT, it was still a century of rapid expansion. Previously hypothesized benefits of treatment were either proven and cemented in protocol or disproven and moved on from. The Undersea and Hyperbaric Medical Society (UHMS) was created in 1967 to help govern and develop safety guidelines for the field of HBOT. Some of the policies include adopting the U.S Navy’s scuba dive tables as the standard to avoid decompression sickness, implementing robust safety precautions, and designing training protocols for techs and physicians alike. The UHMS still exists today and its policies and recommendations are used all around the world.