COMPOUND OXYGEN - ITS MODE OF ACTION AND RESULTS, By G.R. Starkey, M.D.;182 pages. Starkey and Palen, 1529 Arch Street, Philadelphia, 1881. [The cover of this book is reproduced below, followed by a quote from the text. Starkey and Palen, both physicians, appeared to have had quite a thriving business promoting compound oxygen to the public, who were encouraged to come to their Philadelphia salon for inhalation treatments. This book and another edition (1888; quoted below) provide numerous case reports, each with a miraculous cure. They state that compound oxygen gives a higher concentration of oxygen than is normally in the atmosphere, a patently untrue statement. For more on the contemporary view that compound oxygenwas quackery, see 1886 article by Wallian and 1887 book by Ehinger.]
[From COMPOUND OXYGEN - ITS MODE OF ACTION AND RESULTS, by G.R. Starkey, M.D., 1881What is compound oxygen?It is difficult to declare just what our "Compound Oxygen" is. That it contains theelements of the atmosphere we can prove to any one capable of appreciating the value ofchemical tests. This is truly a compound of oxygen and other elements. Hence the name of"Compound Oxygen" is a proper epithet to apply to it; somewhat abbreviated for theconvenience. But it is more than simply a compound of oxygen and nitrogen. In the atmosphere,these elements exist in the proportion of one of oxygen to five of nitrogen; and thecombination of them is that known as "mechanical mixture;" and so, neither element ischanged by being mixed with the other. In the Compound Oxygen the proportion of the elements is so altered that the oxygenis greatly in excess. And in the manufacture of it, the oxygen is magnetized; which givesto it the quality known by scientists as "Ozone." That this is so, can also be proved byapplying the well-recognized tests of ozone to the contents of our gasometer. The change that is thus wrought in the mixture of oxygen and nitrogen is almost toogreat to be believed. By virtue of its being magnetized, its activity is enhanced many fold. But this is not all, nor the principal change. From being the almost insoluble element thatcrude oxygen is, the"Compound" is rendered very soluble. Water will take up severaltimes its own volume, simply by their being brought in contact with each other. |
FURTHER REPORT: ON OXYGEN AS A THERAPEUTIC AGENT. By Samuel S. Wallian,M.D. The Medical Record, October 31, 1885, pages 483-488. [In this and the next article, Dr. Wallian, an ethical practitioner, decries the oxygen charlatans of the 1880s.]
. . .The most serious drawback or hindrance to the rapid progress of this so-calledoxygen treatment, which may be aptly styled the principal branch of natural therapeutics,based as it is on reason, physiology, and clinical success, lies in the fact that, with ourpresent facilities, or lack of facilities, its extensive clinical exhibition involves more time,care, and cumbersome apparatus than a majority of practitioners can devote to it. It is forlack of the required patience and painstaking that so many experiments have failed, andwill continue to fail, of satisfactory results. . ..[Italics original] . . .True, there are yet difficulties in the way of its general use, but there is no reasonwhy enterprising practitioners who are not already too severely overworked, or who arenot too shiftless or indolent to incur the necessary preparation and painstaking, shouldlong be without facilities with which to avail themselves of this potent therapeutic agent. Its use has long enough been surrendered to advertising quacks. It is time the regularprofession rescued it from the smirch of charlatanry which has, to some extent, heretofore attached to it. [Italics original] |
Most of these advertisers name their "secret" preparation "compound oxygen." Some callit simply, "The Oxygen Treatment." As to their nature, all are about alike; and it ought tobe unnecessary to repeat to intelligent physicians that none of them contain any freeoxygen, beyond the inconsiderable quantity always found in common water. They consistgenerally of weak aqueous solutions of nitrates of lead and ammonium, some adding alsochlorate of potash. The clew that these solutions are "the chemical solutions in which wehave been able, after long and carefully conducted experiments, to hold this magnitized (!)substance," etc., is the quintessence of bosh. The exercise of a grain of chemicalcommon sense will forever set at rest any doubt as to whether possibly there might not besome virtue, some undeveloped "secret," behind all this pretensious nonsense. |
CLINICAL NOTES: OXYGEN IN THERAPEUTICS. Charles J. Smith. Published in The Lancet, December 18, 1886. Page 1172. [This paper, by an English physician, lays out the "state of the art" for oxygen therapy in the late 19th century.]
English medical literature is singularly deficient in works upon the value of oxygen as anaddition to our therapeutic agents -- and for this reason, that from one cause or another,but chiefly from the difficulty and cost of production of the gas in any quantity, oxygen hasnever been brought into general use by the profession in this county, so that no largeexperience of its advantages has been gained; while, unfortunately, those persons whohave written at all upon the subject have done so in such a manner as to have exposed itto the suspicion of quackery. This is greatly to be deplored, because there can be noquestion that the gas, which Lavoisier characterized as the vivifying spirit par excellence,is an agent of the highest value to the physician...Two great difficulties which haveopposed the use of oxygen on the very threshold have been the cost of its production andits impurity when produced. |
THE TREATMENT OF PNEUMONIA, in MEDICAL NEWS, 1887, page 324. [The followingpassage is from an unsigned editorial on pneumonia; it was written by William Osler, the master clinician of late 19th and early20th century clinical medicine.]
The inhalation of oxygen recommended by Dr. Loomis in the oedema, has an importantuse whenever, as shown by the lividity, the blood is imperfectly oxidized. |
[In other articles from Medical News for 1887, by Osler or referring to his treatment of asthma and pneumonia, no mention is made of oxygen therapy. These Medical News pieces, plus Osler's 1892 textbook -- see below -- indicate Osler was certainly awareof O2 therapy, but was not an advocate.]
OXYGEN IN THERAPEUTICS. A TREATISE EXPLAINING THE APPARATUS, THEMATERIAL AND THE PROCESSES USED IN THE PREPARATION OF OXYGEN ANDOTHER GASES WITH WHICH IT MAY BE COMBINED; ALSO, ITS ADMINISTRATIONAND EFFECTS, ILLUSTRATED BY CLINICAL EXPERIENCE OF THE AUTHOR ANDOTHERS, by C.E. Ehinger, M.D.; Chicago: W.A. Chatterton & Co., 1887. [An alternative title for this book might well have been, "Everything you need to know about preparing and usingmedical oxygen in the late 1880s." The book is a compilation of a series of articles from 'Medical Current', a journal also published in Chicago at the time. Dr. Ehinter relates many case histories in great detail, and found benefit of the gas in the following diseases or conditions (and keep in mind this was only from brief, intermittent use!):]
asthma pneumonia bronchitis phthsis (TB) capillary bronchitis dyspnea reflex cough indigestion croup headache diptheria albuminuria pulmonary emphysema diabetes spermatorrhea rheumatism gout insomnia cholera anemia chlorosis leukemia asphyxia poisoning puerperal eclampsia uremia tetanus hydrophobia hysteria epilepsy neuralgia paralysis neurasthnia pelvic cellulitis fatty placenta menstrual irreglarities vomiting of pregnancy pyemia septicemia ulcers[Below is a figure from the book, showing a woman inhaling oxygen from a device that stored enough O2 for intermittent use.]
[The quoted passage below is Ehinger's comments on the notorious "Compound Oxygen," then being widely promoted to a gullible public (see promotional materials regarding Compound Oxygen under 1881 and 1888). Compound oxygen was not oxygen at all, but (usually) very dilute "laughing gas" or N2O, made by heating ammonium nitrate; the inhaled gas was mixed with ferric carbonate or potassium chlorate, to give it a color and help assure patients they were inhaling something tangible and useful.]
The objections to compound oxygen are: 1. That there is no such thing as compound oxygen. That the handling of the substance bearing this names has been confined almostentirely to persons without any knowledge of medicine or other qualifications requisiteto the administration of such an agent. That the formula has been retained as a secret which was only made known forprecuniary [sic] considerations. 4. That it has been advertised in an unprofessional, not to say unprincipled, manner. Finally, as to the home oxygen treatment, it may be said that there is no chemical orcombination of chemicals known -- except hydrogen dioxide, which has not beenfound to be an ingredient of their formula -- which will evolve oxygen after the mannerdirected by the venders of the home treatment for its use. |
COMPOUND OXYGEN - ITS ORIGIN AND DEVELOPMENT, By Drs. Starkey & Palen;1529 Arch Street, Philadelphia, PA, 1888. [This is another pamphlet promoting Compound Oxygen, as well as the services of these two physicians in particlular. The pamphlet's cover is shown, along with a picture of Drs. Starkey & Palen, and a drawing of their reception room. Quoted below the figures is information about the costs of treatment. Note that any medical evaluation was free of additional charge - an inducement to sell the worthless remedy.]
[From COMPOUND OXYGEN - ITS ORIGIN AND DEVELOPMENT, by Drs. Starkey and Palen, 1888PRICE OF OFFICE TREATMENT The fee for this Treatment is $30.00 per month, payable in advance. This calls for thirtytreatments, whether in as many consecutive days or otherwise. PRICE OF HOME TREATMENT The HOME TREATMENT is sent by Express, at the cost of the person ordering it, on thereceipt of the price, which is $15.00. It contains two months' supply of "CompoundOxygen," with inhaling apparatus, and full and explicit directions for use. If sent C.O.D.the cost of collection will be added to the Express charges. NO EXTRA CHARGE FOR ADVICE OR CONSULTATION
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ORIGINAL ARTICLE: OXYGEN ENEMATA AS A REMEDY IN CERTAIN DISEASES OF THE LIVER AND INTESTINAL TRACT, by J.H. Kellogg, M.D., Superintendent of the Medical and Surgical Sanitarium at Battle Creek, Michigan. Journal of the American Medical Association 1888;11:258-262.[Dr. Kellog was famous for running the Battle Creek Sanitarium, where enemas of all sorts were routinely given to willing patients. I am not aware of any studies proving the physiologic efficancy (or lack thereof) of oxygen enemas, but suffice to say the idea never caught on.] The importance of the role played by oxygen in the human system has no parallel amont the other substances required for the healthy maintenance of the body and its functions. A man may live a month without food, a week without water, but dies in a few minutes when deprived of oxygen. Oxygen is the vitalizing agent of animal and vegetable life. . . . . .The reception into the body of an increased amount of oxygen means an increased amount of vital work. Tissue building, and tissue disintegration are only possible by the aid of oxygen. Glandular activity, either secretory or excretory, is equally dependent upon a supply of oxygen. The process of digestion, the most essential element of which is gland action, is hence very clearly dependent upon the supply of oxygen. That this is not merely a theorectical conclusion, or a deduction of physiological chemistry, is evidenced by the prodigious digestive powers of the woodsman and the moutaineer, and the corresondingly feeble digestive ability of the persons of sluggish or sedentary habits.. . . I have made use of oxygen by inhalation for a number of years. . .That oxygen may be taken up by the intestinal mucous membrane, or that an interchange of oxygen and carbon dioxide may take place through this membrane, might be inferred from well-known facts in comparative physiology. For example, in certain fishes the mucous lining of the alimentary canal performs a very important part of the work of the respiratory system. . . . . . It seems to me to be entirely probable that oxygen enemata may be advantageously employed in quite a variety of cases. I believe that it may be advantageously used in all cases in which there is such a disturbance of the normal interchange of gases in the lungs as deprives the system of its proper amount of oxygen. The mucous membrane of the intestines presents an absorbing surface, very small, it is true, when compared with the amount of surface presented to the air in the lungs, and yet it is sufficiently great to allow of the introduction into the system of a large amount of oxygen in addition to that which can be gotten in through the lungs; and this additional quantity, though small when compared with the total amount received by the lungs, may be of sufficient value to the system to be of immense advantage to it, especially on account of its introduction at this particular point in the circulation. Case 1.--W. P., a man @ 28, the first case in which the oxygen enemata were employed. A case of chronic lithiasis. The exact amount of uric acid present in the urine at the beginning of the treatment was not determined, but there was the most abundant deposit of urates and uric acid I have ever observed. The deposit disappeared within two days after beginning treatment, and a careful quantitative analysis for uric acid made August 4, six weeks after beginning the treatment, showed the amount present to be only .29 grams, considerably less than the amount ordinarily found in healthy urine. This case had stubbornly resisted all other remedies, dietetic and medicinal, for several weeks before the oxygen enemata were employed. [It appears Dr. Wallian published two separate hardcover translations of Demarquay's 1866 work (see 1866); the first one, quoted above, dealt mainly with medicalhistory and the chemistry of oxygen; the second tranlation appears to have been oriented more toward the practicing physician. An ad for this other translation was included in the 1889 edition of Wallian's first Demarquay translation, and is reproduced below. Keep in mind that the ad refers to an 1889 English translation of an 1866 work by a French physician.] ORIGINAL ARTICLE: THE CONTINUOUS INHALATION OF OXYGEN IN CASES OFPNEUMONIA OTHERWISE FATAL, AND IN OTHER DISEASES, by Albert N. Blodgett,M.D., Boston Medical and Surgical Journal, Vol. CXXIII, No. 21, pages 481-484. (BostonMedical and Surgical Journal was the forerunner of The New England Journal of Medicine. Thisarticle is the first record I could find documenting continuous oxygen therapy. The patient was a37-year-old woman with severe pneumonia, attended to at home by Dr. Blodgett.)1889
1890
. . .For a time there was no appreciable benefit from the [oxygen] gas, but gradually thecolor of the surface improved, the respiration was less embarrassed, the patient couldswallow, and the immediate symptoms were again relieved. . . When I directed thecontinuous administration of the gas, I did so under the positive conviction that the patientwas irrevocably doomed, and the best result that I looked for, was simply relief to thesensation of suffocation, and not any curative action. . . At this time I had only employedthe gas in the manner ordinarily directed, that is, two or three gallons at a time, severaltimes daily. I now directed its use without cessation, and to my great surprise, the patientnot only obtained the relief desired, but was enabled to carry on the function ofrespiration. . . . . .The amount of gas employed was not far from two hundred gallons in twenty fourhours. The dealer who supplied the gas was astonished at the amount required, and,thinking to do me a service, sent me a cautionary message, implying that no human beingcould possibly stand so great an amount of oxygen, on account of the dangerous degreeof stimulation to the system and the increased combustion of tissue. . . . . .I think that the recovery of the patient from the condition in which she then was, isdue entirely and unquestionably to the administration of the gas... . . .I have been able to find only very rare and unsatisfactory allusions tot he use ofoxygen in pneumonia, and what I have found are almost wholly without benefit in forminga conclusion as to the best manner of using this agent, and also in relation to its action. Ihave only found one allusion to the continuous administration of oxygen, and in this casethe gas was conducted into a pail of water, placed by the side of the patient's bed, and theair of the room was fanned toward the patient. . . |
SOURCES OF FAILURE IN THE USE OF OXYGEN, by Samuel S. Wallian, A.M., M.D., New York. The Therapeutic Gaxette, June 16, 1890, pages 361-365. [For over 20 years Dr. Wallian carried the banner of oxygen therapy in the U.S. In this article he discusses some of the technical reasons why oxygen therapy fails, principally because the gas is not properly prepared. However, he also advocated non-respiratory absorption of oxygen, a method we now know doesn't work.]
The therapeutic use of oxygen is becoming much more general than ever before in the history of medicine; but it is questionable whether the efforts, thus far, have resulted in more than a very superficial and imperfect realization of the possibilities of this agent. It is not enough to assume that, since oxygen is everywhere, and at all times essential to the maintenance of animal life, it is therefore, necessarily, a valuable therapeutic agent. Yet this is the substance of the argument used by many of those who have casually investigated it. At the bottom of all cases of failure to realize expected or desired results from the clinical exhibition of this gas is the want of proper appreciation or knowledge of the element itself, its varying conditions, modes of preparation and purification, and best methods of exhibition. To most operators oxygen is oxygen, no matter how evolved, how influenced by treatment or contact, how stored, or how exhibited. For example, a physician who decides that this agent is indicated in a given case, sends to some supply depot for a cylinder of the compressed gas, prepared, he knows not how carelessly, containing, nobody, not even its manufacturer, knows what per cent. of free chlorine and other deleterious impurities, nor how stale from long standing. This gas is brought to the bedside of the patient, and is administered unmethodically, perhaps under strong pressure, and with no definite idea as to the quantity to be used or frequency of exhibition. Any other remedy, used with as little intelligence and method, would hardly be expected to produce other than unsatisfactory results. . . . . .Another reason for shortcomings and unsatisfactory results in the use of oxygen is the restriction of the methods of administration exclusively to inhalation. The respiratory tract, it should be remembered, is but one avenue to the system. Experiments with the gas, used by means of cutaneous absorption and by absorption from the alimentary tract, have not been extensive, but they indicate beyond question that these avenues are not only valuable, but are often more available, and insure more prompt and thorough results, in a rather large class of cases, than can be otherwise obtained. . . |
THE PRINCIPLES AND PRACTICE OF MEDICINE, by William Osler, M.D., 1892. New York, D. Appleton and Company. [This is the first edition of Osler's comprehensive textbook ofmedicine. Oxygen therapy is noteworthy by the absence of any discussion of the subject. Clearly, from the very brief mentions, Osler was aware of the therapy, but was not a proponent. Of the passages quoted, the only one listed in the index under "oxygen" (and the sole entry under that heading) is the treatment of diabetes. For further insight regarding Osler's attitude toward oxygen therapy at the turn of the century, see 1898.]
Diabetes Mellitus (P. 305) - The coma is an almost hopeless complication. Inhalations of oxygen have been recommended, and lately the intravenous injections of a saline solution, as practised by Hilton Fagge. Asthma (p. 501) - The use of compressed air in the pneumatic cabinet is very beneficial, oxygen inhalations may also be tried. Emphysema (p. 549)- Inhalation of oxygen may be used and the remedies given already mentioned in connection with bronchitis. Anemia (p. 696)- Dilute hydrochloric acid, manganese, phosphorus, and oxygen have been recommended. |
THE PRINCIPLES AND PRACTICE OF MEDICINE, by William Osler, M.D., 1898; third edition. New York, D. Appleton and Company. [In the third edition, Osler's comments about oxygen therapy in diabetic coma, asthma, emphysema and anemia are unchanged. However, for the first time he comments on oxygen therapy in pneumonia (p. 137). This passage, quoted below, indicates that Osler still did not personally use or recommend oxygen therapy for his patients.]
OXYGEN GAS -- It is doubtful whether the inhalation of oxygen in pneumonia is really beneficial. Personally, when called in consultation to a case, if I see the oxygen cylinder at the bedside I feel the prognosis to be extremely grave. It does sometimes seem to give transitory relief and to diminish the cyanosis. It is harmless, its exhibition is very simple, and the process need not be at all distrubing to the patient. The gas may be allowed to flow gently from the nozzle directly under the nostrils of the patient, or it may be administered every alternate 15 minutes through a mask. |
THE THERAPEUTIC VALUE OF OXYGEN, by W.L. Conklin, M.D., Rochester, N.Y.New York State Medical Journal, September 2, 1899, pages 338-341. [By the end of the century oxygen therapy was becoming accepted by an ever growing number of practitioners, although many still doubted its utility. It was, as they say about many therapies today, "controversial," but the tide was clearly turning. Note that 19th century mixtures of oxygen frequently contained some nitrous oxide as a mild anesthetic.]
. . . I will not weary you with a detailed account of my own experience with oxygen. I have used it in a variety of pathological conditions accompanied by dyspnoea, with uniform relief so far as that distressing symptom was concerned, and with marked benefit to the patient as well, in nearly every case. . . .I have always used the mixture prepared by the Walton Oxygen Works and kept constantly in stock by the Paine Drug Company. This is made according to the formula of the London Oxygen Hospital and consists of one part of oxygen and two of nitrogen non-oxide. The latter gas has anaesthetic properties which make it of value, and the mixture is not irritating to the lung tissue, as pure oxygen is said to be. In looking over current medical literature I find many cases reported in which the results obtained from oxygen inhalations are so evidently favorable as to furnish, it seems to me, strong clinical proof of its therapeutic value. Believing, as I do, that there are no facts in physiological chemistry which really discredit this clinical evidence, or prove that the use of oxygen is unscientific, I feel confident that it will steadily grow in favor and come in time to be considered of definite and positive therapeutic value by all who will give it a fair trial. |