OXYGEN GAS 
AS A REMEDY IN DISEASE. 
" He breathed into his nostrils the breath of life, and man became a living- 
soul." 
CHAPTER I. 
HISTORY. 
The therapeutical history of oxygen dates almost from the 
moment ot the discovery of the gas. A few months after he 
had succeeded in demonstrating oxygen as a separate princi- 
ple, Priestley discovered its relation to animal life. He found 
that a mouse confined in a limited quantity of this gas lived 
at least twice as long as in a like quantity of common air. 
This fact led him at once to the suggestion that this agent 
might be usefully employed in cases of disease in which there 
was deficient vitality. At the same time, the effect of plun- 
ging a burning body into oxygen inspired him with a misgiv- 
ing that oxygen could not be inhaled to any 'considerable ex- 
tent without danger of exciting excessive action in the system, 
that the patient would " live too fast a phrase which, down 
to the present day, never fails to rise to the lips of the practi- 
tioner to whom this therapeutic measure is suggested for the 
first time. Thus early were the possible remedial uses of this 
1 2 
OXYGEN GAS AS A REMEDY IN DISEASE. 
agent foreseen, and, at the same time, an erroneous idea ad- 
vanced, which has maintained its hold upon the professional 
mind, and prevented much good which might otherwise have 
been attained. 
During the fifteen or twenty years following the discov- 
ery of Priestley, attention was directed more to the physio- 
logical and chemical relations of oxygen than to its use as a 
remedy. The part played by it in the animal economy was 
made the subject of investigation by Spallanzani, Fontana, 
Barthollet, Lavoisier, and others. To Lavoisier belongs the 
credit of first demonstrating the composition of the atmos- 
phere, and the changes produced in the blood by respiration. 
Following in his footsteps, Spallanzani showed that the con- 
sumption of oxygen was in direct ratio to the muscular activ- 
ity of the animal. For instance, he found that the chrysalis 
consumed an exceedingly small amount, the caterpillar a 
much larger proportion, while the active imago demanded 
a very large quantity for its support. 
These researches led to the grand discovery that the new 
element was the only one, a constant supply of which was ne- 
cessary for the continuance of life. Food and drink could be 
withheld for days ; even the nitrogen of the atmosphere could 
be excluded for hours, and yet no serious injury would result. 
But the animal hegan to die from the instant the supply of 
oxygen was cut off. No other element stood in this relation 
to life. No wonder, then, that it was called vital air, and 
that its discovery was thought to have begun a new era for 
humanity. 
The first case in which oxygen was actually employed as 
a remedy was one reported by Caillens, in 1783. I can find 
only a reference to this case, which was published in the Ga- 
zette de Sante. But, in the year following, Jurine, of Geneva, 
published an essay, in which he cites, at some length, a case 
of phthisis in a. young lady, which was very much benefited 
by daily inhalations of oxygen. In 1789 Chaptai, of Mont- 
pellier, reported two cases of phthisis, in one of which the gas 
produced great relief while its use was continued, but in the 
other the effect was not beneficial. 
At about this period the French Government desired an OXYGEN GAS AS A REMEDY IN DISEASE. 
3 
expression of opinion from the Academy upon the value of 
oxygen as a remedy, and Fourcroy was selected to prepare a 
report. In this report, and in other works which followed, he 
resigned himself to a current of speculation which drifted him 
far away from the truth. lie saw the effect of oxygen in the 
action of every remedy, even of muriatic acid, the composition 
of which was not then known. He claims to have employed 
oxygen in a considerable number of cases of phthisis, and to 
have noted a rapid improvement for two or three weeks, after 
which a violent inflammatory action was set up, and the prog- 
ress of the disease was greatly accelerated.1 But his subse- 
quent experiments on animals, in which he describes a state 
of fever occurring, which eventuated in gangrene of the lungs, 
lead to the suspicion that the gas which he employed con- 
tained some irritating impurity which the imperfect chemistry 
of the day did not enable him to discover. He became, never- 
theless, the founder of a school which interpreted all thera- 
peutical effects by the supposed relation of the agent em- 
ployed to the oxygen of the system. But it was not until 
Beddoes began his observations that any valuable practical 
results wTere obtained. 
In 1789 Beddoes published his book entitled " Consider- 
ations on the Factitious Airs." He was at that time Profess- 
or of Chemistry at Oxford, but none the less devoted to the 
practice of medicine, in which he had already attained a high 
position. To him belongs the credit of being the first to ap- 
proach the subject without a theory to sustain. It was not 
until he had accumulated a large number of facts that he at- 
tempted to arrange and classify them. His attempts at gen- 
eralization w'ere not always attended with the happiest results; 
but the readiness wTith which he relinquishes a theory the mo- 
ment it is found to conflict with fact, gives a rare impression 
of candor and impartiality to his work. The scope of the 
work includes observations upon several gases besides oxygen, 
expecially carbonic acid and hydrogen. 
His physiological experiments are of great interest. The 
principal results which he arrived at were the following : 
Oxygen produces a remarkable power of resisting asphyxia. 
1 Annales Chinlie, 1789. 4 
OXYGEN GAS AS A REMEDY IN DISEASE. 
It appears that, when the blood contains an unusual amount of 
oxygen, the animal is better able to support a deficiency of re- 
spirable air, or even the presence of an irrespirable gas. 
Animals which have respired oxygen resist longer the ac- 
tion of frigorific mixtures. 
The action of oxygen seems to be localized principally in 
the muscular system. 
Oxygen is in the highest degree a stimulus to the irrita- 
bility of the heart and blood-vessels. 
The last conclusion is one which succeeding observers will 
scarcely indorse to the fullest extent. As a stimulant to the 
circulation, oxygen is certainly far inferior to alcohol; indeed, 
in many cases, its stimulating effect is scarcely perceptible. 
A few isolated cases of success in the therapeutic use of 
different gases encouraged Beddoes to set on foot the project 
of a Pneumatic Institute, in which this mode of treatment 
could be tested on an extensive scale. The plan enlisted the 
cooperation of Sir H. Davy, who gave himself with ardor to 
the chemical part of the work, and of the eminent engineer 
James Watt, whose genius left nothing to be desired in the 
mechanical appliances for administering the gas. Probably a 
more brilliant triumvirate was never combined in the further- 
ance of a scientific object. 
In pursuance of their plan, a building was erected by 
public subscriptions. It contained small compartments, the 
atmosphere of which could be charged with any desired gas. 
In these rooms the patients were allowed to pass a certain 
time daily. 
The principal results obtained by the use of oxygen are 
summed up in the following table, from a review of Beddoes's 
work -which was published in the British Library: OXYGEN GAS AS A REMEDY IN DISEASE. 
5 
CASES TREATED. 
Cured. 
Relieved. 
Not 
benefited. 
Obstinate Ulcers 
2 
2 
Leprosy (?) 
5 
Spasms 
3 
2 
Gutta Serena 
2 
3 
Chlorosis. . 
5 
2 
* 
Epilepsy 
1 
5 
Asthma 
10 
9 
3 
Cancer 
3 
Dropsy of the Chest 
2 
1 
1 
Hypochondria 
1 
Dyspepsia 
3 
1 
Dropsy 
2 
1 
i 
Hydrocephalus 
1 
Headache 
2 
2 
Poisoning by Opium 
1 
Paralysis 
2 
1 
1 
Scrofulous Tumors 
2 
1 
Deafness 
1 
White Swelling 
1 
Scorbutus 
1 
Venereal 
1 
Melancholy 
1 
1 
General Debility 
1 
Continued Fever 
1 
Intermittent Fever 
1 
Coldness of Extremities « 
1 
•• 
Total 
49 
30 
14 
It will be observed that no cases of phthisis are included 
in this table. The explanation of this is to be found in the 
peculiar views entertained by Beddoes as to the relation of 
oxygen to this disease. Accepting without question the re- 
ports of Fourcroy as to the ultimate acceleration of the disease 
by oxygen, he framed the theory that in phthisis there was a 
change, either in the constitution of the blood or in the sub- 
stance of the lung, that favored the absorption of oxygen, which 
was therefore already present in excess. For this reason he 
considered oxygen as absolutely contraindicated. 
In scorbutus, on the contrary, he supposed that there was 
a deficiency of oxygen in the system, which he thought should 
be supplied by artificial means. 
The labors of Beddoes did much toward establishing the 
true position of oxygen as a therapeutic agent. They demon- 
strated, on the one hand, that the ideas at first entertained as to 
its. curative power were extravagant, and, on the other, that it 6 
OXYGEN GAS AS A REMEDY IN DISEASE. 
was an agent capable of producing good effects in many cases 
not reached by ordinary means. The number and variety of 
diseases in which the treatment was found beneficial suggest 
at first sight a certain air of charlatanism, but subsequent ob- 
servers have corroborated nearly all his statements. Nor, 
when we consider the physiological relations of oxygen, is it 
more surprising that its use should be applicable to a large 
range of cases than that- modification of diet should be bene- 
ficial in so many diverse diseases. 
It is very remarkable that results as satisfactory as those 
obtained by Beddoes should not have led to a more general 
adoption of the treatment. But, with the exception of Hill 
and Thornton, who were contemporaries rather than successors 
of Beddoes, scarcely any British physician seems to have be- 
come interested in the matter, and it was allowed to die out 
with its original promoters. This was doubtless largely due 
to the difficulties which then beset the production of the gas, 
and its transportation to the bedside of the patient. Chemi- 
cal manipulations were then but little understood, and 
chemical apparatus was very imperfect. Caoutchouc was un- 
known, and this simple fact alone would have made that very 
difficult which is now extremely easy. Indeed, when we con- 
sider the part which this substance now plays in the manipula- 
tion of the gases, it is not too much to say that its introduction 
was a necessary preliminary to their general use as remedies. 
While Beddoes was carrying on his observations in Eng- 
land, the therapeutic use of oxygen was exciting no little at- 
tention in Germany. Numerous experiments and observa- 
tions were made during the decade preceding the opening of 
the present century. Prominent among them were those of 
Girtanner, who, following in the footsteps of Fourcroy, gave 
arsenic dissolved in nitric acid for a large range of complaints, 
under the impression that the solution imparted oxygen to the 
system. He was charmed with the effects of oxygen given in 
this.way in intermittent fever. In the midst of similar spec- 
ulations and theories, which seem to have taken the place, for 
the most part, of observations on the practical use of the gas 
itself, it is not surprising that little real progress was made in 
determining the true value of the latter. OXYGEN GAS AS A REMEDY IN DISEASE. 
7 
At Geneva, however, the use of oxygen fell into more prac- 
tical hands. The results obtained by Jurine served to en- 
courage others. Odier, then a prominent physician at Geneva, 
took up the new treatment with great zeal, and the Society 
for the Advancement of the Arts and Sciences caused the 
founding of an institution similar to that of Beddoes. But, as 
in the former case, this was short-lived, and with its decline 
the whole subject of the medicinal use of oxygen sank into 
oblivion. The frightful epidemic of cholera in Europe, in 
1832, brought it again into momentary notice, but, as it failed 
to answer the expectations of those who employed it, it-re- 
lapsed into its former obscurity. 
It is only within the last fifteen years that any serious at- 
tempt has been made to bring this agent again into use. Dr. 
Riadore, it is true, published some observations upon its use in 
1845, recommending it in cases of indigestion, debilitated con- 
ditions of the liver and kidneys, nervous affections, asthma, 
etc. But his cases were not numerous or striking, and failed 
to arouse the attention of the profession. 
In 1857 appeared the first edition of a work on Oxygen, 
by Dr. S. B. Birch, of London. I have not been able to pro- 
cure a copy of this edition, and the second, issued in 1868, seems 
nearly a new work. The writer claims to have presided at 
the renaissance of oxygen, and takes to himself the credit of 
having instigated all that has been done in the past few years 
to place its use on a solid foundation. His book consists of 
a selection of cases, preceded by some general remarks upon 
the properties and uses of oxygen, its modus operandi, etc. 
His ideas with regard to what he styles the quasi-nascent con- 
dition of oxygen are very peculiar, and are not borne out by 
the experience of others. Moreover, his style is singularly 
obscure, and his book lamentably lacking in practical direc- 
tions for the administration of the remedy. While con- 
stantly insisting upon the necessity of judiciously selecting 
cases for treatment, of judiciously administering the gas, 
and of the judicious use of adjuvants, etc., he does not 
give a single practical rule for determining what is judicious 
in the premises. The cases which he publishes are very strik- 
ing, one might almost say, marvellous; and the impression 8 
OXYGEN GAS AS A REMEDY IN DISEASE. 
which the work as a whole is calculated to make upon the 
reader is that, in the hands of the author, oxygen is almost a 
panacea, while at the same time it would be hopeless for the 
general practitioner to attempt to grapple with a treatment so 
intricate, and demanding such peculiar skill. 
In sharp contrast with this work is the article on Oxygen 
in Demarquay's Essai de Pneumatologie published 
at Paris in 1866. A little too diffuse, perhaps, it is still plain, 
simple, and to the point.' The author tells his story as of one 
who has studied the literature of the subject, made some ex- 
periments himself, and treated quite a number of cases by the 
use of oxygen, sometimes successfully, sometimes not. With 
reference to its use in some diseases, while giving the expe- 
rience and opinions of others, he states frankly that he has had 
no experience himself, and does not feel competent to judge 
of its merits. While it appears to me that some of his experi 
ments on the physiological effects of the gas are defective, yet, 
others are novel and extremely valuable. His article is 
marked by perfect candor and frankness throughout, and is by 
far the best treatise upon the subject extant. 
Dr. Hermann Beigel, in his work on Inhalation, published 
in London in 1866, presents a few considerations upon the use 
of oxygen, and cites a number of cases from his practice, in 
which he has used it with more or less benefit. He invented 
an apparatus for the production of the gas, according to Fleit- 
mann's process, from the chloride of lime. His treatment of 
the subject is candid and unpartisan, and his conclusions de- 
mand respect. 
A new era in the history of oxygen is being inaugurated 
by the invention of Tessie du Motay, by means of which the 
gas can be produced in immense quantities from the atmos- 
phere, and at an insignificant cost. Its possible future in 
relation to medicine and hygiene can as yet be only dimly 
discerned. When we shall be able to regulate the proportion 
of oxygen in the atmosphere of the sick-room as easily as we 
now regulate the temperature; when closely packed and ill- 
ventilated tenements can be supplied with this element, the 
free enjoyment of which is necessary to health ; when by its 
use the contamination of the atmosphere by the furnaces of OXYGEN GAS AS A REMEDY IN DISEASE. 
9 
factories and machine-shops shall be prevented or counteracted, 
who can tell what will be the sum-total of the result ? Yet all 
this seems now attainable whenever the public shall become 
sufficiently awake to its importance. 
CHAPTER II. 
MODES OF PREPARATION AND ADMINISTRATION. 
In the preparation of oxygen for medical use, purity is, of 
course, of the very first importance. Undoubtedly many of 
the effects formerly attributed to oxygen, such as the produc- 
tion of bronchial irritation or inflammation, and even of pneu- 
monitis, were owing to impurities in the gas employed. 
The first substance from which oxygen was isolated was 
the peroxide of mercury, and in all the earlier experiments 
the gas employed was obtained from this source. It was not 
long, however, before cases of ptyalism occurring, warned ex- 
perimenters of the danger of using the oxides* of mercury for 
this purpose. 
Chaptai showed, by carefully-conducted experiments, that 
oxygen so prepared contained an appreciable quantity of the 
metal. The peroxide of manganese was then substituted, 
and finally chlorate of potash. 
Recently quite a number of processes have been added to 
the list, so that it now embraces a large range of procedures 
by which oxygen may be obtained with more or less facility. 
I will touch briefly upon the more prominent of these, only 
one having been found by experience to be really adapted to 
the use of the physician : 
1. Decomposition of binoxide of manganese. This is ac- 
complished by heating the oxide to a red heat in an iron re- 
tort, or by treating it with sulphuric acid. In the first case 
a high heat is required, and in the second the acid is disagree- 
able, and dangerous in general practice. Moreover, the gas 
contains four or five per cent, of nitrogen from the impurities 
usually contained in the manganese. If commercial acid is 
used, it also imparts its impurities to the gas, and among them 
usually a certain proportion of arsenic. These considerations 10 
OXYGEN GAS AS A REMEDY IN DISEASE. 
have led to the complete abandonment of this method in prac- 
tice. 
2. The decomposition of sulphuric acid, or sulphate of 
zinc. This process depends upon the decomposition of sul- 
phuric acid by heat into oxygen and sulphurous acid, or that 
of sulphate of zinc into oxygen, sulphurous acid, and oxide of 
zinc. It is probable that oxygen could be produced in large 
quantities in this manner at a very small cost, so that it would 
be available for industrial purposes; but, for the use of the 
physician, the complexity and cost of the apparatus required 
render it an undesirable method. 
3. Process of Boussingault. This consists in procuring 
oxygen from baryta, in utilizing the property which the latter 
possesses of fixing the oxygen of the air at an elevated tem- 
perature, and giving it off again -when the temperature is 
raised still higher. It is difficult to manage, however, and 
the results are not satisfactory. The apparatus, also, is bulky 
and expensive. 
4. Reaction "of sulphuric acid upon bichromate of potash. 
This reaction results in the production of oxygen and chrome 
alum. About sixteen per cent, of oxygen is yielded by the 
bichromate. This yield is too small to render the method de- 
sirable, aside from the objections belonging to every process 
which requires a powerful acid to be placed in unskilled 
hands. 
5. Decomposition of chloride of lime by cobalt. The ox- 
ide or any of the salts of cobalt have the property of inducing a 
species of catalytic action between chlorine and lime, from 
which free oxygen and chloride of calcium result. An ex- 
tremely minute quantity of cobalt only is required. If a 
stream of chlorine gas is passed into warm milk of lime, con- 
taining a little of a salt of cobalt in solution, the chlorine is 
absorbed, and oxygen is given off, and at the close of the pro- 
cess chloride of calcium will have taken the place of the lime. 
This method of procuring oxygen is known as Fleitmann's 
process. Now, by using chloride of lime, we have the chlo- 
rine and the lime united in one substance, and, by merely 
adding the cobalt, and pouring on a little hot water, the 
process is greatly simplified. The gas, however, contains OXYGEN GAS AS A REMEDY IN DISEASE. 
11 
considerable chlorine, and the yield is small in propor- 
tion to the quantity of material employed. This process is 
the one recommended by Dr. Beigel for preparing oxygen for 
medical use, and his recommendation is sustained by Birch, 
who, however, prefers compressed oxygen when it can be ob- 
tained. I have given the method a trial, but, in my hands, 
the quantity of gas was so small, and the quality so inferior, 
that I abandoned its use. However, as the cost is very slight, 
it might be used with advantage in office practice, where a 
large stationary apparatus could be employed, and where ar- 
rangements could be made for washing the gas through an al- 
kaline solution to remove the chlorine. But, for use at the 
bedside, an apparatus, small enough to be portable, would not 
yield the gas in sufficient quantities. 
It remains to consider the method of obtaining oxygen by 
the decomposition of chlorate of potash. This substance, hav- 
ing the formula KO, CIO6 = KC1+06, is broken up by heat 
into oxygen and chloride of potassium. 
By mixing with the chlorate a little peroxide of manganese, 
the disengagement of the oxygen proceeds with greater rapid- 
ity and requires much less heat. It is usual to invoke Hie 
action of catalysis to explain this, but it seems to me to be 
owing simply to the facility with which the manganese con- 
ducts the heat and diffuses it through the whole mass. Chlo- 
rate of potash alone is an exceedingly bad conductor of heat, 
as is also chloride of potassium. Hence the action of slight 
degrees of heat is confined to that part only of the mass ex- 
posed which is in contact with the retort. But the manganese, 
being a heavy metallic substance, transmits the heat readily 
from particle to particle of the salt. Any other substance 
having an equal conducting power will do as well, provided 
it will not combine with oxygen. I have succeeded admir- 
ably with black oxide of copper. Sand may be used, but with 
less advantage, as it is comparatively a poor conductor. It is 
generally stated that this process yields perfectly pure oxygen 
gas. This, however, is not the case if the evolution is at all 
rapid, as the gas will then be slightly contaminated with 
chlorine. There is also another impurity, not noticed in any 
work on chemistry which I have seen. Pure oxygen, as is 12 
OXYGEN GAS AS A REMEDY IN DISEASE. 
well known, is invisible, yet the product from chlorate of 
potash has usually more or less of a smoky appearance when 
first evolved. If the gas be allowed to stand for half an hour 
or an hour, it will lose this appearance, while the glass vessel 
in which it is contained will be seen to have a deposit on its 
inner surface. Under the microscope this deposit is found to 
consist of minute crystalline particles. If enough of these be 
collected to respond to chemical tests, they will be found to be 
chlorate of potash. It would seem, then, that a small portion 
of the chlorate, instead of being decomposed by the heat, is 
sublimed unchanged, and such is its insolubility that it is not 
separated from the gas except by repeated washings. Not the 
least harm results, however, from inhaling it, as I have demon- 
strated repeatedly in my own person. 
The quantity of gas procured by this process is very great, 
amounting in round numbers to five hundred cubic inches for 
each ounce of the chlorate of potash, or thirty-nine per cent, 
by weight. The quantity yielded renders this method pecu- 
liarly adapted for use in the sick-room, where portability of 
apparatus and material is much to be desired. Until recently 
I have employed a copper flask in which to heat the materials. 
But I found inconvenience to result from this form of con- 
tainer, inasmuch as the entire quantity of the chlorate was 
heated at once, resulting in a tumultuous and often unmanage- 
able evolution of the gas. To obviate this difficulty, I have 
had constructed the apparatus figured in the annexed cut. It 
consists essentially of a brass retort in the form of a cylinder, 
nine inches long and one and a quarter inches in diameter, re- 
sembling in shape a very large test-tube. To the open extremity 
of this retort is fitted a cover of cast iron, held in place by 
a clamp which catches upon a projecting flange surrounding 
the mouth of the retort. This clamp is tightened by means of 
a screw. Passing through the cover is the tube carrying 
the gas into the wash-bottle, and which is arranged at a right 
anele to the retort. The latter is therefore in a horizontal 
position, and is supported by its connection with the wash- 
bottle, which in its turn is firmly fastened to a board form- 
ing the base of the whole apparatus. The tube before re- 
ferred to passes to the bottom of the wash-bottle, and has near OXYGEN GAS AS A REMEDY IN DISEASE. 
13 
its lower extremity a great number of very small holes through 
which the gas escapes in fine bubbles. This is important, as it 
insures a much more perfect washing of the gas. Another 
tube, merely passing through the cap of the wash-bottle, pro- 
vides for the passage of the gas into the bag from which it is 
inhaled. 
A, retort. The dotted line indicates the manner in which the chlorate of potash is to be 
disposed. B, clamp, holding the retort in position. C, safety-valve. D, tube leading into 
the wash-bottle. E, delivery-tube. F, Bunsen burner. 
The retort is but half filled with the mixture of chlorate 
of potash aud peroxide of manganese, and this quantity is dis- 
tributed along its whole length to within an inch of the cover, 
thus leaving nearly one-half of the diameter of the retort free 
for the passage of the gas. The heat of a Bunsen burner or of 
a powerful spirit-lamp is employed, beginning first at the closed 
extremity of the retort and moving it along as the material 
becomes exhausted. The wash-bottle is half filled with a solu- 
tion of caustic potash. 
The advantage of this apparatus is, that only a small por- 
tion of the material is heated at a time, and the rapidity of 
evolution is under perfect control. By having two retorts, and 14 
OXYGEN GAS AS A REMEDY IN DISEASE. 
using them alternately, a continuous supply may be kept up, 
sufficient for any emergency. The whole apparatus, including 
the bag, may be easily packed in a box ten inches square and 
five inches deep, and a supply of gas may be generated in 
fifteen minutes, at the house of the patient. 
In using black oxide of manganese in connection with 
chlorate of potash, it is important that it should be free from 
protoxide, and from any combustible substance. Neglect of 
this precaution may lead to an explosion. 
The process of Tessie du Motay is as follows: Manganate 
of soda is exposed to a very high heat in iron retorts, and while 
in that condition a current of atmospheric air is passed over it. 
This results in the absorption by the salt of a large portion of 
the oxygen which the air contains. The current of air is then 
shut off, and a current of superheated steam substituted. The 
steam withdraws from the manganate of soda the added quan- 
tity of oxygen, and carries it with it to a condenser from which 
the oxygen passes in a pure state into the gasometer. The salt 
is then subjected to the action of a second portion of air, fol- 
lowed again by a current of steam, and thus the process goes 
on indefinitely. The manganate of soda retains its activity, 
and loses nothing in weight, so that the only consumption is 
that of fuel. 
For use in the sick-room, the gas may be compressed into 
cylinders of copper or iron, and thus rendered conveniently 
portable. 
In localities sufficiently near to a factory, this is destined 
to supersede all other methods of supplying oxygen for medi- 
cal purposes. The gas is perfectly pure, and the quantity 
which can be compressed into even a small cylinder is suffi- 
cient to meet the requirements of any case likely to occur. 
The method of administration of oxygen is very simple. 
The gas, being in a bag or in a gasometer, is conveyed to the 
mouth or nostrils of the patient by means of a flexible tube, 
terminating in a mouth-piece of glass, hard rubber, or ivory. 
This being taken into the mouth, or held to one nostril, the 
patient breathes the oxygen mingled with a greater or less 
proportion of common air, one or both nostrils being free 
for the admission of the latter. The proportion of gas is regu- 15 
OXYGEN GAS AS A REMEDY IN DISEASE. 
lated by the size of the orifice through which it escapes. Dur- 
ing expiration the rubber tube is compressed between the 
thumb and index-finger. When the patient is not able to do 
this for himself, it may be done by an attendant, who, by 
watching the movements of the chest, soon catches their rhythm. 
I prefer this plan to the use of an inhaler with a complicated 
system of valves, which always offers an impediment to respira- 
tion. 
The quantity given will vary from one or two gallons daily, 
which is sufficient in some chronic cases, to eighty or one hun- 
dred gallons, which may be required in urgent dyspnoea. In 
chronic cases it should be given from a very small orifice, so 
that the inhalation of four or five gallons will occupy fifteen 
to thirty minutes. Feeble patients should take it in the re- 
cumbent position. 
The inhalations may be repeated morning and evening, or 
less frequently, as the case may demand. Some very striking 
results have followed when the interval was as great as three 
days. On the other hand, when respiration is very much ob- 
structed, it may be necessary to give the gas almost constantly 
and but little diluted. 
Knowing the capacity of the bag employed, and bearing in 
mind that an adult usually respires from eight to ten pints of 
air per minute, it is easy to judge approximately of the quan- 
tity of oxygen which is being inhaled. 
The plan of surcharging the atmosphere of a room with 
oxygen, and allowing the patient to remain in it for a certain 
period, has this disadvantage, that, to retain the oxygen, venti- 
lation must be sacrificed. If the room be so large as to do 
away with this objection, the quantity of oxygen required will 
be greater than can generally be supplied. These considera- 
tions have led to the abandonment of this mode of administra- 
tion. 
Dr. Birch lays great stress upon the gas being given in what 
he calls a " quasi-nascent" condition, that is, he thinks it should 
be inhaled at once as rapidly as it is generated, or, if not, that 
it should be kept under pressure until wanted for use. It is 
enough to say that he brings forward no facts to sustain the 
alleged advantage of this plan, and that, moreover, others who 
have not followed it have obtained equally good results. 16 
OXYGEN GAS AS A REMEDY IN DISEASE. 
CHAPTER III. 
PHYSIOLOGICAL ACTION OF OXYGEN. 
In regard to the physiological action of oxygen, the first 
question to he determined is, whether it is possible to cause 
the blood to take up more oxygen than it receives from the at- 
mospheric air; whether-the point of saturation is not attained 
in ordinary respiration. On this point there wTas formerly but 
one opinion. It was thought that there was practically no 
limit to the power of the blood to absorb oxygen. This idea 
was no doubt in part based upon the known energy of com- 
bustion in pure oxygen gas, and the supposed identity of that 
process with the retrograde metamorphosis of animal tissue. 
It was held that the inhalation of pure oxygen would induce 
rapid chemical action within the body, that a state of general 
inflammation would ensue, and that destructive metamorphosis 
would be so much more active than the process of reconstruc- 
tion that the vital machinery would soon be spoiled, and ren- 
dered incapable of continuing its action. 
But after a time it was observed that these extreme results 
did not actually take place, that an animal could remain for a 
number of hours in pure oxygen without sustaining any ap- 
parent injury. This led certain observers to the conclusion that 
the blood-corpuscle became saturated with oxygen when com- 
mon air was breathed, and that it would take up no more, no 
matter how much was presented to it in the air-cells of the 
lungs. This view was defended by Regnault and Reiset, who 
endeavored to sustain it by tlie following experiment: They 
confined animals in oxygen, and after a time examined the 
gas, and found that it contained no more carbonic acid than 
would have been exhaled in the same time if the animals had 
respired atmospheric air. That these experiments were not 
conclusive, will become apparent as we proceed. 
On the other hand, was cited the fact that animals die in a 
period varying from three to eighteen hours if confined in an 
atmosphere of oxygen, and that the tissues present an unusu- 
ally florid aspect, approaching to a vermilion hue. These ob- 
servations I believe to be no more conclusive than the others. OXYGEN GAS AS A REMEDY IN DISEASE. 
17 
On this point Demarquay says : " Science had already taught, 
what our experiments have confirmed, that animals can live 
without danger in an atmosphere of pure oxygen, and for a 
much longer time than in the same .volume of air. But be- 
yond a certain limit these animals at last succumb, and one 
may then satisfy himself that the medium in which they have 
respired is still capable of relighting an ignited body, a very 
evident proof that death has taken place from the oxygen it- 
self and not from any alteration which it may have undergone 
from admixture with the carbonic acid exhaled." 1 
As the test referred to above, that of relighting an extin- 
guished taper, the extremity of the wick being still red hot, 
is constantly relied upon to prove the respirability of the gas 
after such experiments, it is well to state at the outset that it 
is entirely worthless. This is shown by the following experi- 
ment : 
Experiment I.-Two parts of pure oxygen were mixed with one part 
of carbonic acid, prepared by the action of sulphuric acid upon marble. A 
pint jar was filled with the mixture, which sufficed to relight a taper four 
times. 
Demarquay himself states that ten per cent, of carbonic 
acid, mixed with oxygen, is sufficient to render the latter in- 
capable of sustaining life; yet we find, by this experiment, 
that the test which he relies upon would indicate its respiralfility 
when containing thirty-three per cent. 
The apparatus employed by Demarquay in his experiments, 
which are essentially similar to those of his predecessors, con- 
sisted of a large cylinder furnished with two openings, through 
one of which the animal was introduced, while to the other a 
tube was fitted connected with a reservoir of oxygen. The 
animal, having been placed in the cylinder, a large quantity of 
oxygen was introduced by the tube, the amount being suffi- 
cient to drive out the air in the apparatus, which escaped by 
the other opening. When it was judged that the cylinder was 
filled with pure or nearly pure oxygen, both apertures were 
closed. The animals experimented upon w'ere common fowls, 
pigeons, and rabbits. 
1 Essai de Pneumatologie p. 644. 
2 18 
OXYGEN GAS AS A REMEDY IN DISEASE. 
The result of these experiments was that, when the animals 
were allowed to remain in the apparatus for the space of an 
hour and three-quarters, and were then killed, nearly all the 
tissues of the body were found reddened to a greater or less 
extent, but the venous blood retained its darker hue. Two 
rabbits were allowed to remain until death took place, which, 
in one instance, was at the end of fourteen hours, and in the 
other after seventeen hours. At the close of each experiment 
the gas was found to relight a taper. 
These experiments coincide in their results with one of 
my own, in which the conditions were similar: 
Experiment II.-June 10, 1860.-A rat was confined in a jar contain- 
ing about a gallon of pure oxygen, and inverted over water. At the end 
of two and a half hours death took place. On opening the body all the 
internal organs were found to be of a bright-red color. 
It will be observed that, in both these instances, no pro- 
vision was made for removing the carbonic acid and other 
products of respiration, and that the gas must have become 
excessively impure. In the following experiments this omis- 
sion was corrected: 
Experiments III., IV., and V.-July 15, 1869.-A pigeon and two 
mice were confined respectively three, four, and five hours in jars of oxy- 
gen, having a strong solution of caustic potash in the bottom, under a stage 
upoiuwhich the animal rested. The jar was so arranged at the same time 
that a small stream of oxygen from a rubber bag was constantly flowing 
into it, and escaping by an aperture of like size. The solution of potash 
absorbed the carbonic acid, while the gradual change of the atmosphere 
within the jar was sufficient to prevent a sensible accumulation of other 
impurities. 
These animals when killed did not present any appreciable change in 
the appearance of the tissues. 
Experiment VI.-August 25, 1869.-At 3 p. m. a pigeon was placed 
in a jar of oxygen, of the capacity of three hundred cubic inches, and the 
jar inverted over a solution of potash. The following morning the animal 
was found dead. Upward of one hundred and fifty cubic inches of oxygen 
had been converted into carbonic acid, and absorbed by the potash, the 
liquid rising in proportion in the jar. On opening the body no unusual 
redness of the tissues was observable. The feathers of the bird, and also 
the sides of the jar, were wet with the condensed moisture of the breath. 
The animal was also in a constrained and uncomfortable position, which, 
doubtless, hastened its death. OXYGEN GAS AS A REMEDY IN DISEASE. 
19 
The conclusion which I draw from these experiments is, 
that the lively red color of the lungs, heart, liver, etc., which 
are described, and which I have myself seen, does not depend 
upon hyperoxygenation alone, but also upon a coincident re- 
tention of carbonic acid in the tissues. The color pervades 
the intervascular substance as perfectly as the natural color- 
ing-matter pervades the muscular fibre. It cannot, therefore, 
be ascribed to simple increase of vascularity. 
The following experiments show that, in Demarquay's ob- 
servations, the oxygen is as little chargeable with the death of 
the animals as with the change in the color of their tissues : 
Experiment VII.-August 13, 1869.-A mouse was confined in a jar 
of oxygen inverted over a solution of caustic potash. At the end of twen- 
ty-five and a half hours, during which he had had neither food nor drink, 
he was dull and stupid, but, when released, ate greedily, and was soon as 
lively as ever. 
Experiment VIII.-August 16, 1869.-A tin box, seven by ten inches, 
and six inches deep, open at the bottom, and having the top of glass, was 
placed in a shallow vessel containing a solution of potash. A little above 
the surface of the solution was arranged a false bottom of wire-cloth, 
which formed the floor of the apparatus. A circular opening on one side 
of the box was fitted with a projecting rim soldered to its edge. To this 
rim or collar a cap was fitted, and the joint was made air-tight by an india- 
rubber band stretched around it. This opening was for the purpose of in- 
troducing the animal to be experimented upon. A small tube passing into 
the box was connected with a large reservoir of oxygen. By means of a 
stop-cock the amount of gas passing into the apparatus was so regulated 
that a bubble would escape every second or two from under the edge of 
the box. Within the box was placed an open vessel containing chloride of 
calcium to absorb the moisture from the breath, and another vessel with 
dilute nitric acid to take up the ammonia exhaled. Food, water, and a 
quantity of tow for a bed, having been provided, a mouse was introduced 
into the apparatus, and the aperture closed air-tight. Oxygen was then 
admitted freely for some time until all the air was expelled, when the stop- 
cock was closed to the point already indicated. The animal ate, drank, 
and arranged his bed, and acted in every particular as mice generally do, 
until the third day, when he buried himself in the tow, and seemed very 
quiet. By this time his excretions gave to the gas, which escaped from the 
apparatus, a very sickening smell. 
At the end of four days the mouse was removed and transferred to a 
cage, where he recovered at once his accustomed liveliness, and appeared 
no worse for his unique experience. 20 
OXYGEN GAS AS A EEMEDY IN DISEASE. 
This single experiment is sufficient to overthrow the theory 
of hyperoxygenation of the blood, as the term is generally un- 
derstood, and to show that the fatal results heretofore observed, 
as well as the peculiar post-mortem appearances, were the re- 
sult of the admixture of the products of respiration with the 
gas inhaled. 
Are we, then, to accept the conclusion of Regnault and 
Reiset that inhaling pure oxygen makes no difference with 
respiration ? Clinical observation and facts derived from ex- 
periments teach us clearly to the contrary. 
The quantity of oxygen in the blood under normal condi- 
tions is extremely variable. This follows from the varying 
exigencies of the system. The transition frem perfect repose 
to active exertion implies increased molecular action and in- 
creased consumption of oxygen. The blood-corpuscles are 
the carriers of oxygen, and, as their number remains the same, 
each one must assume a greater burden. To explain all the 
phenomena resulting from the inhalation of oxygen, it is not 
necessary to assume the absorption of more than corresponds 
with the extreme limit of this healthy respiratory demand. 
All the analogies of Nature lead us to suppose that this limit 
coincides with the point of complete saturation of the blood. 
To assume a margin beyond it is to suppose a provision 
against an emergency which can never arise. It is con- 
trary to the economy of Nature that the blood should have 
the capacity for absorbing more oxygen than Nature can 
supply. 
My view is, then, that if pure oxygen be taken into the 
lungs, only as much will be absorbed by the blood as would be 
taken up from the air under circumstances involving the great- 
est possible physiological demand for oxygen. I know that it 
has been asserted that blood agitated in a vessel with oxygen 
will assume a livelier red than when agitated with common 
air. This, however, is a mistake. The change will take place 
more promptly with oxygen, but the hue will be in the end the 
same. We may therefore assume that, if the blood and the air 
be brought into sufficiently intimate contact in the lungs, the 
corpuscles will become saturated with oxygen from the ordinary 
atmosphere. 21 
OXYGEN GAS AS A REMEDY IN DISEASE. 
Experiment IX,-August 20, 1869.-A quantity of defibrinated sheep's 
blood was divided into two portions. One portion was thoroughly agitated 
with oxygen, and quickly assumed a bright-red hue. The other was agi- 
tated in the same way with common air. The change took place more 
gradually, but eventually, when the two jars were placed side by side, no 
difference in the color could be distinguished. 
The portion agitated with air was then placed in a vessel filled with 
oxygen, which was closed tightly, while its interior was made to communi- 
cate with a delicate manometer. After the lapse of an hour, during which 
the vessel was frequently agitated, no change had taken place in the 
height of the fluid in the instrument, thus indicating that no additional 
oxygen had been absorbed. 
How, then, is this appearance of superoxygenation of the 
blood to be accounted for, since it never occurs when atmos- 
pheric air is respired? The conditions which obtain while 
breathing oxygen, without removing the products of respira- 
tion, are entirely sui generis. They differ from that observed 
when air is substituted, in that the proportion of carbonic acid 
may become much greater without destroying life. They 
differ, also, from the effect produced by confining an animal 
in a mixture of carbonic acid and oxygen, since in the latter 
case the change is abrupt, while in the former it is very 
gradual. The experiments of Count Morrozo, and of Ber- 
nard, show what an immense difference, in the effect upon the 
animal, results from this circumstance. I offer the suggestion, 
therefore, that the red stain of the tissues is the result of the 
prolonged action of carbonic acid retained in the blood-life, 
meanwhile, being kept up and the activity of retrograde 
metamorphosis sustained by a maximum absorption of oxygen. 
When a considerable quantity of pure oxygen is inhaled, 
there is usually a sensation of freedom about the chest, as if 
respiration were easier. Some persons describe a feeling of 
warmth beneath the sternum, such as results from inhaling a 
slightly-stimulating vapor. Sometimes a slight degree of ver- 
tigo is produced. Generally there is a tendency of the blood 
to the surface, and the hands and feet, if previously cold, be- 
come warm. In some cases this change of the circulation is 
accompanied by a prickling sensation. The pulse is some- 
times accelerated, but more frequently remains unchanged. 
In cases of debility it is often reduced in frequency. The 
temperature is but little changed, if at all. I have sometimes 22 
OXYGEN GAS AS A REMEDY IN DISEASE. 
observed a disposition to yawn constantly during the inhala- 
tion, and there is generally an inclination afterward to sleep. All 
these effects are more marked when the gas is inhaled fasting. 
In reference to the effect of the inhalation of oxygen upon 
the amount of carbonic acid formed, and of urea excreted, 
there has been as yet but little research. The experiments of 
Regnault and Reiset, upon the first point, have been already 
referred to. The subject, however, is beset with difficulties, 
and much caution is required in accepting the results of ex- 
periments as to the amount of carbonic acid exhaled when 
breathing a greater or less proportion of oxygen. Different 
results will be obtained at different times when breathing the 
same medium under apparently the same conditions as to diet, 
stage of digestion, exercise, etc. The slightest bodily exertion, 
or even mental excitement, will vitiate the experiment. In 
experiments with animals, eructations of gas from the stomach 
will sometimes add largely to the percentage of carbonic acid 
obtained. 
My experiments on this point have brought out an (to me) 
unexpected result, viz., tliat the inhalation of a considerable 
quantity of oxygen is followed within a few moments by a 
temporary decrease in the amount of carbonic acid exhaled, as 
is shown in the following table. The experiments were 
made upon myself: 
Hour. 
Cubic inches 
of oxygen inhaled. 
CO2 exhaled per 
minute. 
Experiment XL, 
July 29, 1869. 
4.35 p. M. 
4.45 
5 
5.18 
3.25 
4 
4.10 
12.15 
12.25 
12.30 
12.45 
2 
2.50 
2.55 
2.55 
3.15 
3.35 
6 a. m. (fasting) 
6.15 
6.40 
7 
600 
400 
700 
400 
1200 
500 
21 c. in. 
19 
20 
22 
16 
19 
16| 
18" 
191 
191 
191 
171 
18 
17 
171 
Experiment XII., 
August 3d. 
Experiment XIII., 
August 5th. 
Experiment XIV., 
August 5th. 
Experiment XV., 
August 5th. 
Experiment XVI., 
August 12th. OXYGEN GAS AS A REMEDY IN DISEASE. 
23 
Experiment XVII.-Augusta, 1869.-A pigeon was placedin a jar 
containing three hundred cubic inches of oxygen, and the jar inverted 
over a solution of caustic potash. After twenty minutes the oxygen was 
removed and replaced by common air. In thirty minutes the volume of 
air had decreased thirteen cubic inches. The following day the same 
pigeon was confined again in the same quantity of air for the same period, 
not having previously inhaled oxygen. The decrease amounted to eighteen 
cubic inches. There was no evidence that the health of the animal had 
been injured by the previous experiment. 
The manner in which oxygen produces this effect is not 
easily explained. It is possible that its immediate action may 
be like that of alcohol, which is known to cause a diminution 
of the carbonic acid exhaled from the lungs. This is the more 
probable from the similarity of its other effects, when well 
marked, to those which alcohol produces. 
Notwithstanding this temporary decrease of carbonic acid, 
I am of the opinion that the ultimate effect of oxygen is to 
cause its increase. The increase is probably small, and it 
would doubtless be extremely difficult to demonstrate it con- 
clusively, under normal conditions of activity. Still it seems 
to me that the result of the following experiments could hardly 
be attributed to mere accident: 
Experiment XVIII.-August 12 to 24,1869.-Three observations were 
taken daily of the amount of carbonic acid exhaled by myself. In all, 
twenty observations were made, in seven days, nearly every hour of the 
day being represented. The average of these observations gave 17.2 cubic 
inches per minute. During the four following days, eleven similar observa- 
tions were made-the conditions remaining the same, except that from 
six to ten gallons of oxygen were inhaled each day in divided doses. The 
average of these gave 18.9 cubic inches, as the amount of carbonic acid ex- 
haled per minute. 
These results, while they coincide with the generally-re- 
ceived opinion as to increased activity in the retrograde met- 
amorphosis as resulting from the use of oxygen, show never- 
theless that the increase is confined within narrow limits, and 
thus confirm the view already expressed, that saturation of 
the blood-corpuscles with oxygen is quickly attained, is a 
strictly physiological condition, and in no way necessitates 
the setting up of any morbid action within the system. 
To test the effect of oxygen upon the amount of urea ex- 
creted, I made the following experiment: 24 
OXYGEN GAS AS A REMEDY IN DISEASE. 
Experiment XIX.-December 8 to 22, 1869.-The urine for each 
twenty-four hours was carefully preserved, and the amount of urea es- 
timated according to Haughton's second formula. The result is given in 
the following table : 
Date. 
GALLONS OF 
OXYGEN 
INHALED. 
UREA IN 
GRAINS. 
December 
8 
641 
44 
9 
8 
624 
44 
10 
8 
561 
44 
11 
10 
472 
44 
12 
6 
472 
44 
13 
6 
590 
44 
14 
12 
550 
44 
15 
14 
552 
44 
16 
18 
510 
44 
17 
542 
44 
18 
601 
44 
19 
546 
44 
20 
556 
44 
21 
:: 
495 | 
Thia table shows a rapid decrease in the amount of urea, 
during the first four days after beginning the inhalations of 
oxygen. It then increased again, but did not attain to the 
former figure. With the cessation of the oxygen there is again 
an increase. The average of the days without oxygen is 563 
grains, of those with oxygen 541 grains. 
So far as these experiments go, they indicate that oxygen 
causes a decrease in the amount of urea formed. This is sur- 
prising, if we are to consider urea as the result of oxidation of 
tissue, as is generally held. More extended observation is 
required before it would be warrantable to call in question the 
views so ably enunciated upon this point; but, should it be 
established that the continued use of oxygen really diminishes 
the excretion of urea, it would place the latter substance in 
analogy with the smoke resulting from combustion, a product, 
it is true, of the combustion, but at the same time a measure 
of the incompleteness of the process. 
The quantity of uric acid in the urine is rapidly diminished 
by the daily use of oxygen. This fact, suspected by Dr. 
Golden March 10, 1866), has been fully established 
by Kollmann, of Munich. OXYGEN GAS AS A REMEDY IN DISEASE. 
25 
In the course of the experiments described above, I observed 
a very striking diminution of the coloring matter of the urine. 
At the commencement of the experiment the urine was very 
high-colored, but within twenty-four hours it became very 
pale, and remained so for several days after the oxygen was 
discontinued. This paleness was not owing to an excess of 
water, as the specific gravity never fell below 1.022, and was 
usually above 1.025. 
CHAPTER IV. 
THE USE OF OXYGEN IN DISEASES INVOLVING DEFECTIVE RESPI- 
RATION. 
The diseases to which the use of oxygen is applicable fall 
naturally into twro classes : those in which respiration is more 
or less at fault, and which are for the most part acute; and 
those in which there is defective nutrition, or excretion, and 
which are chiefly chronic. 
In general terms it may be asserted that any disease which 
gives rise to dyspnoea will be benefited, at least temporarily, 
by the use of oxygen, in so far as the dyspnoea is concerned. 
The manner in which this is effected is sufficiently obvious. 
The essence of dyspnoea consisting in a disproportion between 
the quantity of venous blood brought to the lungs and the 
amount of oxygen which finds access to the air-cells, it is plain 
that, by causing the patient to breathe an atmosphere contain- 
ing more than the usual proportion of oxygen, the dyspnoea 
may be pro tanto relieved. 
This is wrell illustrated by the following experiment: 
Experiment XX.-January 15, 1860.-Tracheotomy was performed 
on a rabbit, and a tube provided with a stop-cock was tied in tlie trachea 
in such a way that no air could enter the lungs except through the tube. 
The stop-cock was now turned until symptoms of suffocation were pro- 
duced; the eyes protruded, the pupils dilated, and the whole body was 
convulsed. The free end of the tube was then brought into a stream 
of oxygen, when the symptoms were at once relieved, and, though the 
breathing was labored, there were no signs of actual distress. 
Asthma.-Probably there is no other disease affecting the 
respiratory organs which so immediately suggests the use of 
oxygen as does asthma. The dyspnoea is often very severe, 26 
OXYGEN GAS AS A REMEDY IN DISEASE. 
and the indications of imperfect aeration of the blood very 
apparent. Every movement, every gesture of the patient, is 
a plea for more air. It is not remarkable, therefore, that this 
should have been one of the first diseases in which oxygen 
was applied. Beddoes employed it in twenty-two cases, ten 
of which were cured, nine relieved, and three did not receive 
benefit. 
Demarquay describes two cases, one of which was defini- 
tively cured, the other greatly relieved. Birch reports a case 
of absolute cure. 
Dr. Howard Pinkney, of New York, administered it re- 
cently in one case with the effect of relieving the paroxysms, 
and of reducing most decidedly their frequency. 
Dr. Beigel, of London, reports three cases, two of them 
hereditary, in which oxygen was used conjointly with inhala- 
tions of liq. potas. arsen. The oxygen in each case relieved 
the paroxysms, and apparently contributed to remove the ten- 
dency. At all events, the paroxysms became less and less se- 
vere, and occurred at longer intervals, and finally ceased alto- 
gether. 
The case of the late Secretary Stanton presents an in- 
stance in which oxygen was the means of averting a great 
deal of suffering. He was subject to severe paroxysms of 
asthma, which, during his last illness, constituted a serious 
aggravation of his condition. His medical attendant, Sur- 
geon-General Barnes, of the United States Army, procured 
from New York a supply of compressed oxygen, of which 
from three to four cubic feet were inhaled daily. It con- 
trolled the paroxysms completely, and, so far as the asthma 
was concerned, met every indication. In a recent conversa- 
tion with me, General Barnes expressed himself warmly in 
favor of the gas in similar cases, and stated that both he and 
his illustrious patient were entirely satisfied with its effects. 
I have myself administered oxygen in two cases during the 
paroxysm, with the effect of causing almost instant relief; but, 
as it was not continued during the intervals, no permanent 
benefit was experienced. 
It will be observed that three of the cases reported by 
Beddoes received no benefit whatever. I have, also, had a 27 
OXYGEN GAS AS A REMEDY IN DISEASE. 
similar experience. A clergyman, subject for many years to 
infrequent but prolonged attacks of asthma, which had com- 
pletely baffled all previous treatment, was seen by me at the 
onset of a paroxysm. The respiratory movements were very 
rapid and extremely energetic, and the dyspnoea considerable. 
Still there was no evidence whatever of imperfect aeration of 
the blood. The countenance was flushed, but not in the 
slightest degree dusky. Oxygen was administered very free- 
ly, about four gallons every half hour, but with no apprecia- 
ble relief to the dyspnoea. 
Pulmonary Emphysema.-Dr. Beigel reports a case in 
which the shortness of breath was so great as to prevent the 
patient walking more than a few steps at a time. By inhala- 
tions of oxygen, one gallon every three hours, a prompt ame- 
lioration was brought about, and at the end of six weeks the 
distressing symptoms had nearly disappeared. During this 
time there was no other treatment than inhalations once or 
twice a day of solution of common salt, two gr. to the oz. for 
twelve days, after which " pulverized," pure water was substi- 
tuted. Subsequent to this time a solution of tannin and 
morphia was used in connection with the oxygen, and in less 
than two months from the commencement of the treatment 
the patient was able to return to his business, though he could 
not dispense with the oxygen for more than a few days at a 
time without a return of dyspnoea. 
Two months later the unnatural prominence of one side of 
the chest, which previously existed, had sensibly diminished, 
the area of tympanitic sounds was much decreased, and the 
amount of respiration had increased from 2.150 to 3.200 cubic 
centimetres.-Beigel on Inhalations, p. 143. 
In this case it is evident that something more was accom- 
plished than mere present relief of the dyspnoea. A radical 
improvement in the disease itself was effected. This was per- 
haps due to the diminished force of the respiratory move- 
ments, and the consequent lessening of the strain upon the 
delicate tissues of the air-cells, resulting from the relief to the 
dyspnoea. 
A case is reported by Dr. A. II. Smith in the May num- 
ber of New York Helical Journal, 1869, in which the 28 
OXYGEN GAS AS A REMEDY IN DISEASE. 
gas was given, but only for a short time. The dyspnoea was 
greatly relieved, the countenance lost its livid hue, the pulse 
fell from 122 to 100, and the respiration from 36 to 20. 
The relief continued but a short time after the oxygen was 
discontinued, but was again experienced when its use was re- 
sumed. 
Croup.-Dr. Beigel describes a severe case of croup, in 
which the usual modes of treatment had been exhausted with- 
out avail, the respiration being 40 per minute and noisy, the 
pulse too frequent to be counted, lips livid, and face pale and 
agitated by convulsive movements. The inhalation of one 
cubic foot of oxygen was followed by decided improvement, 
and in the course of two or three hours the child fell asleep, 
awakening convalescent, and making a prompt recovery.- 
Beigel on Inhalations, p. 105. 
Dr. Miquel reports a case with symptoms identical with 
those above mentioned, which was immediately relieved by 
the use of oxygen, and ultimately recovered.-Half- Yearly 
Compendium, January, 1869. 
I have been called in to give oxygen in several cases of 
croup, but always in the last stages, when the long-continued 
dyspnoea had led to mechanical engorgement of the lungs, 
and to poisoning of the nerve-centres by the circulation of un- 
aerated blood. Under these circumstances, although I have 
been able to relieve the dyspnoea in a measure, still death has 
been the result. The termination in such cases is the same 
when the trachea is opened, even if the respiration is thereby 
made easy. 
It is my firm conviction that oxygen will do in croup all 
that can be done by tracheotomy, but neither the one nor 
the other is competent to undo the mischief wrought by severe 
and protracted dyspnoea. Hence the practical rule in the use 
of oxygen is the same as that in the use of the knife-use it 
early. There is nothing painful, nothing horrible, nothing 
dangerous about it. Why, then, should it be resorted to only 
at the last moment, as if it were a more desperate remedy 
even than tracheotomy ? 
Diphtheria.-Dr. Beigel gives the history of two cases in 
which oxygen was used in connection with inhalations of va- 29 
OXYGEN GAS AS A REMEDY IN DISEASE. 
rious atomized solutions. In the first case, that of a child six 
years old, a single administration of the gas roused the patient 
from a state of coma; the eyes, before dull, became brighter, 
and the pulse rose from 60 to 75. After five inhalations the 
tendency to coma disappeared entirely, the countenance as- 
sumed a ruddy color, and the appetite returned. The quan- 
tity used at each inhalation was one gallon. 
In the second case the benefit was also immediate and de- 
cided.-Beigel on Inhalations, p. 114. 
I have given oxygen in but one case of diphtheria, to which 
I was called, in accordance with my usual experience, only 
when the child was in articulo mortis. For four hours life 
was sustained by the gas, which could not be withheld for 
more than a few minutes at a time without producing suffoca- 
tion. At the end of that time the parents were informed that 
the case was hopeless, and it was left for them to continue the 
gas as long as they saw fit, a supply being prepared before- 
hand. The inhalation -was continued an hour longer, and 
then abandoned. Death took place within five minutes after 
the gas was withheld. 
In this disease, in addition to the impediment to respira- 
tion, we have to contend with a septic condition of the blood, 
tending greatly to depress the powers of life. I believe, with 
Dr. Beigel, that this latter condition may be prevented or 
remedied more surely by inhalations of oxygen than by any 
other resource we possess, while, at the same time, the danger 
of death by apnoea is obviated. 
For the removal of the local affection the usual remedies 
may be simultaneously applied. 
Pneumonia.-Dr. Golden reports in the Lancet, for March 
10, 1866, a case of double pneumonia accompanied by great 
dyspnoea, which resolved in four days under the use of oxy- 
gen. 
I have seen a case in which a circumscribed pleuro-pneu- 
monia, occurring in the course of chronic pyaemia, was ap- 
parently aborted within thirty-six hours by the use of the gas. 
Although the existence of acute inflammation, as a rule, 
precludes the use of oxygen, yet, when respiration is seriously 
interfered with, the danger from this source outweighs all risk 30 
OXYGEN GAS AS A REMEDY IN DISEASE. 
from any possible increase of the inflammation which the use 
of oxygen may occasion. In a case of double pneumonia, 
therefore, I should not hesitate to employ it, nor shoidd I 
allow any case of this disease, which appeared to be tending 
toward a fatal termination, to proceed without a trial of its 
effect. The fear formerly entertained, that oxygen would ex- 
cite pneumonitis by its local action, is refuted by its entire 
history as a remedy. Especially in the typhoid form of pneu- 
monia, I should expect great benefit from the gas. 
Dr. Butler, of New York, reports, in the November number 
of the New York Medical Journal, a very interesting case of 
chronic pneumonia, in which the deposit was rapidly absorbed 
under the use of oxygen. 
Capillary Bronchitis.-In this affection oxygen is of great 
value, not only in relieving the dyspnoea, but also in dimin- 
ishing the formation of mucus in the lungs, which latter is in 
a great measure the mechanical result of excessive inspiratory 
effort. For, whenever the inspiratory effort is in excess of the 
capacity of the air-passages to supply the necessary air, the 
atmospheric pressure within the chest is necessarily dimin- 
ished, and turgescence of the blood-vessels of the lungs follows, 
as certainly as hyperaemia of the skin follows the application 
of a cupping-glass. Inhalations of oxygen, by satisfying the 
besoin de respirer, remove the necessity for the employment 
of excessive inspiratory force, and in this way lessen the con- 
gestion of the mucous membrane, and diminish the tendency 
to effusion. Hence it is not only palliative but curative. 
This is admirably illustrated in a case reported by Dr. A. 
II. Smith, in the Medical Record for June 15, 1869. 
The patient, a child, two and half years old, was at the 
point of death from bronchitis, intercurrent with measles. 
The respiration was 80, and accompanied by mucous rales 
audible at some distance from the bed, pulse too frequent to 
be counted; face pale and dusky, extremities cool. Within 
one hour after the continuous administration of the gas was 
resorted to, the pulse had fallen to about 160, and the respira- 
tion to 40. Within another hour the face had regained its 
color, and the rales were no longer audible, unless the ear were 
applied to the chest. The inhalation was continued without OXYGEN GAS AS A REMEDY IN DISEASE. 
31 
interruption for three hours, and irregularly for five hours 
longer, when it was wholly discontinued. The following day 
convalescence was fully established. 
Dyspnoea f rom Cardiac Disease.-I have administered 
oxygen in two cases of dyspnoea from valvular disease. In 
the first case the patient was speechless, could scarcely be 
aroused; face livid, no pulse at the wrist, whole surface cold, 
respiration 40, and extremely labored, pupils widely dilated 
and fixed. Within fifteen minutes after the administration of 
the gas was begun, the pulse became perceptible at the wrist, 
the breathing was easier, intelligence began to return, and 
waking from his lethargy he complained of cold, and re- 
quested more covering. At the end of an hour, the surface 
was warm and slightly moist, face almost natural in color, lips 
still blue, pupils almost normal in size and reacting to light. 
He answered questions intelligently, and swallowed without 
difficulty. Respiration 25, quite easy. Pulse 120, and of 
moderate strength, though small. Patient remained quite 
comfortable for about ten hours, when a sudden paroxysm of 
dyspnoea proved almost immediately fatal. Attempts were 
made to give the oxygen, but the extreme jactitation rendered 
it impossible to do so efficiently. 
In the second case the dyspnoea was less severe, but the 
paroxysms were very much relieved, and often entirely averted, 
by the use of the gas. 
Dr. Const. Paul reports {Bui. Gen. de Therap., tome Ixxv.) 
a case of dyspnoea (cause not stated), which was relieved by 
inhalation of oxygen, after the radial pulse had ceased. 
Poisoning with Opium.-The effect of opium in reducing 
the frequency of respiration indicates that the sensibility is so 
blunted that the blood requires to become unnaturally charged 
with carbon before the besoin de respirer will excite to the act 
of respiration. Hence the blueness of the face, and the gen- 
erally asphyxiated appearance. We should suppose a priori 
that oxygen would be useful in such cases, and such has been 
found to be the fact. M. C. Paul mentions a case in which 
the gas was used successfully after atropia had failed, and 
when the patient appeared to be dying. The respiration had 
fallen to 7, the pulse was very rapid and hardly perceptible, 32 
OXYGEN GAS AS A REMEDY IN DISEASE. 
and there was mucous rattling in the throat.-Bui. Gen. de 
Therap., tome Ixxv. 
Poisoning with, Charcoal Gas.-M. Paul has been success- 
ful in a case in which the face was livid, the surface cold, the 
pulse very small, and the dyspnoea decided. In such a case 
the action of the gas is probably due chiefly to its superior dis- 
placing power for carbonic acid, in comparison with common 
air. 
Poisoning with Chloroform.-Duroy and Ozanam show, 
by a number of experiments, that the effect of oxygen is an- 
tagonistic to that of chloroform, and they propose that it be 
used as an antidote. 
Birch, on the other hand, asserts that it renders the anaes- 
thesia deeper. 
Cholera.-In view of the lividity of the skin, indicating 
imperfect aeration of the blood during the stage of collapse in 
cholera, and of the depression of temperature, showing de- 
crease of molecular action, it was natural to hope that inhala- 
tions of oxygen would be beneficial, and several physicians 
have made trial of its use. There is a wide difference of opin- 
ion among observers as to the value of the remedy. M. De 
Smyttere (Comptes Bendus, October, 1848) speaks of it in 
the highest terms. He employed it in the epidemic of 1832, 
in the algid stage with " full success." He says: " A new 
animation and a salutary reaction follow promptly the em- 
ployment of this means, which is entirely rational, and of 
which no one, so far as I know, has yet thought. I regard the 
inhalation of oxygen gas during the period of cold and pros- 
tration so dangerous in the choleraic attack, and when the in- 
testinal and cutaneous functions are profoundly perverted, as 
the remedy the most prompt and the most efficacious of those 
employed up to the present time." 
Macrae, in India (1850), and Harvey, in London (1853), 
also report favorable cases. 
On the other hand, in the debate in the Academy, upon 
the paper of De Smyttere, cited above. M. Hutin stated that 
he had employed oxygen in numerous cases in 1835, in Africa, 
without a single case of success. 
M. Foy also stated that he had used it in Poland, in 1831, 
without any especial benefit. OXYGEN GAS AS A REMEDY IN DISEASE. 
33 
M. St. Ange had had a similar experience, but thought 
that the difference in the results obtained might be referable 
to difference in the period in the epidemic, in which the ob- 
servations had been made. 
CIIAPTER V. 
THE USE OF OXYGEN IN DISEASES INVOLVING DEFECTIVE NUTRI- 
TION. 
The benefit derived from the use of oxygen, in cases not 
primarily involving respiration, is to be explained on the prin- 
ciple that it aids defective nutrition. The replacement of old 
and effete matter by that which is new and active, is fully as 
much the work of respiration as of digestion. Without the 
oxygen derived from respiration, tissue change would be im- 
mediately checked. If the blood does not convey to the tissues 
the requisite supply of oxygen, the gastro-intestinal system 
may do its part, and the food may be absorbed, but there the 
process will be arrested. The material will be on the spot, 
but the structure will not be repaired. Nor is it enough to 
present the usual supply of oxygen to the blood in the lungs. 
The blood itself must be in a proper condition to receive it, or 
it cannot reach the tissues. The quality of the blood by which 
it takes up oxygen depends upon the exactness of its chemical 
constitution. A slight variation in this will affect its absorb- 
ing power. But a condition of the blood which prevents the 
absorption of sufficient oxygen from the diluted medium usu- 
ally respired, may allow its absorption from a medium in which 
a greater proportion of oxygen is contained. A deficient ab- 
sorbing power may be supplemented by an increased supply 
of the material to be absorbed. 
It is on this principle that even a very small quantity of 
artificial oxygen inhaled each day is capable of producing such 
decided results in cases appropriate for its use. The deficiency 
of oxygen in the blood and in the tissues has been very gradu- 
ally produced, and, once restored, considerable time will be re- 
quired before the previous condition will again be reached, 
even if the cause by which it was produced continues operative. 
Thus, by daily inhalations, the normal condition may be, in a 
3 34 
OXYGEN GAS AS A REMEDY IN DISEASE. 
measure, restored and maintained until Nature is enabled to 
resume her sway. 
But there is one form of disease -which at the same time 
depraves the blood and interferes with the function of the 
lungs, thus striking a double blow at the function of hsemato- 
sis. It may therefore be appropriately considered first, as in- 
termediate between those cases in which respiration is prin- 
cipally involved and those in which nutrition is chiefly at fault. 
Phthisis.-Among chronic diseases, pulmonary phthisis 
was the one which offered from the first the most tempting 
field for the use of oxygen. It -was natural to expect that the 
profound dyscrasia which lay at the root of the disease might 
be favorably modified by an agent bearing such intimate phys- 
iological relations to the normal blood. At the same time 
there was room to look for a double local action within the 
lungs. What might be the result of bringing an excess of free 
oxygen into direct relation with the tubercular matter in the 
pulmonary tissue, was a question not less interesting than 
what might result from the local action of the gas upon the ul- 
cerated surfaces with which it would come into contact. 
After the lapse of eighty years these problems still remain 
but partially solved. With regard to the effect of oxygen upon 
the system generally in phthisis, we have abundant evidence to 
show that, as a rule, in this disease, as in others in which nu- 
trition is defective, the use of the gas favors assimilation and 
results in a gain in weight. But whether it exerts an influ- 
ence upon the morbific principle which constitutes the essence 
of the disease, is a point which facts alone can determine, and 
up to the present time sufficient facts have not been gathered 
to warrant a decided answer. 
The observations of Hill, Thornton, and others, in the latter 
part of the past and the early portion of the present century, 
were made before the days of physical exploration of the chest, 
and their results are therefore of little real value. They report 
a number of cases very decidedly benefited, but we cannot be 
sure that they were instances of genuine phthisis. Since the 
time of Laennec, we have only isolated cases here and there, 
in which the gas -was given for a few -weeks, or at most two or 
three months, and generally without a very close study of the 35 
OXYGEN GAS AS A REMEDY IN DISEASE. 
physical signs. Still, among these cases there is considerable 
reliable evidence to show that oxygen may sometimes arrest 
the progress of this disease for a considerable period, and possi- 
bly eradicate it altogether. What is required, however, is 
that a large number of patients in some public hospital should 
be under careful observation for some time in order to ascertain 
their real condition and the progress the disease is making, and 
that the oxygen should then be administered several times a 
day, and the physical signs watched by ;> competent observer. 
Until this is done, neither the general effect upon the dyscrasia 
nor the local effect upon the lung can be satisfactorily appre- 
ciated. Theoretically there is much to encourage to such a 
trial. First, we have the fact that in phthisis the nutrition is 
faulty to a degree that has given the disease its name, and the 
correlative fact that oxygen promotes nutrition in a remarkable 
manner. Secondly, we know that an impure atmosphere pro- 
motes phthisis, and that persons whose occupation keeps them 
constantly in the open air rarely become phthisical. Thirdly, 
modern chemistry teaches us that oxidation is the first step in 
the metamorphosis of tissue which precedes its resorption, as it 
is the first step in the decay and disintegration of dead organic 
matter. It is reasonable, therefore, to suppose that the pres- 
ence of free oxygen in contact with tubercle would initiate a 
process of disintegration which would favor its absorption. 
How far the few clinical facts on record bear out this reasoning 
will be seen hereafter. 
Lastly, numerous experiments show that oxygen in con- 
tact with a wound or ulcer acts as a stimulant, promoting the 
formation of granulations, and, if carried too far, setting up ac- 
tive inflammation. We have in this fact at once a therapeu- 
tical indication, and also a possible solution of the want of 
success which has so often attended the use of oxygen in 
phthisis, especially in the advanced stages. As a solution of 
nitrate of silver of appropriate strength, applied with discrimina- 
tion, facilitates the healing of an external ulcer, so oxygen, prop- 
erly diluted and carefully employed, may have a healing effect 
upon ulcers of the lung. But as a strong caustic applied indis- 
criminately to external ulcers would often induce excessive ac- 
tion, so oxygen in excessive proportion may excite inflammatory 36 
OXYGEN GAS AS A REMEDY IN DISEASE. 
action in ulcers of tlie pulmonary tissue, which, reacting upon 
the general system, would produce fever and other symptoms 
apparently indicating an aggravation of the general disease. 
These considerations show how far we are from a knowledge 
of the possible usefulness of oxygen in this dread disease. The 
effects heretofore obtained have resulted from a hap-hazard 
use, such as in the case of any other remedy would have in- 
sured its total failure. Only when we learn to use it with the 
same discrimination and care that we exercise in the use of 
opium or strychnia, shall we know the limit of its power for 
good. The quantity and the mode of administration should 
be regulated by the actual condition of the lung. In the first 
stage when we may assume that the mucous surface is entire, 
the gas may be given with impunity diluted with two or three 
times its bulk of air, but even then the symptoms should be 
carefully watched, and especially the temperature, and any 
thing indicating the occurrence of local inflammation should 
be the signal for further dilution of the gas. There is no ne- 
cessity for adding to the inspired air more than three or four 
per cent, of oxygen in order to produce a decided effect upon 
nutrition by one or two inhalations daily of half an hour's du- 
ration each. An atmosphere of this kind could have no ap- 
preciable local effect even upon an ulcerated surface. 
When there is profuse purulent expectoration, or when the 
signs indicate the existence of cavities, the local effect of oxy- 
gen but little diluted might be cautiously tried. In such cases 
the expectoration will sometimes rapidly diminish. This is 
notably the case in chronic bronchitis, and it is probable that 
some of the favorable cases reported by early observers were 
instances of this disease rather than of phthisis. But there are 
cases on record in which oxygen has been for a time beneficial, 
but after a few weeks has produced the symptoms of local in- 
flammation. It is probable that the action in these cases was 
the same as that observed when ulcers on the surface have been 
exposed to the direct contact of oxygen. For a time the ulcer 
improves, the indolent character is lost, granulations spring up, 
and cicatrization commences. But soon the action becomes 
excessive, and inflammation results. By diminishing the ac- 
tion in time, this effect would be avoided and the benefit al- OXYGEN GAS AS A REMEDY IN DISEASE. 
37 
ready procured .would be retained. A like management in 
the cases of phthisis referred to would probably have obviated 
the difficulty experienced. 
The use of oxygen in phthisis need not exclude any of the 
usual remedies employed. On the contrary, such of them as 
undergo a process of digestion and assimilation, as, for example, 
cod-liver oil, would doubtless be more efficacious for being as- 
sociated with the gas. 
I have been able to collect the histories of a considerable 
number of cases of phthisis in which the use of oxygen was 
beneficial. I will mention the leading points of some of these, 
referring the reader to the original source for details, which 
would occupy too much space in this essay : 
Case I.-Reported by Demarquay (p. 733). X , aged thirty-two. 
Tubercles in both lungs; cavity in left of the size of an egg. Greatly ema- 
ciated, pale, anaemic, profuse expectoration, intense fever in the afternoon, 
diarrhoea. Tubercular epididymitis. March ls£.-To take four litres of oxy- 
gen in ten of air, daily. March 3(Z.-The cough is less frequent, expectoration 
less abundant; slept well. Increased the dose to twelve litres. Mh.-A 
little appetite, but little cough, no expectoration. 6<A.-Great appetite, 
sleeps well, physiognomy better. Sth.-Increased to fifteen litres. 107A. - 
Patient has been up and about for the last two days. Appetite so great 
that, after eating the dinner provided by the institution, he goes out and 
dines again in the city. Face has more color, cheeks filling out. Respira- 
tion easier. 16t7z.-Cavity still remains, but the surrounding tissue which 
was hepatized now performs its function. 19t^.-Able to take a long walk. 
26tA-Cough and expectoration have entirely disappeared. No gurgling 
as formerly, respiration still amphoric. 
April SQth.-Discharged in a very satisfactory condition. 
Case IT.-Demarquay (p. 736). Madame De B., aged twenty-seven. 
Tubercles in both lungs. Emaciation, frequent cough, profuse expectora- 
tion, almost no appetite, abundant night-sweats. The appetite improved 
and the strength increased, and, on the twenty-seventh day of the treatment 
by oxygen, patient was able to give a dinner-party and preside for two 
hours at the table. The menses, which had been absent for five months, 
returned. The cough and expectoration, though less, persisted during the 
summer and toward autumn; the use of the gas having been for some time 
suspended, a relapse took place, and death followed the ensuing February. 
It is to be remarked that in this case all other treatment 
was suspended from the moment the use of the oxygen began. 
Case III.-Reported by M. Monod (quoted by Demarquay, p. 739). 
M. C. B., aged twenty-six. For some years has had very abundant luemor- 38 
OXYGEN GAS AS A REMEDY IN DISEASE. 
rhages. Signs indicate a number of cavities and an abundant deposit of 
tubercle, especially in right lung. At the commencement of treatment was 
so feeble that he could only be moved from the bed to the sofa. Abundant 
muco-purulent expectoration, complete anorexia. Twelve litres of oxygen 
were given twice a day, and within a brief period he had so far improved 
that be was able to walk in the garden, and even to attend occasionally to 
business. For sixteen months the treatment has been continued, during 
which time there has been no return of haemorrhage, the expectoration is 
now insignificant, and the cough infrequent. The appetite is habitually 
good. Still the disease is making progress, the pulse is frequent, and 
the strength less than last year. But the oxygen has restrained the march 
of the disease, which last spring seemed to have arrived at its last stage. 
The improvement followed so immediately upon the administration of the 
gas that it could not be attributed to any other cause. 
Demarquay quotes, from notes furnished by M. Herve de 
Lavour, an account of that gentleman's experience with oxygen 
in phthisis which is particularly valuable, as he gives the un- 
favorable as well as the favorable results. He says : " I have 
had only nine patients who have been submitted to a some- 
what regular course of inhalations of oxygen. Among this 
number I have obtained three remarkable successes. The first 
was a phthisical case of old date, having enormous caverns at 
the summit of one lung, and who, at the time I prescribed the 
inhalations, had an abundant expectoration, fever in the after- 
noon, a frequent cough, and such a degree of dyspnoea as 
rendered the least movement fatiguing. Anorexia was com- 
plete. The inhalations of oxygen were prescribed at the dose 
of fifteen litres " (four gallons) " daily in two portions, mixed 
with about one-third of common air. Gradually the quantity of 
gas was raised to forty-five litres daily, taken pure in two doses. 
Under this influence the expectoration ceased, the appetite re- 
turned, and the patient began to convalesce. The gas was 
continued two months, when the dose was diminished gradu- 
ally and finally discontinued. For the last five months the 
patient has gained flesh, follows his usual occupations, and 
goes on as well as possible." 
Case IV.-In the case of the second patient there were crepitant rales 
in almost the entire extent of both lungs, with crackling at both apices, a 
frequent cough, an abundant expectoration, and a horrible dyspnoea, which 
compelled her to pass the greater part of her nights in her chair. 
" There was a consultation, and two of our most eminent practitioners OXYGEN GAS AS A REMEDY IN DISEASE. 
39 
gave the most unfavorable prognosis. The patient went on from bad to 
worse, and at last the appetite failed altogether. I prescribed inhalations 
of oxygen . . . and they were regularly employed for about a month. 
The dose of the gas was at first about fifteen litres mingled with air, then 
twenty, and at last forty-five litres were given without any mixture. Under 
this influence the amelioration was rapid, the dyspnoea disappeared, the 
appetite returned, and the patient is now as well as possible, attending to 
all his affairs, and saying that he has never been better." 
Case V.-The third case is a patient having tubercles at the summits 
of both lungs, and having besides hypertrophy of the heart, with violent 
palpitations, and a dyspnoea which would not allow the least exercise. He 
was submitted for a month to inhalations of oxygen, the cough diminished, 
the appetite, which was nil, returned, as did also the strength. At the end 
of three months the patient was able to take long walks without experien- 
cing either dyspnoea or fatigue. 
" In the case of the other patients the results were much less satisfac- 
tory. Three among them, having cavities, experienced a slight benefit; 
three others perceived no favorable effect whatever, without my being able 
to discover in the condition of the patients the difference in the results ob- 
tained." 
I have quoted these cases in full, on account of the clearness 
with which they are described and the candor with which the 
writer relates his want of success in the larger number of his 
cases. 
Birch relates two cases, in one of which " auscultation, per- 
cussion, and microscopical examination of the expectoration, 
confirmed the diagnosis as regards tubercular consolidation 
and central cavity. . . . From the very first dose of oxygen a 
diminution in the sensations of irritation and weakness of the 
chest could be felt by the patient; within a month marked 
improvement evidenced itself both in the lung and general 
health, and at the termination of four or five months' steady 
treatment . . . the flattening " (of the chest) " had given 
w'ay to almost perfect symmetrys . . . The following winter 
there was still some pain and sensitiveness to the impression 
of damp and cold air, but otherwise, with a little extra pru- 
dence, she enjoyed herself like others. Two years after the 
commencement of the oxygen she was quite well, married, and 
has ever since enjoyed good health." (Written eight years 
after.)-Birch on Oxygen, p. 121. 
In the second case the upper third of the right lung was 
full of small cavities, and soon broke up into a large cavity, 40 
OXYGEN GAS AS A EEMEDY IN DISEASE. 
which, under the influence of oxygen, afterward contracted, 
causing considerable depression of the wall of the chest. Treat- 
ment was continued intermittingly for a year. Patient quite 
well six years after (p. 123). 
During February and March, 1869, a series of experiments 
were tried at the New York Hospital, on the effect of oxygen 
in phthisis. Ten men, having phthisis in various stages, were 
placed in a ward together, and inhaled each about three gal- 
lons of oxygen morning and evening. This was continued for 
about four weeks, when it was found that six had gained in 
the aggregate forty-nine and a half pounds, while the remain- 
ing four had lost seven pounds. 
In several of the cases there was a rise in the temperature 
after the first three or four days, and the gas was discontinued 
for a short time and again resumed, after which the tempera- 
ture remained as before the administration. A transcript from 
the hospital records will be found in the the New York. Nodi- 
cal Journal for September, 1869, and is worthy of attentive 
perusal. While the most prominent fact is the increase in 
weight, yet in several of the cases there was a very marked 
improvement in other respects, and that, too, when the patient 
had been growing worse up to the moment of beginning the 
inhalations. 
In those cases in which the gas seemed to disagree with the 
patient it is probable that the result would have been different 
if it had been given more diluted. 
The figures in Case V. are very remarkable. " February 
15th, weight 127 lbs.; March 5th, 12P|- lbs.; March 10th, in- 
halation resumed, weight 123 lbs.; March 16th, 126 lbs." This 
is one of the cases in which oxygen at first disagreed. 
The Practitioner for May, 1869, contains an article on the 
Inhalation of Oxygen, by Edward Mackey, Professor of Ma- 
teria Medica and Therapeutics, Queen's College, Birmingham. 
Among other cases are mentioned three of phthisis, all benefited 
by the use of the gas. All gained in weight, one of them two 
stone. In two of these cases the disease remained arrested, 
the third died of pleuritis. 
The following cases are from my own notes: Mrs. S., aged 
twenty-eight, was sent to me by a physician in this city, with OXYGEN GAS AS A REMEDY IN DISEASE. 
41 
the request that I would try the effect of inhalations of oxygen. 
She had had a distressing cough for three months, expectora- 
tion profuse, slight dulness, and tubular breathing at the sum- 
mit of both lungs, extremely pale and anaemic, utter disgust for 
food, menstruation had been growing more and more scanty 
for some months past, and the last two periods had failed 
entirely. Three weeks before began the use of iron, but was 
obliged to abandon it as it disagreed with the stomach and 
caused headache. Six hundred cubic inches of oxygen were in- 
haled every morning mixed with about four times its bulk of air. 
For the first week little if any benefit was experienced, after 
that the appetite began to improve. On the tenth day of the 
treatment the menses returned and were more abundant and 
of a better color than for many months previous. The appe- 
tite now became very great, the patient declaring that, when re- 
turning from the office, she could scarcely wait to reach home, 
so great was the desire for food. Iron was now borne without 
difficulty, but after two or three weeks she found that she could 
not take iron and the oxygen the same day without headache, 
but could bear either separately. At this time the cough im- 
proved rapidly. A simple expectorant mixture had been 
ordered, but was taken very irregularly. In six weeks from the 
beginning of the treatment the cough had ceased entirely, the 
patient had gained flesh and strength and considered herself 
quite well. The treatment was then discontinued. Five 
months later she called at ifly office and reported that since I 
last saw her she had gained seven pounds, the menstruation 
had continued regular, and that, in short, she had never been 
better in her life. Respiration normal at the summit of both 
lungs. 
Mrs. W., aged forty. Had been phthisical for eight years, 
having frequent haemorrhages, and being very mnch reduced 
in flesh and strength. The summer of 1858 was spent out of 
town, she being unable to bear the air of the city. While in 
the country she had a succession of haemorrhages which left 
little prospect of even a temporary rally. She improved some- 
what, however, and returned to the city, where she passed the 
winter in a state of extreme feebleness. With the approach 
of warm weather she prepared to go again into the country, 42 
OXYGEN GAS AS A REMEDY IN DISEASE. 
but before doing so decided to try the effect of oxygen, hoping 
it would take the place of a removal out of town. According- 
ly, she inhaled twice a day about four gallons of the gas, and 
found her strength and appetite so much improved that the 
change to the country was abandoned. During the summer 
two very slight haemorrhages occurred, but her health in the 
main was infinitely better than the preceding year, notwith- 
standing the disadvantage of remaining in the city. She has 
continued the use of the gas, with occasional intermissions, up 
to the present time. She cannot omit it for more than a week 
without being sensible of a retrogression. Unfortunately, the 
physical signs were not noted at the beginning of the treat- 
ment, so that we can have no definite measure of her improve- 
ment. But the fact remains that the summer, which has al- 
ways been the most trying season for her, has been passed with 
great comfort. That this was due to oxygen is shown by the 
effect of occasionally omitting its use. 
On the 7th of December, 1869, I administered oxygen to 
Miss H., a patient of Dr. Frauenstein, of New York, aged 
about twenty-five. She was then extremely emaciated, had a 
distressing cough, and presented, as the doctor informed me, 
all the signs of pulmonary phthisis. After the first visit she 
continued the use of the gas under the direction of Dr. F. 
The 3d of January I received a note from the doctor, stating 
that the area of dulness in the lung was becoming less, and 
that although the cough continued she was gaining flesh. He 
wrote: She coughs and grows fat. Three days later she called 
at my office. The change in her appearance was marvellous. 
Her previously hollow cheeks had become round and full, and 
her whole person seemed to have expanded. It was like the 
change that one sees after recovery from a continued fever. 
Certainly up to this time nothing could be more gratifying 
than the progress of this case. 
In several other instances I have administered the gas to 
phthisical patients with considerable benefit, the cough being 
lessened and the sleep improved, but circumstances have pre- 
vented continuing long enough to give decided results. 
In other cases, there being no immediate benefit, the pa- OXYGEN GAS AS A REMEDY IN DISEASE. 
43 
tients have become discouraged, and abandoned the treatment 
without giving it a sufficient trial. 
It appears to me that, in the cases which have been men- 
tioned, and which are far from embracing all which have been 
more or less successful, there is much to encourage the systematic 
use of oxygen in phthisis. Indeed, considering the extremely 
limited number of cases in which it has been thoroughly tried, 
and our ignorance as yet of its proper management, the results 
may well challenge comparison with those from any other 
mode of treatment. While not prepared to indorse the 
opinion of Birch that with the use of oxygen the cure of con- 
sumption in its earlier stages should be the rule rather than 
the exception, I have no hesitation in saying that I have more 
confidence in it than in any and all other remedies. 
Even when it can do no more, it may procure a priceless 
boon-euthanasia. Often, even after the presence of the 
shadowy visitor is felt in the sick-chamber, reluctant life main- 
tains a desperate struggle with its adversary, and the gasping 
sufferer lies for hours pleading for his release, the livid lips, the 
dilated pupil, and the convulsive breathing, bearing witness to 
his agony. In such a case the relief afforded by oxygen is be- 
yond all price, as by it the horrible death by suffocation is ex- 
changed for the peaceful falling asleep of exhausted Nature. 
(See AW York Yedical Journal, May, 1869, p. 149.) 
Anaemia.-From what has been already said, it will be 
seen that oxygen is admirably adapted to this affection. I 
might select numerous examples to illustrate its effect, but will 
confine myself to two from my own notes. 
Mr. S., aged seventeen, upward of six feet high, has grown 
very rapidly in the last two years. Eighteen months ago he 
was attacked with malignant pustule affecting the cheek. He 
convalesced from this very slowly, and was still feeble when 
he was seized with articular rheumatism, from which he suf- 
fered nearly the whole of last winter. After all inflammatory 
symptoms had passed, the least effort would bring on excessive 
pain in the joints, so that he lay for weeks in an almost help- 
less condition. At last he became able to walk a short dis- 
tance with the aid of a cane, but still suffered greatly from 
pain and stiffness in the right hip. 44 
OXYGEN GAS AS A REMEDY IN DISEASE. 
In this condition he first came under my care. Tie was 
pale and anaemic, pulse 108, and so feeble that it would be lost 
every few seconds, and the counting have to be begun anew. 
His appetite was good and had been so during his whole sick- 
ness. Tongue clean, bowels regular. Had been taking iron and 
other tonics for a long time with no benefit. He began on the 
27th of September to inhale four gallons of oxygen each morn- 
ing. For the first two .weeks the pulse fluctuated between 104 
and 120, but by the third or fourth day it had gained decid- 
edly in strength, and could be counted without trouble. His 
strength improved rapidly; he laid aside his stick, and was 
able to walk a number of blocks without fatigue. By the 25th 
of October his pulse had fallen to 84, and was of good volume 
and strength. The gas was then discontinued. He has now 
resumed his business of insurance broker, which he conducts 
with a great deal of energy. 
Wilhelm N., aged twenty-eight, had been becoming more 
and more feeble and bloodless for four months, probably ow- 
ing to the effects of syphilis, from which he had suffered se- 
verely, although there was no longer any external manifesta- 
tion of the disease. Had been under the care of a physician 
who gave him quinine and iron, which had benefited him 
slightly, but, as he was not progressing satisfactorily, he brought 
him to me for a course of oxygen. I first saw him on the 23d 
of November. He was then very anaemic, conjunctivae and 
nails white, hands cold, pulse 96 and very feeble, no cardiac 
souffle. Has an absolute disgust for food, and is very rest- 
less in his sleep. 
Gave him at once four gallons of oxygen, the inhaling of 
which occupied about ten minutes. To continue the use of 
tinct. ferri chlor. The following day the pulse had fallen four 
beats, and there was a little appetite. 2574.-A further de- 
cline of four beats in the pulse, appetite improving. 26^.- 
Pulse 84; appetite quite good ; complains of constipation and 
headache; ordered ext. senna fl. 27M.-Pulse 96; bowels 
moved freely, but headache still continues. 28^A.-Pulse 80; 
headache no better. To omit the iron. 29/A.-Pulse 76; head 
still painful; ordered potas. bromide gr. x ter die. 30^.- 
Head somewhat better; pulse 84; appetite very good; nails 45 
OXYGEN GAS AS A REMEDY IN DISEASE. 
pink; conjunctivae still pale, but not so much so as at first. 
December l«s£.-Head much better; strength greatly improved. 
2/7.-No more headache; has an excellent appetite. From 
this time he steadily improved. 
Dyspepsia.-In this disease oxygen has succeeded when 
all other means failed. Its most unqualified commendation 
is by Trousseau, whose knowledge of the resources of thera- 
peutics has rarely, if ever, been surpassed. He speaks of hav- 
ing by its means, in several instances, " recalled to life women 
regarded as lost," from great depression of the digestive pow- 
ers consequent upon puerperal haemorrhage or excessive lacta- 
tion. He cites, as an example, the case of a girl twenty-two 
years of age recently delivered and exhausted with nursing. 
Her features were " absolutely those of a cadaver." She was 
admitted into the hospital April 1, 1864. The treatment be- 
gan by weaning the child, but for fourteen days there was no 
improvement. She had continuous fever, pulse 120 to 130, 
skin hot and dry, and constantly-increasing debility. The de- 
bility became so great that she could not sit up in bed without 
fainting, and auscultation was rendered almost impossible. It 
was ascertained, however, that there were no tubercles. Ton- 
ics and iron were tried, but failed completely; the anorexia 
remained absolute. On the 14th of April, she began inhaling 
oxygen; very little was given her the first three days; the first 
attempt to inhale caused syncope. Still by the 19th she was 
able to sit up in bed with ease and to eat a little. Pulse 104. 
The 19th, she sat up for an hour, and asked for food. Pulse 
92, skin cool. The 24th, the pulse fell to 80; the patient went 
down into the garden, described her appetite as voracious. 
April 30th, the pulse was 72 to 80, and had been so for the last 
four days. The patient desired to leave the hospital. But 
she was still pale, " the living fibre having regained its tonicity 
sooner than the blood its normal constitution."-Clinique 
Medicale de VHotel Diev,, tome iii., p. 64. 
Demarquay also relates similar cases in which the oxygen 
gave very prompt and decided relief. 
Birch insists strongly on the power of oxygen to remove 
congestions of the liver, and to relieve the dyspeptic symptoms 46 
OXYGEN GAS AS A REMEDY IN DISEASE. 
consequent upon them. He cites a number of cases which 
sustain his views. 
With regard to the possible effect of oxygen upon chronic 
disease of the liver, an observation of Hanfield Jones is very 
significant. In an article on the "Function and Diseases of 
the Liver," he says: " The oily contents of the hepatic cells 
are subject to great variation, both in individuals and in dif- 
ferent classes of animals; the less perfect the type of the respi- 
ratory process, the greater the quantity of oily matter in the 
hepatic cells." 1 This statement suggests the inquiry how far 
fatty liver may be owing to defective hsematosis. May it not 
be that the confinement which produces the foie gras so deli- 
cious to the epicure acts by preventing the reception of a due 
proportion of oxygen into the blood. Surely the " type of the 
respiratory process " under such conditions must be any thing 
but perfect. In the human subject, sedentary habits or im- 
proper alimentation may act to diminish the capacity of the 
blood to carry oxygen, and thus a condition of the respiratory 
process be produced approximating to the type of those classes 
of animals in which the hepatic cells are normally loaded with 
fat. Accepting this hypothesis, the systematic use of oxygen 
ought to be beneficial in such cases. 
Diabetes.-Several cases are recorded in which inhalations 
of oxygen have caused a temporary disappearance of the sugar 
in the urine of diabetes, and with it relief from the general 
symptoms of the disease. Dr. Pinkney, of New York, in- 
forms me that he has met with two such cases. Peroxide of 
hydrogen has been given with the expectation that the sec- 
ond atom of oxygen would be liberated in the system, and re- 
sult in the more perfect combustion of the sugar. Dr. Rich- 
ardson has recently employed it in eleven cases, and gives it 
as his opinion that it is of no value.-Medical Times and 
Gazette, December 12, 1868. 
Mr. Byfield, on the contrary, reports {British Medical 
Journal, October 17, 1868) a case cured (f) in ten weeks. 
Demarquay, referring to the effect upon diabetes of a resi- 
dence in the dense atmosphere of the sea-shore, attributes it 
to the greater quantity of oxygen inhaled, and adds: 
1 Braith., January, 1853. OXYGEN GAS AS A REMEDY IN DISEASE. 
47 
" Iii support of these facts I may cite the results which I 
have obtained with inhalations of oxygen in the case of several 
diabetics, without changing their regimen in the least. I have 
seen the quantity of sugar in the urine diminish in a notable 
manner. The figure may descend in a few days to one-half 
of that usually observed, at the same time that the strength is 
seen to revive. M. Berenger-Ferand, a very distinguished 
young naval surgeon, as also Dr. Yvan, who have both ap- 
plied, at my instance, inhalations of oxygen to the treatment 
of diabetes, have modified advantageously the condition of 
their patients. Without doubt, we have only acted upqn the 
symptoms of the disease; but, in the present state of science, 
what other treatment can we apply to diabetes, since science 
has not determined either the nature or the real cause of the 
disease ? "1 
Albuminuria.-In some cases of this disease the albumen 
in the urine may greatly diminish, or, for a time, disappear 
entirely under the use of oxygen. I have seen two cases of 
this kind. The amendment, however, was but temporary. 
M. Const. Paul reports a similar case.-Half-Yearly Com- 
pendium, January, 1869. 
The frequent occurrence of albuminuria, in pneumonia 
and other diseases or conditions involving the respiratory 
function, is a suggestive circumstance in this connection. 
Rheumatism and Gout.-But little is known as yet of the 
effect of oxygen in these diseases. Dr. Golden {Lancet, March 
10, 1866), observing that the lithic-acid diathesis appeared 
more decided in cases in which respiration was imperfectly 
performed, was led to try the effect of oxygen in gout. The 
result was very satisfactory. Since then Kollmann, an apothe- 
cary of Munich, has experimented as to the effect of the in- 
halation of oxygen upon the quantity of uric acid excreted. 
He found that it produced an immediate diminution, and 
that, after continuing it a few days, the uric acid entirely dis- 
appeared from the urine. The treatment certainly deserves a 
trial in these diseases. 
Uraemia.-I have not been able to find an instance record- 
ed in which oxygen has been employed in this disease, but it 
1 Essai de Pneumatologie Aledicale, p. 709. 48 
OXYGEN GAS AS A REMEDY IN DISEASE. 
appears to me to offer a chance of benefit. If, as I suspect 
from experiments already detailed, oxygen has the effect of 
diminishing the quantity of urea formed, it certainly should be 
useful in this affection.1 
Headache.-La Passe (Essai sur la Conservation de la 
Vie) states that he cured himself of " atroces migraines " by 
frequent inhalations of oxygen. 
Hill cites one case, neuralgic pain in face, which had re- 
sisted every form of treatment, and which yielded promptly 
to oxygen. 
Demakquay.-Case of "migraine" complicated with neu- 
ralgic pains recurring in daily paroxysms, entirely cured by 
oxygen. 
Birch.-Case of " nervo-congestive headache," of long 
standing, perfectly cured; another case in a lawyer, from over- 
work of the brain, relieved while taking the first inhalation. 
A third, connected with uterine derangement, and occurring 
periodically, entirely cured. 
Dr. Mackey, Professor of Materia Medica and Therapeu- 
tics, Queen's College, Birmingham.-Three cases of headache, 
one from chlorosis, one from bilious attacks, and one from de- 
pression from over-use of brain and from mental anxiety-all 
permanently relieved, the headache ceasing each time during 
the inhalation of the gas.-{Practitioner, May, 1869.) These 
are three out of ten cases of various diseases relieved by oxy- 
gen. He considers that these ten cases had this in common, 
that there was venous congestion in some organ or other. 
Speaking of neuralgia in general, Demarquay says: " The 
blood is the regulator of the nervous system. According to 
this idea, it would be right to endeavor to allay certain trou- 
bles of the nervous system by introducing into the blood a 
1 Since the above was written, Dr. Howard Pinkney has kindly fur- 
nished me the notes of a case of uraemia following scarlatina, in a child nine 
years of age, which was successfully treated with oxygen. There was 
paralysis on one side of the body coincident with convulsions on the other. 
The attack had lasted three hours, and the face was dusky and the lips 
blue. After the inhalation of five gallons of oxygen the color improved, 
and by the time eight gallons had been taken the lips had a natural ver- 
milion hue, and the paralysis and convulsions had ceased. There was no 
return, and the patient made a good recovery. OXYGEN GAS AS A REMEDY IN DISEASE. 
49 
greater quantity of oxygen. In fact, modifying the conditions 
of the blood ought naturally to induce a change in the essen- 
tial character (ynaniere d'etre) of the nervous system, central 
or peripheric." 
Paralysis.-Beddoes cites two cases cured, one relieved, 
and one not benefited. 
Birch describes a case of complete paraplegia, of " several " 
years' standing, entirely cured by two years' persistent use of 
oxygen. 
In relation to paralysis, Demarquay observes: "We have 
seen, in the study of the physiological action of oxygen, that 
the muscles fix in some sort more especially this agent . . . 
It is certain that the inhalation of oxygen excites in some per- 
sons a necessity for muscular activity. This indication on 
the one hand, and the anatomical fact which we have cited on 
the other, prove the powerful effect of oxygen upon muscular 
action. The fact of paralysis cured under the influence of 
oxygen comes also to the support of this view." 
Epilepsy.-Beddoes claims to have cured one case, while 
in five other cases he was entirely unsuccessful. 
Birch adds to his almost miraculous cures two of epilepsy, 
one case being of thirty years' standing. 
Dr. Ramskill (Medical Times and Gazette, July, 1863), re- 
ports a case of epilepsy in a young man, aged twenty-three, re- 
sulting from syphilis. The attacks occurred every fourteen or 
sixteen days. He inhaled oxygen twice or three times a day, 
stopping the inhalation only when a feeling of dizziness came 
on. At the end of three months he had had only one attack, 
which was slight. The cachectic aspect which he previously 
had had disappeared. Two years after he saw him in perfect 
health. He had had no attack for sixteen months. 
Fatty Placenta.-Assuming the correctness of the views 
upon which Prof. Simpson bases the treatment of such cases 
with chlorate of potash, we should have in oxygen a more di- 
rect and more powerful remedy than any heretofore employed. 
Once prove that the foetus perishes from a deficient supply of 
oxygen through the maternal blood, consequent upon a dis- 
eased placenta, and the indication is as plain as in croup or 
asthma. 
4 50 
OXYGEN GAS AS A REMEDY IN DISEASE. 
Irregularities of Menstruation.-Beddoes and Birch both 
cite cases in which irregularities of the menstrual function 
were corrected by the use of oxygen. The first case described 
by Birch is one in which the return of each menstrual period 
was attended by a most excruciating headache, beginning two 
days before tlie period, and continuing two days after its ces- 
sation. During all this time the patient was obliged to re- 
main in bed, in a darkened room. This state of things had 
continued for a number of years, and had resisted every pos- 
sible form of treatment. The use of oxygen for a short time 
produced a perfect cure. 
In another case, along with various uterine symptoms, 
there were fulness and weight about the neck and about the 
base of the brain, and impairment of nearly all the special 
senses, and also partial paralysis of one side of the tongue. 
The patient was at the menopause. A few inhalations of oxy- 
gen produced a great improvement in the sight and hearing, 
and a course of six weeks completed the cure. 
CHAPTER VI. 
APPLICATIONS OF OXYGEN IN SURGERY. 
The effect of oxygen upon open wounds or ulcers is very 
remarkable, whether the gas be inhaled into the lungs, or ap- 
plied directly to the part. 
The following experiments by Demarquay are of the 
greatest interest. An incision was made through the skin and 
cellular tissue, and into the muscles near the axilla, of a dog, 
and the wound maintained open for three days. At the end 
of that time the wound was of a grayish color at the edges, 
and slightly red in the centre. The animal was then placed 
with its head in a receptacle of oxygen, the opening being 
made to fit tightly to the neck by means of a band of india- 
rubber. In two minutes the wound had changed to a lively 
rose-color. The surface presented small ecchymotic spots, 
which furnished a slight haemorrhage. At the same time an 
abundant serous discharge flowed from the surface of the 
wound. When the inhalation of the gas was suspended, the 
wound immediately changed its appearance. The rose-color OXYGEN GAS AS A REMEDY IN DISEASE. 
51 
was succeeded by a grayish hue, and the surface, which had 
been shining, became dry and dull-looking, resembling a mir- 
ror which had just been breathed upon. This experiment 
was repeated upon several different animals, with similar re- 
sults. 
In the use of oxygen subsequently in cases of great de- 
pression of the vital powers after capital operations, M. De- 
marquay observed, in several instances, the same effect upon 
the wound. 
These observations are of extreme importance. They show 
the rapidity with which oxygen is taken into the blood, and 
the effect which it produces upon the reparative processes. 
They explain also the wonderful power which oxygen pos- 
sesses, of inducing cicatrization in old and obstinate ulcers, 
and of which some remarkable instances will be cited here- 
after. 
Their bearing upon the treatment of the later stages of 
pulmonary phthisis by oxygen is also very important. That 
the introduction of pure or nearly pure oxygen into the lungs 
in such cases should be followed by a certain amount of 
haemorrhage from the walls of cavities or the surface of tuber- 
culous ulcers is what they should lead us to expect. They 
show also that the occurrence of such haemorrhage should not 
of itself be considered as contraindicating the use of the gas. 
On the contrary, it may coincide with the commencement of a 
reparative process. 
Solutions of continuity in the lungs, however, have this pe- 
culiarity, that while they partake of the effect of the gas acting 
through the circulation, they are also exposed to the influence 
of direct contact. This is of itself capable of producing de- 
cided effects, as has been already stated in another connection, 
and will be hereafter illustrated. 
Beddoes, even in the infancy of the use of oxygen, ob- 
served its effects upon obstinate and ill-conditioned ulcers. 
Among others, he quotes a case of scrofulous ulcers of the 
arms and of one leg, healed in a few weeks under the influence 
of " vital air." 
Another case of ulcer of the leg, which had continued for 
eighteen years, and had been treated in vain for four years by 52 
OXYGEN GAS AS A REMEDY IN DISEASE. 
Pott, and for seventeen months by Sharp, healed at the end of 
four weeks under the influence of oxygen. Six months after, 
there had been no return of the ulcer. 
A third case is related of an old scrofulous ulcer on the 
arm of a debilitated patient. The inhalation of oxygen, in 
gradually increasing doses, caused an astonishing effect upon 
the general health, but no tendency to cicatrization of the 
ulcer. On the contrary,, after a time, an inflammatory action 
was set up. To counteract this, a certain amount of carbonic 
acid was added, and the inflammation was promptly subdued, 
and cicatrization took place. 
Finally, in a fourth case, there was an ulcer on the leg four 
inches long and three inches broad, ill-conditioned, and of 
such a depth as to involve the muscles. After a year of treat- 
ment with a vast number of topical applications, together with 
tonics given internally, there was no improvement whatever. 
Oxygen was then resorted to, and a very rapid change took 
place. The general health, which was very much depressed, 
improved, the strength returned, the ulcer assumed a more 
favorable aspect, healthy pus was formed, and in fifteen days 
the sore had closed over three-fourths of its extent. »In six 
weeks from the commencement of the inhalations cicatrization 
was complete.-{Considerations on Factitious Airs, p. 65.) 
Demarquay describes (p. 792) three cases of phagedenic syphi- 
litic ulcers of alarming extent, which yielded readily to treat- 
ment with oxygen. One had existed eighteen months, and 
had invaded the perinseum, the pubes, and the thighs. 
Dr. Golden {Lancet, March 10, 1866) reports two cases of 
fetid phagedenic ulcers, probably of syphilitic origin, which 
healed very rapidly under treatment with oxygen. 
Birch describes a very remarkable cure of a rapidly-spread- 
ing syphilitic ulcer of the leg (p. 78). He adds that no other 
remedy will compare with oxygen as, in common parlance, " a 
purifier of the blood." 
The increase of the recuperative power which oxygen con- 
fers has been taken advantage of by Demarquay to enable 
patients to withstand the shock of severe surgical operations, 
or the subsequent drain upon the strength which they entail. 
In debilitated subjects he employs it before the operation to OXYGEN GAS AS A REMEDY IN DISEASE. 
53 
prepare them for it, and subsequently to enable them to bear 
up against the after-effects. He is confident that the mortal- 
ity after operations can in this way be immensely diminished. 
In other surgical affections, such as ostitis, caries, etc., es- 
pecially when associated with anaemia, loss of appetite, and 
defective assimilation, oxygen is of great value. Demarquay 
cites a number of cases in point. 
Chronic Pyaemia.-My notes present a case of this disease 
in which oxygen was apparently the means of rescuing the 
patient from otherwise inevitable death. W., aged fifty years, 
had been operated upon four weeks previously for stricture of 
the urethra, by external division. A few days after the opera- 
tion chills set in, and soon an abscess formed under the pec- 
toral muscles of the right side. Another abscess soon fol- 
lowed on the left arm, and a third over the sacrum. By 
this time his strength was reduced to the lowest ebb ; 
he was unable to raise his head from the pillow, his pulse was 
112, soft and gaseous, countenance Hippocratic ; vomited 
every thing taken into the stomach. Tongue broad, dry, 
leathery, deeply fissured, of a light-brown color. When I 
first saw him his friends had already given the necessary 
directions for forwarding his remains into the country, and a 
clergyman had administered the last consolations of religion. 
Within the preceding twenty-four hours a circumscribed 
pleuro-pneumonia had developed in the right lung. His case, 
sufficiently desperate before, seemed now perfectly hopeless. 
Nevertheless, with the consent of the attending physician, I 
determined to see what could be done by oxygen. About four 
gallons were administered every two hours, beginning at 11 
a. m. Each time the gas was given the color returned to the 
cheeks and lips, and the patient expressed himself as feeling 
" brighter." The pulse remained about as frequent, but seemed 
to gain a little strength. Before night the tongue had become 
moist at the tip and edges, there was less irritability of the 
stomach, and the pain in the chest had greatly abated. The 
gas was given every three hours during the night and 
the following day. The close of this day found the pa- 
tient with a tongue moist throughout, pulse 108, no vomit- 
ing, no pain, to speak of, in the chest ; was able to take 54 
OXYGEN GAS AS A REMEDY IN DISEASE. 
freely of stimulants and beef-essence. From this time lie 
gradually but steadily improved. The pleuro-pneumonia dis- 
appeared, without running through the usual stages. The 
appetite returned to a moderate degree. Two more chills oc- 
curred, but no further abscesses. The gas was continued about 
three weeks, the doses being less frequent as the patient im- 
proved. At the end of that time convalescence appeared to 
be established, and the oxygen was discontinued. 
Whether in this case the gas exerted any influence upon 
the septic material in the blood, or whether its effect was 
merely stimulant and tonic, it is difficult to determine. It is 
certain, however, that a very remarkable improvement took 
place simultaneously with the administration of the gas, and 
which could be attributed to no other agency. 
The prolonged contact of oxygen with a denuded sur- 
face produces a stimulating effect which varies in degree with 
the condition of the surface. In the case of recent wounds 
there is merely a sensation of warmth. In suppurating sur- 
faces the first effect is to render the granulations less florid and 
softer, and to increase the discharge. If the contact be too 
prolonged, however, or too frequently repeated, there will be 
a subsequent reaction' so decided as to compel a suspension of 
the treatment. An analysis of the gas after prolonged contact 
with a denuded surface shows the presence of an abundance 
of carbonic acid and a considerable loss of oxygen.-(Demar- 
quay.') 
It does not appear that the local application of the gas 
possesses sufficient advantage over its use by inhalation to 
compensate for the difficulties attending it. Introduced into 
the blood the action is more uniform and satisfactory, and less 
liable to become excessive. A transient contact, however, may 
be of use in cases in which the cutaneous capillaries have lost 
their tone, and passive hypersemia is the result. The effect 
will then be to cause contraction of the vessels, and paleness 
will take the place of the previous congested hue. Demarquay 
has illustrated this admirably in a case of eczema rubrum. OXYGEN GAS AS A REMEDY IN DISEASE. 
55 
CHAPTER VII. 
CONCLUDING OBSERVATIONS. 
The foregoing sketch is far from presenting a complete 
view of the therapeutical results which have been attained by 
the use of oxygen. Only those points have been brought for- 
ward which seem to be sustained by sufficient testimony to 
entitle them to serious consideration. Numerous isolated cases 
could be collected in which curative effects have been obtained 
in a wide range of affections. But enough has been adduced 
to show that in oxygen we have a remedy capable of aiding us 
more or less, under circumstances in which the usual resources 
of therapeutics are inadequate. 
Occupying such a peculiar physiological relation to the 
system, it would be difficult to assign oxygen to any one class 
in a systematic nomenclature of the materia medica. Of its 
remote effects the tonic and alterative are the most prominent, 
while a new word must be coined to express its primary action 
in dyspnoea. Its local action is stimulant, but is appreciable 
only in diseased conditions of the surface to which it is ap- 
plied. 
A vast and inviting field for experiment is afforded by the 
possible effect of oxygen in the whole family of diseases sup- 
posed to depend upon a toxic material in the blood. In some 
of these diseases good has already been accomplished by it. 
But its action in contagious affections, with the exception of 
cholera, has not yet been studied, and presents a tempting ar- 
ray of possibilities to stimulate investigation. Especially in 
New York City, where oxygen will soon be placed within the 
reach of every practitioner, and in a form entirely free from 
every thing objectionable or troublesome, it is to be hoped that 
ere long its relations to disease will be as thoroughly studied 
as have been already its relations to the economy in health. 
There is but one condition which may be considered as 
contraindicating the use of oxygen, and that is the presence 
of acute inflammation. But even to this, as we have already 
seen, there are exceptions. Indeed, it is, after all, a question 
whether we have any clinical proof whatever of this supposed 56 
OXYGEN GAS AS A REMEDY IN DISEASE. 
incompatibility. We do not find in practice that good, pure 
air aggravates inflammation, nor that the severer forms of the 
affection select by preference those in whom hsematosis is most 
perfect. It may well be, therefore, that this supposed contra- 
indication will prove to be merely a fragment of the exploded 
idea formerly entertained as to the physiological action of the 
gas. 
It is undeniable, however, that care should be exercised in 
the use of oxygen in cases in which there are solutions of con- 
tinuity in the pulmonary mucous membrane. In such cases 
the local effect of the gas may be developed, and should be 
vigilantly watched for. The pulse and temperature will fur- 
nish the most reliable guides. But, by using the gas very 
largely diluted, allowing, for example, twenty or thirty min- 
utes for the inhalation of three gallons, any local action will 
generally be avoided. 
In practice, a great difference will be found in different 
persons in the readiness with which the gas appears to be ab- 
sorbed, and in the quantity required to produce a given effect. 
It is possible that this may be owing, at least in part, to the 
fact observed by Chevreul, that oxygen is more rapidly ab- 
sorbed when the blood is more than usually alkaline. This 
suggests the propriety of using alkalies moderately in cases in 
which the oxygen does not seem to be easily absorbed, pro- 
vided their use is not contraindicated. It is possible that by 
their aid oxygen might be used successfully when it would 
otherwise fail to produce the desired effect. 
408 Lexington Avenue.