History of hyperbaric oxygen therapy: key milestones

From changing the air to treating pressure-related illness

The story of hyperbaric medicine begins with attempts to control the air around a person, then develops through the discovery of oxygen, the hazards of compressed-air work, and experiments in diving and clinical medicine. Today’s treatment combines oxygen and increased pressure, but those elements entered the story at different times. An air chamber, a decompression table, and a surgical oxygen chamber were successive contributions to a developing field.

The milestones below show how each advance changed the field. They also explain why a chamber used for altitude research, diving emergencies, or hospital care may look similar while serving a different purpose.

Seventeenth-century air chambers were precursors

Nathaniel Henshaw described an air chamber in Aero-chalinos, published in 1664. The Royal Society records the book and its posthumous 1677 edition; Wellcome’s catalog describes a domicil or air chamber intended to change the air without moving to another location. Henshaw’s proposal belongs to a period when physicians were interested in the relationship between air and health, before oxygen was identified as a distinct gas.

This is a precursor to controlled-pressure environments, rather than modern oxygen therapy. The documented book dates offer a firmer starting point than the often-repeated 1662 claim about a first working treatment chamber. They also make the larger historical change visible: seventeenth-century air proposals preceded a chemical understanding of what people were breathing.

1770s: oxygen becomes a distinct subject of study

In 1774, Joseph Priestley produced the gas later called oxygen by heating mercuric oxide with concentrated sunlight. The American Chemical Society’s historical account also credits Carl Wilhelm Scheele with independently isolating the gas earlier, with publication following in 1777. Antoine Lavoisier gave oxygen its name and helped replace the older explanation of combustion with a new chemical account.

Recognizing that air is a mixture of gases made a distinction possible that remains essential to HBOT: increasing the pressure of ordinary air is different from changing the oxygen concentration of the breathing gas. These chemical discoveries did not create a clinical hyperbaric treatment by themselves. They supplied the conceptual foundation for later research combining oxygen with pressure.

1878–1908: compressed-air illness and staged decompression

Compressed-air workers and divers made the consequences of changing pressure an urgent practical problem. The illness called caisson disease or compressed-air illness became part of the history of decompression sickness. A contemporary naval account later described the shift from explanations based on mechanical congestion to an understanding involving gas bubbles after decompression.

That account identifies Paul Bert’s 1878 work as foundational to understanding high and low pressure and describes his proposal for slow, gradual decompression. In 1908, A. E. Boycott, G. C. Damant, and J. S. Haldane published The Prevention of Compressed-air Illness, developing staged decompression. Their work linked physiological investigation with procedures designed to protect divers and workers. The original paper, also reproduced in Smithsonian proceedings, is a major landmark in this transition.

1930s: oxygen joins recompression research

By 1937, the connection between pressure treatment and oxygen breathing was explicit in naval medicine. Ernest W. Brown’s article in U.S. Naval Institute Proceedings described recompression practice and reported Behnke and Shaw’s experiments comparing oxygen with air during recompression of animals with compressed-air illness. It also discussed British work using oxygen during decompression.

This was an important step toward oxygen-assisted pressure treatment. Pressure was already part of managing decompression illness; oxygen became a deliberate additional component. The same historical account considered oxygen toxicity, showing that benefits and limits were being investigated together. Its old exposure schedules belong to the historical record and are not present-day treatment instructions.

1950s–1960s: clinical oxygen research expands

Clinical researchers explored pressure and oxygen beyond diving injuries. Churchill-Davidson, Sanger, and Thomlinson published High-pressure oxygen and radiotherapy in 1955. In a 1967 clinical account, Duke physician Herbert Saltzman described Boerema’s group performing surgery in a pressurized chamber beginning in 1956. Boerema and colleagues’ Dutch paper Life without blood is indexed with a May 7, 1960 publication date.

Duke installed its initial hypo-hyperbaric research chamber in 1963. Early investigations concerned oxygen toxicity, transport through impaired circulation, and organ responses to hyperoxia. The Undersea Medical Society was founded in 1967, bringing researchers and clinicians into an organized professional community. Completion of Duke’s F.G. Hall laboratory in 1968 expanded the institution’s capacity to investigate both high-pressure diving environments and low-pressure altitude conditions.

From environmental physiology to wound care

Pressure research and clinical treatment continued alongside one another. Duke’s 2018 account describes a facility whose early story centered on extreme-pressure research and whose patient care had come to focus substantially on wound healing, while retaining emergency treatment for carbon monoxide poisoning and decompression sickness. This is an institutional example of the field’s expansion, rather than a single worldwide date when wound care began.

Hospital outpatient wound programs are now a common setting for HBOT. Healogics describes partnerships that can include hyperbaric equipment within a broader wound-care program. The naval strand also continues: Navy Medicine describes NAMI supporting divers and treating altitude-related decompression injuries. Clinical wound services and operational recompression share a historical foundation while serving different referral needs.

From hospitals to wellness centers

Independent practices and wellness businesses now offer services alongside hospital and specialist programs. Restore, for example, describes a commercial mild hyperbaric offering. The growth of settings means that chamber construction, operating pressure, oxygen delivery, and professional supervision need explicit descriptions. A familiar name for the service does not guarantee an equivalent exposure.

The history is a progression from proposed air environments through chemical discovery, decompression science, oxygen research, and clinical institutions. A present-day claim still needs evidence for the particular condition and treatment being offered. Historical interest and current effectiveness are separate questions; the timeline helps explain the field without replacing that assessment.

Questions to ask

• Does a historical claim cite an original document or a later retelling?
• Is the milestone about air, pressure, oxygen, prevention, or treatment?
• What current evidence supports the use being offered?

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