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A4099
October 15, 2013
8:00:00 AM - 9:00:00 AM
Room Room 104-Area D
Orval Cunningham: The Man, His Machine, His Tank in Kansas City and Cleveland
Anthony L. Kovac, M.D., George S. Bause, M.D.
Univ. of Kansas Med. Ctr., Kansas City, Kansas, United States
Introduction: Orval Cunningham, born 1880 in Enid, OK, attended Enid High School (1891), Universities of Oklahoma (1898-1899) and Nebraska (1899-1900), graduating from the University of Chicago in 1902. MD from Rush Medical College (1904), with an internship at South Chicago Hospital (1904-1905). He was associate professor of physiology at University Medical College (1905-1907) and lectured in physiology at General Hospital (1906-1907). He had published articles on the anesthesia administration of ether, nitrous oxide (N2O) and oxygen (O2) in 1908, 1909 and 1913, respectively (1). He was appointed associate professor (surgery) at the University of Kansas in January 1916. A proponent of N2O anesthesia and inventor, he designed his own N2O/O2/ether anesthesia machine in 1908. N2O and O2 were mixed in a dial-controlled ether chamber and warmed by a hot water bath. He included the option to switch from N2O/O2 induction to ether-air maintenance anesthesia. Gases traveled through 3.5 foot long tubing to a low-deadspace face mask with an expiratory valve. Considered the 1st popular anesthesia machine manufactured west of the Mississippi River, the Cunningham Apparatus provided faster inductions with less asphyxia and economized the use of warmed ether, while supposedly producing less postoperative nausea and pulmonary complications. The 1918 influenza pandemic diverted Cunningham’s attention from designing “anesthetic” to “therapeutic [hyperbaric] apparatus.” (2,3)

Cunningham “Tank Treatment” at Kansas City: Having noticed that patients with lung disease appeared to improve when they changed altitude and moved from Denver to Kansas City, he reasoned that this was due to increased oxygen at lower altitude. He designed and constructed a hyperbaric air/O2 tank located at the University of Kansas hospital in what is now Kansas City, Kansas. This 1st pressure chamber in 1918 was an instant success by saving the lives of two seriously ill pneumonia patients. Following success of treating patients with lung problems, he tried hyperbaric treatment for hypertension, diabetes and syphilis.

Cunningham “Timken Tank” at Cleveland, Ohio:

Among those treated successfully in Kansas City was a uremic patient, the “Baron of Bearings” millionaire H. Timken. Thus, uremia was added to the long list of ailments (pneumnia, diabetes mellitus, hypertension, pernicious anemia, syphilis, arthritis, carcinoma) which Cunningham believed could be caused by: “anaerobic infections or diseases” and cured by hyperbaric air treatments.(4) After Cunningham “rescued” Timken from a uremic crisis, Timken gave 1.5 million dollars in 1926 for the building of a 64-foot-diameter, 5-story steel sphere near the Cleveland, Ohio, lakeshore as Cunningham’s newest sanitarium. By May 1928, Morris Fishbein and the American Medical Association (AMA) Bureau of Investigation questioned whether Cunningham’s treatments seemed “tinctured more strongly with economics than with scientific medicine,” (5) A scathing JAMA article and the Great Depression combined to force economic failure upon his Cleveland sanitarium, and the great steel sphere tank passed through a series of owners. Cunningham died from a stroke in 1937. Five years later his “Timken Tank” was wartime scrap.(6) Ironically, some of Cunningham’s hyperbaric concepts would be validated in later years for theoretical reasons he had not originally envisioned.

References:

1. J Am Med Assoc 1908; 50: 1258-62

2. US Patent 1129171. Feb 23, 1915

3. US Patent 1471144 Oct 16, 1923

4. Curr Res Anesth Analg 1927; 6: 64-6

5. J Am Med Assoc 1928; 90: 1494-6

6. J Am Med Assoc 1942; 118:1300

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