Carbon Dioxide Therapy

Review of Carbon Dioxide Therapy. A Neurophysiological Treatment of Nervous Disorders. By L. J. Meduna, M.D. (Pp. 236. £1 16s.) Springfield, Illinois: Charles C. Thomas. Oxford: Blackwell Scientific Publications. 1950.

British Medical Journal, 6 December 1952, p. 1245

   Carbon dioxide therapy is a recent addition to the abreactive methods of treatment in psychiatry. Inhalation of a mixture of 20 or 30% carbon dioxide with oxygen acts as an anaesthetic of rather the same type as ether. There is an induction phase when the patient tends to become excited, the phase of anaesthesia, itself, and then the stage of recovery. During either the first or the last stage opportunity may be taken to use the clouded state of consciousness to induce the patient to react emotionally to the evocation of present worries or past memories, perhaps forgotten or repressed ones.

   Dr. Meduna, the originator of this treatment as well as of the modern application of convulsive therapy, is inclined to overestimate its value. In Britain it has been used in a number of clinics and with varying techniques. Therapists are generally agreed that the patients who respond best to it are those who also respond to such similar methods as narco-analysis, ether abreaction, etc. - that is, patients whose symptoms combine anxiety and hysteria and are related to specific traumatic causes. In his book he describes at length the treatment of a psychopathic alcoholic addict, not the best type to choose for an example. Apart from this section, there are others on the physiological action of carbon dioxide, the technique of treatment, and a theory of its curative action based on the cybernetic views of McCulloch. There is no adequate discussion of indications for choice of this method, and the practical and clinical aspects are generally rather skimped. At the present stage of knowledge it is not possible to found carbon dioxide therapy, any more than the other so-called shock methods, on a secure theoretical basis, and we must still regard them as empirical.