Singultus, paper-bag ventilation, and hypercapnia

Area of Science:

• Medical History
• Neurology
• Anesthesiology

Background:

• The treatment of obstinate hiccough has a long history, with various methods documented across centuries.
• Breath-holding, a simple technique for managing hiccups, has been recognized since antiquity.
• The use of hypoventilation to modulate central nervous system excitability has historical precedents.

Observation:

• Ancient practices, such as Cyriacus's management of seizures in Emperor Diocletian's daughter, suggest early use of techniques akin to controlled hypoventilation.
• The holding of breath method for hiccups is attributed to Philip Henry Pye-Smith but has much older roots, mentioned by historical figures like Aristotle and Francis Bacon.
• Around 1920, several anesthetists independently explored inducing hypercapnia via carbon dioxide (CO2) inhalation as a potential therapy for hiccups (singultus).

Findings:

• While numerous anesthetists are credited with suggesting CO2 inhalation for hiccups, the earliest scientific literature reference originates from French pharmacist Henri Bocquillon-Limousin in 1892.
• Bocquillon-Limousin's work, 'Formulaire des médicaments nouveaux et des médications nouvelles,' provides the first documented instance of carbon dioxide inhalation for singultus treatment.
• The historical trajectory of hiccup treatments reveals a progression from simple maneuvers like breath-holding to more complex pharmacological interventions.

Implications:

• Understanding the historical context of hiccup treatments can inform contemporary therapeutic strategies.
• The early exploration of hypercapnia highlights a long-standing interest in physiological interventions for neurological conditions.
• Documenting the origins of medical treatments, such as Bocquillon-Limousin's work, is crucial for accurate medical history and scientific attribution.