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John C. Mithoefer, M.D.
JAMA. 1952;149(12):1116-1120. doi:10.1001/jama.1952.02930290038009.
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Respiratory depression followed by delirium and coma has developed in several patients with chronic pulmonary emphysema while they were receiving oxygen therapy in this hospital. I have studied some of these patients as well as some normal subjects in an effort to determine the mechanism of production of this phenomenon.

Three normal subjects and four patients with chronic lung disease were studied. Their ages and diagnoses are listed in table 1. Brief summaries of the clinical states of the four diseased patients are given below.

PROCEDURE  The subject lay on his left side, and an indwelling needle was placed in the brachial artery. A lumbar puncture needle was inserted, connecting the subarachnoid space to a spinal fluid monometer. The subject breathed through a rubber mouth piece attached to a three-way valve by which connection could be made either to a 9L spirometer containing 100% oxygen or to room air. During


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