Thursday, October 09, 2014

New Website: asthmahistory.blogspot.com

Over the past several years I've been off on an adventure through time to learn about the history of asthma.  As time has permitted I have posted what I have learned on the pages of this blog.  

This project has been very exciting for me, and it is likewise exciting for me to announce that asthma history has become so gib that we have decided to separate it from this Hardluck Asthma website. 

So the History of Asthma has finally moved up in the world and got its own site, asthmahistory.blogspot.com. And it's -- well, you just go check it out. If you have asthma, or know someone that does, there's no better way to appreciate how good we have it than to learn about our past.  

In the future I will no longer be posting this history on Hardluck Asthma.  The advantage of this is I will now be able to use this space for what I originally intended: to write about my experiences with asthma and as an asthma parent.  

So go check out Asthma History, and go back often, because each time I get back from a journey from the past I will report what I learned.  

2000 B.C.: Assyrian physicians will treat your dyspnea

Of course there is no evidence of asthma in ancient Mesopotamia, although there is evidence the ancient Mesopotamian civilizations had knowledge of the lungs, and were aware that some symptoms,-- excessive sputum, cough, shortness of breath, etc., were caused by "poisons" inside the lungs. There is also evidence of remedies for the various lung ailments that were known, and even something that might be considered the first man made inhaler.  

Now, at what point the knowledge was obtained we can only speculate. Early on in human history asthma-like symptoms must have been observed, and over time someone must have speculated these symptoms were due to the lungs.  A basic anatomy of the lungs must have been known, because mankind had been cutting open animals for food since the beginning of time. And surely accidents occurred where a person was badly mangled, and his lungs were observed.  Surely this opened the door to pondering, and at some point the link was made between shortness of breath and the lungs. 

Somewhere in the course of time herbs were tossed into a fire and inhaled.  Now, when this happened for the first time your guess is as good as mine.  Since it was also known in ancient Egypt that inhaling herbal remedies was the best way to provide breathing relief, it's highly probable this knowledge was obtained at an early time, and then shared among the various tribes or families. However, the techniques used to inhale respiratory medicine in Mesopotamia were different than what was used in Egypt.  So this may be evidence the discoveries were isolated, although we may never know for sure. 

So let's say it's the year 2000 B.C., you live in ancient Assyria, and you are short of breath.  Your first thought may be: "What god is mad at me?" or "What did I do wrong?"  At first you just deal with it, because you don't want to be a burden, although as your shortness of breath continues, you finally decide to seek help.

A baru is sent to your home, and it is his job to diagnose you. He comes adorned with several necklaces made of precious stones, and they rattle as he dances around the fire.  He sings incantations while inspecting your body, makes occasional gestures, and then he closes his eyes and presses his hands together as if in prayer. He stands up and notifies your family that it is now time to interpret the omens.  Since you do not own much, you choose not to sacrifice one of your animals to allow the baru to inspect the liver.

When your brother fell sick years ago a baru visited him, and he wanted your parents to sacrifice one of your sheep.  However, your parents opted to go with the cheaper option, and the baru walked to a nearby pond and placed a few drops of oil on the water and watched how the oil reacted.  The oracle did not give a good sign for your brother, and he died a few days later. Once you saw a baru place a stick in the fire, and he determined by the way the flame continued in the gentle breeze your mother would live another year or so after injuries she obtained when she fell off a horse.

He also used this method to determine that there would be a drought, and the drought would last a long time.   Once there was no water nearby, so he placed the oil in to a cup.  While you were sitting with the baru later that night, you read what he wrote: (10, page 455)
If I drop oil on water, and the oil sinks and rises again.. it means bad luck for a sick man.
If a ring forms from the oil in eastern direction and remains thus it means: for a campaign that I shall undertake it and shall make plenty of booty; for a sick it means that he will recover.
If two rings develop from teh oil, one large, teh other small, the wife of the man will give birth to a boy; for a sick it means that he will recover
If the oil disperses and covers the cup, the sick will die; the army will be destroyed.
If the oil bubble moves in Eastern direction, the sick will die.  (10, page 463)
This time, however, the baru finds a sign from the gods right away.  While inspecting your home for signs of the wishes and voices of the gods, he observed birds flying over the right side of the home, and he determined that this is a good omen, one that means the gods wish you well and will allow you to live.  This is a sign that it is okay to treat you. (10, pages 453-454, 484)

Henry E. Sigerist, in his 1951 history of medicine, explains that descriptions of lung disorders are common in Mesopotamia.  He wrote:
'A man is affected in his lung passage' or 'suffers from teh "pipe of the lungs,"' means that the patient has a disease of the bronchi or upper respirtory organs.  An Assyrian tablet published by Labat and Tournay gives a good description of bronchitis: If the patient suffers from hissing cough, if his windpipe is full of murmurs, if he coughs, if he has coughing fits, if he has phlegm: bray together roses and mustard, in purified oil drop it on his tongue, fill, moreover, a tube with it and blow it into his nostrils.  thereafter he shall drink several times beer of the first quality; thus he will recover. (Sigerist, page 480-481)
Sigerist continues:
In the tables dealing with diseases of the chest, we have a number of diagnoses although they don not go beyond naming the organ affected. 'If a man's breast hurts him, his epigastrum burns him, his stomach (is inflamed (swolen)... that man has lung trouble.' (10, page 481)
If it is determined that the ailment plaguing you is pneumonia, "the treatment recommended in this case was very sensible. The chest was formented with water in which fennel had been boiled, after which balsamic poultices were applied.  this remained the treatment of pleurisy and pneumonia for several thousand years," writes Sigerist. (10, page 480)

He describes other symptoms of lung diseases, such as: (10, page 480)
  • A man "coughs dry, ejecting no saliva"
  • The "lungs cough up pus and the inward parts"
  • "A man is affected in his lungs and they vomit exceedingly"
  • '"f a man's lungs pant with his work"
  • "When the breath of a man's mouth is difficult"
  • "A man is affected in his lung passage"
  • "Suffers from the 'pipe of the lungs"
Sigerest says we can interpret these however  we like.  The use of "panting" and "difficult" may refer to shortness of breath, or dyspnea.  "Pus" and "inward parts" may be excessive sputum, or perhaps it means bleeding, hemorrhage. Although most of these passages must refer to "diseases of the bronchi or upper respiratory organs." (10, page 480)

So now an asu comes to your home carrying with him pottery jars.  He says, "The hands of a ghost are upon you." He chants an incantation, and says, "Your breathing is ailing because of 'restriction of breath.'  We will work with you to remove the ghost the baru says is possible to extricate.  I cannot promise you anything, yet what I offer is the best option for you." (10, page 420)

Sigerist also provides a description of a Mesopotamian remedy for lung disorders, and this may be ideal for your respiratory distress, and it may be that this is what the asu was thinking, and why he brought the two jars :
...If a man is affected in the lungs, thou shalt spread powder of tar over a thornfiore, let the smoke enter his anus... his mouth and nostrils, it shall make him cough (?): thou shalt bathe him with water of vitex: thou shalt anoint the whole of his body with curd: thou shalt bray linseed either in milk (?)..., bind on him for three days, and let his tongue hold honey and refined oil... (11)
Sigerist also writes about an ancient Mesopotamian inhaler:
Like their egyptian colleagues, the Assyrian doctors possessed an apparatus for inhalations.  A decoction of various drugs was placed into a pot, which was sealed with wheaten dough after a reed-tube had been inserted into it.  the pot was placed on fire and then: 'thou shalt put it (the tube) into his mouth, let him draw the steam up by the reed-tube into his mouth... it shall strike his lungs: for nine days thou shalt do this.' 
The baru had many other natural remedies he could prescribe, including a variety of fruits and vegetables, resins, gums, trees, shrubs, and minerals.  Like the ancient Egyptians, they also used a variety of stuff taken from animals, such as fat, blood and liver. Just about any animal's parts could be found useful, including cattle, sheep, goat, pig, donkey, dog, lion, wolf, fox, gazelle, mouse, frog, chicken, pigeon, raven, stork, swan, owl, falcon, and even vulture, according to Sigerist.  Vehicles used were "wines, beers, fats, oils, honey, wax and milk."(10, page 485-6)

Some drugs that they had access to that would some day benefit an asthmatic -- if it didn't happen already -- were hemp and opium.  (10, page 485)

During the course of the next few days you get better, and now your sister is sick.  The baru has a different diagnosis for her, and the asu a different treatment.  She is not prescribed a herbal remedy, only an incantation to site: (10, 464-465)
O! Ninlil, lady of teh gods, I have turned unto thee
To spare and to show favour thou knowest. thy mantle I have taken hold of
A heavy sin (?) I carry, I knkow not to bear it
Because of (my) transgression knkown and unknown I have become weak.
Because of the evil I have done and have not done I perish, O! lady,
(because) of the sin which since the time of my youth I have carried
And which the apostle of god has known or not known I suffer greatly
daily (?), O! my lady, may my evil be expelled.
May thy good breath blow and the darkness be brightened.
 From trouble and calamity that distress take thou my hand,
May not my offender prosper who exults over me
May I live, may I prosper and the greatness of thy great divinity ever shall I cherish
Later on you witnessed a 'a man sick with cough," and in this case the asu recommended the following:
Ground lolium, pounded roses, as mixture thou shalt mix, let him eat it in oil and honey; let him drink soup of pig's meat; when he goes to stool thou shalt light a fire before him, he shall direct it to his anus, and shall recover.
Sometimes people recovered after seen by the baru and asu, and sometimes not.  When they do it's due to the magic of the baru and the asu. When they don't it's because of the will of the gods.

Plus as in modern times, "drugs must have been prescribed occasionally merely because the patient expected something to be done," explains Sigerist.  So perhaps that inhaler the bure prescribed for you merely made you feel better by providing you with hope.

References here are for this post and all posts regarding ancient Mesopotamian medicine:  
  1. Wilder, Alexander, "History of Medicine: a brief outline of medical history and sects of physicians, from the earliest historic period; with an extended account of the new schools of the healing art in the nineteenth century, and especially a history of the american Eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing Co.
  2. Baas, Joh Herman, "Outlines in the history of medicine and the medical profession," translated by H.F. Handerson, 1889, New York, J.H. Vail and Co. 
  3. Garrison, Fielding Hudson, "An introduction to the history of medicine, with medical chronology, suggestions for study, and bibliographic data," 3rd edition, 1922, Philadelphia and London, W.B. Saunders Company
  4. Roberts, J.M., "The illustrated history of the world: Volume 1: Prehistory and the first civilizations," 1998, New York, Oxford University Press
  5. "The Assiatic Journal, for British adn foreign India, China and Australia," volume VIII, New Series, May-August, 1832, London, Parbury, Allen and Co.
  6. Bradford, Thomas Lindsey, "Quiz questions on the history of medicine from the lectures of Thomas Lindsey Bradford," edited by Ray Roth, 1898, Philadelphia, John Joseph McVey
  7. Osler, William, "The evolution of the history of medicine: a series of lectures delivered at Yale University on the Silliman Foundation in April, 1913," 1922, New Haven, Yale University Press
  8. Gill, N.S., "Babylonian gods and goddesses," About.com, http://ancienthistory.about.com/cs/egypt/a/babygodsindex.htm, accessed 4/11/13
  9. Biggs, Robert G., "Medicine, surgery, and public health in ancient Mesopotamia," Civilization of the ancient Near East, edited by Jack M. Sasson, 1995, New York, Charles Scribner's Sons
  10. Sigerist, E. Henry, "A History of Medicine: Primitive and Archaic Medicine," volume 1, New York, Oxford University Press
  11. Sigerist, E. Henry, ibid, page 488, reference used by Sigerist: Thompson, Rev. Assyr.,1934, 31:18
  12. Martell, Hazel Mary, "Kingfisher Book of The Ancient World: from the ice age to the fall of Rome," 1995, New York, Larousse Kingfisher Chambers Inc. 
  13. Hopper, Anthony, "Five Important Phoenician Contributions to Western Medicine," Yahoo.com, http://voices.yahoo.com/five-important-phoenician-contributions-western-11972417.html, accessed 4/13/2013
  14. Foster, Leila Merrell, "The Sumerians," 1990, New York, London, Toronto, Sydney, 
  15. Morris, Jastrow, "The Civilization of Babylonia and Assyria," 1915, Philadelphia and London, J.B. Lippincott Company 

Tuesday, October 07, 2014

1840-1903: Open air treatment for consumption

Figure 1 -1899, National Jewish Hospital, TB patients treated with sunlight (4)
Around the turn of the 20th century tuberculosis was a common ailment, and a leading cause of death.  Yet it also lead to a general feeling of gloom among the populace, especially considering little was known about it and there was no cure.  Yet if you had it there was hope, thanks to places like sanatoriums and hospitals like National Jewish Hospital for Consumptives in Denver Colorado.  

In the 1840s Hermann Brehmer (1826-1889) was diagnosed with the condition and he told his doctor he might benefit from the open air of the Himalayas.  He also decided there might be benefits from isolating tuberculosis patients from the rest of the community, so he created hydrotherapy institution in Gorbesdorf, which is a village in Silesia, Germany. 

Bre
At first he had trouble convincing the medical community he was on the right track, but ultimately he became so successful that various sanatoriums opened in mountainous areas all over Europe and the United States.  One famous one in the United States was built in Denver, Colorado in 1899 by the Jewish Community. 

Many of the Jewish Community who were struck with tuberculosis were flocking to the Denver area because of it's fresh, dry, mountainous air.  Yet many of these victims were without enough money to be able to afford food or housing.

This was brought to the attention of Frances Wishbart Jacobs who worked hard to raise money to build shelter for these destitute victims of consumption.  She was able to find support from members of the Jewish Community and then to generate enough money to build an institution.  (1)

National Jewish Hospital 1892
In 1892 Jacobs died, and a year later the building was finished.  Yet the country was also mired in a recessions that year prompted by the silver crisis, and this resulted in a lack of funds to open the facility.  The building laid empty until Rabbi William S. Friedman took up a project to complete and open the institution.  (2)

The doors to the National Jewish Hospital for Consumptives opened in 1899 with the motto: "None may enter who can pay -- none can pay who enter." (1)  While it was originally built by the Jewish Community, anyone was allowed to enter who needed help.  (2)

One of the original therapies for tuberculosis patients in Denver was to receive heliotherapy, which was sunlight therapy (See figure 1).  It was believed that sunlight would help them "combat the disease."  (3)  This type of therapy, along with open air therapy altogether, was supported by Thomas Beddoes (1803-49), who performed many tests on respiratory patients, and Herrmann Brehmer (1826-89), who, as noted, opened the first sanitorium.  (3, page 37)

Figure 4 -- Open air therapy for TB patient at his home (3, page 38)
Studies were also done that showed TB patients recover faster in the winter than summer months.  In fact, "Dr. Otto Walther says he not infrequently had an inch of snow on his blankets.  At some localities tents are the only shelter, but whether the patients are housed in cottages or in tents, the free access of air must be absolute and uninterrupted. Drafts are not feared. At night the windows, which should constitute at least one side of the room or ward, are kept open; in some places the sashes are removed altogether; the sides of the tents are rolled up, except in the severest storms. In very cold weather the head and hands may be protected with woolen cap and gloves, and at all times the patients are well provided with blankets. In summer the beds or reclining chairs are moved into the open or into covered porches during the day; for the winter most places are provided with glass porches or sun parlors; where the patients spend their days in bed or reclining in steamer chair." (3, page 38)

(5, page 44)
The benefits of open air therapy as reported were: (3, page 39)
  • Reduction of the fever
  • Improvement of the appetite,
  • Induction of sleep
As noted, "Cough and night-sweats disappear in a short time, and, as a logical consequence, the medicinal treatment is reduced to a minimum. Antipyretic drugs are never used and expectorants are rarely required. Suralimentation (the belief that consumption could be cured by forcing them to eat) is practised in many places, especially in the German resorts, where it is pushed to an almost incredible degree; even bed patients with considerable pyrexia are placed on a full diet of meat and vegetables. Trudeau and Flick * content themselves with giving their patients three full meals a day, allowing them to drink milk between meals if they have a desire for it; when, however, there is anorexia, the patient is given raw eggs beaten up with milk every two or three hours." (3, page 39)

While open air treatment was utilized "judiciously" and based on "individual cases," the therapy could also be recommended for home use as well. (See figure 4) Patients may also benefit from treatment in tents, walks or rides in the open air.  (3, page 39)

Another type of therapy was pulmonary gymnastics, or exercise.  While this was debated as an effective therapy, it was often recommended at the various sanatoriums.

In 1895 a German by the name of Wilhelm Konrad von Roentgen discovered the x-ray that allowed doctors to see the disease in its early as well as it's late stages.  This marked the first time that the disease could be diagnosed in its early stages instead of having to wait to see the late signs.  It also allowed doctors to see the tubercles in those who had survived the disease.  It showed both active and inactive tuberculosis.

References:
  1. Gurock, Jeffrey S., ed., "American Jewish History," 1998, New York, vol. 3, part 3, pages 1095-6
  2. "The History of National Jewish," NationalJewish.org, http://www.nationaljewish.org/about/whynjh/history/
  3. Tissier, Pneumotherapy
  4. Photo compliments of National Jewish Health, Facebook, http://www.facebook.com/photo.php?fbid=10151140094301092&set=a.140185801091.110191.41885201091&type=1&theater, accessed on 10/20/12
  5. Picture from the Journal of the Outdoor Life," National Tuberculosis Association, Volume XI, January, 1914, 10 cents an issue or $1.00 a year

Monday, October 06, 2014

4000-2000 B.C: The birth of artificial breathing and tracheotomy

Perhaps as far back as 4,000 years before the birth of Christ some mother grappled for something to do as she watched her child gasp for air.  She had already chanted incantations, and even called the medicine man, so she placed her mouth over the boy's mouth, and exhaled.  As she did so she saw that his chest expanded.

Unknowingly, she became the first person ever to perform mouth to mouth breathing.  Her attempt probably failed, and amid her anguish as she grieved for her child she made no effort to reveal to others what she had done.

Similar efforts were made from time to time, and mostly by mothers making panicked efforts to save their children.  Most of these efforts probably failed, although each would have at least given a child a chance to go on living.

And, lo and be hold, one of these efforts must have resulted in the child gasping and opening his eyes, and this would have been reported to a medicine man who made note of it deep in the back of his mind.  Several years later he was called to a young patient who appeared to be dead.  He breathed three times into the child's mouth and the child breathed life.

Such success would have brought great joy to the parents and family members, and the medicine man hailed as a hero.  This hero would have shared this wisdom with his sons, one of whom shared it with an ancient Mesopotamian messenger, who shared it with a prophet, who shared it with his scribe, who recorded it in some ancient medical texts.

For the first time ever, instead of being relayed from word of mouth, it was privy wisdom shared with the select few who were privileged to attend the few schools that then existed.

This wisdom was used from time to time by ancient physicians, magi, and profits. More often than not such attempts failed to bring people back from the dead, but from time to time it worked.  And with each success some new wisdom was learned.

One day, after a failed attempt at mouth to mouth breathing, a young physician took a sharp knife and created an opening into a suffocating man's neck.  This would have been the first tracheotomy.  Such knowledge would have been recorded by scribes and taught at schools.  This would have been done sometime around 4,000 B.C. (1, page 222)

In 2000 B.C. Ancient Hindu medicine mentioned "throat incision," and about 1500 B.C. the ancient Egyptian architect, scribe and physician Imhotep became the first mention the procedure in writing. While his original works are lost to history, we learn about his thoughts by later writers who would have had access to his original works.  (1, page 222)

The rare patients brought back to life by mouth to mouth breathing were probably merely revitalized by the efforts.  The rare patients who survived early tracheotomies probably died later on due to the unintentional introduction of pathogens to the blood stream during the operation.

References: 
  1. Szmuk, Peter, eet al, "A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age," Intensive Care Medicine, 2008, 34, pages 222-228
  2. Price, J.L., "The Evolution of Breathing Machines,Medical History, 1962, January, 6(1), pages 67-72; Price references The Bible, Kings, 4: 34 
  3. Fourgeaud, V.J, "Medicine Among the Arabs," (Historical Sketches), Pacific medical and surgical journal, Vol. VII, ed. V.J. Fourgeaud and J.F. Morse, 1864, San Fransisco, Thompson & Company,  pages 193-203  (referenced to page 198-9)
  4. "Biographical Dictionary of the society for the diffusion of useful knowledge," Longman, Brown, Green and Longmans, volume III, 1843, A. Spottingwood, London, page 124-5
  5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
  6. Lee, W.L., A.S. Stutsky, "Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS," Semin. Respit. Critical Care Medicine, 2001, June, 22, 3, pages 269-280
  7. Tan, S.Y, et al, "Medicine in Stamps:  Paracelsus (1493-1541): The man who dared," Singapore Medical Journal,  2003, vol. 44 (1), pages 5-7
  8. Ball, James B, "Intubation of the Larynx," 1891, London, H.K. Lewis
  9. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
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Sunday, October 05, 2014

Survived one more hunting camp

During the course of the year a couple of the guys remodel old homes and bring the scraps to the cabin, where one night at hunting camp it's burned.  The ensuing fire makes for an impressive site, but it's not so good on asthmatic lungs.

There were always some issues that resulted from going to hunting camp, especially since both campfire smoke and Captain Jack can irritate asthmatic lungs. But this came to a tailspin in 2011 when the fire nearly killed him (well not really, considering most asthmatics pant to old age).

But that was then and there have now been three years worth of events to deaden that memory.  Surely it still lingers in the back of his mind, but even though the others were reminded a few times NOT to light up the fire the one night the asthmatic was going to brave camp, it was lit anyway.  (This is further evidence how, since most people are unaffected by it, most people don't care about it.)

The asthmatic and his son were riding up to camp about 7:30 p.m. when his son received a snap shot on his i-phone.  Based on the crackling sound, the asthmatic knew what his son had received even before he said, "Dad, they lit the fire already."

The fire was still burning as they pulled into camp, and the cinders were red hot all night, continuing to fill the air with its fumes. A few discussions with Captain Jack later and the asthmatic forgot his efforts to avoid the fumes.  Not helping matters were that Captain Jack, while soothing and necessary, was also an airway irritant.

Thankfully the asthmatic came prepared this year.  Surely avoidance of hunting camp and not lighting the fire surely would have helped, but none of those were any fun (none of those options resulted in living a normal life with this disease). Thanks to modern science there are a plethora of medicines an asthmatic can try to prevent asthma.  While Advair didn't help in 2011, Breo did in 2014.

Still, two days later, while the fire did not take away his air it did cause some mild cold-like symptoms.  As he takes in a deep breath he can feel that some shit did get into his lungs, and it did cause some spasming to occur.

But, thanks to modern science, it was nothing like what happened in 2011. In fact, these side effects are so mild he's tempted to brush it off as happenstance -- but he knows better.

Thursday, September 25, 2014

1600-1700: Some abhorent remedies for asthma

So you have asthma in 1618, and you approach your physician about your problem. You sit in a wooden chair opposite his voluminous desk, leaning on his desk to expand your chest, your chest heaving with each slow breath.

As you're explaining your dilemma, in a huffy fashion, he opens a book on his desk.  You observe the title: "Materia Medica."  You wait as he sifts through the pages, and says, "hmmmmm.  Let's see here."  His finger traces what he's reading.  He leans back in his chair.  

He says, "Now, according to this "Materia Medica" we have a few options here.  Do you have anyone who can hunt for you."

You say, "Well, I'd love to hunt for myself, yet the consequences of doing it put me here."  

"I see." He leans back in his chair, puckers his lips as if in deep thought.

"So what do I need to do?" You ask.

"Well, it says here," he picks up the book, turns it so you can see the page, and he points to the heading "Asthma."  You read the section he's pointing to:
  • Worms
  • Lozenges of dried vipers
  • Foxes Lungs
You say, "Well, I think I can find someone to get me a fox, but I'm not sure about the viper.  I think getting one of those would be next to impossible." You look into the doctor's eyes.  "Don't tell me a viper bite will cure me, doctor."

Your comment induces a laugh from the doctor, and you join in briefly.  The laughter induces a cough, and you produce a large amount of sputum.  The doctor reaches into his desk and offers you a handkerchief.
-----------

For kicks and grins, here are some of the other remedies in 17th century pharmacopaeas:
  • Powder's of precious stones
  • Moss from the skull of the victum of violent death
  • Human urine
  • Blood
  • Fat
  • Bile
  • Horns
  • Crab's claws
  • Crab's eyes
  • Bones
  • Bone marrow
  • Sexual organs
  • Eggs
  • Excreta of animals of all sorts
  • Spider-webs
  • Fur
  • Feathers
  • Hair
  • Scorpions
No wonder physicians struggled to gain respect.  To their credit, though these remedies offered hope to patients, and there were also many other remedies that had an actual benefit to the patient.  Considering the medical ignorance of the time, physicians who offered such remedies must have felt good about their efforts to help a sick person.

Such remedies were slowly phased out of the pharmacopoeia, mainly due to the works of men like William Heberden (1710-1801) who championed to put "diseases upon a scientific basis," and "who did a most important service to therapeutics by dispelling current superstitions and banishing them forever from the pharmacopoeia" in his 1745 book "Essays on Mithridatium Theriaca."*  (1, page 370)

Obviously most of these abhorrent remedies were slowly phased out of the pharmacopoeia, particularly as better remedies were introduced.  For example, stramonium was introduced to the London Pharmacopoeia in 1721 by Sir Hans Sloane.  A few decades later, the authors of the 5th London Pharmacopeia of 1746 condemned the old practice of astrology and folk medicine, dropping the following remedies: (1, page 408)
  • Human fat
  • Spider Webs
  • Moss from human skulls
  • Unicorn's horn
  • Virgin's milk
  • Bones from stag's heart (1, page 408)
Can you guess what was in your asthma medicine?

*Mithridatium = remedy that cures everything, particularly poisons; theriaca = a compound of 64 drugs believed to be a cure for all poisons)

References:  
  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company, page 291

Tuesday, September 23, 2014

1316: Mundinus publishes book of anatomy

So we know that the School of Salerno was a great medical institution from the 10th to 13th centuries, and physicians from all over the world flocked there to get the best medical instruction.  Yet most historians will acknowledge that while it was a great learning place, there were few medical advancements made here. 
One of the great exceptions occured in 1316 when Mundinus of Bologna (1270-1326) wrote a book called "Anathomia."  Although while he wrote it while teaching at Salerno, it was first published at Padua in 1487, and later at Leipzig in 1493 by Martin Pollich-von Mellerstadt. (see figure 1) (1, page 150-151)

Figure 1 --The title page of Mundinus
 "Anathomia," Leipzig, 1493 (1, page 151)
According to Fielding Hudson Garrison in his 1921 book, "An introduction to the history of medicine," "In intention, this book was really a little horn-book of dissecting, rather than a formal treaties on gross anatomy.  (1)

Garrison explains the book was full of "Galanic errors in regard to the structure of the human frame, preserving the old fictive anatomy of the Arabists, with the Arabic terms, this book was yet the sole textbook on anatomy for over a hundred years in all the Medieval schools." (1)

It was people like Mundinus who helped advance medicine through an otherwise dark ages of medicine in the western world.  Surely this was a small achievement, and there may have been no major advancements in asthma and respiratory therapy wisdom as a direct result of this.  Yet had it not been for such small achievements, asthma wisdom would still be in the dark ages, and chronic lungers would continue to be forced to suffer as a result.  

References:
  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
  2. The John Hopkins Hospital bulleton," (volume XV 1904), "from the epoch of the Alexandria School (300 B.C.)"
  3. "The Ancient Medical School of Salerno," associazioneermes.it, http://www.associazioneermes.it/MedicalSchoolSalerno.htm, accessed 12/4/12