Sunday, May 20, 2012

1850: Asthma as a disease of the mind -- rewrote

So asthma is all in your head.  Any exposure to strong smells, dust, and anxious situations causes you to miss time with the guys.  It forces you to spend more time with your mother.  You are thus dubbed to have a nervous disorder.

While the idea was mentioned by ancient asthma experts, it was once again brought to the attention of the medical community in 1850 by a famous British doctor by the name of Dr. Robert Bentley Todd.  He wrote an article for the Medical Gazette in December of 1850, as described by Dr. Henry Hyde Salter in his book, "On Asthma." (1)

Salter explains how Todd really wasn't the first to come of with the idea of nervous asthma, yet he was the first to take the idea seriously, and kind of got the ball rolling that, yes indeed, asthma was a psychosomatic disorder.

In his article, Dr. Todd wrote that asthma is caused by a "poisoning" of the nervous system as it pertains to the respiratory system. The offending "poison," or "peccant matter, was referred to by Todd as  the materies morbi. The result is a "spurious and morbid sense of want of breath," writes Salter about Todd's theory.  "This breathlessness is the first step in the morbid phenomena. That it may have no real objective cause in the lungs themselves; that bronchospasm is a accompaniment not a cause, of the dyspnea of asthma; and that you may have asthma without any bronchial contraction whatever." (1)

Todd describes that the signs of asthma (particularly bronchospasm and the resulting dyspnea) are not what asthma is, but merely a symptom of asthma. Asthma is the poisoning of the nervous system.

The idea here is that even if you are not having an exacerbation of asthma, you still have asthma. Todd describes that asthma is a permanent condition of the mind. It is always there, yet it only shows itself some of the time.

In this way asthma is not unlike other conditions that "irritate" the nervous system to cause prominent symptoms, such as:
  • Gout (Sudden joint pain that eventually goes away)
  • Epilepsy (Seizure that eventually goes away)
  • Asthma (Shortness of breath that eventually goes away)
Dr. Salter disagreed with Dr. Todd in Todd's assumption that asthma could occur without bronchospasm.  Salter believed simply the fact you can hear wheezes is a sign that bronchospasm occurs, because when you narrow pipes it makes a similar noice. (Salter, page 19)

Yet Salter agreed with Dr. Todd in his assertion that asthma is nervous.  Salter later went on to prove, or attempt to prove, why he suspected as much.

The following is Salter's evidence that asthma was nervous in origin:
  • Fatigue and mental emotion bring about an attack
  • Remedies that appeal to the nervous system allay an attack, such as stramonium, antimony and chloriform.  
  • The periodicity of asthma.  It goes away and comes back without warning by recurrence of hay fever, indigestion after dinner, expectoration after a good nights sleep, etc.  
  • Symptoms of asthma, such as clear urine (nervous urine), nervous headache, drowsiness, and  an attack after laughter or animation.  These are similar to hysteria and epilepsy.
  • No organic change in the lungs during or following an attack.  Post mortem exam of asthmatics shows no organic changes, or damage, to the lungs.  They are essentially normal.
  • Asthma is muscular in that it is caused by muscular fibre that spasm and squeeze the air passages of the lungs.  Muscular disorders like this are always nervous as the nerves are connected with the mind (2)
Salter's writings on asthma originally appeared in magzines, and was so well received he was encouraged to publish his works in a book.  He did such a good job by his writings that his ideas about the causes of asthma were well respected by the medical community.  

His evidence that asthma was nervous continued to hold sway in the medical community until it was scientifically disproved in the 1950s.  Yet it was 30 years after it was disproved -- like in teh 1980s -- that asthma experts finally gave up the idea that asthma was nervous
References:
  • Salter, Henry Hyde, "On Asthma: It's Pathology and Treatment," 1882, London, pages 8-
  • Salter, ibid, pages 13-16

2 comments:

  1. I agree with Salter. It definitely is a 'state' of mind. It's like a mind has two sides - one that says everything is going to be okay, relax, and one that says everything is doomed, panic. This is all the time that they are in conflict with one another. I believe that asthma is the panic side over reacting and leaving the other mind in a state of diminishment. '
    I have used asthma inhalers and they don't work. They make your MORE nervous, and strung out, unable to relax and in turn you use more. By suppressing my self while NOT in an attack, I have learned to control my self when I feel anxiety of an attack coming on.
    I know Salter was right, because I am living example of how the mind really is the center of all wellness and disease.

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  2. There is a type of anxious asthma, although asthma in itself is not psychosomatic as Salter suggested. I do believe asthma can be anxious, and that's probably the type of asthma you have. It must have been quite the revelation when you came to that realization.

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