Writing as early as 1818 Professor Louis Rostan wrote that he did not believe in nervous asthma. In fact, he went as far to conclude in his writings that asthma was not even so much asthma but was nothing more than cardiac asthma.
J.B. Berkart, in his book "On Asthma: It's pathology and Treatment," 1878, mentioned on page 22 that Rostan had always found some pathological explanation for dypsnea, such as the heart, and therefore had "no reason to assign this to a derangement of the nervous system."
Likewise, Berkart writes on page 32 that Rostan believed "emphysema was a disease of gradual and insidious development, it therefore seemed to them highly probable that the asthmatic paroxysm were merely its precursory symptom."
He thus believed asthma was a symptoms of emphysema. Ironically, he got it backward. Asthma sometimes results in emphysema (air trapping). And asthma and emphysema have nothing to do with cardiac asthma, even though the two are still often confused even to this day..
In the "Medical and Surgical Journal," published in 1859 and edited by W.W. Morton (page 517), it was likewise noted by the chapter author (Prof. Trouseau) that Rostan did not believe in nervous asthma, and what he "regarded it (asthma) as being symptomatic of affections of the heart."
The authors also note that when Rostan was a physician who studied old men, and based on his studies determined there was no difference between asthma and dyspnea. The author (Trouseau) disagreed.
Rostan's theory arose from the fact he studied older men and women with dyspnea, and determined the cause was not asthma but heart failure (cardiac asthma). So most of Rostan's cases probably weren't even asthma to start with. Thus you can see why he might come up with the theory that all dyspnea and asthma were one and the same.
Berkhart writes that he is wrong and vague in his descriptions of asthma. Yet while Berkhart says this, he was not much closer to the true definition of asthma as the man he was critiquing. Yet he didn't know this.
Trouseau's view was that asthma was a "malady" separate from cardiac asthma, in that sometimes it causes dyspnea, yet also it can cause episodes of gout "or gout in a more diffused form, in attacks of gravel, or rheumatism."
He further notes that if all dyspnea were asthma, then all that is short of breath would be asthma. Or, if all that is dyspnea is asthma, then all diseases of the heart would be asthma, all diseases of the great vessels would be asthma, all cases of dyspnea caused by edema of the glottis would be asthma (I believe he's referring to epiglotitis), and all dyspnea caused by croup would also be asthma.
In retrospect, Trouseau makes a good point here, although he's not exactly correct on his definition of asthma as we define it today.
He also notes that even mild heart disease might cause dyspnea with exertion, such as walking, and this might happen with regularity. While asthma may cause dyspnea, it does not happen with regularity, and generally occurs due to something other than exertion. Sometimes the cause is emotion, and sometimes something else altogether.
He also relates asthma to a fever, where it usually comes on slowly, whereby cardiac asthma occurs suddenly. He figured this out in 1818, and today some nurses and doctors still call upon my services to give bronchodilator breathing treatments for all that is dyspnea. It's interesting anyway to consider this. Still, Trouseau still considered both fever and asthma nervous in origin.
Then the nervous asthmatic and the person with a fever is left with perfect health until the next episode. Heart disease comes on abruptly, and never completely leaves the person in a state of perfect health between episodes as does asthma. It is always threatening to cause dyspnea.
The patient with cardiac asthma will always fear dyspnea with every exertion, while this is not the case with asthma. The asthmatic will, between events, follow his normal course of life.
However, he further notes, this does not rule out that someone with heart disease cannot have asthma and vice versal.
While we know Rostan was correct in his assertion asthma was not nervous, he was incorrect in his assertion that asthma was cardiac related. However, while he may not have came up with the diagnosis of cardiac asthma, he came up with the term.
Which is funny, because here we are in 2011 and most doctors still treat cardiac asthma as though it were real asthma.