1600s: Spasmotic and nervous theories of asthma formed

So the term asthma was first appeared in Ancient Greece in the writings of Homer, and was defined as a medical term by Hippocrates.  In Ancient Rome it was used sparingly, and it didn't find its way into English and other European languages until about 1398.

Medical wisdom in Western societies hit a wall of sorts with the fall of the once mighty Roman Empire, only to rise up in Eastern socieites.  Around the 10th, 11th and 12th centuries such wisdom started to filter back West, yet it was a slow transition to say the least.

With the fall of Constantinople in 1453 the dark ages ended and the age of Reniassance began.  Old Western ideas about medicine and science started to re-emerge, and new ideas started to form.  The first Western physician during this era to take a look at the term asthma was Jean Baptiste van Helmont (1579-1644).

Even during modern times physicians and scientists who become rapt in a certain disease are usually those who are affected by it, and van Helmont was no exception.  He was afflicted with asthma from a young age, and he became especially interested in it as a physician.

He was the first to describe asthma as anything other than simply a symptom.  He was the first to propose the idea that asthma was a disease of bronchospasm when he wrote:  "The lungs are contracted or drawn together."  Galen mentioned something of the sort, yet it was van Helmont who focused attention on the subject.

Van Helmont was also the first to describe asthma as a nervous disorder. Thomas Willis (1621-1675) is given credit for the nervous theory of asthma more so than anyone, yet that's only because Willis wrote more specifically about it than van Helmont.  So we will give due credit where credit is due. (1, page 6)

Thus, we can accurately say the van Helmont is responsible for the following theories:

• The spasmotic theory of asthma (also called convulsive theory of asthma)
• The nervous theory of asthma (later called psychosomatic theory of asthma)

Ironically, van Helmont is not given credit for either of these theories by many historians.  Thomas Willis often gets credit for the nervous theory of asthma, and John Floyer (see below) gets credit for the spasmotic theory of asthma.  Perhaps in my asthma history van Helmont gets credit for both for the first time.

Regardless, as you will soon see from our study of asthma, these two theories would continue to grow in popularity, and their validity will be continually debated long after the former is proved in the 19th century and the later disproved in the 20th century.

English physician John Floyer (1649-1734), who also had asthma, worked to distinguish asthma from other disorders.  According to the American Journal of Respiratory Cell and Molecular Biology, "A Centennial History of Research on Asthma Pathogenesis," written by Michael J. Walter and Michael J. Holtzman: (2)

"Dr. Floyer, who developed asthma following a respiratory infection,provided detailed accounts of the asthma signs and symptoms, treatment, prevention, and prognosis. He also also described a hereditary component of asthma, and numerous exacerbating factors such as air pollution, infection, cold air, exercise, sleep, psychological stress, and tobacco smoke, and astutely observed the benefits of clean air and environmental change."

Still, the spasmotic theory of asthma was debated through the 19th century as we will discuss soon on this blog. The nervous theory likewise gained major acceptance until it was finally shot down in the 1950s.  In fact, one of the main reasons the spasmotic theory of asthma originally proposed by van Helmont and Floyer was because of their belief in the nervous theory of asthma.

However, in their defense, asthma was often described as a nervous disorder even by the ancients, especially once it was learned that asthma left no scars in the lungs.  Since there were no scars asthma must be nervous in origin.

Asthmatics tended to be looked at as weak and inferior in most civilizations. They weren't able to go off to war, weren't able to ride horses, weren't able to sleep with pigs, and tended to spend more time socializing with women than hunting with the men.

Still, the 17th century provided a dawn of sorts for asthma wisdom.  Thanks to the works of van Helmont and Floyer future asthma experts had a foundation to work from, however flawed it was.

One of the main reasons it was debated was due to the nervous theory of asthma.

Click here for more asthma history.

References:

1. Berkart, J.B., "On Asthma," 1878, page 
2. Walter, Mmichael J, Michael J. Holzman, "Americana Journal of Respiratory Cell and Molecular Biology, "A Centennial History of Research on Asthma Pathogenesis," http://ajrcmb.atsjournals.org/content/32/6/483.full (accessed 2/22/13)