Tuesday, October 18, 2011

1579- 1644: Van Helmont creates nervous theory of asthma

Jean Baptista van Helmont
(8, page 260)
From about the time of Jesus to the Renaissance there were few advances in medicine. The Greek terms asthma and dyspnea had made their way into the vocabularies of doctors, yet little was considered about their causes.  Then along came the scientific revolution and Jean Baptiste van Helmont, who referred to asthma as "epilepsy of the lungs." (1, page 216)(2, page 176)(8, page 374)

Up until this time the works of Galen were considered the gold standard in medicine.  Science wasn't needed, because every thing any physician could possibly need to know about any disease, asthma included, was in one of Galen's books


This started to change when the dark ages ended with the fall of Constantinople in 1453.  This is believed by many historians to have ended the dark ages and sparked a Renaissance where lost Greek and Roman wisdom was recaptured.

It was in 1514 that Galen's reign as supreme master and god of medical superstitions took a major hit. This was the year Nicolaus Copernicus was questioning the belief that the Earth was the center of the Universe and started writing his theories about the earth rotating the sun. Out of fear of being rejected and maybe even killed, his works weren't published until eight years after his death in 1543.

This one event got many people to thinking, or, better yet, inspired thinkers to become courageous, thus giving birth to the age of reason, or the Renaissance. This was a time people started questioning the views that were etched in stone by the Ancient Greeks and followed through the Middle Ages.

This was a time when fresh ideas that were based on science as opposed to superstitions and false logic. New ideas were formed in physics, astronomy, biology, chemistry and medicine.

Copernicus was the first to use scientific research as opposed to superstitions in science, and it was Galileo Galileo who risked all as he published his book on scientific reason during his lifetime.  Galileo became famous, and because of this he is now called the father of modern science. He set the way for others to question old scientific and medical superstitions that were regarded as facts, and one such physician was Jean Baptiste Van Helmont, who, in 1579, was born into the dawn of the Scientific Revolution in Brussels.

He was the younger son of a noble family, and his father died in his second year. He entered the University of Louvain (Leuven) at a young age, and graduated from his studies in mathematics, astronomy, astrology, and philosophy at the young age of 17. (3, page 260) (4, page 113-114)(7)

He had an opportunity to become the imperial physician, but he declined it because medicine failed to heal him when he obtained scabies from a girl. Instead he decided to "spend his time by fasting, supplication and prayer, and in poverty. He chose the poverty of Christ, giving to his sister all his worldly possessions." (4, page 115)

He then spent time as a Capuchin friar just prior to studying law, botany and medicine. Once this task was completed, he traveled to Switzerland and Italy (1600-1602) and then France and England (1602-15), and then he received his medical degree in 1599. As a physician he was "unwilling to accept money from his sick fellow-man in return for so doubtful an art." (4, page 114)(7)

He put to use his medical skills during a plague that broke out in Antwerp in 1605. (7) This must have earned him quite a bit of fame.  It was also about this time that he was introduced to a person who introduced him to Paracelsus (1493-1541), and he studied his works "zealously." (4, page 114)

Perhaps due to the fame he earned by his travels and experiences, he was offered many attractive jobs from princes and archbishops, although he turned all of these down in 1609, claiming the he did not want to live in the "misery of my fellow men." (7)

It was that same year, in 1609, that he abandoned poverty and Christ, and married a rich heiress by the name of Margaret van Ranst. Through he he inherited several estates, and he retired to one of them, leaving the medical profession to devote his entire life to "chemical science" and transforming the works of Paracelsus. (4, pages 14-15) (7)

Unlike Paracelsus, van Helmont didn't believe in ancient Greek theories.  In fact, he became the first to dismiss the idea that asthma (and diseases in general) was a disease caused by an imbalance of the humors and instead was a disease caused by a narrowing of the pipes in the lungs. It was this view that made him a very controversial person during his lifetime.

 Historian Fielding Hudson Garrison explains van Helmont this way:
Like his master, Paracelsus, van Helmont believed that each material process of the body is presided over by a special archaeus, or spirit (which he calls Blas), and that these physiologic processes are in themselves purely chemical, being due in each case to the agency of a special ferment (or Gas). Each Gas is an instrument in the hands of its special Blas, while the latter are presided over by a sensory-motive soul (anima sensitiva motivaque), which van Helmont locates in the pit of the stomach, since a blow in that region destroys consciousness. (3, page 260)
Bradford explained him as follows:
Van Helmont transmuted the fancies of Paracelsus into a sort of mystic and pious system based on chemical principles. He was a considerable chemist. He thought that air and water were the elements; from the water everything on earth takes its origin—the world is the creation of God.(4, pages 114-115)
In order to prove the basic element of the earth was water he performed an experiment where he grew a tree in a a tub for five years and gave it nothing but pure water. We weighed the tree and soil before the experiment, and in the end the soil weighed the same and the tree had gained 160 pounds. He attributed the weight gain of the tree as being due to water. While his conclusion may not have been completely accurate, some historians refer to him as the father of biochemistry because of this experiment.

Bradford continued:
Disease is something active and is caused by the fall of man. The spirit of man came from God, but on account of the fall became so corrupted that a lesser spirit in man gained control. There was next lower a perceptive soul, and below that a something which he called Archaeus; then there is also Gas which arose by the influence of the Archaeus on water. To Van Helmont we owe this word Gas. (4, page 115) 
The term "gas" he derived from the Greek word for chaos.  Due to his experiments with gases he is considered by many historians as the father of pneumatic (air) science.

One of his most famous experiments was when he burned charcoal and produced the substance carbon dioxide. He explained this was the same product produced from fermenting musk, which rendered the air inside caves as unbreathable. Yet at that time he did not use the word carbon dioxide, he used instead the word gas sylvestre.

He also described other gases, such as carbon monoxide, chlorine gas (prescribed by later physicians as an asthma remedy), digestive gases, sulfer dioxide, and a "vital" gas in the blood that we now refer to as oxygen.

Perhaps one of the reasons van Helmont studied air was that he was an asthmatic.  He generally believed asthma was a physical disease of the lungs caused by factors outside the lungs, such as substances one might come into contact with, substances in the air, and substances affecting the mind.  

Orville Brown explains how van Helmont suspected the "archeus" was the cause of asthma: (5, page 27)
"Archeus"—a something—a vital spirit—was enshrined in the stomach, and when disturbed, was responsible for disease by sending forth a peculiar fluid, which, reaching the lungs, caused asthma.  (5, page 27)
To grasp a more complete understanding of this system of van Helmont, I will once again refer to Thomas Bradford, who said:
Van Helmont declared a very mystical and fanciful philosophy; the spleen and the stomach were the rulers over the body. The spleen presided over the abdomen, the sexual organs; the stomach over sleep, waking, and folly. This Archaeus also possessed a great power both in man and in animals. Disease depended on a perverted action of the Archaeus. (4, page 115)
More specifically, Pagan said that Helmont believed asthma was caused when a "specific disease semen has planted its root; in the present case (for asthma) a semen that closes the peripheral pores through which air passes from the lungs into the chest cavity.  It is a semen with the property of causing contraction of members and parts."  (2, page 175-176

That this has occurred, Pagan said of Helmont's theory, "is eveident with the phenomena associated with asthma," such as: (2, page 176)
  • Diuresis
  • Diarrhea 
  • Gurgling of the gut
  • Contraction around the gums (2, page 176)
Pagan likewise said that because the lung contracted, Helmont referred to asthma as "epilepsy of the lungs." He also called it this because asthma was observed to be "latent for long periods, only to provoke on special occasions attacks of contraction that chiefly concern one organ; in this case the lungs, in real epilepsy the nervous system." (2, page 176)  (2, page 176)

Pagan added one other thing about the "specific disease semon" that causes asthma:
Basically, however, neither of these is a localized ailment but one conditioned by the influent archeus, the vital principle of the organism as a while. This is shown by the associated symptoms outside the lungs.  But the anatomical changes must be looked for in the lungs, where the poison attacks directly, and where they are produced as at a specific seat. To that extent asthma (as indeed every other disease) is a local and localized affair. Its poison irritates in the same way cantharides do, and is essentially identical with the poison of epilepsy, but not strong enough to produce the latter. (2, page 176)
It is believed by many historians that he was the first to link asthma with hysteria, and therefore should be given credit as the father of the nervous theory of asthma.  But he usually doesn't get this credit, perhaps because of the controversial nature of his work, and the fact hat he fad no followers.

Most historians give Thomas Willis, his contemporary, credit for creating the nervous theory of asthma.  This is usually the case even though Willis mentioned nervous asthma several years after van Helmont did.  Yet this is just the way history is, sometimes giving credit for discoveries to the most popular person as opposed to the correct person.

Bradford said van Helmont's remedies for just about any disease were: (4, page 115)
  • Conjuratoins
  • Charms
  • Prayer
  • Power of god  (4, page 115)
He also used "earthly medicines," such as: (4, page 115)
  • Opium
  • Mercury
  • Antimony
  • Wine (for fevers  (4, page 115)
Barry Brenner said:
(Van Helmont) noted that the bronchi were the origin of asthma, and that inhaling dust and fish in certain individuals brought on attacks.  He noted that the bronchi would react with spasm to dust, especially from t demolition of houses and temples.  He described a monk who, while eating fish fired in oil, fell down, deprived of breathing, "so that he was scarce distinguished from a strangled man." The concept put in in conflict with the official Church view of internal humors as the cause of disease, and he was condemned to death until he recanted. (6, page 5-6)
Once he retired he dedicated about seven years to chemical research, and then he spent the rest of his life in "relative solitude and mostly in peace."  (7)

This was despite the fact that most of what he discovered, and most of what he believed, was contrary to the views of the church.  It was due to such controversies surrounding his work that he waited until he was on his deathbed to give his works to his son to edit and publish. So all of what was described above, all he accomplished in his life, was never published until after he was dead.  (7)

Van Helmont had an illustrious mind, one who decided to do what he thought was right as opposed to what was popular.  Surely this caused some controversy during his lifetime, but it was to the benefit of future generations.

References:
  1. Nulan, Sherwin B, "The mysteries within: a surgeon explores myth, medicine and the human body," 2000, New York, Simon and Schuster
  2. Pagan, Walter, "Joan Baptista Van Helmont: Reformer of Science and Medicine," 1982, UK, Cambridge University Press\
  3. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1921, 3rd edition, Philadelphia and London, W.B Saunders Company
  4. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
  5. Brown, Orville Harry, "Asthma, presenting an exposition of the nonpassive expiration theory," 1917, St. Louis, C.V. Mosby Company
  6. Brenner, Barry E, author of chapter one in "Emergency Asthma" called  "Where have we been? The history of acute asthma," 1999, New York, Marcel Dekker, Inc
  7. "Jan Baptista van Helmont," Britannica.com, http://www.britannica.com/EBchecked/topic/260549/Jan-Baptista-van-Helmont, accessed 11/11/13
  8. Gill, M. H., "Review and Bibliographic Notices: "On the spasmotic asthma of adults," by Bergson, published Gill's book, "The Dublin Quarterly Journal of Medical Science," volume X, August and November, 1850, Dublin, Hodges and Smith, pages 373-388

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