Monday, May 07, 2012

1810: Bree's asthma remedies

Dr. Robert Bree was recognized as a predominant expert on asthma during the first half of the 19th century, as I wrote here.  In 1910 he wrote a book titled, "A Practical Inquiry into Disordered Respiration Distinguishing the Species of Convulsive Asthma, their Causes and Indication for a Cure."  The following are the remedies he recommends for asthma:

1.  Cathartics:  These are medicines or herbs that cause evacuation of the bowels, or purging.  Purging is the use of vomiting or laxitives to clear the stomach, according to  For example, one patinet noted taking "10 grains of powder of jalap, and three grains of colomel when the fit commenced, which completely removed the fit, on many occasions by evacuating a load of bile."  Yet Bree wasn't a big fan of cathertics, and suggested that if this relieved the asthma the cause was something other than asthma.  However, he admits that cathertics to work for some asthmatics. 

2.  Emetics:  These are medicines that induce vomiting, according to  Tartarized Antimony and Antimonial Wine or small doses of Ipecacohan can incuce vomiting.  Amid other things, they promote exhalation from the lungs and are therefore "powerful expectorants."

3.  Diaphoretics:  These are medicines that promote sweating, according to  He recommended "gentle diaphoresis, but not sweating." 

4.  Bleeding:  This is where you cut a vein and allow blood to flow in an attempt to balance the humors.  He believes this has "doubtful effects" on asthmatics.  However, he does recommend it for most species of asthma. 

5.  Diuretics: These are medicines that make you pee.  "Natron taken every night, in doses of eight grains, has been found to be very beneficial" for certain types of asthma. 

6.  Issues:  These are medicines to treat mental or emotional problems, according to  "In very old asthmatics, issues are sometimes necessary.  In younger subjects, when the disease is not yet inveterate, they may occasionally be useful, by diverting acqueous humour from the lungs, and giving a better opportunity for the operation of tonic remedies...  When the disease is complicated by dropsy (an old term for edema, according to, I have seen great advantage to the breathing, from from their application in the thighs." 

7.  Antispasmotics:  These are medicines that relax smooth muscles, such as the muscles that wrap around the air passages in the lungs or that line the respiratory tract.  One common medicine is opium and it is enhance by the use of ether.  Calcined zinc has proven beneficial for epilepsy, although is not useful for asthma.  "Velerian, cardamine, camphor, musk, castor, belladonna, tobacco infusion, extract of  henbane, fetid gums, cuprum ammoniacle in various doses, more or less joined with the other antispasmotics, or tonic medicines, and combined with opium in large and small portions" helps sometimes but most often prolongs the paraoxym. 

8.  Expectorants:  These are medicines that induce sputum production.  Ammoniac is a very valueable expectorant, although it should be given with opium to prevent purging (unless you want purging).  Squills are sometimes useful.  Squills also work when given with vinegar, similar to what John Floyer prescribed.  This is often called vinegar of squills.  A side effect is nausea and purging.  Tincture of squills combined with extract of henbane and the nitric acid is a good combination of expectorant and sedative.  Oxymell is efficatious if combined with vinegar or squill.  Honey and sugar are good for cough, but not so much for asthma.  Decoction of seneca can be useful in older persons, but is too irritating for younger people.  If asthma takes on the character of peripneumonia, decoction of seneca should be given with amonia during the febrile state, and when the fever goes away squill and camphorated tincture of opium will promote expectoration, perspiration, and urine.  All expectorants may cause nausea and vomiting, and this may be good in that it may remove the irritaing matter.  However, they also help relieve phlegm from the chest.

9.  Inhaling vapours:  "Hippocrates introduced the inhalation of vapours from various herbs and gums.  He used herbs and nitre boiled with vinegar and oil, and directed the vapour of such boiling compositions to be drawn into the lungs through a proper pipe."  Fumes can also be used to dry secretions that are known to cause asthma.  Frankincense, myrth, and many other gums, and these are occasionally mixed with arsenic. 
Modern physicians recommended inhaling vapour of aether "raised in the steam of warm water."  However, aether can make asthma worse.  Vapour of hemlock leaves can be useful for some forms of asthma, and especially for it's narcotic qualities. 

10.  Smoking tobacco:  Bree actually recommends asthmatics stop smoking "with great advantage to their health." 

11.  Oxygen:  May benefit asthma when the color of the skin turns blue.  May help cease labored respirations.  It works expecially well for convulsive asthma. 

12.  Hydrogen:  This has been proven to be beneficial to asthmatics, particularly spasmotic asthma. 

13.  Stomachics:  "These remedies are absolutely necessary in asthma to correct dyspepsia (upset stomach), in whatever species of the disease it may appear.  Bitter tinctures are not to be used in the paroxysm, but bitter infusions and testaceous powders are generally beneficial.  Acetous acid is also grateful to the stomach when any bilious acrimony is present.  In this case "

14.  Diet:  Any food that is an exciting cause of asthma should be avoided.  Barley water and all weak liquors that are likely to ferment or relax the stomach should be avoided.  Infusion of coffee is good for any type of asthma except the second. "Pure cool water has frequently removed the bad effect of an imprudent meal.  If the asthmatic perceive his stomach to be disordered or uneasy, he may next expect more certain symptoms of a paroxysm.  In these circumstances I have experienced, very frequently, the advantage of repeated draughts of water, so that two or three pints have been taken in the whole, from the commencement of the uneasiness; and this has given perfect relief when coffee had failed."  It is wise not to eat more than the stomach can handle."  (page 204)

Note:  According to Bree, the above remedies vary in accordance to the species of asthma diagnosed by the doctor.  However, in order to simplify Bree's work I have left out which species of asthma the above remedies are for.  In either case, all of the above remedies were recommended for one or another species of asthma.  I did find Bree's writings to be quite complicated to understand, and I apologize if my interpretations of Bree's work isn't exactly as he understood.


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