Thursday, August 22, 2013

1976: What causes asthma?

So it's 1976 and you're an asthma doctor.  You look into your medical books and magazines to get an update on the latest asthma wisdom.  When you were in medical school in the 1950s you were taught asthma was a disease of bronchospasm that mainly occurred when the asthmatic was anxious or stressed.  You want to know if things have changed.

Ever since the 1850s doctors suspected the mother as a major source of asthma.  In 1976 a report in the Archives of General Psychology noted that most psychologists "generally agree on the mother as one primary cause of childhood asthma.  'Something in the mother's personality sets off a child's dark, hidden fears and anxieties,' the theory goes.  'This in turn produces allergic reaction in the child which constrict the bronchial tubes and make breathing difficult or even painful."  (1, page 125)

Most psychologists agree that the mother is a source of stress for the asthmatic.  When the mother scolds the child this induces an inner anxiety.  Of course mothers may not understand that an asthmatic child may have psychological issues of his own just because he is asthmatic, such as:
  • Kids picking on him because he is wheezing, sniffling and sneezing
  • Kids picking on him because he is perceived as the wimp because he can't play sports 
  • Not being able to do things with his dad, such as hunting camp, hunting, stacking wood
  • Not being able to play with his siblings in the dusty basement, fort, outdoors.
  • Not being able to play outdoors in cold weather
  • Not being able to play outdoors when chimney smoke fills the air
  • Humidity:  Yes, that humidifier your mom and grandma used can make asthma worse because it makes the air thicker, and creates a breeding ground for germs
All of this is true, and all of this causes anxiety.  Yet these in and of themselves are symptoms or consequences of asthma, not the cause.  Yes, they can make asthma work, but they do not cause asthma.  Yet, still, asthma experts in the 1970s and 1980s don't quite understand this.  They continue to place a major emphasis on the the theory "it's all in your head," as opposed to looking elsewhere for causes.  

However, and thankfully, the psychological theory of asthma started to fade in the 1970s.  More and more studies seem to disprove it.  Many doctors and psychologists start to doubt this theory, and they start to postulate new ones, such as (1, page 124-127):
  • Air pollution causes it.  Studies start to confirm this
  • Eczema causes it.  About 50% of kids with eczema end up with asthma 
  • Food causes it.  Many kids are showing signs of milk and chocolate allergies
  • Infections cause it:  Many kids with colds end up with asthma symptoms
  • Emotion causes it:  Yes, it can still trigger an attack
  • Family incompatibility:  Yes, stress induced from parents can cause it  Mom's who refuse to get rid of dogs.  Moms who refuse to get rid of indoor plants.  Parent's who refuse to become educated about this disease, and get irritated when their child is different than other kids
  • Climate changes:  Living near allergens, hay fields, grass fields
Yes, the asthma experts start to look in other areas, and this is a good thing.  It pretty much sets up the next stage in the evolution of asthma, which takes place in the late 1990s with the initiation of asthma guidelines.

Another idea that still abounds is the removal of the asthmatic from the climate.  If the child lives around a hay field, it may be best to move to a region of the United States where there are no hay fields or other such allergens.  Many are still taking their asthmatics to places of higher altitudes and drier air, such as Denver and Phoenix.

Many asthmatics quit their jobs, or quit school, and moved away from their family and friends seeking a place where their asthma or allergies was improved.  Some left permanently, and others left temporarily. Some were removed from their homes and admitted into asthma institutions like National Jewish Hospital/ National Asthma Center in Denver, Colorado. 

The theory that asthma is all in your head starts to fade in the 1950s, and the idea that asthma is caused by other things, such as pollution, also start up at this time.  But convincing a dogmatic medical community often takes time.  Yet once new causes are understood, this can often lead to better treatment, and a better life for the asthmatic.

New ideas have to be taught to a new generation of medical students, and the older doctors either have to accept change, admit they were taught fallacies, or we just have to wait for them to retire.  New ideas like the ones above slowly grew in the medical community by the process of assimilation. 

  1. "The Encyclopedia of Common Diseases," by the staff of Prevention Magazine, "What makes children asthmatic?" 1976, United States

1 comment:

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