Salter aimed to prove asthma was nervous

Sticking to Dr. Henry Hyde Salter's view of asthma as being all in your head, he offered the following as proof.

1. Many patients feel fine as soon as they enter the doctor's office
2. Mental emotion can bring on a paroxysm of asthma
3. Mental emotion can resolve a paroxysm of asthma
4. Remedies that relax the nervous system resolve asthma, such as tobacco, antispasmodics, sedatives, and nervous depressants. Examples include tobacco, alcohol, morphine, and especially chloroform.

Reference: 

1. Salter, Henry Hyde, "On Asthma: It's Pathology and Treatment," 1868, London, pages 24-30

Here's how I keep track of my asthma

Here's another topic I was asked to discuss on my blog:  Share your best practices for keeping track of your asthma and how you use that information to guide conversations with your doctors.

I remember back in the 1980s when I had to take some medicine every three to four hours.  As a kid I found that this ultimately resulted in skipped doses and eventually life got busy and this resulted in me just saying, "Forget it."  Then I'd have no controller meds in my system and when exposed to my triggers I'd come crashing down and end up in an emergency room bed.

So then came along modern asthma controller medicines like Advair which only needs to be taken twice a day, and Singulair which only needs to be taken once a day.  These new medicines are exactly what I needed to get my asthma under control.

I don't think it's so much that these newer medicines are any better than older medicines, but it's just that they only need to be taken once or twice a day.  Thus, for the first time I was able to create an easy to follow daily ritual.  I get up and take my medicine, and then a take my medicine as I'm getting ready for bed. That's it.  No need for any further thought.  Even the laziest asthmatic can follow that plan.

So if I were to provide any wisdom regarding how to keep track of your medicines, I'd recommend that you don't be afraid to try these new medicines that only need to be taken once or twice a day.  Get into the habit of taking your medicines when you wake up and go to bed.

This will make all your life so much better because you'll kill two birds with one stone:  1) You'll have the medicine in your system and, 2) as a result, when exposed to your triggers your asthma attack will be less severe and easier to control, and it bay even be prevented altogether.

So the easiest way to keep track of your medicine is simply to keep it seldom and keep it simple.

Yet then theirs the problem of when your asthma does show it's ugly head.  Then what do you do?  Well, you'll have to use your Albuterol.  That's easy. Get instant relief.  You might want to work out a plan with your doctor, have it written down, open a drawer, pull out the paper, read it when you're in crisis, and then follow the algorithm.

Personally, I know I'll never do that.  It's not me.  So I basically treat the symptoms I feel.  That's me. That's how I do it.  If you're a person whose good at keeping papers and following written plans, then I think that's something you should try.  Yet if you're a normal person like me, common sense is the way to go.

If you have the ability to keep up an asthma diary, go for it.  I can think of no better way to keep track of your asthma, and what caused you to have a flare.  In retrospect I wish I had kept one through the years.

Monitor your symptoms, and then work with your doctor, or do your own research, and come up with a plan that will help you control and treat your asthma.  For tips on how to treat and control your asthma, click here.

While I have found a system that works for me, your job is to find a system that works for you.  You can create a plan that's unique like mine, or you can keep an asthma diary, or you can just do something.  The key is to find something and stick with it long term.

If you don't currently have a plan, I encourage you to do you own research.  If you have a plan, I encourage you to share what works for you in the comments below.

1850s: Asthma was thought to involve other organs

Asthma prior to the 1850s, and in many cases to the 1950s, was often considered to effect many organs, and not just the lungs. Consider the following:

• Lungs: Bronchospasm, emphysema (air trapping), fluid in the lungs


• Heart: Increased in size, weak pump, failure


• Nose: Crease on bridge of nose, nasal irritation


• Chest: Barrel chest, malformation of chest wall


• Spine: Curvature of the spine, hunchback


• Stomach: Eating too much made breathing difficult

Of course we know now that asthma does effect many systems of the body. For example, 70% of asthmatics have allergies, and this also results in nasal inflammation and irritation resulting in a crease due to constant rubbing.

We now know that too much food in the stomach causes the stomach to press up against the diaphragm making breathing difficult. Plus new studies show high fat food can cause an immune response where your body treats substances in fat as an allergen, and this causes increased inflammation in the lungs.

Chronic barrel chest and emphysema are not so much asthma but components of emphysema, a separate but equally distressing disease. An asthmatic can have a barrel chest, an asthmatic can have air trapping, yet it usually goes away once the exacerbation has diminished.

Of course it should be noted here that emphysema was not very understood and older references to emphysema generally refer to what we now call air trapping that causes a barrel chest.

Yet still, given limited wisdom, it's interesting to read how asthma experts of the past tried to link other organs as participating in the asthma patient's misery. One such expert I will introduce you to in a future post even linked asthma with rickets.

Asthma resolutions don't work for me

I was asked to participate in asthma awareness month by creating a list of three or five resolutions for how I will better manage my asthma in the next year, or how I will take action to help others with asthma.  I have decided I am unable to do this.

I suppose I could just ignore this topic altogether, yet it makes for a good talking point.  The reason I can't make a resolution to help me make my asthma better is not because my asthma is perfect, it's because I know I will never stick to it.  That's just me.  I know me.

We humans are creatures of habit.  My habit when I get up in the morning is to take my asthma controller medicines and then brush my teeth.  When I go to bed I take my asthma controller medicines and then I brush my teeth.  That's my habit.  That's my routine.  That's my life.

I can say that I will create a diary and do a peak flow daily to monitor my symptoms, but I know I won't stick to it.  I might do it a week or two, but I won't stick to it.  So making a resolution to make this change might be nice, and it might even result in better asthma control, yet I much prefer to simply monitor my symptoms.

It's what I've always done.  Besides, I know me.  I know my signs and symptoms of asthma.  I also know peak flows are made to get lost and never found.

I can make a blog post with five resolutions of how I will use my blogs to help other people, but isn't that something I already do?  Sure, I could do more, yet I'm not a social person so I know I won't make a public appearance any time soon.  Any communicating or teaching I do is right here in the faceless blogosphere.

Ten years ago this might have been different.  Ten years ago I didn't know me well.  Ten years ago I was still trying to be like my dad.  Yet now I know I'm not the outgoing, partying, cool, fun, social person that my dad is.  I'm me.  I'm an asthmatic, introvert, thinking, writing, blogging, educating, history loving, reading, fool.

I personally think that the best way to gain control of your asthma is to know yourself and be yourself.  Once you discover who you are, everything else -- including your asthma action plan -- will fall into place.

Resources: Management and Treatment, So You Have Asthma

For tips on how to better manage your asthma click here and then click here.

(May is Asthma Awareness month, and May 3 is asthma awareness day. For more information about asthma, check out the Centers for Disease Control and Prevention/ Asthma.)

10,000 B.C.: Asthma caused by too much phlegm?

Were disease theories formed during the Neolithic Revolution about 10,000 B.C.?

Asthma-like symptoms were described in ancient societies in Egypt, China, Korea, India, Greece and Rome, and while various terms were used to describe respiratory ailments, most societies believed in one way or another that disease was caused by an imbalance of bodily humors. 

The humors are the bodily fluids. Primitive people must have noticed puss on open sores, and colored phlegm in those sick with breathing trouble.  They must have noticed the diarrhea and vomiting of people with stomach discomfort, pain, nausea and malaise.

So early on they must have associated the humors with being associated with disease, and at some point linked them with the cause.

They most likely would have noticed that, upon spitting up a wad of phlegm the person who was short of breath felt better, or that after a good bowel movement or after vomiting, a person with stomach discomfort felt better.

So early on they must have linked the humors with the cure.

Some humors that were most certainly observed were blood, phlegm (sputum, nasal secretions, saliva), water and bile. (1, pages 111-112)

There are different descriptions of the humoral cause of disease.  For instance, the Chinese describe it as an imbalance of yin or yang causing an obstruction of sorts to the flow of human life, or qi.  The Ancient Greeks believed it was an imbalance of the four bodily humors:  blood, phlegm, yellow bile and black bile.

The cause of such an imbalance was believed to be things like living non-virtuous lives, stressful living conditions, poor living conditions, uncleanliness and improper diet.  Remedies for disease were believed to be incantations, drinks or inhalents of various herbal concoctions, or anything to purify the system to return the humors back to normal. 

Yet whatever way you look at it, the similarities of the causes and cures of diseases by different civilizations is stunning.  It almost makes one think such a theory was proposed before mankind split up into six different regions during the neolithic revolution or agricultural revolution nearly 10,000 years before the birth of Christ.

Either that or there was more communication between Ancient Eastern and Western societies than historians are aware of.  And in this way was devised the convection theory by Friedrich Ratzel in 1882 which states that nations have "identical phenomenon" because of communication between the various groups of humans, according to Fielding H. Garrison, in 1921 his book "An introduction to the history of medicine."  (2, pages 17-19)

A separate theory mentioned by Garrison is the convection theory devised by Adolf Bastian in 1881.  This states that "the appearance of identical ethnic phenomenon in different relations of space and time is due to the spontaneous development of certain 'elemental ideas' which are common to primitive man everywhere.(2, pages 17-19)

Garrison explained it as the "Solidarity of folkways."  This theory postulates "humans have instinctive actions" that cause them to gather in groups, form societies, and generate myths to explain natural phenomenon.  They tend to reach a "common point of similarity or identity." (2, pages 17-19)

Worded another way:  "The development of the individual is but an epitome of the development of the race. Left to itself in a favorable environment, any savage tribe will inevitably evolve a culture all its own, for the regulation of food supply, sexual and social relations, adjustments to the unknown, manifesting itself as a political economy, ethics, law, medicine, religion, and so on." (2, pages 17-19)

In this way it's believed certain human actions are instinctive, no matter when a society is formed, at a certain stage in it's development.  This may explain why the ancient Egyptians created their pyramids and mummification, and similar pyramids and mummification methods were discovered in Mexico thousands of years later.  There may have been no communication between the two groups, just that the Mexicans were slower to develop their society and advance to this state.

Religions and laws in all societies are ultimately realized to be an important element of maintaining peace in the society, and a government with a totalitarian ruler was determined to be the best way to get people to do things that were needed to be done for the society to function, such as tending to the land, creating structures, and managing irrigation.

And plants were determined to have poisonous and medicinal properties in the evolution of the society.  To explain how they worked myths were created.  Myths were also created to explain health and sickness.  It just so happens at a certain point the myths appear to be the same, such that disease is caused by an imbalance of some sort of substance, which the Greeks called humors and the Chinese called Qi and other societies called something else.  Yet the ideas are similar, and this type of medicine is referred to as folk medicine (folklore).

These similarities are the natural, or instinctive, evolution of human societies.  And at some point the society will develop a need to communicate ideas from one generation to another, and this is where folklore comes in.  Poems and songs are recited to make it easier to remember stories and recipes, and then at some point a form of writing material and written language is developed.  It's by this we have evolved to where we are today as a society.

In this way, societies evolve as new ideas are thought up to make life better for the civilization, but the heart and soul of the people has never changed.  Humans always have an inert tendency to socialize, to think, to communicate, to breathe, to eat, to adjust to change, and to have empathy for fellow men and women.

Men and women observed their relatives and friends suffering, and yearned to find a way to help them.  They attempted to find myths to explain the symptoms they observed or their fellows complained of.  They created myths to give people hope and faith for a better future.  This is always essential, as death and sickness are omnipresent.  Life can be melancholy, and hope and faith are needed to give people a reason to do what they need to do to keep the society afloat.

Asthma, or asthma-like symptoms were believed to be caused by too much phlegm that causes a ceizure or epilepsy of the lungs resulting in various respiratory symptoms such as foaming at the mouth, cough, dyspnea (short of breath), and wheezes.  These symptoms would be the result of anything that causes dyspnea, including exertion from running or battle.  The remedy for asthma, as with any disease, was as simple as improving diet and getting plenty of sleep and exercise.

While the definition of asthma matured through the years, it wasn't until the mid 19th century that the myth of humoral causes of disease left the medical profession. This evolutionary advancement occurred in western nations of Europe and the United States.  In this sense, the humoral cause of disease was such a simple description of disease it was easy to believe, and this dogmatic theory lasted perhaps 11,850 years if not longer. Yet at a certain point in the advancement of knowledge science would be learned, and myths would be found to be myths.  Although I think it's safe to say that some medical myths still linger.

Even the great asthma expert of the second half of the 19th century, Dr. Henry Hyde Salter, didn't completely reject the humoral theory, although he was the first to successfully sway from this mindset. And even then it took a lot of convincing to finally change the minds of dogmatic physicians and an ignorant society.  It took science, and a lot of hard work by a few physicians struck by asthma.

While most modern civilizations have moved on from old myths, some primitive societies continue to believe in them.  They continue to worship gods and spirits, and justify health and sickness as being caused by transcendental forces.  Medicines are thus gifts from the other world.  As their society advances, as knowledge progresses, they too will some day reach the modern world.

Likewise, if our society continues to exist, society will continue to change.  Who knows what the future will bring.  Yet what we do know is that the heart of humans will continue to be the same.

Click here for more asthma history.

References:

1. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press
2. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia and London, 

It's time to grade your asthma action plan

So I guess if I were to review my asthma action plan and grade myself on how well I adhered to my doctor's recommendations, I'd have to give myself a A+. The main reason is that I've been able to keep my asthma under control without the need for any unscheduled doctor visits since 1997.

My Asthma Action Plan is a bit unique, and perhaps even simpler, than the ones recommended by most asthma experts. Mine does not involve my doctor, and generally incorporates vigilance and common sense.

Myplan pretty much consists of the following:

• Take my asthma controller medicines daily


• Avoid my asthma triggers as best I can
• Monitor my asthma symptoms
• Play it by ear

I have to do it this way because I know me. I know I will never keep a diary. I know I won't do a peak flow on a regular basis, and even if I do I won't remember my personal best anyway. That's me. I know me. I know how I function. And catering your asthma action plan to YOU is what it's all about.

It's about controlling your asthma so YOU can live a normal life. What I wrote above is what I do to maintain control of my asthma based on what I know about myself. And for the most part, it's worked like a charm for 14 years.

I can do better, as we all can do better. Yet one of the main problems I encounter is I like to live a normal life, and I like to, well, clean my basement for example. And I know that most people, myself included, become rapt in certain project they enjoy and want to work until they get the job done.

Yet as an asthmatic I cannot do that. I know If I get rapt, and I don't pay attention to the early warning signs of asthma, and I just keep on a working on cleaning my basement, I will have trouble breathing for the next couple weeks. It will be a major set back. The job will never get done.

So I have learned that a better method, even though it is hard for me to do, is to limit myself to 30 minutes on any given day involved in any project in my basement. Once thirty minutes is up I have to be done. I have to quit at the 30 minute mark. My wife too has to understand that projects entrusted to me might take a while.

You see, if you have asthma you have to make adjustments in your life. You have to do what you need to do to live a normal life the way you see it.

I ask you, my readers, to review your asthma action plans and grade yourself on how well you're doing. What's that? You don't have an asthma action plan? Well it's time you invent one.

You ideally should work with your doctor, and I have done that in the past. Yet as an adult perhaps you'll find you're better at doing one on my own. After all, YOU know yourself better than anyone.

Do you give yourself an A grade? Keep up the good work. Do you give yourself a B? A C? Perhaps you guys should refocus on self-management and consider identifying a “personal champion” for encouragement and support.

Any F’s? Perhaps you should wisit their doctor to reassess your asthma action plan and determine whether alternate treatment options would be better for controlling YOUR asthma. And don't feel bad if you grade yourself an F, because we all start out there -- I did too.

As you learn about yourself, and your illness, you'll learn, perhaps, how to adjust your asthma action plan to your personality.

To learn how to create an asthma action plan click here.

Download Printable Action Plan by clicking here

(May is Asthma Awareness month, and May 3 is asthma awareness day. For more information about asthma, check out the Centers for Disease Control and Prevention/ Asthma.)

Happy Easter!!!!

Happy Easter fellow asthmatics.  The two girls and dressed real cute in matching dresses.  The older boy is dressed nice but more interested in the baseball cards he got in his Easter basket (yes, 12 year olds are spoiled by Easter bunnies too).  And the 8 MO is is giggling and cooing and crawling all over the place looking for trouble.

Sure the squabbles and the occasional wine is normal, and it's on days like this we are reminded of the joys of being a parent.  It always seems there is always one Easter basket that gets hidden really well, even so well that the dad can't even find it.  This year it so happened to my 7 YO, and she was even getting frustrated and thought the Easter Bunny had forgotten her.

Yet when she finally did find it hidden behind the towels in the bathroom, this just made her smile that much bigger.  So here we are ready to set off on another Easter adventure, which will consist of nothing but a modest trip to church and a brief meal with the wife's siblings.  Nothing exciting, yet always special, especially to the little ones.