Can I excel despite asthma?

I've done this with quite a bit of success on my other blogs, so I thought I'd try it here at Hardluck Asthma. I like to check my statcounter to see what searches are leading readers here. Assuming the queries were not answered, I provide here my humble responses.

1. Can I smoke even though I have asthma? Yes you can, yet why would you want to. Smoking is linked to worsening asthma, and can even cause severe asthma. If you smoke and have asthma, here's 20 incentives to quit.

2. I have asthma and I can't smell:  Seventy five percent of asthmatics are believed to have allergies, and about 75 percent of asthmatics also have a history of rhinitis and sinusitis. All of these cause inflammation of the nasal passages which in turn can effect your sense of smell. I've had this problem in the past, and still do at times. The best treatment is to work with your doctor to find a good medicine regime to help you out.

3. Can I excel despite asthma?  Yes you sure can. Asthma wisdom and medicine has improved so much in the past 20 years to the point where most asthmatics should be able to live a normal active life. You'll have to work with your doctor though, and continue reading about asthma and how to control it. For good tips on how to control your asthma click here.

4. What's the 18th century name for asthma? Actually, in the 18th century asthma was called asthma. Nasal inflammation was called catarrh. Allergies were described yet not yet identified. Chronic bronchitis, cystic fibrosis, allergies, and many other causes of wheezes and shortness of breath were often all associated with asthma. There were often various classifications of asthma, yet these classifications were usually different from doctor to doctor.  For the most part, 18th century doctors described any condition that caused dyspnea or a wheeze as asthma.  For more click here.

5. Have you achieved excellence despite asthma? I have five blogs, a great job, a wonderful wife, great kids, and an overall wonderful life. To learn how asthma has benefited my life, click here and here

6. Is asthma a nervous condition? No. It was believed to be in the 19th century, yet by 1950 that theory was proven wrong. Stress and Depression may be linked to asthma, and may trigger asthma, but asthma is a real physical condition, not a mental disorder. Click here for more.

7. What are asthma organs? Asthma is more than just a lung disease. I write about this here.

8. Can a barrel chest go away with asthma? Yes it can. It's caused because air gets trapped in your lungs. Once you gain control of your asthma it will go away. I know because mine went away.

So there you have it. If you have any further questions you are free to email me absolutely any time. Thanks.

x1851-1913: The history of asthma sputum

Ernst Victor von Leyden (1832-1910 discovered
crystals in asthmatic sputum, and suspected these
to be the cause of asthma. During his era, he was
the closest supporter of Dr. Robert Bree's
bronchitic theory of asthma. (9, pages 14-15)
He believed these crystals somehow irritated the
"vagus in the mucus membrane of the bronchials,
and hereby caused by reflex action a spasm
of the muscles of the small bronchial tubes."
(10, page 8)

Most people find sputum disgusting, and so will have nothing to do with it. But as far back as 400 B.C. the medical significance of it was observed by ancient Greek physicians, and probably even earlier than that.

If you mention it at the dinner table your mother might smack your hand. But for the sake of gaining a complete grasp on the history of asthma and respiratory disease, we must delve into the topic of sputum.  Sorry, but we must.

It must have been observed at an early date in history that people with breathing issues produce sputum, sometimes consisting of a putrid smell, often consisting of many varied colors such as red, yellow, brown and white.

Yet rather than being petrified by the grossness of the substance, Greek philosophers became fascinated by it. They even gave it its own classification as one of the four humors that, along with determining ones personality, also determined whether was healthy or sick.

Prior to the philosophical medicine of the ancient Greeks, other ancient societies, and the primitive clans and families that roamed the lands before them, believed sputum was the production of some evil spirit, demon or god. When a person expectorated the substance, they were in essence expectorating an evil substance that caused the symptoms they were suffering from.

From the ancient world to the scientific revolution there were few changes in the way physicians viewed diseases and treated their patients.  In 1799 Dr. Robert Bree speculated that sputum contained a poison that it was trying to get out of the body, and asthma was the result.  This theory wasn't much different than any idea Hippocrates might have postulated.

Since the sputum preceded the asthmatic fit, Bree essentially speculated that asthma was essentially bronchitis, and thus created the bronchitic theory of asthma.  Others, without much more evidence, speculated sputum was the effect of asthma rather than the cause.

Such speculation gradually tapered off, but never really came to an end, during the scientific revolution, and mainly due to the inventions of the microscope, which allowed physicians to see that the human body was made up of substances too small to be seen by the unassisted eye, and the stethoscope, which allowed physicians to hear changes that occurred inside the chest and to diagnose diseases with accuracy prior to autopsy.

The microscope allowed physicians to learn that air passages were surrounded by smooth muscle, and that it was capable of spasming when stimulated.  The stethoscope allowed them to hear when sputum accumulated in the chest, and learn that it was the effect and not the cause of asthma.

So, pretty much, prior to the 1850s asthma was basically considered to be a disease of excess sputum, mainly because this was all physicians could observe with the unaided eye and ear.

Yet by the 1850s it was looking pretty clear that asthma was also a disease associated with spasms of the air passages, particularly by the wheezes heard by air flowing through narrowed air passages, and rhonchi heard as air flowed through sputum lined air passages.  (1, pages 592-595)

In 1851, Dr. Beau, along with his assistant Cozart, observed that fits of asthma usually ended with a wad of sputum being coughed up. Beau used this observation as evidence to support his theory that asthma was a disease of chronic catarrh, and that asthma was caused by increased sputum in the air passages.  (3, page 31)

When this sputum dried out mucus plugs formed that were capable of blocking the air passages, thus resulting in dyspnea and other symptoms of asthma, including the "sonorous and sibilant rhonchi -- their 'rales vibrants' heard upon auscultation with a stethoscope."  (3, page 31)

The fit, therefore, was resolved when mucus plugs were broken up with a fit of coughing.  (3, page 31)

Then, in 1878, at a time when most physicians had accepted the nervous and spasmotic theories,  J.B. Berkart used Beau's research as evidence of the bronchitic theory of asthma.

Berkart said:

With the displacement of the mucous plug into the larger bronchus, or on its expulsion by means of a fit of coughing, the dyspnea ceases, and with it also the rales disappear.  This form of bronchitis is, in their (Beau and Crozant's) opinion, due partly to an idiosyncrasy of the patient, partly to exciting causes, which greatly vary in different individuals."

Tiny crystals were first observed in sputum in 1851 by Jean Martin Charcot, but it wasn't until 1872 that these crystals were linked to asthma by Ernst Victor von Leyden. So history has given credit for this discovery to both men by calling the crystals Charcot-Leyden crystals.

Leyden, whose asthma theories were similar to Dr Bree's bronchitic theory, believed Charcot-Leyden crystals caused asthma by irritating...

...the peripheral extremities of the vagus nerve, and produce reflex spasm of the bronchial muscle."  

The asthma attack, as Bree and Beau observed, ended when a wad of sputum was coughed up during a fit of coughing. (4, page 14-15

However, it was the discovery of these Charcot-Leyden crystals that would ultimately put an end to the bronchitic theory of asthma.  This was noted by Dr. John Charles Thorowgood in 1878.  He said that these crystals were found in sputum obtained from patients with "ordinary catarrh and croupus bronchitis."  (4, page 15)

Thorowgood said:

The asthmatic patient while in a fit presents abundance of symptoms distressing enough to endure or to witness; and yet, when things seem to be at their worse, and the patient well-nigh at his last gasp, a remission comes on, the spasm yields, air enters the lungs, and the attack subsides, coincidentally often with access of cough and mucous expectoration." (4, page 16)(9, page 1,2)

In 1879, bacteriologist Paul Erlich discovered the eosinophil, and it was soon discovered that elevated levels of eosinophils (eosinophilia) was commonly found in asthmatics. (5)

In 1882 Heinrich Curshmann observed other spirals in asthma sputum and believed they were associated with causing asthma. He believed since Leyden's crystals didn't cause asthma, perhaps his crystals did. (5)

Later Curshmann's crystals were determined to be fragments of mucus plugs associated with asthma, and Leyden crystals were determined to be fragments of eosinophils. Eosinophils were later learned to be a type of white blood cell that, along with mast cells, are involved in the allergic reaction.

In 1911 Hermann Sahli described eosinophils in asthmatic sputum. Yet Sahli noted another author from 1891 who described eosinophils in asthmatic blood, and he concluded that these must be pathological with asthma. Yet he also noted that neither the cause of the eosinophils nor their origin was known. (7)

Sahli could isolate the area where the sputum came from based on epithelial cells in it, yet he did not understand the mechanisms of its production as we do today. (7)

Dr. James Adams describes asthma sputum in 1913: (8)

"Asthmatic sputum varies. Often there is none till the end of the attack; then it is in the typical form of small, tough pellets expelled by laborious coughing. The attack may then cease, or it may go on till a more free and profuse expectoration occurs."

He also wrote:  (8)

"The sputum does not readily decompose, and is said to be wonderfully free from microbes; but this is not always so, as I have occasionally found it teeming with them."

The true purpose of sputum is to ball up microbes inside the lungs and haul them out, and in this way the lungs stay sterile.  Surely asthma can be caused by inhaling a microbe, such as a bacteria, but it's also caused by asthma triggers (dust mites, smoke, fumes, chemicals, pollution, animal dander) that are innocuous to most people, and non infecting agents.

So this might explain why Adams most often found asthmatic sputum without an infecting agent, and sometimes "teeming with them."

Backing up a moment to 1906, Australian pediatrician Clemons van Pirquet coined the term allergy when he observed that some of his patients were hypersensitive to substances that did not bother other people (what we now refer to as allergens, or asthma triggers).  This was the first time asthma was linked with allergies.

By 1910 Histamine was discovered and found to be a major component in the allergic response.  So some went on to speculate that finding a way to block histamine would cure both allergies and asthma.

By 1946 antihystamines hit the market, and within a decade they were among the most commonly prescribed medicines.

Yet as time went by, it was learned that there was more to asthma and allergies than just histamine.  It was learned that asthmatic and allergic immune systems respond irrationally to allergens and asthma triggers by increasing production of eosinophils and this spearheads inflammation of the bronchial muscles.

Another weapon of the immune system is mast cells that line the respiratory tract and eyes, and these were discovered in 1953.  .

In 1967 Immunoglobulin E antibodies (IgE) were discovered.  It was later learned IgE has a significant role in the asthmatic and the allergic response.  The first time asthmatics are exposed to asthma triggers (allergens), say dust mites, their immune systems develop dust mite IgE antibodies that attach to mast cells that line the epithelial layer of the skin or respiratory tract.

The second time that person is exposed to that allergen (dust mites in this case), a mast cell that has a dust mite IgE antibody attached to it explodes and releases its contents:  the mediators of inflammation.  A mediator of inflammation called histamine was discovered in 1910, and others called cytokines and leukotrienes were discovered in the 1970s.

These mediators, when released into the blood stream, cause inflammation of the respiratory tract, thus causing the allergic and asthmatic responses.

In the allergic person, they can also cause inflammation of the upper respiratory tract, which includes the back of the throat and nose.  The offending substance (dust in our case) is recognized by the immune system, trapped in the mucus layer, absorbed by the mucus, balled up by the mucus, and sent on it's way up the respiratory track to be coughed up.

So this would explain what Dr. Bree, Beau, and Berkart observed. While hacking up a wad of sputum may have been related to the fit of asthma, it was not the cause, and had nothing to do with the cure.

Later it was learned that asthmatic lungs tended to produce an abnormal number of goblet cells, this results in an abnormal increase in mucus production during an asthma attack.  While some of this sputum may be coughed up, some becomes trapped in obstructed air passages, dries out to form mucus plugs, and this further blocks the air passages, thus compounding the asthma response.

When the fit ends, when the air passages relax and dilate, which may be a result of time or medications, the asthmatic will probably expectorate this sputum, which will usually be, if no bacteria or virus is balled up within it, white and sterile.  It will also have IgE and eosinophils in it, hence your Charcot-Leyden and Curshmann crystals.

So it's easy to understand how this production of sputum at the end of an attack could easily be misinterpreted as the cause, rather than the effect, of asthma.

References:

1. Lotval, J., "Contractility of Lungs and air tubes: experiments performed in 1840 by Charles J.B. Williams, European Respiratory Journal, 1994, (7) pages 592-595
2. Bree, Robert, "A Practical Inquiry into Disordered Respiration Distinguishing the Species of Convulsive Asthma, their Causes and Indication for a Cure," 4th ed, 1810, London, page pages 117-118
3. Berkart, J.B., "On Asthma: Its Pathology and Treatment," 1878
4. Thorowgood, John C., "Asthma and Chronic Bronchitis: A New Edition of Notes on Asthma and Bronchial Asthma," 1894, London, Bailliere, Tyndall, & Cox
5. Lipkowitz, Myron, Tova Navarra, "Encyclopedia of Allergies," 2001
6. Brenner, Barry E, "Emergency Medicine, 1998, page 10
7. Sahli, Hermann, "A treatise on diagnostic methods of examination," 1911
8. Adams, James, Asthma and it's Radical Treatment, 1913
9. Thorowgood, John C., "Notes on Asthma," 1878, 3rd edition, London, J & A Churchill
10. Shmiegelow, Ernst, "Asthma, considered specially in relation to nasal disease," 1890, London, H.K. Lewis

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,