1600s: Nervous theory introduced to medical community

Perhaps the most prevalent theory regarding asthma through most of history was the nervous theory of asthma.  The idea was that, since no scars were found in asthmatic lungs, that it must be caused by the mind.  While this idea was tinkered with by various ancient physicians, including Galen, it wasn't taken seriously by the medical community until the 17th century.

So we understand so far that the term asthma first appeared in the ancient Greek writings of Homer, and was defined as a medical term by Hippocrates.  In Ancient Rome it was used sparingly, and it didn't find its way into English and other European languages until about 1398.

Medical wisdom in Western societies hit a wall of sorts with the fall of the once mighty Roman Empire, only to rise up in Eastern societies.  Around the 10th, 11th and 12th centuries such wisdom started to filter back West, yet it was a slow transition to say the least.

With the fall of Constantinople in 1453 the dark ages ended and the age of Renaissance began.  Old Western ideas about medicine and science started to re-emerge, and new ideas started to form.  The first Western physician during this era to investigate the term asthma was Jean Baptiste van Helmont (1579-1644).

Even during modern times physicians and scientists who become rapt in a certain disease are usually those who are affected by it, and van Helmont was no exception.  He was afflicted with asthma from a young age, and he became especially interested in it as a physician.

He was the first to describe asthma as anything other than simply a symptom.  He was the first to propose the idea that asthma was a disease of spasms of the air passages when he wrote:  "The lungs are contracted or drawn together."  Galen mentioned something of the sort way back in the first century, yet it was van Helmont who focused attention on the subject.

Van Helmont was also the first to describe asthma as a nervous disorder. By this, he meant that irritation of the nerves triggered the asthma response.

Several years later, Thomas Willis (1621-1675) also described asthma as a nervous disorder that caused spasms of the air passages of the lungs.  Yet it was his writings that were more generally accepted by the medical community at the time, mainly because he wrote more abundantly and specifically on the subject than van Helmont.  For this reason, he it is Willis who is generally given credit for introducing the nervous theory of asthma to the medical community.  (1, page 6)

So it's important to understand that van Helmont was the first to postulate the nervous theory of asthma, yet Willis is often given credit because.  This is mainly because, if not for his writings, the theory would never have gained the attention of the medical community.

Likewise, while van Helmont also was the first to postulate the idea of the spasmotic theory of asthma, he didn't get credit for it either.  Credit here goes to John Floyer, who would dissect this disease even further than either van Helmont or Willis.  Floyer is given credit mainly due to the fact he was among the most famous physicians of his era.  (1649-1734).

Very rarely will you find an author on the subject giving credit to van Helmont. Just to give an example, in his 1835 book "Asthma, its species and complications," Francis Ramadge said Willis was "the first to observe the nervous character of complicated asthma."  (3, page 92)

While this may not be fair to van Helmont, it's just the way history was written; it's just the way it is.

For the sake of simplicity, I want to give a quick overview of the nervous and spasmotic theories of asthma.

• The spasmotic theory of asthma; also referred to as the convulsive theory of asthma, and later the bronchospasm theory of asthma
• The nervous theory of asthma; later called psychosomatic theory of asthma

It also should be known here that many authors on the subject believe that asthma is both nervous and spasmotic, or that one is synonymous with the other.  So as one physician is referring to the nervous theory of asthma, he is generally referring to spasmotic asthma caused by the nervous response.  Or, he is referring to irritation of the mind that causes it to send signals via nerves to start the asthma response, which is spasms of the air passages.  

Regardless, these two theories would continue to be dissected and debated for the next three centuries.  

Click here for more asthma history.

References:

1. Berkart, J.B., "On Asthma," 1878, page 
2. Walter, Mmichael J, Michael J. Holzman, "Americana Journal of Respiratory Cell and Molecular Biology, "A Centennial History of Research on Asthma Pathogenesis," http://ajrcmb.atsjournals.org/content/32/6/483.full (accessed 2/22/13)
3. Ramadge, Francis Hopkins, "Asthma, its species and complications, or researches into pathology or disordered respiration; with remarks on the remedial treatment applicable to each variety; being a practical and theoretical review of this malady, considered in its simple form, and in connection with disease of the heart, catarrh, indigestion, etc." 1835, London,  Longman, Rees, Orme, Brown, Green, and Longman

2698-1000 B.C.:Asthma in ancient China

 Huang Ti about 1000 BC

(Edited 2/18/12)  While the Eber Papyri provides the oldest account of asthma remedies, it wasn't discovered by the modern world until the 19th century.

That left as the oldest known medical book through most of history as Nei Ching written by Huang Ti about 2,697 BC. The work basically consists of conversations between the emperor and his physician Ch'i Pai.  Parts of the dialog are recorded medical descriptions of asthma-like symptoms and possible remedies. 

Huang Ti Nei Ching Su Wen was known as the Yellow Emperor who reined over Ancient China from approximately 2697-2598 B.C.  He is known as the Father of Chinese Medicine. (1)

He is believed to have ruled China as the third of China's first five rulers from 2696-2598 B.C.  There is an ongoing debate as to whether he actually existed or was the work of legends. There's also an ongoing debate as to whether he actually wrote the Nei Ching Su Wen or whether it was actually written about 1000 B.C and antedated "as to enhance it's value," according to one historian.  Veith quotes one historian who questioned that Ti could possibly rule a nation and still have plenty of time for dialog with his physician ch'i Pai and also time to write it all down. (2)

Of significance in the Nei Ching is the relevance of Yang, Yin and Tao.  Ilza Veith, in her 2002 book, "The Yellow Emperor's Classic of Internal Medicine," described that in the beginning there was chaos between the three primary substances -- force, form and substance.  This ultimately results in a light substance rising to form heaven, and a heavy substance sinking to form the earth. 

The Nei Chung

These two substances were referred to as the Yang (heaven) and the yin (earth), or the "dueling" powers of the universe.  Veith describes Yang as the sunny side of a river and Yin as the shadowy side of a river.  She explains that "Yang stands for sun, heaven, day, fire, heat, dryness, light, and many other related subjects.  Yin stands for moon, earth, night, water, cold, dampness, and darkness; Yin tends to contract and to flow downwards.  As Heaven, Yang sends fertility in the form of sun (and rain) upon the earth; hence heaven's relation to earth is like that of man to wife -- the man being Yang and the wife being Yin."  Any imbalance of these essence's are the cause of any problems that might ensue.

This whole concept was similar to other civilizations, such as in the West the belief was that disease was the result of an imbalance of the four humours.  In China disease was believed to be caused by too much of the essence yang and/ or too little yin.

So in order to maintain health one would have to maintain a balance of Yang and Yin, which was ultimately accomplished by good behaviours towards Tao, which refers to "the way." Veith explains that man must completely adjust to the "flow" of the Universe, which was the responsibility of Tao.  For example, the earth was dependent on the heavens, such as rain was needed to end drought, sun was needed to melt snow, etc.  In this way the yearly cycle of life flowed smoothly and was completed in a year.  This was Tao, or the way.  Essentially, there was "the Tao of Heaven, the Tao of the Earth, and the Tao of Man, one fitting into the other as an indivisible entity."

The first paragraphs of the first chapter of the Nei Ching has the emperor asking his physician, Ch'i Po, why it is that ancient people used to live to be 100 years old and now people only live half that long.  The physician answered:

"In ancient times those people who understood Tao (the way of self cultivation) patterned themselves upon the Yin and the Yang (the two principles of nature) and they lived in harmony with the arts of divination.... There was temperance in eating and drinking.  Their hours of rising and retiring were regular and not disorderly and wild.  By these means the ancients kept their bodies united with their souls, so as to fulfill their allotted span completely, measuring unto a hundred years before they passed away.... nowadays people are not like this; they use wine as beverage and they adopt recklessness as usual behavior.  They enter the chamber (of love) in an intoxicated condition; their passions exhaust their vital forces; their cravings dissipate their true (essence); they do not know how to find contentment within themselves; they're not skilled in the control of their spirits. They devote all their attention to the amusement of their minds, thus cutting themselves off from the joys of long (life).  Their risings and retiring is without regularity.  For these reasons they reach only one half of the hundred years and then they degenerate." (3)

It is this "degeneration" then that causes diseases which plague a person in life, and many of which cause an early death.  People that lived to be 100 are "in harmony with Tao, the Right Way."  Health, or longevity, was completely dependent on a person's "behavior towards Tao, Veith explained. "Thus, man saw the universe endowed with a spirit that was indomitable in its strength and unforgiving toward disobedience."  Longevity, thus, was a "token of sainthood." (4) 

So asthma-like symptoms were believed to be caused by an imbalance of Yin and Yang.  The lungs were believed to be responsible for metabolism and flow of fluids through the body, and an imbalance of Yang and Yin in the lungs will cause too much phlegm, edema, sweat and cause diseases such as breathing disorders.  (5) 

This ultimately obstructs Qi (also referred to as Chi).  Imbalances of Yang and Yin are believed to be caused by obstruction of Qi, which may be described as the energy or life force that keeps the humors in balance and the body functioning properly.

The force of Qi was the essential force of keeping the body healthy, and it was inhaled with each breath after birth.  Once inhaled it was up to each healthy organ to transfer both Qi and nutrients throughout the body.

In order for the organs of the body to function properly, Qi must continue to flow properly throughout the body.  So dysfunction of the lung will result in failure of respiration, "leading to failure of fresh air to be inhaled and the turbid Qi of the body to be exhaled, with the resultant inadequate formation of Qi." (6)

Likewise, the lungs were associated with mucus.  Yang was heat and Yin was cold.  Cold was believed to diminish Yin in the lungs, and this resulted in an imbalance of Qi in the lungs, which resulted in an increase in mucus, which ultimately resulted in difficulty in breathing, or asthma-like symptoms. 

It should be noted here that unlike Western medical doctrines such as the Hippocratic Corpus, the Nei Ching failed to specifically define any diseases.  So terms equivalent to asthma and dyspnea were not used.  Instead, diseases were referred to as "'injuries of the heart,' 'injuries of the lungs,' etc." (7)

The Nei Ching basically called for diagnosing diseases by measuring the pulse, and treating diseases by remedies that reset Yang and Yin, which mainly involved mental balance, herbal medicine, diet, massage, acupuncture (inserting needle into certain regions of the body) or moxibustion (placing cones of powdered leaves on various regions of the body and burning them until blisters form).  Since diseases of the lungs were caused by an imbalance of Yin caused by cold, asthma remedies were believed to warm the lungs, balance Yin, decrease mucus, and make breathing easier. 

Another neat similarity between the Nei Ching and the later written document the Hippocratic Corpus (such as the Hippocratic Oath) is that both writings mention the use of careful technique and responsibility by the physician. 

The Nei Ching notes that "The most important requirement of the art of healing is that no mistake or neglect occur... poor medical workmanship is neglectful and careless and must therefore be combated, because a disease that is not completely cured can easily breed new disease or there can be a recurrence of the old disease... illness is comparable to the root; good medical work is comparable to the topmost branch; if the root is not reached, the evil influences cannot be subjugated... The superior physician helps before the early budding of the disease.  The inferior physician begins to help when the disease has already developed; he helps when destruction has already set in.  And since his help comes when the disease has already developed, it is said of him that he is ignorant. " (8)

While Nei Ching is the oldest known recorded Chinese medical treaties, Shen Nung, who lived from 2838-2698 is often considered as the founder of Chinese Medicine as well as the "Fire Emporor."  (9) 

Shen Nung (2838-2698)

Shen Nung created the Pen Ts'ao, or "Divine Husbandman's Materia Medica."  It's basically a pharmacopoeia describing how to create remedies from drugs and plants to treat various diseases. He was the first to mention using the plant Ma Huang (Now referred to as ephedra) for treating respiratory disorders.

The leaves and/ or stems of the Ma Huang plant were dried prepared in such a way that it was served as a drink, often as a bitter tasting tea.  Nung believed Ma Huang worked by reversing the flow of Qi.

One of the truly interesting things about ancient Chinese asthma treatment is the use of Ma Huang to treat asthma-like symptoms.  The modern world refers to this plant as ephedra, and from it was derived the bronchodilator ephedrine in 1901

Leaves of the plant were crushed and served in a bitter tasting yellow tea. This may actually have provided relief from an asthma attack. While Veith describes that Western medicine reached China early in the 17th century, (10) it would be another 300 years before ephedrine would play a significant role in the treatment of asthma in the U.S. and Europe, as I describe in this post.

So while Ancient Chinese asthmatics may have been able to obtain asthma relief by using ephedra, the rest of the world (except for maybe Japan and Korea) would have to wait. 

Click here for more asthma history.

References:

1. Saunders, M, J.B. Dec, "Huang Ti Nei Ching Su Wen -- The Yellow Emperor's Classic of Internal Mediciner,"  Calif Med. 1967 July; 107(1): 125–126
2. Veith, Ilza, author /translator, "The Yellow emperor's Classic of Internal Medicine," 2002, Los Angeles, pages 4-6
3. Ibid, page 97-8
4. Ibid, pages pages 98 and 10-14
5. "Qi Theory,  damo-qigong.net,  http://damo-qigong.net/qi-theory1.htm
6. Ibid, http://damo-qigong.net/qi-theory.htm
7. Veith, op cit, pages 49 and 50
8. Veith, op cit, pages 57-8, also see chapter 26 beginning on page 217
9. Navara, Tova, "The Encyclopedia of Asthma and Respiratory Disorders," 2003, New York, page 177
10. Veith, op cit, page 1

5000 to 50 B.C.: Asthma in Ancient Egypt

Eber Papyrus showing treatment of asthma

It's a blessing to be alive during a time when there are many options to help us asthmatics.  We have rescue medicine like Albuterol to cure an attack, and asthma controller medicines to prevent asthma altogether.

 

Yet could you imagine living 5,000 years ago?  How would you treat your asthma in the ancient world?  Thankfully there were a few unknown writers we can thank for preserving ancient wisdom.  Plus we have the Bible. 

 

The Bible has perhaps the first recorded evidence that physicians existed in Egypt about 1,700  years before the birth of Christ.  Whe Jacob died, "Joseph commanded his servants, the physicians, to embalm him; and the physicians embalmed Israel, and forty days were fulfilled for him, for so are fulfilled the days of those that are embalmed." (1)

 

Moses was rescued from the river by one of the daughters of the pharaoh, and he was raised as a son of pharaoh and educated "in all the knowledge of the Egyptian priesthood, in which he became proficient," according to Pierre Victor Renouard in his 1856 book, "History of Medicine: From the origin to the 19th century," (2)

 

Renouard explains that it was this wisdom, particularly the esoteric medical wisdom he obtained, that allowed Moses to lead the Hebrews to the promised land.  He preached good hygeine, and he made sure his followers ate only the purest of foods, such as the rabit and hog, even though these animals were considered impure in Egypt.  Perhaps, Renouard proclaims, this is evidence that Moses held "his own views other than those ascribed to him." 

 

The ultimate goal being to keep people clean, especially while traveling to foreign lands, and when touching strangers, and handling dead bodies.  This was a technique of keeping people "pure" in order to avoid sickness. For an example Renouard refers us readers to the Bible, Numbers Chapter XV. 

 

It is also beleived by many historians that Moses helped to carry knowledge, including medical knowledge from the Egyptians, to the Hebrews, and later to other people who came into contact with the Hebrews.  In this way Moses was a very important historical figure not just in Biblical terms, but also for the the spread of medical wisdom, writes Renouard. 

 

He explains the Egyptians were perhaps the first society to record what medicine worked for what disease.  They also took care of the sick in public so anyone in attendance could share any knowledge they had that might help the sick.  (3)

 

By the time Alexandria was a flourishing city, Egypt was the leading nation when it came to medical knowledge.  Many physicians went to Egypt to learn medicine, and it is believed that even Hippocrates, who later became known as the father of medicine, traveled to Egypt to hone his medical skills. 

 

Egyptians physicians/ priest who did the embalming were surely familiar with human anatomy, according  Renouard.  He writes:

When Pliny (the elder) assures us that the kings of Egypt permitted the opening of the corpse, for the purpose of discovering the causes of diseases, he always means the Ptolomies, under whose reign anatomy was carried to a very high degree of perfection." (4)

I write about Pliny the Elder here, so I won't delve into his career in this post.  Yet Ptolomy (90-168 A.D.) was a Greco-Roman who lived in Egypt and was one of the seven bodyguards who served Alexander the Great.  After Alexander's death Ptolomy was declared Governor of Egypt and he declared himself King Ptolomy.  He was accepted as the ruler, and so future members of his family essentially replaced the pharoah as rulers of Egypt.  So these are the kings Pliny was referring to, or so we should assume by Pliny's writings.

 

So at least some knowledge of anatomy must have been known by the Egyptians.  Through their writings they made recollections, as did cave men through their cave drawings, of where the best place to shoot prey.  Physicians likewise had knowledge to internal organs, although their understanding of them was primitive and speculative at best. 

 

The Eber Papyri describes various vessels of the body, and by "feeling the pulse you feel the heart that 'speaks out of the vessels of every limb,' the text then proceeds to list 46 vessels."  (5, 349-351)

 

As a random example, consider the following from one transclation:

There are 2 vessels in him to the back of the head.
There are 2 vessels in him to hi forehead.
There are 2 vessels in him to his eyes.
There are 2 vessels in him to his eyebrows.
There are 2 vessels in him to his nose.
There are 2 vessels in him to his right ear; the breath of life enters into them.
There are 2 vessels in him to his left ear; the breath of death enters into them.

Renouard describes Egypt as being divided into six orders:  kings and princes, priests, soldiers, shephards, laborers and artisans.  Your priests were also your physicians, and they were the "most respected and the most powerful; it was a depot of the laws, science and religion."  They shared their wisdom by their writings, and they took great care to make sure their writings were esoteric only to the priesthood. 

 

In 1862 a 110 page scroll was discovered between the legs of  a mummy in Thebes.  We have no idea who wrote it, nor if it was written by one scribe or many.  Ancient texts like this were hand written, and copies were often made of copies.  (5) 

 

This means that the texts that we now have access to may have been added to many times.  If you're a physician you have your own scroll, and you scrible some of your own formulas in the margins.  When it's recopied these scribbles may end up in the text, making it difficult for historians to know what text was original and what was added to it. 

 

The scroll is 20.32 meters long and consists of 108 columns of 20-22 lines.  Unlike other ancient Egyptian texts which are only fragments of larger texts, the Eber Papyrus is believed to be a complete text.  (6, page 311) It is believed to have been found in a a tomb in the necropolis in Thebes with another papyri -- the Edwin Smith Papyri, and purchased by Egyptologist Edwin Smith in 1862. (6, page 303)

 

German Egyptologist Georg Eber purchased the papyri from Smith in 1870 and it was transcribed, published,  and ultimately referred to as the Georg Eber Papyri.  (6, page 310) It then became the most important medical papyri of all Ancient Egypt, and the oldest preserved medical document of all time.

The Eber Papyrus is believed to have been written about 1500 B.C. and copied from earlier texts dating as far back as 3400 B.C.  Prior to such writing the formulas were relayed from parent to child, or physician to apprentice, by word of mouth.  By writing the formulas it gave physicians the ability to share wisdom more easily.  It also made it so medicine could become more complex. 

Once transcribed it was learned the scroll contained over 700 magical formulas and remedies for the most common ailments of that time, including asthma. Diseases back then were believed to be caused by an imbalance of phlegm or humors in the body, and remedies were an attempt to balance these humors.

 

While the word asthma was not used in the papyri, asthma-like symptoms were described.  Physicians were unable to differentiate between different causes of shortness of breath and cough, so these symptoms were generally grouped as one malady, and the recommended treatment was uniform regardless of the actual cause. 

 

If you consulted a physican he may first assess you to make sure you were worth treating.  If there was no hope of saving you he may decide to let you die.  Yet if there was hope, he would have a variety of options to help you.  He may then recommend you eat a balanced diet, bathe yourself, or even shave your body hair.

 

He may have access to real remedies, such as herbs and minerals drunk in wine or beer, or rolled up in dough -- the first pills -- and swallowed, or placing a salve with honey in it over wounds (while they may not have known it, honey really does firght against infection). (7)

He may also recommend:    

Another remedy was to place herbs on heated bricks or stone so those with breathing difficulties could inhale the medicine -- the first inhalers.  The columns your physician would seek are as follows:

Thou shalt fetch 7 stones and heat them by the fire, thou shalt take one therof and place (a little) of these remedies on it and cover it with a new vessel whose bottom is perforated and place a stalk of a reed in this hole; thou shalt put thy mouth to this stalk, so that thou inhalest the smoke of it.  Likewise wit all stones.  Thereafter thou shalt eat something fat, of fat meat or oil." (8)

• Enemas (the stomach was believed to be a cause of breathing problems)
• Animal excreta (including crocodile and camel)
• Herbs such as squill and henbane
• Fumes of burned sundried and crushed Belladonna leaves and roots (heated on brick)
• Eating foods such as figs , grapes, frankincense, cumin and juniper fruit
• Drinking wine and sweet beer

Belladonna plant

Surely the best remedy was the belladonna plant, which was the mother of modern medicines like Atrovent and Spiriva.  It's a mild bronchodilator.  Yet if you're like me, you know neither of these does much to allay an attack of asthma.

 

Belladonna had many other  uses, one of which was as a cosmetic.  Young ladies placed drops in their eyes to dilate their pupils.  This made their eyes pretty and attractive to young men.  Italians later referred to it as bella-donna, which means pretty lady.

 

Once he's done treating you he may perform religious ceremonies, marriages, embalming, and funeral services.  Your physician was a busy man, one who was paid well for his services.  Yet you may not have to pay him, as his services would be taken care of by the king, the wealthy, with healthcare to all others provided for free.  Although you may reimburse him with a small offering.

 

If his healing methods didn't work for you a priest/ magician might be summoned.  He would first diagnose you.  He'd then give you an amulet to wear and an incantation to say each morning. Or he might place his gentle palm over your throat or chest and chant an incantation to induce healing and scare away the evil demons that were causing you to breathe heavy.  

 

One can only imagine how hard it would have been for asthmatics back then.  They were most likely treated as burdens on society, and therefore the best treatment might be to keep your mouth shut and simply tough it out.  Could you imagine?

 

Click here for more asthma history.

 

References:

1. Renouard, Pierce Victor, "History of Medicine: From it's origin to the 19th century," 1856, Cincinnati, Moore, Wistach, Keys and Co., page 26, chapter 1, "Medicine of the Antique Nation."
2. Renouard, ibid, page 83
3. Renouard, ibid, page 30
4. Renouard, ibid, page 31
5. I will get this up soon. 
6. Sigerist, Henry E, "A History of Medicine," vol II, "Primitive and Archaic Medicine," 1951, New York, Oxford University Press, pages 303, 310-11
7. Lambert, Tim, "A brief history of medicine," localhistories.org, http://www.localhistories.org/medicine.html, observed May 26, 2012
8. Jackson, Mark, "Asthma: A biography," 2009, New York, Oxford University Press, page 39.  From a translation of the Ebery Papyrus by B. Ebbell (B. Ebbell, "The Papyrus Ebers: The Greatest Egyptian Medical Document," 1937, Copenhagan, page 67)

25 BC-50 AD: Celcus spearheads quest to define asthma

The second century A.D. was a fruitful era in literature and philosophy, among those influential in our quest to investigate the history of asthma are Pliny the Elder, Seneca the Younger and Aurelius Cornelius Celsus.

I will write about Pliny and Seneca in a future post, yet for this day I would like to introduce to you Celsus, who was born of respectable parents, was well learned, and shared with us his wisdom through his many writings. He was a philosopher, physician, surgeon and pharmacist.  Some noted him to be so skilled at his craft that he was "second to none."(1)

Celsus was born in Greece in 25 B.C.  He was a stoic, which meant that he did not believe in an after life.  As an arch opponent of Christianity he wrote "The True Word," which was a well read attack on Christianity, a new philosophy in that era.
He wrote several other books as well, such as "A Treaties on Agriculture" and "A Treaties on Military Tactics," yet what history remembers him best for is his "Treaties on Medicine."

 In his medical writings he emulated Hippocrates, and parts of his book are word per word transcriptions from the "Hippocratic Corpus." In fact, he did this so often that one later author, Nicholas Mondaris, referred to him as the Ape of Hippocrates (2)


Yet he also incorporated into his book the latest wisdom of the day, plus some of his own ideas. This is clearly evident in his writings on asthma.

When asthma was first defined by Hippocrates around 400 B.C. it was often difficult to distinguish between the causes of dyspnea, and therefore they were grouped under the umbrella term asthma.  Thus, all that caused dyspnea was referred to as asthma.  (3)

Celsus, on the other hand, believed asthma was more than just dyspnea, and for this reason he provides us with our first description of asthma as more than simply a blanket term for all that causes dyspnea.
Celsus believed there were three thoracic disorders:

1. Dyspnea:  Moderate, unsuffocative breathing without a wheeze; it's chronic
2. Orthopnea:  Breathing only takes place in an erect position; it's acute
3. Asthma:  Vehement breathing that is sonorous and wheezing; it's acute (3)

He was also the first to describe asthma as a specific condition involving constriction of the air passages in the lungs, and he was likewise the first to describe a wheeze.  He described an attack of asthma this way:

(Asthma is caused by)  the narrow passage by which the breath escapes, it comes out with a whistle; there is pain in the chest and praecordia, at times even in the shoulder blades, sometimes subsiding, then returning; to these there is added a slight cough."

Mark Jackson, in his 2009  book, "Asthma: The Biography," explained that Celsus's approach to treating diseases, asthma included, was more aggressive than that of the Hippocrates.  According to Jackson, Celsus advised the following asthma remedies:

• Blood letting (a standard remedy)
• Milk (often supplemented blood letting)
• Clysters (enemas, and often supplemented blood letting to loosen the bowels)
• Hot forments
• Plasters
• emollients to east chest movement
• Diuretics (to make you pee in order to reduce fluid in lungs and rest of body, although they probably believed the excreted fluids were full of the poisons that caused the humors to be imbalanced
• Emetics
• Exercise
• Massage (to move the poisons around the body to create balance of humors, and to make breathing easier)
• Drinking hydromel (a mixture of honey and water)
• Mead containing hyssop or crushed caper roots
• Sucking white nasturtium seeds mixed with honey
• Consuming the liver of a fox, dried and pounded into a cupful of wine
• Eating the fresh, roasted lungs of a fox

While some of the Celsus's remedies were later proved to have medical significance, most were simply palliative.  Still, Celsus's ideas were studied and followed for many years after his death. 

We asthmatics should be thankful to Celsus for spearheading -- although he didn't know it at the time -- a 2,000 year effort to define asthma as a disease all its own.     You can decide for yourself if you'd have been satisfied with his remedies for your asthma.  

(Later physicians, such as Sir John Floyer and Robert Bree, would break down these three classifications into three:  continued (heart failure, chronic bronchitis), and convulsive (spasmotic asthma and orthopnea).  

Click here for more asthma history.

References:

Celsus, Aurelius Cornelius, "De Medicina," translated by L. Targa, London, pages xiiv-xxiii, "The Life of Cornelius Aurelius Celsus," by J. Rhodius and translated from Almeloveen's Lugduni Batavorum, page xxi, xxii

Celsus, ibid, page xvii

Good, John Mason, "The Study of Medicine," 1864, New York, page 363

Celsus, op cit, page......

Toilet seat inhaler

As I've written many times I lose inhalers left and right.  My son must have found one and was playing with it when I suddenly heard a slam in the bathroom.

My initial reaction was that he had his hand slammed in the toilet -- again.  Yet upon entering the room he was just standing next to the toilet crying.  I picked him up and end of story.

Three hours later I'm at work and my wife sent me the following picture.  Apparently he was holding the inhaler when the seat slammed.  I just thought I'd share this with my readers. 

10 Reasons chronic lungers should work in a hospital

My dad recommended when I was in high school that I get a job working in a hospital.  He likewise recommended I become a respiratory therapist.  I heeded my dads advice, but didn't go to school to be an RT until I was 25 only because I was afraid I'd fail chemistry.

Yet working in a hospital sure has it's advantages when you're an asthmatic, or if you have any lung disease for that matter.  So, listed here are the advantages of working in a hospital if you have a lung disease:

1.  You become better educated about your disease

2.  You have access to all the best medicine

3.  You work with doctors and nurses who can treat you if you're ill

4.  Nurses can suck the excess wax out of your ear

5.  Observant nurses can observe that your asthma is acting up and that you need help

6.  Air conditioning

7.  Clean and safe work

8.  You can rest often

9.  You get to hang out with other patients with similar diseases

10.  You can take treatments at work

Ear wax and infections

It's seems as though the asthma body leads us from one ailment to another.  If it's not asthma its hay fever.  If it's not hay fever it's a wandering eye.  If it's not burning flat feet it's a headache due to sinus problems.  If it's not that it's an ear ache and a sense of fullness in an ear or two.

That was my most recent problem.  My right ear has felt full the past several months.  I actually saw my doctor a couple weeks ago and that was the only day my ear wasn't bothering me, and for some reason he didn't check my nose and ears.  

Yet yesterday my ear totally plugged off, a headache raged through my head, and the ringing was terribly annoying.  Plus I was working.  Then I decided I couldn't stand it no more so I wandered down to the ER clinic room and asked a PA if she'd do me a favor and check my ears.

I have a history of wax buildup in my ears, and I have a history of ear infections too.  Yes, I know otitis media is a disease that kids get, but I get it too.  I remember as a kid getting ear aches so bad I couldn't stand.  I don't have that problem any more, yet the sense of fullness is equally annoying.

A few years ago an ER doctor found that I had an ear infection and gave me a prescription of antibiotics.  It's nice to have doctor friends this way.  This time, however, the PA said I had an impaction in my.  She asked a nurse to flush my ear pro bono.  Yes, it's nice to work in a hospital sometimes.  

Walking back to the RT cave I could hear sounds I didn't even know existed, and that I didn't hear on the way to the ER clinic.  It was so nice to have my hearing back.

All she did really was flush my ears out with warm water.  She put the warm water into a syringe and squirted it into my ear.  It felt funny but good.  The excess water dripped into a basin.  It's probably a remedy you could do yourself at home.  

Yet I suppose so long as I have access to such good friends at work why would I need to do such a thing myself. Yes, working in a hospital is nice.