30,000 B.C.: The dawn of medicine

The first humans in Europe were cro magnums.  They are thought
to have marched into Europe sometime around 40,000 B.C. 

So humans must have developed empathy early on, and they would make sacrifices to help the suffering in any way they could.  Perhaps this meant something as simple as pulling out a splinter, or sacrificing a meal to feed a child.  Or perhaps it means pulling an arrow you accidentally shot into your brother, or providing a sympathetic shoulder to your mother who was having trouble breathing.  By around 30,000 B.C. such empathy would reach a culmination of sorts, into an era that many refer to as the dawn of medicine.

Once again, it's hard to know what internal ailments man suffered from 2.5 million years ago, let alone 30,000 years ago.  It's highly probable, or so I would think, that heart and kidney failure have plagued mankind since the beginning, and Lord knows these ailments cause shortness of breath, even air hunger, or what the ancient Greeks referred to as asthma (and what later was referred to as dyspnea, allowing the term asthma to take a different route).

It's hard to imagine what it would be like to suffer from heart failure, bronchitis, tuberculosis, pneumonia, or any such respiratory disease 2.5 million years ago, let alone 30,000 years ago.  The asthmatic boy leaned up against a tree or rock and dealt with the agony as best he could, trying hard to keep up with his clan, performing the duties expected of him.  But as his breathing worsened, or failed to get better, he'd more than likely become a burden to his clan, and they'd have to go out of their way to help him, to guide him along, to feed him, to provide him with drinks, to provide him with incantations and magical words of healing. Of he died it was because he was poisoned, if he lived it was because of the magic.

By pondering about the world around them, by learning from such events as this that they observed and experienced, and speculating about that of which they could not learn by empirical means, these people created the first myths about what happened before birth, and what happened after death, and why a person got sick.   Perhaps it was by this means that fears of the unknown lead to evil spirits abounding all around, peering amid the trees, and in the dark crevices of caves, and in the fields, and in the sky, even lurking in dreams. Some of these possessed friends and family members, and no doubt one of these had entered the asthmatic boy.  Other spirits became real beings in the Heavens, and these turned into the first gods, and these gods became the first physicians who were responsible for health and healing.

A young girl was excited to see her mother give birth, and after her brother was born, her mother became very sick and she died.  That night the girl did not sleep, instead she was haunted by the creepy sounds in the night.  She decided the sounds must have been made by her mother, who died too soon.  Her mother was now a ghost or spirit, and she was ever present and probably very unhappy because she died too soon.  She might protect her family, or she might be too blind sighted by her own death and haunt those show loved when she was alive.  As noted by Henry Sigerist in his 1951 history of medicine: (6, page 137)

Particularly feared are the ghosts of people who died without having fullfilled their mission on earth, young children, brides, women in childbirth or childbed. they more than any other dead must be eager to return to life or, feeling lonely, they may wish to kill some who were close to them so as to enjoy their company in the world of the spirits. (6, page 137)

One early man or woman realized a sharp bone could be used to slice into prey, and another learned to attach this sharp object to a stick to be used as an ax for killing prey or cutting down brush or trees for making shelter.  By cutting up food the heart was found to still be beating, and the heart was learned to be the best target when hitting prey with a knife, spear or arrow.  The head was learned to be the best target for the blunt ax as it shattered the skull. As noted by Plinio Prioreschi in his 1999 history of medicine: (5 Prioreschi, page 29)

Neolithic man must have noticed that the results of the wounds inflicted by the two kinds of weapons were quite different. Deep wounds of the abdomen and chest inflicted by piercing weapons were always mortal either soon or after, or some time later (in the later case because of infection -- e.g. peritonitis). On the other hand, head blows delivered with blunt weapons often had strange results: the animal (or the enemy) would immediately fall "dead" and whereas sometimes it (or he) would stay dead, sometimes, after a short period, it (or he) would revive, that is, would become "undead." The individual who became "undead" after a head blow had always a small head wound, whereas those who failed to revive usually showed a massive injury. (5, page 29)

It must have been assumed that the "undead" was a person with magical powers, or who was blessed by the demons, spirits or a god.  He was thus "brought back from the dead." He was "cured." Those who came into contact with this "cured" person were blessed. This was probably where superstitions and religion were started. Yet it was also by these observations where people learned what weapons were best for what purpose.  In this way, people learned by trial and error, and they speculated, and they came to conclusions.

People learned early the benefits of bathing in the rivers, lakes and streams to keep themselves clean and pure, because purity was the way to keep the body in balance and to keep the evil poisons out of your body.  This may have been the first observation that cleanliness resulted in better health; the first hygienic practices.  Some men washed daily, and maybe had their wives check them for ticks and fleas or whatever bugs crawled onto them while they were busy hunting in the forest.

Slowly the tree of knowledge blossomed and grew.  Mankind learned that by working together they could accomplish more in life, and as part of working together they learned how to socialize.  They therefore learned to have empathy for a fellow human who was suffering, as was evidenced by the efforts to emphasize and help the ailing boy.  They learned they could make a difference in the lives of others by the love they offered, or simply by offering a kind shoulder to lean on.  Although the earliest help was primitive indeed, this was the beginning of medicine. (1, page 2)

Perhaps a dad provided pressure on a cut to stop bleeding, or made a splint out of stick to aid the healing of a broken finger, or used wool of a sheep to produce a basic bandage, or used a sharp stick or stone to pluck out a sliver.  When the cause of suffering was unknown, incantations were chanted to suck out the evil spirits and demons.

So while allaying illness may have originally been a personal task -- each man or woman for him or herself, it eventually became a task of the many.  People developed consciences; they learned to love, care and appreciate the people in their lives.  They cared for and doted the sick, young and old.  Each person becoming pseudo nurses, physicians and respiratory therapists. So in essence, all of these jobs were born amid the primitive or prehistoric world by savage humans.

An elderly man, perhaps, found relief for his ailing back when he stood by the hot fire.  He learned that by removing the splinter of wood in a boy's hand this would speed recovery of the wound. Perhaps by the quest to find food when hungry, early humans discovered the poisonous and medicinal properties of various herbs.  An elderly lady must have mixed some herbs with berries and learned it didn't make such a good meal, although later she rubbed some on her skin and found it to have soothing or healing properties. (6, page 115-116)

Perhaps by such experimentation, these early humans came up with the first herbal remedies, creating the first recipes that turned into salves, ointments,  potions, pills and even inhalents. Perhaps, just perhaps, an elderly lady was experimenting with poppy seeds.  It is believed by many historians that poppy seeds, or opium, was one of the first remedies used by mankind for its hallucinogenic and pain relieving effects.  Perhaps this was one of the most important drugs of the primitive world (5, page 7), as it relieved pain and suffering.

Perhaps she experimented with the leaves and roots of a belladonna plant, and she laid them out in the hot sun for days to dry, and then after they dried she tried to make food or a potion from them, and she learned that when ingested the result was soothing to the mind, definitely a gift from the gods.  And one day, when the asthmatic boy was huffing and puffing over the fire, she inadvertently discarded the remaining roots and stems into the fire, and the smoke created by them was inhaled by the boy, and his breath instantly, his mind at ease by the hallucinogenic effects.

The boy's father investigated this remedy, and he remembered the recipe, creating easy to remember lyrics so the recipe could be shared from one generation to the next.  By trial and error, in this way, they learned what remedy works best for what ailment.  If an elderly lady was sick, for example, her husband, or sister, or friend, used knowledge obtained by lyrics sung by the campfire late at night to help in any way they could.  Perhaps an elderly sister rubbed salves on her aching back, or made her drink a soothing potion (perhaps containing a drug such as opium). And it was rationalized these remedies had powers of healing because they were gifts from the gods above. (5, page 35)  

If the magic available to these folks didn't work, it was time to call for the medicine man, who was able to form a link between the patient and the spirits, demons and gods. He was the wisest member of the tribe, the one who remembered all the recipes, and held all the esoteric knowledge of the privileged few. He was the earliest magician/ sorcerer/witch/priest/physician all rolled into one, who had the ability to create a link between the sick and the spirits, demons and gods that were ubiquitous and invisible.  He would dress in animal skins to mimic a spirit or demon, he'd use rattles and drums to set the milieu, and he'd suck out the evil spirit from the sick woman. He had different names in different places of the world, although some called him Shaman or Seer, because he had the ability to "see" into the netherworld. (3, page 22)

If this magic didn't work, there were other options the medicine man, or woman, might experiment with, and one was was called trepanation. Experts have shown this can be easily done using flint knives and "scratching the (parieetal) bone (of the scull), or by making a circular incision that was gradually deepened, or finally by drilling a series of small holes arranges in a circle and then cutting the bridges between them." (6, page 110-113)

Many such sculls have been found by archaeologists in various parts of the world,  and no one knows exactly why this procedure was performed, although many speculations have been made.  Perhaps the patient was driven insane or possessed by demons, and this was a last ditch effort to cure the person. Perhaps the person was seizing due to epilepsy.  Perhaps the person had end stage emphysema, or was having a severe, prolonged asthma attack. (Lord help help the boy with asthma if this was the remedy.)(6, page 110-113)

The medicine man may provide the sick lady, or her family, with an amulet and an incantation to recite at various times of the day.  An amulet was blessed with magical powers of healing, and could be made of the teeth of animals, claws of eagles, knives, axes, dried rabbits heart, dried rabbits foot, the bone fragment from trepanation (called rondelles), or just about anything. He may also provide such an object as a talisman, and these would be for good luck, to keep you healthy, and to keep you alive. Such objects may also be just about anything, from a wood carving or replication of an eye, heart, liver, kidney, liver, arm or leg. It could be a dried rabbits foot, necklace, bracelet, etc. (6, page 145)

In times when suffering and death inflicted several members of the clan, in times of epidemics of disease, the medicine man would use his magic on the entire family or clan.  They would gather around the fire at night, under the moon-lit sky, and the medicine man would shake his rattles and beat his drums and hum magical incantations and prayers, and he would toss the dried and crushed herbs of opium or belladonna onto the fire, and the smoke would be inhaled, and the recipients would sit around the fire and hallucinate about the world around them. These hallucinations would surely be revelations from the gods, and they would be interpreted by the medicine man.  These were the first mass inhalations, or fumigations.  In times of trouble, in times of great plagues, such fumigations would provide an explanation for the suffering, and a divination of the end of the suffering, or what could be done to end it.  

Much of this knowledge had matured into a flourishing tree by 30,000 B.C.  Knowledge that was slowly picked up by previous generations was now habitual.  Basic methods of maintaining health, and for offering healing, were standard.  The cause of illness, and the reason for healing, was by the wishes of the ubiquitous spirits, demons and gods.  Some historians consider this period as the dawn of medicine.

References:

1. Wilder, Alexander, "History of Medicine, a brief outline of medical history and sects of physicians, from the earliest historic period; with an extended account of the new schools of the healing art in the nineteenth century, adn especially a history of the American eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing Co.
2. Netzley, Patricia D, "World History Series: The Stone Age," 1998, San Diego, CA, Lucent Books
3. Garrison, Fielding Hudson, "An Introduction to the history of medicine," 1921
4. Unknown reference
5. Prioreschi, Plinio, "A History of Medicine: Primitive and Ancient Medicine," Vol. 1, 1999, reprinted edition, originally published 1995, Horatius Press
6. Sigerist, Henry E "History of Medicine," volume I: Primitive and Archaic Medicine, 1951, New York, Oxford University Press
7. Suter, Joanne, "Fearon's World History," 2nd edition, 1994, U.S., Globe Fearon Educational Publishing

Harold Beck's Asthma Story

I'm so excited this morning.  On the very first day I decided I was going to work on an asthma history, about five years ago,  I came across an article by an elderly man who described how he survived asthma in the early 21th century.  He wrote that he even needed to have facial reconstruction surgery because people in one nation, with a certain facial configuration, had a low incidence of asthma.  Yet for the life of me I couldn't re-find this article.  By mere coincidence I found it this morning, and I'm thrilled.  I want to add his story to my history because it pretty much shows the plight of asthmatics prior to the advent of modern medicines.

Maybe you've read the article before by Harold Beck.  If not, click on over and check it out.

Update February 26, 2016: Sad to say, the link is no longer available. I wish I had printed off and saved the article, because it was extremely interesting. 

I was, however, able to salvage some of his story. Here it is.

I was about 4 years old when I was in a Convalescent Home in Ventnor which puts it around 1928.

I recall that the Home was high up overlooking the sea. I probably arrived on Guy Fawkes night for I was taken to see fireworks some distance away, looking out over a large garden. I have an image in my mind of watching the display standing by a huge stone bowl on a massive pedestal - though since I was quite small the garden ornament may actually have been of no great size. I also remember that my father visited me once during my time there - he brought gifts, which were probably Christmas psents. I imagine my mother was tied to the home in London during the run-up to the appearance of my next brother or subsequently.

In 2008, while on a holiday in Ventnor, I identified the Home as St. Catherine's and there is little doubt that I was accommodated in Elm Grove, a property high up on the hill overlooking Ventnor and with extensive grounds, which was acquired by St. Catherine's in 1923.
For many years the nursing of patients and the running of the Home had been placed in the hands of the Sisters of East Grinstead, an Anglican Order in Surrey. At the time I was there a Sister Kathleen was in charge and she instituted a policy that the children in her care should remain at the Home full time, including holidays. In essence the Home became a School as well as providing nursing care. Apparently it was also Sister Kathleen's policy that the children should brave the elements when walking from Elm Grove to other buildings in the Home and School complex and in expeditions in and around Ventnor. 

A Note on the History of St. Catherine's Home.

The climate of Ventnor was considered very beneficial for recovery from pulmonary conditions and in 1859 the Royal National Hospital for Diseases of the Chest was was built on the Western outskirts of Ventnor close to sea level and with all rooms facing South. The Hospital expanded rapidly and was especially used for the treatment of tuberculosis, which was rampant in all sections of the population at that time.

Some 10years later, on the initiative of the wife of the Vicar of St. Catherine's Anglican Church in Ventnor, a charity was established to provide care for people with pulmonary conditions, the idea being that treatment should be provided for the less well-off sufferers.

St. Catherine's Home expanded rapidly with properties being purchased and facilities provided as funds became available. Soon after 1910 the Home took in children suffering from asthma and under nourishment and a little later came the policy that the children should remain at the Home full time, including holidays. In essence the Home became a School as well as providing nursing care. In 1923

Elm Grove was bought and in 1926 this became the place of residence for the youngest boys and girls.

What was St. Catherine's Home is now a residential Special School for children and young people with speech, language and communication impairments.

800 B.C.: The beginning of Western Medicine

Thales of Miletus (620-546 B.C.) is known
as the first Greek philosopher. 

Why?  How?  These are questions people in Ancient Greece started asking around 800 B.C., the same time that Homer was busy transcribing ancient prose into writing.  They asked questions like:  are the gods really responsible for all good and evil?  Why was the world created?  How was the world created?

According to Henry Sigerist, "A History of Medicine," prior to this time people tried to master nature, to live within it, and to cope with it.  Yet after this time the emphasis was changed to an effort to understand nature.  Why are the trees green?  What are the main substances of life?

One of the first Greek men to record such thoughts was Thales of Miletus, who lived around 585 B.C.  While he didn't have access nor knowledge of science, he made speculations based on his observations.  He concluded that "life was bound to the presence of water." (1, page 90)

Likewise, Sigerist explains, Thales believed that life was not created spontaneously by the gods but "developed gradually from a primary element through natural processes which could be observed every day.

Aristotle later named Thales as the first of the great Greek philosophers.  This is significant to the history of medicine because it got people to thinking about the most common problems of life.  They started asking questions about life, and health, and disease.  They started speculating of solutions other than seeking out the gods.

Anaximander (610-546 B.C.) was the pupil of Thales.

Around 560 B.C. Anaximander didn't believe one element could make up the world, and he speculated their were four such elements:  "water, earth, fire and air, with their qualities, wet, dry, hot, and cold -- were derived from one common indeterminate substance.  

From these substances, with their primary pairs of opposites, he came to his own speculations as to how the world was formed.  He even went as far to speculate that lightning was not caused by the god Zeus but by a natural phenomenon.  

Yet his theory of two pairs of elements with their opposite qualities may have been the beginnings of the theory of opposites later postulated by Heraclitus (RT Cave 11/3/12) and refined by other scientists until the Hippocratic writers tied all these theories together to the culmination of ancient Greek medicine.

Around 450 B.C. Empedocles provides us with a variety of writings about his view of the world.  He likewise believed the world was created by four basic elements:  water, earth, fire and air.  He was the first to speculate that air was a substance that could affect other substances including the flow of blood.  For his many speculations he's often given credit as the Father of Modern Chemistry.  (1, pages 105-107)

Empedocles (490-430 B.C.) was the first to write about the
power of the four elements, qualities and humors.  

Ideas that started with a few men asking questions evolved through time.  It started out as philosophy and ultimately turned into the science. From here it turned into the first medical schools that pre-dated the Ancient Greek Schools of Medicine that influenced the authors of the "Corpus Hippocraticum."

These original schools were not associated with buildings, and there were no school books, or no medical texts.  Rather, schools were associations of teacher and student.  The students would follow the teacher to learn the craft, and the teacher would hold classes at random places to teach his wisdom.  The students and the teachers would carry with them the tools and drugs needed and they would practice medicine and even perform surgeries.  As the need arose these "schools" could move from one location to another with ease.  (1, page 100)

Philosophy is the search for wisdom, and all that was learned was taught at these schools, regardless of what career was ultimately sought.  Both Hippocrates and Galen would later explain that this was a good thing, because a good physicians would be well rounded in all wisdom.

Of this, Hippocrates said:

It may be concluded then... that knowledge and medicine must go hand in hand. The physician who is truly a philosopher is a demigod. Medicine and philosophy are closely allied. That which is taught by the latter, is practised by the former,—contempt of riches, moderation, decency, modesty, honour, justice, affability, cleanliness, gravity, a just appreciation of all the wants of life, courage in adversity—opposition to fraud and superstition, and due consideration of the Divine power. (2)

As historians trace Ancient Greek history by studying writings available, they learned that some of the first medical schools were formed in Greece sometime around 550 B.C. "in the periphery of the Greek world, in Croton, in Cyrene, and... Sicily, Rhodes, Cnidus, and Cos."  (1, page 89-93)

An ignorant public must have had more faith in the priests at the Asclepion than the remedies of the physicians.  It would be the family of physicians at the school of Cos who aimed to improve this image. This school would ultimately give rise to a man, Hippocrates, who would transform medicine from myth to fact.

What started as a few thinkers asking questions turned into a slow evolution that transformed would ultimately make Greek philosophy the key to all medical wisdom.

References:

1. Sigerist, Henry E, "A History of Medicine," Volume II, 1961, Oxford University Press, New York, pages 89-93
2. Hippocrates, "On decency in manners and in dress," epitomised from the original Latin translations, by John Redman Coxe, "The Writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston

400 B.C.: The Hippocratic Oath

Wall plaque of Hippocratic Oath

What good is a physician who cannot be trusted.  If you were wounded in battle and had access to a physician, then you could get a soothing salve to allay your pain and speed your recovery.  Yet amid rumors your doctor took a bribe to poison a friend of yours, you wonder if you should avoid your doctor at all costs.

It was such poor ethics among the medical community around 400 B.C. that enticed the writers of the Corpus Hippocraticum to write an oath.  The goal was to improve ethics among physicians, and increase respect for the profession among the peoples.  The original oath was as follows:

I swear by Apollo the Physician and Asclepius and Hygieia and Panaceia and all the gods, and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art – if they desire to learn it – without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken the oath according to medical law, but to no one else.

I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honoured with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

Like many ancient oaths it begins with an acknowledgement of the gods. Apollo, Asclepius, Hygieia and Panaceia are the gods of health, and every person seeking good health will worship and make sacrifices to one of these gods.

This oath appears in the Corpus Hippocraticum, and is generally attributed to Hippocrates or one of his students.  Although some historians place it's origin after the death of Hippocrates, and it's these historians who think it was written by some other physician and later added to the Corpus. Although the true origin may never be known.

The Ancient Greeks and Romans, unlike other ancient civilizations, liked to give credit for ancient texts to the original author.  Yet when the original author is unknown, the texts is attributed to the next best thing:  a hero.  In this way, Hippocrates is often given credit for all the Hippocratic writings.  Yet we know there were many writers.

The oath became so famous that one version of it or another has been said by physicians even to this day.  The modern version is as follows:

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of over treatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, be respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

The integrity of the medical profession has grown exponentially since the time of the Hippocratic writings, in part due to the ethical standards set forth by this oath. Some of the most respected people in any community are your doctors.

Do people hate asthmatics?

Sometimes I wonder if the good folks over at the FDA and EPA hate asthmatics.  They forced many good asthma medicines off the market with the Montreal Protocol, and they scared doctors into no longer prescribing other medicines that work great for some asthmatics when used as prescribed.

Personally I never cared for Intal, although I know of many asthmatics who got along great with the medicine.  Too bad!  It's been taken off the market  Theophylline is no longer a top line asthma medicine, but at least it's still on the market.  But that doesn't matter, doctors are so scared to use it (even though it was safely used for many years).

The FDA has put so many warnings on Advair that my doctor has been trying to convince me to use Symbicort for five years now.  The problem is that Advair works just fine, and I've used it safely since 2003.  It's the first medicine to really allow me to control my asthma. 

The problem with Symbicort is it makes me feel as though I have an electric volt running through my body.  Symbicort works great, even better than Advair, yet I'm not willing to put up with that side effect.  It's a great option (something the Fed doesn't like I presume) for asthmatics, although not a good option for me.  

The Montreal Protocol has caused a spike in asthma medicines that has made them too expensive for most asthmatics.  I can honestly tell you that about 80 percent of the asthmatics I see daily in the emergency room are asthmatics who can't afford their asthma prescriptions they already have.

I have no problem with the Montreal Protocol.  I have no problem with making an effort to protect nature.  Yet I do have a problem when those making decisions put nature over people.  

As you can see from my list here, I place people over nature.  It seems the Fed has priorities reversed.  

To be honest, I think HFA inhalers work better than CFC inhalers.  Science has proven it's equally effective and even gets deeper into the lungs for better distribution of the medicine.  It's even better than DPIs, which is why Advair recently came out with an inhaler  

Yet I see no reason why options can't be left on the table for asthmatics, options that would also keep prices down so asthmatics can get the control that is possible if they are on these medicines.  As it is, it appears many folks love their planet before the God fearing people who live on it.  

So, my question is:  Do people hate asthmatics?  

1194-800 B.C. Medicine in Ancient Greece

If you had an internal disease like asthma around 1194-800 B.C., chances are you wouldn't go to see a doctor. Physicians existed, but they were more trained to treat wounds such as those obtained in battle.   The person you'd go to see would be your priest, magician or witch.

The reason was simple:  most ancient societies, the Greeks included, believed disease was caused by the wrath of the gods.  To get your remedy you needed to find a person -- a priest, witch or magician -- to help you find out which god was mad at you and why.  Then you'd have to learn how to make that god happy again so you would have a shot at getting better, explains Henry E. Sigerist in his book, "A History of Medicine."  (1)

Yet the more common option, as Sigerist notes, was be to seek out your priest to learn what kind of offerings to make to the gods for healing in this way.  This was more common because it was far less expensive than seeking a potion offered by a magician or witch.  (1)

He may prescribe fore you a magic amulet, an incantation, and quite possibly an animal sacrifice, a pig perhaps, or a goat. Such a sacrifice would show the angry god that you value his wisdom over your own possessions. Since the gods were thought to live and breathe like men in the Heavens, the sacrifice was thought to provide a food offering to the god.

This was a common form of medicine in the ancient world, a bribe of sorts.  I will provide you with this food offering if you make me well again.

A common ritual was to travel to the god's temple by walking, riding a horse, riding a donkey, or riding a cart.  The temple belongs to one of the healing gods, such as Ascepius.  You'd spend time amid the priests, who had the ability to talk to the gods and hear their advice for healing.  Most often you'd sleep among them, and in the morning your cure would be revealed.

In this way, you received the healing benefits this god had to offer.

There were many such temples scattered around ancient Greece, and often they were associated with nearby hostels to house those who traveled for this purpose. Some early historians, Sigerist said, believed these "hostels attached to the Ascelpia were the first Western hospitals and poorhouses where indigent sick people stay and are treated by priest," writes Sigerist (1, page 73)

Later historians note that these weren't hospitals in the way we think of them today, as the sick merely spent time there to learn the cure; they did not stay in the hostels until they were healed, but just one night.

Priestly healing was very common during this era.  In fact, the belief gods were responsible for good luck and bad luck, health and healing, made worshiping the god Ascepius very popular even up to the Birth of Jesus Christ.  Sigerist explaines that it was for this reason the pagan god Ascepius was the greatest competitor of Jesus Christ. (1)

Sigerist said that one of the main reasons Ascepius was the greatest competitor to Jesus Christ was because he wasn't as greedy as the other gods, and he would accept even modest gifts.  This made it possible for him to be worshiped by both the rich and the poor. (1)

This was significant, because poverty was one of the main attractions of Christianity.  The poor couldn't afford physicians, nor the sacrifices demanded of most gods, and so Christianity was a viable option.  Yet so too was the god Asclepius.

Over time there was another medical paradigm that was growing in popularity and significance in ancient Greece, and that was the belief in natural medicine.  Some priest physicians were knowledgeable of which plants had medicinal and poisonous properties.  As time progressed, even the common folks were privy to this knowledge.

A good example of this was explained in the Odyssey by the great Greek poet Homer.  Henry E. Sigerist, explains the following: (1)

"There is relatively little mention of magic in the Homeric epics although the ancient Greeks believed in magic and, like everyone else in antiquity, practiced some...  The drug given to Helen by the Egyptian lady, Polydamna, had strong euphoric properties, so that whoever took it forgot all unpleasant memories and would not shed a tear even if his closest relative died; this drug might be opium or hashish, but it could just as well be the kind of miracle drug found in many fairy tales." (1)

As Sigerist explained, the Odyssey cannot be taken seriously, however, it was based on real life events. The Greeks probably had access to various medicines, such as opium, and simply told of this medicine as a magic potion crated by, say, witches or magicians.  Since the gods created everything, then they must have also created the magical powers present in some plants.

Knowledge of the inner organs and what they did was limited, yet observations from experience working with the wounded and the dead gave soldiers a pretty good idea where to aim their weapons to produce the most damage to the enemy's body.  They knew the best places to aim were the lower abdomen or to aim their arrows at the nipples.

Physicians had magic healing powders and soothing drugs used to help people who were wounded in battle.  These tales also describe various poisons.  For example, Sigerist noted a line from Homer's Odyssey:

"Circe was a beautiful witch who could transform human beings into pigs, and it is absurd to assume that Eurylochus who told the story had been the victim of hallucinations."  (1)

While these stories are twisted and turned into a memorable fairy tales, they may actually be descriptions of poisons used to punish or kill an enemy.   What these drugs and medicines actually were we can only speculate.

While all ancient medicine started off as mythical, natural medicine was soon a viable option. Natural medicine may have been resisted at first, although through time its benefits were so obvious they couldn't be resisted.  So, of course, natural remedies found their way to mythology.

Note: The dates chosen for this article are based on the estimated dates for the writings of Homer (800 B.C.) and the siege of Troy as described in Homer's Iliad (1194-1184 B.C.). The medical knowledge expressed in this post may also have effected you prior to and after these listed dates, which are mainly listed simply as a reference to make it easier to write a history, and easier to picture in your head where these events may have occurred. And even if you lived in Greece during these times, you may also have been subjected to primitive medicine, or pre-Greek medicine. I obtained the dates from Albert Henry Buck in his book "The growth of medicine from the earliest times to about 1800." (1917, London, Oxford University Press, page 46).

References:

1. Sigerist, Henry E, "A History of Medicine," vol. II, "Early Greek, Hindu, and Persian Medicine," 1961, Oxford University Press, pages 19, 20, 23, 28, 51

Why the hang up on theophylline?

Perhaps I'm a stubborn old asthmatic (although I'm only 42), or perhaps I have a viable argument, but I contend it's time physicians got over their fear of theophylline and start prescribing it again for asthmatics who need it.  

Between 1972 and 2007 I was chronically addicted to the substance.  That sounds bad in and of itself, but the theophylline worked.  It worked to keep my lungs opened up.  It helped me and thousands of other asthmatics before Long Acting Beta Adrenergics were combined with improved inhaled corticosteroids.  

Before I started taking Advair in 2003, and when I forgot a dose of theophylline (which was most often Theo-dur), my airways twitched and an asthmatic attack often ensued.  These attacks were the worse ever, and a sure sign of my addiction.  Getting off the substance was something I yearned, yet never hoped for.  

After starting Advair I observed I didn't have such attacks when I missed a dose of theophylline.  It was at this point I started talking to my doctor about weaning myself off the theophylline.  It took a year, and I succeeded.

Now fast forward five years.  Thanks to allergies the Advair is sometimes not enough to prevent an asthma attack.  When I had one last year at hunting camp, I suffered all night and the entire weekend before my breath came all the way back.  

The next time that happened, and I felt panicked, I reached into my medicine cabinet and grabbed the bottle of theophylline I kept in their as a momento of my long-time addiction to the product.  I downed one.  Thirty minutes later my breath came back.  

A month later the same happened, and the theophylline pulled me from the grips of an asthma attack once again.  So I talked to my doctor about this hoping he'd at least give me one bottle of theophylline so I didn't have to dip into the five year old bottle.  He said no.  

Why?  If something works so well, why not let me have it.  It makes me kind of almost upset I told him I was able to wean myself off it.  

To his defense, he gave me a prednisone pack.  That's great, but why would I take prednisone for two weeks when one theophyllline would pull me out of an attack?  It is my view that one theophylline pill would be much safer than two weeks of prednisone.   He disagreed.

I suppose I should add the fear of theophylline to my growing list of myths of respiratory therapy.  It's not like you can get high off theophylline, and it's not like I want to take it regularly.  I tolerated it without side effects for more than 30 years.  So why the hang up?  

I don't want to waste valuable time at a doctor/patient visit to discuss this.  However, one of these days I'm going to run into him on a slow day at work, and I'm going to embellish him with compliments and suck him into a discussion about theophylline.

Related post:

• Theophylline no longer a top line asthma medicine