3000-900 B.C.: Asthmatic boy in Babylon

So as soon as we get back from Ancient Egypt our time machine is ready for another journey, and we're asked to quickly board so we don't upset the time space equilibrium, whatever that is.  After a few shakes and quakes the ride is rather pleasant.  I'm thankful I already tucked my rescue inhaler into my pocket.

When we arrive we are amid ten people, a family I assume, each with long black hair tied with a ribbon, and all squatting -- all but one boy that is -- around a large bowl, eating slop with their fingers.  The sun is setting in the east and the air feels cool yet comfortable, stained with the aroma of whatever was dinner and the fire (the smoke of which is making my lungs feel tight). The men and women wear woollen cloaks, making us feel out of place in our 21st century sweatshirts and jeans.  (Sigerist page 400)

No, they don't see us, as we are merely observers. Yet as an asthmatic I can't help but to notice the teenager slumped in the corner, leaning against a flat rock.  The others seem to ignore him, and he makes no effort to seek help either.  I find this odd.  Although our guide states this isn't odd, because the boy doesn't want sympathy.  While we may surmise he has asthma, these folks have no concept of asthma.  The symptom was the disease as primitive man had no concept of nosological entities, that is, of disease.  The young man, if he doesn't recover, is a burden; a hindrance.  He wants no sympathy.

Likewise, our guide states, we must understand that a disease is a curse and illness was a punishment of something you did wrong.  The boy may simply not know what he did wrong, and maybe he didn't do anything at all.  Yet that won't stop his family from assuming he was a bad boy.  Because he had no idea what he did so wrong to feel so bad, he was resigned.  So it was easier for the boy to hide, or pretend to be fine.

Our guide says we must be somewhere around 1500 B.C. in Babylonia.  We also learn from our guide that a variety of primitive societies lived in Mesopotamia -- the land between two rivers (Tigris and Euphrates) for thousands of years, and united to manage the rivers.  They dug canals that filled when the rivers rose to prevent floods from wiping out villages and cities.  After the floods the canals were drained to irrigate the land.  (Sigerist page 378)

Each primitive society had it's own gods and demons, and as the people united a variety of city states formed that adapted some of these gods and demons and created some of their own.  At the center of each city-state is a hill with pyramidal structure with a flat top used to worship the gods.  The first ones appeared around 3,000 B.C.and this is considered the beginning of the Sumerian civilization.  It's greatest city-state may have been Ur, which sat on the Tigris close to the sea.  Even after Ur fell, Sumeria lasted until around 2400 B.C., and had a resurgence later that lasted until 2004 B.C.

While the Sumerians created the first civilization in Mesopotamia, they're customs and culture continued to influence people for thousands of years.  One city-state, Babylon, grew to be the largest city in the world, partly due to the influence of Hammurabi. He was a great ruler who created what we refer to as the Code of Hammurabi, which was a code of strict punishments for wrong doings.  It was an eye for an eye, a tooth for a tooth, a limb for a limb.  It lasted from about 1830-1531 B.C.

Another city-state along the Tigris grew into a national state of Assyria, that lasted from about 2400-612 B.C. Nineveh would later become the new capital of the empire that flourished from 750-612 B.C.  The Book of Genesis mentions Ur as the birthplace of Abraham, and Niveveh also has a Biblical impact, mainly having to do with its demise and destruction. 

Unlike the Ancient Egypt society, which was also growing at this time, the Mesopotamians aren't concerned with the After Life.  What they are concerned about, as most primitive societies were, are all the demons that surrounded them.  They carried amulets and charms, and cited incantations and prayers to prevent and treat diseases that were caused by these demons.  Yes, these demons were everywhere, like the bacteria and viruses we have to live with today. 

Yet as we don't live in fear of bacteria and viruses, they don't live in fear of demons.  They have learned through years of experience, and constant reminders by the priests, what needs to be done to keep the positive balance between the demons, the spirits, the dead, and the living.  Disease in this way can both be prevented and treated.

Plus if you lived during this time in this society, you probably worked all day, as the people we see did all day, a day that exceeded 110 degrees Fahrenheit (which I find stunning considering how cool it is).  So the Sumerians, and later the Babylonians, don't have time to worry about the transcendental, other than the rituals, incantations, and prayers.  They arduously manage their crops, the river, or fight wars, and have little time to fear the unseen.

Yet as an asthmatic myself, one who yearned for my inhaler, I know that young lad had no such inhaler to help him.  He had no rescue medicine to give him instant relief.  So what would he do if his breath didn't come back?  I know from my own personal experience with this disease he can only pretend to be fine, to hide, so long.  So what are the options for the young asthmatic in Babylon?

As we sadly watch the lad huff and puff, our guide explains that both the Sumerians and the Babylonians knew little of anatomy.  They did not dissect humans or perform autopsies, and they did not mummify the dead as the Egyptians did.  They did, however, dissect some animals in search of omens.  They examined the entrails, especially the liver, for signs of good and evil.  Yet they had no concept that diseases were caused by these organs, nor that they were essential for life.  So they rarely thought to dissect them to learn what was inside.   (Sigerest 455)

He explained there were three types of priests. This knowledge didn't interest me at first, because how was a priest going to help an asthmatic boy.  Yet then as I listed, I realised the priest was the best help for the boy aside from waiting it out. The three types of priests were:  Seers, Exorcists, and physicians.  Seers are experts in omens, exorcists drive out evil spirits, and physicians treat illness and wounds.  All options are viable to the boy, who finally gives up and seeks the help of his father as he finishes licking his chops. 

Another option for the boy is what Herodotus observed when he traveled to Mesopotamia to learn how they lived.  He observed the ill being set in a public square, and everyone passing by was encouraged to ask what symptoms he was suffering from.  Anyone with knowledge of the symptom and remedies was encouraged to speak up.  (Withington, page 34)

I watch as the family huddles around the suffering boy.  A lady, the mother perhaps, places her hand on the boy's head and says what I believe is an incantation.  He touches an amulet on the boy's chest, a small bone I think, and says another incantation.  Soon the entire family is singing a song, or perhaps it's an incantation or prayer.  I wonder if this has happened before, and the family is doing what a priest suggested to ward off whatever evil spirit is causing the dyspnea. 

The father leaves the courtyard.  The mother stays with the boy, as if trying to comfort him.  The rest of the family enters the home.  Nothing changes for several hours, until the father returns with an elderly man well garnished with necklaces and earrings. He's also carrying a satchel. This, I assume is a priest.  What kind of priest is he? I wonder. 

The priest approaches the boy, who's now sitting on the ground with his mother rubbing his brow with a damp cloth.  The priest kneels so he's at the height of the boy and touches his brow. He utters some words, and then the mother rushes into the home and comes out with a pot.  He sets it between the boy and the priest, which I realize is a physician as soon as he pulls various herbs or drugs from his satchel and tosses them into the pot.  He inserts a reed tube into the pot, seals it with wheaten dough, and places it onto the fire.

Once the pot is steaming the boy places his mouth around the reed tube and inhales.  The boy appears to get little if any relief from this.  Yet he smiles as he walks with his parents inside, we assume with the hope of falling asleep.  The physician leaves.  Darkness ensues. 

I attempt to follow the physician to learn more, but am shoved back into the time machine just as the door shuts.  I'm forced to return to the modern world with no knowledge of how the boy fared.
------------------------------

Back in my office I wonder about the boy.  Surely the physician had access to rational medicine to help the asthmatic?  Right?  What I  learned was quite interesting.

As my guide suggested, the gods of ancint Mesopotamia were all powerful, and they were the cause of all diseases, and they were the only means of a cure. However, the best method of treating sickness and injuries was to prevent them altogether. Each city-state had its own gods to worship, and huge temples were built for these gods to live.  The priests performed rituals where they offered prayers, incantations, and sacrifices to appease them.  Smaller temples were built where average citiens could offer sacrifices too. 

To make the job more difficult these gods had the ability to make demons, and they could either be good or evil depending on the wishes of the god. These demons, or monsters, appeared in a variety of forms, such as animals, birds, or both. 

Herodotus was a historian who lived in Ancient Greece from 484-425 B.C.  He traveled the world so he could write about it. He dismissed Ancient Mesopotamian medicine because he believed they had no doctors.  However, modern historians know from excavated cuneiform tablets that various types of physicians existed in Ancient Mesopotamia from an early time, just as in Ancient Egypt.

The Mesopotamian physician is among the most educated in this society; he or she is literate (a member of the literate), familiar with tradition, and well trained. (Sigerist, page 432). He will give the boy hope, and hope alone has psychological benefits that should help the boy cope until his breath comes back. 

Edward Withington, in his 1894 book "Medical history from the earliest times," explains that "If a Persian wished to practice medicine, he must first practice upon unbelievers; should three of these die under his hands he is forever incapable; should he cure three, he is qualified to act as a physician... for ever and ever..." (Withington, page 36)

From Henry Sigerist, in his 1955 book, "A History of Medicine," we learn that the physician probably did have knowledge of lung diseases, and he did -- as I saw on my journey, have access to an inhaler of sorts.  Yet there was no knowledge of asthma, only the symptoms of dyspnea, cough, excess sputum, chest pain, and anxiety.  Each was a disease, and the one that was most prevalent -- the dyspnea in the boy's case, was the diagnosis. 

Yes, he probably did know about dyspnea.  Some examples are mentioned by Sigerist:

"A man 'coughs dry, ejecting no saliva,' or the 'lungs cough up pus and the inward parts,' or 'a man is affected in his lungs and they vomit exceedingly.'"

Surely  this isn't asthma, yet it's a lung ailment.  Sigerist also writes: 

"Dyspnea is probably referred to in several passages which say:  'if a man's lungs pant with his work,' although the translation is not certain.  'When the breath of a man's mouth is difficult,' is probably also a reference to dyspnea."

Also, "'A man is affected in his lung passage' or 'suffers from the 'pipe of the lungs,'' means that the patient has a disease of the bronchi or upper respiratory organs.  You hear no specific descriptions of that make you think asthma, although bronchitis, or at least bronchitis symptoms, are known. 

Sigerist mentions a passage from an Assyrian tablet:

"If the patient suffers from hissing cough, if his wind-pipe is full of murmurs, if he coughs, if he has coughing fits, if he has phlegm: bray together roses and mustard, in purified oil drop it on his tongue, fill, moreover, a tube with it and blow it into his nostrils.  Thereafter he shall drink several times beer of the first quality; thus he will recover."  (Sigerist, page 480-81)

Other than incantations and prayer, or simply toughing it out, some physicians might provide the asthmatic with what you would consider among the first inhalers, similar to the Egyptian method of heating dried herbs on stone and inhaling the smoke.  The Mesopotamian inhaler is described by Sigerist as such:

"A decoction of various drugs was placed into a pot, which was sealed with wheaten dough after a reed-tube had been inserted into it.  The pot was placed on fire and then: 'thou shalt put it (the tube) into his mouth, let him draw the steam up by the reed-tube into his mouth... it shall strike his lungs: for nine days thou shalt do this.'"

Ah, and this is so stunningly accurate to what I saw.  Amazing! 

Yet there is little knowledge that the drugs placed into the pot, when inhaled, did any good to relieve the boy's dyspnea, whether it was caused by asthma, bronchitis or pneumonia.  Yet at least it proved to be a somewhat more rational (rational acording to our modern definition anyway) approach to treatment of respiratory conditions, as compared with prayer, incantation, and hope alone. We can only wonder how the boy fared.

1200 B.C.: The first healers

By 2,600 B.C. in Ancient Egypt you had three choices for the treatment of  your asthma-like symptoms.  You could seek out any of the following

1.  Physician:  They used rational cures to treat natural illnesses. They mostly used herbs and spices mixed in an array of formulas to treat diseases rationally.

2.  Sorcerer:  A person who practiced black magic.  He had an an ability to communicate with the spirits in order to rid your body of evil spirits or back magic.  Synonym:  witch, wizard, medicine man.  They used magic amulets, fetishes and talismans to prevent and treat diseases.  

3.  Priest:  A person who had the ability to communicate with the gods, or God, in order to keep them happy in order to prevent them from causing diseases or illness.  They used prayer or incantations to prevent illness and  to remedy diseases.

To read more about the above click on the links provided.  

1907: Home for children afflicted by TB

Figure 1 -- Frannie E. Lorber breaking ground at the Denver Sheltering 

So in the late 19th century many people were becoming inflicted with a disease then called consumption (what we now call tuberculosis.)  The going trend at the end of the decade was to move to a place with cool, dry and sunny weather because it made breathing easier.  

Such victims from all over the United States, particularly from New York, flocked to Colorado, where it's high altitude provided such an atmosphere.  

There were ultimately so many tuberculosis victims, and their families, in Colorado, that the state became known as the "World's Sanatorium."  

Denver, Colorado, carried a huge number of such families, and many of them were without any money to pay for help, and many were also Jewish.  So this caused certain healthy members of the Jewish community to open up their hearts and their wallets to create a home for tuberculosis victims.  

And so the Jewish Community rose to the occasion and opened up National Jewish Hospital for Consumptives in Denver.  In 1899 National Jewish Hospital for Consumptives in 1899 opened it's doors and was quickly full of patients who had no money.  However, there still remained a need to take care of other people afflicted by the disease, mainly the children.  

With parents who were sick, or who had succumbed to the disease, their children had no where to go, no one to care for them, and no money.  So in the early 20th century the Jewish Community once again opened up pocket books and opened up a shelter for these children.  Ground was broke, and a shelter was open for business in 1907.  

Prior to this opening many of the children were transferred to the Cleveland Jewish Orphanage, but many members of the community were concerned by this.  So the new shelter was open on the West side of Denver.  The name of the shelter was the Denver Sheltering Home for Jewish Children. It was an 11 room frame house.

The home filled up fast.  Some of the kids staying in the home were orphans, but most had parents inflicted with tuberculosis, and many of whom were staying at the nearby National Jewish Hospital.

Figure 2 --From right to left: Joey Carsh, Barbara Blackmer, Joey Barret,
Ester Cash, and Alvin Uikon sitting in a garden at the National Home for 
JewishChildren at Denver in Denver, Colorado. The Home later became
 NationalAsthma Center, and in 1978 merged with  National Jewish
 Hospital.Back reads: Smiling Pals -- The Beginning of Life-Long Friendships, 
late 1930s (1)

Among the leaders in the drive to get this project completed was Frannie Lorber, Bessie Willens, and other women.

You can see a picture of Lorner breaking ground in figure 1.  The shelter was located at the corner of 19th and Julian Streets on the West side of Denver.

The home quickly grew in size, but in 1914 a fire destroyed.  By 1914 it was rebuilt so that it had much larger facilities, with separate dormitories for boys and girls. (3)

The base of the organization was expanded, and by the 1920s it was a national organization, with support coming from as far away as New York.  Also in the 1920s the campus was changed so the children were housed in small group homes, or what was also called the cottage plan. (3)

Each cottage had it's own live in matron in an attempt to recreate a more family-like structure.  And of the over 1000 children that passed through the home over the years, and the fear of tuberculosis, only six of the kids contracted the disease, and only three children at the home died. (3)

By 1928 the name was changed to National Home for Jewish Children in Denver, mainly due to the fact the home was sheltering more than just children affected by tuberculosis.

Lorner would spend the next 51 years working to raise money for this and other similar projects in Denver and across the United States.

In 1939 the home began taking in children with intractable asthma.  Throughout the 1930s and 1940s there was a rise in the number of asthmatic patients at the home, and by 1953 the name was changed to show the change in the type of customer at the Shelter.  This home would end up becoming one of the worlds most prominent asthma shelters in the United States, and in the world.

Figure 3 -- Children of Denver ShelteringHome for Jewish Children, 1907
(2)

(According to the Rocky Mountain Jewish Historical Society, ClaraGertz was an orphan at the shelter from ages 9-15 in the 30s and 40s.)  Gertz says life at the orphanage can best be described as “regulated.” everyone got up at 6 a.m., washed, then marched singlefile through an underground tunnel to the dining room to eat. The younger children walked together to nearby Cheltenham School. After school, the children were given a snack, then it was time for chores. Daily duties might include working in the dining hall, the kitchen, or the laundry. Gertz learned to use the sewing machine and mended clothes. Children who dusted had their work inspected by a matron’s white glove. Evenings were spent studying in the library until bedtime. “I think that living a regulated life was wholesome and beneficial,” says Gertz. “I never it looked at it as so terrible, having lived that kind of regimented life. You adhered to the rules. I mean there was no other way…” While a predictable daily routine may have had its benefits, the same philosophyapplied to cuisine made for a monotonous diet. What did Gertz think of orphanage dining hall fare? “I think in terms of sameness,’ to the degree that today I will not eat a sweet roll because we had them every day.” She ponders a moment recalling another dining hall memory: “If there’s something I dislike in this world it’s bread pudding. I would take the napkin and I’d put it on my lap and I’d drop the bread pudding on it and then I’d run to the bathroom and flush it down the toilet. I hate bread pudding!”

Mending clothes was one of the routine chores preformed by the girls. (2)

At the end of the school week, activities changed but were equally regimented. “There was always Friday night service. We always had chicken. We had Sunday school on Sunday morning, even if you had company or were going out.” (Sunday was visiting day.) Was Saturday a free day? Only “to a point,” said Gertz. That was the day when volunteer instructors came to teach music or dance lessons. One of her favorite Saturday afternoon activities was going as a group to the movies. In winter, children from the home ice – skated on Sloan’s Lake. 

 Discipline at the home was meted out in different ways, ranging from corporal punishment to loss of privileges. “The matron in the girls’ building had a radiator brush and she’d pound your bottom or you were restricted from going to the show on Saturday,” Gertz recalls, adding later, “I must also tell you I was a very bad child, I mean bad! At one point in the religious class at night I’d get all the kids to stare at the teacher and it made her very uncomfortable. And at one point the superintendent said to me, If you don’t behave, we’re going to put you out as a domestic!’”. (2)

Teacher Abe Kirschstein stands behind Sunday School
students seated at desks at the National Home
for Jewish Children in Denver (1)

There were various such shelters throughout the United States, and they provided a great opportunity for children.  From all the accounts I have read from the kids who were fortunate to have been taken up by the shelter, the experiences were really good.

During the 1980s the shelter was razed and there is now nothing left.  To hear some of these accounts you can click here.

For the rest of the story, check out: 1930-1950: The rise of the asthmatic institution

References:

1. Photo information from University of Denver, Penrose Library, Digitalized Collection, http://digital.library.du.edu/penrosepresents/items/show/3173, accessed 11/8/12
2. "Memories of the Denver Sheltering Home for Jewish Children," Rockey Mountain Jewish Historical Society, University of Denver, http://www.du.edu/cjs/memories_of_the_denver_sheltering_home.html
3. Abrams, Jeanne,"For a Child's Sake: Denver Sheltering Home for Jewish Children in the Progressive Era," American Jewish History, Winter 1989-90, Volume LXIX, No. 2, University of Denver

2,600 B.C.: The birth of Rational Medicine

Editors Note:  The following post was rewritten here

Without knowledge of the human anatomy ancient men and women rationalized illness by the only means they understood, and that was by assuming it was caused by evil spirits, demons, the dead or the gods.  To them this was rational medicine. (1)  What they would call rational we refer to as magico-religious.  As we travel back in time in our quest to learn about asthma this is essential for us to understand.

To the modern asthmatic rational medicine is anything that truly makes breathing easier; it's medicine that has a real effect; it's civilized medicine.  According to Henry E. Sigerist in his book, "A History of Asthma," rational means "physical, dietic, and pharmacological treatments that are not mystical in themselves; it's also surgery; cutting with the knife.  They are generally treatments used by physicians, although they can work their way into the magico-religious."

According to historians rational medicine as we define it developed early on in Egyptian and Mesopotamian medicine, but developed over 1,000 years later in Ancient China.  The west often credits Imhotep, although most speculate physicians with their rational medicine existed long before the vizier and architect of King Djoser around 2,600 B.C.

Edward Withington, in his 1894 book "Medical History of the Art of Healing," describes the discovery of a tomb of Sekhet' enanch who was chief physician of the Pharaoh Sahura.  Inscriptions show he "healed the king's 'nostrils' for which his majesty wishes him 'a long life of holiness.'"

The tomb of Sekhet' enanch is dated to sometime around 3533 and 3000 B.C., as the physician is believe the pharaoh and physician were members of the 5th dynasty of Egypt.  He is the first known physician, although there is evidence of physicians before him.

Withington explains that the first physicians were probably medicine men.  In Egypt the "profession" was later divided up as specialties developed: Sorcerers specialized in magic, priests in religion, and physicians in civilized medicine.

Common ailments such as colds, asthma, headaches, and stomach aches may have been treated with herbal remedies, but the unexplained diseases were probably treated with magic. Wounds from war, bone breaks, lacerations were treated with surgery.  The type of medical treatment you receive is generally up to you, who you know, and/or your location. (4)

Empirico is defined as what we learn from experience and observation.  A good example is the asthmatic who is having trouble breathing.  One of his friends tosses Belladona leaves into the fire and this asthmatic just happens to inhale some of the smoke.  His breathing gets better.  He assumes it was the Belladonna that helped him.  He remembers this for next time.  He experiments.  He observes.  He tells his kids.

Belladonna is referred to as a herbal remedy.  It's natural, although even while so the "pharmacological aspect of therapy must be understood, however, in the context of the supernaturalistic paradigm: the medicines worked through magic, their effect depended on the recitation of the proper words and the performance of the correct actions. In fact, the consecration of the remedies was a significant part of the sacred utterances of the healer.  The potency of herbs was usually due to their relationship with gods or goddesses who were behind their curative powers." (1)

Many historians like to refer to magic and religious medicine as magico-religious and natural medicine as emperico-rational.  Magico-religious medicine will be explained further in another post.  Emperico-Rational medicine consists of natural remedies for natural diseases. Natural diseases are those that are normally occurring, such as your common colds, aches and pains, pneumonia, pleurisy, etc.  (2)

Natural diseases were generally treated with herbs, massage, broths, salves, etc. Herbs available included opium, coca, cinchona, ephedrine, caffeine, carcara, sagrada, chaulmoogra, digitalis, ipacacuanha, podophyllum, pyrethrum, squill, belladonna, and strammonium. While their effect may have been known, they knew not the why or how.  Generaly, the why and how was believed to be magical. 

In our modern world we see herbal remedies such as Belladona as rational: it may actually make you feel better.  Yet as we take into mind the scope of knowledge of primitive men and women, we must understand that even what we view as magico-religious medicine may actually have a rational or real effect. So in the scope of the primitive mind, magico-religious was rational medicine, according to Plinio Prioreschi. in his 1991 book "A history of Medicine."

It would be similar to you or me going to your priest for help with your hardluck asthma because your doctor has done all he can for you.  As far as medicine, you are on all the best medicine and it's not helping you.  So you seek a priest for guidance.  He may help you pray. He may help you find comfort.  In this way he may help soothe your mind.  In a sense, this is good medicine.  Studies even show those who "believe" get better quicker than those who don't believe. 

In fact, in 30,000 B.C. magico-religious medicine may even be better than emperico-rational. If you had asthma you may even prefer to seek out a priest or sorcerer over a physician.  Just think about it.  Your physician may prescribe you take Ipacec to vomit. He may prescribe an emetic to make you relieve your bowels.  These things can make you worse. 

On the other hand, while magico-religious medicine may offer no real remedy, at least it does no harm.  The best case scenerio is the placebo effect makes you think something is being done.  You feel better.  You relax.  Your breath comes back -- eventually. 

In this way, sometimes doing nothing is better than doing something stupid, which primitive physicians might do.  Now the physician may prescribe for you to inhale the fumes of dried and crushed belladona placed on heated bricks.  If he does you are in luck.  Yet if he prescribes something quacky you may have been better off calling for a priest or scorcerer. 

As both Henry E. Sigerist and Plinio Prioreschi wrote in their respective books on the history of medicine, primitive man developed magico-religous medicine first prior to developing emperico-rational medicine.  Ultimately the two paradigms existed side by side, and this actually continues to be true to this day as we have rational medicine working side by side with religion, as an example.  In China and India you see this to a greater degree.

Emperico-Rational medicine first started, as noted above, by trial and error by primitive men.  A societies further developed along the Tigris, Euphrates and Nile rivers medicine further developed into a specialty of physicians.  This is believed to have happened early on in Egypt and Mesopotamia, and over 1000 years later in China.

While the true birth of emperico-rational medicine probably happened early on, perhaps even early than 30,000 B.C., it was available by random people at random locations.  Knowledge was obtained mainly through word of mouth, mainly from parents, and perhaps through poems that were easily memorized.  Yet it's Imhotep, around 2,600 B.C. who is given credit as the inventor of rational medicine.  For this reason the year 2,600 is usually noted by historians as the birth of rational medicine.

Many ancient writings have made their way to us from around 2,000 B.C., although the information contained on these texts is much older, going as far back as 5,000 B.C.  The texts that we now possess are believed to be copies of copies of copies.  Even the originals were copies of what was at first handed down by word of mouth. So the knowledge goes way back, farther than what we might suspect.

Herodotus traveled the world to learn and write about the culture of other civilizations other than Greek.  He observed there were many different types of physicians in Ancient Egypt:

The practice of medicine is so divided among them, that each physician is a healer of one disease and no more.  All the country is full of physician, some of the eye, some of the teeth, some of what pertains to the belly, and some of the hidden diseases." (3)

Herodotus observed the Ancient Mesopotamians had a dislike of physicians, although this may actually represent the Greek view of Mesopotamia rather than fact.  Many records from history show Mesopotamia had many physicians and they were respected.  So rational medicine was widely available in ancient civilizations.

Homer wrote of the Egyptians that "each one is a physician, skilful beyond all men, for verily they are of the race of Paeon." (4, page 16) By this he may mean that every person, to some degree, had knowledge of medicine sort of like most people today have some knowledge of how to treat common colds, cuts, scrapes and the like.  Likewise, we all have some knowledge of medicine, with some salves, pills and lotions in our medicine cabinets.

In fact, Withington (page 16) describes the discovery of the medicine chest of Pharaoh Mentu'-hotep of the 11th dynasty around 2,500 B.C.  The chest belonged to his wife, and consisted of "six vases, one of alabaster and and five of serpentine, with dried remnants of drugs, two spoons, a piece of linen cloth and some roots, enclosed in a basket of straw-work, the whole standing in a wooden chest found in the queen's tomb."

Whithington explains this may be one example of the medical skills of the general population of Egypt that Homer was referring to.

So if you had asthma-like symptoms in Egypt, Mesopotamia, or China after the discovery of natural/ rational medicine, you now had the option of seeking out a priest or scorceror for your magico-religious treatment, or one of many different types of physicians for your emperico-rational treatment.  Although if you were among the primitive folks your priest or scorcerer would be just as rational, if not more so, than your physician.  Your choice.

References:

1. Prioreschi, Plinio, "A History of Medicine," 1991, volume I, page 248
2. Sigerist, Henry E, "A History of Medicne," 1955, second editionn, vol. I, 
3. Prioreschik, op cit, page 365-6, referring to Herodotus, II, 84, Translation by A.D. Godley.  
4. Withington, Edward Theodore, "Medical history from the earliest tiimes: A popular history of the art of healing," 1894, London, The Scientific Press, pages 14-23 (Chapter IV: Medicine in Ancient Egypt)

Severe and Complex allergy Syndrome (SCAS)

I think most people forget that there's more to asthma than just asthma.  I get people emailing me all the time saying stuff like: You know, if you're using your inhaler more than 2 times in a two week period you don't have asthma control."  I'd like to take those people and smack them right up alongside the face.  Ha, that actually felt good saying.  

Seriously, folks, I think that many people get caught in the flux that all cases of asthma are the same, and they aren't.  I think the asthma guidelines, which created the above definition of control, were describing "pure asthma," or asthma not complicated with anything else.  

Yet most asthma is complicated.  Most asthmatics have something else.  For example, 75 percent of asthmatics have allergies.  When this happens you have extrinsic asthma.  That's what I have.  I have extrinsic asthma.  When I was a kid this was ignored.  Even at National Jewish Health I was diagnosed with "High Risk Asthma."  I think even that definition comes with a flaw.  It ignores the general cause of my asthma: allergies.  

My point of this post is I think most of my doctors ignore the fact that the main cause of my asthma is not asthma, it's allergies.  I think if I had pure asthma it would be generally controlled.  But those dog gone allergies pop up, and wham!!!  When there's a bad allergy season, which it has been the past year, wham!!!

So for the 9 year period from 2002 to 2010 my asthma was great.  But then it took a turn for the worse.  I told my doctor this, and his goal, up to this point, has been to increase my steroids.  Yes, I'm not on Advair 500, which is the severe asthma dose.  Surely this helps, but the asthma is still there, hovering over me like a Japanese suicide pilot on a WWI American Ship in the Atlantic.  

The best example I can give of this was back in 1995 I saw an allergist, and he said, "We're going to do some allergy testing on you."  I said, "No, I don't want to do that again.  All it does is make me itch like crazy because I'm allergic to everything."  He said, "No one is allergic to everything."  I said, "Well, I am."  He said, "No one is!"

Well, as he was performing the test, and as my back was itching like crazy, he said, "Well, I guess you were right.  You are allergic to EVERYTHING! Wow, I've never seen this before."  

So my last doctor had me trial Singulair.  On my own, and based on my own research, I decided to take Singulair and and Claritin every day to treat my allergies, or to try to allay the damage.  Yet my new doctor told me to quit taking Singulair because he hasn't seen it do any good.  Then Wham!!!  So I put myself back on the allergy medicine.  

I also told my doctor I can't clean my house, I can't mow the lawn, I can't go to hunting camp, and he said, "Why not?"  Yes, it's frustrating.  The thing is, my current doctor is the smartest doctor I've ever had, seriously.  He knows his stuff.  So when I told him I put myself back on Singulair, he said, "Okay, whatever works for you."  

"Well, I'm not saying it works for me at all.  I'm saying we asthmatics are stubborn, and when we perceive something's working we like to stick with it."  Still, the main reason I have severe asthma, I think, is because I have severe and complex allergy syndrome, a diagnosis I just made up.  It forces me to do this as opposed to normal things.  While I enjoy doing this, I don't think people understand that I'm not lazy, I just can't do those things.  And it's frustrating.  

It's also frustrating that it's nearly impossible to get people to understand allergies.  Just watching a show like iCarly where they keep making fun of the kids with allergies ads to my frustration.  We live in a society where allergy ridden people are freaks.  And this is funny since we live in a supposed anti-bullying society

When I was 12 I decided I wasn't normal

Bell Curve of Intelligence

I was probably about eleven when I realized I wasn't normal.  Before that time I thought it was normal to not be able to breathe when other people were having fun; to have to remember your medicine before leaving the house; to have to pace yourself when playing sports or otherwise doing things normal kids do, like playing in tents made of old, dusty blankets stored in the dusty basement.

When I did these normal things, I felt abnormal.  My chest would burn, my chin itch, and my breath, well, my breath wasn't very good.  To get air in I had to suck it in, and before I was twelve I thought this was normal.  Before I was twelve I didn't understand why everyone else was having fun at grandma and grandpas house and I wasn't.  At twelve I realized I couldn't roller skate in the basement, and I realized I couldn't, or shouldn't, sleep in the bed by the fireplace in the same room my grandpa slept in. When I was twelve I realized I couldn't play football -- or shouldn't, because I did -- on Thanksgiving day when the snow was blowing and so too was smoke from the wood stove billowing out the chimney.  Yes, while all these things were normal, they made me not be able to breathe, which was, I decided when I was twelve, not normal.

It was also when I was 12 I decided I had a special gift that no one else had, a gift that made me special, and a gift I must never share with anyone.  I can share the product of the gift, yet I can never share the gift.  You see, if you are gifted, if you have a gift that makes you abnormal, you share it at your own risk.  When you share it with others, when you tell them your secret, you will be treated as a quack.  Yet I wasn't a quack, and I'm still not a quack.  Although, I contest, I am not normal (although, and this is a discussion for a later post, normal is also subjective).  

Since most people are normal, I decided I wasn't able to communicate with them my gift.  You see, normal people think of normal things.  Normal people have no incentive to think about deeper, inert things.  Normal people have no incentive to think about how other people feel.  Normal people aren't able to receive telepathic messages from other people.  Normal people have no need to think about any one else but themselves and their family and their survival.  Yet when you have a disease like asthma, you're forced to live different and think different.  You are forced to make changes.  

So I had a gift, and the gift was born out of my asthma.  You see, because I had asthma, and because I was not normal as noted above, I was forced to live my life like abnormal people life their lives.  I, thus, was forced to make changes.  I had to stay inside when the other guys were playing, or hunting, or camping, or what guys do.  I was forced to stay inside and read and think.  I was forced to reach into a deeper part of my mind.  

And anyone who has asthma knows, it's nearly impossible to get people who don't have your disease to understand what it's like to live with a disease.  Even to this day, even though my dad sat with me hundreds of hours in hospital rooms watching me suffer with asthma, he still has no clue that I am forced to be different.  Even though I've told him a thousand times the past year -- 20 years after the last time he sat in an ER room with me -- that I cannot go to hunting camp anymore because there are too many allergens out there, he still keeps begging me to go.  He is normal, and he is able to have fun out there without having to worry about his asthma (do I have my inhaler? do I have a clean pillow case? how will I get home if I can't breathe, etc.).  So he has no clue what it's like when you're not normal.  

I think the best way of describing what it's like to be abnormal is to describe the bell curve of intelligence.  Now, I'm not implying I'm intelligent the way you're thinking, no I do not have a 200 IQ.  No I'm not any smarter, per se, than you are.  Because I don't see intelligence that way.  I believe that we are all smart in our own way.  While you may have the highest IQ in the world, you may not be intelligent when it comes to asthma, or you may be clueless how to write.  You see, we all have a different level of intelligence.  My gift is my ability to think of things, and to write.  You may find this awkward me saying this, but I cannot communicate by words the way I communicate here.  Rush Limbaugh is a good verbal communicator, and in that way he's word smart.  I'm writing smart.  So that's what I mean.  

So let me describe this bell curve.  You take the people at the top who have the highest IQs, and you take those on the bottom with the lowest IQs, and you toss them out.  These we consider rare IQ scores, or abnormally gifted and abnormally stupid people.  Or, perhaps these scores were errors.  Either way, you toss them out.  That gives us a means.  So by using this bell curve, I can describe what I'm discussing in this post.  No, I do not have a high IQ. But, if you use this curve to show asthma intelligence, or writing intelligence, then you can see what I'm describing.  Most people I know have no clue what I'm talking about when I'm talking about asthma.  Most people I talk to are ignorant about asthma.  So, in this way, I MUST be in the top half of the bell curve that was tossed out.  I say this because there has to be a mean, and if I'm in the mean and everyone else in the mean is stupid, then there would be no mean.  So that can't be so, so I MUST be in the top of the bell curve.  

When it comes to gossip intelligence, or people smarts, I'd be in the bottom portion of the bell curve.  I'm not people smart at all.  So I'm gifted.  And most of you guys reading this probably think I'm nuts, that I'm a quack for thinking this way.  Or, you probably think I'm being arrogant.  That's not the case either.  I do, however, have an uncanny interest in history, respiratory therapy, philosophy, writing, and politics.  I find few people enjoy the same interests.  I'm abnormal.  And when you're abnormal living in a world with normal people, you just keep your mouth shut about it, although I'm breaking that rule here.  Yet it was my asthma that made me this way.  So perhaps you can see why I like to tell people asthma was a gift from God.  If it weren't for my asthma I wouldn't have this gift, and you wouldn't know me.

30,000-2600 B.C.: Medicine man wards off black magic

In the primitive world, the medicine man was the person you'd seek
out when you were sick.  He had the ability to communicate with
the spirits, and therefore had the ability to heal. 

Humans migrating to Europe around 30,000 years ago rationalized everything by transcendental forces. When you were sick or injured you were powerless, and you needed the help of the all powerful spirits and gods of healing.  For this reason a medicine man (or woman) was needed to intercede, creating a link between patient and the all powerful supernatural beings.

There were various names for these medicine men and women, such as witches, witch doctor, magicians, sorcerers, seers, shamans, healers, wizards, priests, etc. He would make noise with rattles and drums, chant incantations, and use a variety of magical maneuvers to hide whatever he was doing.  In the meantime, he'd be "pretending (or endeavering) to extract the active principle of the disease by sucking it through a hollow tube," according to Fielding Hudson Garrison in his 1922 history of medicine.  "To prevent future attacks, in other words, to keep the demon away for the future, he provides his patient with a special fetish or amulet to be worn or carried about his person."(1, page 21) 

He would create potions using a variety of plants and herbs, and these were believed to work by their magical qualities, probably provided by the spirits or gods. And over time he developed "a special talent for herb doctoring, bone setting, and rude surgery," writes Garrison. "We find that savages in widely separated countries easily get to know the most fatal arrow poisons—curare, ouabain, veratrin, boundou—as well as the virtues of drugs, like opium, hashish, hemp, coca, cinchona, eucalyptus, sarsaparilla, acacia, kousso, copaiba, guaiac, jalap, podophyllin, or quassia." (1, page 25) 

They also learned about viable remedies for asthma by experimenting with the leaves, stems and roots of the deadly nightshade called belladonna (and strammonium).  And he also must have experimented with the effects of drugs like opium, tea, coffee, and alcohol and learned they caused a sort of "artificial paradise," according to Garrison.  All of these would provide at least some relief to the sick and injured, if for no other reason than to provide some mental relief and relaxation, or to help them forget their misery.  Such relaxing effects may even have ended an attack caused by the spirits. (1, page 30)

And if these remedies didn't work, he might try a remedy called bleeding by using a sharp stone or flint knife to balance the humors of the body. Or perhaps he might try trapanation to let the evil spirits out of the sick man's body by cutting or sawing an opening in the scull.(1, page 26)

Although the emphasis of the medicine man was on more than just a healer of the human body.  Garrison writes: (1, page 23)

Primitive medicine is inseparable from primitive modes of religious belief. If we are to understand the attitude of the primitive mind toward the diagnosis and treatment of disease we must recognize that medicine, in our sense, was only one phase of a set of magic or mystic processes designed to promote human well-being, such as averting the wrath of angered gods or evil spirits, fire-making, making rain, purifying streams or habitations, fertilizing soil, improving sexual potency or fecundity, preventing or removing blight of crops and epidemic diseases, and that these powers, originally united in one person, were he god, hero, king, sorcerer, priest, prophet, or physician, formed the savage's generic concept of 'making medicine.' A true medicine-maker, in the primitive sense, was the analogue of our scientific experts, philanthropists, and "efficiency engineers," a general promoter of human prosperity. (1, page 20-21)

When these "sorcerers" first appeared is unknown, although it's speculated they originated as the smartest, wisest, most sagacious, most knowledgeable, most curious members of the families, clans or societies that grew from the ashes of mankind. These individuals listened to the lyrics told at night, and remembered them.  They asked questions about the human body, and searched for and experimented with the various plants and herbs amid the lands around them until they found the answers.

They created various medical recipes, and, by experimentation, learned of their poisonous or healing properties. Many of these sorcerers were seen as healers, and were sought out when needed.  Others were seen as utilizing what was referred to in Egypt as the "black art," and they were punished with death.  So how they were viewed differed from one nation to the next. Although, what is known about them is they were the first physicians, with their specialty in healing, divination, pharmacy, chemistry, and magic. Although many of these specialties evolved over time.

Primitive and ancient people did not have an understanding of the human body, and their curiosities of it were nary satiated because to investigate the human body was considered to be offensive to the gods. What they did learn about anatomy was accumulated by animals they dissected for food and sacrifices, and later by the process of embalming, although due to fear of the ubiquitous gods even the priests performing these duties were fearful to exceed the bounds of the task at hand.

The ancient Egyptians had knowledge of the vessels of the body, and they knew that they originated in the heart.  They knew the heart beat could be felt at various points on the body. And although they had some knowledge of anatomy, they in no way associated this with the various ailments and the remedies used to treat them.  They did not know diseases were caused by germs, or problems with the inner workings of the body, and they did not know that the remedies they created over time had anything to do with their effects on the body.

For thousands of years transcendental forces were at work all the time.  People had to "know prayers, sacrifices, rites, spells," to keep the transcendental forces happy and at balance.  (2, page 270) They were educated about these by the medicine man, and when their own self remedies failed, or when they could no longer tough it out, the medicine man was sought for his wisdom.

By all means, the spirits of the dead were abounding, and they needed to be satisfied and even fed.  If they were not satisfied, they caused diseases and injuries.  Another thing that caused disease was when a person was not pure, or did something wrong.  Often times when a person was sick the rest of the clan would wonder what god or spirit he offended.  And, of course, the only person who had the ability to learn this, and how to placate that god or spirit, was the medicine man; the sorcerer; the priest. He also had the ability to drive out demons, and to counteract black magic that might have been used to cause the ailments.

So the ailments that plagued the various clans, villages and civilizations were not caused by germs or problems with the body, and injuries did not just happen by chance: they were caused by spirits, demons, gods, and black magic.  People, therefore, didn't think of diseases the way we do today.  What we have today are a variety of diseases based on quantitative evidence about various systems of the body. We see diseases such as asthma, allergy, cold, sinusitis, rhinitis, etc.  Through most of history, however, ailments were diagnosed by the symptom.  If more than one symptom persisted, the diagnosis was based on the more prominent.

In other words, your sypmptom was your disease.  In this sense, even while the following may be caused by various disorders, most prehistoric, primitive and ancient people/societies considered them diseases (1):

• Fever
• Coughing
• Dyspnea (shortness of breath)
• Nausea
• Hematuria
• Headache
• Shortness of breath
• Excessive sputum
• Pain

The following definitions will help you understand the role of the medicine man/sorcerer:

1.  Black magic:  This is evil.  The use of supernatural powers for selfish and evil purposes.  An example is casting a spell on someone you don't like to cause a disease or to cause something bad to happen.  It can be as simple as an evil eye, witchcraft, or finding someone to make an evil potion for someone to drink.

2.  Black art:  This was the use of drugs for evil purposes.  This involved the mixing and matching of various drugs and solutions to create potions that were used to evil purposes, such as poisons to kill people you did not like.  Early alchemy, chemistry, and pharmacy was considered to be a black art in the early days of ancient Egypt.  

3.  Omen: Telling the future.  It can tell you if something good or bad is going to happen to you.  If something bad is going to happen you can seek out help in order to prevent it from happening.  

4. Amulet: An object that possesses magic properties to ward off evil spirits. Generally it can be anything from a bone from prey, a rondel (bone chipped away during trepanation of skull), a rabbit's foot, a squirrel's tail, stones, rocks, etc. It may be an object such as an ax, knives, necklace, bracelet, etc. They meet and destroy evil spirits. They catch and neutralize black magic directed toward the owner of the amulet. These are often the chief means of preventative medicine in many primitive and ancient societies. (1, page 40)(2, page ?) They are objects that must be worn at all times in order for their magic to work. Ancient Roman children were made to wear necklaces with amulets made of amber hanging from them. This was so that its magic would protect the child when the parents were not around. (4, page 80)
5. Fetish: An object that is the seat of magic power. It may be the abode of a spirit or may have been charged by the medicine man with the mystic power, mana, or manitou, or whatever it may have been called. It may be an object of worship. The owner of a fetish expects it to act according to his intentions.

6.  Totem:  The totem is usually an animal or other natural figure that spiritually represents a group of related people such as a clan. 

7:  Charm:   Something worn or carried on one's person for its supposed magical effect, such as an amulet, talisman, incantation, conjuration, prayer and even exorcisms.  It could be a bracelet, necklace, ring, or just about anything. It could be anything that provides the magic necessary to ward off evil, either words or some object. It could be words like ABRACADABRA. (1, page 41)

8.  Talisman:  These are amulets or charms that were "closely guarded but not worn." (1, page 41) It could consist of stone, metal, or even parchment paper that has certain characters engraved on it. (4, page 80) The ancient Romans would often have a talisman in their homes in order to protect it, although it would also have the ability to protect the owner too. It's simply any object that possesses magic properties and brings good luck, and does not have to be worn at all times like a an amulet does.

9.  Mascot:  An animated talisman, a person or animal that brings good luck

10.  Incantation: The chanting or uttering of words that are supposed to have magic qualities, as through preventing or healing disease.

11.  Prayer:  Words, a petition, meant to provide protection and healing by calling to the divination for such help.

12. Spells: According to dictionary.com it's "a word, phrase, or form of words supposed to have magic power" which may include a charm or incantation.

The following are what the sorcerer evolved into:

13.  Fumigation: Creating fumes or smoke with fires, incense, pipes, steam, etc., with the intent of healing through inhaling the fumes of burned or steamed herbs or otherwise, and more likely in ancient times, to please or ward off evil spirits to prevent and treat diseases, prevent bad things from happening, etc.


Now, it is true that you might see the medicine that is described here as poppycock and quack medicine. However, when you think of it, this was probably the best medicine available at the time as it gave people hope and faith. This was observed by Fielding Hudson Garrison in his 1922 history of medicine:

In surveying these different superstitions, one point becomes of especial moment. It is highly improbable that any of the remedies mentioned actually cured disease, but there is abundant evidence of the most trustworthy kind that there have been sick people who got well with the aid of nothing else. How did they get well? Short of accepting the existence of supernatural forces, we can only fall back upon such vague explanations as "the healing power of nature," the tendency of nature to throw off the materies morbi or to bring unstable chemical states to equilibrium, the latter being the most plausible. But, in many cases of a nervous nature or in neurotic individuals, there is indubitable evidence of the effect of the mind upon the body, and in such cases it is possible that a sensory impression may so influence the vasomotor centers or the internal secretions of the ductless glands as to bring about definite chemical changes in the blood, glands, or other tissues, which, in some cases, might constitute a "cure." (1, page 42)

He also wrote:

"The best inspirer of hope is the best physician," an aphorism which contains the germ of the Freudian theory of psycho-analysis—to "minister to the mind diseased" by removing the splinter of worry or misery from the brain, in order to restore the patient to a cheerful state of mental equilibrium... It is also the secret of the influence of religion upon mankind, and here the priest or pastor becomes, in the truest sense, tin Arzt der Seele. In practical medicine, the principle now has a definite footing as psychotherapy... Psychotherapy cannot knit a fractured bone, antagonize the action of poisons, or heal a specific infection, but in many bodily ills, especially of the nervous system, its use is far more efficient and respectable than that of many a drug which is claimed to be a specific in an unimaginable number of disorders. (1, page 33-34)

So while the magic of the medicine man/ sorcerer/ priest may not have healed you physically, it may have provided you with the mental relief, or peace of mind, necessary to buy time for nature to cure what ails you, even the dyspnea caused by asthma.

References:

1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, 3rd edition, Philadelphia and London, W.B. Saunders Company
2. Sigerist, Henry,"History of Medicine: Primitive and Archaic Medicine," volume I, 1951, Oxford University Press, page 322
3. More references will be listed here soon as some of the wording among the lexicon here is not mine.  Sorry for any invonvenience.  Much of the lexicon comes from Sigerist's 1922 history of medicine, and I will update this reference as soon as his book arrives in the mail. 
4. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey