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Friday, October 3, 2014

4000-2000 B.C: The birth of artificial breathing and tracheotomy

Perhaps as far back as 4,000 years before the birth of Christ some mother grappled for something to do as she watched her child gasp for air.  She had already chanted incantations, and even called the medicine man, so she placed her mouth over the boy's mouth, and exhaled.  As she did so she saw that his chest expanded.

Unknowingly, she became the first person ever to perform mouth to mouth breathing.  Her attempt probably failed, and amid her anguish as she grieved for her child she made no effort to reveal to others what she had done.

Similar efforts were made from time to time, and mostly by mothers making panicked efforts to save their children.  Most of these efforts probably failed, although each would have at least given a child a chance to go on living.

And, lo and be hold, one of these efforts must have resulted in the child gasping and opening his eyes, and this would have been reported to a medicine man who made note of it deep in the back of his mind.  Several years later he was called to a young patient who appeared to be dead.  He breathed three times into the child's mouth and the child breathed life.

Such success would have brought great joy to the parents and family members, and the medicine man hailed as a hero.  This hero would have shared this wisdom with his sons, one of whom shared it with an ancient Mesopotamian messenger, who shared it with a prophet, who shared it with his scribe, who recorded it in some ancient medical texts.

For the first time ever, instead of being relayed from word of mouth, it was privy wisdom shared with the select few who were privileged to attend the few schools that then existed.

This wisdom was used from time to time by ancient physicians, magi, and profits. More often than not such attempts failed to bring people back from the dead, but from time to time it worked.  And with each success some new wisdom was learned.

One day, after a failed attempt at mouth to mouth breathing, a young physician took a sharp knife and created an opening into a suffocating man's neck.  This would have been the first tracheotomy.  Such knowledge would have been recorded by scribes and taught at schools.  This would have been done sometime around 4,000 B.C. (1, page 222)

In 2000 B.C. Ancient Hindu medicine mentioned "throat incision," and about 1500 B.C. the ancient Egyptian architect, scribe and physician Imhotep became the first mention the procedure in writing. While his original works are lost to history, we learn about his thoughts by later writers who would have had access to his original works.  (1, page 222)

The rare patients brought back to life by mouth to mouth breathing were probably merely revitalized by the efforts.  The rare patients who survived early tracheotomies probably died later on due to the unintentional introduction of pathogens to the blood stream during the operation.

  1. Szmuk, Peter, eet al, "A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age," Intensive Care Medicine, 2008, 34, pages 222-228
  2. Price, J.L., "The Evolution of Breathing Machines,Medical History, 1962, January, 6(1), pages 67-72; Price references The Bible, Kings, 4: 34 
  3. Fourgeaud, V.J, "Medicine Among the Arabs," (Historical Sketches), Pacific medical and surgical journal, Vol. VII, ed. V.J. Fourgeaud and J.F. Morse, 1864, San Fransisco, Thompson & Company,  pages 193-203  (referenced to page 198-9)
  4. "Biographical Dictionary of the society for the diffusion of useful knowledge," Longman, Brown, Green and Longmans, volume III, 1843, A. Spottingwood, London, page 124-5
  5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
  6. Lee, W.L., A.S. Stutsky, "Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS," Semin. Respit. Critical Care Medicine, 2001, June, 22, 3, pages 269-280
  7. Tan, S.Y, et al, "Medicine in Stamps:  Paracelsus (1493-1541): The man who dared," Singapore Medical Journal,  2003, vol. 44 (1), pages 5-7
  8. Ball, James B, "Intubation of the Larynx," 1891, London, H.K. Lewis
  9. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
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