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Sunday, March 22, 2015

400 B.C.: The Hippocratic Inhaler

The first inhaler was probably invented long before Hippocrates walked the earth in the 5th century B.C.  Yet the first time it was ever recorded was by Hippocrates, or at least by one of the writers of the Hippocratic Corpus.  

The inventor is unknown to history, although one might suspect that a young Greek priest learned about it on one of his journeys, and it appeared to him in a vision at the Aesclepion at Cos.  He provided it as a remedy and it worked for what he was told it would work for.  It was then recorded in the votive tablets.

Many years later, while making his own effort to record the wisdom of the ancients, Hippocrates would have learned of this inhaler.  He wrote about it in his Hippocratic Corpus.  

Of course he didn't refer to it as an inhaler, of course not, as the term wasn't coined yet.  Also, chances are pretty good the inhaler he learned about was not used for asthma, or even asthma-like symptoms, but some other unknown malady.  Yet it may have been used for asthma at some point.

So, in the Corpus Hippocrates mentions this inhaler-like device.  The model basically consisted of a jar with a hole in the lid for the insertion of a hollow reed for inhaling the contents. The mouth was saved from burns by use of a soft sponge or egg shells between the mouth and reed.  (1, page 461)

Boiling water would be inserted into the jar, perhaps a recipe of medicines, the lid placed atop the jar, the reed stick inserted through the hole.  The patient would inhale by placing his mouth on the reed stick.  It was a simple design and must have worked quite well, because it was the design used by physicians for many years.

Hippocrates also described fumigations, which probably would have been of smoke or steam.  This treatment might have been more readily available than the inhaler.  (2, page 241)

However, it should be noted that the most common use of fumigations and the inhaler was probably not for respiratory ailments.

For instance, he recommended fumigation to induce menstuation in virgins.  He
recommended fumigation, among other treatments, as a option when a female had pituitous (mucousy) menstruation, or when female hysteria results form displacement of her uterus, which might cause sterility.  It was also recommended when a female could not feel her infant moving in the uterus at four or five months. He also recommended it for severe ulcers, among other similar non-respiratory ailments.  (2, page 300, 304)

He did, however, recommend fumigations for certain types of phthisis, although mainly for spinal tuberculosis and not the pulmonary type. (2, page 281)

He also recommended inhalation for quinsy, or the various diseases that causes swelling of the throat. He also recommended inhalation for angina. (2, page 281, 260-262)

Getting back to the inhaler, many believe it was the Hippocratic Inhaler that was fine tuned during the 19th century when the first two inhalers were manufactured and placed on the market.

  1. Glasgow Medical Journal, Volume 14 By Glasgow and West of Scotland Medical Association, Royal Medico-Chirurgical Society of Glasgow
  2. Hippocrates, Claudius Galen, writers,  John Redman Coxe, translator, "Hippocrates, the Writings of Hippocrates and Galen," 1846,, accessed 7/6/14, also see the book online at Google books, Philadelphia, Lindsay and Blakiston
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