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Tuesday, May 27, 2014

Some interesting facts about the history of asthma

I think asthma is among the most interesting diseases of all time. Consider the following:

1.  Sometime around 400 B.C. the Hippocratic writers defined asthma for the medical industry as shortness of breath.  Yes, that's right!  If you were short of breath, you were diagnosed as having asthma.  

2.  Through most of history asthma was a nervous disorder.  It wasn't that you were psychotic, merely that nerves ran from your brain to your lungs that triggered asthma when you were upset, anxious, depressed or stressed.  

3.  One of the main reasons asthma was considered to be 'all in your head' was because the disease left behind no scars, like pneumonia and tuberculosis did.  The only logical conclusion was that asthma must be a neurotic disorder.  

4.   For most of history asthmatics asthmatic boys and men were considered the weaklings of society.  This had to be the case because they weren't able to do normal things, like hunt, chop wood, ride horses, etc.  They were made fun of, ridiculed, and even killed.  

5.  Asthma is among the oldest known diseases known to man, having been around since the beginning of time.  It was described in many of the first writings of Egypt 1,500 years before the birth of Christ.  

6.  Despite the long history of asthma, it wasn't defined as something other than a symptom until the 17th century when Jean Baptiste van Helmond defined it.  He was the first to define it as a disease of airway spasms when he wrote:  "The lungs are contracted or drawn together."

7.  During the 19th and until about the 1950s, the most common asthma remedy was to smoke asthma cigarettes.  It's true.  Other options were to sniff the asthma power, or burn incense.   The medicine inhaled was basically Atropine, the mother of modern medicines like Atrovent and Spiriva.  (Similar remedies were belladonna, stramonium, lobelia, tobacco, potash, Indian hemp, and cannabis).  It's difficult for us to imagine smoking to treat asthma, but these medicines are mild airway relaxants, plus they also took the edge off.  The best way for the medicine to work was to inhale it, so that's what was done.  Asthma doctors doing there rounds often knew there asthma patients by the smell of these inhalants in the air.  For more on this click here.

8.  The greatest discovery in the history of asthma was the discovery of epinephrine in 1901.  This was a medicine that provided instant relief of asthma, although with some heavy cardiac side effects.  Epinephrine is the grandmother of our modern rescue medicines like Albuterol and Xopenex.  Could you imagine life with asthma with out rescue medicine?  

9.  Perhaps the second most important discovery in the history of asthma was that of cortisone in 1900.  It was isolated in the 1930s, and proven useful to treat inflammation in rheumatoid arthritic in 1944. By the 1950s it was proven useful for asthma, and in 1955 prednisone was discovered and approved by the FDA.  In 1960 Beclomethasone was introduced to the market as the first inhaled corticosteroid, and you may know this better as Vanceril or Beclovent or more recently as Qvar. Other brands are Flovent, Pulmicort and Azmanex, and this medicine is also in Advair, Symbicort and Dulera.  These inhaled corticosteroids are the main medicine used to prevent asthma, and the systemic varieties such as prednisone are often prescribed by doctors to end asthma exacerbations.  

10.    Despite asthma's longevity, we are still only at the beginning of asthma knowledge.  We still have not expanded beyond the theory stage of what causes it and why people get it.  We still do not have a cure, or any perfect remedy for it.  Doctors still have no way of preventing people from getting it.  

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