Is asthma psychological?

The following was originally published on May 13, 2013 at healthcentral.com/asthma.

Is asthma all in your head?

In a series of articles written throughout the 1850s, Dr. Henry Hyde Salter, himself an asthmatic, wrote a series of articles about asthma that were published in the book "On Asthma: It's Pathology and Treatment." In this book he wrote that "Asthma essentially a nervous disease." 

He offered the following proof:

• Many patients feel fine as soon as they enter the doctor's office
• Mental emotion can bring on a paroxysm of asthma
• Mental emotion can resolve a paroxysm of asthma
• Remedies that relax the nervous system resolve asthma, such as tobacco,antispasmodics, sedatives, and nervous depressants. Examples include tobacco, alcohol, morphine, and especially chloroform.

So there you have it: asthma is a nervous disease. This was the belief about asthma that prevailed even up to the 1980s, and even beyond that. This myth continued to live on despite it being disproved in the 1950s.

Dr. Salter did such a good job inculcating the idea that asthma was nervous, that many asthma websites and books have to go to make light of it even to this day. In noting the common triggers of an asthma attack, the experts atNational Jewish Health note:

Emotions do not cause asthma, but can make asthma worse because strong feelings can lead to changes in breathing patterns. Times of "good" stress and "bad" stress can cause problems for people with asthma. However, it is important to express your emotions, and good asthma management can minimize the effect of stress.

Dr. Salter was a very good doctor for his time, yet his idea asthma was "all in your head" was incorrect. Yet he wasn't the only asthma expert of old who was fooled, as so too were Hippocrates (the father of medicine) around 400 B.C.,Galen of the 1st century, Thomas Willis and Jean Baptise van Helmont in the 17th century, and William Osler (the father of modern medicine) in the late 19th and early 20th century. They were all fooled.

They were fooled mainly because asthma, in its uncomplicated or pure form anyway, left no visible scars on the body. Even upon autopsy, doctors found the lungs of asthmatics to be normal. So they simply speculated it must be nervous in nature.

We don't fault them, however, because they didn't know about the immune system. Dr. Osler probably knew about it, but knowledge of it during his time was primitive. Yet the link between the immune system and asthma was eventually discovered, and now we know asthma is not nervous at all.

Today we know asthma is a disorder of the immune system; it's an autoimmune disease. It occurs because your immune is tricked into thinking things that are innocuous (harmless) -- like dust mites, mold, fungus, cockroach urine -- to most people are harmful to your body.

So instead of ignoring these things when inhaled, yoor body develops a defense against them, and attacks them, and this is why you have an asthma attack. So I personally don't fault doctors like Dr. Salter for thinking asthma was nervous.

Reference: 

1. Salter, Henry Hyde, "On Asthma: It's Pathology and Treatment," 1868, London, page 24-30. Other references are provided in the posts linked to above.

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