62 A.D.: Seneca's view of life helped him cope with asthma

I am in love with Seneca the Younger.  He was an asthmatic with allergies just like me, only he suffered with the disease over 2,000 years ago.  His descriptions of the disease were simply amazing, yet more impressive was the way he learned to cope, and the way he wrote about how asthma made him a better person simply for having experienced it.   

And even more amazing is the methods that he developed to conquer his asthma. He wrote that you cannot dwell on the past and say things like, "Oh why me?" You cannot say things like, "No one had ever been in such a bad state." You cannot say things like, "The torments and hardships I endured." These thoughts should be banned, he wrote, because they are of little use. Dewlling on what ailed you in the past does you no good. (1)

Seneca

Likewise, he wrote that you cannot worry about an asthma attack that will strike you in the future either, because that will do you no good.  What you need to do is try to make the best of your life right now.  You need to clear your mind of such evil thoughts.

In his 78th letter to his friend Lucius he wrote that those who suffer through the battle of an asthma attack are like the boxer who suffers even during the trials of training. He wrote that a boxer does this for wealth and fame. He wrote, "Let us too overcome all things, with our reward consisting not in any wealth or garland, not in trumpet calls for silence for the ceremonial proclamaiton of our name, but in moral worth, in strength of spirit, in a peace that is won for every once in any contest fortune has been utterly defeated." (1)

He wrote this over 2,000 years before I wrote my post The Seven Benefits of having Asthma and Seven Ways Asthma has Benefited my Life. I wrote pretty much what Seneca wrote to his friend Lucius, only I wrote it before I ever even discovered who Seneca was.
To manage his asthma he didn't rely on witchcraft, or magic, or prayer, nor did he rely on remedies based on some poppycock superstitions or false logic. The way he learned to cope with his disease was by eating well, staying in shape, and by having many friends, diverting your mind so you don't think about the pains in your life. He generally wrote about the importance of relaxing and soothing your mind to remedy pain or dyspnea or any physical ailment. Today we refer to this as relaxation exercises.

He wrote that to think about the misery you put up with in the past, or to fear the future is senseless and will only increase your anxiety and make your disease and your life even worse; that fear and anxiety will only bring on an attack of "gasping for breath" or catarrh. (1)

He said, "'I am suffering from pain,' you may say.  'Well, does it stop your suffering it if you endure it in a womanish fashion" (1)

He continued, "Plus there are men who have suffered greater sufferings than you have and survived.  In this way you should consider yourself fortunate.  You could have something worse, like "having your arms stretched on a rack or burnt alive... There have been men who have undergone these experiences and never uttered a groan... Surely pain is something you will want to smile at after this." (10

"But my illness has taken me away from my duties and won't allow me to achieve anything," he wrote as another example of a common complaint of the suffering. (1)

He said:

"It is your body, not your mind as well, that is in the grip of ill health.  Hence it may slow the feet of a runner and make the hands of a smith or cobbler less efficient, but if your mind is by habit of an active turn you may still give instruction and advice, listen and learn, inquire and remember.  Besides, if you meet sickness in a sensible manner, do you really think you are achieving nothing?  You will be demonstrating that even when one cannot always beat it one can always bear an illness.  There is room for heroism, I assure you, in bed as anywhere else.  War and the battle-front are not the only spheres in which proof is to be had of a spirited and fearless character:  a person's bravery is no less evident under the bed-clothes. There is something it lies open to you to achieve, and that is making the fight with illness a good one.  If its threats or importunities leave you quite unmoved, you are sending others a signal example.  How much scope there would be for renown if whenever we were sick we had an audience of spectators!  Be your own spectator anyway, your own applauding audience." (1)

In essence, he is saying that you are alive and therefore you have a gift to offer to the world if you see it and if you use it.  Your job is to bring yourself up, rise up, and make something of what you have left in life.  Use what is not ailing you: your brain, your ability to speak or listen, your ability to read and write and to communicate ideas. 

The benefits I wrote about are perspective on life and an appreciation for every breath, a sense of vulnerability in that you know that you will not live forever and that you must get what you can out of life, and give what you can give while you are here.  You know that you might die tomorrow, so you live forever today.  You touch as many people as you can.  You read instead of doing things that might trigger your asthma. You write and communicate what you learn.  And, in this way, you are in effect making a difference in the world with the faculties you have left.

He said:

"Moreover, even if death is on the way with a summons for him, though it comes all too early, though it cut him off in the prime of his life, he has experienced every reward that the very longest life can offer, having gained extensive knowledge of the world we live in, having learnt that time adds nothing to the finer things in life.  Whereas any life must needs seem short to people who measure it in terms of pleasure which through their empty nature are incapable of completeness." (1)

We must never let the things that ail us set us back.  We must continue on and give what we can in this life.
References:  

1. Campbell, Robin, Lucius Annaeus Seneca, "Letters from a Stoic: Epistulae morales ad Lucilium, " Penguin, 1969, letter LXXVII.

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62 B.C.: Seneca the asthma philosopher

During the last three years of his life, Seneca the Younger spent much of his time writing down his thoughts about the world around him, including his thoughts about asthma and how it impacted his life.  He also gave his advice to other people suffering from this disease.

He said:

"What in fact makes people who are morally unenlightened by the experience of physical distress is their failure to acquire the habit of contentment with the spirit. They have instead been preoccupied by the body... so do not go out of your way to make your troubles any more tiresome than they are and burden yourself with fretting." 

Like the writings of Pliney the Elder, Seneca's writings became well read, and Seneca became one of the most well known philosophers.  In one of his letters to Lucilius, a friend and correspondent of Seneca's, Seneca provided a description of asthma, although he doesn't use the term asthma.

 Sculpture of Seneca by Puerta de Almodóvar in Córdoba, Spain

From his 54th letter to his friend Lucius (who also had asthma and catarrh), we get Seneca's description of asthma from "On Asthma and Death" as translated by Richard M. Gummere:

My ill health had allowed me a long furlough, when suddenly it resumed the attack. "what kind of ill-health?" you say. And you surely have a right to ask; for it is true that no kind is unknown to me. But I have been consigned, so to speak, to one special ailment. I do not know why I should call it by its Greek name; for it is well enough described as "shortness of breath." It's attack is of very brief duration, like that of a squall at sea; it usually ends within an hour. Who indeed could breathe his last for long? I have passed through all the ills and dangers of the flesh; but nothing seems to me more troublesome than this. And naturally so; for anything else may be called illness; but this is a sort of continued 'last gasp.' Hence physicians call it 'practising how to die." For some day the breath will succeed in doing what it has so often essayed (breath will succeed in doing what it is supposed to do). (2, page 361)

In letter 65 he wrote about his catarrh and the catarrh of his friend Lucius (1):

"I am all the more sorry to hear about your constant catarrh, and the spells of feverishness that go with it when it becomes protracted to the point of being chronic, because this kind of ill health is something I have experienced myself. In its early stages I refused to let it bother me, being still young enough to adapt a defiant attitude to sickness and put up with hardships, but eventually I succumbed to it altogether. Reduced to a state of complete emaciation, I had arrived at a point where the catahhral discharges were virtually carrying me away with them altogether. On many an occasion I felt the urge to cut my life short there and then, and was only held back by the thoughts of my father who had been the kindest of fathers to me and was then in his old age. Having in mind now how bravely I was capable of bearing the loss, I commanded myself to live. There are times when even to live an act of bravery." (1)

This was probably saying a lot back then, because I can imagine living in a state of shortness of breath.  And I can imagine this coupled with the misery of allergies on top of that.

Yet I cannot imagine what those two ailments would be like when there was no cure and no remedy that really provided any relief.  It must have been pure hell to live like that.  I can understand how he might be compelled to think about just ending the misery right "there and then."

Yet life is special, and there are few who get to enjoy this special gift.  Seneca realized this.  He used his father to provide himself the courage to go on. 

In letter 65 he described to his friend Lucius what he did to survive the attacks of asthma and catarrh (1). 

"Let me tell you the things that provided me consolation in those days, telling you to begin with that the thoughts which brought me this peace of mind had all the effects of medical treatment. Comforting thoughts contribute to a person's cure; anything which raises his spirit benefits him physically as well. It was my Stoic studies that really saved me. For the fact I was able to leave my bed and was restored to health I give the credit to philosophy. I owe her -- and it is the least of my obligations to her -- my life. But my friends also made a considerable contribution to my health. I found a great deal of relief in their cheering remarks, in the hours they spent at my bedside and in their conversations with me. There is nothing, my good Lucius, quite like the devotion of one's friends for supporting one in illness and restoring one to health, and for dispelling one's anticipation of dread and death. I even came to feel that I could not really die when these were the people I would leave surviving me, or perhaps I should say I came to think I would continue to live because of them, if not among them; for it seemed to me that in death I would not be passing on my spirit to them. These things gave me the willingness to help my own recovery and endure all the pain. It is quite pathetic, after all, if one has put the will to die behind one, to be without the will to life.

Another remedy he later adds...

"is to turn your mind to other thoughts and in that way get away from your suffering. Call to mind things which you have done that have been upright and courteous; run over in your mind the finest parts that have been played. And cast your memory over the things you have most admired."

No potions.  No magic.  No herbs.  Seneca might have been one of the first asthma experts to recommend, mainly due to his own experiences, the importance of relaxing to control your asthma.

"There then are your remedies," he said.

Click here for more asthma history.

References:

1. Campbell, Robin, Lucius Annaeus Seneca, "Letters from a Stoic: Epistulae morales ad Lucilium, " Penguin, 1969, letter LXXVII.
2. Seneca, Lucius Annaeus, "Seneca Ad Lucilium epistulae morales: Books I-LXI," translated by Richard M. Gummere, 1917, "The Epistles of Seneca," letter LIV "On Asthma and Death," New York, London, William Heinemann, G.P. Putnam's Sons, pages 361-363

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2640 B.C.: The first description of allergies?

Figure 1 -- King Menes (circa 2925 B.C.)

About 2,640 years before the birth of Christ, King Menes of Egypt was reported to have died after being stung by a wasp. This might very well be the first account of an allergic reaction.  

The Roman leader Caesar Augustus (100-44 B.C.)is believed to have suffered from seasonal symptoms that might have been allergies and asthma  (1)

Roman Emperor Claudius (10-13 B.C to 54 A.D) is also suspected of having suffered from seasonal allergy symptoms.  His son Brittanicus (41?-55 A.D.) is thought to have suffered from an allergy to horses. Literature describes how exposure to horses made his eyes swell and a rash appear.

Figure 2 -- Prince Nero and Prince Brittanicus

Brittanicus was heir apparent to the throne.  Yet due to his allergies he was limited in what he could do.  And when his mother died, Claudius remarried to Agrippina the Younger.  She had a son named Nero, and Claudius adapted him.  Nero almost immediately won the favor of the public, and Nero ultimately eclipsed his younger brother and was named Emperor in 54 A.D.

Nero became famous for throwing Christians to the Lions.  Yet within only a few months of his reign, he poisoned his weaker, older brother Brittanicus to death.

Ancient Roman physicians were probably the first physicians to recognize allergy symptoms, although they failed to recognize it as anything other than a minor ailment. With limited anatomical wisdom, and deadly diseases in need of their immediate attention, minor ailments like allergies received barely a footnote in ancient literature.

For example, Roman philosopher Lucretius (99-55 B.C.) said, "What is good for some may be fierce poisons for others."  Some speculate speculate this was an allusion to allergies. (2, page 4)

Allergies were again alluded to by the Middle Eastern Physician El-Razi or Rhazes (865-924).  He wrote his observation of redness and swelling of the nasal passages in some of his patients.  Some of his contemporaries observed these symptoms occurred in the presence of roses, referring to it as Rose Fever.

Still, while the condition may have been recognized in a few patients, physicians had little time to spend on such a trifling ailment, especially given there were deadly diseases that needed their attention.

Plus most who suffered from it had too much work to do to let it slow them down. So most who suffered probably just brushed it off as a minor ailment, making the disease barely recognizable by the few men who recorded history.

References:

1. Cantani, "Pediatric Allergy, Asthma and Immunology," 2000, New York, page 724
2. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2008

2640 B.C.-1820 A.D.:First descriptions of hay fever

Like asthma, allergies were probably prevalent early in human history.  Yet the symptoms of a runny nose, sniffy, sneezes and wheezes, along with red and watery eyes, were probably confused with other maladies, such as asthma or influenza. So there were only random notations describing the malady before it was formally defined by the medical community in 1819.  

About 2,640 years before the birth of Christ, King Menes of Egypt was reported to have died after being stung by a wasp. As far as historians are aware, this is the first account of an allergic reaction.  So it's evident allergies go all the way back to the ancient world.   

King Menes (circa 2925 B.C.)

Right around this time a Middle Eastern Physician named El-Razi observed redness and swelling of the nasal passages in some of his patients.  He described what we might consider allergic rhinitis or hay fever.  Yet those terms weren't used until the 19th and 20th centuries.

Arnoldo Cantani, in his book, "Pediatric Allergy, Asthma and Immunology," described how Caesar Augustus suffered from asthma and seasonal rhinitis (allergies/ hay fever).  Caesar is also believed to have suffered from asthma. (1)

Roman Emperor Claudius (10-13 B.C to 54 A.D) is believed to have suffered from allergy symptoms, and his son Brittanicus (41?-55 A.D.) is believed to have suffered from an allergy to horses. Historical reports have it that when exposed to horses his eyes would swell up and he'd develop a rash.

Princes Nero and Brittanicus

Brittanicus was heir apparent to the throne.  Yet due to his allergies he was limited in what he could do.  And when his mother died, Claudius remarried to Agrippina the Younger.  She had a son named Nero, and Claudius adapted him.  Nero almost immediately won the favor of the public, and Nero ultimately eclipsed his younger brother and was named Emperor in 54 A.D.

Nero would ultimately become famous for throwing Christians to the Lions.  Yet within only a few months of his reign, he is believed to have poisoned his weaker, older brother Brittanicus to death.

Paul M. Ehrlich and Elizabeth Shimer Bowers, in their 2008 book "Living with Allergies," note that it was an Ancient Roman Physician who was the first to describe allergies.  The authors quote Lucretius, who lived from 99-55 B.C., as saying, "What is good for some may be fierce poisons for others." (2, page 4)

Physicians around 850 A.D. observed many of their patients developed sneezing, nasal stuffiness and runny noses when the roses were blooming.  Upon further examination they observed redness and swelling in the nasal passages that resulted in the runny nose, and they referred to this condition as rose fever.

The medical term catarrh was first used to describe the miserable condition that result in a runny nose around 1350 and 1400 A.D, according to dictionary.com. The term catarrh comes from the Greek word katarrous which means "literally down-flowing."  So the term catarrh refers to the redness and swelling of the nasal passages that results in nasal drainage regardless of the cause.  It was a term commonly used by physicians through the 19th century.

King Richard III (1452-1485)

Ehrlich and Bowers mention how legend has it that King Richard III (1452-1485) knew he had an allergy to strawberries and he used this knowledge to kill Lord Hastings. The King purposely ate some strawberries and blamed his allergic reaction on a curse from Lord Hastings. Lord Hasting's was beheaded as punishment, and his head was served on a platter.
In 1656 a French doctor named Pierre Borel suspected one of his patients developed a rash when this patient ate eggs. So one day he attempted to test his theory by placing some egg particles on the patient's skin. When blisters developed on the patient's skin the physician knew he had made the correct diagnosis.
Dr. Morell Mackenzie explained that in 1565 Dr. Botallus (the man who's name is applied to the foramen ovale in the heart) recognized that many of his patients developed sniffling, sneezing and facial irritation when they smelled roses.  The condition was thus dubbed rose cold or rose fever.  (3, page 18) (6, page 93)(8)

Mackenzie notes that "This observer, therefore, came very near the mark to the real cause of the disease, to which he applied the term coryza a rosarum odore.'

Jan Baptise van Helmont (1579-1644), who helped define asthma, also noted the symptoms of hay fever.  (3, page 18)  Vanhelmont noted that in some of his patients "sweet smelling causing headache, and in some cases difficulty breathing." (6, page 93)

In 1673 I.N Binningerus wrote that he was informed several times by professor James A. Brun of the University of Bastle that is wife, Ursula Falcisin, "suffered from coryza for several weeks every year during the rose season."  (6, page 93)

In 1691 I. Constant Rebecque described how "for thirteen years he had been afflicted with coryza during the rose season...  At first he attributed his sufferings to heat, but in the year 1685, when the summer was exceptionally hot and there were hardly any roses on account of caterpillars, he was struck by the fact his annual disorder did not trouble him.  The symptoms came on at once, however, after inadvertently plucking a rose toward the end of the season.  He concludes that something flows from roses which stings the nose" (7, page 93)

Seventeenth century physician John Floyer noted, in 1698, that asthma symptoms lasted longer and were more "acute" in summer than in the winter.  (3, page 18)

Eighteenth century physician William Cullen may have been referring to hay fever when he wrote that "in some persons asthmatic fits are more frequent in summer, and more particularly during the dog-days, than at other colder seasons of the year," wrote Charle's Blackley in 1873. (4)

William Heberden (1710-1801) wrote on the subject of catarrh: "I have known it (catarrh) to return in four or five persons annually in the months of April, May, June and July, and last a month with great violence." Heberden's book was published posthumously in 1802 and edited by his son.  (5, page 14)

Mackenzie explains that Heberden made a connection between "rose catarrh of the seventeenth century and the hay fever of the nineteenth, for though this physician does not seem to have been at all aware that the complaint had any connection with flowering plants, he mentions casually that five of his patients suffered from catarrh for a month every summer, while another was similarly affected during the whole of that season."

Various other physicians made references to hay fever or rose fever, such as by C.L. Parry in London in 1801 and 1809.  Or by Elliotson in 1821 who "tells of a patient who had had hay-fever since 1789, and another who was sixty-six years of age and who had had the disease since his seventh year, i.e. since 1755, and of a third who had been afflicted for many years. (3, page 18-19)

Finally, in 1819, the condition would be recognized by the medical community. By that time the term hay-fever had been around for many years, although there is no evidence as to who created the term, where, and when is a mystery.

References:

1. Cantani, "Pediatric Allergy, Asthma and Immunology," 2000, New York, page 724
2. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2008
3. Hollopeter, William Clarence, "Hay-fever and its successful treatment," 1898, Philadelphia, P. Blakiston's Son & Co.
4. Blackely, Charles Harrison, "Hay-fever: its causes, treatment, and effective prevention," 1873, 1880 2nd edition, London, Bailliere
5. Smith, William Abbotts, "On Hay-Fever, Hay-Asthma, or Summer Catarrh," 1867, London, Henry Renshaw
6. Mackenzie, Morell Sir, "Hay fever and paroxysmal sneezing," 5th edition, 1889, London, J&A Churchill, also see Morell Mackenzie, "On Hay Fever and Rose Fever," The Medical Record, New York, August, 1884, vol. 26. no. 9, page 225
7. Mackenzie, Morell, ibid, Sir Mackenzie notes here that "This observer, therefore, came very near the mark to the real cause of the disease, to which he applied the term coryza a rosarum odore.'
8. Koessler, Karl K., "The Specific Treatment of hay fever (pollen disease)," page 665, of "Forchheimer's Therapeusis of Internal diseases," Frederick Forchheimer, edited by Frank Billings and Ernest E. Irons, Volume V, 1920, New York and London

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30,000 B.C.: The birth of allergies

Surely allergies have been around since the beginning of human existance.  Dr. Paul M. Ehrlich, in his 2009 book "Living with Allergies," explained one theory in which allergies are believed to be "a leftover survival tactic" whereby ancient people living along the Tigris and Euphrates Rivers where repeatedly exposed to harmful germs such as bacteria and parasites.  (1, page 6)

Ehrlich said that back then, perhaps as far back as 30,000 years before the birth of Christ, our immune systems needed to be powerful to fight off these germs.  The people with the strongest immune response survived while others died.  "So," he said, "being an allergic person may have been an advantage." (1, page 6)

Yet today we have many defenses against such invaders, such as shoes, clothing, clean drinking water, processed food, vegetables that are treated with pesticides, air conditioned buildings, etc.  We receive vaccinations and use hand sanitizers.  People today are barely exposed to germs, so the allergic response isn't needed.

For most of us, our immune systems have adapted to the change.  Yet for some of us, our immune systems continue to work overtime.  Lacking harmful germs to occupy our immune systems, they become bored and develop a sensitization to things that are supposed to be safe, such as dust mites, pollen, molds, and cockroach urine.

So this is the basis, at least one theory anyway, of why about 10 percent of the world's population develop allergies.  I would speculate the same holds true to asthma as well.

References:

1. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2009, page 6

History of Difficult Breathing

It's time we embark on a journey through the tunnels of time.  Yet rather than traveling along the warpath of mankind, we'll be traveling along the path of disease, particularly asthma and respiratory therapy.

Like the path of war, the path of disease takes us all the way back to the beginning.  Actually, certain diseases may go back farther than war itself, as they exist regardless of the desires of mankind.

This history begins the spring of 1981, although the tunnels will take us back to a time when the first people walked the earth.

I was dreaming I was unable to breathe. To use an overly used cliche, it felt as though an elephant was sitting on my chest.  No matter how hard I tried, and I tried vigorously, I could not get in half a breath.

Quickly I realized I was no longer suffering in a dream but real life.  I stood up on the bed and leaned against the window pane, putting my face up to the screen where a cool night breeze brushed upon my face, appearing to give me a slight hint of relief.

There was a little white Alupent inhaler clutched in my left fist, although there most of the medicine was gone except for a few drops.  I figured when I was absolutely desperate I'd run it under hot water and see if I could get one or two more puffs of relief.  But I had to wait just a little longer.

My heart was pounding from all the puffs I had already taken.  A fear within was that if I fell back asleep I might not wake up, but this fear arose from inhaler abuse more so than from difficulty breathing.  You see, I had nights like this so frequently during the first several years of my life I sort of just took it in stride.

It was this thought, of taking the inability to breathe in stride, that had me wondering about the past as I smelt the dusty screen.  I wondered how many people had suffered like this in the past, a time before medicines like Alupent existed.

What if I lived in 1881?  Worse, what if I lived in 1881 B.C.?  I decided that having asthma would have been much like this: suffering with no one to empathize with you because you didn't want to bother anyone.  Your parents and siblings were asleep, so you suffered alone.

I was introduced to the Alupent inhaler in 1980, I was ten-years-old.  I sat frogged up on the edge of the doctor's bed in Dr. Gunderson's office at the Apothecary shop on 1st Street in Manistee, Michigan. He told me to sit up high, take in a deep breath, and when I did he squirted the medicine into my mouth.  I inhaled as he instructed, holding my breath, regardless of the nasty taste, for ten seconds before I finally exhaled.

A minute later he gave me a second puff, and I took in a deep breath.  Ah, it felt so great to be able to breathe.

My mom held on to my Alupent inhaler for about a month or so, but she found that I asked for it so frequently she ended up just giving it to me.  I don't know if this was good or bad, because the medicine worked so well, and I was short of breath so often, I found I was using it without much hesitation.

Yet on this particular night as my inhaler had gone dry, the third time this had happened in the past month (Dr. Gunderson had said an inhaler should last about six months), I was hesitant to wake my parents because I had already bothered them too many times.

I certainly felt alone, yet not just alone in this room but in this world.  I had never seen anyone else suffer like this, nor heard of it.  So I was alone, the only person in the world stiff and struggling to inhale with his face against a window screen.

A few years later, in 1985, Dr. Gunderson and my parents would have me flown on a United Airline jet on a three hour trip to Denver Colorado so I could spend time with the best asthma doctors in the world at National Jewish Hospital/ National Asthma Center.  I would learn that I was not alone, that there were many asthmatics just like me.

Yet for the time being, I could feel my heart palpating fast and powerful, as I looked out into the dark night air trying to see if I could make the outline of a poplar tree, smelling the lilac bush just under the window, I wondered, just for a brief moment perhaps, if this was the fate of asthmatics prior to the discovery of modern medicine, and the invention of modern inhalers.

I did end up waking my mom up that night, and she was not angry as I suspected. Mom woke dad up and dad drove me to West Shore Hospital, where, despite my fear, no one inquired as to how frequently I had been using my rescue inhaler.  In fact, just the opposite as I expected, I was treated quite well.

A respiratory therapist started a breathing treatment, but, as expected, it was useless.  A nurse poked my right arm, and as she did so I watched the clock on the wall.  More specifically, I watched that second hand, and as soon as it spun around five times, just as I had experienced before, my breath came in like new.  I could breathe.

For a splint second, my mind wandered to a young boy, from 1881 B.C. perhaps, who was leaning against a tree to breathe sometime before the advent of modern medicine like Alupent and Susphrine.  Unlike me, he had no choice but to suffer alone and wait for nature to either give him his breath back, or give him peace through death.

While I didn't know it then, couldn't know it then, this was the beginning of my history of asthma and respiratory therapy.  A journey through time would take me all the way back the the beginning of mankind to the first person who suffered from asthma.

Yet asthma back then was more than just asthma, as people had no concept of changes in the body that resulted in symptoms.  So, back then, if you suffered from trouble breathing you were just having trouble breathing; your asthma-like symptom was your disease.

Surely I knew that I had asthma as we define it today, yet the boy from 1981 B.C. might just as easily have suffered from chronic bronchitis, emphysema, heart failure, influenza, tuberculosis, pneumonia, cystic fibrosis, scoliosis, osteoporosis, allergies, dyptheria, or kidney failure.  They were all diagnosed as the symptom of shortness of breath, or dyspnea, or as the ancient Greeks would later call it, asthma.

This is how it was for 99.9 percent of history.  As I enjoyed the relief provided by the shot, I couldn't help to appreciate that I was born in 1970, as compared with 1870, or worse, 1870 B.C.

Although, as we travel through time, we'll realize life wasn't much better for the asthmatic in 1870 as it was in 1870 B.C. Truth be told, there were few advancements in asthma medicine during this time.

So while most histories follow the path of war, the history of asthma and respiratory therapy follows the path of health and healing, with an emphasis on asthma, respiratory therapy, nebulizers and inhalers.  In order to organize this history I will use the following definitions:

• Prehistory (prehistoric):  Time prior to the first written language, or recorded history, which is generally considered to be around 2700 B.C. 
• Ancient:  Time after written language, or time with recorded history.  This period lasted from around 2700 B.C. until the fall of Rome in 476 A.D. 
• Time:  After the birth of Christ people developed a need to keep track of time, and so the birth of Jesus was chosen as the date to begin time.  The date of his birth was estimated and this was chosen as 1 A.D. When a child is born we usually refer to the first year as zero.  With time the first 100 years is considered the first century, and therefore the years 100-199 were referred to as the 2nd century.  It's for this reason why the years 1900 to 1999 were referred to as the 20th century.  This is just how it is.  

This system was created to help people study history and keep track of dates and time.  Whether accurate or not, this is how history is recorded.  I will use this system to categorize this history of asthma:

• Beginning to 5000 B.C.: Prehistoric people (prehistory)
• 5000-2700 B.C.: Ancient Societies (Before History and Time)
• 2700 B.C.-1 A.D.: Ancient Societies (During History, Before Time)
• 1 A.D.-276 A.D.:  Ancient Societies (Beginning of Time)
• 276 -1600 A.D.: Middle Ages (The Dark Ages of Medicine)
• 1600-1800:  Age of Reason (The Age of Enlightenment)
• 1800-1900:  The Scientific Revolution (the Age of Progress)
• 1900-2000: The Age of Results
• 21st Century:  The present

Considering the vastness of our history, and the brief time each person lived among it, this history is but a small glimpse of the past.  Most of our history is told by the select few privileged to learn to read and write, so it is nearly impossible to impress upon what life was like among the common folk.

Despite this, from the various pieces of literature left behind by those who suffered from this disease, or those who took care of those who suffered, we can gather a pretty good picture of what life would have been like for the asthmatic during nearly every era of human existence.  

So, what was it like to live with asthma in fill in location and year?  To best answer this question, I make a gallant effort to describe the various cultures. This, I think, should allow us to gain a more complete understanding of what it would be like to be sick if you lived among them.  

However, I would like you to consider the following quote from historian Henry E. Sigerist:

"We have no evidence whatsoever of any paleolithic medicine." (1, page 107)

I use this quote because there will be times throughout this history when we must use our imaginations to gain an understanding of what it was like to live with asthma in fill in the year and place.

So what was life like for asthmatics 2.5 million years ago?  Let's go!

(For the duration of this history, a post will be published every Friday and Saturday right here at the RT Cave.)

Reference:

1. Sigerist, Henry E "History of Medicine," volume I: Primitive and Archaic Medicine, 1951, New York, Oxford University Press