206-220 A.D.: Quack Chinese doctors kill people

If you had asthma in Ancient China in the 3rd century A.D. you had access to some rational treatment for your asthma, most significantly Ma Huang, which was an asthma remedy discovered for the west at the beginning of the 19th century. It's a medicine almost as potent as epinephrine with the ability of quickly ending an asthma attack.
Yet chances are you were very hesitent to see a doctor. Some historians speculate, based on writings from the era, the Chinese feared physicians.

According to Plinio Prioreschi, in his 1991 book "A History of Medicine:

Little is known about the social position of physicians in the earlier times. We know that later, and throughout Chinese history, they were often the object of derision and scorn. In the Spring and Autumn Annals of the State of Lu (one of the feudal states in which Confucius was born in 551 B.C.), for example, we read: (Physicians) employed poisonous drugs to expel diseases, hence ancients despised and assigned them a low position in society.

Prioreschi listed many ancient proverbs that show the inferiority of doctors, such as:

• Doctors cannot cure their own complaints. (Huai an Tsu)
• What the doctor says is all right, but what he sells is false.(Proverb)
• Quack doctors kill people (proverb)
• Do not take medicine compounded by a doctor who is not backed by the experience of three generations.
• Medicine does not kill; the physicians kill (Proverb)
• To take no medicine is the best cure. (Proverb)

However, some debate that doctors were held to such a low status in China. Some believe these were just proverbs warning people to be careful, and not to seek medicine if they could resolve their medical problems on their own with household remedies.

If you lived in Ancient China during the Han Dynasties of 206-220 A.D. you would have been wise to be wary of quack medicine, although you'd also be wise to seek a doctor who was knowledgeable of the medicine called Ma Huang. 

Hopefully you'd learn to find the plant yourself, to prepare it into a powder, and to mix it into a tea to drink when your asthma acted up.
Reference:

1. Prioreschi, plinia, "A History of Medicine," volume I "Primitive and Ancient Medicine," 1991, The Edwin Mellen Press, New York, chapter II, pages 124-5

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200 A.D. Galen wonders what causes asthma

Galen saw that some of his patients presented with a symptom described by Hippocrates as asthma, and he saw this malady in his own patients.  By placing his ear to their chests he heard their wheezes.  He thus set off on a relentless quest to find the natural cause of asthma and remedies to cure it.

He relentlessly questioned and assessed his asthmatic patients. He would have loved to have dissected those who died of the malady, but such an act was forbidden under sentence of death and punishment by the gods.

So he cut into apes, pigs and monkeys instead.  He cut open their chests and observed their lungs.  He cut into the lungs and traced the air passages.  He concluded this was where the vital force of life, the pneuma, entered the body.

He traced vessels from the lungs to the brain.  Perhaps this confirmed his assumption, one Hippocrates had alluded to, that asthma was similar to epilepsy. Like epilepsy, asthma displayed no symptoms between attacks (sporadic), and left no observable traces of disease.

He believed epilepsy was caused by an increased abundance of phlegm in the brain, and this caused seizures of the air passages. So he concluded asthma was caused by an increased abundance of phlegm in the lungs, and this caused difficulty breathing by blocked air passages.

He also noted a second cause of asthma, and this was tubercles in the lungs.  (13, page 1)

In one experiment he severed the medulla spinalis (spinal cord) and artificially produced asthma.  He used this experiment to prove to his pupils that asthma could be produced artificially.  Perhaps later physicians used this experiment as proof that asthma was nervous in origin.  (13, page 1)

Actually, In 1851, Joseph Bergson said that Galen may even have been among the first to suspect that asthma was nervous in origin.  He wrote:

Galen, who made sections of the spinal marrow in different places in living animals, in order to demonstrate to his pupils the influence of it on motions of respiration. (12, page 374)

Asthma historian Mark Jackson said that on Galen's experience he wrote that "if the breathing is rough and noisy it indicates that a large amount of thick and sticky humors in the bronchial tubes of the lungs has accumulated and become annoying because it is difficult to expectorate." (4, page 24)

In this way Galen is credited by history as being the first to link asthma to the air passages of the lungs, and the first to describe asthma as a disease of obstructed air passages.

Remedies by Galen were meant to restore the balance of the elements and humors. If you sought him out to cure your asthma, he'd probably first recommend a bath, a good diet, and exercise.  Once these simple remedies were attempted and failed, only then would he dip into his stock of medicine.

In 1815, Thomas Young said that general remedies prescribed by Galen were copied from the likes of Asclepiades, Musa, Andromachus, Heron, Crito, Menecrates, Archigenes, and Phillipus.  Galen mentioned a treatment borrowed from Asclepiades for orthopnia, a common symptoms of asthma, that contained mellepedes, which were supposed to have a diuretic effect (makes you pee).  (5, page 145)

Arabic historian Paulus Aegineta said that for asthma Galen prescribed the following (in parenthesis is what modern experts believe would be the effect of the remedy): (6, page 407)

1. Squill (alleviates coughing)
2. Pepper (stimulates digestive system)
3. Wormwood (stimulates digestive system)
4. Opoponax (antispasmotic, respiratory decongestant)
5. Storax (expectorant)
6. Oxymel (expectorant)
7. Sulfer (eases allergy symptoms such as sore throat and cough)
8. Millepedes (diuretic)(6, page 407)

Jackson said he made about 70 references to asthma, sometimes as the symptom of rapid breathing described by Homer and Hippocrates, and sometimes as a disease that caused breathing difficulties.  (4, page 24)

The theories he postulated about asthma, as with all his medical theories, influenced the world for the next 1,800 year. Slowly, through the course of time, a few brave physicians would expound upon his ideas about asthma, and by this means the definition would mature.

References:  see the post "120-200 A.D.: Galen becomes world's greatest physician"

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150-219: The Chinese Sage of Medicine

Zhang at work

If you had asthma in China prior to the 3rd century A.D. your doctor may have recommend a remedy of drinking a bitter tasting tea made from dried stems of the Ma Huang plant.

This remedy made your breathing better, and your cough often subsided too. The trick was your physician would have to remember it and the formula to concoct it.

You see, there were few books with medical wisdom for your physician to reference. Most medical knowledge, especially regarding herbal remedies, were passed on from one generation to the next to anyone who wanted to learn about it.

This all changed around 220 A.D., and it all changed because of a war that caused a virus to strike the village of a man named Zang Zhong Jing (also known as Zhang Ji).

Legend has it he was 50 when two-thirds of his village died of a fever in a short span of ten years, and that inspired him to become an expert on ancient medical text, such as the Nei Ching  and the Hippocratic Corpus.

This resulted in him writing a medical book that helped shape Chinese medicine, and resulted in him becoming well known to the Chinese medical community by giving birth to Traditional Chinese Medicine. (1)

His book was called "Shanghan Zabing Lun" which translates in English to "Treatise on Cold Pathogenic and Miscellaneous Diseases."  It's a compilation of the medical wisdom from all those who lived before him.

Yet his book was lost in a war, and was not available until 1065 when the rulers of China saw a need for the wisdom contained in these old books and formed the Bureau for Collation of Medical Books of the Song Dynasty.  Wang Shu-He collected what he could of Zhang's writings and recompiled them into two books he called the "Shang Lun," which translates into "Treaties on Cold Induced Fevers."

The two books were:

• Shan Han Lun (On Cold Damage), a compilation of herbal remedies to treat infectious diseases that cause a fever
• Jinkui Yaolue (Essential Prescriptions of the Golden Coffer), which records his clinical experiences

These books describe methods of diagnosing, treating, and monitoring the effect of treatment. He recommended the importance of using the pulse not only to diagnose as Huang Ti recommended 1000 years earlier in his book "Nei Ching," but to monitor the course of treatment.

He was also the first to mention artificial respiration.  And he also recommended forcing water down a person's throat who attempted suicide by poisoning to bring up the poison, and this is a technique similar to what is used in hospitals today. (3)

Like Hippocrates, Zhung recommended against the practice of physicians taking advantage of patient  naivety for the purpose of making a profit.  He noted that some physicians concocted bogus formulas and sold them as viable remedies.  He berated this practice and encouraged good medical ethics.  

So his books were very helpful to Chinese physicians and their patients.  Yet of most importance were the formulas he calculated for collecting and concocting herbal remedies for many of the ailments of his day, especially those that are contagious and cause fevers like what wiped out his village.

One of the neatest things about Zhang's herbal formulas is that many are still used to this day, and many have even been proven by science to be effective remedies. This includes a description of asthma-like symptoms in Jinkui Yaolue and a formula for creating a remedy using Ma Huang. He described breathlessness or panting as chuan, and wheezing as xiao. (2)

His works have earned him the respect of Chinese Historians as one of the best physicians of all time, so much so that he's often referred to as the sage of medicine.  Actually some consider him to be a god, and others believe his existence was merely a legend.

While revered in China, his works also influenced and forever changed the way medicine was practiced in Japan, Korea, Vietnam and Mongolia. 

He's such a significant "legend" that his books continue to be required readings for any student of Traditional Chinese Medicine.  (4)

Considering this fame, little is known about his life, nor exact dates associated with his life.  It's estimated he lived from 150-219 A.D, yet many historians continue to debate these dates.

References:

1. Selin, Helaine, ed., "Encyclopedia of the History of Science, Technology, and Medicine in Non-Western Cultures," 1997, Netherlands, page 893
2. Jackson, Mark, "Asthma: The Biography," 1998, New York, page 41
3. Selin, Op. Cit, page page 893
4. "Chinese Herbal Formulas and Application," chapter 1, page 31

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619 A.D.: Brief glimpse at the insides of a body

Ptolomy Soter, the brother of Alexander, made it so Alexandria was the greatest place of learning in the world.  It was under him a great Alexandrian library was built, and his relaxed policies that made it possible for the Alexandrian School of Medicine to form, and for Erasistratus to form the school of anatomy at the school.  

It was in this way that the school of Alexandria became the first place in the ancient world where it was legal to perform autopsies.  Erasistratus, and his contemporary Herophilus, took advantage of this opportunity by performing many autopsies in the process of learning much about the human body.  

Yet this shining light would soon grow dim again.  The school would continue to a great place of learning until the school and library, and all the wisdom contained within, was burned to the ground by barbarians in 619 A.D. Yet despite the longevity of the school, autopsies were no longer allowed to be performed after the deaths of Erasistratus and Herophilus.  

D. Kerfoot Shute, in 1910, said:

After the death of Herophilus and Erasistratus the science of anatomy retrograded, their writings became lost, and their discoveries remained sterile, and once more the dissection of the human body was abandoned. (1, page 197)

Even as the school fell under the control of the mighty Roman Empire, the ability to inspect dead bodies was forbidden because it was considered sacrosanct. Despite all the great physicians who practiced in ancient Rome, none of them made a living of studying the insides of the human body, not even Galen.

Shute said that he found this to be amazing, especially how the ancient participated in sporting events that often lead to the slicing open of the human body.  He said:

Among the Romans the brilliant example set by the Alexandrian School was not followed and the study of practical anatomy was pursued on the lower animals, and even Galen, five centuries after Herophilus, and whose anatomical writings are the most correct, precise and numerous of all that have been descended from ancient times, very evidently dissected the lower animals and not human subjects. (1, page 197)

He continued:

This fact speaks volumes for the religious attitude of the classic Roman mind towards anatomical science in the second century of the Christian era. "Vast audiences made up of every stratum of society thronged the amphitheatre, and watched "exultingly while man slew his fellow-man in single or multiple combat. Shouts of frenzied joy burst from a hundred thousand throats when the death stroke was given to a new victim. The bodies of the slain, by scores, even by hundreds, were dragged ruthlessly from the arena and hurled into a ditch as contemptuously as if pity were yet unborn and human life the merest bauble. Yet the same eyes that witnessed these scenes with ecstatic approval would have been averted in pious horror had an anatomist dared to approach one of the mutilated bodies with the scalpel of science. It was sport to see the blade of the gladiator enter the quivering, living flesh of his fellow-gladiator; it was joy to see the warm blood spurt forth from the writhing victim while he still lived; but it were sacreligious to approach that body with the knife of the anatomist once it had ceased to pulsate with life." (1, page 197)

One could only wonder that there were physicians, particularly Galen, who would have loved to have performed an autopsy.  Actually, chances are pretty good that he did.  Chances are he and a few of his non-superstitious, non-religious friends went grave robbing one night, and fretted vigorously under the risk that they would die if caught.

Even if they learned something by their investigations, they were nary able to publish their findings, because such would be nothing more than the admittance of guilt.  Plus publishing information that was the antithesis of what the Church had already accepted as fact was also punishable by death.

When Galen passed away, not only were physicians no longer investigating the insides of the human body for science, "inquiry into natural science lapsed" altogether, said Shute.

So despite the burning passion of ancient Greek and Roman philosophers and physicians for learning, the inability to inspect the insides of the human body was a significant fetter that stopped medical progress in its tracks.  The school of Alexandria, if only for one brief shining moment, provided a rare opportunity to study the human body without fear of persecution.

After the death of Erasistratus in 250 B.C., it would be another 1800 years before it would be legal to perform an autopsy.  Regardless, there would be a few daredevil physicians and their students during that time who would risk everything, including their lives, to steel and inspect a human corpse.  A small percentage of them would even publish their results.

References:

1. Shute, D. Kerfoot, "The life and works of ndreas Vesalius," Old dominion journal of medicine and surgery, Tomkin, Beverly R. Tucker, Douglas Vanderhoof, Murat Willis, R.H. Wright, editors, 1910, Richmond Virginia, The Old Dominion Publishing Corporation, pages 195-211

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100 B.C.- 200 A.D. Ancient physicians recognize pneumonia

Plutarch (46-120 A.D.)

After Hippocrates introduced the medical world to pneumonia around 400 B.C., little was changed regarding how it was defined and treated.

Plutarch was a Greek author who wrote over 227 works, including 60 essays on ethical, religious, physical, political and literary topics.  (1)

He recognized that while pleurisy often accompanied pneumonia and may have been responsible for the pleuritic chest pain and fever, it sometimes occurred on its own. (2) (8)

He decided that the term peripneumonia was superfluous, and therefore referred to inflammation of the lungs as pneumnonia, and inflammation of the pleural sac as pleurisy. (2) (3, page 191)

Areteaus of Cappadocia, one of the ancient authors who helped us define asthma and how it was treated by the ancient world, concurred with Hippocrates regarding peripneumony, noting that death usually ensues on the sevenths day.

He wrote about the usefulness of the lungs, and explained that certain maladies can cause havoc: (2)

But if the lungs be affected, from a slight cause there is difficulty breathing, the patient lives miserably, and death is the issue, unless someone effects a cure. But in a general affection, such as inflammation, there is a sense of suffocation, loss of speech and breathing, and a speedy death. This is what we call peripneumonia, being an inflammation of the lungs, with acute fever, when they are attended with heaviness of the chest, freedom from pain, provided the lungs alone are inflamed."

The cure Areteaus wrote about for pneumonia was similar to that of Hippocrates, although he added the following to the list of options:  (2)

• Wine
• Hysopp
• Rubafacients containing mustard applied to the chest
• Diluent drinks

Claudius Galen of Pergamum, who was perhaps the most significant medical authority of the ancient world, also differentiated pneumonia from pleurisy, although he continued to refer to them as peripneumonia. (2, page 2)

His remedies for the malady were also similar to those of Hippocrates.  So the greatest medical mind of the 2nd century, and whose works were worshiped by physicians for the next two millennium, had no desire to add to the wisdom of the ancient Greeks, at least regarding pneumonia.

References:

1. "Plutarch," britannica.com, http://www.britannica.com/EBchecked/topic/465201/Plutarch, accessed 7/20/14
2. Marrie, Thomas J, "Community Acquired Pneumonia," 2001, New York, chapter one by Jock Murray, "The Captain of Men and Death: The History of Pneumonia."
3. Allbutt, Clifford, ed, A System of Medicine, 1909, Toronto, chapter on "Lobar Pneumonia,"  by P.H. Pye-Smith, pages 191-205

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2nd century A.D.: Medical profession starts to decline

By the 2nd century A.D. there were so many schools of medicine that a person might scratch his head in a dumbfounded effort to actually find a real doctor. Some of the schools around at this time were: (1, page 39)

1. Empiric
2. Dogmatic
3. Methodist
4. Pneumatist
5. Eclectic/ Episynthetics

There were so many schools of medicine, so many "diverse and fanciful opinions" that the medical profession, much like the rest of Rome, was falling apart, said medical historian Thomas Bradford. (1, page 39)

He said the result of this was to "lower the standard of the real medical science. The physicians nowhere aimed at useful discoveries, but simply devoted themselves to making as much money as possible. In fact, medicine like everything else in Rome at this time was fast decaying." (1, page 39)

There was also no requirement to become a doctor, so any quack, trained or otherwise, could claim to be one. This made it so those seeking help were often left confused and deterred.

So, after the death of Galen, medicine collapsed with the rest of Rome.  Of this, Bradford said:

At the death of Galen (the end of the 2nd century) there began a period during which the art of medicine not only ceased to advance, but went backward, and became enveloped in the myth and ceremonies of the priesthood. For a while the schools of philosophy and medicine still existed at Alexandria, but in the year 372 the city was subjected to pillage and fire. The scholars were stripped of their elegant quarters, the buildings were completely destroyed, and the vast collection of manuscripts were used to heat the water in the public baths. (1, page 45)

Western Civilization entered a dark ages of medicine.  Medicine would not come out from under this dark cloud until after the invention of the printing press in 1450.   In the meantime, if you needed help in times of sickness you were on your own.

References:

1. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey

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50 A.D.: Pneumatic School of Medicine

About 50 A.D. Athenaeus of Attaleia established the Pneumatic School of Medicine, which is an advancement of sorts of the Hippocratic/ Dogmatic School of Medicine. Members of this school were known as "pneumatists." (3, page 490, (2 page 110) (8, page 73)

According to Claudius Galen, Athenaeus (which today would be in South West Turkey) was the pupil of the stoic Posidonius. (3, age 490)(4, pages 156-158)(5, page 207-208).

Medical historian Vivian Nutton said, in her 2013 book, "Ancient Medicine," that the medical theories of Athenaeus were a mixture of stoicism and Dogmatism (Hippocratic, Rational), and he rejected Atomism.

Medical historian Plinio Prioresch said, in 2002, that no one knows for certain when Athenaeus lived, although by the fact that Celcus and Pliney wrote nothing about him, and Galen did, and that Galen said he was the Pupil of Posidonius, many historians say he lived in the first century, but not after 50 A.D. He sad he might have been born during the reign of Tiberius (14-37 A.D.) and "flourished" during the reign Claudius (41-54 A.D.). (4, pages 156-158)

Prioreschi said:

Probably Athenaeus felt that Methodism by reducing all pathogeneses to status strictus, laxus and mixtus, was unsatisfactory it its simplism; that Empiricism with its rejection of all medical theories lacked intellectual stature; that Dogmatism simply rejected the old view of Hippocrates. Possibly, he felt that something new was needed. He therefore developed an intriguing old philosophical concept that was part (even if a secondary one) of the Hippocratic paradigm:  the pneuma. (4, pages 156-158)

This idea of a "vital substance" was recorded in the Hippocratic writings, and believed to have been influenced by the Sicilian medical school that was founded by Empedocles.  

Medical historian Max Neuburger said in 1910 that Empedocles believed that respiration occurred through the mouth and the skin, and "that the blood is the seat of inherent warmth."  (10, page 117-118)

Sicilian physicians studied and wrote about the heart, its valves, pericardium and pericardial fluids, and these were mentioned as the Hippocratic writers were describing the heart.  (10, page 117-118)

Neuburger said: (10, page 117-118)

Anatomical observation of the emptiness of the arteries after death, as well as general scientific consideration upon the significance of the air and of wind-movements, may have brought it about that Sicilian physicians looked upon the pneuma as the most important regulator of organic life. The pneuma was supposed to be distributed through the veins, to circulate with the blood, to temper the heat of the body, to assist all sense impressions and movements and, by stimulation, of putrefactive process, in conjunction with warmth to aid digestion. The heart was regarded as the center organ of the pneuma. (10, page 119) 

Prioreschi said:

According to Athenaeus, the pneuma is the world soul or energy, from which the souls of men, animals, and plants emanate; it is also the maker of all that exists. He considered the four qualities (heat, cold, dryness, and wetness) of the elements (fire, earth, air and water), the primary constituents of man, and added to them pneuma.  Pneuma, absorbed from the air, passes from the lungs to the heart and through the arteries to the whole body, and its alterations determine health and disease. (4, pages 156-158)

Prioreschi quotes Galen:

According to Athenaeus, the four primary elements of man are not fire, air, water and heart but their qualities, that is to say, heat, cold, dryness and wetness.  Of these, two are active, mainly heat and cold, and two are passive, namely dryness and wetness.  From stoic doctrine he also introduced a fifth one: pneuma, which penetrates everything, by which everything is held together and governed.  Athenaeus and Archegenes believed that... all diseases result from an alteration of the pneuma. Hence, those who believe that all depend on the pneuma are called Pneumatists. (6, page 158) 

Pneumatists, therefore, believed health was maintained by the balance of the humors and pneuma, which means "vital air" or "spirit."  Pneuma was inhaled through the lungs, stored in the heart, circulated by the vessels, and measured by the pulse.   (2, page 110)

Pneumatists believed disturbances in the four humors (blood, phlegm, yellow bile and black bile), or an excess or deficiency in any one, would disturb the pneuma of that person, and cause medical problems. (2, page 111)

They also believed that: (2, page 112)(5, page 208)

• Blood is formed in the liver from food (2, page 112)
• Phlegm is secreted from the brain to other organs (2, page 112)
• Yellow bile comes from the liver (2, page 112)
• Black bile comes from the spleen (2, page 112)
• The most important organ is the heart, since it's the site of heat and pneuma (2, page 112)
• The heart draws pneuma from the lungs, which cools it, and is stimulated by it  (2, page 112)(5, page 208)
• The spinal cord was an expansion of the brain, so all neurons began in the brain (2, page 112)
• Respirations are a result of expansion and contraction of the lungs, involving the thorax and diaphragm (2, page 112)
• The nose was the most important organ in the body, mainly because it was used to inhale air, and pneuma.  (7, page 58)

Because the temperature of the pneuma could be affected by the environment around a person, Athenaeus paid special attention to the seasons, and other things that might affect the atmosphere around a person, including such things as design of the house. To keep the pneuma healthy, a steady diet was necessary, along with clean drinking water and exercise. (4, page 208)(5, page 208) 

Athenaeus and the pneumatists who followed him believed contrariis contrarius, or opposite by opposite.  By this he believed that the remedy was the opposite of the cause, or diseases caused by heat were treated with coolness. For example, a fever was cured by placing a cool rag on the patient's forehead or ice under their armpits.  (4, page 208)

Nutton said that if the Posidonius mentioned by Galen was Posidonius of Apamea, and if Posidonius actually attended his lectures, it's actually possible that the pneumatist school was formed as early as 50 B.C. or 60 B.C. (5, page 207)

However, considering neither Celsus nor Pliney mention it, Nutton said that most historians agree that he probably lived around 50 B.C., which is the date that most historians attribute as the beginning of the Pneumatist School of Medicine.

The basic tenants of the Pneumatic school were carried on by Claudius Agathinus of Sparta (50-100 A.D), who was a pupil of Athenaeus and lived during the reign of Nero.  Although, he most likely referred to the school he created as episynthetic, which was basically an eclectic school, because he also accepted ideas from the Methodist and Empiric schools. (4, page 159) (8, page 73)(11, page 98)(12)

The two most famous pupils of Agathinus were Herodotus and Archigenes of Apamea, and they carried on the basic tenants of pneumatism.  (4, page 160)

Nutton said the pneumatists became the "most influential rivals of the Methodists of the first and second centuries.  (5, page 207)

Many of the medical ideas of the Pneumatists were later picked up by Galen of the 2nd century, particularly the idea of the pneuma and contrariis contrarius. 

Further reading:

1. 1st Century:  The four schools of medicine 
2. 100 A.D.:  Aretaeus defines asthma

References:

1. Moffat, John, translator, "Aretaeus: consisting of eight books, on the causes, symptoms, and cure of acute and chronic diseases; translated from the original Greek." 1785, London, Logographic Press
2. Magill, Frank N., editor, "Dictionary of World Biography," Volume I: The Ancient World, 1998, Salem Press Inc., California
3. Algra, Keimpe, Jonathon Barnes, Jaap Mansfeld, Maldolm Scholfield, editors, "The Cambridge History of Hellenistic Philosophy," 2002, Cambridge University Press
4. Prioreschi, Plinio, "A History of Medicine," volume III "Roman Medicine," 2001, NE, Horatius Press
5. Nutton, Vivian, "Ancient Medicine," 2nd edition, 2013, Routledge, NY, GreenGate Publishing Services
6. Prioreschi, op cit, page 158, reference given by Prioreschi is: Pseudo-Galen, Introduction sive medicus, ix, K, XIX, pp. 698, 699
7. Hastings, James, John Alexander Selbie, Louis Herbert Gray, "Encyclopedia of Religion and Ethics," volume XII, 1922, New York, Charles Scribner's Sons
8. Garrison, Fielding Hudson, "An introduction to the history of medicine: with medical chronology, Bibliographic data and test questions," 1913, Philadelphia and London, W.B. Saunders company
9. Meryon, Edward, "History of Medicine: comprising a narrative of its progress from the earliest ages to the present and of the delusions incidental to its advance from empericism to the dignity of a science," volume I, London, 1861,
10. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press
11. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
12. "Agathinus, Claudius," encyclopedia.com, http://www.encyclopedia.com/doc/1G2-2830900054.html, accessed 6/24/14

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50-400 A.D.? Antyllus describes asthma remedy

Of his writings we have none. Of his life we know nothing. When he lived we know nothing. When and where he practiced medicine we know nothing. Yet we do know he was a physician and surgeon who lived in the 2nd century, and that he wrote about asthma. His name was Antyllus.  

Claudius Galen (130-200 A.D.) diligently collected the works of all medical writers who came before him, yet of Antyllus he wrote nothing. So if he lived before Galen as some speculate, one might wonder why Galen ignored him. So another theory is he lived after Galen.

For preserving the ideas of this surgeon we owe thanks to Oribasius of Pergamus (320-403 A.D.). He quoted many medical authorities prior to his time, including the works of physicians we would otherwise know nothing of, such as Antyllus. (5, page 129)

Some speculate he lived as late as the Roman Emporor Velerium who ruled Rome from 260-264 A.D. (1, page 129, (3, page 11). Still others speculate he lived as late as the fourth century. (2, page 124-5)
Regardless, he must have held a reputable reputation in the medical community because he was written about by many authors, including Oribasius, Aetius, Rhazes and Paulus Aegineta. Oribasis was the first to write about him, so this used as a baseline for dating his life. (2, page 125)

What he did for the medical community we can gather some hints. Aegineta was the first to mention a technique for performing the operation of tracheotomy, and credits Antyllus for educating him on the best method of doing this. (2, page 124)

He's also credited as being among the first to describe a method of surgically treating aneurysms. Overall, his "works seem to be useful and interesting, as it contains some of the most valuable surgical observations that have come down to us from antiquity." (2, page 124)

Regarding asthma we have gathered some knowledge from Antyllus, and for this we are thankful to John Watson for bringing this knowledge to us in his book, "Medical Profession in Ancient Times," as noted here:

He treated humid asthma with suffumigations, placing the patient in such a position as readily to inhale the fumes from particles of aristolochia (treats edema) or clematis (mild diuretic) previously sprinkled over burning coals in a chaffing-dish or brasier. (4, page 129)

So if you had asthma an Antyllus, or one of his followers, was your doctor, this is what you might expect as your treatment.

References:

1. Watson, John, "Medical profession in ancient times: an anniversary discourse delivered before the New York Academy of Medicine November 7, 1855," 1856, pages 128-129
2. "Biographical Dictionary of the society for the diffusion of useful knowledge," Longman, Brown, Green and Longmans, volume III, 1843, A. Spottingwood, London
3. Peters, John C., "On Sects in Medicine read before the Medico-Legal Slociety of New York, 1870," 1874, New York, J.R. McDivitt, Law Publisher
4. Watson, John, op cit, see page 129, and also see reference 3 above (Peters, John C., page 11)
5. Withington, Edward, "Medical History from it's earliest times," 1894

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AD 32-79: Pliny the elder's contribution to asthma

Pliny the Elder had an intense curiosity and he yearned to know
everything.  His exuberant interest in knowledge was perhaps
lead him to write one of the most well read books of all time.

Gaius Plinius Secondus, better known as Pliny the Naturalist, Pliny the Second, or Pliny the Elder, was a Roman admiral, an encyclopedist, and an asthmatic who mentioned asthma-like symptoms in his book, "Natural History."
Russell M. Lawson, in his book "Science in the Ancient World: An Encyclopedia," wrote that Pliny was born in 23 A.D. during the reign of Rome's second emperor Tiberius. He was of the equestrian class, of whom the emperors relied upon for political support and to fill the many administrative positions. (1)
He served in the military as a provincial governor, and was head of the Roman fleet, a position he held at his death when mount Vesuvius erupted and he supposedly died of either asthma or heart complications in 79 A.D after he tried to help those who were trying to flee the volcano. (2)
Medical historian Thomas Lindsey Bradford, in his 1898 book "Quiz questions on the history of medicine," said that Pliny died because of his quest for knowledge. "He approached by vessel very near in order to note everything of importance concerning the phenomena. He passed the night not far from the mountain. The next morning the surrounding country became enveloped in a suffocating gas or vapor and he was killed by it." (11, page 36-37)
Yet by the time he passed he had already left behind a vast encyclopedia, providing historians an accurate view of history prior to and during his time. (8, page 37)
I think it was interesting to learn from Lawson that Pliny was a Stoic, which meant that he believed there was no after life, and this life was all a person had. Thus, perhaps for this reason, he slept little and spent most of his time writing. He wrote other books, but his most famous was Natural History. 

Lawson explained that Natural History is a "diverse collection of anecdotes, history, geography, medical information of varying worth, discussions of astronomy and earth science, and a catalog of Roman knowledge of botany and zoology." (3)

Russell further explained that because the book was filled with "interesting information and useful facts it became one of the most widely read books during the Late Roman Empire, Middle Ages, and Renaissance." (4)
Likewise, Russel said, Pliny based many of his studies on the writings of other physicians and scientists along with his own experiences, and when he recorded the observation of other writers such as Herodotus, Polybius or Alexander the Great, Pliny's descriptions were often better than that of the original authors. (5)

The book is mentioned frequently by other historians.
He mentions asthma-like symptoms in his book, yet he preferred to use Latin terms to describe dyspnea, shortness of breath instead of asthma. (6) 

Pliny wrote once that Rome had gone 600 years without physicians so why do we need them now. He wrote this in reference to Rome adapting Greek medical terms and Greek methods of diagnosing and treating patients.

Remedies he prescribed for asthma to "facilitate the respiration" were:  (7, page 344)

1. Blood of wild horses taken in drink
2. Asses milk boiled with bulbs
3. The liver or lights of a fox in red wine
4. Bear's gall in water

Other remedies included: (6, page 17)

1. Oil of balsamum
2. Rue combined with bitumen
3. Pitched wines unless there was also a fever involved
4. Chrysochola combined with honey is good for sore throats and asthma (8)
5. Snails: Good for a cough and stomach ache, and a cure for asthma, fever, etc. (9)
6. Vinegar (10)

Many of the magical cures, superstitions, remedies for physical illnesses described in Natural History were followed and used for over 2,000 years.

Pliny was a classic recorder and cataloger of events that occurred in his day, but he was also great at recording things he learned from others, either fact or hearsay, and likewise the wisdom of other great discoverers, writers, and explorers who lived before him.

It is for this reason he is described as encyclopedic, and, as Lawson said, one of the main reasons students of the ancient world "know of ancient writers and writings that would otherwise be unknown, save for Pliney's eforts."

Click here for more asthma history.

References:  

1. Lawson, Russell M., "Science in the Ancient World: An Encyclopedia," 2004, California, pages 190-192
2. Lawson, ibid
3. Lawson, ibid
4. Lawson, ibid
5. Lawson, ibid
6. Jackson, Mark, "Asthma: A Biography," 2006, New York, page 17
7. Pliny the Elder, "The Natural Hisotry or Pliny," translated by John Bostock and H.T. Riley, Vol. V., 1856, London, page 344
8. Bostock, John, "The first and thirty-third books of Pliny's Natural History; a specimin or proposed translation of the whole work with notes and etc," 1928, London, page 47
9. Harmer, S.F. (editor), "The Cambridge Natural History," Volume III, 1895, Norwood, Massachusettes, page 120
10. Lawson, Russell, op cit, page 190-192
11. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey

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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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25 BC-50 AD: Celcus spearheads quest to define asthma

So what would life be like for the asthmatic when Jesus and Caesar walked the earth? From my investigations into this era I'd imagine the best remedy might simply be to tough it out, as many of the recommended remedies seem like they'd be worse than the disease. Of course this was true of most medicine prior to the 20th century.

Aurelius Cornelius Celsus was a voluminous writer. While

most of his works have been lost to history, his medical treaties

became one of the most read books during the Renaissance.

The second century A.D. was a very "fruitful era of literature
and philosophy." (1, pages xxi, xxii) It is for this reason we have resources available to help us learn what was known about asthma at that time and the remedies to treat it. Among those most influential to medicine were Pliny the Elder (23-79 A.D.), Seneca the Younger (4 B.C.- 65 A.D.) and Aurelius Cornelius Celsus.  (25 B.C. to 45 A.D.)

We have already delved into the philosophical writings of Seneca, and the works of Pliney will be discussed in a future post.  Today I would like to shine the light on Celsus, whose contributions to our term asthma were quite significant.

Although, we must be sure we are shining the light on the right Celsus, for this name was among the most popular of that time. The name Celsus in 2nd century Rome was akin to modern surnames such as Garcia, Rodriguez, Martinez, Smith, Williams, Jones, Hansen, Andersen, or Johnson. (5, pages 32-33)

Perhaps because there were so many by the same name that we know so little about our Celsus, whos can be seen as we enter a courtyard of one of the homes of some unknown Roman village, reclining back comfortably on a couch with the tablets set firmly upon his knee. With a pen he writes about asthma today, a symptom he probably learned about during his philosophic studies. (5, pages 32-33)

Already in his repertoire were treaties on philosophy, architecture, rhetoric, agriculture and war. He also wrote a book called "The True Word," in which he attacked Christianity, the newest philosophy of his era.

Yet all those treaties would eventually be lost to history. The only remaining treaties that we have of his is his Treaties Medicina, of which he wrote about medicine and surgery. The first eight books were on medicine, the first four of which treated internal diseases with diet and regimen. The fifth and sixth dealt with pharmacology, or the drugs used to treat diseases. The seventh and eighth dealt with surgery. (5, page 32-33)(3, page 74)

He was born Aurelius Cornelius Celsus in 25 A.D. to respectable parents in Greece. He was a stoic, meaning he did not believe in an after life. He was also well learned, meaning that he was educated in all the knowledge of the day. His specialty became pharmaceutics, medicine, surgery, war, and architecture.  He wrote voluminously on all these subjects.

His writings were later described as "diligent" and "attentive." (2, pages 425-5) Yet while some say that his skills as a surgeon were "second to none," (1, page xvii) others suspect he may not have practiced what he preached, that he was neither a physician nor a surgeon. (2, pages 425-5)(7, page 5)

He rose above his peers by paying attention to all aspects of medicine, rather than just one. For instance, prior to his time medicine was divided into three parts: (9, page 33)

• Dietetic: Curing by diet
• Pharmaceutic:  Curing by medicine
• Chirurgic: Curing by manual operations (knife, cupping, etc.)(5, page 33)

Celsus became the first to preach the importance of all three. (5, page 33)

Perhaps it was for this reason that his medical writings were "ignored by Roman practitioners of his day, and his name is mentioned only four times by the medieval commentators," said medical historian Fielding Hudson Garrison in his 1913 book "An introduction to the history of medicine." (3, page 74)
Not until 1478 would he get his revenge. In this year his book, De Re Medicina, would become the first medical treaties printed on the Gutenberg Printing Press. The treaties would then pass " through more separate editions than almost any other scientific treaties," said Garrison (3, page 74)

This was partly due to the fact it was a medical treaties, but more due to the fact of the way it was written. "It was due largely to the purity and precision of his literary style, his elegant Latinity assured him the title of 'Cicero medicorum,'" said Garrison. (3, page 74)
Medical historian Thomas Lindsley Bradford, in his 1898 book “Quiz questions on the history of medicine said that his medical treaties was a "test of Latin scholarship, and of a liberal education, for if the student was familiar with Celsus he received the purest Latin of the Augustinian Age." (5, page 33)

Along with his writings on medicine and surgery, he also described the history of medicine, giving descriptions of over 72 medical authors, although all have been lost except for the works of Hippocrates. He likewise provides us with the most precise account of medicine at the time of Jesus, describing both the Dogmatic and the Empiric Schools of medicine. (3, page 74)(5, page 33)

Celsus defended the idea that anatomy was important in medicine, so he was definitely not an Empiric who did not support the notion that anatomy was important to medicine. Despite this, "his knowledge of anatomy was somewhat superficial." (5, page 33)  Some say he more fittingly belonged to the eclectic school, or a combination of dogmatic and empiric. (7, page 6)

Regardless of how he was perceived in the past, Celsus remains an important figure in our history of asthma. It is thanks to him that we learn what physicians knew about asthma during the time of Jesus.

As a medical writer Celsus emulated Hippocrates, and parts of his books are word per word transcriptions from the "Hippocratic Corpus."  In fact, Celsus did this so often that one later author, Nicholas Mondaris, referred to him as the "Ape of Hippocrates" or the "Latin Hippocrates." (1, pages 259-61)(7, page 5)

The Treaties on Medicine written by Celsus would become the first
medical treaties printed on the Gutenberg Printing Press.
 It would go on to pass through more editions than
any other scientific treaties.  

Yet he incorporated into his treaties the latest wisdom of his day, plus some of his own ideas. This is clearly evident in his writings on asthma.
When asthma was first defined by Hippocrates in 400 B.C., it was often difficult to distinguish between the causes of dyspnea, and therefore they were grouped under the umbrella term asthma. Thus, all that caused dyspnea were referred to as asthma.
Celsus, on the other hand, believed asthma was more than just dyspnea, and for this reason he provided us with our first description of asthma as more than simply a blanket term.

Celsus wrote the following:

Est etiam circa fauces malum, quod apud Gracos aliud aliudque nomen habet. Orane in difflcultate spirandi consistit; sed haec dum modica est, neque ex toto strangulat, appellator. Cum vehementior est, ut spirare aeger sine sono et anhelatione non possit; cum accessit id quoque, ne nisi recta cervice spiritus trahatur. (4, page 10)

By the above, which is taken from John Charles Thorowgood 1890 book "Asthma and Chronic Bronchitis," we learn that Celsus believed there were three thoracic disorders that resulted in difficulty of breathing, and they varied by their "degree of violence":

1. Dyspnea:  Moderate, unsuffocative breathing without a wheeze; it's chronic
2. Asthma:  Vehement breathing that is sonorous and wheezing; it's acute
3. Orthopnea:  Breathing only takes place in an erect position; it's acute (1, pages 259-61) (4, page 10)

By the order above, Celsus implies that asthma is the "mean" level of difficulty of breathing, with dyspnea being less severe than asthma, and orthopnea being more severe than asthma. (4, page 10)

He was also the first to describe asthma as a specific condition involving constriction of the air passages in the lungs, and he was likewise the first to describe a wheeze. He described an attack of asthma this way:

The symptoms common to these are, that on account of the constriction of the respiratory passage, the breath is emitted with a sibilous noise (whistle or wheeze), there is pain in the chest and precordia (over the heart), sometimes also in the shoulder; and that sometimes departs, sometimes returns; in addition to these a slight cough accedes. (1, pages 260)

His remedies for asthma included any of the following:

1. Blood letting (common remedy for just about any ailment)
2. Milk (to relax the bowels)
3. Purging of the bowels with enemas (clysters) or injections if necessary
4. Hydromel (honey diluted in water)
5. Head must be kept high in bed
6. Thorax relieved by fomentations (warm, moist medicinal compress)
7. Thorax relieved by hot cataplasms (a heated medical dressing, either dry or moist)
8. Malagma (lotion or salve) or iris ointment after fomentations and cataplasms (these act as emollients to soften skin to make chest movements easier)
9. Hydromel as a drink (mixture of water and honey)
10. Bruised root of capers has been boiled
11. Nitre or white cresses fried, bruised, then mixed up with honey and given as electuary (oral, by mouth)
12. Honey, galbanum, and turpentine resin boiled together and, when they are coalesced to the size of a bean, dissolved under the tongue daily
13. Impure sulfur or southernwood triturated together in a glass of wine and sipped warm
14. Fox's liver dried, hardened and pounded into a powder and sprinkled on a drink (such as wine)
15. Eating the fresh, roasted lungs of a fox (but you can't cook it with iron utensils)
16. Gruels (watery porridge) and mild food
17. Light austere wine
18. Sometimes a vomit (Emetics)
19. Anything that promotes urine (diuretics make you pee, but they probably believed they were full of poisons that caused the humors to be imbalanced)
20. Gentle walking (nothing more) 
21. Massage (he referred to it as friction; it's done to move poisons around the body to balance the humors and to make breathing easier) (1, pages 259-61)

While some of these were later proven to have medical significance, most were simply palliative, and some were downright barbaric.  Still, his ideas were studied and followed for many years after his death.

We asthmatics should be thankful to Celsus for spearheading -- although he didn't know it at the time -- a 3,000 year effort to define asthma as a disease of its own. You can decide for yourself if you'd have been satisfied with his remedies for your asthma,  or if you would rather have just stayed home and suffered.

References:

1. Celsus, Aurelius Cornelius, "De Medicina," translated by L. Targa, London, pages xiiv-xxiii, "The Life of Cornelius Aurelius Celsus," by J. Rhodius and translated from Almeloveen's Lugduni Batavorum
2. Parr, Bartholomew Par, M.D., "The London Medical Dictionary," 1809, London, Vol. 1, pages 425-5
3. Garrison, Fielding Hudson, "An introduction to the history of medicine: with medical chronology, Bibliographic data and test questions," 1913, Philadelphia and London, W.B. Saunders company
4. Thorowgood, John C., "Asthma and Chronic Bronchitis: A New Edition of Notes on Asthma and Bronchial Asthma," 1894, London, Bailliere, Tyndall, & Cox
5. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
6. Celcus, Aurelius Cornelius, "The Eight Books of on Medicine of Aurelius Cornelius Celsus with a Literal and Interlineal Translation on the Principles on the Hamiltonian System Adapted for Students in Medicine," volume II, 1830, London 
7. Bell, John, editor, "Retrospection in Medicine," The Eclectic Journal of Medicine, November, 1836, volume 1, number 1, Philadelphia, Haswell, Barrington, and Haswell

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