History of Asthma
The earliest recorded reference to respiratory distress – a disorder characterized by “noisy breathing” (wheezing?) is found in China in 2600 BC.
The Babylonian “Code of Hammurabi” recorded symptoms of breathlessness: “If a man’s lungs pant with his work.” (1792-1750 BC).
Hippocrates (~400 BC) was the first to use the term “Asthma” (Greek for “wind” or “to blow”) for panting and respiratory distress. He is considered to be the physician who identified the relationship between the environment and respiratory disease correlating climate and location with illness. Some suggest he was the first allergist.
When Alexander the Great invaded India, smoking the herb stramonium (an anticholinergic agent related to ipratropium and tiotropium currently used in inhalers) was used to relax the lungs.
Roman doctors described asthma as gasping and the inability to breathe without making noise. They noted “if from running or any other work, the breath becomes difficult, it is called asthma.” Pliny the elder (~ 50 AD) observed that pollen was a source of respiratory difficulty and recommended the use of “ephedra” (forerunner of ephedrine) in red wine as an asthma remedy. Unfortunately, he also suggested that drinking the blood of wild horses and eating 21 millipedes soaked in honey could help.
The Jewish Talmud (200-500 AD) counseled “drinking three weights of hiltith,” a resin of the carrot family as a therapy for asthma. Maimonides (1135-1204 AD), Jewish scholar and Saladin’s physician treated the Egyptian’s son for asthma. His “Treatise on Asthma” prescribed rest, good personal hygiene and environment, avoidance of opium, a small quantity of wine and a special diet. Nuts, fruit, milk, cool vegetables and legumes (peanuts are a member of this family) were forbidden, while “The soup of fat hens” was considered beneficial.
Tobacco introduced from the America’s to Europe (1500’s), was used to induce coughing and expectorate mucus. In Central America, Aztecs ingested an ephedra containing plant to clear mucus and, in South America, Incas treated asthma with a cocaine-like dried leaf. In the 1800’s, Arsenic was prescribed for respiratory conditions. In the early 1900’s, allergy immunotherapy was first introduced to treat asthma.
Asthma medicines of the 1940’s and 1950’s consisted of epinephrine injections (adrenaline) and aminophylline tablets or suppositories. In the 1960’s oral combinations were the staples of chronic therapy. Inhalation of epinephrine (Primatene) and isoproterenol (Isuprel) were used as rescue agents. Oral prednisone was and continues to be prescribed for severe disease.
Since the Allergy and Asthma Medical Group & Research Center was founded in 1969, many therapeutic advances have occurred. Inhaled bronchodilator medications are less likely to stimulate the heart and are available in both short and long acting formulations. Inhaled corticosteroids target the underlying inflammation and minimize the potential cortisone side effects seen with the tablet and liquid products. Our clinical research department is currently actively evaluating new asthma therapies that promise to further benefit patients.
Though asthma has been a known entity for over two and a half millennia, nearly 25 million people in the United States still suffer from this condition. However, we have come a long way in understanding its causes and triggers and have made large strides in our ability to treat and control it. We pledge to continue to give our best efforts to expertly and compassionately care for our patients with asthma.