Monday, August 3, 2015

1530: The bellows of Paracelsus

Paracelsus was perhaps the first to use bellows
to provide artificial breaths to an unconscious
person.  (2, p
The next person in our history to experiment with the use of bellows in performing artificial breaths was a man called Aureolus Theophrastus Bombastus von Hohenheim, and who became better known as Parecelsus.

He was born in Maria Einiedeln near Zurich in 1493 to a physician who instructed him in his path to becoming a physician, including alchemy, astrology, and medicine. Then he traveled the world, visiting all the sages thereof, in order to hone in his skills. (5, pages 82-83)

By the age of 32 he returned home and "became famous for his cures," said Thomas Bradford. At the age of 33 he had cured thirteen princes who had been declared hopeless by the Galenic physicians. As a result of this, he was made professor of physic and surgery in the University of Basle in the year 1526." (5, page 83)

Paracelsus is perhaps among the more interesting men in our history of respiratory therapy, although his contribution is almost insignificant.  Yet if we could imagine for a moment if the ability to control electricity existed during his time, it's possible he could have invented the first method of performing artificial breaths to an unconscious patient.

Medical historian Pierre-Frances Renouard , in his 1867 history of medicine, explains that Paracelsus was born in Switzerland to a physician who provided a basic medical education to his son. His father then "made him travel, according to the custom of the scholastics of those times, to visit the universities and hear the most celebrated professors. But instead of frequenting the schools, young Paracelsus sought the conversation of clever women, barbers, renovators, magicians, alchymists, in whose society he boasted he had obtained valuable secrets."  (1, page 358-360)

Between the ages of 25 and 30 it is said that he spent most of his time drinking wine and socializing, although he must have obtained quite a bit of medical knowledge as well, because by the time he was was "admired by every one as a second Esculapius." (1, page 358-360)

He became among the believers who lived during the renaissance that what was taught by ancient writers such as Hippocrates, Galen and Avicenna was poppycock and quack medicine and he was among those who aimed to prove them wrong. (1, page 358-360)

He believed medicine should be taught and performed based on observation at the patient's bedside and not on antiquated textbooks. (reference) He was even known to toss those old texts into the fire. (1, page 358-360)

Renouard explains:
He had just been called to Basle to fill the chair of Physic and Surgery. A crowd of curious and idle persons, and of enthusiasts attended his first lectures. The thaumaturgist, in order to astonish his auditors, commenced by burning the works of Galen and Avicenna; then he began to read and develope his own writings, breaking off from time to time in declamations of this kind: “ Know, ye doctors, that my hat knows more than you—that my beard has more experience than your academies. Greeks, Latins, Arabs French, Italians, Jews, Christians, and Mohammedans, you must follow me; I shall not follow you, for I am your monarch, and sovereignty belongs to me 1”  (1, page 359-360)(also see 5, page 83)
Bradford added:
All this soon lost him the esteem of the people.  He was said not to have regularly graduated.  He became a great drinker, a thorough drunkard.  This was the habit of the time, however, and drinking bouts to see who could drink the most were very common, even among the high born.  (5, page 84)
Some say he was so drunk he didn't even dress himself, and went to sleep at night with his sword, only to wake up in the night walking around with it "to the great alarm" of those around him.  Others say he only drank enough to "stimulate his mind."  (5, page 84)

Regardless, Bradford said that regardless of where he went "he regarded the regular faculty to hatred by his pretend or real cures and his unmitigated contempt for the doctors and their systems... He now cast nativities, told fortunes, aided those who had money to burn to find the philosopher's stone, prescribed remedies for cows and pigs, and aided in the recovery of stolen goods." (5, pages 84-85)

When he wasn't busy drinking and socializing, he studied.  Among his studies he would have read the works of Hippocrates and Galen, and learned that Hippocrates described inserting a reed tube into the neck of a person suffocating due to an upper airway obstruction.  He would have known that Galen likewise acknowledged the procedure, and described inflating lungs with bellows. He also would have known of Paul of Aegineta, who perfected the procedure, which he referred to as bronchotomy.

So Paracelsus had some basic airway knowledge he attempted to expound upon.  Although, unlike many of his predecessors, he believed rather than just make things up based on observation, one must perform experiments to prove or disprove ideas.   J.L. Price, in his 1962 article "The evolution of breathing machines," explains:
The first mechanical refinement of mouth to mouth resuscitation was attributed to Paracelsus, who in 1530 inserted the nozzle of fireside bellows into the nostrils of apnoeic patients and rhythmically inflated their lungs. The bellows used were said to have been fouled by cinders and Paracelsus had little success with their gestures."  (2, page 67)
He therefore was the first that we are aware of to document experimentation with bellows to perform artificial respiration.  Unfortunately his experiments didn't work.

His death was almost as controversial as his life.  Some say he died in 1541 of natural causes, while other say he "he was drinking in an inn," said Bradford, "and disputing with a doctor, when he so excited the doctor to wrath that he ordered his servants to pitch the boaster and quack from the window; this was done and his neck was broken from the fall." (5, page 85)

  1. Renouard, Pierre-Victor, writer, Cornelius G. Comegys, translator, "History of medicine: from its origin to the nineteenth century," 1867, Philadelphia, Lindsay and Blakiston
  2. Price, J.L., "The Evolution of Breathing Machines,Medical History, 1962, January, 6(1), pages 67-72; Price references The Bible, Kings, 4: 34
  3. Tan, S.Y, et al, "Medicine in Stamps:  Paracelsus (1493-1541): The man who dared," Singapore Medical Journal,  2003, vol. 44 (1), pages 5-7
  4. "Resuscitation and Artificial Respiration,", Scientific Anti-Vivisectionism,  
  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
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