Wednesday, November 18, 2015

1666: Dr. Sydenham will cure your asthma

If you lived in Europe and the United States during the course of the 17th century you could take your chances with the botanic physician and his natural remedies. Chances are, however, if you had access to a licensed physician you would heed his advice, and take his remedies, however harsh they were.

While most botanic physicians had no medical degree, the licensed physician would be well educated, and chances are he would have had read, and probably even had a copy of it on his desk, a book called "The Works of Thomas Sydenham M.D."

So you are having trouble breathing, and so you have your son travel on horseback to fetch the doctor.  Chances are, unless he had his remedies memorized, he'd refer to this book, opening it up to page 464.  He would read the following.
1. THERE are three kinds of this disorder: 1. a dyspnoea, which is a dense, quick, and difficult respiration, without'a stertor or rattling, and proceeds from a stuffing of the lungs; 2. an asthma which is a quick and difficult respiration, accompanied with violent motions of the diaphragm, intercostal and abdominal muscles, and a rattling in the throat. In the former species the Kmgs themselves, and in the latter the bronchia are stuffed; 3. an orthopnosa, which is the greatest difficulty of breathing, insomuch that the patient cannot breathe but in an erect posture, and is attended with violent motions of the muscles of the breast and shoulders. 
2. Take away ten ounces of blood from the right arm, and next day give the common purging potion, which must be repeated twice more, once every third day. 
3. On the intermediate days of purging let the following medicines be used:
Take of the seeds of anise, finely powdered, two drams; Locatellus's balsam, enough to bring it into a mass for pills, and make six pills of a dram, three of which are to be taken every morning, and at five in the afternoon, drinking four ounces of the bitter decoction without purgatives, warm, after them. 
4. If the disorder does not go off, let the whole process be repeated. (1, page 464)
In the meantime, you are sitting in a chair at the kitchen table with your elbows hard pressed against the wood table to hold your shoulders high.   A breeze from the kitchen window seems to make your breathing easier, but only slightly.  The breeze feels good upon your sweated brow.

Yet your mind drifts as you try to forget your distress.  Perhaps for one brief moment you feel a panic, and wonder why the doctor is not here yet.  A tear dribbles down your cheeks, although you quickly wipe it away as you don't want your son to see you cry.

You sit, close your eyes, and concentrate on the breeze, and your breathing. You drift back into your fantasy world, perhaps a place where the weather is warm and you're lying on a beach, listening to the soft whisper of waves.

You are awakened from your fantasy by a knock at the front door, and then you hear it open and then slam shut.  You are also instantly reminded of your predicament, and you try to force a breath in that doesn't seem to want to enter. You arduously lift your shoulders up, chest wall out, and stomach in, and this sucks some air into your stiff lungs. Your chest burns.  Your head aches.

You hear the voice of your son and the doctor, and then the doctor appears in the kitchen with his medicine bag.  Your heart skips a beat as you know what he is going to do, and you know that it will bring more grief for you before it makes you better -- if it makes you better.

You watch anxiously as he opens his bag, and pulls out a blade.  He uses it to slice a drain, and you watch as blood dribbles down your arm, landing on the floor. This being done, he bandages the wound and reaches into his bag for a bottle of medicine.

"Take one of these now," he says, handing you a horse pill.  "Then take one again tomorrow.  The draught should be taken, and then taken again tomorrow following the pill.  This will make you feel better."

You take the pill, wondering if the doctor truly believes what he says.  Yet almost as he were reading your mind, he says, in a deep, full and binding voice:
These are the remedies of the great physician Sydenham.  If you had consumption his recommendation was to have the patient ride on a horse.  He was also the first to recommend fresh air, particularly in sick rooms.  The fact you have the window open made me think of this." (2, page 271)
You smile minutely, if only to amuse the physician.  You close your eyes to concentrate on your breathing.  You tune out the physician and don't even notice when he leaves.

So the good doctor arrives at your house carrying his leather medicine bag.  He did not knock, just barged right in, probably with the permission of your son.  You don't mind, because you know exactly who he is, and what he's going

He would set the bag on the table next to the chair you are sitting in.  As you struggled to breathe, you watch as he

He also had ideas that would benefit people with other medical conditions associated with breathing, such as:
  1. He was among the first to recommend fresh air in sick rooms (6, page 271)
  2. He recommended horse back riding for consumptives.  (6, page 271)
  1. Sydenham, Thomas, M.D., "The works of Thomas Sydenham, M.D., on acute and chronic diseases, with their histories and mode of cure, with notes intended to accommodate them to the present state of medicine, and to the climate and diseases of the United States, by Benjamin Rush, M.D., professor of the Institutes and Practice of Medicine, and of Clinical Practice, in the University of Pennsylvania," 1809, Philadelphia, Published by Benjamin and Thomas Kite. 
  2. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
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