Thursday, April 30, 2015

800 B.C.: The Greeks transform medicine

While medicine was born around 30,000 B.C., it was revolutionized around 800 B.C. by the Ancient Greeks.  The Greeks were the first to reap the rewards of accumulated wisdom and technological advancements.  They had time to enjoy life, to think, discover, and invent.

Around 1500 B.C. villages started to form in Greece that grew to become powerful city-states.  Each city state was separated by mountains, so they each developed their own government and culture.  Sometimes they even fought with each other.  The most famous such war was between the two wealthiest and most powerful city-states: Sparta and Athens.  (1, 88-90)

Each city-state was surrounded by villages and farms that provided food for everyone.  The trade off was the city-states offered protection from invaders.  (1, page 88-90)  Because of this arrangement, and because of slaves who did most of the work, people who lived within the city-states had plenty of time to think.

The people of wealthy city-states such as Athens decided to use this time to create things that made life more enjoyable.  At first each landowner was declared a citizen and had a say in government, yet by 508 B.C. many traders, merchants and business people who came to the city got rich there and wanted a say in government.  (1, page 93)

This resulted in one of the worlds first compromises that resulted in one of the world's first constitutions. The constitution declared that all free men were citizens. Each citizen had a right to vote and sit on a jury. This constitution, coupled with slavery and the hard work of the farmers, gave the citizens of Athens plenty of time to loaf around. (1, page 93)

They created bath houses where slaves kept the fires going so those who had time could take nice hot baths and socialize while doing so. They built a large Acropolis with huge theaters, a huge temple to their goddess Athena called the Parthenon. They spent time there bantering and philosophising. They asked questions about the world around them, and came up with theories.(1, page 88-90)

Lord Macaulay (1800-1859) described it best, perhaps humorously:
Almost all of a Greek consisted in talking and listening. His opinions on all subjects were picked up casually. If he wished to study physic, instead of shutting himself up with books, he walked down to the market-place to look for a gymnastic physician.
They built huge gymnasiums where the young could train and participate in various sports. They created Olympic events where the various city-states would compete every four years. They created schools amid the gymnasiums where children were educated about life. They were trained to be thinkers. Or, if you lived in Sparta, you were trained to be a warrior.

They watched as men were hurt in battle and while playing the sports they so enjoyed to watch, and saw that something could be done to help the wounded. They learned that certain medicines made the wounds better, and certain procedures helped the process of healing. After caring for the wounded they started wondering about other diseases: What causes disease? What is the cure?

Physicians were first educated between the ages of six or seven and twenty in the gymnasium, where they learned the arts of reading, writing, geometry, computation and astronomy: (2, page 18)
At the Gymnasia the course of education consisted, first, of music, which according to the ancient use of the term, included every study for developing the intellectual and moral faculties; and secondly, of gymnastics, in which was included every exercise for strengthening and improving the body. It was a rule with these people that what the boy first learns in sports he will afterwords love, and exercise with more ability as the serious occupation of his manhood; and hence, that children should practice as amusements such sports as are best suited to prepare them for their future occupations. (2, page 18)
It was at the gymnasiums, and the battlefield, where the Greeks were exposed to accidents, such as twisted ankles, broken bones, cuts, and bruises. From these experiences, and watching those skilled in treating them, young Greek boys were exposed to medicine. Some speculate the "Homeric heroes had probably acquired their surgical skill in this manner." (2, page 20)

About a hundred years before Plato and Hippocraetes, Pythagorus (570-495 B.C.) traveled to Egypt to be educated in the art of medicine, and he traveled back to Greece ("Crotona Graecia, now south of Italy). Thus it was in Crotona "where medicine was first cultivated as a department of philosophy." (2, page 21)

The Pythagorum school of medicine was formed. It was from here that the first known Greek physicians were educated: (2, page 21)
  • Empedocles, who wrote a medical poem (See The Beginning of Western Medicine)
  • Alcmaeon, who dissected brute animals
  • Democedes, the most skilled physician of his time
  • Acron, the first to prefer practical rather than speculative "inquiries." This idea will play a part later in our history.
The Pythagorean schools were ultimately replaced by schools formed around Asclepions. And in either case, medicine continued to be taught at schools of philosophy where "some attention was always devoted to medicine as a department of speculative knowledge." (2, page 20)

In this way, physicians were being taught by philosophers.  They were taught by the same philosophers who educated non physicians like Plato (427-347 B.C.) and Aristotle (384-322 B.C.).  This can be seen by "allusions" they made in their writing.  Plato, for example, divided medicine into five branches (2, page 22)
  • Pharmaceutic: Cures by many drugs
  • Chuirurgic:  Cures by cutting and burning
  • Dietetic:  Produces a change in the disease by a change in their diet
  • Nosognomic: Makes known the character of disease
  • Boethetic: Instant assistance palliates suffering (2, page 25)
So it was in this way medicine was transformed in Ancient Greece.  It was transformed from superstition to philosophy, and ultimately from theory to experience.

References:
  1. Suter, Joanne, editor, "Fearon's World History," 2nd edition, Paramount Publishing, 1994
  2. Watson, John, "The medical profession in ancient times," 1856, Baker and Godwin, New York
  3. Meryon, Edwared, "The 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 empiricism to the dignity of a science," volume I, London, 1861, from the miscellaneous writings of Lord Macaulay
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Wednesday, April 29, 2015

800 B.C: Homer was first to use the term asthma

Bust of Homer (British Museum, London).
  
As a child, Homer (800 or 850 B.C.) listened to poems recited by his dad about a war that occurred almost 400 years before he was  He was so impressed that as a young man he spent many hours in the open courtyard writing them down.

He couldn't remember word per word the stories his dad told. What made it even more confusing was that his uncle sang the same stories, only the twists and turns were different. The names used, the plot, the ending, and the morals learned, however, were the same no matter who told the stories.

So, many years later, as he was jotting down the stories from memory, he realized it was okay to exaggerate and to expound at times in order to make his story more complete.  The important thing was to have the story in writing so future generations could tell the same story every time it was told.  

As the years passed Homer became so rapt in his task that he became the slightly obese middle-aged, bearded man that is represented in the various busts of him. He would go down in history as one of the first and greatest story tellers of all time.

Whether or not he was actually the first to tell these stories may never be known, although what is known is he is often given credit.  This was because, unlike the ancient Egyptians and Mediterraneans, the ancient Greeks liked to associate works of writing to either the author or some famous person.  While Homer may not have been the creator of the Iliad, he is given credit as it's creator because he was the first to take the time to write it down on paper.  (1, page 19-20)

It was a story of a siege at Troy estimated to have occurred between 1194-1184 B.C. (4, page 46)  After writing this story, Homer would write many more.  As eluded to above, he probably obtained most of his stories from those told by his ancestors by word of mouth, mainly through poems and songs that were easy to remember.  (1, pages 19-20)

Another thing Homer did, as his father and uncle did earlier, was add into the story modern events.  This made the story more interesting to the modern audience. While he may not have known it at the time, this would give future historians a better idea of what life was like in ancient Greece.  (1, page 19-20)

The story would also become significant to medical historians, because Homer made allusions to the state of medicine at the time.  While he described the battles, he also described battle wounds, and the symptoms that resulted from these wounds, sometimes in the process of dying.  So various medical historians have made reference to these allusions as some of the earliest knowledge of medicine. (1, page 19-20)

Homer was also the first, or so it is thought, to use the term asthma (άσθμα) in an actual piece of literature. (2, pages 10-11)

The term asthma is referenced in the Iliad, book XV, line 10:
"He saw Hector lying on the plain, his companions
sitting round him. Hector was gagging painfully,
dazed and vomiting blood." 
In this scene Zeus wakes up as the Greeks are trying to push a line of Trojans back, and he finds the Trojan leader Hector breathing painfully and vomiting blood. The above is the English translation, although the word Homer used for "gagging painfully" was asthma or asthmati.

Homer later made another reference to asthma in the Iliad, book XV, line 290:
"He was just starting to recover,
to recognize his comrades round him. He'd stopped
gasping and sweating, for aegis-bearing Zeushad revived his mind"
In this scene Homer described Hector as just starting to catch his breath.

Homer used the term asthma to refer to being winded as from fighting in battle, or as from wounds obtained in battle.  It made sense to use the term asthma this way, because it was a term meaning short, gasping breaths.  It was a vague term used simply to describe the symptom of dyspnea, or shortness of breath, regardless of the cause.

Another term that was sometimes used by the Greeks was panos, which meant panting.  Homer apparently preferred the term asthma, as opposed to panos. Perhaps due to this preference the term asthma is still used to this day, and panos has been lost to history.

Another early description of asthma was the sacred disease.  Actually, epilepsy was the sacred disease because the seizures were thought to be caused by divine intervention.  Those with the disease were thought to be rewarded with happiness in the next world.

Asthma was also referred to as the sacred disease simply because it was thought to be epilepsy of the lungs.  Perhaps the gasping efforts of the asthmatic made the chest appear as though it were seizing.  So if you had asthma you were blessed with eternal happiness.

While asthma was considered a divine blessing, this does not mean that the gods didn't cause all other diseases too, because they did.  This is confirmed, perhaps, by homer in his Odyssey (ix. 411):
"The blinded and howling Cyclops is told by his friend that, if he is ill, he should remember that sickness comes from Zeus and is unavoidable." (3, page 38)  
Homer did not, however, refer to the "disease" asthma. His use of the term was simply to describe the symptom of dyspnea, or air hunger, or shortness of breath.

References:
  1. Sigerist, Henry E, "A History of Medicine," Volume II, 1961, Oxford University Press, New York, pages 19-20
  2. Jackson, Mark, "Asthma: The Biography," 2009, Oxford University Press, pages 10-11.  Note:  While Mark Jackson is not the only person to acknowledge the Iliad as the first reference to the term asthma, I still want to give him credit here.  
  3. Withington, Edward, "Medical History from the earliest times," 1894, London, page 38
  4. Buck, Albert Henry, Williams Memorial Public Funds, "The growth of medicine from the earliest times to about 1800," 1917, London, Oxford University Press
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Tuesday, April 28, 2015

800 B.C.: The beginning of Western Medicine

Thales of Miletus (620-546 B.C.) is known
as the first Greek philosopher. 
Why?  How?  These are questions people in Ancient Greece started asking around 800 B.C., the same time that Homer was busy transcribing ancient prose into writing.  They asked questions like:  are the gods really responsible for all good and evil?  Why was the world created?  How was the world created?

According to Henry Sigerist, "A History of Medicine," prior to this time people tried to master nature, to live within it, and to cope with it.  Yet after this time the emphasis was changed to an effort to understand nature.  Why are the trees green?  What are the main substances of life?

One of the first Greek men to record such thoughts was Thales of Miletus, who lived around 585 B.C.  While he didn't have access nor knowledge of science, he made speculations based on his observations.  Sigerist said he concluded that "life was bound to the presence of water." (1, page 90)

Likewise, Sigerist said, Thales believed that life was not created spontaneously by the gods but "developed gradually from a primary element through natural processes which could be observed every day.

Aristotle (384-322 B.C.) later listed Thales as the first of the great Greek philosophers.  This is significant to the history of medicine because it got people to thinking about the most common problems of life.  They started asking questions about life, and health, and disease.  They started speculating of solutions other than seeking out the gods for answers.

Anaximander (610-546 B.C.) was the pupil of Thales.
Around 560 B.C. Anaximander didn't believe one element could make up the world, and he speculated their were four such elements:  "water, earth, fire and air, with their qualities, wet, dry, hot, and cold -- were derived from one common indeterminate substance.  

From these substances, with their primary pairs of opposites, he came to his own speculations as to how the world was formed.  He even went as far to speculate that lightning was not caused by the god Zeus but by a natural phenomenon.  

Yet his theory of two pairs of elements with their opposite qualities may have been the beginnings of the theory of opposites later postulated by Heraclitus  and refined by other scientists until the Hippocratic writers tied all these theories together to the culmination of ancient Greek medicine.

Around 450 B.C. Empedocles provides us with a variety of writings about his view of the world.  He likewise believed the world was created by four basic elements:  water, earth, fire and air.  He was the first to speculate that air was a substance that could affect other substances including the flow of blood.  For his many speculations he's often given credit as the Father of Modern Chemistry.  (1, pages 105-107)

Empedocles (490-430 B.C.) was the first to write about the
power of the four elements, qualities and humors.  
Ideas that started with a few men asking questions evolved through time.  It started out as philosophy and ultimately turned into the science. From here it turned into the first medical schools that pre-dated the Ancient Greek Schools of Medicine that influenced the authors of the "Corpus Hippocraticum."

These original schools were not associated with buildings, and there were no school books, or no medical texts.  Rather, schools were associations of teacher and student.  The students would follow the teacher to learn the craft, and the teacher would hold classes at random places to teach his wisdom.  The students and the teachers would carry with them the tools and drugs needed and they would practice medicine and even perform surgeries.  As the need arose these "schools" could move from one location to another with ease.  (1, page 100)

Philosophy is the search for wisdom, and all known wisdom -- mathematics, philosophy, science, astronomy, astrology, natural medicine, mythology, etc. --was taught at these schools, regardless of what career was ultimately sought.  Both Hippocrates and Galen would later explain that this was a good thing, because a good physicians would be well rounded in all wisdom.

Of this, Hippocrates said:
It may be concluded then... that knowledge and medicine must go hand in hand. The physician who is truly a philosopher is a demigod. Medicine and philosophy are closely allied. That which is taught by the latter, is practised by the former,—contempt of riches, moderation, decency, modesty, honour, justice, affability, cleanliness, gravity, a just appreciation of all the wants of life, courage in adversity—opposition to fraud and superstition, and due consideration of the Divine power. (2)
As historians traced Ancient Greek history by studying available literature, they learned that some of the first medical schools were formed in Greece sometime around 550 B.C. "in the periphery of the Greek world, in Croton, in Cyrene, and... Sicily, Rhodes, Cnidus, and Cos."  (1, page 89-93)

An ignorant public must have had more faith in the priests at the Asclepion than the remedies of the physicians.  It would be the family of physicians at the school of Cos who aimed to improve this image. This school would ultimately give rise to a man, Hippocrates, who would transform medicine from myth to fact.

What started as a few thinkers asking questions turned into a slow evolution that transformed what would ultimately make Greek philosophy the key to all medical wisdom.

References:
  1. Sigerist, Henry E, "A History of Medicine," Volume II, 1961, Oxford University Press, New York, pages 89-93
  2. Hippocrates, "On decency in manners and in dress," epitomised from the original Latin translations, by John Redman Coxe, "The Writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston
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Monday, April 27, 2015

225 - 200 B.C. Dogmatism is challenged

Even while the dogmatic school of medicine (rational medicine) was being formed at the school of Cos by Hippocratic writers, so too was forming the emperical school of medicine at the school of Cnidos, about 20 miles away. (1, page 29)

In other words: "By the side of dogmatic philosophies Skepticism slowly arose," said Norman Maccoll in 1868.  (6, page 10, 18-19).

What is skepticism?  It is a branch of ancient Greek philosophy thought to have been created by Pyrrho.  Who was he?

Pyrrho lived lived 360-270 B.C., and was among the first of the skeptics, or philosophers who doubted that all wisdom could be learned.  (Skeptic comes from the ancient Greek term "skepsis," which, according to Meriam-Webster, means examination or doubt).

He is often considered as the father of skepticism. His followers were called Pyrrhoneans.  His philosophy was called Pyrrhonism, his school called the Pyrrhonean School. (6, page 13)

However, as was normal for the ancient world, many believe ideas contributed to him arose prior to his lifetime and were merely attributed to him later on.  (6, page 13)

Of his disciples or pupils, Maccoll said the one most important to historians of philosophy was Timon, who lived from 320-230 B.C.  While Pyrrho is known to have written only one poem addressed to Alexander, Timon wrote voluminously. Therefore, it "was through him that Pyrrho's doctrine became first generally known." (6, page 27, 28, 30)

Maccoll wrote that it was Timon who said that a philosopher should ask the following questions:
  1. How are things constituted?  Our conclusions should not come from our opinions or senses because answers derived from them are neither true nor false.  Answers must be derived from empirical evidence. (6, page 21, 22)
  2. In what relation should we stand to them?  We cannot form opinions on things that are beyond our knowledge.  In other words, "We cannot distinguish the false from the true, for both to the senses and the reason all things are alike: they possess no criterion of truth: we must not hazard those decided judgments, in which the dogmatist indulges: we must incline neither to the right hand nor to the left: we must remain unmoved." (6, page 21, 22)
  3. What will result to us from our relation to them? "What effect on our happiness will our attitude to Things have ? This attitude has already been determined to be suspension of judgment. If therefore we are to make a rule of abstaining from all judgments, our happiness must be dependent on this abstinence, and consist in regarding everything external with undisturbed tranquillity of mind; for there is no certainty with regard to what is external, and, where there is no certainty, there can be no happiness. The soul must retire upon itself, looking upon all outside itself as indifferent, and striving to become neither the slave nor the mistress of circumstances, but separate from, and independent of, them." (6, page 21, 23)
Of this third question, Maccoll said: 
The answer to the third question shows the aim of Pyrrho's doubt: like all his contemporaries he searched for a summum bonum: he was not a sceptic in the modern sense of the word : he doubted because doubt appeared to give him the most secure promise of happiness. (6, page 24)
Of the three questions, Maccoll said:
They relate of course to the old points: " Is knowledge absolutely relative ? Is there any objective truth ? Can we have any knowledge of Things as they are in themselves ?" (6, page 31)
The quest of Pyrrhonism was to find the summum bonum, or the highest good. In this regard, Pyrrhoneans were considered eudaemonistic (eudaemonism), which, according to Merriam-Webster, was a theory that the highest goal is happiness and personal well being. (6, pages 8-9,24)

Skepticism died out after the death of Timon, only to be re-established by later philosophers.  (6, page 69)

However, it was from the skeptics, or Pyrrhoneans, that arose the empirical school.  It was the empirics who would ultimately counter dogmatism.  

Empiricism arose through the wisdom of the following triad:  (1, page 29) (3, page 68)(4, page 91)
  • Herophilus:  He lived 325-280 B.C., and came up with many of the theories followed by the the empirical school of medicine
  • Philinus: He was a pupil of Herophilus around 250 B.C., and started the empiric school of medicine
  • Serapion: He was successor of Philinus around 225 B.C., and supported empiricism
This Empirical School of Medicine was basically established to counter the "extravagances" of the Dogmatic School of Medicine at the School of Cos.  (3, page 69)

A common saying of the empiracist was:
"It is not the cause but the cure of disease that concerns us; not how we digest, but what is digestible." (5, page xiii)
The major differences between these schools were as follows:  (1, page 29)(3, page 69) (4, page 68-9)

Dogmatists/ Rationalists/ Hippocratic
Dogmatic School of Medicine
Empiricists/ Emperics
Empirical School of Medicine
Supported ideas of the physician Hippocrates
Supported ideas of the philosopher Pyrrho
Were in search for causes of disease
Were not concerned with causes.  A person was ill is all they needed to know
Speculated on possible causes and remedies
Did not speculate
Created theories to explain causes and why a remedy will work.  Generally, diseases were caused by the body as a whole.
Did not create theories to explain anything.  If something was unknown, it was left at that
Cures were based on the theory postulated. 
Cures were based on experience.  If something worked in the past, it will work today.  Medicine not based on experience could injure
They had few remedies, many of which were harsh, such as bleeding, purging, and vomiting
They had many remedies, and they were generally friendlier than dogmatist remedies and probably worked better
They believed anatomy was important to understand the physiology of disease
They despised anatomy and physiology. 

Serapion was the most outspoken of the empirics, and "he wrote with great vengeance  (1, page 29), as he said:
"What is the use of  knowing the shape and position of the brain and liver, or whether there are such things as brains or livers at all."  (4, page 68)
Another common saying of the empirics was:
"It is not the cause, but the cure of diseases that concerns us; not how we digest, but what is digestible." (4, page 68)
Galen wrote about Serpion the empirist in his Outline of Empericism: (2, page 161)
Of the ancients, however, Hippocrates, Erasistratus, and Herophilus have stated nothing about the treatment suffering from the disease (i.e. lethargy).  But Serapion the Empericist, in Book 1 of his treaties Against the Haireseis, gave some instructions (about this) which are, however, too obscure to be reported here.
Serapion thus became an experimentalists.  He experimented to see what drugs worked best for said disease.  He recorded and made conclusions based on his own observations and experiments, as opposed to coming to speculative conclusions.  (1, page 30)

As described by Edward Withington:
"In short, they (empiricists) reduced the whole art and science of medicine to a system of therapeutics.  A person is ill, that is, he has certain unpleasant feelings or symptoms; surely the first thing to do is to find something which will remove them, and the whole duty of the physician is to discover what particular treatment, and especially what drugs, will get rid of particular sets of symptoms."  (3, page 68-9)
The way to do this is based on the "tripartite foundation" (1, page 30) of the following three methods:  (3, page 69)
  1. Experience:  His own experience and observations
  2. History:  Learning from the experience and observation of his contemporaries and  predisessors
  3. Analogy:  Drawing conclusions based on similar situations to find remedies for new and strange cases
 And thus was formed the Empirical school of medicine.

The empirics were essential to this time because they created an important alternative to the dogmatists, some of whom (see Erasistratus) performed autopsies on live convicted criminals to see what organs did during life.  Hopefully, as some reports suggest, many such victims were given a large dose of morphine before the procedure.  Yet still it was considered inhumane and irrational by the empiricist, and reasonably so.

While the dogmatists based their remedies on speculation, the empiricists used only remedies that were shown by experience to work. This was a viable alternative to the extreme remedies of bleeding and purging used by many dogmatists.  The empiricist also added quite an array of new remedies, including opium and sulpher.

The dogmatists became known as rationalists due to their desire to rationalize diseases and their remedies.  They believed "everything must have a sufficient reason for its existence," Empirics believed what can be observed by experience is known, and what is not known is not to be speculated upon.

References
  1. 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,
  2. Eijk, Philip J., editor, "Ancient Histories of Medicine: essays in medical doxography and histeriography in classical antiquity," 1999, Boston,
  3. Withington, "Medical History from it's Earliest Times: a popular history of the healing art," 1894, London, The Scientific Press
  4. Watson, John, "Medical Profession in Ancient Times: an anniversary discourse delivered before the New York Accademy of Medicine November 7, 1855," 1856, New York, Baker and Godwin
  5. Brock, John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
  6. Maccoll, Norman, "The Greek Skeptics from Pyrrho to Sextus: An Essay which obtained the Hare Prize in the Year 1868," 1868, London and Cambridge, Macmillan and Co.
  7. "Ancient Greek Skepticism," Internet Encyclopedia of Philosophy, http://www.iep.utm.edu/skepanci/, accessed 6/20/14
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1194-800 B.C. Medicine in Ancient Greece

A Healing Temple of the god Asclepius
If you had an internal disease like asthma around 1194-800 B.C. and lived in Greece, chances are you wouldn't go to see a doctor. Physicians existed, but they were more trained to treat wounds such as those obtained in battle.   The person you'd go to see would be your priest, magician or witch.

The reason was simple:  most ancient societies, the Greeks included, believed disease was caused by the wrath of the gods.  To get your remedy you needed to find a person -- a priest, witch or magician -- to help you find out which god was mad at you and why.  Then you'd have to learn how to make that god happy again so you would have a shot at getting better, explains Henry E. Sigerist in his book, "A History of Medicine."  (1)

Yet the more common option, as Sigerist notes, would be to seek out your priest to learn what kind of offerings to make to the gods for healing.  This was more common because it was far less expensive than seeking a potion offered by a magician or witch.  (1)

He may prescribe for you a magic amulet, an incantation, and quite possibly an animal sacrifice, a pig perhaps, or a goat. Such a sacrifice would show the angry god that you value his wisdom over your own possessions. Since the gods were thought to live and breathe and eat like men in the Heavens, the sacrifice was thought to provide a food offering to the god.

This was a common form of medicine in the ancient world, a bribe of sorts.  I will provide you with this food offering if you make me well again.

A common ritual was to travel to the god's temple by walking, riding a horse, riding a donkey, or riding a cart.  The temple belongs to one of the healing gods, such, as Asclepius.  You'd spend time amid the priests, who had the ability to talk to the gods and hear their advice for healing.  Most often you'd sleep among them, and in the morning your cure would be revealed.

In this way, you received the healing benefits this god had to offer.

There were many such temples scattered around ancient Greece, and often they were associated with nearby hostels to house those who traveled for this purpose. Some early historians, Sigerist said, believed these "hostels attached to the Ascelpia were the first Western hospitals and poorhouses where indigent sick people stay and are treated by priest," writes Sigerist (1, page 73)

Later historians noted that these weren't hospitals in the way we think of them today, as the sick merely spent time there to learn the cure; they did not stay in the hostels until they were healed, but just one night.

Priestly healing was very common during this era.  In fact, the belief gods were responsible for good luck and bad luck, health and healing, made worshiping the god Asclepius very popular even up to the Birth of Jesus Christ.  Sigerist explained that it was for this reason the pagan god Asclepius was the greatest competitor of Jesus Christ. (1)

Sigerist said that one of the main reasons Asclepius was the greatest competitor to Jesus Christ was because he wasn't as greedy as the other gods, and he would accept even modest gifts.  This made it possible for him to be worshiped by both the rich and the poor. (1)

This was significant, because poverty was one of the main attractions of Christianity.  The poor couldn't afford physicians, nor the sacrifices demanded of most gods, and so Christianity was a viable option.  Yet so too was the god Asclepius.

Over time there was another medical paradigm that was growing in popularity and significance in ancient Greece, and that was the belief in natural medicine.  Some priest physicians were knowledgeable of which plants had medicinal and poisonous properties.  As time progressed, even the common folks were privy to this knowledge.

A good example of this was explained in the Odyssey by the great Greek poet Homer.  Henry E. Sigerist, explains the following: (1)
"There is relatively little mention of magic in the Homeric epics although the ancient Greeks believed in magic and, like everyone else in antiquity, practiced some...  The drug given to Helen by the Egyptian lady, Polydamna, had strong euphoric properties, so that whoever took it forgot all unpleasant memories and would not shed a tear even if his closest relative died; this drug might be opium or hashish, but it could just as well be the kind of miracle drug found in many fairy tales." (1)
As Sigerist explained, the Odyssey cannot be taken seriously.  However, it was based on real life events. The Greeks probably had access to various medicines, such as opium and hashish, and simply told of this medicine as a magic potion created by, say, witches or magicians.  Since the gods created everything, then they must have also created the magical powers present in some plants.

Knowledge of the inner organs and what they did was limited, yet observations from experience working with the wounded and the dead gave soldiers a pretty good idea where to aim their weapons to produce the most damage to the enemy's body.  They knew the best places to aim their arrows were the lower abdomen or, better yet, the nipples.

Physicians had magic healing powders and soothing drugs used to help people who were wounded in battle.  These tales also describe various poisons.  For example, Sigerist noted a line from Homer's Odyssey:
"Circe was a beautiful witch who could transform human beings into pigs, and it is absurd to assume that Eurylochus (a companion of Odysseus) who told the story had been the victim of hallucinations."  (1)
While these stories are twisted and turned into a memorable fairy tales, they may actually be descriptions of poisons used to punish or kill an enemy.   Although, whether this was the case we may only speculate.

While all ancient medicine started off as mythical, natural medicine was soon a viable option. Natural medicine may have been resisted at first, although through time its benefits were so obvious they could no longer be resisted.  So, of course, natural remedies found their way into mythology.

Over time, the two forms of medicine -- mythology and natural medicine -- would separate into two separate paradigms.

*Note: The dates chosen for this article are based on the estimated dates for the writings of Homer (800 B.C.) and the siege of Troy as described in Homer's Iliad (1194-1184 B.C.). The medical knowledge expressed in this post may also have effected you prior to and after these listed dates, which are mainly listed simply as a reference to make it easier to write a history, and easier to picture in your head where these events may have occurred. And even if you lived in Greece during these times, you may also have been subjected to primitive medicine, or pre-Greek medicine. I obtained the dates from Albert Henry Buck in his book "The growth of medicine from the earliest times to about 1800." (1917, London, Oxford University Press, page 46).

References:
  1. Sigerist, Henry E, "A History of Medicine," vol. II, "Early Greek, Hindu, and Persian Medicine," 1961, Oxford University Press, pages 19, 20, 23, 28, 51

Sunday, April 26, 2015

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

Saturday, April 25, 2015

1700-1940: 'The asthmatic pants into old age'

There is a stunning array of evidence that prior to the 1950s, and even into the 1980s, physicians had a view of asthma as a benign disease; that morbidity (severity) and mortality (the death rate) from asthma was negligible.  The evidence comes in the form of quotes from the physicians themselves.

Dr. William Cullen (1710-1790), who wrote extensively on asthma, said:
"The asthma, though often threatening immediate death, seldom occasions it; and many persons have long lived under this disease. In many cases, however, it does prove fatal; sometimes very quickly, and perhaps always at length." (6, page 451)
Dr. William Withering (1741-1799), who recommended the diuretic digitalis for asthma, said:
  "The disease does not cut short the usual period of life." (4)
Dr. Rene Laenec(1781-1826) , the inventor of the stethoscope, said:
Asthma gives the patient the best hope of a long life. (9)
An attack of purely nervous asthma is rarely fatal. (17, page 443
Dr. Armand Trousseau (1801-1867)said:
Asthma was "the certificate of a long life."  (9) 
Dr. Francis Hopkins Ramadge, in his 1835 book "Asthma, its species and complications," said:
The prognosis of asthma is seldom difficult.  Doubt can arise only in cases severely complicated. When asthma wears the purely nervous form, danger is rarely to be apprehended." (18, page 36)
Dr. Walter Hyde Walshe, in his 1871 book "A practical treaties on diseases of the lungs," said:
Spasmodic asthma not only does not directly destroy, but is compatible with remarkable prolongation of, life: the popular adage likens the possession of the disease to a " lease of a long life." (19, page 551)
Dr. Henry Hyde Salter, in his 1882 book "On Asthma: It's Pathology and Treatment, said:
"Asthma never kills; at least I have never seen a case in which a paroxysm proved fatal." 
(2, page 82)
Salter also said this:
"If death did take place from asthma it would by by slow asphyxia -- by circulation of imperfectly decarbonized blood; and before this occurred I think the spasm would yield."
Dr. J.B. Berkart, in his 1878 book "On Asthma: It's Pathology and Treatment," said:
"The prognosis of life is generally favorable.. the patient lives to the age of seventy and beyond, in spite of the intercurrent attacks of dyspnea." (10, pages 204-205)
Dr. John Thorowgood, in his 1878 book "Notes on Asthma," said:
During the intervals between his attacks the patient probably enjoys fair health, and, as a rule, lives to a good age; should he, however, be cut off prematurely by death; should he, however, be cut off prematurely by death, what do we find as the morbid anatomy to explain the wel marked symptoms seen during life? (16, page 2)  
Thorowgood also notes the following:
The prognosis in asthma is generally good, and asthmatics are well known to be, as a rule, long-lived; so that invalids who may have been for some time suffering in the chest are wont to feel much satisfaction and comfort when they are assured that their complaint is " only asthma," or is likely to " turn into asthma."  (16, page 35)
Dr. William Aitken, in his book "The Science and Practice of Medicine, said:
"Asthmatic patients generally live to a good old age." (5, page 489)
Osler also wrote in his 1892 medical textbook "The Principles and Practice of Medicine:
"We have no knowledge of the morbid anatomy of true asthma.  Death during the attack is unknown." (8, page 4)
Dr. Anthony Rebuck and Dr. Kenneth R. Chapman said in 1987:
It is now general knowledge that asthma can be fatal and that in some countries with a sophisticated level of medical care the death rates appear to have been increasing. Yet as recently as 1983 an editorialist in the Lancet found it necessary to point out that some physicians still considered the disease "a benign nuisance related mainly to emotional problems" (14, page 353
Dr. William Osler (1849-1919), the father of modern medicine, said in 1901:
 "The asthmatic pants into old age." (4)(7, page 3 and 11)
Dr. Lawrence K. Altman, in the 1990s, said the following:
In 1963, Dr. H.L. Alexander of St. Louis concluded that, prior to 1930, "death during an asthmatic attack was almost unknown." 
Altman also said:
"It (this belief) persisted well into this century.  A textbook in 1935, for example, said that the life of an asthmatic is not endangered. (8, page 4)
References: 
  1. Garrison, Fielding Hudson, "Introduciton to the history of medicine," 1922, London, W.B. Saunders Company
  2. Salter, Henry Hyde, "On Asthma: It's Pathology and Treatment," 1882, New York, William Wood and Company
  3. Brenner, Barry, editor, "Emergency Medicine," 1999, New York, Marcel Dekker;  Brenner writes in his forward that "Osler though asthma never caused mortality." 
  4. Christennsen, Alan, Michael Antoni, editors, "Chronic Physical Disorders: Behavioral Medicine's Perspective," 2002, United Kingdom, Blackwell Publishers LTD., page 247
  5.  Aitken, William, "The science and practice of medicine," volume II, 1872, Philadelphia, Lindsay and Blakiston
  6. Cullen, William, "The works of William Cullen, M.D.," Volume II, London, 1827 (also see his book "First Lines of the Practice of the Phsych," 1784, Edinburgh, Vol. 3, 4th ed., page 399)
  7. Altman, Lawrence K., "The Public Perception of Asthma," Chapter one of the book "Fatal Asthma," edited by Albert L. Sheffer, New York, Marcel Dekker, Inc, pages 3 and 11. Lawrence notes the following about this quotation by Osler: "The origin of this statement is obscure.  Many authors have said it was one of Osler's aphorisms.  However, it is not included in the book of aphorisms." Other notable authors credit the following: William Henry Osler, "Principles and Practice of Medicine," 4th ed, 1901, Pentland, Edinburgh,
  8. Altman, ibid, page 4. Lawrence notes the following reference: "Osler W. The Principles and Practice of Medicine. Edinburgh: Petland, 1892
  9. Quoted in a variety of sources
  10. Berkart, J.B., "On Asthma: It's Pathology and Treatment," 1878, London, J&A Churchill
  11. Altmon, op cit, page 4.  The reference Altmon is referring to comes from an article by Speizer and Doll (see reference 12 below)
  12. Speizer, F.E., R. Doll, "A Century of Asthma Deaths in Young People,British Medical Journal, 1968, 3, 245-246
  13. Altman, ibid, page 2
  14. Rebuck, Anthony S. Kenneth R. Chapman, "Asthma: 1. Pathophysiologic features and evaluation of severity," Canadian Medical Association Journal, February 15, 1987, volume 136, pages 351-354.  The reference here referred to by the authors is "Childhood asthma", Lancet, September, 1983, volume 322, issue 8351, pages 659-660
  15. Speizer, F.E., R. Doll, P. Heaf, "Observations on recent increase in mortality from asthma," British Medical Journal, February 10, 1968, 1, pages 335-339
  16. Thorowgood, John Charles, "Notes on Asthma," 1878, 3rd edition, London, J and A Churchill
  17. Laennec, Rene Theophile Hyacinthe, "A treaties on the diseases of the chest, and on mediate auscultation," tranlated by John Forbes, 1838, New York, Philadelphia, Samuel S. and William Wood, Thomas Cowperthwaite and Company
  18. Ramadge, Francis Hopkins, "Asthma, its species and complications, or researches into pathology or disordered respiration; with remarks on the remedial treatment applicable to each variety; being a practical and theoretical review of this malady, considered in its simple form, and in connection with disease of the heart, catarrh, indigestion, etc." 1835, London,  Longman, Rees, Orme, Brown, Green, and Longman
  19. Walshe, Walter Hyde," A Practical Treaties on the Diseases of the Lungs," 1871, 4th edition, London, Smith, Elder & Company

Monday, April 13, 2015

950 B.C.: Solomon will heal your asthma

King Solomon engraving
by French artist Gustav Dore
(1832-1883)
He was the son of David, the slayer of Goliath, and he reigned as King of Israel from 970-931 B.C. He is considered one of 48 Biblical prophets, and that means that he had healing powers.

As an educated man, he most surely would have received knowledge of health and healing. What this healing powers entailed no one knows.  

For evidence of this healing power we need look no further than the Bible itself.  One example can be found in Acts of the apostles 5: 12-16:
And by the hands of the apostles were many signs and wonders wrought among the people; (and they were all with one accord in Solomon's porch.  And the rest durst no man join himself to them: but the people magnified them. And believers were the more added to the Lord, multitudes both of men and women.) Insomuch that they brought forth the sick into the streets, and laid them on beds and couches, that at the least the shadow of Peter passing by might overshadow some of them.  There came also a multitude out of the cities round about unto Jerusalem, bringing sick folks, and them which were vexed with unclean spirits: and they were healed every one.
Perhaps among them were folks with asthma, or allergies, or bronchitis, or heart failure, or kidney failure or some other respiratory disorder. Perhaps it was a person who was near death, dyspeic due to failure of the various organs of the body.  All of these would have been healed through the healing powers of the prophet and King: Solomon

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Sunday, April 12, 2015

1200 B.C.: Asthmatic Hebrew Girl

The Israelite children were amused in song as the ladies stood by in delight. Yet one girl, her name is Adina, does not sing. She stands near the edge of the woods, leaning against a tree, her shoulders hunched high, her breathing obviously heavy. Instead of song she mouths words of prayer to the Jewish God for healing.
How blessed is he who considers the helpless; the Lord will deliver him in a day of trouble.The Lord will protect him and keep him alive,and he shall be called blessed upon the earth...The Lord  will sustain him upon his sickbed; in his illness, You restore him to health.
It's a psalm (Psalm 41:1-3) she sang when her breathing was labored, and lately this was often.  She prayed and she stood in the back of the group hoping no one would notice; hoping savta (grandma) didn't notice, because savta surely would pay Adina special attention Adina felt she didn't deserve.

I interviewed Adina for several hours as we walked through the woods.  She showed me her favorite place of worship in a clearing where the sun showed bright and hot overhead.  It was her God peering down upon her, blessing her with His touch.  She knelt in prayer and encouraged me to do the same.  

In a mellifluous whisper she prayed, a psalm of healing (Psalm 57: 2-3):  "I will cry out to God Most High, to God who performs all things for me.  He shall send from heaven and save me." 

As if on cue a soft, fresh breeze wafts over the field causing the grass and leaves to talk.  "It's our God talking," she says.  She smiles brightly, holding firmly in her grasp the device that saved her, the device that gave her her breath back, the device I brought with me from a distant time, a time when her God, the Israelite God, is still worshiped.  

"Do you not have natural remedies?" I ask.  "Something like that inhaler, something you inhale, that gives you your breath back like that inhaler did. It's a natural remedy."

"No," she answered swiftly.  "God alone decides who is sick and who is well.  His people see it as pointless, blasphemous, to take measures that would interfere with His will."  (Prioreschi, vol I, page 520)

"I consider that inhaler," I motion to the blue device in her grasp, "a gift from God. Why wouldn't your people?"

"I guess we are not there yet," she closes her eyes.  "We do have physicians, although they are from distant lands.  They have what you call natural remedies.  They have salves and smoke to inhale through reeds.  Savta has me use such from the chabash (Prioreschi, page 521)although sometimes they make me worse.  I don't want to insult her, so I try to hide my," she pauses as though in search of the best word, "dyspnea, as you call it."  

After saying several prayers with her, and listening to her sweet voice sing many others, I was summoned back to the time machine.  On the way back to 2012 I reviewed Plinio Prioreschi's "A History of Medicine, where he listed the following Biblical references to physicians and natural medicine:

And Joseph commanded his servants the physicians to embalm his father...  (Genisis, 50: 2)

And Asa in the thirty and ninth year of his reign was diseases in his feet, until his disease was exceeding great: yet in his disease he sought not to the Lord, but to the physicians. And Asa slept with his fathers, and died in the fortieth year of his reign. (II Chronicles, 16: 12,13)
But ye ar forgers of lies, ye are all physicians of no value.  (Job, 13: 4) 
Is there no balm in Gilead; is there no physician there?  why then is not the health of the daughter of my people recovered? (Jeremiah, 8: 22)
...shall grow all trees... and the fruit thereof shall be for meat, and the leaf thereof for medicine. (Ezekiel, 47: 12) 
...thou has no healing medicines... (Jeremiah, 31: 13)
...in vain shalt thou use many medicines;; for thou shalt not be cured.  (Jeremiah, 46:11)
A merry heart doeth good like a medicine:  but a broken spirit drieth the bones. (Proverbs, 17:22)
We must understand that the Ancient Hebrews, the Israelites, as Adina said, had access to physicians and natural medicine, although they were more focused on using prayer for it's healing purposes.

The reason was, or may have been, because the Hebrews believed God created all things, including health and sickness.  For this reason, to seek a physician for medicine may have been seen as "blasphemous," said Prioreschi (1, page 526-7).

Physicians were only sought when prayer failed to work.

This may have been for the best too, as natural remedies were sometimes worse than allowing nature to take it's course.

Note:  Chabash is a Biblical term used for healer (Prioreschi, "A History of Medicine," Vol. I, second edition, 1996, page 460, page 521 in the first edition printed in 1991).  Teruphah is Hebrew for "healing reemedy." (Prioreschi page 535)

References:

  1. Prioreschi, Plinio,"A History of Medicine," volume I, pages 516 and 521

Saturday, April 11, 2015

1500 B.C.: Asthma in Ancien Egypt: the Ebers Papyri

Thoth: Scribe of the Gods ( The British Museum)
Thoth was the Egyptian moon god, and he had a significant role in medicine that was eerily similar to that of Apollo a thousand years later in ancient Greece

It is believed he talked to an Egyptian priest (or priests) during the early ages of Egypt, and this priest (Imhotep perhaps?) wrote down the wisdom he learned from the god. There are various references to these documents by various physicians, although the original texts have long disappeared. (2, page 19)(4, page 49)

However, this theory, while garnishing some excitement, was ultimately believed to be untrue, as experts now figure the document to be an encyclopedia of all sorts of medical wisdom from various ancient documents. (9, page xv)

Smith Quotes Warren R. Dawson from his 1929 book "Magician and Leech" as saying the Ebers Papyrus is basically a compilation of recipes for the various ailments of that time taken from various other books that are "many centuries older."  (9, page xv)

Dawson, referencing Smith, said the Ebers Papyrus... (9, page xv)
"...is not a book in the proper sense of the word: it is a miscellaneous collection of extracts and jottings collected from at least forty different sources. It consists mainly of a large collection of prescriptions for a number of named ailments, specifying the names of the drugs, the quantities of each, and the method of administration." (9, page xv)
As noted above, a few sections deal with diagnosis, symptoms and anatomy. (9, page xv)

This theory may be supported by the fact the papyrus has scribbles in the margins, such as "this is a genuine remedy," or "Excellent. I have often made it, and also proved it," said medical historian Edward Withington. (2, page 17) 

Perhaps notes similar to these were scribbled next to the description of our first inhaler:
Thou shalt fetch 7 stones and heat them by the fire, thou shalt take one therof and place (a little) of these remedies on it and cover it with a new vessel whose bottom is perforated and place a stalk of a reed in this hole; thou shalt put thy mouth to this stalk, so that thou inhalest the smoke of it. Likewise wit all stones. Thereafter thou shalt eat something fat, of fat meat or oil." (6, page 9)
It is unclear exactly what herbal preparations were used, although it's probable that they used stramonium, belladona, henbane, and bitumen to "alleviate catarrh and coughs, and ease breathing," said Mark Jackson in his article, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma." (14, page 174)

One major difficulty with interpreting these old documents, or so the experts say, was that it may sometimes be difficult to translate Egyptian writing into our modern language. This in mind, I think, therefore, I can honestly say there is scanty evidence this Egyptian "inhaler" was used for anything more than a priest-physicians's trick to fool a patient into thinking something was being done, perhaps by the magic of the gods.

Henry Sigerist, in his 1951 book "A History of Medicine: Primitive and Archaic Medicine," said that "Fumigations were not infrequently used in the treatment of anus and vagina and a recipe of the Berlin Papyrus (and Ebers Papyrus) tells us what the technique was. Seven bricks were heated, and the cold drug was poured over one after another while the patient was held over the developing fumes."

My point here is we must be careful in thinking any inhalers or fumigations used by the ancient Egyptians were anything more than just something that was not understood being used for an ailment that was not understood. 

Jackson said:
While (Eber's) specific interpretation has been challenged by other translators, the papyrus certainly appears to list remedies to remove phlegm, alleviate catarrh, coryza, and coughs, and to ease breathing. Significantly, Egyptian treatments for respiratory conditions included not only the oral consumption of a variety of concocted vegetable, mineral, and animal products but also the delivery of active substances directly to the lungs by inhalation. (13, page 38)
So, as you can see, we could easily use our imaginations here as it comes to the treatment of asthma in ancient Egypt. You are short of breath, you call for a priest/physician, and a specialist comes to your house. You hope he's an Internist who specializes in diseases of the chest, and you hope he has knowledge to this primitive inhaler, and that he also has a medicine called Belladonna that he tosses on those heated bricks. Belladonna would take the edge off by easing both your breathing and your mind.

Sigerist said the teeth, where food enters, and the anus, where food exits, were highly regarded by the ancient Egyptians. Sigerist even notes various references to "the holy anus," and "shepherd of the Anus." (5, page 317, 335)

These shepherds were probably physicians who specialized in ailments of the anus, such as "hemorrhoids, prolapsus recti, inflammation and pruritus of the anus." (5, page 317, 335)

The pharaoh had his very own anal physician to take care of it, and perhaps this physician recommended this inhaler for hemorrhoids, a remedy we might think of as purely irrational, although to the Egyptians, it was most surely rational. (5, page 317, 335)

We must realize that Egyptian physicians had scanty knowledge of anatomy, and this is true despite the fact they prepared animals for food and sacrifice, and humans for mummification. They knew about the inner organs, and they knew about vessels and blood, but they didn't know about the relationship with these and ailments of the body. They did not make that connection.

So they would have no idea about diseases like asthma, nor other diseases that would make a person short of breath. Basically, all physicians could do was note the symptoms -- chest pain, short of breath, wheezing -- and what remedies seemed to work.

Likewise, it must be understood here that Egyptian medicine was based on mythology, and ailments were caused by the wrath of gods, particularly the god Isis. So remedies, in a sense, were believed to be gifts from the gods of health and healing, such as Isis, Thoth, Sekhmet, Heka, Serket, and Ta-Bitjet. They worked by magical means. So while these remedies may seem irrational to the modern reader, they were quite rational given the medical wisdom of the time.

Once translated, the Ebers Papyrus scroll was learned to contain over 700 magical formulas as remedies for the most common ailments of that time, with various incantations randomly assorted through the text. Some of the remedies included pills in the form of dough, herbs and minerals that were put into beer and wine, salves and oils to rub onto the skin and wounds, a salve made from honey was put over wounds, and gargles and inhalations.

If you had complained of an ailment, a physicians would be summoned. Egyptian physicians specialized in particular symptoms, so you would see a physician who specialized in treating your symptoms. If your specialist was an internist, perhaps you would be provided with the remedy above, which may actually contain breathing relief, considering Belladonna was later proven to contain a mild bronchodilator component.

Yet, more than likely, your treatment would be a general treatment. Since the Egyptians were among the first society to attribute sickness to good health, he might suggest something simple to cleanse your body, which may involve any of the following:
  • Enemas (the stomach was believed to be a cause of most diseases, including breathing problems)
  • Emetics (to vomit out the poisons)
  • Animal excreta (including crocodile and camel)
  • Herbs such as squill and henbane
  • Fumes of burned sundried and crushed Belladonna leaves and roots (as noted above)
  • Eating foods such as figs , grapes, frankincense, cumin and juniper fruit
  • Drinking wine and sweet beer 
Along with the above treatments, the following were considered routine in order to keep your body clean: (11, page 18, 23)
  • Daily baths
  • Abstinence from certain foods (like cow flesh, pigs, flatulent beans, etc.)**
  • Gymnastics
  • Linen clothing worn for cleanliness
  • Purgatives and emetics every three months to cleans body***
  • Friction and inunction of the body (basically involves rubbing certain parts of the body)
  • Fumigations (usually during epidemics to "purify the air."  
  • Inhaling steam from inhalations 
  • Careful system of nurturing from childhood
  • Incantations (magic words)
  • Amulets (to wear or keep close to you and or your home to ward off spirits and for healing)
Or, if your asthma-like symptoms were diagnosed as being caused by witchcraft, the following remedy may be used:
"Against all kinds of witchcraft -- a large beetle; cut off his head and wings, boil him, put him in oil, and apply to the part. Then cook his head and wings, put them in serpent's fat, warm it, let the patient drink it." (2, page 18)
If your physician didn't heal you, you might consult a priest or magician who would provide you with an amulet or incantation to say each morning. Or he might place his gentle palm over your throat or chest and chant an incantation to induce healing and scare away the evil demons that were causing you to breathe heavy. Perhaps the good feeling of hope by this method was more healing to you than what your physician might recommend.

Another neat thing to note here is that by dating the Ebers Papyrus to around 1500 or 1550 B.C., this would place it as being written about the time of the Exodus. That means it was probably written around the time Moses walked the earth, and the wisdom it contained was available to him. So the Bible may provide us with another good source for learning what life was like for Asthmatics in Ancient Egypt.

Further reading:
*Hieratic is a form of Egyptian cursive, and was used "chiefly on sacred and medical papyri and on wooden coffins... the characters are written from right to left... about 300 A.D. all knowledge of the meaning of the characters had died out, and it was not until the discovery in 1799 of the Rosetta stone (by Boussard, a French artillery officer) that any real progress was made in the decipherment." (10)

** Note that the upper classes of Egypt did not eat pig, and despite this, historians note a high incidence of hardened arteries.  One study of Egyptian mummies found hardened arteries in three fourth of the mummies studied.  While this was a recent study, some historians noted this as far back as the 1930s. You can read more about this here

***While many historians have noted the Egyptians to drink to excess, others speculate, that while beer and wine was consumed during meals (and mostly wine), it was watered down and not very potent.   

 References: 
  1. Selin, H., "Encyclopedia of the History of Science, Technology and Medicine in Western Cultures," 2nd edition, 2008, Springer
  2. Withington, Edward Theodor, "Medical History from its earliest times," 1894, London, Aberdeen University Press
  3. Nunn, John F, "Ancient Egyptian Medicine," 1996, University of Oklahoma Press
  4. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia and London, W.B. Saunders Company
  5. Sigerist, Henry E, "A History of Medicine," vol II, "Primitive and Archaic Medicine," 1951, New York, Oxford University Press
  6. Ebell, B.,  translator, "The Papyrus Ebers: The Grea)test Egyptian Medical Document," 1937, Copenhagan, page 67.  I found references to this passage by Mark Jackson (Asthma: A biography," 2009, New York, Oxford University Press, page 39), and Henry E. Sigerist (see reference immediadely above, page 339).  Sigerist says that a similar passage can also be found in the Berlin Papyrus.  
  7. Reference Pending
  8. Osler, William Henry, "The evolution of modern medicine," 1921, New Haven, Yale University Press
  9. Smith, G. Elliot, introduction to Cyril, Bryan,s book, "The Papyrus Ebers," 1930, London, The Garden City Press, Bryan's book was an English translation of the German translation of the papyrus. 
  10. Von Klein, Carl H., "The Medical Features of the Papyrus Ebers," The Journal of the American Medical Association, December 23, 1905, Volume 45, page 1928, George H. Simmons, editor, volume XLV, July - December, 1905, Chicago, American Medical Association Press.  This article provides a fuller story of how the document ended up in the hands of Georg Ebers, how it came to existence, etc.  
  11. Baas, Johann Herman, author, Henry Ebenezer Sanderson, translator, "Outlines of the history of medicine and the medical profession," 1889, New York
  12. Libby, Walter, "The history of medicine in its salient features," 1922, Boston and New York, Houghton Mifflin Commpany
  13. Jackson, Mark, Asthma: A biography," 2009, New York, Oxford University Press
  14. Jackson, Mark, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma," Medical History, 2010, 54: 171-194
  15. "Medicine in Ancient Egypt," Indiana.edu, http://www.indiana.edu/~ancmed/egypt.HTM, accessed on 6/5/14