Wednesday, December 30, 2015

1664: Schneider discovers truth about phlegm

Conrad Victor Schneider (1614-1680)
Ancient physicians believed that phlegm was secreted by the brain, or at least attracted to the brain from food and drink that was taken in.  This continued to be a common theory until Conrad Victor Schneider used the microscope to inspect the nose in the 17th century.

Conrad Victor Schneider (1614-1680) studied the membranes in the nose, and became the first to recognize that phlegm was secreted by this membrane, what is now known as the Schneiderian Memberane.  (1, page 124)

This was a significant revolution, considering Galen believed that when too much phlegm was formed in the brain, it flowed down pathways to the ears, eyes, spine, skin, nose and lungs.  When this occurred the various diseases formed.

Schneider's observation, which was made in 1664, disproved another one of Galen's theories.  It was necessary in order to slowly, ever so slowly, put an end of the age old Grecian theories holding back the medical profession.  (1, page 124)

References:

  1. Bradford, Thomas Lindsley, "Quiz Questions in the History of Medicine," 1898, Philadelphia

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Tuesday, December 29, 2015

1861: Did Martin Van Buren Die of Asthma?

Another historical figure who was diagnosed with asthma was President Martin van Buren.  Although, chances are pretty good it was cardiac asthma he suffered from an not asthma.

Van Buren was born in Kinderhood, New York, to a tavern keeper and farmer.  He grew into a 5 feet six inch democratic republican who was very concerned about his appearance.  For his small stature, he earned the nickname "Little Van."  He was also known as an amiable and social man who loved to drink, and for this he earned the nickname "Blue Whiskey Van."

He was appointed by John Adams to be Secretary of State and Andrew Jackson to be Vice President. He became the 8th president of the United States in 1836. He is often sited as an insignificant President for his failure to end the economic depression that followed the panic of 1832, although further review of the evidence shows that Martin van Buren was a significant President.

Here is what the historychannel.com writes about van Buren's health.
(On January 21, 1862) former President Martin Van Buren, who served as the nation’s eighth president between 1837 and 1841, slips into a coma.
Van Buren, who developed asthma in 1860, had a history of heavy drinking as well as, later in life, cardiac problems. The drinking, for which he had earned a reputation as early as age 25, may have contributed to a host of illnesses he experienced in his lifetime. However, historians claim the man known as “Blue Whiskey Van” had largely given up, or began to hide, his alcohol consumption by the time he became Andrew Jackson’s vice president in 1829.
During his presidency and in subsequent years, Van Buren’s history of drinking, plus his increasing obesity, led to a battle with gout. He caught frequent colds, suffered from serious bouts of flu and developed a nervous stomach. For the stomach ailment, Van Buren was treated with a combination of water, charcoal and soot. After his tenure at the White House, at the age of 71, Van Buren’s continued struggles with gout led him to travel to France to stay at the same spa at which Thomas Jefferson sought treatment in 1821 for a fractured wrist.
Eight years later, as Van Buren developed asthma, his circulatory system began to fail, causing the coma. Three days later, he passed away. Some historians claim that a possible case of sleep apnea, caused by disruptive snoring, may have contributed to Van Buren’s declining health and his ultimate death.
He was diagnosed with asthma in 1860 and suffered from it for several months.  He also suffered from it in 1861. There is not evidence he suffered from asthma earlier in his life.

Chances are that what he suffered from was dyspnea associated with cardiac asthma, and not asthma as we know it today.  Having suffered from obesity, he was accused by the campaign of William Henry Harrison in 1840 as having been a snorer as well. There is no evidence of this, but, considering his obesity, it's likely.

Both obesity and snoring, especially if he had sleep apnea, could contribute to heart failure (a.k.a cardiac asthma).  Cardiac asthma presents eerily similar to asthma.  Given the inability to differentiate between the two at the time, it only makes sense that he would be diagnosed with asthma.

Per drzebra.com: "In early 1862 van Buren was attended by the noted physician Dr. Alonzo Clark in New York ?City, presumably for "asthma." Van Buren returned to his upstate home in May 1862. He was weak and largely bedbound. He developed signs of circulatory failure, such as cold and clammy skin, in mid-July. On July 21 he became comatose, and died three days later, age 79."

You can decide for yourself if Martin Van Buren was a significant President or not.  The challenge here will be staying unbiased while doing your research. This may be difficult considering most Presidential scholars educating kids today tend to teach he was insignificant.

You can also decide for yourself whether he had asthma or not.  This task may be more of a challenge considering the lack of written material regarding the health of the President, particularly prior to his time in public office. Lacking further evidence, I think we can safely say he had cardiac asthma.

Further reading:

Monday, December 28, 2015

1661: Malpighi completes Harvey's work

Marcello Malpighi (1628-1694)
So William Harvey proved that blood circulates through the body and published his proof in 1628.  Yet one thing that limited his research, almost causing it to come to a "standstill," was his inability to see where the arterial system connects with the venous system.

However, this problem would be resolved, thanks to the microscope, and thanks to the investigations of Marcello Malpighi.  He was the first to observe and report capillary anastomosis, which are the microscopic connections joining arteries and veins. (11, page 245)

Malpighi was professor at the University of Bologna.

By using a microscope in 1661, he observed the exchange of air from the lungs to capillaries in a frog.  He therefore was the first person to see the alveoli and capillary system. However, said Garrison, he did not apply much significance to this discovery (7, page 474)  (14, page 142)(11, page 252)

Garrison said that this was the missing link that Harvey was looking for regarding the complete circulation of blood through the body. However, considering Malppighi applied little significance to it, the discovery was not well regarded.  It would be left to a later investigator to complete Harvey's work. (11, page 247, 252)

A few years later, in 1665 he discovered blood corpuscles, (14, page 142) or what we refer to as red blood cells.  These cells are the main constituent in blood, and their main responsibility to is carry oxygen through the blood stream to the various organs of the body.

Malpighi's discover was verified by later observations:
  • Dublin professor William Molyneux observed the capillary system in lizards in 1683.  
  • William Cowper "saw the passage of the arterial into the venous current in the mesentery (membrane that attaches the intestines to the abdominal wall) of a cat in 1687 
  • Anton von Leeuwenhoeck (1632-1723) observed capillaries in the larvae and feet of frogs in 1688 (14, page 142)
References:
  1. Tissier
  2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
  3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
  4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
  5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
  6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
  7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
  8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
  9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
  10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
  11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
  12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
  13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
  14. 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
  15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
  16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
  17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14
  18. "Antony van Leeuwenhoik (1632-1723)," ucmp.berkeley.edu, http://www.ucmp.berkeley.edu/history/leeuwenhoek.html
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1772: Heberden describe cardiac asthma

William Heberden (1710-1801)
William Heberden, sometimes referred to as "the last great physician," is known to the medical community as the first to describe angina pectoris, or what would later become known as cardiac asthma. (1, page 369)(2)

Heberden was born in London in 1710, only a few short years before William Cullen, one of the first physicians to specialize in asthma.  While Heberden did not specialize in asthma per se, he did share his knowledge about the disease.

He was the son of Richard Heberden, a physician who left behind no track of his medical profession.  Because William Heberden showed promise, he was allowed to start secondary school at an early age.  He started at St. John's College and then moved on to Cambridge.  He earned his medical degree in 1739.

Twentieth century medical historian Fielding Hudson Garrison said:
A Cambridge graduate of superior attainments, Heberden was esteemed as one of the finest Greek and Hebrew scholars of his time, and he resembles the classic writers in his careful portrayals of disease. (1, page 369)
Among his most significant accomplishments was his description of angina pectoris, a condition that would later be classified under the rubric term asthma by Erasmus Darwin in 1818, and then would gradually become better known as cardiac asthma, and ultimately become a disease entity of its own.  

Garrison said:
An actual case of angina pectoris was described in the memoirs of the Earl of Clarendon (1632) in the person of his own father, but it was Heberden's classic account that put the disease upon a scientific basis, and his work was soon confirmed by the observations of Parry (1799) and Edward Jenner. (1, pages 369-370)
In 1632, Richard Heberden wrote:
the pain in his arm seizing upon him, he fell down dead, without the least motion of any limb. (3, page 219
Thirty-six years later, in 1768, his son William Heberden first first described angina pectoris to the Royal College of Chest Physicians. His description was later published in 1772 in his book "Commentaries on the History and Cure of Disease."    (1, page 369)(2)

He referred to the condition under the heading "Pectoris Dolor."  He wrote:
Beside the asthma, hysteric oppressions, the acute darting pains in pleurisies, and the chronical ones in consumptions, the breast is often the seat of pains, which are distressing, sometimes even from their vehemence, often from their duration, as they have continued to tease the patient for six, for eight, for nine, and for fourteen years. There have been several examples of their returning periodically every night, or alternately with a head-ach. They have been called gouty, and rheumatic, and spasmodic. There has appeared no reason to judge that they proceed from any cause of much importance to health (being attended with no fever), or that they lead to any dangerous consequences; and if the patient were not uneasy with what he feels, he needs never to be so on account of any thing which he has to fear. (4, page 302)
So it's clear from this description that he, unlike Darwin a century later, clearly saw angina pectoris as something unique from asthma.  Although, it was similar to asthma in that it it was distressing and that it was intermittent.

Check out his remedy:
If these pains should return at night, and disturb the sleep, small doses of opium have been found serviceable, and may be used alone, or joined with an opening medicine, with a preparation of antimony, or with the fetid gums. (4, page 302)
This is interesting because morphine was often sometimes used as a remedy for asthma.  Even more interesting is that over 240 years later, morphine is still a top line recommendation for the treatment of chest pain.

He also prescribed blisters of the chest, or an issue to the thigh, as external remedies.  Thankfully these remedies have long since been abolished as medical treatments.  (4, page 303)

He also suggested other remedies:
A large cumin plaster has been worn over the seat of the pain with advantage. The volatile or saponaceous liniment, may be rubbed in over the part affected. Bathing in the sea, or in any cold water, may be used at the same time. (4, page 303)
He then, more specifically, described angina pectoris  He wrote:
But there is a disorder of the breast marked with strong and peculiar symptoms, considerable for the kind of danger belonging to it, and not extremely rare, which deserves to be mentioned more at length. The seat of it, and sense of strangling, and anxiety with which it is attended, may make it not improperly be called angina pectoris. (4, page 303)
 He continued:
They who are afflicted with it, are seized while they are walking (more especially if it be up hill, and soon after eating) with a painful and most disagreeable sensation in the breast, which seems as if it would extinguish life, if it were to increase or to continue; but the moment they stand still, all this uneasiness vanishes. In all other respects, the patients are, at the beginning of this disorder, perfectly well, and in particular have no shortness of breath, from which it is totally different. (4, page 303)
The pain is sometimes situated in the upper part, sometimes in the middle, sometimes at the bottom of the os sterni, and often more inclined to the left than to the right side. It likewise very frequently extends from the breast to the middle of the left arm. The pulse is, at least sometimes, not dist rbed by this pain, as I have had opportunities of observing by feeling the pulse during the paroxysm. Males are most liable to this disease, especially such as have past their fiftieth year. (4, pages 303-304) 
After it has continued a year or more, it will not cease so instantaneously upon standing still; and it will come on not only when the persons are walking, but when they are lying down, especially if they lie on the left side, and oblige them to rise up out of their beds. In some inveterate cases it has been brought on by the motion of a horse or a carriage, and even by swallowing, coughing, going to stool, or speaking, or any disturbance of mind. (4, page 304)
He was clearly describing dyspnea with exertion associated with chest pain, or what would become known as cardiac asthma.  Modern physicians refer to it as heart failure, a condition that still is confused with asthma as it presents with similar signs and symptoms.

The end of a fit of angina pectoris, according to Heberden, was similar to that of asthma:
The termination of the angina pectoris is remarkable. For if no accident intervene, but the disease go on to its height, the patients all suddenly fall down, and perish almost immediately. Of which indeed their frequent faintnesses, and sensations as if all the powers of life were failing, afford no obscure intimation. (4, page 305)
He believed the disease was, like asthma, spasmotic in nature:
The angina pectoris, as far as I have been able to investigate, belongs to the class, of spasmodic, not of inflammatory complaints.
He offered the following evidence:
  1. The access and the recess of the fit is sudden
  2. There are long intervals of perfect health
  3. Wine, and. spirituous liquors, and opium, afford considerable relief.
  4. It is increased by disturbance of the mind.
  5. It continues many years without any other injury to the health.
  6. In the beginning it is not brought on by riding on horseback, or in a carriage, as is usual in diseases arising from scirrhus, or inflammation.
  7. During the fit the pulse is not quickened. 
  8. Its attacks are often after the first sleep* which is a circumstance common to many spasmodic disorders (4, page 304-305)\
He noted some cases that presented with unusual circumstances.  For instance, some patients spit up blood, and some note feeling dizzy and drop dead on the spot.  

William Heberden died in 1801 at the age of 91.

References:
  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 3rd edition, 1821, Philadelphia and London, W.B. Saunders Company
  2. "William Heberden: Study of cardiac disease," Britannica.com, http://www.britannica.com/EBchecked/topic/259009/William-Heberden, accessed 2/12/14
  3. Guthrie, Douglas, "Heberden Society: Dr. William Heberden," Annals of Rheumatic Disease, September, 1951, 10 (3), pages 217-220
  4. Heberden, William, "Commentaries on the History and Cure of Disease," 4th edition, 1816, London, Printed for Payne and Foss - Pall Mall
  5. Brown, Orville Harry, "Asthma, presenting an exposition of nonpassive expiration theory," 1917, St. Louis, C.V. Mosby Company

Wednesday, December 23, 2015

1654: Bennet describes the inhaler

The Bennett Inhaler (3)
While the inhaler wasn't invented until the 19th century by Dr. Stern and Dr. Mudge, Dr. Christopher Bennett (1617-1655) was the first to draw up an illustration of an inhaler for the medical community in his 1654 book "Theatri Tabidorum."

His "inhaler" was essentially the first known method of inhaling medicine aside from primitive methods such as inhaling steam from a teapot or smoke from a pipe.  (1, page 173)

Bennett was an English physician who had tuberculosis, and might have invented this device to benefit himself, although he must have thought it would also benefit his patients who suffered from the disease. (2, page 530)

According to the 2011 book "Controlled Pulmonary Drug Delivery:
(Bennnet) gave us four woodcut drawings of an inhalation device, with measurements enabling the reader to have their own inhaler made. The treatment was balsam. There is no evidence that Bennett's inhaler was ever manufactured. Bennett succumbed to tuberculosis the following year." (2, page 530)
He was only 38 when he died.  (3)  Perhaps had he lived the inhaler would have been of greater significance to our history of respiratory therapy, lung diseases, and inhalers.

References:
  1. Korting, Monika Schafer, editor, "Drug Delivery," 2010, Germany, Springer-Verlag Berlin Heidelberg
  2. Smyth, Hugh D.C, Anthony J. Hickey, "Controlled Pulmonary Drug Delivery," 2011, Springer, New York Dordrecht Heidelberg London
  3. Sanders, Mark, "Bennett's Inhaler,"  http://www.inhalatorium.com/page162.html, the picture is also compliments of Sanders.  
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Monday, December 21, 2015

1645: Van Helmont learns about air

The path for science had been established.  It began, however, under the guise of alchemy, a type of chemistry that particularly, even more so than science itself, was despised by the Church.  Yet it was this arrangement that made it possible for two great minds to investigate and learn the true contents of air and the purpose of why we breathe.

The first such great mind was that of Paracelsus, a man who was discussed in an earlier post.  He was a Swiss Alchemist who, in 1541, suggested that a substance in air was essential for sustaining life.  (6)  Of course such ideas were not well accepted by the medical profession, which generally thought of Paracelsus as a madman. (2, page 40)

The second was Jean Baptiste van Helmont , another man who was discussed in an earlier post.  He greatly appreciated the works of Paracelsus, and performed tests on the substance air, and he "recognized its true origin and defined its principle characteristics."  (1, page 19)

Van Helmont is also the first to use the term 'gas.' as something "distinct from air and water vapor." (2, page 40) (1, page 19)(16)

He believed that when God created Heaven he thus created water and air. Van Helmont performed a variety of tests to prove that water was separate from air, and that water could not be turned into air. He determined that air could be compressed and water could not, and he also deduced that "air could be reduced to one-half of its original volume under pressure." (3, page 96)

He likewise observed that water could be metamorphosed into ice, vapor and gas (his new term).  (4, page 64)

He knew he had a substance that was not water and not vapor, and he knew he had to come up with a term to describe it.  So he used the term "chaos," shortened it a bit, and came up with his new term 'gas."  He explained that "I have called this mist Gas, owing to its resemblance to the Chaos of the Ancients." (5, page 179)

Elizabeth Potter, in her 2001 book, said:
Experimentally, we see that when the flame of a candle burning on top of a water surface and enclosed in a cylinder has consumed the air, the water rises in the cylinder and extinguishes the candle.  Helmont argued that the otherwise empty space within the air contains magnale or spirit of the air.  This Magnale is also a third thing between spirit and matter, and it, not air, keeps us alive when we breathe. (3, page 96-7)
Ulf Lagerkvist, in his 2005 book, said van Helmont also, like Bacon before him, described a substance called gas sylvestre.  He came to this conclusion "as the result of burning charcoal and the fermentation of must." (2, page 40)

What he did was take 62 pounds of ash, burned it, and discovered that what was left was 1 pound of ash, according to historyworld.net. (16)
What has happened to the rest? Van Helmont is convinced, ahead of his time, of the indestructibility of matter. Indeed he is able to demonstrate that metal dissolved in acid can be recovered without loss of weight. (16)
So he now reasons that the missing 61 lbs have escaped in the form of an airy substance to which he gives the name gas sylvestre (wood gas). (16)
Another interesting tidbit about van Helmont was that he is believed by many historians to be the first physician to oppose the Hippocratic humoral theory of disease, that diseases were caused by an imbalance of the four humors: blood, phlegm, black bile and yellow bile.

He was  the first to prove that there was more to life than the four basic elements (Earth, Air, Water, fire) championed by ancient Greek philosophers, that these were not the only essential elements of life. Instead, he created some of his own theories based on his experiments.  For example, he believed the two primary elements were water and air.

Of course, like Paracelsus before him, Van Helmont was considered to be a madman by the scientific community and the medical profession.  His wisdom was simply not appreciated because it opposed accepted the accepted doctrines of Galen and other ancient philosophers.  (2, page 40)

Out of fear of persecution, van Helmont's works weren't published until after his death in 1648 by his son. While his works were ignored by most of his immediate successors, his ideas would eventually become accepted doctrine, and he would go down in history as the father of pneumatic chemistry. 

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Friday, December 18, 2015

1636: Boyle learn benefits of artificial breathing

Robert Boyle (1627-1691)
1637:Boyle learns benefits of artificial breathing

By his accurate anatomical descriptions, Andreas Vesaleas inspired a generation of physicians to learn about the human body.  He also did some experiments himself, one of which included his using bellows to push air into the trachea of an animal.  This experiment was later used by Robert Hooke to prove that artificial respiration could be used to keep a person alive.

In 1636 Robert Boyle (1627-1691) discovered the presence of gases in the blood, and is therefore perhaps the first to describe an element. He found that "fresh defibrinated blood gave off bubbles of gas when it was exposed to the vacuum of an air pump."

A few years later John Mayow (1640-1679) thought the gas was nirto-aerial gas, or what we now refer to as oxygen.  (7, page 517)

Boyle, on the other hand, is responsible for many discoveries, his most famous being what is now referred to as Boyle's Law. 

This states that at a constant temperature the pressure of a gas has an inverse relationship to it's volume.

This law would become very significant to many of the later researchers. It would be used to explain why we breathe, why popcorn pops, why a tea kettle whistles, and why a balloon bursts when you blow too much air into it.

The same law would later be used by physicians to explain why inventions like Robert Hooke's bellows might cause trauma to the lungs.

1590: The invention of the microscope

The name of the person who invented glass will forever be unknown to history, although what is known is that it was invented in the first century by the ancient Romans. 

After grinding various shapes and sizes of lenses, they spent quite a bit of time looking through these, and they observed the some objects appeared larger -- were magnified -- when observed through certain lenses.  In this way, the ancient Romans discovered the first simple microscopes.

This knowledge, however, was not used much until the 13th century when spectacle makers ground different sizes and shapes of lenses in order to find a way to help people see better.  

While they invented the first spectacles, they also ended up inventing the first microscopes.  These first microscopes, however, were basically nothing more than large magnifying glasses.  

In 1590, two spectacle makers by the name of Zaccharias Janssen and his father Hans, were experimenting with various lenses.  They ended up putting one lens in a tube, and then two, and then three, to see how this might improve or change the appearance of objects observed. 

What they ended up discovering was the by using two lenses they could make an object appear 3-10 times larger than normal, and even larger than they appeared in any simple magnifying glass.  It was in this way that they invented the compound microscope.  

Soon after other investigators learned of this new invention, Galileo Galillei improved upon it by performing his own experiments.  He would use it to investigate the sun and the solar system.  

Jan Swammerdam and Robert Hook would also use it to investigate the unseen elements of the human body, making discoveries that would help advance medicine.  

Anthony Leeuwenhoek would also use a microscope, although the one he invented was a simple microscope that, because he became so adept at grinding lenses and adjusting light, was able to magnify objects far greater than any compound microscope, or up to 500 times.  

In this way, the microscope would become one of the most significant tools of science and medicine.

References:
  1. Tissier
  2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
  3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
  4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
  5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
  6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
  7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
  8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
  9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
  10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
  11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
  12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
  13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
  14. 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
  15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
  16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
  17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14
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1628: William Harvey discovers circulation, and proves it

Robert Hooke discovered the respiration
was not to keep the circulation of the
blood moving.In 1553 
While a book published by Andreas Vesaleas began a quest to learn about the human body, the discovery that the blood circulates by William Harvey would was a revolutionary breakthrough that allowed scientists and physicians to truly understand te human body, and how changes within caused disease.

Galen alluded to the idea that blood circulated through the body in the 2nd century. Yet in his many writings he described blood as moving back and forth between organs in a to and fro motion. Whether he had a notion it circulated is left to speculation.

Vesaleas was the first person to publish an accurate anatomy of the body. He performed autopsies, and had a painter paint what he saw, and this was published in a book, De humani corporis fabrica, in 1543. However, he erred in believing that the purpose of circulation was to cool the blood. (7, page 474)(11, page 243-4)

A contemporary of Vesaleas was Realdus Columbus (1516-1569).  He was a surgeon and professor of anatomy at Padua from 1544 until his death in 1569. He continued Servetus's work on circulation of the blood, describing the passage of blood from the vena-cave through the pulmonary circulation, and then through the left ventricle and aorta. (8, page 70-71)

Columbus also saw that blood changes in the lungs.  (11, page 243)

Andrea Cesalpino (1519-1603) was the first to describe the idea that blood circulates through the body.  But he usually doesn't get credit for this observation because he failed to prove it.

Hieronymus Fabricius (1537-1619) studied the venous system of the human body, and discovered membranous folds that he referred to as valves. He speculated that these allowed blood to flow upward. Since the blood pressure was lower the farther blood gets from the heart, these valves were necessary to prevent gravity from pulling blood on it's way back up the legs to the heart and lungs from being pulled back down to the lower legs and feet (and thus causing dropsy of the feet). (14, page 92)

In other words, his discovery of valves made Fabricus wonder if the blood circulated as opposed to moved in a to and fro motion as Galen had suggested. But whether this was true or not would be left to one of his students to determine, one of whom was William Harvey. (14, page 93)(15, page xxiii)

Michael Servetus discovered circulation to the publication of his 1553 book, although he also failed to prove it.  So the door was still wide open for a major breakthrough in science, and just the man to accomplish this task was William Harvey, who essentially took over the work of Servetus.

William Harvey (1578-1657)(11, page 242)
Medical Historian Thomas Bradford said Harvey was born in 1578 at Folkestone in Kent, and by the time he was ten-years-old he was accepted at Caius College, Cambridge, in 1593. He studied there for five years, then traveled to France and Germany, and then studied at the "celebrated" medical school at Padua. (14, page 119)

Bradford said that he studied under some of the most renowned anatomists of the era, including Dr. Fabricius. 14 page 91)(15, page xxiii)

Some say he lectured by candle light. Perhaps it was in this "light" that William Harvey was introduced to veins and valves. This wisdom, coupled with the enthusiasm of his instructor, inspired Henry to further investigate these veins and valves to learn more about them. "Perhaps," Harvey must have wondered, "Fabricius is right, that the blood does circulate." (14, page 119)

Bradford said he graduated from Padua in 1602 and began a practice in Cambridge in London.  Then, in he became a physician at Bartholomew's Hospital, and in 1615 became professor of anatomy and surgery at the college.  It was here he began his own anatomical research.  (14, page 119)

Like Andreas before him, he wasn't satisfied with the current method of just speculating about the movement of the blood and heart, or that assuming it was knowledge only God was privy to. He studied the heart and vessels in animals, and came to the conclusion that the heart was a pump, and it circulates the blood through the body. (9, page 168-169)

While his comrades initially rejected his theory that blood circulates through the body, Bradford said:
King Charles took great interest in these discoveries and witnessed several experiments. He appointed Harvey his physician in 1643.  In 1633 he accompanied the king and his court to Scotland.  When "Old Parr" died the king gave the body to Harvey to dissect.  (14, page 120)
Several years after he made this discovery, and when he was 50 years old, he would publish, in 1628, Exercitatio anatomica de Motu Cordis et Sanguinis (An Anatomical Exercise on the Motion of the Heart and Blood in Living Beings).  (14, (page 119-122)

Of course, once Harvey published his discovery in his 1628 book  his medical practice took a hit, and he was criticized by a dogmatic medical profession.  (11, page 246)(14, pages 119-120)(17)

However, in the end, Harvey would be proved right, and his ideas (of course based on science as opposed to theory) would win out, and he lived long enough to see his theory become accepted, said Garrison. (11, page 246) (also see 14, pages 119-120)

Perhaps it was due to his friendship with the king that his ideas were accepted before his death in 1657. (14, page 119-122)

Garrison said William Harvey "was the "greatest name in the seventeenth century... and whose work has exerted a profounder influence upon modern medicine than that of any other man save Vesalius.. it was the most momentous discovery since Galen's time." (11, )

Charles Auffray and Denis Noble, in a 2009 article in International Journal of Molecular Science, said that Harvey may even have come close to discovering how the heart may continue beating even after it is removed from the body.  They quote Harvey as saying:
The heart of an eel and of certain other fish and animals, having been taken out of the body, beats without auricles.  Furthermore, if yo ucut it in pieces, you will see the separate pieces each contract and relax, so that in them the very body of the heart beats and leaps after the auricles have ceased to move. (17)
Auffray and Noble said:
He (Harvey) could not, in his day, take this dissection further down to discover that the rhythmic mechanism was integrated at the level of individual cells, since the cell theory was formulated by Matthias Schleiden (1804-1881) and Theodor Schwann (1810-1882) two centuries later based on observations with the microscope introduced  in practice in the life sciences of Anton van Leeuwenhoek (1632-1723) only after Harvey's death.  However, he was the first to realise that rhythmicity was a property of the smallest structures he could discern. (17)
Had he had access to the microscope, perhaps Harvey would have made similar discoveries.  Yet he did not need to make any further discoveries, considering his discovery of circulation, and his proving it, was enough to secure his spot in history books.

Despite his accomplishments, Harvey's view that the purpose of breathing was to cool the blood "retarded the development of the true physiology of respiration for a long time." (11, page 242-244)

However, Garrison further explains that Harvey's proof that all blood passes through the lungs, and circulates around the body, made it possible for physiology to become a "dynamic science."  (11, pages 244-248)

It was through this discovery  that made it possible for later investigators to inject dyes and other solutions into the vessels that resulted in many anatomical discoveries, such as:  (11, pages 244-248)
  • Lacteal Vessels by Gasparo Aspelli in 1622
  • Thoracic Duct by Jean Pecquet 
  • The Pancreatic Duct by Georg Wirsung in 1642
  • Circle of Willis in by Thomas Willis in 1664
  • Capillaries in the lungs by Marcello Malpighi in 1661 (see below)
Of course each of these discoveries dispelled some ancient myth about the flow of substances through the body. For instance, Galen believed the purpose of "veins and lymphatics of the intestines carried chyle to the liver, said Garrison. This theory of Galen was disproved by the above discoveries, all thanks to the discovery that blood circulates through the body by Harvey. (11, page 246-7)

Galen believed the pulse would help determine changes in the pneuma, indicating disease. Harvey, on the other hand, described that the beating of the heart correlates with the pulse felt at the various points on the body. As the pulse is felt, this is when blood is forced through the many vessels of the body during contraction of the heart. The heart then relaxes, and this is when the heart receives blood. The strength and force of the pulse, therefore, is a direct correlation to the strength and force of the heart. (9, page 168-169)

He generally agreed with Columbus that the right ventricle of the heart pumps blood to the pulmonary arteries and then to the lungs where the blood is nourished, and the left side of the heart pumps blood to the various arteries of the body. As quoted by Osler: (9, page 170)
"I began to think whether there might not be A Movement, As It Were, In A Circle. Now this I afterwards found to be true; and I finally saw that the blood, forced by the action of the left ventricle into the arteries, was distributed to the body at large, and its several parts, in the same manner as it is sent through the lungs, impelled by the right ventricle into the pulmonary artery, and that it then passed through the veins and along the vena cava, and so round to the left ventricle in the manner already indicated." (10)
Marcello malpighi was the first to observe
capillary anastomosis, although he did not
attach importance to it.
Garrison added:
The most brilliant outcome of Harvey's experimental method was in the clearing up of the obscure matter of the physiology of respiration... Before Harvey's day, men still believed, with Galen (including Vesalius and Harvey), that the object of respiration was to cool the fiery heart, the purpose of the chest movements being to introduce air for generating vital spirits by the pulmonary vein, and to get rid of the heart's smoky vapors by the same channel. This Galenic notion was not a mere piece of symbolism, as in Richard Crashaw's (1612-1649) poem on St. Teresa (The Flaming Heart), but was part and parcel of actual belief about the physics of the circulation. "Before Harvey's time," says (Sir Clifford) Allbutt (1836-925), "respiration was regarded not as a means of combustion but of refrigeration. How man became such a fiery dragon was the puzzle." Harvey's demonstration showed that the blood is changed from venous to arterial in the lungs, but beyond that point, as even (Samuel) Pepys (1633-1703) has recorded in his Diary, no one could tell how or why we breathe (13, page 266)
Per Garrison, Pepy's wrote regarding respirations:
But what among other fine discourse pleased me most was Sir G. Ent about Respiration; that it is not till this day known or concluded among physicians, nor to be done either, how the action is managed by nature, or for what use it is." (13, page 266) 
While the Fabrica of Vesalias opened the eyes of the anatomist, the discovery that blood circulates inspired the anatomist to learn more about the physiology, or the functions of the body. In this way, he inspired people to learn more about medicine, and how medicine affects the various organs of the body. Harvey, therefore, is often referred to by many as the modern father of medicine.  (15, page xxiii)

References:
  1. Tissier
  2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
  3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
  4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
  5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
  6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
  7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
  8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
  9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
  10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
  11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
  12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
  13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
  14. 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
  15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
  16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
  17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14
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Wednesday, December 16, 2015

1600s: Nervous theory introduced to medical community

Perhaps the most prevalent theory regarding asthma through most of history was the nervous theory of asthma. The idea was that, since no scars were found in asthmatic lungs, that it must be caused by the mind. While this idea was tinkered with by various ancient physicians, including Galen, it wasn't taken seriously by the medical community until the 17th century.

So we understand so far that the term asthma first appeared in the ancient Greek writings of Homer, and was defined as a medical term by Hippocrates.  In Ancient Rome it was used sparingly, and it didn't find its way into English and other European languages until about 1398.

Medical wisdom in Western societies hit a wall of sorts with the fall of the once mighty Roman Empire, only to rise up in Eastern societies.  Around the 10th, 11th and 12th centuries such wisdom started to filter back West, yet it was a slow transition to say the least.

With the fall of Constantinople in 1453, the dark ages ended and the age of Renaissance began.  Old Western ideas about medicine and science started to re-emerge, and new ideas started to form.  The first Western physician during this era to investigate the term asthma was Jean Baptiste van Helmont (1579-1644).

Even during modern times physicians and scientists who become rapt in a certain disease are usually those who are affected by it, and van Helmont was no exception.  He was afflicted with asthma from a young age, and he became especially interested in it as a physician/scientist/alchemist.

He was the first to describe asthma as anything other than simply a symptom.  He was the first to propose the idea that asthma was a disease of spasms of the air passages when he wrote:  "The lungs are contracted or drawn together."

Galen mentioned something of the sort way back in the first century, yet it was van Helmont who focused attention on the subject.

Van Helmont was also the first to describe asthma as a nervous disorder. By this, he meant that irritation of the nerves triggered the asthma response.

Several years later, Thomas Willis (1621-1675) also described asthma as a nervous disorder that caused spasms of the air passages of the lungs.  Yet it was his writings that were more generally accepted by the medical community at the time, mainly because he wrote more abundantly and specifically on the subject than van Helmont.  For this reason, he it is Willis who is generally given credit for introducing the nervous theory of asthma to the medical community.  (1, page 6)

So it's important to understand that van Helmont was the first to postulate the nervous theory of asthma, yet Willis is often given credit because.  This is mainly because, if not for his writings, the theory would never have gained the attention of the medical community.

Likewise, while van Helmont also was the first to postulate the idea of the spasmotic theory of asthma, he didn't get credit for it either.  Credit here goes to John Floyer, who would dissect this disease even further than either van Helmont or Willis.  Floyer is given credit mainly due to the fact he was among the most famous physicians of his era.  (1649-1734).

Very rarely will you find an author on the subject giving credit to van Helmont. Just to give an example, in his 1835 book "Asthma, its species and complications," Francis Ramadge said Willis was "the first to observe the nervous character of complicated asthma."  (3, page 92)

While this may not be fair to van Helmont, it's just the way history was written; it's just the way it is.

For the sake of simplicity, I want to give a quick overview of the nervous and spasmotic theories of asthma.
  • The spasmotic theory of asthma; also referred to as the convulsive theory of asthma, and later the bronchospasm theory of asthma
  • The nervous theory of asthma; later called psychosomatic theory of asthma
It also should be known here that many authors on the subject believe that asthma is both nervous and spasmotic, or that one is synonymous with the other.  So as one physician is referring to the nervous theory of asthma, he is generally referring to spasmotic asthma caused by the nervous response.  Or, he is referring to irritation of the mind that causes it to send signals via nerves to start the asthma response, which is spasms of the air passages.  

Regardless, these two theories would continue to be dissected and debated for the next three centuries.  

References:
  1. Berkart, J.B., "On Asthma," 1878, page 
  2. Walter, Mmichael J, Michael J. Holzman, "Americana Journal of Respiratory Cell and Molecular Biology, "A Centennial History of Research on Asthma Pathogenesis," http://ajrcmb.atsjournals.org/content/32/6/483.full (accessed 2/22/13)
  3. 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
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Monday, December 14, 2015

1600-1900: Botanic medicine becomes a craze, part 4

These are three patent medicine bottles: Daffy's Elixir
Dalby’s Carminative and Turlington’s Balsam of Life. 
These products were patented in Britain.  Note that
each bottle has a unique design, particularly the King's
Royal Patent: Turlington's Balsam of Life.  This was to
prevent copycats from making pirated versions, and to
make the official patented product easy to spot by
potential customers.  (4)
During the botanic medicine craze that lasted through the course of the 17th, 18th and 19th centuries, it is said that there were over 100 British patent medicines sold in both Europe and America.  Listed here are some of the more common remedies you might take for respiratory ailments.

1.  Scot's Pills:  These were initially made by Patrick Anderson around 1635. The compound contained aloes, jalap, gamboge, and anine. (1, page 291)

Here is part of an article about Scott's Pills in the London Gazette, probably from some time in the 17th century:
Dr. ANDERSON's, or The Famous SCOTS PILLS; ARE
faithfully prepared only by JAMES INGLISH, son of DAVID INGLISH, deceased... to prevent Counterfeits from Scotland, as well as in and about London, you are desired to take Notice, That the true Pills have their Boxes sealed on the Top (in Black Wax) with a Lyon Rampant, and Three Mullets Argent, Dr. Anderson's Head betwixt I. I. with his Name round it, and Isabella Inglish underneath the Shield in a Scroll.
They are of excellent Use in all Cases where Purging is necessary, and may be taken with Epsom, Tunbridge, or other Medicinal Waters.
This product was provided with a letter's patent, which was a type of patent granted by parliament in 1624 "to curb arbitrary actions like those of previous monarch (prior to King James II)."

Anderson persuaded King James II to grant him a letter's patent for his pills, which meant that he had sole rights to his product so long as he supplied it to the king. The Glorious Revolution of 1688 put an end to an exercise of such royal power over the U.S. Colonies, and the grant was named invalid. This began a rivalry of the various people who claimed to make this remedy. (19, page 71-72)

Daffy's Elixer:  This was a concoction first introduced by Reverund Thomas Daffy in 1650,  and made famous by his relative Dr. Anthony Daffy, who created a pamphlet calling it "the choice drink of health."  He "promised" that it cured gout, dropsy, rickets, consumption, melancholy, etc. (3, page 73)  (3, page 128)(4, page 163)

The elixir was mainly a concoction of alcohol (mainly alcohol) and various herbs, roots and a laxative.  (4, page 128) 

It was available throughout the 18th century and much of the 19th century.  There were also various recipes published in magazines and newspapers for the product for homemakers to make their own versions of the remedy.   

Dutch Drops or Harlem Oil:  Garrison said this is a "mixture of oil of turpentine with other ingredients, has been used since 1672 as a 'medicamentum" (remedy) or routine preventative of disease." (1, page 292) There were other similar remedies that were supposedly meant to be a cure all, many of which could be purchased from private individuals.

This is an ad from the Chicago Tribune in 1880 (10)
Dalby's Carmanative: This was an elixir originally made by James Dalby of London, England, about 1780, and later in the United States around 1804. The product was still being sold at the turn of the 20th century. (7)

The main indications for this remedy were: flatulence, gripes, convulsions, gout, bloody flux, etc.

This medicine is the most ancient and popular arcana in Great Britain, chimed the authors of The Dublin Journal of Medical Science in 1845. It was good for people of all ages, including infants. The authors of the magazine also include the following warning:
"Like other popular nostrums, Dalby's Carminative is made after various receipts, so that the dose, which is perfectly safe when the cordial is prepared by A., may be poisonous when it is manufactured by B. In the Returns from the Coroners of England and Wales, made to the House of Commons in 1839, we find ten cases of death from Godfrey's Cordial, and one from Infant's Mixture. Dr. John Clarke mentions an infant destroyed by forty drops of Dalby's Carminative.—Translator's Note].Medical Gazette.
This is a before after picture for people who use patent
medicine.  This was a window exhibit at a Chicago drug
store used by Collier's to help Adams make his point.  The
caption under said: Don't dose yourself with secret "Patent
Medicines," almost all of which are frauds and humbugs.
When sick Consult a Doctor and take his prescription: it is
the only Sensible Way and You'll find it cheaper in the end.
This note is interesting, considering one of the main concerns of medicines like this, along with the possibility of inducing alcohol dependence, was inducing side effects -- such as death -- due to the narcotic (in this case opium) contained in it.

Surely the medicine would ease pain and suffering, yet opiates (possibly the most ancient medicine known to mankind) also have a tendency to slow respiration, and may even stop breathing all together.

Considering the doses may vary depending on who makde the elixir, there is no true guarantee how much had been blended into the product.

Goddard's Drops:  Dr. Jonathon Goddard invented this "famous elixir" as a result of performing chemical experiments.  Dr. Goddard died in 1675 of apoplexy, in the street, on his way to his carriage. (26, page 190) (29, page 52) and then the patent was taken over by his relatives.

This was actually the first medicine to be patented in Britain. (22, page 334-336)

Dr. Goddard, before he died, gave his secret to the Royal College, under the stipulation they not publish it during his lifetime (apparently they didn't have to wait long.) (29, page 52) King Charles II granted the patent because he thought commoners  would benefit from it.   (22, page 334-336)

The product was advertised in 1673 by Dr. C. Goddard and communicated by his nephew, Dr. Thomas Goddard. The recipes varied, and one version included "hartshorn, portions of the skull of a criminal who had been hanged, dried vipers bodies and other unmentionable substances." (22, page 334-336)

The drops were  recommended by Dr. Thomas Sydenham, physician known as the Hippocrates of English medicine.  In referring to them, he said they were made by Dr. Goodall. (24, page xlvii).

Sydenham said the  drops are "a highly volatile oleous alcaline spirit, drawn from dead silk worms: but the present practice takes no notice of it." (23, page xlvii)

Dr. Martin Lister said he saw the patent, and that "they were nothing more than the volatile spirit of raw milk rectified with oil of cinnamon."  Along with gout, the pills were also used in "fainting, appoplexies, lethargies and no better than ordinary spirit of hartshorn and sal ammoniac, or other sudden and alarming onsets." (25, page 25)

They were also known as "King's Drops," or "English Drops," because King Charles II loved to use them, even purchasing the secret for 1500 (or was it 5000, or 6000, or 15000, depending on the source) pounds.  (23, page 205)  (1, page 292)

They were also sometimes referred to as "Spirit of Scull." They may also have be recommended for epilepsy.  King Charles II may have also made his own version of the remedy in his own laboratory. (27, page 119)

They were originally sold under the name spiritus salis volatilis oleosus, and later sal volatile drops, and then spiritus ammonia aromaticus. (29, page 52)

Tuscora Rice:  Mrs. Sibilla Masters started production of this product in 1711 under the company name Sibilla Masters.  She went to England to try to get her product patented, but she was rejected. She later sent her husband, Mr. Thomas Masters, to England, and he was granted a patent for the same product.  The product was "actually a food and not a patent.  Little is known about the product nor whether sales were successful." It was the first American patent. (16, page 2)(1, page 402)

Dr. Bateman's Pectoral Drops: According to Griffenhagen and Iogard, it  was the first medicine to be given a patent in Britain by the new rules set forth by parliament after the Glorious Revolution, and the second medicine patent was given to Stoughton's Great Cordial Elixir.  The patent was awarded to Benjamin Okell in 1711.  The product was being regularly advertised by Okell in London by 1721, with advertising in the London Mercury that said: "Each bottle (was) sealed with the boar's head," on which was inscribed "By the King's Patent."  (19, page 72)
 (22, page 334-336)

Stoughton's Great Cordial Elixer:  According to David Wondrich, in his 2007 book, Richard Stoughton owned an apothecary shop in London, and, in 1690, decided create his own proprietary medicine to "get in on the action." (17, page 169)

It was an "alcohol infusion," and it was initially intended as a remedy for stomach and blood ailments, although "users seem to have discovered it was good for one set of symptoms in particular. (17, page 169)
He received a royal patent in 1712, "only the second to be granted to a medicine." (17, page 169)

In 1710, Stoughton's advertising, which had previously hinted at this somewhat less exalted indication, came right out and said: the elixir is "Drank by most gentlemen... to recover and restore weakened or Lost Appetite... occasioned by hard Drinking or Sickness, &c." and "carry off the effects of bad Wine, which too many die of."  (17, page 169)

In other words: it was a hangover cure

Stouighton created a bottle design that made it unique, and it became so common that it "gained dictionary definition." Circulars extolled the product, and served as the package label, mainly because these early bottles did not have paper labels: they usually came wrapped inside the label.  This product made patent medicine popular in Britain.  (19, page 72)

While this remedy wasn't necessarily recommended for respiratory disorders, I would imagine a good draught of booze might take the edge off.  If you drank too much, Stoughton's Great Cordial Elixer would take the edge off your hangover.

Timothy Byfield's sal oleosum volatile:  It's a chemical preparation that "hath been found very helpful and beneficial as well in uses medicinall as others and will much tend to the public use and benefit of our subjects." It was supposedly for ails of the stomach. (18, page 342)

Goddard's Drops were used in making this recipe. (28, page 80)

Mrs. Winslow's Soothing Syrup:  A product similar to Dalby's only it was recommended as a soothing medicine for infants, children and animals, regardless of age. (7)

Along with lots of alcohol, the product contained morphia, which is perhaps one of the oldest medicines known to mankind for it's ability to ease pain and suffering of mind and body. Too much, however, and it has a tendency to slow (or even cease) respirations, thus causing death.

Turlington’s Balsam of Life: This product was invented by merchant Robert Turlington, and he obtained a patent from King George II in 1744.  The product gained fame in Britan and in the American Colonies as an elixir that pretty much cured any malady. (9, page 98)

Turlington made an extensive effort to advertise his product with testimonials and warnings against purchasing pirated versions.  He even went as far as to create a unique shaped bottle with the intent of making it very recognizable to customers, and difficult to pirate. The patent claiecds that the product contained over 27 ingredients. (9, page 98)

Molded into the glass of one side of the unique pear shaped bottles was the following: 
"By the King's Royal Patent Granted to"
On the other side was printed:
"Rob't Turlington for his Invented Balsam of Life."
Also, on one edge was printed:London," and on the other the date the bottle was introduced "January 26, 1754."

This unique idea made it very difficult to create counterfeits.

Other patent medicine makers soon used the idea of molding their names into the glass bottles, such as was done with bottles of Dalby's Carminative, which came out with a steeple shaped conical bottle with "carminative" on one side and "Dalby's" on the other. (19, page 73)

The product was so popular that there was even a book published about it called "Turgington's Balsam of Life, prepared and sold by the patentee...The Efficacy and Virtues of which Incomparable Medicine are Exemplified by an Account of Some of the Cures Perform'd Thereby, in this Book Briefly Mentioned," and "By Virtue of the King's Patent: Turlington's Balsam of life is....", and a variety of other similar titles.

Dr. James Powder:  Dr. Robert James introduced his patented medicine in 1747. It was also referred to as Fever Powder, or Dr. James Fever Powder. The powder contained antimony and bone ashes, and it was supposed to make you vomit and perspire. The medicine was marketed as a remedy for fevers, although it was also used for a variety of other ailments, including delerium and asthma (of course asthma was considered a nervous disorder). The remedy was given to King George III to treat his delerium. (31 , page 203)(32, page 79)(33, page 146)(34, page 281)

Francis Hopkins Rammage, a famous asthma expert from the early 19th century, wrote of the remedy being useful for convulsive asthma. (35, page 99)

Does this not look just
like a bottle of liquor?
Was this just a coincidence,
or was it purposeful?  Your
guess is as good as mine. (11)
Kickapoo Indian Medicine Company:  This was among the most famous Companies to make Indian Remedies in the United States, created by John E. Healy and Charles F. Bigelow in Philadelphia.  They had a variety of products that were first patented in the 1860s, and as the company advertisements could be found in various newspapers around 1888.  They had a cure for just about anything, such as:
  • Kickapoo Worm Killer: A drink containing a variety of contents claiming to kill worms
  • Kickapoo Salve: for skin ailments
  • Kickapoo Oil: Containing, among other things, alcohol and opium
  • Kickapoo Indian Cough Cure: It was a syrup that contained many ingredients, including ipecac, which made a patient puke.  (11, 30)
  • Kickapoo Indian Sagwa:  The product contained mostly alcohol, and was good for dyspepsia. Since dyspepsia can also lead to nervousness, it can also cure nervousness. (30, page 23)
Hale's Honey or Horhound and Tar:  This was supposedly a remedy that would cure inflammation or catarrh.  It was good for coughs, cold, influenza, and "Lung and all bronchial complaints."

Dr. Bull's Cough Syrup: Dr. John W. Bull started manufacturing a family of proprietary products in 1845, and the products (including many pirated versions) by a variety of other people. Most of the products, including the cough syrup, were marketed under the claim "The People's Remedy." There were a variety of similar products, such as Red Star Cough Cure, and the product may also have had other names, such as Dr. J.W. Bull's Vegetable Baby Syrup. The company ultimately became known as the A.C. Meyer and Company, (15) which claimed, in a letter to Adams, that "there is no case of hoarseness, hoarseness (12, page 48)

Shiloh's Consumptive Cure:  It's a nice name, although the contents are not listed, at least not in the U.S.  Adams said the product is made in Leroy, New York, by S.C. Wells and Company, and contains chloriform and prussic acid.  He says "the public would probably exhibit some caution in taking it.  Under the present lax system there is no warning on the bottle that the liquid contains one of the most deadly of poisons." (12, page 47)

Dr. King's New Discovery:  Marketed mainly as a cure for consumption, is was also effective for any disease that caused shortness of breath, or of the chest or throat, including asthma.  An ad for the product said: "Knowing the many wonderful curative qualities of this great discovery, we are willing to stake our reputation on its merits." (12, page 48)

The Special Liquid Blood Cure:  It was the remedy of Dr. Bunyan Along with curing asthma, it was also supposed to cure just about any other malady, including: enlarged tonsils. enlarged glands, ulcers, sores, eruptions, scrofula, impurities of the blood and whole system, etc. According to Adams, "the product looked "cheap at $2, until the Bureau of Chemistry analyzed the miraculous mixture and found it to consist of iodide of potassium and milk sugar with a trace of corrosive sublimate. Then it didn't look like such a bargain." (12, page 129)

Birney's Catarrh Powder:  This product was made by the Birney Catarrhal Powder Company, and ultimately advertised their product as "Cocaine Dr. Birney's Catarrhal Powder." The bottle that contained the powder claimed that you blew the powder and inhaled it through your nose. The company also claimed the product contained less than 3% cocaine. Some reports show that strammonium and menthol were also in the product, along with various other substances. (13, page 297)(12, page 11)

This graphic was used by John Hopkins
Adams in his articles to show that the
alcohol content of many patent medicines
was similar to whisky, champagne, and beer
(12, page 16
Duffy's Malt Whiskey:  Sold as a regular drink at saloons, it was patented as a medicine and cure all. It contained mostly water and alcohol. Adams said that doing this was an easy way for manufacturers to sell alcohol where alcohol in states was prohibited. Eventually, when the prohibition amendment was passed, this provided an amble market for patent medicine makers. Of the whiskey, Adams said: "But Duffy's Malt Whiskey is a fraud, for it pretends to be a medicine and to cure all kinds of lung and throat diseases. It is especially favored by temperance folk. "A dessert spoonful four to six times a day in water and a cription for consumptive, makes a fair grog allowance for an abstainer." (12, page 17-18)

Antikamnia (heroin tablets): This was a remedy that was delivered through the postal service, and claimed to be a remedy for a variety of ailments, and was particularly advertised as a painkiller. The claim of the product wa that "its effect on the respiratory organs is not at all depressing, but primarily it is stimulating, which is promptly followed by a quietude which is invigorating and bracing, instead of depressing and followed by lassitude... it neither stupefies nor depresses the patient, but yields all the mild anodyne results without any of the toxic or objectionable phases." (13, page 583)  Adams claimed such claims were "no less fraudulent and dangerous.

Dr. Peruna's book, "The ills of life":  The owner of Peruna products was Dr. S. B. Hartman, who was "once a physician in good standing," wrote Adams. Adams claimed the product was essentially just a mixture of water and alcohol, with food coloring to make the product look appealing, and sweeteners to make the product taste appealing, and was marketed as a "cure all."  (12, page 13)

The author claimed the remedy (Peruna) treated catarrh. John Hopkins Adams claimed, in a series of articles in 1906, that basically any product could claim to be a cure for catarrh, which was basically an old term for inflammation. He said that any ailment presents with catarrh.  (12, page 13

Adams said: (12, page 13

No matter what you've got, you will be not only enabled, but compelled, after reading Dr. Hartman's Peruna book, "The Ills of Life," to diagnose your illness as catarrh and to realize that Peruna alone will save you. Pneumonia is catarrh of the lungs; so is consumption. Dyspepsia is catarrh of the stomach. Enteritis is catarrh of the intestines. Appendicitis—surgeons, please note before operating—is catarrh of the appendix. Bright's disease is catarrh of the kidneys. Heart disease is catarrh of the heart. Canker sores are catarrh of the mouth. Measles is, perhaps, catarrh of the skin, since "a teaspoonful of Peruna thrice daily or oftener is an effectual cure" ("The Ills of Life"). Similarly, malaria, one may guess, is catarrh of the mosquito that bit you.  (12, page 13
Other products were advertised in newspapers, appearing as advertisements, although no advertiser is marked, said Adams.  One example of such an ad is as follows:
CURES CATARRH AND ASTHMA
Foreign Specialists Give Reasons For
Marvelous Success of New
Remedy, Ascatco
Vienna, Sept. 9.—The astonishing suc-
cess of the Ascatco treatment for catarrh,
asthma and bronchitis is wholly attributed
to its marvelous action on the mucous mem-
branes, and having no disturbing influence
on other organs of the body. (12, page 56)
Of this, Adams said:
"It is claimed by European savants, from whom this remedy emanated, that five hundred drops will cure permanently even the most obstinate cases. The dose is small and pleasant to take, being only seven drops twice daily. The Austrian dispensary, 32 West Twenty-Fifth Street, New York, N. Y., will send a trial treatment of Ascatco free by mail to all sufferers who have not tested the wonderful curative powers of the specific. (12, page 56)
Adams used this photo to show that many patent
medicine manufacturers used patent medicine as
guise to avoid alcohol taxes.  As seen here, Duffy's
Pure Malt whiskey, a patent medicine, was available
with other alcohol bottles in this saloon window
in Auburn, New York.  (12, page 18)
Anyone who profited from the benefits of patent medicine, or profited from the sale of them, was out of luck after Teddy Roosevelt signed the Food and Drug Act of 1906.

If you had asthma and you relied on such remedies, you were now forced to seek alternatives.  Those responsible for the passage of the law would probably recommend you see a licensed physician.

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