Friday, June 17, 2016

1811: Frank insists asthma is periodic

Johan (John) Peter Frank (1745-1821)
During the last half of the 18th century, a time when nosological systems were being framed, most physicians confused asthma with other causes of dyspnea and angina (chest pain).  One physician who did not do this was Dr. Johan (John) Peter Frank, said Joseph Bergson in 1851.  

According to, Frank was born in Germany in 1745, and died in Vienna in 1821.  He studied at Heidelberg and Strasbourg. He became physician at Rastadt in 1769, professor at Göttingen (the school made famous by Haller) in 1784, and professor at Privia in 1785.  He held a couple other jobs before opening a practice at Vienna in 1811. (5)

Being that the second half of the 18th century was dedicated to nosology, or classifying diseases, Frank joined in on this quest, becoming known for is systematising of everything known about public health at that time.  He was among the first physicians to endorse the international regulation of health problems, according to   He likewise "endorsed the notion of 'medical police,' whereby one of the duties of the state was to protect the health of its citizens."(5)

He is often referred to as the founder, or father, of public health.  Along with being a physician, he also spent time as a teacher of physiology, pathology, forensic medicine, and public health. (6, pages 81-82)

His most significant book was System einer vollstandigen medicinischen Polizey published in 1784, and it was his systematisation of public health wisdom, and it made him quite famous.  In fact, is was due to this work that he was offered his jobs at both Rastadt and Göttingen. (6, pages 81-82)

As part of his writings he took some time to note what he thought about asthma. He wrote, via a review by G.H. Hill, the following in Latin: 
"Asthma non habetur solum pro respiratione anxia cum sibilo et stertore, sed exposcit, ut simul periodice recurrat, libera prebeat intervalla et nullius alterius evidentis morbi sit symptoms." (1, pages 374-375)
By running that quote through Google Translate, we get the following:
"Asthma is not the only breathing with a hiss and stertore anxious, but insisted that they periodically return provides free intervals and no other obvious disease is a symptom."
He basically said that asthma is not just a disease of wheezing and noisy breathing, but is a disease that occurs periodically.  When it does occur there are no obvious symptoms of disease, meaning there are no apparent scars or organic lesions on the body or lungs.

Dr. G. Lingen, in 1839, quotes him as saying:
"In asthmate, ut nominant, puerili, glandulas bronchioles, praeter sanitatis modum, turgidas, maxime verothymum insigniter tumefactum invenerunt anatomici: ita quidem ut totam fere anterioris pectoris regionem ille occupaverit, &c." (2, page 208)
Running this through Google Translate we get:
"In the asthma, to name, childish, glands of bronchioles, in addition to health manner of it, turgid, but especially the thyme and remarkably swollen with pride and they found a anatomists, even so, indeed, as he had taken possession of almost the whole of the anterior region of the breast, & c." 
He basdically said asthma results in swelling and congestion of the air passages of the lungs.

He also referred to asthma as "asthma thymicum," or spasm of the glottis.  It was periodic, and occurred frequently in children.  He, therefore, was probably referring to croup, or dyspnea caused by swelling of the vocal cords. He is essentially describing croup in children. (2, page 208) (3, page 202)

Frank wrote a book called De curandis hominum morbis epitome: praelectionibus academicis dicata, or "The curing of diseases, summarize, academic lectures devoted to the clinical," in 1811.

  1. Gill, M. H., "Review and Bibliographic Notices: "On the spasmotic asthma of adults," by Joseph Bergson, published Gill's book, "The Dublin Quarterly Journal of Medical Science," volume X, August and November, 1850, Dublin, Hodges and Smith, pages 373-388
  2. Lingen, G., "A Case of Asthma Thymicum Koppi, or Laryngismus Stridulus Anglorum, Crowing or Croup Like Inspiration," in the book "Miscallanies of Homeopathy," edited by an association of homeopathic physicians, 1839, Philadelphia, L. J. Kinderlen, pages 207-210
  3. Stokes, William, "A Treaties on the Diagnosis and Treatment of the Chest," 1837, Philadelphia, A. Waldie
  4. Rush, Benjamin, "Letters of Benjamin Rush," in this book Rush describes who Mr. Frank was and what he thought about asthma
  5. Johan Peter Frank,,, accessed 1/19/14
  6. Sigerist, Henry E., translator and author of the introduction, "The People's Misery: Mother of Diseases, An Address Delivered in 1790 by Johann Peter Frank,, accessed on 1/18/14
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