Monday, June 20, 2016

1815: Parry supports bronchitic theory of asthma

Caleb Hillier Parry (1755-1822)
Much like the great London physician William Heberden, Dr. Caleb Hillier Parry of Bath was known for taking copious nots. Perhaps he used these notes when describing asthma in his 1815 book "Elements of Pathology," (1, page 372)

He was born in Bath in 1755 and received his general education at the academy of Warrington, and his medical and philosophical education at the schools of Edinburgh and London.  (2, page 372)

William Heberden was the first to describe Angina Pectoris in a speech he gave to the Royal College of Chest Physicians in 1768.  In 1772 his speech was published in The Transactions of the Royal College.  While he described the symptoms of chest pain accurately, Heberden did not know chest pain was caused by a diseased heart.

A few years later, in 1786 a friend of his by the name of Edward Jenner, the same man who earlier had discovered the world's first vaccination, said that angina pectoris was caused by "ossification," or hardening of the coronary arteries, or the arteries that deliver blood to the heart.  In a letter to Dr. Heberden, he said that without the right amount of blood, the heart could not perform its function of pumping blood through the vessels of the body.  (2, page 372)(3, pages 37-38)

Jenner shared his knowledge on the subject with his friend Dr. Parry.  Parry, in turn, communicated what Jenner learned about the subject, plus some insights of his own, with the medical community through his 1797 book "An Inquiry into the Symptoms and Causes  of Syncopy Anginosa, Commonly Called Angina Pectoris."  (2, page 372)(3, page 37)

This work was well received by the medical community. It was through this book that Caleb Parry became the first person to suggest that the way we live, and the foods we put into our bodies, may lead to disease, particularly angina pectoris. He suggested regular exercise and the avoidance of fresh meat.  (2, page 372)(3, page 38)

While "Angina Pectoris" was well received, his most famous work by far was "The Elements of Pathology," which, according to The Gentleman's Magazine:
This exhibits a great system of original and unexampled depth of observation, accuracy of conclusion, and abundance of fact and illustration; it may truly be considered as an almost unparalleled example of great originality and capacity.
It was in this book that he shared, among other things, his knowledge on the subject of asthma.
In patients who are subject to spasmodic asthma, fits of that disorder often begin with a violent coryza, in which the eyes become red and watery, and all the symptoms of a cold in the head are observable. After a few days, or sometimes even only hours, these symptoms suffer some degree of alleviation, and the malady proceeds to the bronchia, occasioning all the well-known signs of spasmodic asthma. What, then, is this state in the bronchia, but an affection of the mucous membrane of those cells, exactly similar to that which had previously existed in the same membrane in the nose? (4, page 196)
It may, however, be said, that asthma is a spasmodic affection, depending on causes acting on the mind, &c. and returning at regular periods. (4, page 197)A
A little over a century later, Orville Brown summed up Parry's view of asthma this way:
Parry suggests that engorgement of the mucous membrane of the bronchi produced such tumidity of it as to mechanically interfere with the passage of the air. (4, page 32)
In other words, like Robert Bree, Parry was a supporter of the bronchitic theory of asthma.  He was a great physician and medical philosopher until he was afflicted by a case of palsy 1816. He died in 1822.

Further Reading:
  • 1815: Dr. Parry shares his wisdom of asthma (5/3/16)
References:
  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 3rd edition, 1821, Philadelphia and London, W.B. Saunders Company
  2. Urban, Sylvanus, "Dr. Caleb Hillier Parry," The Gentleman's Magazine and Historical Chronical, from January to June, 1822, volume XCII, London, printed by John Nichols, pages 372-373
  3. Roberts, Barbara H., "Treating and Beating Heart Disease: A Consumers Guide to Cardiac Medicines," 2009, Jones and Bartlett Publishers, chapter two: "Treating Angina Pectoris," 
  4. Parry, Caleb Hillier, "Elements of Pathology and Therapeutics; being the outlines of a work intended to ascertain the nature, causes, and most efficacious modes of prevention and cure, of the greater number of the diseases incidental to the human frame," Volume I: General Pathology, 1715, London, Printed by Richard Cruttwell
  5. Brown, Orville Harry, "Asthma, presenting an exposition of nonpassive expiration theory," 1917, St. Louis, C.V. Mosby Company

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