Friday, September 9, 2016

1841: Romberg verifies nervous theory of asthma

Moritz Heinrich Romberg (1795-1873)
By 1841 there seemed to be quite a bit of evidence in support of the nervous theory of asthma.  It was in this year that Dr. Moritz Heinrich Romberg verified this evidence, hence proving once and for all that asthma was definitely nervous, or so many supporters of the theory believed.

In the 17th century Jean Baptiste van Helmont and Thomas Willis came up with the idea that asthma was nervous.  In the 18th century William Cullen further supported this theory. Then, in the 19th century, the experiments of various physicians seemed to provide the evidence in support of the nervous theory of asthma.  (1, page 506)

In 1835 Francis Ramadge wrote papers, in 1836 Joseph Bergson and Amedee Lefevre wrote prize essays, all of which seemed to provide support for the nervous theory of asthma.  Based on this evidence, Romberg also supported this theory, and he did experiments to put an end to any arguments once and for all. (1, page 506)

J.B. Berkart, in his 1878 book "On Asthma," said Romberg described "two affections of the vagus... of which are productive of dysponeal attacks:
  • Bronchial spasm:  He generally referred to this as "bronchial cramp" or spasmus bronchialis.  (2, page 28)(3, page 4
  • Paralysis: This was essentially paralysis of the muscles of respiration, or emphysema (2, page 28)
There were also later studies that likewise verified the works of Romberg.  Alfred Wilhelm Volkman (1801-1877) and M. M. Valentin proved that irritation of the pneumogastric, or vagus, nerve causes contraction of the air tubes, or bronchioles. (4, pages 5-6

Orville Brown, in his 1917 book, described Volkman's experiment:
Volkmann tied a tube into the trachea of an animal and set a candle before the opening and then stimulated the vagus and the flame showed that air was thereby caused to come from the lungs. (2, page 33)
These results were verified again by Ludwig TraubePaul Bert, and others.

These men confirmed that asthma was nervous, and this influenced the remedies used to treat it, often resulting in physicians prescribing such medicines that calmed the nerves and relaxed the mind in order to prevent and treat asthma. (4, pages 5-6)

The experiments of these men helped enshrine the image of asthma as nervous for greater than the next hundred years. 

References:
  1. Whitaker, James Thomas, "The theory and practice of medicine," 1893, New York, William Wood and Company
  2. Berkart, J.B., "On Asthma: It's Pathology and Treatment," 1878, London, J. & A. Churchill
  3. Schmiegelow, Ernest, "Asthma, considered specially in relation to nasal disease," 1890, London, H. K. Lewis; he references the following source; Bergson, Das krampfAsthma der Erwaohsenen, Nordhausen, 1850.
  4. Thorowgood, John Charles, "Notes on Asthma: It's Nature, Forms, and Treatment," 1878, London, J. & A. Churchill
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