Wednesday, September 28, 2016

1851: Reid and Bergson verify spasmotic theory of asthma

Figure 1 --
While Reid and Bergson argued that asthma was spasmotic,
Dr. Carl (Karl) Friedrich Canstatt (1807-1850), pictured here, 
was a pioneer of medicine in Germany who, in 1855,
 wrote that a differential diagnosis of asthma didn't matter 
because anti-spasmotics were equally beneficial for both diseases.
  He believed asthma was a "spasm of the breathing organs"
 as opposed to accepting the spasmotic theory of asthma. 
(1, page 32)(5, page 32)(6)
The next in a series of experiments that confirmed the spasmotic and nervous theories of asthma were performed by Dr. John Reid and Dr. Joseph Bergson. Reid performed the experiments, and later, in 1851, Bergson used these to make his argument to disprove the paralytic theory of asthma, and prove asthma was only spasmotic and nervous.

M.H. Gill, in an 1850 edition of the Dublin Quarterly Journal of Medical Science, said Bergson was a physician from Hamburg, Germany, and that he wrote a prize essay based on experiments he performed with Amedee Lefevre. (3, page 373)

Figure 2 --Bergson, among other physicians, believed signals sent
 from the brainvia the vagus to the lungs caused an asthma attack.
 You can see by this diagram that the vagus feeds the various organs
 of the body, including the heart and lungs. Vagi is singular for vagus nerve.
 The vagus is responsible for all the things your body does without
you having to think about them, such as your heart beating, your mouth
 salivating, your eyes blinking, your lungs inhaling and exhaling, etc. 
Of course at the time the two prevailing theories regarding asthma were the spasmotic and nervous theories, although another theory that was gaining steam was the paralytic theory of asthma, which basically stated that paralysis of the muscles of respiration, the muscles that make you breathe, resulted in emphysema. 

The theory, therefore, postulated that emphysema was also a part of asthma. Berkart, therefore, believed Reid's experiments proved this paralytic theory wrong.  
Of this, J.B. Berkart, in his 1878 book "On Asthma," said: 
Bergson, however, denied the existence of a paralytic asthma, because, according to the experiments of John Reid, section of both vagi (figure 2) produces no dyspnoea so long as the animals are at rest and the supply of air unlimited—a fact duly confirmed by the later experiments of Rosenthal. Bergson, therefore, admitted only the spasmodic form of the disease, consisting in paroxysmal constrictions of the bronchi and air-vesicles, in consequence of a morbid irritability of the vagus. (1, page 28)
Ernest Schmiegelow, in his 1890 book, said:
It was especially after the publication of Bergson's prize work that a decided separation was made between the idiopathic nervous asthma, characterized by its periodical attacks, which are separated by perfectly free intervals, and the numerous forms of difficulty in breathing, which appear purely symptomatic in many different complaints of the chest. To Bergson the idiopathic nervous asthma is an independent neurosis of the organs of the chest, whose origin is a cramp or spasm which like all other neuroses can be caused by a central or peripheral irritation of the nervous centre. (2, page 4)
Gill said Bergson described asthma this way:
Having detailed a number of experiments from various sources, as the result of which our author considers himself justified in the conclusion that the asthmatic fit consists in a spasmodic contraction of the bronchial and pulmonary air-cells, caused by the action of the par vagum on the muscular fibres in these structures, so that he thinks it may properly be termed spasmus bronchialis, he divides it into two kinds: the first proceeding from the brain (cerebral asthma), and the second from the spinal marrow (spinal asthma). (3, page 377) 
In other words, he believed, as with other asthma experts of his era, that asthma was both nervous and spasmotic; that irritation of the nervous center by various stimuli triggered the muscular fibers that wrap around the lungs to spasm, thus causing the various symptoms of asthma.

Further reading:
  1. 1851: Bergson describes typical asthma attack (2/23/16)
  1. Berkart, J.B., "On Asthma: It's Pathology and Treatment," 1878, London, J. & A. Churchill
  2. 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.
  3. Gill, M. H., "Review and Bibliographic Notices: "On the spasmotic asthma of adults," by 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
  4. Freudenthal, Wolff, "Bronchial Asthma," New York Medical Journal: A Weekly Review of Medicine, edited by Edward Swift Dunster, James Bradbridge Hunter, Frank Pierce Foster, Charles Euchariste de Medicis Sajous, Gregory Stragnell, Henry J. Klaunberg, Félix Martí-Ibáñez, volume CV, January-June, 1917 (Saturday, January 6, 1917), New York, A.R. Elliot Publishing, Co., pages 1-5
  5. Brown, Orville Harry, "Asthma, presenting an exposition of nonpassive expiration theory," 1917, St. Louis, C.V. Mosby Company
  6. Karl Friedrich Canstatt "Images from the history of medicine,",, the photo is in the public domain, accessed, 3/10/14
RT Cave Facebook Page
RT Cave on Twitter
Print Friendly and PDF

No comments:

Post a Comment