1853: Gairdner defends spasmotic theory of asthma

William Tennant Gairdner (1824-1907)

William Tennant Gairdner made no significant contributions to medicine, nor to our history of asthma. However, by his his high stature as a physician, he pushed hard in support of the spasmotic theory of asthma.

According to his obituary, he was born November 8, 1824, to Dr. John Gairdner, a physician in Edinburgh. He was educated specifically for his father's profession at the University of Edinburgh. In 1845 he received his medical degree. In 1850 he was elected Fellow of the Royal College of Physicians of Edinburgh; and a year or two later was appointed physician and pathologist to the Royal Infirmary.  In 1862 he accepted an invitation to become professor at the University of Glasgow.  (1)

He appears to have been more dedicated to his professorship than advancing medicine, as other physicians in similar positions have done in the past.  Although, while he was noted as an expert on the heart and lungs, he did publish various lectures and articles.  He also published some books, such as "Clinical and pathological notes on paricarditis,"Insanity: modern views as to its nature and treatment," "The physician as naturalist, and "Three things that abide: faith; hope; love."  (1)(5)

He did write a few articles significant to our history.  In 1851 and 1853 he published articles defending the spasmotic theory of asthma and rejecting other theories, such as J. S. H. Beau, who supported the bronchitic theory of asthma. (2, page 24)

Gairdner wrote a review of of Beau's "Memoir of a New Distinction of Two Forms of Bronchitis," that was very influential among the community of physicains who argued against this theory and in support of the spasmotic theory.  Among the most notable to use Gairdner's arguments was Dr. Henry Hyde Salter.

While I have access to Gaird's original article, which was published in an 1853 issue of the British and Foreign Medico Chururgical Review and Quarterly Journal, I think it suffice to limit our discussion to a brief portion published in Dr. Salter's book.  Obviously he felt this suffice to prove his argument.

Salter said:

Dr. W. T. Gairdner... so happily exposes the untenability of the bronchitis-theory of asthma, and so exactly expresses the objections to it that have struck my own mind, that, although I have elsewhere shown the entire independence and distinctness of the two affections, I cannot forbear quoting his words... (2, page 24)

Those words by Gairdner that so impressed Salter are so posted here:

"We had thought that the experiments of Williams, of Longet, and of Volkmann, which are, or ought to be, well known in France, might have saved the spasm-theory of asthma from being consigned so very coolly, as it is in the first sentence of the above paragraph, to the limbo of medical tradition; more especially as there never has been any doubt, even among the most hazy and 'traditional' of the spasm-theorists, as to the existence of an obstruction in the bronchial tubes. The wheezing and 'vibrating rules' were too evident a portion of the asthmatic paroxysm to be overlooked, even before auscultation and percussion were introduced. M. Beau has entirely missed the real point of the controversy, and has not offered the shadow of a proof on the real matter at issue—viz., whether the vibrating rales, the obstruction of the tubes, and the consequent dyspnoea, are caused by mucous secretions, as he himself maintains, by sudden inflammatory engorgement of the mucous membrane, as others have supposed, or by spasmodic narrowing of the tubes generally or locally, as is the common opinion in this country. (2, pages 24-25)(3, pages 373-374)

"On the part of the mucus-theorists, it is alleged that the paroxysm of asthma is almost always terminated by expectoration of a thick, semi-transparent mucus, and that its accumulation was in all probability the cause of the paroxysm. We admit the fact to be true, but doubt very much the correctness of the inference; at least it is certain that, in ordinary bronchitis, enormously greater accumulations of mucus take place with comparatively few signs of general obstruction. We think this position must be admitted by every unbiassed observer; and it is, in our opinion, fatal to this theory. Nor can we find more probability in the theory of inflammatory or congestive thickening of the bronchial mucous membrane. That such a lesion should become the source of most serious dyspnoea in ten minutes (an incident of frequent occurrence in the violent forms of asthma); that it should subside with almost equal rapidity; that it should almost never produce a directly fatal result by asphyxia, and very rarely issue in the expectoration of pus, while, on the other hand, far more severe forms of inflammatory bronchitis often produce comparatively little evident dyspnoea—these are, in our opinion, ample reasons for rejecting the congestion theory of asthma, and maintaining the spasmodic as probable, even had the power of the bronchial fibres to produce sudden and rapid obstruction not been positively ascertained." (2, page 25)(3, page 374)

He resigned his professorship in 1890 and became a resident of his home town of Edinburgh.  Although, according to the University of Glasgow webpage he was regius at the university from 1862-1900.  (1)(5)

He passed away at the age of 82.

References:

1. "Sir W. Gairdner," Obituaries, The Times, Monday, Jul 01, 1907; Issue 38373, page 7; column D, London, accessed from Wikisource, http://en.wikisource.org/wiki/The_Times/1907/Obituary/Sir_W._Gairdner, on 1/21/14
2. Salter, Henry Hyde, "On Asthma: It's Pathology and Treatment," 1864, London, Blanchard and Lea, pages 12, 24-25
3. "Reviews: Memoirs on a New Distinction of Two Forms of Bronchitis by J.H.S. Beau," British and Foreign Medico Chururgical Review or Quarterly Journal, Volume XI, January-April, 1853, New York, S.S.&W. Wood, pages 355-376, or, more specifically, 373-374
4. Hamilton, David James, "A Textbook of Pathology: Systemic and Practical," Volume II, 1894, London, Macmillan and Co., page 66
5. "Sir William Tennant Gairdner," University of Glasgow, http://www.universitystory.gla.ac.uk/biography/?id=WH2281&type=P, accessed 1/21/14

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