Wednesday, October 12, 2016

1855: Duchenne proves diaphragmatic theory of asthma

Fig. 1: Guilluame Benjamin Amand Duchenne
(1806-1875) was the first physician to treat
nervous and muscular diseases with electric shock
 therapy. He was, therefore, the founder of
electrotherapy. (1, page 690)
In 1840 and 1855 respectively, William Budd and Alton Wintrich disproved the convulsive and nervous theories of asthma.  Guillaume Benjamin Amand Duchenne was a French neurologist who, unaware of the works of Budd and Wintrich, proved Budd right in 1855 --or so he thought.

Amand was born on September 17, 1806, to a family of seafarers at Boulogne, so it only mades sense his father wanted him to become a sailor Amand,  on the other hand, had a passion for science that he believed sailing would not satiate.   (1, page 690)(2)

So instead of sailing, he attended school at Paris, and among the physicians he trained under was Rene Laennec, the man who invented the stethoscope. Armand graduated in 1831 with a medical degree, practiced in Boulogne for a few years, and then in 1842 he moved to Paris where he dedicated his life to neurology (the study of nerves) and electrophysiology (the study of electrical properties of cells and tissues). (1, page 690)(2)

Medical historian Fielding Hudson Garrison described Duchenne as follows: 
Fig. 2: Michael Faraday (1791-1867) came from
poor parents and received little formal education.
In 1831 he invented the technology needed to
that would allow him to turn it to good use.  He
invented electromagnetic induction, and created
the basic ideas behind the electric generator and
transformer.  He coined words like electrode,
cathode, and ion. Named after him is faradisation,
or a method of applying electric currents to cells
of the body for medical reasons. This, along
with galvanization, were early means of
applying electricity to various parts of the body
for study. (4)(5)
His method of prosecuting his studies was peculiar. A strange, sauntering, mariner-like figure, he haunted all the larger Parisian hospitals from day to day delving into case-histories, holding offhand arguments with the internes and physiciansin-chief, who frequently laughed at him for his pains, and following interesting cases from hospital to hospital, even at his own expense. All this was done in an unconventional and eccentric way, which at first laid him open to suspicion and exposed him to snubs, but the sincerity of the man, his transparent honesty, and his unselfish devotion to science for itself, soon broke down opposition, and, in the end, when his reputation was made, he was greeted everywhere with the warmest welcome. Being timid and inarticulate in relation to public speaking, he was aided by his friend, the fair-minded and generous Trousseau, who, out of fondness for Duchenne, often voiced his ideas with effect in medical societies. (1, pages 690-691)
Through his intricate study of the nervous and muscular systems of the body, he became the first to describe many nervous and muscular diseases that plagued mankind (such as a disease that later became known as Duchenne's Muscular Dystrophy), and he became the first to use electric shocks as a treatment of these diseases.  (1, pages 691-692)(2)

As an expert on nerves and muscles it only made sense that he would study asthma, which, at that time, was considered a nervous disorder.  J.B. Berkard, in his 1878 book, "Asthma: It's Pathology and Treatment," said:
Fig: 3: Duchenne was the first to use electric shock therapy
to treat patients with nervous and muscular disorders,
such as paralysis and hypochondria. He used
faradisation or galvanization to shock or stimulate
specific muscular or nervous cells. While often effective,
it was also very painful for the patient (4)(5)
(Photo from 8, cover page. Caption underneath
reads: "Duchenne, faradising the frontal muscle."
Duchenne demonstrated that faradisation (see figure 2) of the phrenic nerve caused tetanus of the diaphragm. In the animals experimented upon, that operation was followed by distension of the lower half of the thorax, projection of the epigastrium, and extreme dyspnoea, the frequency of respiration being at the same time considerably diminished. Death, however, invariably followed when the electrical irritation of the nerve was continued for more than a few minutes. Unacquainted with the opinions of Budd and Wintrich, Duchenne was at first inclined to attach no importance to his discovery, because he thought a tetanus of the diaphragm was not as yet known to occur in man. Vallette, however, subsequently met with and reported a case of acute articular rheumatism, in which a fatal attack of dyspnoea had lasted for several days uninterruptedly, and from the symptoms of which he distinctly recognised a tetanus of the diaphragm. Duchenne thereupon concluded that a tonic spasm of this muscle was the main cause of the asthmatic paroxysm. (2, page 35)
By these experiments, he therefore unknowingly verified the evidence of Budd and Wintrich in disproving the nervous and convulsive theories of asthma, and proving the diaphragmatic theory of asthma.

Near the end of his life he developed arteriosclerosis of the brain, and he passed away on September 15, 1875. He was 69 years old. (1, page 669)(6)

Note: So the diaphragmatic theory of asthma has been supported by Budd, Wintrich, and Duchenne.  The next, and final, supporter will be Bamberger.

Note: You can view Duchen's book here

  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 3rd edition, 1821, Philadelphia and London, W.B. Saunders Company
  2. Berkart, J.B., "On Asthma: It's pathology and treatment," 1878, London, J. & A. Churchill
  3. Brown, Orville Harry, "Asthma, presenting an exposition of nonpassive expiration theory," 1917, St. Louis, C.V. Mosby Company, page 34
  4. "Michael Faraday,", accessed 3/5/14
  5. "1830s Electromagnetism and Faradisation,", accessed 3/5/14
  6. "Guillaume Benjamin Amand Duchenne,",, accessed 3/5/14
  7. Duchenne, Guillaume Benjamin Amand Duchenne, "Selections from the clinical works of Dr. Duchenne," translated, edited, and condensed by G.V. Poore, 1883, London, New Sydenham Society 
  8. Poore, G.V., "A short sketch of the life and work of Duchenne," in the book "Selections from te clinical works of Dr. Cuchenne," edited by G.V. Poore, 1883, London, New Sydenham Society, pages IX-XX
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