Friday, December 9, 2016

1865: Bamberger supports diaphragmatic theory of asthma

Heinrich von Bamberger (1822-1888)
Heinrich von Bamberger was an Austrian pathologist who provided evidence, similar to Duchenne before him, that he said supported the diaphragmatic theory of asthma.

Born in Prague in 1822, he earned his medical degree in 1847.  He worked as a pathologist at the University of Wurzburg and, beginning in 1872, at the University of Vienna.  (1)

While he wrote two books that were well received by the medical community, including his 1857 book "A Treaties on the Diseases of the Heart," he also published a book for physicians in 1865 sharing his knowledge of asthma called "Ueber Asthma Nervosum."  (1)

He supported the theories of Alton Wintrich, Guillaume Benjamin Amand Duchenne, and Michael Anton Biermer.  Joseph Berkart, in his 1878 book "Asthma: It's Pathology and Treatment," said:
In a case of fatal dyspnoea he had occasion to observe the tetanus of the diaphragm, and to convince himself by post mortem examination, of the absence also of structural lesions. Although the symptoms of that case by no means resembled those usually assigned to asthma, he, nevertheless, regarded them as characteristic of the disease. Reviewing then the theories held on the nature of the affection, he arrived at the conclusion that the presence of the bronchial muscles did not warrant the assumption of a bronchial spasm. If this existed, he would expect to find the diaphragm ascended, the intercostal spaces drawn in, and a dull resonance on percussion; indeed all the physical signs described by Williams and Bergson in conformity with their theory. But, as yet, he had never met with a case presenting those symptoms. So far as his observations went, he had always found dilatation of the thorax and hyper-resonance on percussion. These signs could be accounted for only by assuming a tonic spasm of the diaphragm and the auxiliary muscles of respiration; and he therefore inclined to the opinion of Wintrich, Duchenne, and Valette. (2, page 36-37)
Berkart said Bamberger further divided asthma:
  • Central: Nervous asthma that causes tetanus of the diaphragm (he also beleived that paralysis of diaphragm was a cause of asthma, especially in cases of muscular atrophy observed by Duchenne.) (2, page 37)(3, page 7)
  • Peripheral: Asthma that accompanies emphysema, bronchitis, pleuritic effusions and tuberculosis (2, page 37)
Other physicians who supported the diaphragmatic theory of asthma were Lehmann, George H. Kidd, and Germain See.  (2, page 37)

So you can see that the diaphragmatic theory of asthma garnished some very respectable support during this era.

References: 
  1. "Bamberger, Heinrich von, "The Encyclopedia Americana," 1920, compliments of wikisource, http://en.wikisource.org/wiki/The_Encyclopedia_Americana_(1920)/Bamberger,_Heinrich_von, accessed on 3/6/14
  2. Berkart, J.B., "On Asthma: It's pathology and treatment," 1878, London, J. & A. Churchill; Berkart references the following: Ueber Asthma nervosum: Wiirzb. Mediz. Zeitsch., Bd. vi, 1868, p. 102-116.
  3. Thorowgood, John Charles, "Notes on Asthma," 1878, 3rd edition, London, J and A Churchill
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