1872: George Catlin describes Native American Respiratory Therapists

George Catlin (1796-1872)

There are many people we can thank for preserving the history of respiratory therapy, and among them is Georgy Catlin.  He was a painter who traveled to North and South America taking portraits of Native Americans.

By living among them between the years of 1832 to 1839, he became an expert of sorts on their way of life.  Included among his wisdom was knowledge on their view on air and breathing. 

Along with making portraits of them, he recorded their habits and their rituals.  He noted that their view on medicine was not the same as ours, as the Indians essentially thought of medicine as a mystery.  So as they used the term medicine pipe, they were essentially saying mystery pipe, meaning they didn't know how it worked.

Catlin, in "Notes of Travels Amongst the North American Indians," said he observed that the Indians, in their savage state, were healthier and had fewer diseases  --- including weakness of the lungs, bronchitis, and asthma -- than people who lived in the civilized world.  He made a similar observation in his book "The breath of life, or mal-respiration."   (3, page 3, 73) John D. Hunter (3, page 342) and John Lawson (4, page 151)

Georege Catlin oil on canvas
portrait of native american
See-non-ty-a,
an Iowa Medicine Man
1844-45 (Wikepedia)

He said he decided to write "breath of life" because...

...I have visited 150 Tribes, containing more than two million souls; and therefore have had, in all probability, more extensive opportunities than any other man living, of examining their sanitary system; and if from those examinations I have arrived at results of importance to their health and existence of mankind, I shall have achieved a double object in a devoted and toilsome life, and shall enjoy a twofold satisfaction in making them known to the world; and particularly to the Medical Faculty, who may perhaps turn them to good account." (2, page 3-4)

Along with diseases being rare, he observed that fatal conditions of the lungs were rare among the savages and the animals that lived amid the wild -- dog, ox, horse, etc.  This was not true among civilized man.  Lung ailments, along with ailments of the spine and abdomen, were rarely heard of among savage people, while civilized people had an amalgamate of ailments, including a variety of diseases, and aches and pains.
  

The natives believed that breathing was essential to life, and of this Catlin said:

Per Catlin: "Shut—your—mouth. " (2, page 71

Man's cares and fatigues of the day become a daily disease, for which quiet sleep is the cure; and the All-wise Creator has so constructed him that his breathing lungs support him through that sleep, like a perfect machine, regulating the digestion of the stomach and the circulation of the blood, and carrying repose and rest to the utmost extremity of every limb; and for the protection and healthy working of this machine through the hours of repose, He has formed him with nostrils intended for measuring and tempering the air that feeds this moving principle and fountain of life; and in proportion as the quieting and restoring influence of the lungs in natural repose, is carried to every limb and every organ, so in unnatural and abused repose, do they send their complaints to the extremities of the system, in various diseases; and under continued abuse, fall to pieces themselves, carrying inevitable destruction of the fabric with them in their decay.... The two great and primary phases in life and mutually dependant on each other, are waking and sleeping; and the abuse of either is sure to interfere with the other. For the first of these there needs a lifetime of teaching and practice; but for the enjoyment of the latter, man needs no teaching, provided the regulations of the All-wise Maker and Teacher can have their way, and are not contravened by pernicious habits or erroneous teaching... If man's unconscious existence for nearly one-third of the hours of his breathing life depends from one moment to another, upon the air that passes through his nostrils; and his repose during those hours, and his bodily health and enjoyment between them, depend upon the soothed and tempered character of the currents that are
passed through his nose to his lungs, how mysteriously intricate in its construction and important in its functions is that feature, and how disastrous may be the omission in education which sanctions a departure from the full and natural use of this wise arrangement? (2, page 15-16)

He observed that native American mothers closely watched the breathing of their infants, of whom rarely, if ever, passed from this life (In fact, Catlin quotes an Indian Chief as saying that it is rare that a child under the age of ten passes away.)  Catlin explained:

When I have seen a poor Indian woman in the wilderness, lowering her infant from the breast, and pressing its lips together as it falls asleep in its cradle in the open air, and afterwards looked into the Indian multitude for the results of such a practice, I have said to myself, "glorious education! such a Mother deserves to be the nurse of Emperors." And when I have seen the careful, tender mothers in civilized life, covering the faces of their infants sleeping in overheated rooms, with their little mouths open and gasping for breath; and afterwards looked into the multitude, I have been struck with the evident evil and lasting results of this incipient stage of education; and have been more forcibly struck, and shocked, when I have looked into the Bills of Mortality*, which I believe to be so frightfully swelled by the results of this habit, thus contracted, and practised in contravention to Nature's design

There is no animal in nature excepting Man, that sleeps with the mouth open; and with mankind, I believe the habit, which is not natural, is generally confined to civilized communities, where he is nurtured and raised amidst enervating luxuries and unnatural warmth, where the habit is easily contracted, but carried and practised with great danger to life in different latitudes and different climates; and, in sudden changes of temperature, even in his own house... The physical conformation of man alone affords sufficient proof that this is a habit against instinct, and that he was made, like the other animals, to sleep with his mouth shut—supplying the lungs with vital air through the nostrils, the natural channels; and a strong corroboration of this fact is to be met with amongst the North American Indians, who strictly adhere to Nature's law in this respect, and show the beneficial results in their fine and manly forms, and exemption from mental and physical diseases, as has been stated.

The Savage infant, like the offspring of the brute, breathing the natural and wholesome air, generally from instinct, closes its mouth during its sleep; and in all cases of exception the mother rigidly (and cruelly, if necessary) enforces Nature's Law in the manner explained, until the habit is fixed for life, of the importance of which she seems to be perfectly well aware. But when we turn to civilized life, with all its comforts, its luxuries, its science, and its Medical skill, our pity is enlisted for the tender germs of humanity, brought forth and caressed in smothered atmospheres which they can only breathe with their mouths wide open, and nurtured with too much thoughtlessness to prevent their contracting a habit which is to shorten their days with the croup in infancy, or to turn their brains to Idiocy or Lunacy, and their spines to curvatures—or in manhood, their sleep to fatigue and the nightmare, and their lungs and their lives to premature decay.

If the habit of sleeping with the mouth open is so destructive to the human constitution, and is caused by sleeping in confined and overheated air, and this under the imprudent sanction of mothers, they become the primary causes of the misery of their own offspring; and to them, chiefly, the world must look for the correction of the error, and, consequently, the benefaction of mankind. They should first be made acquainted with the fact that their infants don't require heated air, and that they had better sleep with their heads out of the window than under their mother's arms—that middle-aged and old people require more warmth than children, and that to embrace their infants in their arms in their sleep during the night, is to subject them to the heat of their own bodies; added to that of feather beds and overheated rooms, the relaxing effects of which have been mentioned, with their pitiable and fatal consequences. (2, pages 16-19)

He was actually onto something here that may have been proved in the modern world.  Many of the diseases and plagues that ail civilizations are of our own doing.  By taking children away from nature, their immune systems aren't exposed to microscopic forces necessary for maturation.  This results in diseases such as asthma, or so states the Hygiene Hypothesis and the Micro Flora Hypothesis.  Yet these are modern theories. Catlin came to this realization by his own observations, without ever having done any studies.


"Who ever waked out of a fit of the Nightmare in the middle of the night
with his mouth strained open and dried to a husk, not knowing when or
 from where, the saliva was coming to moisten it again,without being
willing to admit the mischief that such a habit might be doing to the lungs,
 and consequently to the stomach, the brain, the nerves, and every
 other organ of the system?"  It requires no more than common sense
to perceive that Mankind, like all the Brute creations, should close their
mouths when they close their eyes in sleep, and breathe through their
nostrils, which were evidently made for that purpose, instead of dropping
the under jaw and drawing an over draught of cold air directly on the lungs,
through the mouth; and that in the middle of the night, when the fires
have gone down and the air is at its coldest temperature—the system at rest,
 and the lungs the least able to withstand the shock. (2, page 21-22)

Like John D. Hunter, Catlin observed that sleep was essential to resting the lungs and the limbs from the labors of life.  While one is sleeping the breathing and the pulse is slowed.  Yet too much sleep is also bad. Catlin explained:

In natural and refreshing sleep, man breathes but little air; his pulse is low; and in the most perfect state of repose he almost ceases to exist. This is necessary, and most wisely ordered, that his lungs, as well as his limbs, may rest from the labour and excitements of the day.

Too much sleep is often said to be destructive to health; but very few persons will sleep too much for their health, provided they sleep in the right way. Unnatural sleep (due to sleep inducing drugs?), which is irritating to the lungs and the nervous system, fails to afford that rest which sleep was intended to give, and the longer one lies in it, the less will be the enjoyment and length of his life. Any one waking in the morning at his usual hour of rising, and finding  by the dryness of his mouth, that he has been sleeping with the mouth open, feels fatigued, and a wish to go to sleep again; and, convinced that his rest has not been good, he is ready to admit the truth of the statement above made.

Breathing with mouth closed is ideal  (2, page 22)

There is no perfect sleep for man or brute, with the mouth open; it is unnatural, and a strain upon the lungs which the expression of the countenance and the nervous excitement plainly slow. (2, pages 20-21)

So the Indians, at least according to Catlin, were very conscious of the importance of breathing and sleeping.  They must, in a sense, be considered among the first true respiratory therapists.

*Bills of Mortality are a means of keeping death statistics in the 16th, 17th and 18th centuries, and mainly started after the plague of London in 1592.  Statistics were generally taken every week in order to keep track of how many people died, along with the cause of death. Sometimes they also included the age of the deceased.  See figure here and here.  Bills of Mortality are believed to have originated due to the ideas published by John Gaunt of England in his 1662 publication "Natural and Political Observations upon the Bills of Mortality." The book is considered the "first book of vital statistics."  He learned that more boys were born than girls, and that by creating an accurate death count he could estimate the population.  This was, therefore, the "first step in the application of mathematical methods to the interpretation of statistics." Truly, however, the first people to keep track of such statistics were the ancient Hebrews and Romans. (5, page 273)

References:

1. Catlin, George, "Manners, Customs, and Condition of the North American Indians," 1841,
2. Catlin, George, "Breath of life, or mal-respiration and its effects upon the enjoyments and life of man," 1872, New York, John Wiley and Sons, Publishers
3. Hunter, John D., "Memoirs of a Captivity Among the Indians of North America," 1823, London, Paternoster-Row
4. Vogel, Virgil J., "American Indian Medicine," 1970, London, Oklahoma University Press
5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company

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