Monday, January 30, 2017

1873: Lebert creates new asthma theory

Herman Lebert (1813-1878)
In 1873, Herman Lebert came up with an interesting theory about asthma that lasted for several decades, and into the 19th century.  

Lebert was born in Germany, and later became professor of pathology in Paris and Zurich.  As a pathologist he spent hours in a lab investigating tissues under the microscope.  

Steven I. Hajdu, in a 2004 article in Annals of Clinical Laboratory Science, said Lebert was one of the first clinical pathologists who often goes unrecognized by pathologists, when he should be a household name to them.  (1)

Hajdu said he sliced"fresh tissues with a razor-like knife and prepared cell samples (smears) by scraping, washing, or by squeezing the tissue slices. Samples from fluids were placed on glass slides without preservatives. Most microscopic preparations were unstained, but occasionally a drop of iodine was applied as a stain." (1)

It was by this approach that he learned about cancerous tumors.  Hajdu said:
In his text on cancer (1851), Lebert gave concise summaries and organ specific descriptions of all forms of tumors. The book consists of 885 pages and discusses the dietary, surgical, and medical treatment of cancer. In 1857, Lebert published a comprehensive pathology text in two volumes that covered everything that was known at that time about anatomic pathology, as well as discussions on clinical pathology. (1)
Hajdu said it was Lebert's work, along with fellow pathologist Julius Vogel (1814-1880) who developed the "concepts of cellular pathology.  Vogel and Lebert established the solid basis on which Rudolph Virchow, in the 1860s, built his general theory about cells."  (1)

Despite his accomplishments, Hajdu said, Lebert (and Vogel too) does not get the credit he deserves, at least as far as pathologists are concerned.  This is yet another example of how history is not always written fairly.

Along with his other accomplishments, Lebert also did research on lungs and vessels, and he used this to establish opinions about asthma.

In 1873, he supported both the spasmotic theory of asthma and the diaphragmatic theory of asthma. However, he  believed asthma was caused by dilation of the blood vessels in the lungs. (2, page 45)

In fact, this theory was still believed to be true when epinephrine was later invented in 1900, as the vasoconstricting (vasopressor) component of epinephrine was thought to increase blood flow to the lungs to make breathing easier. (3, page 38)

Lebert also offered an interesting remedy for asthma. Rene Laennec, among other asthma experts of the 19th century, observed asthmatics often developed asthma at night, or in the dark.  Based on this observation, "Lebert advised the use of as many candles as possible in the rooms of asthmatics," said Orville Brown in 1917.(3, page 38)

  1. Hajdu, Steven I, "The first cellular pathologists," Annals of Clinical Laboratory Science, 2004,, accessed 3/11/14
  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
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