1889: Osler's asthma remedies

Dr. Osler's book "The Principles and Practice
of Medicine" was first published in 1892, and
was continually updated until 2001. 

Dr. William Henry Osler's recommended treatment for asthma didn't sway much from what other physicians of his day prescribed.  Since there really was no one medicine to resolve an asthma attack, which medicine to recommend was mainly based on personal preference.

However, Osler was among the first to note the urgency of treating asthma.  He said "immediate and prompt relief is demanded."  Remedies include any of the following:

• A few whiffs of chloroform will produce prompt but temporary relief
• Perles of nitrite of amyl may be broken on the handkerchief or 2-5 drops on cotton-wool and inhaled
• Strong stimulants given hot or a dose of spirits of chloroform in hot whiskey will sometimes induce relaxation
• Morphia or morphia with cocaine will produce more permanent relief (requires hypodermic injection). Good for obstinate attacks.
• Antispasmotics, such as belladonna, stramonium, and lobelia in solution or cigarettes
• Solanacae with nitrate or chlorate of potosh (common in most remedies)
• Any form of asthma cigarettes (one form benefits one pt while another benefits another)
• Nitre paper made with strong solution of potash.  "Filling a room with the fumes of this paper may sometimes ward off a nocturnal attack."
• Tobacco smoke:  sometimes as potent as the prepared cigarette
• Large meals early in the day as opposed to later
• Coffee is better than tea
• City is better than country
• High and dry altitudes are more beneficial than sea shore
• Oxygen may also be tried
• City living was better than country living

Osler was among the first to recommend oxygen for the treatment of asthma, yet while epinephrine (adrenaline) was discovered in 1901, updated editions of his book prior to his death did not mention this quick acting medicine.

Many historians have  noted that Osler was unique in that he mentioned that "death from the attack is unknown."  However, many asthma experts during the 19th century, including Henry Hyde Salter, made similar observations.

References:

1. "Sir William Osler At Seventy -- A Retrospect," The Journal of the American medical Association," 1919, Saturday, July 12, pages 106-108
2. Osler, William, "The Principles and Practice of Medicine," 1892, New York, pages 497-501
3. Bliss, Micheal, "William Osler:  A Life in Medicine," 1999, New York

Further readings:

1. Jackson, Mark, "Asthma: The Biography," 2009, New York, pages 211-12
2. Brenner, Barry E, ed., "Emergency Asthma," 1998, New York, pages 212-14