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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1823: Native American sweat houses, an early panacea

Native Americans of both South and North America believed that sweating was one of the simplest and most effective means of treating diseases. The various people who lived among or studied native Americans observed their use of herbal remedies to cause a sweat, or sweat houses.

Virgil Vogel, in his 1970 book "American Indian Medicine," notes that the Aztecs used the sweat bath as a cure all for many ailments. There were various experts who noted the use of sweat baths among the natives of North America. He quotes Jean Bernard Bossu (1720-1792) who observed the Choctaws of Canada using "steam cabinets in which are boiled all sorts of medicinal and sweet-smelling herbs. The vapor filled with the essence and salts of these herbs enter the patient's body through his pores and his nose and restores his strength." (2, page 255)

John D. Hunter also describes sweating, and says it's a good asthma remedy. In fact, Hunter says that most of the medicines used to treat asthmaare meant to induce a profuse sweating, which is believed to cause healing. You may read of other remedies, and sweating is usually the desired result; rather, improved breathing through sweating. (1, page 410)

We must understand that sweating was not just used for asthma, it was sort of a panacea for many ailments. (2, page 256) It was a way of cleansing the body and the soul. Hunter describes this:

Nes-ni-ne-shu-ka-ah. — The salt water runs. Sweating. — Among all the various Indian nations with which I am acquainted, sweating constitutes one of their principal remedies, and amongst some of them * like bathing, it is practised for the pleasurable sensations which it produces. Various means are resorted to for the attainment of this object. Some effect it by drinking warm infusions; others assist these means by enwrapping themselves in blankets or skins, while a majority have separate apartments prepared for the purpose of procuring it by exposure to the steam of water. For this, a house sufficient in size to contain one, two, or more persons, is constructed of sticks or logs; commonly on the sloping side of a hill, and convenient to water. An excavation is next made in the earth-flooring, in which they place heated rocks. The bath thus prepared, the patient closes himself in, and pours water on the rocks till the apartment is filled with steam, and the intended effect produced. Herbs and roots of various kinds are placed on the rock, with a view that their virtues may unite and ascend with the vapour. During the process, the patient drinks freely of the infusion of dittany, mountain tea, or other herbs. He remains in as long as the heated rocks retain warmth sufficient to produce vapour. When he leaves it, he wraps himself in a buffalo robe or blanket, and immediately, if able, repairs to his house, and if not he is assisted and goes to bed. I have frequently known them to remain in until they became quite faint. When this bath is used as a luxury, they frequently, on leaving it, plunge into cold water; and I have never witnessed any dangerous or ill effects to arise from the practice. Some tribes resort to another expedient to induce sweating. They make a hole in the ground of a size and depth sufficient to contain the body of the person wishing to undergo the operation. They continue a fire in it till it becomes quite heated. The patient wrapped in his blanket or robe, stands over the excavation, water is poured in it, and the steam rises between his body and its envelop; while others again immerse themselves in the water.They also produce sweating by covering themselves in the hot sands of the barrens, and I believe with much advantage in some cases. (This may also be considered an early, or primitive, fumigation.) (1, page 423-44)

It was a soothing remedy and one that was easy to do. It was a remedy that was inculcated deep into folk medicine. I remember when I was a kid and having asthma trouble, my dad would sit with me in the bathroom with the hot water showering in the tub. My grandma would have me sit with my head
under a towel in the bathroom sink with the hot water on. Surely this provided a cool sensation, but it rarely if ever provided any breathing relief.

References:

1. Hunter, John D., "Memoirs of a captivity among the Indians of North America, from childhood to the age of fifteen: with anecdotes descriptive of their customs to which is added some accounts of the soil, climate and vegetable productions of the territory westward of teh Mississippi," 1823, London, Paternoster-Row
2. Vogel, Virgil J. "American Indian Medicine," 1970, London, Oklahoma University Press

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1823: Hunter shares native American asthma remedies

Figure 1 - John D. Hunter

John D. Hunter published a book in 1823 describing his experiences growing up among the Indians of North America, providing us a rare opportunity to see inside Indian Tribes. Of particular interest to our asthma history is Hunter's description of how the Indians perceive hasthma and what remedies they used to treat it.

Hunter recollected no idea where he was born, although he knew the Indians massacred his parents, and took him prisoner. He became the property of a warrior named Fongoh of a tribe of the Kickapoo Nation along the Kalkaska river in Michigan. The Kickapoo were among the hundreds of thousands of Algonquin Indian tribes, and they were nomads who "roam with unrestrained freedom" to hunt for game and to cultivate the soil for the purpose of planting crops used to make food and crafts. The main crop of the Indians Hunter lived with was sugar, at least while they lived along the Kalkaska River. (1, page 8)

Figure 2 -- Kickapoo Hut (wickiup) and tribal member

The Kickapoo set up huts called wickiups, which consisted of an "oval base and a rough frame covered with reed mats, grass, or brushwood."

You can see a picture in figure 2.

As they traveled from place to place these were easily set up. Inside many of these homes, and amid the contents carried on their backs as they traveled, were medicine bags made of beaver or otter skin that were "curiously ornamented."

These bags contained "small sacred articles," along with "medicinal barks, roots, and herbs." Since they were considered sacred, not even "unhallowed hands" would interfere with their contents. (1, page 342)

Hunter said that...

...every encroachment made upon their territory, whether with or without their consent, is, sooner or later, regarded as infringement of their natural rights, and has frequently given rise to long, cruel, and exterminating wars, not only between different tribes, but between the Indians and the whites. They regard the latter with much the most scrupulous jealousy; because experience has taught them that every settlement on their part, within their boundaries, is a precursor to their farther recess, which, they most sensibly feel, will only terminate with their final expulsion, extermination, or incorporation with those they esteem their natural and most bitter enemies. (1, page 8)

This, he believes, is how he came to live among the Indians. He watched them go to war with white families, and massacre the warriors, and take the children prisoners. While jealousy is a main cause for war, he said that in most cases the the Indians were "provoked" by "frauds and thefts practised upon them, which provoke to retaliation and aggression; consequently, the innocent and guilty indiscriminately suffer. Such conduct, mutually practised by them and the whites, along the whole extent of the conceived, though arbitrary boundary, is the cause of the inveterate hostility that exists between them, and leads to all the scenes of Indian cruelty that are practised on the frontier settlers." (1, page 9)

So it was in this way that he and others like him were "forced to assume the Indian character and habits," and after a while they became "happy and contended as though they had assembled directly from the Indians, and were in possession of their patrimony." (1, page 13, 14)

Many of the other white children raised by the Indians adapted to the simple primitive life so well that they chose to live out the remainder of their lives among the Indians, Hunter said.

He added that he was not one of these.   (1, page 13, 14)

When he was 19 or 20 he says he was allowed to go free, and he most duly accepted his freedom. He returned to become a citizen of the United States, and it was during this part of his life that he wrote of his experiences among the Indians.  (1, page 13, 14)

The first Indians he lived with marched north to Mackinac where there was better hunting, and they joined with other Indians, and at some point these Indians, and all the Indians he lived with, were massacred, and once again all the women and children were taken prisoners. Somehow along the way he ended up with a tribe associated with the Osages, who were much less settlers as the Kickapoo were, and more likely to wander in search of game. Occasionally they came into skirmishes, as did the Kickapoo, and in the course massacres occurred, and the heads of enemy warriors were walked back to camp, along with prisoner women and children. He didn't know the name of the tribe, although he knew they were among the Pawnee. (1, page 18)

His tribe ended up among the Kansas tribe, were ambushed, and members of his tribe either fled, were killed, or taken prisoner. Hunter was among those taken prisoner, and with his new tribe set off on a long march to the Kansas River. He was "adapted into the family of Kee-nees-tah by his squaw (wife), who had lost a son in one of their recent engagements with the Pawnees. I was exceedingly fortunate from this election; and not only the chiefs and squaws, but the whole tribe, treated me with regard and tenderness. This conduct in respect to myself was not singular, for all the women and children were treated in the same manner; while the warriors who were so unfortunate as not to fall in battle were nearly all tortured to death: a few of them, however, were respected for their distinguished bravery, and permitted to live amongst them. (1, page 19)

In comparing the Kickapoo with the Kansas, he said:

Injustice to my own feelings, I cannot avoid making some remarks in this place, on the difference of character that exists between the Kickapoo and Kansas Indians. The former are treacherous, deceitful, cunning, not tenacious of a good character, exceedingly remiss in their social habits and intercourse, and are held in humble estimation by the neighbouring tribes: while the character of the latter, according to the estimation I formed of their conduct to me, is directly the reverse.  In this difference of their general character, it is, however, possible for me to be mistaken; but gratitude is a virtue inculcated by all the Indian tribes with which I have been acquainted; and so great was the change of conduct towards me, after my transposition from the former to the latter, that I am persuaded my readers will excuse me, even should I have committed an error. (1, page 19-20)

They had horses, and they ate venison, buffalo meat, corn, nuts, etc. He learned how to ride horses, learned how to hunt, and learned to protect his hunting grounds from encroachments. He learned their virtues, values, and customs by listening to the "inspiring narratives" of the sages. The sages, according to Hunter, would say things like:

"Never steal, except it be from an enemy, whom it is just that we should injure in every possible way. When you become men, be brave and cunning in war, and defend your hunting grounds against all encroachments. Never suffer your squaws or little ones to want. Protect the squaws and strangers from insult. On no account betray your friend. Resent insults — revenge yourselves on your enemies. Drink not the poisonous strong-water of the white people; it is sent by the Bad Spirit to destroy the Indians. Fear not death; none but cowards fear to die. Obey and venerate the old people, particularly your parents. Fear and propitiate the Bad Spirit, that he may do you no harm; — love and adore the Good Spirit, who made us all, who supplies our hunting grounds, and keeps us alive."

It is in this way that Hunter learned the ways of the Indians, and became a credible author on the subject. He said that the Indians were were a very healthy people, and that the warriors were morel likely to die in a fray as compared to natural causes. There were essentially few diseases among the Indians, and most tribes were familiar with the diseases that were most common to their tribe, and by trial and error they learned of the best remedies for treating these maladies. Since asthma was a disease that plagued those who lived to old age, there would be remedies for asthma in many medicine bags. (1, page 342)

He wrote the following about asthma:

Asthma. — When we consider the hardships the Indians undergo, it is not surprising that they should be subject to asthma. This is not an unfrequent disease among them. Their remedies are blisterings, fomentations, and anodynes. There is, perhaps, no complaint, in which Indian remedies are more successfully employed. They use the sweat-oven, as before described, with great success. Sometimes relief is obtained by the application of small bags of wet ashes upon the breast; and sometimes by inhaling the streams arising from water poured upon hot stones, and herbs of various kinds. But by far the most valuable remedy ever used among them for the cure of this distressing complaint, is a small plant, .wesh-ke-nah. This plant somewhat resembles the common flax, though it is more branched, and not linty like the latter. An infusion of it, roots and tops together, in doses of half a pint, at intervals of twenty minutes, till relief is obtained, is the usual mode of administering it . In a short time its beneficial operation is perceivable by a gentle moisture on the skin, more easy respiration, ability to lie in a recumbent posture, &c. Shortly after a more copious sweating comes on, attended with an expectoration of phlegm or mucus, and entire relief from pain. The patient now falls into a comfortable sleep, from which he awakes free from his disease. Thus have I seen these untutored followers of Esculapius subdue some of the worst cases of asthma. (1, page 443-4)

This description of asthma is not the same as our modern definition. As would be normal for the time, his description was mainly of the symptom of shortness of breath or dyspnea, which could be from any generic cause.

He also explains the asthma remedies stored in the medicine bag.

• Wesii-ke-nah.—  It relieves hard breathing. The flax weed—grows in the fissures of rocks, particularly on cliffs, on the margin of the rivers, to the height of ten or twelve inches; the root sends off many branches, which in July produce numerous small pale blue flowers. The Indians gather the plant, while in blossom, and prescribe it for asthmas and coughs with the happiest effect . The roots, leaves, and stalks, are made into a decoction, and given freely to the patient, as warm as he can conveniently take it; and no medicine displays its salutary effects more promptly. I speak thus confidently, because I have witnessed its operations. The Indians sometimes while travelling, or when just returned from long and fatiguing journeys, are seized with the asthma, but are certain to obtain prompt and decided relief from this remedy. I believe it almost uniformly excites a perspiration, on the appearance of which the patient becomes easy. (1, page 410)
• Was-saw-ba-he-ja. — The fat of the bear. Bears' oil.— This is used as a medicine, both internally and externally, in combination with many drugs...  For colds they seethe the roots of wild liquorice in it, which they drink hot as they can well bear it. They also take it for asthma and pleurisy. They esteem it among the most valuable articles of food, especially in their journies. It is highly nutritive, agrees well with the stomach, and produces no thirst . From the smallness of the quantity necessary to satisfy the appetite, it produces no shortness of breath. The Indians, while travelling, take about four ounces in twenty-four hours, which they continue for days together, with very little other nourishment. (1, page 404)
• Ne-pe-sha.—Bad luck to touch it. Milk-weed.— ...The Indians use the roots in decoction for the cure of dysentery, dropsy, and asthma. It is also used as an emetic, and held in tolerably high estimation as a medicine in the above cases. (1, page 414)
• Sin-des-nes-ni.—It grows by the water. Green-twig.—(Willow) This is a shrub very common on the banks of rivers and water courses. It seldom attains to a height exceeding six or eight feet, and is considered valuable in colds, and asthma; they give a warm infusion at night, with a design to excite perspiration. (1, page 411)
• TU-TUS-Se-GA-O-GA-SHE. To expel Wind. Spikenard. — This spikenard is one of the most luxuriant of the forest plants: it grows in the beds of hollows in hilly districts in great abundance, and if it possesses half the virtues ascribed to it by the Shawanee Indians, it merits a high rank in the Materia Medica. They give it with a view to expel wind from the stomach, to stop coughs, and to relieve pain in the breast and asthma. (1, page 422)
• Sweating:  The various herbs above usually cause improved breathing by causing the patient to sweat. (1, page 410)  Another means is to take in a draught of herbs and spices.  Another means was to places herbal solutions on heated bricks, rocks, or pots, and place a blanket or furs over the patient's head.  Another means was the sweat house, where water was placed on heated rocks and the fumes inhaled.  This was done while drinking tea. (1, page 423-4)

There are other ailments that plagued the Indians besides asthma, and these included pleurisy, fevers, and upset stomachs and pains. Consumption also plagued them, although rarely. (1, page 342, 347)

Usually the plagues were short term, and were the result of exposure to the elements and fatigue from long excursions and working hard and bravery. Although at times diseases became chronic, or the patient became "dangerously sick." (1, page 342, 347)

Some of these patients become sick enough to be housed in a hut for sick people, with cots that were raised from the ground. The medicine men would treat these patients daily, and nurses, usually women, would care for their daily needs. These may have been considered as hospitals. As they traveled from place to place, the sick were continuously cared for (1, page 342, 347)

Since pure asthma must have been extremely rare among the Indians, most asthma must have actually been bronchitis from inhaling smoke, or heart failure from old age, and these probably would have been the asthmatics referred to by Hunter. This must have often been what ensued when a warrior lived to old age. Of these, Hunter wrote the following: 

When all natural means fail, the physicians do not abandon their patients; on the contrary, they cling to them till their last gasp, but substitute, instead of their prescriptions, fastings and prayers to the Great Spirit. "So long as there is life," say they, "there is room for hope; and to despair of effecting good, and to neglect means that appear remote and almost foreign to the disease, bespeak a careless and unskilful practice." When their hopes fail, they seldom inform their patients of their danger, but are very cautious that their last moments may be calm and undisturbed. In general, they look upon sickness and affliction as chastisements for their offences against the Great Spirit, and commonly bear them with great resignation and fortitude. When they become peevish and fretful, as sometimes happens, their doctors then say, that the abatement of their disease permits their minds to be idle or unoccupied, and the danger is past. (1, page 350-351)

He described the Indians as having "no anxiety about the future, and they, but leave the world with an apparent satisfaction, under a belief, provided their conduct has been in consonance with the precepts which they have been taught, that their title to the future happiness is unquestionable." (1, page 352-3) 

This must be similar to modern Christians, whose belief in God and the afterlife allows them to end life with grace in dignity.

For the most part, however, as a remedy was needed, either the patient or the nurse, who was mostly the mom or consort or some other woman in the tribe, gave the remedy to the sick person.  

If the remedy no longer worked, which most likely would happen if the person was severely sick (as if close to death), the medicine man (or physician) would be consulted.  I will describe the healing powers of the North American Indian Medicine Man in my next post.  

Note:  Similar remedies were used for colds, pneumonia, consumption, and pleurisy.  (You can find some more asthma remedies by reading "Herbal and Magical Medicine: Traditional Healing Today," edited by James K. Kirkland et al, page 157)

References:  

1. Hunter, John D., "Memoirs of a captivity among the Indians of North America, from childhood to the age of fifteen: with anecdotes descriptive of their customs to which is added some accounts of the soil, climate and vegetable productions of the territory westward of teh Mississippi," 1823, London, Paternoster-Row

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1805: American Indians smoked asthma weed

American Indians smoked dried herbs stuffed into pipes too.  Now, did they get this wisdom from travelers from far off lands, or did they come up with the idea on their own?  No one knows for sure, and either theory is a possibility.

Figure 5 -- Kellog's Asthma Relief
contained both lobelia and strammonium (2)

Either way, American Indians had access to another member of the nightshade family called lobelia inflata.  Various people experimented and observed it's effects when ingested and inhaled, and soon it was learned of the hallucinogenic effect.

At first it must have been tossed into fires, later on heated bricks or in pots, and ultimately the herbs were stuffed into pipes and smoked, just as they were in ancient India, and probably Egypt and Mesopotamia before that.

While American Indians mostly smoked their pipes for the hallucinogenic effect, or to benefit other ailments, the medicine was, at some point, recommended for asthma-like symptoms too. It is for this reason that Indian Hemp is often referred to as Indian Tobacco or Asthma Weed.

American physicians were introduced to lobelia and used it for asthma releif, yet they also used it to make some patients vomit.  The idea here was that along with vomit, toxins would be removed from the body to balance the humors and cure the ailment.

For this reason it was often referred to as pukeweed and vomitwort.  (1)

References:

1.  University of Maryland Medical Center, "Lobelia,"  http://www.umm.edu/altmed/articles/lobelia-000264.ht
2. Picture used with permission from Inhalatorium.com
3. Jackson, Mark, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma,"  Med Hist., 2010 April; 54(2): 171–194.

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