1645: Van Helmont narrows asthma definition

Jean Baptiste van Helmont (1580-1644)

Galileo set the way for others to question old scientific and medical superstitions that were regarded as facts, and one such physician/ scientist/ alchemist was Jean Baptiste van Helmont, who, in 1579, was born into the dawn of the Scientific Revolution in Brussels.

He was the younger son of a noble family, and his father died in his second year. He entered the University of Louvain (Leuven) at a young age, and graduated from his studies in mathematics, astronomy, astrology, and philosophy at the young age of 17. (3, page 260) (4, page 113-114)(7)

He had an opportunity to become the imperial physician, but he declined it because medicine failed to heal him when he obtained scabies from a girl. Instead he decided to "spend his time by fasting, supplication and prayer, and in poverty. He chose the poverty of Christ, giving to his sister all his worldly possessions." (4, page 115)

He then spent time as a Capuchin friar just prior to studying law, botany and medicine. Once this task was completed, he traveled to Switzerland and Italy (1600-1602) and then France and England (1602-15), and then he received his medical degree in 1599. As a physician he was "unwilling to accept money from his sick fellow-man in return for so doubtful an art." (4, page 114)(7)

He put to use his medical skills during a plague that broke out in Antwerp in 1605. (7) This must have earned him quite a bit of fame.  It was also about this time that he was introduced to a person who introduced him to Paracelsus (1493-1541), and he studied his works "zealously." (4, page 114)

Perhaps due to the fame he earned by his travels and experiences, he was offered many attractive jobs from princes and archbishops, although he turned all of these down in 1609, claiming the he did not want to live in the "misery of my fellow men." (7)

It was that same year, in 1609, that he abandoned poverty and Christ, and married a rich heiress by the name of Margaret van Ranst. Through her he inherited several estates, and he retired to one of them, leaving the medical profession to devote his entire life to "chemical science" and transforming the works of Paracelsus. (4, pages 14-15) (7)

By this he became a chemist, although, more than likely, he was an alchemist, following in the footsteps of Paracelsus, of whom, many agree, was also an alchemist.

Unlike Paracelsus, van Helmont didn't believe in ancient Greek theories.  In fact, he became the first to dismiss the idea that asthma (and diseases in general) was a disease caused by an imbalance of the humors and instead was a disease caused by a narrowing of the pipes in the lungs. It was this view that made him a very controversial person during his lifetime.

 Historian Fielding Hudson Garrison explains van Helmont this way:

Like his master, Paracelsus, van Helmont believed that each material process of the body is presided over by a special archaeus, or spirit (which he calls Blas), and that these physiologic processes are in themselves purely chemical, being due in each case to the agency of a special ferment (or Gas). Each Gas is an instrument in the hands of its special Blas, while the latter are presided over by a sensory-motive soul (anima sensitiva motivaque), which van Helmont locates in the pit of the stomach, since a blow in that region destroys consciousness. (3, page 260)

Bradford explained him as follows:

Van Helmont transmuted the fancies of Paracelsus into a sort of mystic and pious system based on chemical principles. He was a considerable chemist. He thought that air and water were the elements; from the water everything on earth takes its origin—the world is the creation of God.(4, pages 114-115)

In order to prove the basic element of the earth was water he performed an experiment where he grew a tree in a a tub for five years and gave it nothing but pure water. He weighed the tree and soil before the experiment, and in the end the soil weighed the same and the tree had gained 160 pounds. He attributed the weight gain of the tree as being due to water. While his conclusion may not have been completely accurate, some historians refer to him as the father of biochemistry because of this experiment. (9)

Bradford continued:

Disease is something active and is caused by the fall of man. The spirit of man came from God, but on account of the fall became so corrupted that a lesser spirit in man gained control. There was next lower a perceptive soul, and below that a something which he called Archaeus; then there is also Gas which arose by the influence of the Archaeus on water. To Van Helmont we owe this word Gas. (4, page 115) 

The term "gas" he derived from the Greek word for chaos.  Due to his experiments with gases he is considered by many historians as the father of pneumatic (air) science.

One of his most famous experiments was when he burned charcoal and produced the substance carbon dioxide. He explained this was the same product produced from fermenting musk, which rendered the air inside caves as unbreathable. Yet at that time he did not use the word carbon dioxide, he used instead the word gas sylvestre.

He also described other gases, such as carbon monoxide, chlorine gas (prescribed by later physicians as an asthma remedy), digestive gases, sulfer dioxide, and a "vital" gas in the blood that we now refer to as oxygen.

Perhaps one of the reasons van Helmont studied air was that he was an asthmatic.  He generally believed asthma was a physical disease of the lungs caused by factors outside the lungs, such as substances one might come into contact with, substances in the air, and substances affecting the mind.

Orville Brown explains how van Helmont suspected the "archeus" was the cause of asthma: (5, page 27)

"Archeus"—a something—a vital spirit—was enshrined in the stomach, and when disturbed, was responsible for disease by sending forth a peculiar fluid, which, reaching the lungs, caused asthma.  (5, page 27)

To grasp a more complete understanding of this system of van Helmont, I will once again refer to Thomas Bradford, who said:

Van Helmont declared a very mystical and fanciful philosophy; the spleen and the stomach were the rulers over the body. The spleen presided over the abdomen, the sexual organs; the stomach over sleep, waking, and folly. This Archaeus also possessed a great power both in man and in animals. Disease depended on a perverted action of the Archaeus. (4, page 115)

More specifically, Walter Pagan, in his 1982 book about van Helmont, said van Helmont believed asthma was caused when a "specific disease semen has planted its root; in the present case (for asthma) a semen that closes the peripheral pores through which air passes from the lungs into the chest cavity.  It is a semen with the property of causing contraction of members and parts."  (2, page 175-176

That this has occurred, Pagan said of Helmont's theory, "is eveident with the phenomena associated with asthma," such as: (2, page 176)

• Diuresis
• Diarrhea 
• Gurgling of the gut
• Contraction around the gums (2, page 176)

Pagan likewise said that because the lung contracted, Helmont referred to asthma as "epilepsy of the lungs." (2, page 176)(1, page 216)(8, page 374)

He also called it this because asthma was observed to be "latent for long periods, only to provoke on special occasions attacks of contraction that chiefly concern one organ; in this case the lungs, in real epilepsy the nervous system." (2, page 176)  

Pagan added one other thing about the "specific disease semon" that causes asthma:

Basically, however, neither of these is a localized ailment but one conditioned by the influent archeus, the vital principle of the organism as a while. This is shown by the associated symptoms outside the lungs. But the anatomical changes must be looked for in the lungs, where the poison attacks directly, and where they are produced as at a specific seat. To that extent asthma (as indeed every other disease) is a local and localized affair. Its poison irritates in the same way cantharides do, and is essentially identical with the poison of epilepsy, but not strong enough to produce the latter. (2, page 176)

It is believed by many historians that he was the first to link asthma with hysteria, and therefore should be given credit as the father of the nervous theory of asthma.  But he usually doesn't get this credit, perhaps because of the controversial nature of his work, and the fact hat he fad no followers.

Most historians give Thomas Willis, his contemporary, credit for creating the nervous theory of asthma.  This is usually the case even though Willis mentioned nervous asthma several years after van Helmont did.  Yet this is just the way history is, sometimes giving credit for discoveries to the most popular person as opposed to the correct person.

Bradford said van Helmont's remedies for just about any disease were: (4, page 115)

• Conjuratoins
• Charms
• Prayer
• Power of god  (4, page 115)

He also used "earthly medicines," such as: (4, page 115)

• Opium
• Mercury
• Antimony
• Wine (for fevers)  (4, page 115)

Barry Brenner, in his 1999 history of asthma, said:

(Van Helmont) noted that the bronchi were the origin of asthma, and that inhaling dust and fish in certain individuals brought on attacks. He noted that the bronchi would react with spasm to dust, especially from the demolition of houses and temples. He described a monk who, while eating fish fired in oil, fell down, deprived of breathing, "so that he was scarce distinguished from a strangled man." The concept put it in conflict with the official Church view of internal humors as the cause of disease, and he was condemned to death until he recanted. (6, page 5-6)

Once he retired he dedicated about seven years to chemical research, and then he spent the rest of his life in "relative solitude and mostly in peace."  (7)

This was despite the fact that most of what he discovered, and most of what he believed, was contrary to the views of the church.  It was due to such controversies surrounding his work that he waited until he was on his deathbed to give his works to his son to edit and publish. So all of what was described above, all he accomplished in his life, was never published until after he was dead.  (7)

Van Helmont had an illustrious mind, one who decided to do what he thought was right as opposed to what was popular.  Surely this caused some controversy during his lifetime, but it was to the benefit of future generations.

References:

1. Nulan, Sherwin B, "The mysteries within: a surgeon explores myth, medicine and the human body," 2000, New York, Simon and Schuster
2. Pagan, Walter, "Joan Baptista Van Helmont: Reformer of Science and Medicine," 1982, UK, Cambridge University Press\
3. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1921, 3rd edition, Philadelphia and London, W.B Saunders Company
4. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
5. Brown, Orville Harry, "Asthma, presenting an exposition of the nonpassive expiration theory," 1917, St. Louis, C.V. Mosby Company
6. Brenner, Barry E, author of chapter one in "Emergency Asthma" called  "Where have we been? The history of acute asthma," 1999, New York, Marcel Dekker, Inc
7. "Jan Baptista van Helmont," Britannica.com, http://www.britannica.com/EBchecked/topic/260549/Jan-Baptista-van-Helmont, accessed 11/11/13
8. Gill, M. H., "Review and Bibliographic Notices: "On the spasmotic asthma of adults," by Bergson, published Gill's book, "The Dublin Quarterly Journal of Medical Science," volume X, August and November, 1850, Dublin, Hodges and Smith, pages 373-388
9. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14

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1666: Dr. Sydenham expands medical wisdom

If you were sick with asthma during the 16th, 17th and 18th centuries, who would you want to treat you? You had an option between a botanic physician and his natural remedies, or a licensed physician and his harsh remedies? Dr. T'homas Sydenham would try to convince you to see him, as opposed to some quack doctor.

Back in this era the common folk simply had a bleak image of licensed physicians. Virgil Vogel, in his book "American Indian Medicine," said this was even noted by men like Thomas Jefferson, Thomas Neville Bonner, and Dr. Oliver Wendell Holmes.

Vogel quoted Nevelle as saying: (1, page 114, 115)

The stubborn addiction of most physicians to mercury, bleeding, and calomel was responsible for widespread fear of the medical men and their medicines.  (1, page 114, 115)

Vogel quotes Jefferson as saying: 

"It is part of the medicine that I wish to see reform, an abandonment of hypothesis for sober facts, the first degree of value set on clinical observation, and the lowest on visionary theories."

He also quotes Holmes, who said:

Nature heals most diseases without help from the pharmaceutic art."  

Thankfully, however, there were some well respected physicians, such as Dr. Thomas Sydenham in Britain and Dr. Benjamin Rush in American.  Although, neither did anything to allay the public's bitter perception of the profession.  

Sydenham had published his books in Britain, and there were no copies of them in America. Rush so respected the medical ideas of Sydenham that he self published Sydenham's book in America in 1809, complete with an introduction by himself. This book was aptly titled: "The Works of Thomas Sydenham M.D."

Historian Thomas Bradford said that Thomas Sydenham was born in 1624 at Winford Eagle, in Dorsetshire, England, to a father with a large fortune. He said that little is known about his early life.  What id known is that he started at Oxford, but war interrupted his studies. Some say he ended up as a soldier in the Parliamentary army of 1642. In 1646 he returned to his studies at Oxford. (3, page 118)

Rush said he obtained a Bachelor's Degree in Physic (the art of medicine) at the University of Oxford in 1648 and in the process obtained "some medical knowledge.  (2, page xvi)

A.J. Cain, in his 1999 book, said Sydenham wasn't content, and continued to travel abroad to further his education. He didn't obtain his M.D. until 1676 at Pembroke Hall at Cambridge. (4)

Bradford said he then moved on to the "celebrated" medical school at Montpelier. He received his degree of doctor at Ct Cambridge, and settled in Westminster, London, where he began his medical practice "sometime before 1661. He received his license from the College of Physicians of London." (3, page 118)

Historian Fielding Hudson Garrison said he is credited as reinstating the hippocratic art into medicine, which involved the art and skill of the physician more so than science and theory.  He believed that "the mind is limited and fallible, and to it final causes must remain inscrutable.  Scientific theories are, therefore, of little value to the practitioner since, at the bedside, he must rely upon his powers of observation and his fund of experience." (5, page 270)

Garrison said he was friends with fellow Englishmen Robert Boyle and John Locke.  However, and interestingly, it is generally believed he did not know of the works of many of his contemporaries, such as Andreas Vesalius, William Harvey, Marcello Malpighi, and John Mayow. Among his favorite books were Hippocrates and Don Quixote.  (5, page 269)

Rush said that Sydenham was well aware of the fact that his continued research into physick elevated him above his peers.  Regardless, he continued to have respect for the wisdom of those who came before him.  

To show this, Rush told the story of one of his meetings with Sir Richard Blackmore, who was physician to King William III and a famed writer and poet. (9). 

Rush said:

It is the general opinion, that he was made a physician by accident and necessity, and sir Richard Blackmore* reports, in plain terms, that he engaged in practice without any preparatory study, or previous knowledge, of the medical sciences; and affirms, that when he was consulted by him what books he should read to qualify him for the same profession, he recommended Don Quixote.

That he recommended Don Quixote to Blackmore, we are not allowed to doubt; but the relater is hindered by that self'love, which dazzles all mankind, from discovering that he might intend a satire very different from a general censure of all the ancient and modern writers on medicine, since he might perhaps mean, either seriously or in jest, to insinuate, that Blackmore was not adapted by nature to the study of physic, and that, whether he should read Cervantes or Hippocrates, he would be equally unqualified for practice, arid equally unsuccessful in it.  

Whatsoever was his meaning, nothing is more evident than that it was a transient sally of an inclination warmed with gaiety, or the negligent effusion of a mind intent on some other employment, and in haste to dismiss a troublesome intruder; for it is certain that Sydenham did not think it impossible to write usefully on medicine, because he has himself written upon it; and it is not probable that he carried his vanity so far, as to imagine that no man has ever acquired the same qualifications besides himself. He could not but know that he rather restored than invented most of his principles, and therefore'could not but acknowledge the value of those writers whose doctrine he adopted and enforced. (1, xvi-xvii)

Sydenham wrote a lot about his ideas on the medical profession of his time, and he had several books published in Britain.  None of these survive, so all that we have left of his works is the book published by Rush.  (3, page 118)

Sydenham believed in the four humors of Hippocrates, and that diseases were caused by some form of peccant matter (or "morbific particles") in the air that were inhaled, and disease states were the result of the body attempting  to expectorate the peccant matter.

Dr. Syndenham describes diseases as follows:

DISEASE,  in my opinion, how prejudicial so ever its causes may be to the body, is no more than a vigorous effort of nature to throw off the morbific matter, and thus recover the patient. For as God has been pleased so to create mankind, that they should be fitted to receive various impressions from without, they could not, upon this account, but be liable to different disorders; which arise either from such particles of the air, as having a disagreement with the juices, insinuate themselves into the body, and mixing with the blood, taint the whole frame; or from different kinds of fermentations and putrefactions of humours detained too long in the body, for want of its being able to digest, and discharge them, on account of their too large bulk, or unsuitable nature.(2, page 1)

In the introduction to the book, Dr. Benjamin Rush (1746-1813) wrote the following:

"The works of Dr. Syndenham are singular, in being alike, celebrated and neglected by modern physicians.  They owe their fame to the invaluable truths that are contained in them; and the neglect with which they have been treated, to certain errors, which have been refuted by modern discoveries and improvements in medicine." (2, page III)

Dr. Rush did little to improve upon the image of the profession, as his methods differ by only a slight degree from those of Sydenham.  For example, Dr. Rush did not believe that "morbific matter" was the cause of disease, nor that the expulsion of this "morbific matter" would cure the disease. (2, page IV)

For the most part, however, Rush supported the medical views of Sydenham.  Dr. Rush said:

To enumerate the many truths that are contained in the following work, would be to transcribe, with the exception of a few pages, nearly every part of it. His histories of acute diseases; his details of the laws of epidemics; his intuitive discernment of old diseases, entangled in new ones; his defence of cool air, and pf depleting remedies, to which millions owe their lives; his sagacity in discovering the precise time, and manner of administering his remedies, and the difference of his practice in the same disease in different seasons, constitute a galaxy of medical knowledge, and mark that rare assemblage of discriminating and combining talents, which have elevated him above the claims of the century and nation in which he lived, and rendered him the physician of all ages and countries. The same talents, employed upon subjects of more general and popular inquiry, would probably have placed him upon the same grade with sir Isaac Newton, in a scale of human intellect... Indeed, so convinced have later times been of the validity and accuracy of his descriptions, that they are considered as the unrivalled delineations of nature; so universally have they been esteemed for their exactitude and truth, that poets never made freer use of, or stole more from Homer, Pindar, or Virgil; satyrists from Juvenal, Persius, or Horace; orators from Demosthenes, Quintilian, or Cicero; nor dramatists from Shakespeare, than physicians have from Sydenham."  (2, page VI)

Dr. Rush believed all medical students should study Sydenham, who believed it was the job of the physician to offer medicine to guide the body in its attempt to rid the body of the peccant material.  For example, Sydenham said of gout:

What is the gout, but the contrivance of nature to purify the blood of aged persons, and, as Hippocrates phrases it, to purge the recesses of the body? And the same may be said of many other diseases, when they are perfectly formed. (2, page 1)

What is impressive here is that the same philosophies of medicine written about by Hippocrates in 400 B.C. were still inculcated in the 17th century, and even still during the 18th century.  This, in essence, should explain some of the harsh remedies -- such as purging and bleeding to expel some peccant matter -- amid the licensed medical profession of the 17th and 18th centuries.

Amid a society that was growing skeptical of the harsh remedies of the licensed medical profession, it only makes sense that a gullible populace would seek the natural alternatives offered by the root and herb doctors, or the botanic physicians.
Chances are, however, that if you had access to an esteemed gentleman physician such as Dr. Sydenham, you'd probably have faith in his remedies.  Of this, Dr. Rush said:

What was his character as a physician, appears from the treatises that he has left, which it is not necessary to epitomize or transcribe; and from them it may likewise be collected, that his skill in physic was not his highest excellence; that his whole character was amiable ; that his chief view was the benefit of mankind, and the chief motive of his actions the will of God, whom he mentions with reverence, well becoming the most enlightened and most penetrating mind. He was benevolent, candid, and communicative, sincere and religious; qualities which it were happy if they would copy from him, who emulate his knowledge, and imitate his methods. (2, page xx)

He was among the most well respected physician of his era, influencing medicine well into the next century.  By his method of studying diseases by direct examination of the living, he is often cited as the founder of clinical medicine.  By his belief that it was important to understand diseases in order to better control them, he is often cited as the father of epidemiology. (6)(7)(5, page 270)

He also lived in a era where the various elements of science were first being categorized.  He believed, as Garrison said, "that each disease belonged to a certain definite species, which could be described and classified as a botanist describes plants. (5, page 270)  

Garrison said:

His theory of medicine was simple.  The human mind is limited and fallible, and to it final causes must inscrutable.  Scientific theories, therefore, are of little value to the practitioner since, at the bedside, he must rely upon his powers of observation and his fund of experience. (5, page 269-270)

Perhaps due to his Puritan beliefs, he rejected pathological anatomy, or using the microscope to learn more about the causes of internal diseases. He believed it was better for a physician to assess his patient and use his senses to determine proper treatment, as opposed to trying to learn about internal causes. (8)

Bradford said, "His model was Hippocrates, and he thought that we should follow nature; he differed from him in attempting to arrest the natural course of disease by giving specifics," said Bradford. (8)(3, page 118)

He continued to practice until 1789 when he died at the age of 65. He was so esteemed by his fellow British physicians that "a monument was erected to him by the college of physicians... (posthumously) he was called the English Hippocrates," said Bradford. (3, page 118)

References:

1. Vogel, Virgil J., "American Indian Medicine," 1970, London, Oklahoma University Press
2. Sydenham, Thomas, M.D., "The works of Thomas Sydenham, M.D., on acute and chronic diseases, with their histories and mode of cure, with notes intended to accommodate them to the present state of medicine, and to the climate and diseases of the United States, by Benjamin Rush, M.D., professor of the Institutes and Practice of Medicine, and of Clinical Practice, in the University of Pennsylvania," 1809, Philadelphia, Published by Benjamin and Thomas Kite. 
3. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
4. Cain, A.J., "Thomas Sydenham, John Ray, and some contemporaries on species," Archives of Natural History, 1999, volume 26 (1), pages 55-83, http://www.euppublishing.com/doi/abs/10.3366/anh.1999.26.1.55
5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
6. "Thomas Sydenham," britannica.com, http://www.britannica.com/EBchecked/topic/577463/Thomas-Sydenham, accessed 6/9/13)
7. "Clinical Medicine," The Free Dictionary By Farlex, http://medical-dictionary.thefreedictionary.com/clinical+medicine, accessed 6/9/13
8. "Thomas Sydenham (1624-1689)," sciencemuseum.org, http://www.sciencemuseum.org.uk/broughttolife/people/thomassydenham.aspx, accessed on 7/5/14
9. "Sir Richard Blackmore," britannica.com. http://www.britannica.com/EBchecked/topic/68560/Sir-Richard-Blackmore, accessed 6/9/13

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1453: The world wakes up to science

Nicholas Copernicus (1473-1543)

From about the time of Jesus to the Renaissance of the 16th century, there were few advances in medicine and science. The Greek terms asthma and dyspnea had made their way into the vocabularies of physicians, yet little was considered about their causes. Theories speculated air contained a life-giving substance, although what it contained was left to speculation.  That was all about to change. 

Up until this time the works of the famous Greco-Roman physician Claudius Galen of the 2nd century were considered the gold standard in medicine.  Science wasn't needed, because everything any physician could possibly need to know about any diseases and air was in one of Galen's books 

Galileo Galilei (1564-1642)

This started to change when the dark ages ended with the fall of Constantinople in 1453. This is believed by many historians to have ended the dark ages and sparked a Renaissance where lost Greek and Roman wisdom was recaptured.

It was in 1514 that Galen's reign as supreme master and god of medical superstitions took a major hit. This was the year Nicolaus Copernicus was questioning the belief that the Earth was the center of the Universe and started writing his theories about the earth rotating the sun. Out of fear of being rejected and maybe even killed, his works weren't published until eight years after his death in 1543.

This one event got many people to thinking, or, better yet, inspired thinkers to become courageous, thus gave birth to the age of reason, or the Renaissance. This was a time people started questioning the views that were etched in stone by the Ancient Greeks and followed through the Middle Ages.

This was a time of fresh ideas based on science as opposed to superstitions and false logic. New ideas were formed in physics, astronomy, biology, chemistry, alchemy and medicine.

Copernicus was the first to use scientific research as opposed to superstitions in science (at least he was the first to publish such results).

Perhaps among the most significant contributions to science came from Nicolaus Copernicus (1473-1543), who in 1543 discovered that the planets revolve around the sun.  Out of fear of persecution, his works weren't published until after his death, although they had an astounding impact on other great minds, thus opening the door for the scientific revolution that followed.

Galileo Galileo was the first to oppose the Church during his lifetime. As a result Galileo became famous, and because of this he is now called the father of modern science.

In 1609 Galileo Galilee  (1564-1642) invented the telescope,  (1, page 255), and continued on to make astronomical observations that supported the works of Copernicus.  He had the courage to face the dogmatic Church, and published his works during his lifetime.  As a result, he was arrested for heresy and spent the rest of his life under house arrest.  His energy, courage and sacrifices, however, made him a significant player in the scientific revolution.  By history, he is considered among the fathers of modern physics and science.

Fielding Hudson Garrison, in his book "Introduction to the history of medicine," said that the works of investigators such as Copernicus and Galileo, and other such great men, also had an impact on medicine.  For example, in 1600 Galileo invented a "rude thermometer or thermoscope, and as early as 1600 (Johannes) Kepler had used pulse-counting to time his astronomic observations."  (1, page 258)

Surely investigators studied the stars and planets, they also studied plants, animals and humans, learning much about anatomy, how life is created and sustained, and about diseases.  Also investigated was the air we breathe, and its relationship with the sustenance of life.

Thanks to these two men, over the next few hundred years diseases like asthma would be better understood, and theories about air and the purpose of breathing would be proven false and replaced with scientific fact.

References:

1. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, 

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1500: The quest for the philosopher's stone

An alchemist in search of the philosopher's stone in his laboratory.

If you lived with asthma in the medieval world, during the 16th or 17th centuries, perhaps you believed in the power of the philosopher's stone, or that by working ardently in their laboratories an alchemist would discover a substance that would heal all sickness, and offer eternal life with vast riches and unlimited wisdom.

To understand about the philosophers stone we have to travel back in time to the beginning of the world, to a time when the gods realized they were tired of living alone and were eager to create a planet and populate it with people to keep them company. One god had the power to take the four basic elements -- fire, earth, water and air -- to form the sun and all the planets.

He was called Thoth in ancient Egypt, Hermes Trismegistos in ancient Greece, and Mercury in ancient Rome.  He was the messenger to the gods and had access to all the wisdom of the world, and therefore was the first philosopher.  While he was a god in mythology, it's also possible he was an actual person at one time, only turned into a god by his legacy.

As secretary to the gods, he had access to all the wisdom of the heavens.  As messenger, he had the ability to communicate with philosophers on earth. Perhaps the first people he communicated with were the ancient Egyptians, of whom we find our first evidence that alchemy and chemistry was practiced.

As we learned earlier in this history, the term "khemi" comes from the Egyptian term for 'the black earth,' which is in reference to the black soil of the great Nile River.  Yet the terms 'al' and 'khemi' are Arabic terms.  (7, page 21-22)

It was by communicating with the god Thoth, Egyptian philosophers were able to learn all the wisdom of the god.  In this way, they learned the esoteric wisdom necessary to blend various substances in order to create an elixir of life.  It was also by this process that lead to many of the medicines used by Egyptian priest/physicians.  They, in essence, became the first chemists and alchemists.

Through the ancient philosophers Thoth wrote 40 books filled with all the knowledge that he was willing to share.  Since they called him Hermes, the Greeks referred to these writings as the Hermetic Books.  Since they were thought to have been written on an emerald tablet, some refer to them as the 'emerald tablet.'

Regardless, the pages of the Hermetic books contained the wisdom Thoth/Hermes/Mercury used to create the cosmos.  While the book is lost, it is thought that this first philosopher used the four basic elements and combined: (5, page 28)

• Philosophical Salt, which is all wisdom
• Mercury, which is personal skill and application
• Sulphur, which is vital energy and fire of will (5, page 28)(4, page 366)

These primordial substances are often referred to as "the substances of the philosophers and not those commonly designed by these names, said Grillot de Givry, in his 1931 book "Witchcraft, Magic and Alchemy." (4, page 365)

No one knew what was formed by combining these three substances. Since many thought it was stone, it's often referred to as the philosopher's stone. Yet some thought it was a powdery substance used to create a magical elixir, an elixir of life, that would turn basic items into precious items, base metals -- such as copper, aluminum, cobalt, iron and lead -- into precious gold. It would reveal all wisdom, and heal all wounds, and cure all sickness, and create immortality.

Alchemists believed that by working arduously in their laboratories mixing this chemical and that chemical, perhaps by heating them in their athenor (type of furnace that was capable of maintaining a uniform and durable heat for a long time, according to merriam-webster.com), they would ultimately create a natural environment for a substance similar to the philosopher's stone to form.

After the Arabs conquered Egypt in the 7th century A.D., they absorbed all the Egyptian knowledge of chemistry and alchemy. During the 11th century, European crusaders returned to Europe with Arabic wisdom, including knowledge of alchemy and the quest for the philosopher's stone. (7, page 247)

The stone, or powder, or whatever the primordial substance was, captured the imaginations of some of Europe's most impressive minds, including Paracelsus, Roger Bacon, Pope John XXII, Jon Baptiste van Helmont, Robert Boyle, Isaac Newton, and Raymond Lilly, among others.

Because these men must have worked as alchemists sureptitiously, they are often known as chemists. Either way, many went on to make significant contributions to both science and medicine.

Roger Bacon (1214-1294) was one of the early alchemists who lived in England. He performed many experiments and made many discoveries for the medical community, although what held him back, and created angst among the orthodoxy, was the belief that he was also dealing in magic and the black arts. As with other alchemists, he was also a believer in the philosopher's stone. While it was a challenge, he did manage to get his ideas published. (3, page 112-113)

Paracelsus (1493-1541) was an alchemist who believed all other elements -- earth, fire, water and air -- were derived from this element that was yet to be found, and the mysterious element was indeed the philosopher's stone.

While some chemists openly dabbled in alchemy as Bacon and Paracelsus did, some secretly dabbled in order to avoid the risks associated with being accused of dealing in magic, the black arts, or witchcraft.

Fielding Hudson Garrison, in his book "An introduction to the history of medicine," said:

Although the making of gold and silver and other magic practices was opposed by the Church in the famous bulls , "Spondent pariter" (1317) and "Super ittius specula" (1326) of (Pope) John XXII, alchemy became an intensive cult of extraordinary magnitude in the sixteenth and seventeenth centuries, because it appealed particularly to the lust of money, the love of life, and the corresponding fear of death. For the philosopher's stone, otherwise known as "the quintessence" or "grand magistery" was not only supposed to transmute the baser metals into gold, make precious stones and a universal solvent, but also conferred perfect health and length of days. It was described by all who claimed to have seen it as of a reddish luster. Raymond Lully (1232-1315) called it a carbuncle; Paracelsus likened it to a ruby; Berigard de Pisa, to a wild poppy with the smell of heated sea-salt; van Helmont, to saffron with the luster of glass. The choral symphony in praise of its capacity for maintaining health resembled the testimonials of "Vin Mariani" and other nostrums of our time. (1, page 286)

While alchemists used elements of chemistry, the art was essentially based on mythology and magic. This was why the Church opposed the art, thus punishing those accused of practicing alchemy, including those who admitted to searching for the pagan philosopher's stone, as these were the antithesis of Biblical beliefs.

Grillot de Givry said:

Through the whole of the Middle Ages and down to about the end of the seventeenth century -- even later in Germany, Spain, and Italy -- sorcerers were vilified, persecuted, and hunted down.  It was thought that the worst of punishments were reserved for them in eternity, and the tale ran that the Devil was often to be seen seizing a witch when her promised period of grace had run out, and carrying her off to the place in Hell she had undoubtedly earned." (4, page 195) 

If you had asthma during this period, a time when there were no true remedies for your disease, would it be worth risking eternal damnation to search for it, or would it be better to deal with it as best you can while worshiping the Bible under the hope of eternal comfort in Heaven?

References:

1. Garrison, Fielding Hudson, "Introduciton to the history of medicine," 1922, London, W.B. Saunders Company
2. "Dr. Anderson's, or the famous Scot's Pills," http://www.london-gazette.co.uk/issues/10552/pages/2/page.pdf
3. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
4. deGivry, Grillot, "Witchcraft, Magic and Alchemy," translated by J. Courtenay Locke, 1931, 1971, New York, Dover Publications, Inc
5. Swinburne, Clymer, "Alchemy and the Alchemists," volume 3, 1907, PA, The Philosophical Publishing Co.
6. Anonymous, "The Book of Acquarius: Alchemy and the Sorcerers Stone,"
7. Regardie, Israel, edited by Chic Cicero and Sandra Tabatha Cicero, "The Philosopher's Stone: Spiritual Alchemy, Psychology, and Ritual Magic," 2013, MN, Llewellyn Publications

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900-1300: The Soporific Sponge

Physicians at the School of Salerno in the 15th century are believed to be the first to provide anesthetics during surgery.  The method used was to turn a simple sponge into an inhaler, what surgeons referred to as the "soporific sponge," according to historian Garrison Fielding Hudson. (1, page 142)

Hudson said that "surgical sleeping draughts" are referred to as the "soporiphic sponge" as early as the 11th century in "the beautiful Jenson imprint of the Antidotarium of Nicholas of Salerna that was published in Venice in 1471.  (1, page 142)

This was a sponge that was "steeped in a mixture of opium, hyoscyamus, mulberry juice, lettuce, hemlock, mandragora and ivy, dried, and, when moistened, inhaled by the patient, who was subsequently awakened by applying fennel-juice to the nostrils." (1, page 142)

This "prescription" was believed to be derived from earlier treatments of "anodyne applications" used to treat insomnia at the temples of the Aesclepius by the Ancient Greeks and Romans.  Later on Mandragora became "preferable to opium and hemlock."  (1, page 142)

Could you imagine the stress that a physician wanted to give you such a medicine in an age when it was still greatly feared to be operated on?  This type of fear was noted in a poem in Marlowe's Jew of Malta: (3, page 143)

"I drank of poppy and cold mandrake juice. And being asleep, belike they thought me dead." (3, page 143)

So the anesthetic may have been taken internally by some, yet it was due to this fear that the anesthetic was not taken "internally by Salernitan physicians."  I think this was a wise decision, and this made the "Soporific Sponge" a wise alternative.

The"Soporific Sponge" is an early, yet primitive, example of one of the first uses of an inhaling device. It is for this reason I mention it here.

It is also surmised that the Salerno medical community greatly influenced Arabic medicine. (1, page 187)

Yet, ultimately, Arabic medicine would grow so that it superseded the old Greek traditions taught at Salerno, and this is believed to be what caused the fall of Salerno from its "high estate."  (1, page 187)

The School of Salerno met its demise sometime in the middle of the 13th century.(1, page 187)

References:

1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company

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1316: Mundinus publishes book of anatomy

Figure 1 -- Title page of Mundinus:
 "Anathomia," Leipzig, 1493
(1, page 151)

So we know that the School of Salerno was a great medical institution from the 10th to 13th centuries, and physicians from all over the world flocked there to get the best medical instruction.  Yet most historians will acknowledge that while it was a great learning place, there were few medical advancements made there. 

One of the great exceptions occurred in 1316 when Mundino de'Luzzi, or Mundinus of Bologna (1270-1326), who wrote a book called "Anathomia," which translates to "Dissection."  Still, while he wrote it while teaching at Salerno, it was first published until 1487 at Padua, and 1493 at Leipzig by Martin Pollich-von Mellerstadt. (see figure 1) (1, page 150-151)

Mundino was professor of medicine and anatomy at the University of Bologna, and he was one of the few physicians "to turn his eyes from the pages of Galen to the book of nature, and to learn for himself, by actual dissection of the human body, how this body was constituted." (5, page 199)

It was, therefore, from his own observations that he compiled his book.  (4, page 199)

The book was basically an account of how to perform an autopsy beginning with the abdominal cavity, which contains the perishable viscera, and then moving to the chest, where he provides a description of the heart, and to the skull where he describes opening it.  (4, page 376) (1, page 150-151)

However, because of the dogmatic nature of the Church, he was not able to sway far from the teachings of Galen, said D. Kerfoot Shute in 1910.  "The all-powerful Church still taught the sacredness and the inviolability of the human corpse and was alert and ready to punish as a sacrilege the use of the anatomist's scalpel; and what Mundinus did was done in the face of this powerful opposition." (5, page 199)

Perhaps this is why Garrison said:

In intention, this work was really a little horn-book of dissecting, rather than a formal treaties on gross anatomy.  (1, page 150)

He said the book was full of...

...Galanic errors in regard to the structure of the human frame, preserving the old fictive anatomy of the Arabists, with the Arabic terms, this book was yet the sole textbook on anatomy for over a hundred years in all the Medieval schools." (1)

The book would be the "universal textbook" of anatomical dissection for the next 200 years at all medieval schools, passing through "39 separate editions and translations." (4, page 376) (1, page 151)

His work was continued by his pupil Niccolo' Bertuccio (died 1347), said Garrison.  He said:  "After this time, dissecting gained a firmer foothold as a mode of instruction." (1, page 151)

However, Shute said that, perhaps due to the opposition of the Church, "Mundinus had no disciples carry on his work.  All that remained of him was his very inadequate book which was used in schools merely as an introduction or help to Galen.  At best he became little more than a later and smaller Galen." (5, page 199)

While there were little or no advancements in medicine as a result of his book, it helped to preserve medicine during the dark ages of medicine.  It would be over 200 years after Mundinus (at the beginning of the 16th century) that the Church would finally start to lose its grip and influence over medcine.   (5, page 199)

Jacobus Berengarius da Capri, who lived from 1460-1530, was an Italian physician who continued the work of Mundinus.  Shute said:

But he had his struggles with the church. He was driven to desert Bologno, where he had long been a teacher, and to live in exile in Ferrara.

Yet this was a time when the Church learned to appreciate anatomy, although trough paintings more so than medicine.  Shute said

In the sixteenth century the ruling powers of the church not only sanctioned but even favored the pursuit of that branch of anatomy which is indispensable to sculpture and painters. In 1525 Albert Durer published a work illustrating the symmetry of the body—but as an artist and not anatomist. Under the protection of the Popes, Julius II and Leo X, Leonardo da Vinci, Michael Angelo, and Raphael copied from nature the superficial muscles. (5, page 199)

This was the state medicine was in when two of the most significant figures in our medical history were born: Jacobus Sylvius and Andreas Vessalius.

References:

1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
2. The John Hopkins Hospital bulleton," (volume XV 1904), "from the epoch of the Alexandria School (300 B.C.)"
3. "The Ancient Medical School of Salerno," associazioneermes.it, http://www.associazioneermes.it/MedicalSchoolSalerno.htm, accessed 12/4/12
4. Frampton, Michael, "Embodiments of Will: Anatomical and Physiological Theories of Voluntary Animal Motion from Greek Antiquity to the Latin Middle Ages, 400 B.C. - A.D. 1300," 2009, Berlin, VDG Verlag
5. Shute, D. Kerfoot, "The life and works of ndreas Vesalius," Old dominion journal of medicine and surgery, Tomkin, Beverly R. Tucker, Douglas Vanderhoof, Murat Willis, R.H. Wright, editors, 1910, Richmond Virginia, The Old Dominion Publishing Corporation, pages 195-211

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400 B.C.: How did Hippocrates assess his patients

Hippocrates examining a child, a painting by Robert Thom, 1950's.

Hippocrates became the most famous physicians of ancient Greece during the Age of Pericles by his skill and gentle approach as a physician. His approach to medicine was highly regarded not just by his patients, but by his peers. By his example, and through his writings, he would almost single handily improve the image of medicine.

In order to help future physicians develop the skills and technique needed to become a respected physician, and to create a good image of the profession, he compiled all the medical wisdom from the school of Cos into a series of 60 medical treaties called The Hippocratic Corpus.  

Most historians now believe that he did not write all of the Corpus by himself, although most would agree that he was, for whatever reason, the most significant and respected physician of his era, and for this reason his name is attributed to the treaties.  It would go on to become the cornerstone of Greek medicine, and all of medicine for the next 2,000 plus years.  

In this way, Hippocrates became the most famous physicians of his era and all time.  Not only was he referred to as "The Great Physician" during his time by the philosopher Plato, but he is referred to by most historians as "The Father of Medicine." 

By resorting to simple or natural remedies first, Hippocrates, like other physicians at the school of Cos, preferred the medical philosophy of looking out for the best interest of the patient, and to avoid risky treatment.  Such may be evident by the motto "first do no harm."

When Hippocrates was called to help a patient, he would pack his bags and travel to the patient's home.  As he was taught by his predecessors at the school of Cos, he would consider the patient as a whole.  As noted by 18th century physicians Bernardino Ramazzini, Hippocrates encouraged the following: 

'When you come to a patient's house, you should ask him what sort of pain he has, what caused them, how many days he has been ill, whether the bowels are working and what sort of food he eats.' (1, page 15)

Of the assessment of the patient, Garrison said:

Hippocrates instituted, for the first time, a careful, systemic, and thorough-going examination of the patient's condition, including the facial appearance, pulse, temperature, respiration, excreta, sputum, localized pains, and movements of the body. (2, page 89-90) 

Medical historian Max Neuburger said the following were also assessed:

Odour of the sweat, of the sputum, of the vomit, the urine, the faeces, of the discharge from wounds; the taste of skin secretions, of wax from the ear, of nasal mucus, of the tears and sputum (sweet or the contrary) and of diverse other body fluids had to be investigated, partly by the physician, partly by the patient himself.  (5, page 145)

The color, consistency, and smell of phlegm was also assessed.  The assessment was useful in helping the physician come up with a diagnosis and prognosis, which would help determine if the patient was curable.  If the patient was curable, the prognosis was used to determine the eventual remedy or cure. 

For instance, as noted by Neuburger:

Yellow sputum, mixed with a little blood, occurring at the beginning of the illness in a patient suffering from inflammation of the lungs is a sign that he will recover, and is beneficial, occurring for the first time about the seventh day it is a somewhat surer sign.  (5, page 145)

Hippocrates himself wrote the following of his assessment:

Thus, it considers the voice, as to its clearness or hoarseness. It examines the discharges from certain regular channels; and drawing consequences from their odour, colour, consistence or fluidity,—he judges of the character of the disorders, and the existing state of the patient; and by the same means, medicine is even enabled, not only to ascertain the past, but likewise his future state. After having thus become acquainted with diseases, by their symptoms, if nature is unable to effect a cure, art then teaches how to excite those salutary movements, by which, without danger, the system may discharge itself of what is injurious to it. (3)

Regarding the movements of the body, Hippocrates was known to listen to a patient's heart and lung sounds by placing his ear upon his patient's chest, although if he wanted a more thorough examination of the humours inside the patient's chest, he would shake the patient, gently perhaps. This allowed him to hear secretions, if they were present, in the patient's chest.  (2, page 90)(5, page 146)

The procedure was called succussion, and was mainly used to recognize the presence of pus in the lungs to diagnose the presence of an empyema (pus in the pleural cavity, or the cavity surrounding the lungs. In fact, if a physician performed the procedure and failed to diagnose empyema when it was present, this was considered a "sign of lack of surgical dexterity," said Neuburger. (5, page 157)

According to Neuburger:

This shaking was supposed to effect the outflow of pus from the parenchyma of the lung by way of the bronchi... Recognition during this process of the splashing sound which occasionally occurred (in pyo- and hydropneumothorax, but also in bronchiectasis and cavities) resulted in the employment of succussion (known now as Hippocratic succussion) as a diagnostic method in order to determine whether and where pus were situated in the pleural cavity, also the most suitable spot for incision in thoracocentesis (a procedure involveing placing a needle into the chest and drawing up the excessive pus in the pleural space, or the cavity surrounding the lungs). (5, page 146)

Neuburger said succussion, "If it, and the pouring of fluid into the throat to excite coughing and expulsion of the pus, fail, then the operation of thoracocentesis is called for." (5, page 146)

Sounds other that the rare secretions heard upon succussion were also listened for by auscultation.  Some conditions caused a rattling sound in the trachea.  Diseases such as pneumothorax might cause crepitations, which is air bubbles under the surface of the skin, particularly on the upper chest area.  Pleuritic frictions, or what is now called a pleural rub, was also listened for.  This might indicate a collapsed lung (pneumothorax) or other such malady.

Certain noises in the chest may indicate hydrops of the lungs, or what would now be considered pulmonary edema caused by heart failure, kidney failure, or sometimes pneumonia.  Hydrops is an old term for water in the lungs.  Of this, Neuburger wrote:

Of the diagnosis of "Hydrops of the lung" it is stated: "When the ear is held to the side and one listens for some time, it may be heard to seethe inside like vinegar."  A pleuritic friction is well described... "A grinding may be heard which sounds as if it came from two leather straps." (5, page 147)

The Hippocratic concept also took into consideration the desires of the patient. As noted by Withington:

The wishes, and even the whims of the patient are to be indulged as far as possible, and a physician should rather lose his fee than trouble a sick person about it, for the memory of a good deed is better than a temporary advantage. He should also neglect no opportunity of serving the poor and the stranger, for "where the love of the art is, there is the love of man. "  This last quotation, indeed, is from a work of very doubtful authorship, but it expresses the spirit, if not the words of Hippocrates. (4, page 51)

Hippocrates paid attention to the prognosis more so than the diagnosis. Neuburger said this was so "that the preservation of the organism be his goal." (5, page 147)

He said Hippocrates was well aware of the "limitations and of the potentialities of his art."

And he made sure he "occupied himself only with those diseases in which a cure might be anticipated and approached the sick-bed inspired by the principle: 'Do good, or at least do no harm.'" (5, page 147)

He spared no effort to ease the mind of the suffering, even when he knew there was no chance that his remedies would cure the patient's disease.

References:

1. Ramazzini, Bernardino, writer, "Disease of Workers," Wilmer Cave Wright, translator, 1964, New York, Hafner,  (8)
2. Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
3. Hippocrates, "The Art of Medicine," Section I, Treaties III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (10)
4. Withington, Edward Theodore, "Medical History from the Earliest Times: A Popular History of the Art of Healing," 1894, London, The Scientific Press.  (3)
5. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume 1, London, Oxford University Press

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1700 B.C.: Hebrew Bible influences medicine

The Bible only has a few vague descriptions of diseases, and none of these vagaries refer to respiratory diseases such as asthma.  However, the Bible does show what life was like for asthmatics in ancient Egypt, Mesopotamia, and the Jewish (Israelite, Hebrew) Community.

The Bible was probably written in the 1000 years that preceded the birth of Christ (10, page 511), although the information obtained in it goes back much farther.  Some experts estimate the Biblical date for the beginning of time as 4004 B.C.  

Now, before we delve into a discussion on the Biblical impact on history, we must first understand the Bible and the people who wrote it. You see, the style of writing at this time was pithy and allegorical, and they told truths about God, not so much about history.  For this reason, Biblical stories may allude to true events, and allude to scientific and medical achievements, yet not provide any detail to help historians paint a detailed picture.

The key to understanding the Bible is to understand the difference between truth and fact.  Simply put, something can be truthful without being factual.  For example, if you are trying to download a large file onto your computer and it is taking a long time, you might say that it is "taking a million years." You would be speaking the truth: the file is taking a long time to download.  Figurative language such as this communicates truth without relying totally on facts.

A good example from the Bible is the Bible saying that Adam lived 930 years.  Here again you have to consider the era in which the Bible was written.  People back then never even considered the idea of keeping track of a person's time in this world.  When the Bible says that Adam lived to be 930 years old, it is teaching the religious truth that he lived a long life, which is a sign of God's blessing.

Likewise, since the authors of the Bible, particularly the Old Testament, were recording stories that had previously been relayed by word of mouth from generation to generation, probably through prose, and probably around nighttime campfires, such stories are pithy.  They had to be pithy, because long stories would never be remembered in the days prior to writing.

So this is another cause of confusion regarding events recorded in the Bible.  Adam, for example, lived many years before his story was written, so there is no way of knowing exactly how long he lived.  Likewise, no one knows how long creation took, so the Bible makes it easy by summing these events into seven days

Okay, so that said, now we can get on with our history lesson.

Hebrew history is interesting because the people were nomads, meaning they had no home, or at least they were in search of a home.  Where they came from and why they left remains a mystery, and this is true of many of the societies that made their way to Egypt and Mesopotamia.

Because the Hebrews were nomads,  they lived among, and therefore were influenced, by the various cultures they came into contact with.  Among these cultures were those present in and around ancient Mesopotamia and Egypt.

The Babylonians believed that all disease was punishment from the gods, and some speculate this is why the Jews/ Hebrews likewise believed that their God, the only God, was responsible for causing all diseases and healing all diseases.  Through priests, who acted as mediators, the Hebrew God healed, or he allowed the prophets to heal.  (5, page 28)

The Hebrew were held captive in Egypt for several centuries prior to the exodus around 1550 B.C., and they were also held captive in Babylon around 604 B.C.  So there are various references to both the Mesopotamian and Egyptians medical beliefs, providing evidence that the early Jews were influenced by both.

Fielding Hudson Garrison, in his 1922 history of medicine, explains that:

In the Old Testament, disease is an expression of the wrath of God, to be removed only by moral reform, prayers and sacrifice; and it is God who confers both health and disease: 'I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee.' (7, page 57)(Exodus 15:26)

After God gave Moses the laws, the Lord said, "If you will obey me completely by doing what I consider right, and by keeping my commands, I will not punish you with any of the diseases that I brought on the Egyptians.  I am the Lord, the one who heals you." (Exodus 15: 26)

The Bible also refers to the Babylonian method of diagnosing through hepatoscopy, or inspecting the liver of sacrificial animals.  It is by this means they diagnose through divination or omens:

"For the king of Babylon stood at the Paring of the ways, at the head of the two ways to use divination:  he made his arrows bright, he consulted with images, he looked in the liver." (Ezekiel 21:21)

There are many references to God's ability to cause sickness and to heal, such as is mentioned by Job:

"God bandages the wounds he makes; his hands hurt you, and his hands heal you." (Job 5: 18) 

Abraham, who was labeled as "Father of Israel" by Israel's God, and who set the Israelites off on a quest for the land of Canaan, the promised land, mentions it sometime around the 2nd century B.C.:

Because of what had happened to Sarah, Abraham's wife, the Lord had made it impossible for any woman in Abimelech's palace to have children.  So Abraham prayed for Abimelech, and God healed his wife and his slave girls, so that they could have children. (Genesis: 20:17)

The prophet Jeremiah, who lived in the later part of the 7th century B.C., mentions it:

"But I will heal this city and its people and restore them to health.  I will show them abundant peace and security.  I will make Judah and Israel prosperous, and I will rebuilt them as they were before.  I will purify them from the sins that they have committed against me, and I will forgive their sins and their rebellion.  Jerusalem will be a source of joy, honor, and pride to me; and every nation in the world will fear and tremble when they hear about the good things that I do for the people of Jerusalem and about the prosperity that I bring to the city." (Jeremiah 33: 6)

"I will make you well again; I will heal your wounds." (Jeremiah 30:17 

Moses, who lived around 1550 B.C., mentions it as he calls for the Lord to heal his wife Miriam:

So Moses cried out to the Lord, "O God, heal her!"  (Numbers 12:13) 

Isaiah, who lived in the 8th century B.C., believed that not only was Assyria a great threat to Judah, but so too was the sin of the people.  In the Book of Isaiah, the Lord said of the Israelites:

"I have seen how they acted, but I will heal them. I will lead them and help them, and I will comfort those who mourn. I offer peace to all, both near and far! I will heal my people. But evil men are like the restless sea, whose waves never stop rolling in, bringing filth and muck. There is no safety for sinners," says the Lord. (Isaiah 57:18-21)

The prophet Hosea, who lived sometime before the fall of Samaria in 721 B.C., mentions it:

The people say, "let's return to the Lord!  He has hurt us, but he will be sure to heal us; he has wounded us, but he will bandage our wounds, won't he? In two or three days he will revive us, and we will live in his presence.  Let us try to know the Lord.  He will come to us as surely as the day dawns , as surely as the spring rains fall upon the earth." ( Hosea 6:1-3)

According to Garrison, priests were hygiene police, meaning that they made sure the people of Israel washed and purified their bodies in order to prevent the spread of disease.  Yet the priests, he says, did not act as physicians.  Instead, this task was left to the physician.  (7, page 57)

In the Bible, the various references to magi, or physicians, or high priests, are usually in reference to Egyptian or Babylonian healers  So there was definitely a crossover of the beliefs of the various ancient societies.

The Bible has perhaps the first recorded evidence that physicians existed in Egypt about 1,700  years before the birth of Christ.  When Jacob died, "Joseph commanded his servants, the physicians, to embalm him; and the physicians embalmed Israel, and forty days were fulfilled for him, for so are fulfilled the days of those that are embalmed." (1, page 26)(10, page 17)(7, page 57)(Genesis 50: 2)

Garrison explains that "the king Asa consulted physicians instead of the Lord and 'slept with his fathers' for his pains (II Chronicles 16: 12-13), or that if two men fight and one of them be injured to the extent of having to keep his bed, she or her 'shall pay for the loss of his time, and shall cause him to be thoroughly healed.(Exodus 21:19)" (7, page 57-58)

While the Bible makes no mention of asthma nor asthma remedies, it does make (perhaps) the first reference to a narcotic: (9, page 9)

During wheat harvest, Reuben went out into the fields and found some mandrake plants, which he brought to his mother Leah. Rachel said to Leah, “Please give me some of your son’s mandrakes.”  But she said to her, “Wasn’t it enough that you took away my husband? Will you take my son’s mandrakes too?” (Genesis 30: 14-15)

Mandrakes are a member of the nightshade family (solanaceae) of plants that, when ingested or inhaled, can make breathing easier and cause a hallucinogenic effect, easing pain and suffering.  The sonanaceae family of plants will play a significant role later in our asthma history, although it's doubtful (although possible) this was used as a remedy for dyspnea in the Biblical age.

Further reading:

• 5000-50 B.C.: Asthma in Ancient Egypt, and Physicians
• 5000-50 B.C.: Asthma in Ancient Egypt, and Eber Papyri 
• 2700 B.C.: Imhotep invents rational medicine

References:

1. Renouard, Pierce Victor, "History of Medicine: From it's origin to the 19th century," 1856, Cincinnati, Moore, Wistach, Keys and Co., page 26, chapter 1, "Medicine of the Antique Nation."
2. "Moses," Catholic Encyclopedia, http://www.newadvent.org/cathen/10596a.htm, accessed 3/21/13
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