1848: Rudolf von Kolliker strengthens convulsive theory of asthma

Rudolf Albert von Kolliker (1817-1905) (5, page 489)

In the 18th century William Cullen believed muscle was a continuation of a nerve, and he used this as his proof that asthma was a nervous disorder.  In 1848, a Swiss histologist by the name of Rudolf Albert von
Kolliker proved Cullen's claim to be wrong.

Kolliker was born on July 6, 1817, in Zurich, Switzerland  He began his secondary education at the University of Zurich in 1836, and then the University of Bonn in 1838.  He later studied at the University of Berlin where he became a pupil of two great physicians by the names of Friedrich Gustav Jakob Henle and Johannes Muller.  From these men he learned about the microscope and microscopic anatomy.  (1, page 422)(2, page 194)(3)(4)

Friedrich Gustav Jakob Henle (1809-1885) was
one of Johannes Muller's pupils, one of his prosectors,
and later one of von Kolliker's professors.
 He became the greatest histologist of his time,
and one of the greatest anatomists of all time.
 (5, pages 483-486)(6)

He received his medical degree from Heidelberg in 1842, and became Henle's prosector in 1843 (that means that he prepared a dissection for demonstration). This set him up nicely to become professor of anatomy and physiology at Zurich in 1844.  In 1847 he became professor of anatomy and physiologyat Wuzburg, where he was offered an opportunity to specialize in microscopic anatomy, and where he spent the rest of his active life. (1, page 422)(2, page 194)(3)(4)

He was among the first physicians to study the microscopic structures of the body, and he proved that cells did not just form on their own, only by existing cells.  He also was the first to isolate and observe minute cells called smooth muscle cells (unstriated muscle cells), and advanced scientific knowledge of nerve cells, nerve fibers, and red blood cells. (1, page 422) (2, page 194)(3)(4)

Johannes Muller (1801-1858) was one
of the first physicians to use the microscope
to study the microscopic structures
of the body.  (5, pages 475-478)

Upon further inspection, he discovered that smooth muscle cells lined the bronchiolar air passages all the way down to bronchioles as small as 0.18 milimeters in diameter. (2, page 194)

By his study of such minute structures of the human body he became one of the fathers of histology, or the study of tissues.

His research helped strengthen the convulsive or spasmotic theory of asthma in that he confirmed both the studies of Franz Daniel Reisseissen, who proved muscular fibers wrap around the air passages, and J.B. Williams, who proved these fibers constrict when stimulated.

He resisted all offers to take him away from the "quiet academic life of the Bavarian town, where he died on the 2nd of November 1905. (4)

References:

1. Daintith, John, editor, "Biographical encyclopedia of scientists." 2009, 3rd edition, Florida, CRC Press
2. Geddings, W.H., author of the chapter on "Bronchial Asthma," in the book  "A System of Practical Medicine," edited by William Pepper and Louis Star,Volume 3, 1885, Philadelphia, Lea Brothers and Co.
3. "Rudolf Albert von Kolliker," britannica.com, http://www.britannica.com/EBchecked/topic/321429/Rudolf-Albert-von-Kolliker, accessed 4/4/14
4. "Rudolf Albert von Kolliker," 1911 Encyclopedia Britannica, http://www.studylight.org/enc/bri/view.cgi?n=28434&search=span, accessed 4/4/14
5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 3rd edition, 1821, Philadelphia and London, W.B. Saunders Company
6. "Friedrich Gustav Jacob Henle," britannica.com, http://www.britannica.com/EBchecked/topic/261245/Friedrich-Gustav-Jacob-Henle, accessed 4/4/14

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1820-1850: Race to define asthma

In the year 1840 Dr. Charles J.B. Williams proved the bronchospasm theory of asthma, and Dr. William Budd rejected this proof by performing experiments of his own.  This theory was debated for the rest of the century.

Likewise, from this year on you had one physician after another come up with his own theory as to the cause of asthma, with each being convinced he was right, and each offering proof.  Historians can argue whether this slowed down or sped up search for better asthma wisdom.

Dr. Franz Daniel Reisseissen:  He was a German physician who studied the lungs, and concluded "there is another apparatus appointed for contracting the bronchi, which consists of transverse muscular fibres.  As far as the cartilaginous rows extend, these fibres are inserted...." (1, page 186)

Reissiessen proved muscle fibres wrap around the air passages of the lungs almost all the way to the alveoli.  His writings are published in Berlin in 1822. You can check out his 1835 book by clicking here.

Charles J.B. Williams later proved that certain irritants cause contraction of the muscular fibres that Reisseissen proved wrap around the air passages in the lungs.

Francis Hopkins Ramadge:  In 1835 he described food as an asthma trigger, recommends moving from the city to country,  and of asthma being mostly a nocturnal disease. He discourages use of opiates because they impede respirations that are already impeded. He mainly recommends strammonium because it "produces a grateful forgetfulness and a balmy oblivion like opiates." (2, page 7)

He regarded asthma as a neurosis of the respiratory organs.

Prize essays of Bergson and Lefevre:  This occurred in 1836.  They regarded, as did Ramadge, asthma as a neurosis of the respiratory organs (3).

Lefevre observed his own asthma and that of a friend and concluded asthma could only be caused by bronchospasm, and that this bronchospasm was caused by the mind, according to J.B Berkart. (4)

Berkart said that ant "in essence of the disease he (Lefevre) considered to be an increased irritability of the nerves of the lungs, in consequence of which the slightest irritation applies to the bronchial surface induced spasm of the bronchial tubes." (4)

Romberg:  He further established the view of asthma as a nervous disorder in 1841, and based his conception of the disease as a spasmus bronchialis, upon the discovery by Reiseissen (1808) of muscular tissue in the finer bronchial tubes, and the contraction of these tubes under galvanization of the lungs by Charles J.B. Williams (1840), and irritation of the vagus (nerve) by Dr. Francois Achille Longet (1842)." (3)

Dr. Francois Achille Longet:  According to a brief history of asthma by W.H. Geddings, "It was ascertained by (Charles J.B.) Williams that by irritating the lung he could cause contraction of these fibres, and Longet subsequently proved that the same effect could be produced by galvanizing the pneumogastric nerve."  (5, page 184)

Berkart said that in 1842 Longet performed experiments to prove "irritation of the pneumogastric nerve always produced spasmodic contraction of the bronchi, whereas section of the nerve led to emphysema, which was described as distention of the air vesicles."  (4, page 27)

Longet also believed bronchospasm and emphysema were both parts of asthma.

Rudolph A. von Killiker:  In the 18th century William Cullen believed the muscle was just a continuation of a nerve.  Von Killiker was a histologist who proved this was not true.  He basically confirmed the works of Williams and Reisseissen when he isolated smooth muscles in the lungs  (6, page 422)

This essentially proved Cullen wrong, that the muscle was not just a continuation of a nerve.  Yet since nerves still connected to muscles, van Killiker's discovery was unable to stop the fallacy of the nervous theory of asthma. (6, page 422)

Interesting notes:  Williams must have agreed with Rene Laennec and J.B. Berkart that asthma was an abused term. James Thomas Whitaker noted that in 1768 there were 17 different types of asthma (as described by Savage) and in 1822 this was reduced to 11 (by Richter). This was confusing. Williams wanted to simplify the definition of asthma.(3)

The thing to note about most of these experts is that even while they believed in the bronchospasm theory of asthma, they continued to believe in the nervouse theory of asthma, and their experiments proved the two co-existed  -- or so they thought.

During the 1850s, asthma was described by Dr Henry Hyde Salter as a disease of bronchospasm caused by an exciting cause that triggers the nervous system.

References:

1. Floyer, John, ed., "The Cyclopaedia of practical medicine," 1833, volume 1, page 186
2. Brenner, Barry E, ed, "Emergency Asthma" 1998, page 7 (chapter one is a history of asthma written by Brenner)
3. Whitaker, James Thomas, "The theory and practice of medicine," 1893
4. Berkart, J.B.,"On Asthma:  It's Pathology and Treatment, 18xx, volume 1878, London, J. & A. ChurchillI, page 23 (Berkart started his book with a good history of asthma up to his time.
5. Geddings, W.H., writer, "Bronchial Asthma," in the book, "A System of Practical Medicine," edited by William Pepper and William and Louis Star, Volume 3, Philadelphia, Lea Brothers & Co., pages 184-209
6. Daintith, John, editor, "Biographical encyclopedia of scientists." 2009, 3rd edition, Florida, CRC Press
7. Ramadge, Francis Hopkins, "Asthma, its species and comications, 1835, London

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