802--1300 A.D..: The School of Salerno

Figure 1 - An early depiction of the School of Salerno

The Dark Ages of Medicine that engulfed western civilization from the 9th to 14th centuries were not completely dark, as there were a few places where wisdom continued to shine brighltly.

There were various towns and cities in and around Europe where the old Greek and Roman traditions continued to be studied and worshiped. One of the most significant of these towns as far as our medical history is concerned is that of Salerno in Naples. It was here that medical schools were formed amid a flourishing medical community.

Salerno was a town in Southern Italy "that was beautifully situated in a district which as early as the times of the Roman Emperors was famous as a health resort and attracted a number of visitors to it's precincts."   (3, page 187)

Some authorities say the school was founded in 802 by Charlemagne, said historian Thomas Bradford, although no one knows for sure.  Others say it "dates from the destruction of the library of Alexandria by the Arabs." (6, page 103)

Ordericus Vitalis, a historian from the 12th century, said it was started in ancient times. Another historian speculated it was formed by fugitives from Alexandria.  (3, page 187)

In all actuality, there there were probably towns like Salerno all over Europe where Greek and Roman tradition continued to flourish. Chances are that physicians in these towns, in Salerno, had no connection with the clergy that influenced the decline of the Roman Empire.  (3, page 187)

What is known for sure is that a school, hospital, and university were established in in the town of Salerno, thus creating a "bridge over which ancient culture took its way during the Middle Ages from East to West. They were the means of crystallizing the great thoughts of the early fathers so that we of the present times are enabled to understand them."  (6, page 106)

Salerno was on the route taken by pilgrims trying to escape the Christians who ruled much of Europe and Asia, and therefore they took refuge in Salerno. There teachers at the School of Salerno (or Salernum) were a combination of Greek, Arabians and Jews, said Bradford. (6, page 103)

The School was referred to as The Schola Medica Solernitano.  It thrived between the 10th and 13th centuries. While exact dates of when it started and when it closed are unknown, what is known is that the sick who wanted the best medical treatment went there, and medical students who wanted the best education went there.  It became known as the city of Hippocrates (Hippocratica Civitas or Hippocratica Urbs) (4)

By the mid 11th century, Salerno was a full, flourishing medical community that was significant to the evolution of the history of medicine. There were many physicians who worshiped under the traditions of Alexandrian medicine. They studied the works of Hippocrates, Galen, and the other ancient philosophers and physicians.

Here is a portrayal of a hospital at Salerno.  
"Patients eat and rest while workers share a meal and
 others engage in domestic tasks."  From the book:
De donservanda bona valetudine, opusculum
Scholae Salernitanae published 1545. It was written
 by Arnaldus de Villanova  who lived from 1240 to 1311. (5)

The school was a place where traditional Greek and Roman medicine commingled harmoniously with Jewish and Arabic medicine. Many historians say that both men and women were involved in education there, with the main courses of education being, along with medicine, philosophy, theology and law. (4)

Students were taught by physicians from their own country, and in their own language the various subjects essential to medicine, which included "symptomatology, dietetics, treatment and materia medica," said Bradford, "but little time was given to anatomy and physiology." (6, page 104)

Of anatomy, however, Bradford said that:

In the twelfth century Frederick II (1194-1250) ordered a special provision with respect to the study of anatomy at this school, made in his medical code. It is said that by the emperor's direction a dissection was made every five years at Salernum. No one was allowed to practice medicine in the kingdom of Naples who had not been examined and created a master by the college of Salernum. In order to do this the student was obliged to study logic three years, and follow a course of medicine and surgery for five years. In order to become admitted to an examination at the end of the term, the student must present a certificate of his legitimate birth, and that he had attained his 25th year (according to Baas in his 21st year); after this he was examined publicly in the therapeutics of Galen, the first book of Avicenna, and the aphorisms of Hippocrates. He then took an oath to be faithful to good conduct, to submit to the rules of the profession, to give gratuitous attention to the poor and not to share in the profits of the apothecaries, to teach correctly according to the received doctrines, and to administer no poisons. All these things having been fulfilled, the candidate received a ring, a wreath of laurel, a kiss, and finally the benediction. The graduation was in public. Renouard says that after this the candidate must have his diploma confirmed by the proper officer of state, and was then obliged to continue with some experienced physician before entering into independent practice. Baas says that after the graduation he could teach and practice wherever he wished; the office of medical teacher was open also to him. The degree conferred was that of magister, or doctor. (6, page 104-105)

During it's most prosperous times the "town of Salerno was famous for the skill of physicians." After the decree of Frederick II, it was perhaps the first school since the School of Alexandria in 300 B.C where dissections were performed and anatomy was studied.  (2, page 28)

It was also a town where successful surgeries were performed and where people traveled hundreds and thousands of miles in search of a treatment or cure for ailments.  (3, page 187)(6, page 105)

Two other schools of medicine that were significant to the transfer of medicine from the ancient world to the revival of medicine among western civilization were Monte Casino and Montpellier.  (6, page 102)

Bradford said the school of "Monte Casino was founded by the Benedictines on the site of an ancient temple of Apollo in Campania."

He said school of Monpellier "was first mentioned in 1137 when Bishop Adelbert II went there to listen to its medical teachers."  He said both the Jews and Christians lived among the city.  (6, page 102-106)

The schools, hospitals and universities of Salerno gradually declined, "until in the fourteenth century the poet Petrarch (1304-1374) mentioned the school as a memory." (6, page 103-104)

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. Suppan, Leo, "The Medical School of Salerno and the Salernitan Writers," The National Druggist, May, 1918, 
4. "The Ancient Medical School of Salerno," associazioneermes.it, http://www.associazioneermes.it/MedicalSchoolSalerno.htm, accessed 12/5/12
5. "Arnoldus de Villanova (1240-1311) and the School of Salerno,"Vaulted Treasures, virginia.edu, http://exhibits.hsl.virginia.edu/treasures/arnaldus-de-villanova-ca-1240-1311-and-the-school-of-salerno/, accessed 12/5/12
6. 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

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865-925: Rhazes describes allergies

Rhazes didn't choose to become a physician until he was
into his 40s, and this may have helped the man become among
the most well respected physicians of his era.  He wrote about
asthma, and is thought to be among the first physicians to
describe allergies. 

While allergies were alluded to before him, and would not be defined for the medical community for another thousand years after his death, many medical historians believe the Arabic physician Rhazes was the first to accurately describe allergies. So it's easy to see that he was a physician ahead of his time.

He was born Abu Bekr Mohammed ben Zechariah in the year 865, and is known best by the name of Rhazes. He was born in a town in Persia, in the province of Baghdad, in a town called Rai, "and it is from this that his last name was derived -- Ar-Razi,"  said historian Thomas Bradford in his 1898 book "Quiz questions on the history of medicine."  (9, page 62).

He was originally a musician, playing the flute in his youth. And even while he was a "passionate lover of music," he put this love aside in favor of philosophy and medicine, claiming "that music proceeding from between mustachios and a beard had no charm to recommend it," said V.J. Fourageaud in an 1868 article in the Pacific Medical and Surgical Journal. (1, page 164)(9, page 62)

Yet this turned out to be a great thing for the medical community, as "he is said to have been the ablest physician of his age; a master of all kinds of learning; skilled both in the theory and practice of medicine, said Bradford." (9, page 62)

He started studying medicine in his forties, explained Bradford, and traveled abroad to "Jerusalem, Syria, Egypt, Persia, and Spain, the better to perfect his knowledge by conversing with botanists, oculists and surgeons. Having thus become master of his profession, he settled in Bagdad, and so great was his learning that he was selected from over a hundred eminent competitors as the director-in-chief of the grand hospital in that place.  He is said to have been the ablest physician of his age; master of all kinds of learning, skilled both in the theory and practice of medicine." (9, page 62-63)

By this position he was "director of the hospitals of Ray (the same town he was born in), Jondisabour, and Baghdad, said Fourageaud..  (1, page 164)

Bradford and Fourageaud both said that his reputation was so great as an Arabian professor that students traveled from far away to hear him speak. (1, page 164)(9, page 62)

Edward Withington, in his 1894 book, "Medical history from the earliest times, said he became the "first and most original of the Arab physicians."   (2, page 145)

He is considered by many historians as the most independent thinker among the Arabic physicians.  (5, page 156)  He encouraged physicians to practice by empirical means (experience and observation) and in this way became the first physicians to encourage scientific based medicine. (3, page 31)

He wrote over 150 books, although some say he wrote as many as 220.  He wrote on philosophy, medicine, history, and chemistry, although his passion was medicine.  Unfortunately most of these works are lost to history, said Fred Ramon in his 2006 book "Albacasis."  (8, page 62) (9, page 63)

While he copied many of the idea of ancient physicians, such as Hippocrates and Galen, it's his scientific descriptions of diseases that make him among the most well known of the Arabic writers.

He became famous while being among the few Arabic physicians who did not earn a medical license.  And, despite his fame, he did not become rich, mainly because he chose to practice among peasants who could not afford much.  This type of 'boldness and originality' earned him the title "The experimenter," said Withington.  (2, page 145)

Among the medical community he is best known for writing the "oldest existing treaties on smallpox and measles," said Withington.  (2, page 146)(9, page63) and he is the first to have described fever as a defense mechanism of fighting off diseases.

He's also the first to describe asthma as a specific disease, and the first to mention allergies.  He was a chemist and pharmacist, and by this he gathered a collection of remedies (some of his own too) and recorded them in one of his publications.  Some of the remedies were for asthma, said Ramon. (8, page 70)

As noted by these writings, coupled by his writings about asthma and coryza (inflammation of the nasal passages/ hay fever), he was the first to write a treaties on the diseases of children.  (6, page 175)

During his life he would create voluminous volumes for the medical community.  In his Hawi or Continens, which exceeded the length of the works of his contemporaries (including the Canon of Avicenna) he gives an account of asthma and it's remedies: (2, page 146)

Ben Musue (an Arabian physician of the 8th century) said, 'Let persons troubled with asthma or shortness of breath take two drachms of dried and powdered fox lung with decoction of figs in their drink.'  Galen (De med. simple.) said that many cure asthma with owls blood given in the drink, or by giving owl's flesh with the blood in spidebeg(?), and taking it's blood afterword in wine. I say that owl's blood is not to be given in any case of asthma, for I have seen it administered, and it was useless."

Maimonides wrote of the remedies for asthma, and in doing so mentions Rhazes:

Maimonides endorses a remedy of Rhazes' to clear the lungs of moisture, ease respiration, and eliminate the cough: soak wheat bran over night in hot water, filter, and add sugar and almond oil; place on the first until it resembles a julep and drink when lukewarm.  (7, page 27)

Also of significance is he was the first to write a book about hay fever:  A dissertation on the cause of the coryza which occurs in the spring when the roses give forth their scent.  (3, page 31)(4, page 338)

In his work Essay on the cause of why Abu Zayd al-Bahli is subject to rhinorrhea in springtime when smelling roses, he described the inflammation and runny nose that occurred in the springtime when the roses were blooming.

Many consider this the first description of hay fever, or what would eventually be considered as springtime allergies, sinusitis, hay fever, seasonal allergies or rhinorrhea.  In a sense, he may also have been the first to describe allergic asthma.

Fourageaud said that near the end of his life he approached Al-Mansur, the Prince of Chorasan, in Baghdad to present to him a book on alchemy he dedicated to the prince.  The prince loved the work and rewarded Rhazes with a thousand dinars. (1, page 64)

The Prince said, "I wish for you to put into practice what you have laid down in this book."
Rhazes said, "That is a task for the execution for which ample funds are necessary, as also various implements and aromatics of genuine quality; and all this must be done according to the rules of art, so that the whole operation is one of great difficulty."

The Prince said, "All the implements that you require shall be furnished you, with everything necessary for the operation; so that you may be in the practice the rules contained in your book."

Rhazes said he was unable to perform the task, at which time the Prince said, "I should never have thought a philosopher capable of such faleshoods in a work represented by him as a scientific treaties, and one which will engage people's hearts in a labor from which they can derive no advantage.  I have given you a thousand dinars as a reward for this visit, and the trouble you have taken, but I shall assuredly punish you for being guilty of a falsehood." 

The Prince struck Rhazes in the head with a whip and sent him on his way with provisions to complete the task.  Rumor has it this is what made him blind, although some say it was because he was because he ate too many beans.

Believing his blindness was caused by cataracts, an "occultist" was about to operate on him when Rhazes said something like, "How many membranes does the eye have?" 

The occultist had no response.  Rhazes then said something like, "I will not entrust my eyes to someone who is ignorant of their structure."

Later, when further urged to have the operation, he said, "No, for I have seen so much of the world that I am weary of it."  (1, page 64)

So most historians describe his as a very wise man, and Bradford credits him with the following wise sayings: (9, page 63)

• When you can cure by regimen, avoid having recourse to medicine
• When you can affect a cure by a simple medicine, avoid a compound one.
• When a wise physician and an obedient patient, sickness soon disappears.
• Treat and incipient malady with remedies that will not prostrate the strength. (9, page 63)

Exactly when he died remains unknown, although much speculation of modern historians has the date at 925 A.D. Regardless, he was a renowned physician in his day, and was one of the Arabs who helped save medicine while a dark cloud hovered over western medicine.

References:

1. Fourageaud, V.J., "Historical Sketches: XIII: The epidemics of the sixth century, the plague, small pox, and measles.  Ahrun, Bachtishwa, Mesue the Elder, Honain, Serapion, Alkhandi, and Rhazes," Pacific Medical and Surgical Journal,  Medical and Surgical Journal, edited by V.J. Fouregaud and J.F. Morse, Volume VII, 1864, San Francisco
2. Withington, Edward, "Medical history from its earliest times: a popular history of the healing art," 1894, London, The Scientific Press 
3. Colgan, Richard, "Advice to the Young Physician: on the art of medicine," 2009, New York
4. Lehrer, Steven, "Explorers of the body: Dramatic Breakthroughs in Medicine from Ancient Times," 2006, United States
5. Fantini, Bernardino, Grmek Mirko editors, Antony Shugaar, translator., "Western Medical Thought from Antiquity to the Middle Ages," 1998, U.S., 
6. Gee, Samuel, "A Survey of the Literature of the Diseases of Childhood:  An address delivered at the offering of the section of diseases of children at the annual meeting of the British Medical Association in Liverpool, August, 1883, The Medical Times and Gazette, Vol. II, 1883, London, Pardon and Sons
7. Rosner, Fred, translator, "The Medical Legacy of Moses Maimonides," 1998, KTAV Publishing House, U.S.
8. Ramen, Fred, "Albucasis (Abu Al-Qasam Al-Zahrawi):  Renowned Muslim Surgeon of the 10th Century,"  2006,New York
9. 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

1769: Dr. Rush writes about asthma in children

Benjamin Rush (1745-1813) was a strong 
advocate of bleeding, and surely he 
recommendedit as a remedy for asthma. 
 Even as his practice started to decline
near the end of his career, he still
insisted on prescribing it.   

Benjamin Rush added nothing new to our disease asthma, although by reading what he wrote about the disease we can gather a good idea of what it would have been like to live with asthma during colonial times in the United States, and what would be the treatment if you saw a licensed physician for it.

As a physician he would have seen many adults and children suffer from asthma, especially in an era when there were few physicians in America.  Yet in the summer of 1769 he was called to take care of many children who were afflicted with the disease, some of whom suffocated and died.  This caused him to take this disease seriously, and to form opinions of his own regarding the disease.

Rush was born in Byberry, Pennsylvania, on the eve of Christmas in 1745, to John Rush and Suzanne Hall. His parents emigrated to America from Oxfordshire, England, becoming Quakers and Baptists.   (1, page 3)

His mother had attended boarding school, and so she was well educated for a woman of this era. His father was a farmer, as were most of his ancestors. He died when Benjamin was only six-years-old, and at this time his mother placed him under the care of her brother, Dr. Finley, who became his teacher and advisor. It was by his uncle's influence that Benjamin became interested in medicine. (1, page 4)

Benjamin obtained a bachelor's degree at the college of Philadelphia. He studied under Dr. Redman for four years, and then attended school at Edinburgh where he obtained his medical degree. He then spent several years in Europe studying medicine and science prior to returning to Pennsylvania in 1769, where he opened a private practice and was appointed professor of chemistry at the College of Philadelphia. (2)

From this time on, the following is what he accomplished:

• He became a very popular physician by attending to the poor
• He became very popular for his skills as a professor
• He published the first American textbook on chemistry
• In 1773 he wrote essays for the patriot cause
• In 1776 he was elected to attend the provincial conference to send delegates to the Continental Congress
• He represented Philadelphia as a signer of the Declaration of Independence
• In 1777 he was appointed surgeon general of the middle department of the Continental Army, although he ultimately resigned. 
• When the war looked grim, he surreptitiously campaigned for the removal of George Washington as commander in chief. He was ultimately busted and confronted by Washington, and no longer participated in any activities regarding the war. 
• In 1789 he wrote in favor of adapting the Federal Constitution
• He was elected to the the Pennsylvania Convention, and he voted in support of the Federal Constitution
• He was treasurer of the U.S. Mint from 1797-1813
• He was a proponent for the abolition of slavery
• He petitioned for a national educational system for both men and women
• He petitioned for medical clinics to treat the poor
• He was an advocate for bleeding in medicine, and utilized it for nearly every diagnosis, including asthma. 
• He died April 19, 1813.  He was 68-years-old. 
• Throughout his life, he was the most popular physician in America.  (2)

So not only was he a well respected professor and physician, he was an important founding father; he was an important figure in the establishment of the United States of America.

As far as medicine was concerned he was a strong supporter of the ideas of Dr. Thomas Sydenham, and even went as far to write the introduction to the American edition of Sydenham's book "The works of Thomas Sydenham" that was published in 1808.

As far as our asthma history is concerned, he wrote the following articles:

1. An account of asthma, from an uncommon cause
2. A dissertation on the spasmotic asthma in children
3. An inquiry into the natural history of medicine among the Indians

"A dissertation on the spasmotic asthma in children," was published in the Pennsylvania Gazette in the winter of 1769.  It was basically a letter to Dr. John Millar about an epidemic of asthma that winter. It must have hit him hard to witness so many children suffer, and to watch as some died.   (2, page 1)

He said asthma was not well known among the populace of Pennsylvania, and that even the ancients knew little of it.  It was a condition that was either inflammatory or spasmotic, and usually associated with "particular climates or situations."  (2, pages iii, 2)

He said there were other names for it. The Irish called it the Hives "from the resemblance it bears to a disorder which prevails in Ireland of that name."  (2, page 2)

He said it presented with "difficulty of breathing... and other symptoms of oppression and disorder in the lungs."  Dr. Home of London, who was the first to give an accurate history of it, called it "the Croup, -- or Suffocatio Stridula, -- a name by which it is known in Scotland." (2, page 3)

He mentioned Dr. John Millar, who described an outbreak in England in 1755.  He described it this way:  (2, page 3)

Children at play were sometimes seized, but it generally came on at night; a child who went to bed in perfect health, walked an hour or two afterwards in a fright, with his face much flushed, or sometimes of a livid colour, -- incapable of describing what he flet, -- breathing with much labour, and with a convulsive motion in teh belly, the returns of inspiration and expiration quickly succeeding each other in that particular sonorous manner, which is often observed in hysteric paroxysms.  The child's terror sometimes augmented the disorder.  He clung to the nurse, and if he was not speedily relieved by coughing, belching, sneezing, vomitting, or purging, the suffocation encreased, and he died in the paroxysm. (2, pages 3-4)

He also published a letter from Dr. Haygarth to Dr. Smith, in which Dr. Haygarth said that Dr. Russel was the first to describe convulsive asthma in children in his book De Oeconomia Naturoe.  Dr. Russel is quoted to have written:

A Fever attends this disease with great remissions; but upon every fresh access, the respiration becomes very short and difficult; the child is forced to sit up erect in its bed, or to get up; when it cries, is very hoarse; but often makes, upon every inspiration, a shrill, skreaking, or clangose sound; and is if it is not instantly relieved by nature or art, must die. -- I have seen this distemper carry off, very suddenly, several children in a family. (2, pages 27-28)

Dr. Rush said that it used to be believed that asthma in children was inflammation in the lungs. Yet the theory believed by most physicians was that it "occassioned by a preternatural quantity of phlegm or mucus," said Rush. (2, page 4)

Upon dissecting children who died of the disease, Dr. Home discovered a large quantity of mucus in the trachea and bronchi.  "This opinion," Rush said, "is now pretty universally received by most practitioners, particularly in this part of the world."  (2, page 5)

However, based on his own experiences and observations as a physicians, he did not support this prevailing theory.  He said he witnessed many adults diagnosed with asthma or peripneumony in life who, when an autopsy was performed after death, they had not even the slightest sign of inflammation in the lungs and no evidence of respiratory disease.  (2, page 4)

A three-year-old child was seized with asthma early one morning, and his mother observed all the symptoms of hives: his breathing was difficult, his abdominal muscles were worked hard as he breathed, and pulse was rapid, his skin was warm to the touch and of livid color.  She was also concerned because he was coughing up quite a bit of blood.

So she called for Dr. Rush.

He traveled to the child's home by horse and buggy, and was met at the door by an anxious mother.  He followed her into the house, carrying his worn leather bag, without much as a word, and he saw a girl sitting on the edge of the couch.
Her chest was bare, and her ribs were evidently showing.  The shoulders of the girl were high, and his abdomen was vibrating hard with each inhalation.
Her skin was pale and dusky, and she had a bluish tinge around her lips and finger tips.  He observed all this in the first seconds of being in the same room as the girl.

"I'm sorry to be a bother," the lady wailed, "but I was so concerned for him breathing this way."

"You did right by calling me," he said to the lady to allay her anxiety.

He sat in a chair opposite the girl and set his bag between her legs.  He opened it and rummaged through its contents until he found a small box.  He opened it, exposing various small jars.  He took out one of them and opened the top.

"I need a teaspoon, please," he said nonchalantly.

She rushed into the kitchen and then back with a teaspoon that she handed the physician.  He handed her the bottle, and she poured some of the emetic onto the spoon and gave it to the boy.  Even though the Dr. knew it was of a horrible taste, the girl never winced; a sure sign she was desperate for any remedy.

The mother, who was wearing her pajamas and her hair was ruffled, grabbed a bowl from the shelf and gave it to the girl to use as an emesis basin.  The mother rubbed the girl's back and head as he emptied his stomach contents.  This initially seemed to ease his breathing, but, after twenty minutes of waiting, it seemed to be of no avail.

The doctor then took some small cups from his bag and a candle.  He lit the candle and warmed the cups.  He then had the girl lie on his back, and as he set the first cup upon the girl's chest the boy jumped up.  The mother hugged and consoled the girl, who was now crying vehemently.

"A bath," the doctor said, "A warm bath.  The steam might help."

The doctor sat next to the girl, and tried to sooth him with his words.  He actually thought he got a slight smile from the girl when he said something funny that had happened to him in the morning.  Perhaps, he though, the girl could at least forget his distress.

Right then his mother said, "It's ready."

The doctor helped the girl take off his pants, and carried him to the tub.  He gently set her in.  The boy immediately placed his arms on the side of the tub to lift his shoulders.  She was now struggling hard to breathe.  She was crying now, wailing.

Dr. Rush could feel the steam on his own face, and as he looked at the mother he could barely distinguish her tears from moisture from the steam.  After several moments of watching the girl suffer so, he lifted her from the water and set her back on the couch.  The girl was now unconscious.

The next day, after the funeral at the girl's home, Dr. Rush pulled the mother aside, once again, and gave her a big hug.  "I'm sorry I couldn't help," he said.

"It's okay," she whispered through tears.  "She's in a happy place now."

She introduced the doctor to her husband.  Dr. Rush then garnished the nerve to talk to them about something he had wanted to do for some time.

A few days later he sat in his study to finish working on his book about the disease he just tried to treat.  He wrote: "

As I was uncommonly anxious to see a dissection of a patient that died of this disorder, I prevailed, with some difficulty, with the parents to let me open her. By their particular desire, I called my worthy friend Dr. Duffield, to assist me in this dissection. Upon opening the thorax we found the lungs adhered pretty closely to the left side. this affection, we had reason to believe, was of long standing, from the closeness with which it adhered, and the force it required to separate it from the pleura. Those who are acquainted with the dissections of dead bodies, know that this is no uncommon thing in most of the bodies we meet with. There are few persons that have ever had an inflammation in their lungs or pleura, but what have adhesions of this kind, and yet feel not the least inconvenience from them. The lungs were quite found, nor could we perceive the least appearance of inflammation in them. Uon opening the Trachea, we found no signs of phlegm or hardened mucus in it. This, together with both the Bronchia, appeared in a sound and natural state.  this dissection, together with the arguments we advanced before, serve as irrefragable proofs that the disorder is not occasioned by the causes assigned by Dr. Home, but by some spasmodic affection of the lungs..  (2, pages 10-12)

By this autopsy he confirmed his suspicion that asthma was not inflammatory, and it was not caused by increased phlegm.   Instead, he suspected asthma "to be rather of the nervous or spasmotic," he wrote.  (2, page 7)

His listed the following as evidence:

• "The suddenness with which children are seized with it.  This corresponds with other convulsive disorders we are acquainted with.  Did it depend upon the presence of phlegm in the wind-pipe, the disorder would come on more gradually; for the accumulation of this phlegm is certainly gradual."  (2, page 8)
• "The disease in many cases is periodical.  This too corresponds with nervous diseases." It appears only at night, or at certain times of the day.  "If the disorder depended upon phlegm, it would certanly be more uniform in its effects, for we know that same causes will always (caeteris paribus)produce the same effects." (2, pages 8-9)
• "We often see patients in this disorder relieved by nervous medicines.  The warm bath has sometimes given immediate relief, when they have appeared to be in the very jaws of death.  It seldom fails of affording a temporary relief.  Opium, we all know, is a powerful antispasmodic medicine. An ingenious physician in New-York, informed me, that he makes it a constant practice to give small quantities of thebaic tincture, joined with oxymel of squills, in the Hives, after giving a puke or two, and that he had seldom found it fail to succeed." (2, page 9-10)
• The fact that the disease does not dissipate after the expectoration of phlegm is evidence that it is not caused by phlegm.   (2, page 10)

While he believed that asthma was spasmotic and nervous in both children and adults, that is where the similarities end.  He said:

Besides this, do we not perceive a considerable  resemblance between this disorder and the asthma in adults?  erhaps they difer from each other only in degree.  Now that asthma has always been supposed to be occasioned by a spasm upon the extremities of the Bronchia. (2, page 14)

(To view a case of adult asthma described by Dr. Rush, click here. It's only about four pages, and the words are big, so it should be a quick read.  Just remember that in many books printed in the 18th century many of the s's are replaced with f's, so this can make reading a little tricky, but not impossible.)

So, if you brought your child in to see Dr. Rush, and he diagnosed your child with asthma, what are the remedies that he might have used?  I will list them here:

1. Bleeding: "Bleeding is generally ordered in the first stage of the disease.  It may act by taking off the tension and fullness from the vessels, which tend greatly to keep up the spasm. I am far, however, from thinking it of so much importance as some have imagined. The disorder, we have proved, is not of the inflammatory kind.  Bleeding therefore, in some cases, I believe, has done more harm than good."  (I just want to remind my readers here that inflammation in this era was considered congestion of blood in the vessels that could be remedied by removing some of this blood, hence the use of bleeding was often recommended. The procedure would be performed with the use of the lancet.  Pneumonia, apoplexy, rheumatism, and hydropsy are just a few examples of a disease considered to be caused by inflammation.) (2, pages 18-19)
2. Vomits (emetics):  "Our chief dependence should be placed on these.  They may be given at all times of the disorder.  What vomits should we prefer?  It is a matter of little consequence which of them we use, provided we give them strong enough. the antimonial vomits are the surest, and most to be depended upon.  In the cases I have been called to, I have always given small doses of tartar emetic.  Some I know join calomel with vomits.  I cannot say I ever saw it do any service, and I believe few practitioners would venture to depend upon it alone.  Others join ipecacoana with the tartar emetic.  I cannot tell upon what this practice is founded." (2, pages 19-20)
3. Warm bath:  "This w know is of singular use in all spasmodic disorders.  I have seen it in one or two cases afford immediate relief, and I have heard of several cases, in which it has saved the lives of patients, apparently in the agonies of death."  (2, page 21)
4. Blisters:  "Blisters are justly ranked among the most powerful antispasmodics... It is a much better practice to apply the blisters directly to the breast, than between the shoulders." (2, page 21-22) 
5. Bronchotomy (tracheostomy): While other physicians have performed the procedure in croup with some success, Dr. Rush did not recommend it.  (2, pages 24-25)
6. Antispasmotics: Such as musk, camphor and opium may have an affect on the disease.  Dr. Rush said he used it a few times with success, although he had no evidence that it was a truly effective remedy for this disorder. (2, page 25-26)
7. Other:  "Every attempt to lessen the number, or mitigate the violence, of diseases in children, is laudable, especially in a young country, like this, where the population is so much to be desired.   (2, page 26)

So Benjamin Rush was an essential figure in the creation of a new nation.  In a era when there were few physicians, Rush presented the residence of Pennsylvania with a solid option of obtaining medical advice and treatment.

And even thought the disease Dr. Rush described here is probably croup and not asthma, we can gather a good idea of how you would be treated by him if you requested his services to treat your asthma.

Note: In reviewing Dr. Rush's letter, I think it can be quite certain that the disease that Dr. Rush was describing here was not asthma, but croup. It makes sense that he would confuse the two diseases, as they often display similar symptoms. According to Alyn Brodsky, Hives was another way of describing a condition called Heaves, which was a description of the forceful act of children inflicted with this disease trying to inhale and exhale. (5, page 94)

References: 

1. Good, Harry G., "Benjamin Rush and his services to American education," 1918, witness press
2. Benjamin Rush, http://www.ushistory.org/declaration/signers/rush.htm, accessed 1/3/14
3. Rush, Banjamin, "A dissertation on the spasmotic asthma of children: in a letter to Dr. Millar, 1770, London, printed for T. Caddell, and D. Wilson and G. Nicoli, Eighteenth Century Collection Online Print Editions, originally published in October of 1769 in the Pennsylvania Journal.  According to It was one of the first medical publications published in the American colonies. 
4. Rush, Benjamin, "An account of asthma, from an uncommon cause, Medical Observations and Inquiries, volume 5, London, as published in the book "Medical and philosophical commentaries,"1776, volume 4, pare 1, by a society in Edinburgh, London, pages 198-202, as 
5. Brodsky,Alyn, "Benjamin Rush: Patriot and Physician," 2004, New York, St. Martin's Press

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625-690: What did the ancients know of the cardiovascular system?

Sometime during the 7th century A.D. Paulus Aegineta recorded all he knew about ancient medicine.  It is from his works that we can gather a sense for what the ancient physicians thought about the heart and lungs.

The lungs were essential to life, as they provided for the breath that was necessary for the inhalation of a spirit, or pneuma, that was essential for the establishment of life, or a soul.  Yet the main purpose of the lungs were to facilitate the heart with nutrients, and to make sure it doesn't become too hot.

Aegineta noted what he learned about the heart.  I will break down what he said to make for easier reading.  He said:

"These are the marks of an unusually warm heart:

• Largeness of respiration
• Quickness and density of pulse
• Boldness and maniacal ferocity
• The chest is covered with hair, particularly the breast, and usually the parts of the hypochondriac regions adjoining to it
• The whole body is hot, unless the liver powerfully antagonise. 
• And capacity of chest is also a mark of heat, unless the brain in that case antagonise. 

"But an unusually cold heart has the pulse smaller than moderate, and such persons are timid and spiritless, more especially if there be no hairs on the breast.

"Dryness of the heart renders the pulse hard, and the passions ungovernable, fierce, and difficult to quell; and, for the most part, the whole body is drier than usual, unless the parts about the liver antagonise. 

"These are the marks of a more humid temperament: 

• A soft pulse
• A disposition easily roused to anger and easily pacified, 
• The whole body more humid than common, unless antagonised by the parts about the liver. 

"When the temperament is both hotter and drier, the pulse is large, hard, and quick and dense; and the respirations large, quick, and dense. And of all others such persons have the most hair upon the breast aud pnecordia; they are prone to action, given to anger, fierce and tyrannical in their dispositions; for they are both passionate and implacable.

"But, if humidity prevails with heat, such persons are less covered with hair than the afore-mentioned; they are prompt to action, their disposition is not tierce, but only prone to anger; their pulse is large, soft, quick, and dense. 

"But when the temperament is more humid and cold than common, the pulse is soft, the disposition spiritless, timid and sluggish; they have no hair on the breast, and neither indulge in lasting resentment, nor are prone to anger. 

"A cold and dry heart renders the pulse harder and small. Of all others, such persons are least given to anger, but when provoked they retain their resentment. They are also particularly distinguished by having no hair on the breast.

Okay, so the modern reader might read all that and think: what a bunch of bull. What does hair on the chest have anything to do with the heart.  However, when we consider what the ancients thought of the heart, it all makes sense.  Francis Adams, who translated the works of Aeginenta in the 19th century, clarifies what Aegineta wrote.  Adams said:

In the ancient system of physiology, the heart was considered as the seat of the Vital powers, its office being the preservation of the innate heat of the body.

The philosopher, Aristotle, had pointed out the connexion between heat and vitality, and had taught that the heart, as being the centre of heat, is the prime organ in the animal frame. Hence, as his commentator, Averrhoes, remarks, it is the primum movens et ultimum moriens (the first mover and the last dying).

Galen, however, maintained with Hippocrates, that the animal frame is a circle, having neither beginning nor end, and that, consequently, it has no prime organ. He taught that the brain does not, properly speaking, derive its powers from the heart, nor the heart from the brain; but that these organs are mutually dependent upon one another, the heart being in'" 'debted to the brain for supplying the parts concerned in respiration with muscular energy, and the brain being indebted to the heart for its vital heat, without which it could not continue to be the vehicle of sensibility and motion.

We have mentioned in the preceding Section, that the ancient physiologists looked upon respiration as being a process similar to combustion. The heart, then, was supposed to convey heat to all parts of the body, by means of the animal spirits incorporated with the blood in the arteries.

Respecting the contents of the arteries, two hypotheses divided the ancient schools of medicine. The first was that of the celebrated Erasistratus, who maintained, that the arteries do not contain a fluid, but merely certain airs or vapours. The other hypothesis was that of Galen, who keenly attacked this, as he did most of the tenets of Erasistratus, and endeavoured to prove, by experiment, observation, and reasoning, that the contents of the arteries is blood, mixed, indeed, with a certain proportion of heat and airs, but in every respect a fluid, little different from that contained in the veins.

It was also part of his system, that the right cavity of the heart attracts blood from the liver, and conveys it to the left, from which it is diffused all over the body by the arteries. He taught that, at every systole of the arteries, a certain portion of their contents is discharged at their extremities, namely, by the exhalents and secretory vessels; and that at every diastole a corresponding supply is attracted from the heart. He decidedly inculcates, in opposition to Asclepiades, that it is the expansion or diastole of the artery which occasions the influx of the blood, and not the influx of the blood which occasions the expansion of the artery; or, in other words, that the systole is the function of the heart, and the diastole its return to its natural state.

Though he demonstrated the anastomosis of arteries and veins, he nowhere hints his belief, that the contents of the former pass into the latter, to be conveyed back to the heart, and from it to be again diffused over the body. In a word, his system appears to have been nearly, or altogether, the same as that which was afterwards taught by the unfortunate Servetus.

It is clear, therefore, that Galen had made a very near ap proach to the Harveian theory of the circulation; indeed, Harvey himself candidly admits this. It will be perceived, from what' "' we have stated, that the grand point of difference between Galen and Harvey, and that upon which the theory of the latter mainly rests, is the question whether or not at every systole of the left ventricle more blood be thrown out than is expended on exhalation, secretion, and nutrition. Upon this point Galen held the negative, Harvey, as we all know, the affirmative.\

With regard to the passages collected by the ingenious M. Dutens and others, from the works of Hippocrates, Plato, Nemesius, Pollux, and Theodoret, to prove that the ancients were acquainted with the circulation of the blood, as taught by Harvey, we shall only remark, that, after having attentively considered them, we cannot but draw the conclusion, that some of these authors must have had, at least, an obscure idea of this doctrine, although, in general, these passages may be understood to refer merely to the lesser circulation and the movement of the blood from the centre to the extremities, as maintained by Galen.

The last of these writers, whose minute acquaintance with the earlier works on medicine entitles his opinion to every consideration, after a searching investigation into the state of anatomical knowledge in the days of Hippocrates and his immediate successors, comes to the conclusion, that the germ of the theory of the circulation is, beyond doubt, to be found in the Hippocratic treatises.

In 1553, Michael Servetus (1509?-1553) was the first to accurately describe the circulation of the blood through the body, although he was burned at the stake for opposing accepted opinion.  His pupil was William Harvey (1578-1657), and because he was the first to publish evidence that blood circulates, he is given credit by history.

However, Harvey openly acknowledged that he was not the first to conclude that blood circulates, even going as far to say that the ancients knew of it, or, if not, were very close to knowing it.

Still, Galen described the blood as ebbing to and fro, from the heart to the liver and back to the heart, for example.  This was a common belief until Harvey proved, without a doubt, that the blood did circulate.

Further reading:

• 1213-1644: The discovery of gases and basic anatomy 

References:

1. Aegineta, Paulus, "The Seven Books of Paulus Aegineta," translated by Francis Adams, volume I, 1834, London, Snydenham Society, pages 94-96

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642 A.D.: Stephanus, the last Bryzantine physician

Stephanus (550-630 A.D.) is generally referred to as the last known Byzantine physician to be educated at the school of Alexandria.  He was professor of philosophy and medicine when the school was captured by Arabs in 642 A.D.  (1, page 213)

Perhaps  because he was born in Athens some refer to him as Stephanus of Athens. Perhaps because he was educated at Alexandria, and later became a physician at the school, some refer to him as Stephanus of Alexandria. Perhaps because he flourished in Byzantine during the reign of Justinian I (527-565) some refer to him as Stephanus of Byzantine.

Despite the various names, little is known of him.  Rather, perhaps that so little is known about him has resulted in the confusion about his name.

Oxfordreference.com says he was a contemporary of Justinian and that he was a Christian. He was neither a a geographer nor a historian, but a grammarian.  He was not completely uncritical, although his main task was as a compiler of the ancient writers whose works had been lost.  (8)

At some point during the reign of Heraclius (575-641) he migrated to Constantinople. (7, page 52)

He is known to have expounded on the works of Hippocrates, Aristotle and Galen, and is important to our history mainly because he expounded on the Hippocratic view regarding asthma. (2, page 82)

Garrison says Stephanus was a "pupil of Sylvius at Paris, and a prominent publisher of medical books during the Renaissance, was persecuted and imprisoned for heresy and died in prison. (5, page 156).

I'd delve further into the life of Stephanus, although apparently he left no furhter clues about his own life, nor was anything written on the subject by anyone who followed him, at least that we are aware.

All that we know of him is that he was the last of the Byzantine physicians and that he published books, one of which is relevant to our history: "Commentary on Hippocrates' Aphorisms."

Jackson quotes Stephanus form this book as saying the following about asthma:

We know already what asthma is: quick and frequent breathing.  And how do we explain the asthma?  There is an inward pressure on the vertebrae at the occiput (the back portion of the skull), it presses on the esophagus, which presses on the larynx and thus narrows the air passage, so that there is quick and frequent breathing called asthma by Hippocrates.  (3, pages 26-27)(6)

Galen said the faculties of nature were those naturally occurring events in the body that result in life.  For example, the soul and nature make life, the veins and liver make blood, the blood makes nutrition, nutrition is assimilated into the organ to make growth, and adequate growth assures continued life  and good health as long as possible.

Galen also said disease was the result of changes in the body, perhaps caused by a weakening of the natural faculties, that caused an increase or decrease in any one of the four humors: blood, yellow bile, black bile or phlegm.  An increase in phlegm in the lungs, for example, was what Galen believed caused asthma.

Staphanus expounded on this.  He is quoted once again by Jackson:

Middle age is characterized by an irregular temperament, and by this irregularity of temperament the natural faculties are weakened, in consequence of which various and manifold diseases  are produced in this group; in the same way autumn with its irregular temperament produces various and manifold bad humors, which naturally cause various and manifold bad humors, which naturally cause various and manifold diseases owing to the weakening of the faculties, since irregularity of any kind weakens the faculties and upsets the constitution... middle age is analogous to autumn, the prime of life to summer; and because of this analogy, just as autumn is the cause of many diseases, so there are many various diseases which middle age tends to produce. (3, page 27)(6) 

These people are prone to asthma. We have heard more than once what asthma is: heavy and very fast breathing.  The asthma is easily explained by the irregularity of the temperament. Phlegm is produced by weakening of the faculties and failure to digest the food; this phlegm flows to the pharynx, the larynx, and the trachea, thus the air is prevented from passing, and this causes asthma.  (3, page 27)(6) 

As we learn more about Staphanus we will be sure to publish it here.    

References:

1. 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," 2008, page 213
2. Smith, William Sir, "A Dictionary of Greek and Roman Biography and Mythology," page 964-5
3. Jackson, Mark, "Asthma: A biography," 2009, New York, Oxford University Press
4. Prioreschi, Plinio, "A History of Medicine," 2004, Omaha, Horatius Press
5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1913, Philadelphia and London, W.B. Saunders Company
6. Jackson, op cit, page 27, reference used by Jackson:  Stephanus of Athens: Commentary on Hippocrates' Aphorisms Sections III-IV, translated by Leendert G. Weserink (Berlin, 1992), page 151
7. Galen, De Diebus Decretoriis, from Greek into Arabic, translated by Glen M. Cooper, 2011, Great Britain, MPG Books
8. Stephanus of Bryzantium, Oxfordreference.com, http://www.oxfordreference.com/view/10.1093/oi/authority.20110803100531207, accessed 11/22/13

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625-690.: What did the ancients know about the pulmonary system?

What did ancient physicians know about the lungs?  What did they think was the purpose of the soft, sponge-like organs that surrounded the heart in the chest?  The best answer to this comes from one of the world's first medical historians: Paulus Aegineta, who lived from 625-690 A.D.

He said:

Not only does the stomach render us thirsty and otherwise, and excite a desire of warm and cold drink, but also the thoracic viscera, namely, the heart and lungs, and likewise the liver. And drinking does not straightway allay the desire, but a small quantity of cold drink will rather allay the thirst than a great quantity of warm. Persons so affected are refreshed by inhaling cold air, which has no effect in alleviating the thirst of the stomach. Thus, also, those who are contrariwise affected, suffer sensibly from breathing cold air; this is the strongest mark of coldness of the lungs; but they also hawk up phlegm, and expectorate it with coughing. Dryness of the lungs is marked by freedom from excrementitious discharges and from phlegm; and humidity, by being excrementitious, and rendering the voice dull and hoarse; and the recrementitious discharge is also very great when they attempt to speak in a louder or sharper tone.

While that sounds like a bunch of nonsense to the modern healthcare professional, it makes total sense if you understand the lungs from the perspective of the ancients.  Francis Adams (1807-1886), who translated the writings of Aeratus, clarified what Aerateus was saying.  Adams said:

The ancients were of opinion, that the lungs are an accessory organ, made to administer to the heart. "It" is the heart," says Aretaeus, "which imparts to the lungs the desire of drawing in cold air." And in like manner, Theophilus holds that the other organs of respiration were made for the sake of the heart, in order that its innate heat may be cooled, increased, and nourished.

So, the purpose of the lungs was to cool and nourish the heart.   He continued:

The physiologists differed respecting the uses of respiration. Thus, according to Galen, the famous Asclepiades held that it is for the generation of the soul itself, breath and life being thus considered to be identical...

The Asclepiades were temples in ancient Greece where the sick visited, and while sleeping inside the god Asclepius would reveal the cure, which would be interpreted by a priest. These cures were recorded on votive tablets stored inside the temples, and it was from these that some speculate Hippocrates obtained his medical wisdom.

Adams continued:

(The purpose of the lungs, according to) Hippocrates "'for its nutrition and refrigeration; and Erasistratus for the filling of the arteries with spirits. All these opinions are discussed and commented upon by Galen, who determines the purposes of respiration to be twofold: first, to preserve the animal heat; and second, to evacuate the fuliginous portion of the blood. He was aware of the analogy between respiration and combustion, and comes to the conclusion that they are processes of a similar nature: he accordingly compares the lungs to a lamp, the heart to its wick, the blood to the oil, and the animal heat to the flame.

Aristotle gives the name of pneuma to the vital heat of animals, and ascribes the source and maintenance of it to the double functions of respiration and digestion.

The following extract from Alexander Aphrodisiensis will explain the opinions entertained by physicians... of a later age:  "Wherefore there is a natural tepidity, the same I mean as the innate heat, whence springs the origin of the animal, its nature; for it is congenital with the animal, and therefore is called natural, being in the main the instrument of the soul's powers."

The following extract from Haly (Abbas) will show that the opinions of the Arabians on this subject did not differ from those of their Grecian masters, and more especially of Galen: "Respiration is necessary, for the sake of the heart, which is the fountain, and, as it were, the focus of vital heat, whence it is diffused over the rest of the body. It requires some aerial substance to ventilate the heat and ebullition of the heart, and in order to evacuate the fuliginous vapours which are found in it."

So you can see that the ancient Greeks created theoeries regarding the lungs, and the heart too, that were regarded by the medical community long after the fall of Rome in 476 A.D. and the end of what many consider the ancient world.

References:

1. Aegineta, Paulus, "The Seven Books of Paulus Aegineta," translated by Francis Adams, volume I, 1834, London, Snydenham Society, pages 93-94

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625-690: What did the ancients think of colds and allergies?

Viral and bacterial infections, common colds, allergies, hay fever, rhinitis and other such affections of the upper respiratory tract were generally all considered one and the same thing for most of history.

They were generally referred to as coryza, catarrh, and cough.  They were basically symptoms, and therefore the disease.  Coryza being inflammation of the nasal passages, catarrh being increased mucus and discharge in the nose and throat, and cough being a cough.  (1, page 469)

Paulis Aegineta, our Arabic medical historian from the 7th century, said "All these complains have this in common, that they are occasioned by the defluxion of a redundant humour  from the head to the parts below.   (1, page 469)

This basically meant that there was too much phlegm in the brain, and when this occurs it spreads to the nasal passages, mouth, throat, and lungs.  Therefore, the same cause also resulted in diseases of the throat and lungs, including croup and asthma.

Aegineta generally worded it this way:

When, therefore, it seats in the nostrils, the disease is called coryza; when in the pharynx and roof of the mouth, simply catarrh; but when it attacks the larynx and arteria trachea, so as to occasion a roughness of the membrane which lines them, the voice becomes hoarse, and the disease is called branchus, or morbus arteriacus: these terms being applicable not only to the inflammatory roughness occasioned by a defluxion from the head, but also to that arising from vociferation and inhaling cold air. (1, page 469)

It makes sense that they believed it was caused by inhaling cold air, considering people are more likely to catch a virus or bacteria when huddled close together in a warm room due to cold weather outdoors.  Yet they would have associated it with the cold air.

Cough pneumonia and influenza were also likely to be caused by the same thing. Aegineta said:

When the complaint is protracted, and the defluxion is carried down to the chest and lungs, it gives rise to bad coughs. And a cough often arises from an intemperament; sometimes a hot one, as in fevers, and sometimes a cold, as in northerly states of the weather, which is rather a dry one. Cough is also sometimes symptomatic of some other disease, such as pleurisy, hepatitis, phthisis, or peripneumonia. (1, pages 469-470)

Another disease would have been chronic bronchitis, which was not officially a disease until many centuries later.  Paulus might have been referring to this when he wrote:

Wherefore Galen relates that, in certain chronic cases of cough, chalazia (hail-stones) have been brought up from the chest. But Alexander relates that a certain heavy stone, like that which forms in the urinary organs, was brought up in a chronic cough, upon which the cough ceased. (1, page 470)

 Paulus lists the following as remedies for coryza and catarrh: (1, pages 470-471)

• Baths, and have a large quantity of hot water poured upon the head
• Foods such as spoon-meats and eggs in a state to be supped, starch, sweet cake, sesame, rice, almonds, the fruit of the cones of pine, and all confections from milk. 
• The wines which are drunk should be sweet and not old.
• A restricted diet is to be observed, and the head anointed with some heating and attenuating ointment, such as that of nard or rue.
• The ointment of iris is not only to be rubbed in, but is also to be injected into the nostrils
• Internally, they are to be rubbed with frankincense and myrrh, with oil; and this more especially when the coryza arises from cold.
• Odoriferous substances with burnt linen, or by gith and cumin burnt and bound up in a linen rag.
• Let them also smell to the cyphi seleniacum, and let it be rubbed into the forehead; and to it let there be added one of the antiphlogistic plasters, such as the Icesian, the Oxera, the Barbarum, and the Athena.
• For catarrh from cold it will be expedient to drink of cyphi, and to rub into the chest the juice of balsam by means of unwashed wool
• Apply calefacients to it (the chest), along with storax, the ointment of iris, or that of dill. 
• Let them also use hot and concocting food. But when the matter is already concocted, a masticatory will answer well with them, and detergent ointments (smegmata) to the head, such as the soap of Constantine, and the like (1, pages 470-471)

For affections of throat and trachea and coughs, the remedies are essentially the same, so I won't go into them.  Chances are none of these remedies did much good anyway, other than to have a placebo effect.

He does, however, offer some recipes for pills that might be useful for catarrh and cough.  He said:

Of storax, of myrrh, of opium, of galbanum, equal parts; mix with must, or pound by themselves in a mortar, and make into pills the size of a tare. Give three, four, or five at bedtime, and swallow with some must. These things are for an acrid and thin rheum.—Another: Of the seed of henbane... of pine-nuts... of saffron.  Mix with rob or with must, and use. An electuary. Of honey  of butter.... Boil together and give; and let the decoction of hyssop, of figs, of pinenuts, and of iris, be swallowed. Pills for more inveterate coughs. Of storax... of myrrh... of turpentine, of galbanum, of opopanax, and of iris, of each..., of white pepper, of nitre, of henbane-seeds, of the juice of poppy, of each... Beat in a mortar without any liquid, form into pills, and use as formerly directed. (1, page 472)

Francis Adams said that most of the other ancient physicians, with the exception of Aretaeus, agreed with Paulus Aegineta regarding his description and treatment of coryza, catarrh, cough and common throat ailments. The same is true of Arabian physicians.  So we have no reason to delve into their thoughts on the subject. However, if you want to learn about them, you can click on the link provided below. (1, page 472)

However, it must be understood that most physicians, no matter what era they are from, have form their own opinions about diseases and their remedies, and so how you were treated would depend on who your physician was.

Don't scratch your head trying to figure out what all these remedies are or what they amount to.  I just wanted to show you what some of the remedies would be if you suffered from the common cold or allergies in the ancient world.  

Chances are, you'd be better off toughing it out, which is probably what most people did.  

References:

1. Aegineta, Paulus, "The Seven Books of Paulus Aegineta," translated by Francis Adams, volume I, 1844, The Snydenham Society, pages 469-475 

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