Asthma Through the Centuries

There are more than 26 million people just in the U.S. who have asthma, 6 million of them kids.1 And those numbers have been rapidly rising for the past 3 decades. In fact, according to the World Health Organization (WHO), they've increased over 60 percent in that same amount of time.2 But, did you know that asthma has actually been around for centuries?

It's true. Health care officials have been aware of the medical condition eventually named asthma, although they may not always have known how to treat it. But the face of asthma has changed greatly through the centuries.

Asthma in ancient times

Asthma was originally recognized more as a symptom, rather than a disease. Chinese, Egyptian, Greek, Hebrew, and Roman documents describe breathlessness in various contexts.3,4 The Greeks, though, were the first to give it a name.

The Greek physician Hippocrates first used the Greek word, "asthmaino", which means panting or gasping, somewhere between 460 and 377 BC.3 Basically, the term was applied to anyone who was short of breath.

It wasn't until around 500 years later (130–201 AD) that another physician, Greco-Roman Claudius Galen, made a connection between the upper and lower airways as relates to asthma.3

Asthma through the middle ages

For many centuries, very little attention was paid to asthma, either its symptoms or the disease itself. However, Maimonides, a physician during the latter part of the 12th century, did suggest that asthma could be treated with a combination of:3

  • Rest
  • Avoidance of opium (!)
  • Proper personal and environmental hygiene
  • Dietary factors

In the 16th century, a German physician linked environmental factors to airway symptoms, with an emphasis on occupational hazards in miners. During the Renaissance, further connections were made between asthma and exposure to seasonal allergens.

Asthma in the 19th century

With the invention of the stethoscope around the beginning of the 18th century, asthma was identified as a unique airways disorder characterized by bronchospasm.3 But in 1860, Dr. Henry Hyde Salter, an asthmatic himself, defined asthma as a condition where airways narrow due to contraction of their smooth muscle.5

By the end of the 19th century, physicians recognized that asthma was a unique disease. They accepted that it had a specific set of causes, clinical effects, and required specific treatments.

Asthma in modern times

It was Sir William Osler, one of the founders of Johns Hopkins School of Medicine, who finally nailed down the ins and outs of asthma, as we recognize it today. He did this at the very end of the 19th century. Osler is regarded as the "father of modern medicine."5

Some of the factors he identified include:

  • The inflammatory nature of asthma
  • Asthma and allergy's (hayfever) close connection
  • Hereditary risk factors
  • Environmental triggers

Unfortunately, though much of the 20th century, physicians viewed asthma only as a disease that caused bronchospasms. Thus, treatment centered on bronchodilators, which were eventually so widely used, they were available over the counter. Unfortunately, this resulted in unrestricted overuse, which led frequently to asthma deaths.5 There was also an overemphasis on "emotional stress" as being a major factor in asthma.

Finally, by the 1980s, we began to recognize more clearly the inflammatory nature of asthma. Physicians realized that treating asthma as only an acute disorder of episodic exacerbations was not effective. Inhaled steroids began to be used as ongoing controller medicines for asthma.

Asthma today

Here in the 21st century, asthma continues, as stated at the beginning of this post, to be an exceedingly common condition. But, thanks to abundant research and clinical trials, we are learning more about asthma and how to treat it all the time.

New asthma treatments are being developed regularly as we improve our understanding of the immunology of asthma. And, while we recognize that emotions can play a role in triggering asthma symptoms, we now know that asthma is not a disease "of the mind."

What experts haven't necessarily gotten a handle on is why asthma has "exploded" as a disease in the last 30 to 40 years. The roots to that answer may lie in changes in our environment and in modern lifestyles.

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