The History of Asthma Medicine
So you’re suffering from an asthma attack. You sit on the edge of the bed and reach for your rescue inhaler. But it’s not there. Now what do you do? You do what people did before the modern age of medicine: you suffer.
Other than just suffer, what would you do treat your asthma if you lived in…
5,000 B.C.: You’d seek out a priest, magician or witch to find out what god was mad at you and what you can do to allay the anger of this god. You’d say an incantation or prayer for healing.
3,400 B.C.: If you’re lucky enough to live in Egypt and you know a physician to prescribe crushed and sun-dried stammonium leaves and roots. You’d take these and set them over heated bricks and inhale the fumes. It won’t heal you, but will give you some relief.
1,500 B.C: If you lived in China you were given a cup of yellow tea with an herb in it from the plant called Ma Huang. It tastes bitter, but it’s worth it. It was by far the best ancient remedy for asthma. Unfortunately, it wasn’t discovered for the rest of the world until 1887.
400 B.C.: In Ancient Greece quack medicine starts to fade, and your doctor recommends a healthy diet and exercise. Only if you were desperate would he recommend herbs, purging or bleeding to rid the body of whatever poison or peccant matter is causing your asthma. Purging means you vomit. Bleeding means someone slits open your skin.
100 A.D.: If you’re lucky enough to live in India you’d stuff sun-dried and crushed strammonium into a crude pipe you handcrafted. The relief is better than anything else you ever tried.
1 A.D.: How about trying a fox’s liver dried, eating the fresh, roasted lungs of a fox (but you can’t cook it with iron utensils), or a good vomit. You could rub salves on your chest, drink austere wine, drink milk or hydromel (honey diluted in water), or relieve your thorax with a medicinal dressing. You could also go for a walk or get a massage. Or you could just lean against a table and tough it out.
50 A.D.: Seneca is among the first to recommend relaxing to control your asthma. He isn’t a supporter of potions, magic and herbs. He simply recommends relaxing and thinking of something that makes you happy. Oh, and Pliny the Elder recommends drinking the blood of wild horses and eating snails. Yummy.
1198 A.D.: Maimonides recommends chicken noodle soup, clean urban air, travel to dry regions, exercise, sleep, cold bathing, massage and avoiding gas producing foods.
1700: Sir John Floyer recommends cold baths, a light diet, gentle exercise, bleeding, opiates to ease the mind and relax the body, abstinence from anger or shouting, clysters to relieve the bowels, herbs to cause vomiting, and anything that made you pee. He also recommends you avoid climate changes. Bernardino Ramazzini recommended you avoid occupations that generate dust and fumes, such as tinsmiths, horseback riding, bakers, etc.
1794: William Cullen recommends avoiding asthma triggers like warm bathing, cold air, dust, odors and warm weather.
1797: British physician Robert Bree recommends strong coffee, which does relax your breathing some.
1803: An old remedy from India finally makes it’s way to the west, and your doctor may prescribe inhaling the smoke of strammonium and belladonna. You can inhale incense, stuff it in a pipe, or roll up a cigar or cigarette.
1860: You have many options, such as smoking stramonium, lobelia or belladonna, or inhaing ether, chloroform, or potassium nitrate fumes. Some doctors may recommend bleeding, vomiting, emetics, coffee, or a random assortment of things that probably don’t give you much relief. Atropine was isolated in 1833 and is now available as an option to be inhaled ihaled in pipes or cigars.
1879: Strammonium, belladonna and atropine were now available in mass produced cigarettes. Now you can buy one of many varieties of asthma cigarettes, which may also include henbane, atropine, or even cannabis. Your doctor will know you’re an asthmatic by the scent of such herbs when he opens your front door.
1903: Epinephrine (epi) and Isoproterenol (Iso) are now available as injections to immediately relieve an asthma attack. Ephedrine is also an option that works almost as well.
1910: Epinephrine is now available as a solution to be nebulized, yet nebulizers are large, made of glass, and the medicine had to be inhaled by squeezing a rubber bulb.
1930: Now you have an electric, mass producible nebulizer so you can take epi and iso at home when you need it.
1955: Epi and Iso are now available as an inhaler you can carry with you in your pocket or purse. Now you can get instant relief anywhere and anytime. Theophylline is a pill that make your breathing better if taken four times every day.
1961: Metatprateronol (Alupent) is now available as either an inhaler or solution to be nebulized. It gives instant asthma relief without the side effects of iso and epi.
1951: Iseotharine (Bronkosol) approved by the FDA as another option to treat asthma. It’s another rescue medicine.
1960: Allen & Hanbury markets Becotide (beclomethasone) as the first inhaled corticosteroid inhaler. It was only available outside the U.S. The recommended frequency was two puffs four times daily to to treat and prevent asthma.
1963: Alupent approved by FDA and Americans now have access to this great medicine.
1970: Terbutaline is another rescue medicine introduced to the market. It was stronger than Iseotharine and lasted 4-6 hours. It was later available as an inhaler called Brethine or Bricanyl or Brethaire
1982: Albuterol (Ventolin, Proventil) was approved by the FDA and would soon become the most popular asthma medicine. It gave you your breath back instantly and with hardly any side effects. It was initially available only as a solution, but soon as an inhaler. Albuterol continues to be the rescue medicine of choice.
1989: New asthma guidelines recommend changing the focus from just treating symptoms to preventing asthma. Beclomethasone (Becotide, Vanceril, Beclovent), Triamcinolome (Azmacort) and Flunisolide (Aerobid) are top line asthma medicines to treat chronic asthma. Albuterol is recommended to treat acute asthma symptoms.
1994: Salmeterol (Serevent) is added as another option. It’s a long acting beta adrenergic (LABA) that keeps your lungs open for up to 12 hours. What makes it so great is it’s only taken twice a day to prevent asthma symptoms.
1998: Studies show asthmatics may benefit from taking both a LABA and inhaled corticosteroid. Advair was the first medicine that combined both medicines, and it quickly became a top line asthma medicine to prevent asthma. Now your asthma is so controlled you hardly ever need your rescue inhaler.
1999: Levalbuterol (Xopenex) is now another rescue medicine available as a solution. Some say it’s stronger than albuterol with fewer side effects, although it costs a ton more.
Today: The emphasis is on controlling asthma with preventative medicine, and using rescue medicine only to treat acute asthma symptoms. To check out what’s available click here.
Your asthma is so much better than if you lived in 5,000 B.C. It’s even better than if you lived 20 years ago. Many asthma cases are so controlled we almost take it for granted. I think it’s good to look into the past to appreciate how great we have it today.
For a more complete asthma history check out the following:
- Any of the links above
- The book “Asthma: A Biography” by Mark Jackson (a must read for all asthmatics)
John Bottrell is a registered Respiratory Therapist. He wrote for HealthCentral as a health professional for Asthma and Chronic Obstructive Pulmonary Disease (COPD).