In 1892 Sir William Osler described Asthma in his book Principles and Practice of Medicine as:
- Spasm of the bronchial muscles
- Swelling of the bronchial mucous membrane
- A special form of inflammation of the smaller bronchioles
- Having many resemblances to hay fever
- The affection running in families.
- Often beginning in childhood and sometimes lasting into old age.
- Bizarre and extraordinary variety of circumstances which at times induce a paroxysm:
- Climate and atmosphere e.g. hay, dust, cat
- Fright or violent emotion
- Diet (overloading of the stomach) or certain foods
- Cold infection
- Sputum is distinctive: rounded gelatinous masses (“perles“) and Curschmann spirals & octahedral crystals of Leyden
At the time Asthma was treated as a disease of Bronchospasm.
Ma Huang was described by the Pen-tsao Kang-mu as a diaphoretic. The literal translation was “hemp yellow”. The drug was investigated by Nagai Nagayoshi who isolated it from an alkaloid then named it ephedrine in 1885. In 1924 Ko Kuei Chen and Carl Schmidt did a study which to a collaboration with Thomas Miller that showed ephedrine was active as a bronchodilator in asthma.
In 1910, Samuel Meltzer suggested that asthma was an anaphylactic phenomenon.
In 1950 a small three person study was done to see the effects of cortisone on bronchial asthma and hay fever occurring in subjects sensitive to ragweed pollen. Below is the abstract:
1.1. Three patients received injections of cortisone during the season when ragweed pollen, to which they were allergic, was in the air.
- 2.2. Each patient experienced prompt relief from the symptoms of bronchial asthma and hay fever occurring as the result of that pollen sensitivity.
- 3.3. The symptoms of bronchial asthma were relieved more quickly than were symptoms of hay fever.
- 4.4. Within 3 days following the onset of administration of cortisone, only occasional allergic symptoms, which were of a mild and transitory nature, were observed.
- 5.5. The relief of symptoms was apparently confined to the period during and immediately following the time when cortisone was being administered.
A six week double blind cross-over sequential trial was reported in 1967 of an antiallergic compound named disodium cromoglycate.
In 1990 a study was performed in the UK that determined in addition to genetic antiallergic factors, exposure in early childhood to house-dust mite allergens is an important factor in the later development in asthma.
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