History of Asthma

Asthma, the condition where you feel as if you are starving for air to breathe is actually a chronic disease of the respiratory air passages which inhibits the smooth passage of air while breathing. During the asthma attack there occurs narrowing of the airways to lungs. This is mainly due to constriction of the smooth muscle cells that surrounds the bronchi and the resulting inflammation.

The word Asthma was derived from a Greek word aazein, meaning to pant, to exhale with open mouth. There are evidences which show that asthma persisted years before. The expression asthma was used for the first time by Homer in his Greek epic poem llaid, it states: “ho d’ argaleoi echet’ asthmatic …..haim’ emeon”, which means “he was grabbed by ( echet) severe asthma  ( asthmatic), vomiting up ( emeon ) blood (haim’)”. Here the word asthma was used just to mention a condition of short drawn breath. The term asthma was first used as a medical term by Hippocrates (460-360 B.C.), in The Corpus Hippocraticum, but we cannot be sure whether he meant asthma as a clinical entity or just a symptom. The best clinical description of asthma was written by Aretaeus of Cappadocia (100 A.D.), an ancient Greek master clinician. In the writings of Galen (130-200A.D.), ancient Greek physician “asthma” was mentioned several times which agreed with the texts of Hippocrates and to some extend with the texts of Aretaeus of Cappadocia. Galen described asthma as obstruction in bronchi and he treated it with owl’s blood in wine.

Moses Maimonides, a 12th century rabbi and philosopher was in addition a Physician who practiced in the Court of Saladin, the Sulthan of Egypt and Syria wrote Treatise of Asthma for his royal patient Prince Al-Afdal. Maimonides stated that his patient’s symptoms started as a common cold especially in the rainy season and continued until the patient gasped for air and finally expelled phlegm through cough. He found that the dry seasons of Egypt were favorable for the asthma patients than cold and rainy seasons. He also asked his patients to avoid strong medications, to moderate their sleep, food, drink, sexual activity, to stay away from polluted environment. In addition he suggested his patients to consume soup of chicken or fat hen.

Jean Baptiste Van Helmont, a 16th century chemist, physician and physiologist from Belgium stated that asthma originates in the pipelines of lungs. According to Bernardino Ramazzini, a 17th century Italian physician who is also known as the Father of Sports Medicine, there are a direct link between asthma and the organic dust particles. At the beginning of 18th century the case of asthma was very rarely mentioned, and just 4-5 patients with asthma constituted the case report. During early 20th century asthma was considered as a psychosomatic disease and between the years 1930s -1950s it was considered as one of the Holy Seven psychosomatic illness. In 1901, the use of bronchodilators for the treatment of asthma began .It was after 1960s that asthma was recognized as an inflammatory disease.

Symptoms and Causes of Asthma

The symptoms of asthma mainly include:

  • Coughing
  • Wheezing
  • Difficulty in breathing
  • Difficulty in speaking
  • Chest tightness
  • Weakness

These symptoms may be severe at night which disturbs the sleep or may be severe during day time.
The exact cause of asthma is not yet known properly. Common difficulty that all asthma patients suffer is the restriction of airflow through breathing the tubes. This is due to the inflammation caused by constriction of bronchial smooth muscle cells and accumulation of mucus in the breathing tubes which is secreted by the immune system. Asthma is actually a type of allergic reaction which is induced when exposed to certain triggers. There are different types of triggers.  The triggers which cause asthma in one person may not cause it in other i.e., these triggers may differ from person to person with each one having a specific one. Some of the most common asthma triggers are:

  • Air pollution
  • Tobacco
  • Wood smoke and fumes
  • Cold climate
  • Some food stuffs
  • Certain medicines
  • Fugal spores
  • Perfumes
  • Pollen
  • Physical exercise
  • Emotional factors like stress, laugh etc.
  • Certain food preservatives
  • Respiratory infections like sinusitis, flu, cold, bronchitis etc.
  • Animal fur

Heredity plays an important role in the case of asthma. There are chances of getting this disease if your close relatives like parents, sister, brother, first cousins are sufferers of asthma. Hay fever and eczema are the other two risk factors for developing asthma.

Types of Asthma

Traditionally asthma has been classified in three major types. Extrinsic asthma, Intrinsic asthma and Mixed asthma.

Extrinsic Asthma also known as atopic asthma/ allergic asthma is due to the body’s immune system response to inhaled allergen or antigen. When an allergen enters the body, the immune system recognizes it as foreign substance or antigen and produces corresponding antibodies to fight against it. Thus in extrinsic asthma there is an increase in the serum IgE level.

Intrinsic Asthma / Non allergic asthma on the other hand is caused due to factors like infection, cold whether, emotional factors, some medicines, exercise, food preservatives etc. This type of asthma is not allergy related and no antibodies are produced. Here asthma attack is induced due to the irritation of muscle cells or nerve cells in the airways and those suffering from intrinsic asthma will be hypersensitive.

In Mixed Asthma, the attack may be induced either by allergens or by certain extrinsic factors.

Besides Intrinsic, Extrinsic and Mixed forms asthma has been further categorized into different types as follows:

Childhood Asthma

In childhood asthma the individual suffers from asthma attack only during his childhood and gets cured as he grows up. This happens as the body undergoes various hormonal and functional changes during the growth phase.

Adult Onset Asthma 

Adult onset asthma is usually affected after the age of 20 and is seen most commonly in women than in men. Asthma attack in this case is induced by allergens such as smoke, dust, polluted air etc.

Exercise Induced Asthma

Exercise induced asthma is also known as sports induced asthma and occurs after an exhausting exercise due to change in temperature of air in the lungs.

Occupational Asthma

Occupational asthma mainly develops due to the exposure to certain allergens such as gasses, plastics, dust, smoke etc. at their work place. Here the most common symptoms are running nose, irritation of eye, and cough rather than severe wheezing. Some of the most common jobs which might lead to this type of asthma include farming, animal breeding, painting, carpentry etc.

Nocturnal Asthma

In Nocturnal or night time asthma the symptoms are severe during night time and early hours of morning. This shows that the circadian rhythm has direct influence on asthma symptoms. The patient may have cough, wheezing and other symptoms when lying down for sleep or some times the symptoms may not be noticed until they awoke in the middle of sleep.

Cough Variant Asthma

In this case, the asthma patients have severe cough as the major symptom. This can be severe either in the night time or day time.

Allergic Asthma

Allergic asthma is mainly triggered by specific allergens. Most common symptoms include sneezing, running nose and coughing.

Bronchial Asthma

This is an allergic reaction which is induced by hypersensitivity to allergens like dust, smoke, pollen and so on or to certain food particles. In this case due to mucus accumulation in the air passage there will be difficulty in breathing.

Tests and Treatments for Asthma

Pulmonary Function Test and Allergy Test are the most two most important tests to detect asthma and lung capacity.
Asthma treatment may vary depending on the type of asthma. Most of the treatments aim at lessening the severity of attack and relieving the symptoms. Asthma treatment takes long time sometimes even life long.   Treatment mainly includes use of bronchodilator inhalers, nebulizers, steroid therapy and anti inflammatory drugs.

Asthma Statistics

  • There are over 150 million asthma sufferers world wide.
  • The number of asthma cases has been increased gradually during the last 20 years.
  • USA, UK, Ireland, Australia and New Zealand are the countries worst affected by asthma and countries like Albania, Georgia, Indonesia and Romania are least affected.
  • There are 20 million asthma sufferers in United States.
  • Over 9 million among the US patients are children.
  • Around 70-80% suffers from allergic asthma.
  • In America more than 10 million people are reported to have allergic asthma.
  • In America, asthma causes around $ 16 billion a year.
  • Each year around 5,000 Americans die out of asthma.
  • In Australia one among three children under the age of sixteen suffers from asthma.
  • In UK about 8% of adults and 10 % of children out of the total population are asthma patients.
  • In the last decade, the number of asthma patients has been doubled in Western Europe.
  • Sufferers of asthma in Swiss are around 18% of the population compared to 2% a decade ago.
  • In Japan, there are around 10 million asthma sufferers.
  • In 2003 it was found that the number of female asthma patients were 35% greater than males.

Globally, the numbers of asthma patients are increasing each year. But according to the current study researchers have found that these statistics could be gradually reduced with proper education and treatment.