The History of Respiratory Therapy: Discovery and Evolution

The History of Respiratory Therapy: Discovery and Evolution

by Dennis W. Glover

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ISBN-13: 9781449014902
Publisher: AuthorHouse
Publication date: 04/28/2010
Pages: 156
Product dimensions: 6.00(w) x 9.00(h) x 0.36(d)

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The History of Respiratory Therapy

Discovery and Evolution
By Dennis W. Glover

AuthorHouse

Copyright © 2010 Dennis W. Glover
All right reserved.

ISBN: 978-1-4490-1490-2


Chapter One

Discovery: 6000 BC

For more than six thousand years, respiratory therapy has been used to relieve all sorts of ailments. It has only been in the past two hundred years that this practice has achieved more popularity, due to advanced medical understanding.

The early use of respiratory, or inhalation, therapy had its origin in ancient India, Greece, Rome, Egypt, the Middle East, China, Japan, Korea, South America, Central America, and North America. Various records depict the empirical inhalation of vapors, anesthesia, aromatherapy, and fumigation started circa 6000 BC. The majority of inhaled herbs, oils, animal parts, and minerals were first tried on the practitioner himself (as in China). The practitioners included folk healers, priests, shamans, medicine men, quacks, and elders. The causes and cures for illness were founded on the beliefs of spirituality, sin, destiny, or astrology, to name a few.

Medical practice and education did not stand alone until the founding of medical schools in Italy, Iran (the University of Gundishapur was established during the Sassanian Period, 224-641 CE), and Egypt (Achaemenical Medical Schools built by Darius the Great, 522-486 BCE) (Vohuman.org, August 18, 2005).

Before medical institutions were established, alchemy was practiced by scientists. This belief included the study of medicine, but also chemistry, physics, astrology, nature, mysticism, and art. Humorism was the practice in the Roman and Greek period. The theory involved the makeup and working of the human body. It was supposedly the most commonly held view of the human body in Europe until the nineteenth century. The theory maintained that the body was filled with four basic substances, which were the humors. They were identified as phlegm, yellow bile, black bile, and blood. All diseases and disabilities were the result of an excess or deficit of one of these humors. For example, if someone had too much phlegm, they were phlegmatic.

In ancient Egypt, physicians mixed vinegar with water poured over Memphite stone to produce a vapor with an analgesic effect; cough was treated by inhalation of honey, cream, milk, carob, colocynth, and date kernels. An apparatus for inhalation therapy is also evident. In Iran, bangha (hashish) was extracted from the seeds of cannabis from India. It was mixed with wine to deliver anesthesia. In China, in about 2600 BC, the Yellow Emperor, Huang-ti, used ma huang (ephedrine) to treat asthma. In Egypt, in about 1554 BC, physicians vaporized black henbane on hot bricks for inhalation. In South America, around the ninth century, Mayan Indians smoked tobacco and various psychoactive drugs for religious rituals.

Aromatherapy is a form of alternative medicine originating some six thousand years ago. It was practiced by the Greeks, Romans, and Egyptians. It is a process of treating various illnesses with the inhalation of oils and fragrances which are derived from botanical plants. The ingredients of these plants are taken from the bark, fruit, resin, leaves, and seeds. They are made into oils and heated to produce fragrant vapors which stimulate the smell receptors and, it is believed, the immune system. This, in turn, aids the healing process. The plant ingredients are used as anti-inflammatories, antidepressants, pain relievers, and expectorants. They also are used to enhance digestion and diuresis.

Fumigation was a practice used by the Romans and Egyptians to disinfect rooms. But it also was used to eliminate "tooth worms, " which were believed in this time to be the cause of tooth decay. One remedy consisted of the following: four grains of henbane and Leah seeds; two and one-half onions; knead with goat fat until smooth; roll into pills with the weight of a silver coin; burn one pill in a funnel; and cover the patient's head for direct inhalation.

Chapter Two

Evolution: First through Sixteenth Centuries

In the centuries of the Dark Ages (first through fourth centuries AD) and the Middle Ages (fifth through twelfth centuries AD), the administration of respiratory therapy has fallen into the hands of a corrupt church. The priests are ignorant, mean-spirited, and not concerned with the general welfare of their followers. They replace valuable remedies with superstition and for what is best for religious purposes. However, they do recognize and maintain fumigation as a medicinal therapy. In the Renaissance Period (1300-1600), after the church is finished with its inept influence over the practice of medicine, physicians are able to return to previously used treatment remedies.

Chapter Three

Seventeenth and Eighteenth Centuries

In the seventeenth and eighteenth centuries, physicians recommend the fumigation and inhalation of myrrh, styrax, cloves, sulfur, balsam, frankincense, asafoetida, and other substances.

These fumes or vapors can be applied directly to the lungs and are used to treat consumption and assorted maladies. Some of these medicaments are thrown directly onto hot coals and inhaled through a tube, with some disastrous results to the respiratory system and toxic insult to the body.

1600s

Until the mid-seventeenth century, very little is known regarding the physiology of respiration. Basically, the only knowledge about this process is that if breathing stops for a short period of time for a man or an animal, death soon follows. They do know that the respiratory rate increases in some diseases and upon exertion.

Robert Boyle 1627-1691 Courtesy of Chemical Heritage Foundation Collections, Photograph by Will Brown

In 1666, Robert Boyle, a chemist, carries out experiments which conclude that inhaled air is necessary for life. In one of his discoveries, he uses an air pump to create a vacuum. Boyle's law states "that the volume of a gas varies inversely with pressure." He also has a book published in 1692: The General History of the Air.

In 1667, Robert Hooke observes the lungs collapse when the chest of an animal is opened. The animal can be kept alive if holes are made in the lungs and a continuous flow of air is passed through the lungs.

In 1673, Dr. John Mayow is getting close to explaining the concept of the relationship between increased breathing and muscular work.

As a fellow of All Souls College, Oxford, Mayow became interested in respiration. By observing a mouse in a glass container he was able to deduce that as the mouse breathed the amount of air in the vessel diminished. He also calculated in a separate experiment that an object burning in a small space uses air. Together these experiments allowed Mayow to make a connection between combustion and respiration, information that led later to the discovery of oxygen.

According to Dr. John Haldane, Dr. Mayow almost discovered oxygen. Dr. Mayow also purports that atmospheric air is absorbed into the blood through the lungs, carried to the brain, separated into the ventricles, and passed on through the nerve tubules to the muscles. He concludes that increased breathing and muscular work are accompanied by an increase in the "nitro-aerial spirit" (oxygen) from the air.

Further knowledge on respiration does not develop until the eighteenth century.

1700s

In 1750, Joseph Black makes a significant contribution to knowledge of the physiology of breathing when he determines that "fixed air" (carbon dioxide) is given off by the lungs in respiration.

Joseph Priestly 1733-1804 Courtesy of the Chemists' Club Collection, Chemical Heritage Foundation Collections, Photograph by Will Brown

In the 1770s, Joseph Priestley of England completes scientific research on the nature and properties of gases. In 1774, he heats mercuric oxide, and the gas released he calls "dephlogisticated air." This term refers to a combustible substance that when heated releases components into the atmosphere. Priestly believes he is purifying this air. He inhales this air and feels essentially no difference. He comments that this pure air may someday become fashionable. Little does he know that in the 1800s and today, this pure air would be sold in oxygen parlors and bars. About the same time, Karl Scheele of Sweden burns mercuric oxide and potassium nitrate. He obtains a gas which makes candles burn more brightly.

Joseph Priestly used this apparatus to prepare oxygen by heating mercuric oxide floating on the surface of some mercury in an inverted phial in 1774. He established its properties in a long series of experiments with mice and plants. The single lens in the picture was Priestly's own. The bowl and the phial are modern reconstructions. Courtesy of 'Science Museum/ Science & Society Picture Library.

However, he does not report this experiment, as Priestley does in 1775. Thus, Joseph Priestley takes the honor of discovering oxygen. He also discovers nitrous oxide in 1772. Priestley also contributes to the knowledge of respiration and photosynthesis, and he is the first to "carbonate" water.

The next recording of therapeutics is in 1755 by Dr. Bennett, an English physician who recommends and fully describes a variety of substances.

Antoine Lavoisier 1743-1794 Courtesy of Chemical Heritage Foundation

It is not until 1778 that Antoine-Laurent Lavoisier of France proves water is composed of oxygen and hydrogen. He calls Priestley's pure air "oxygene" (acid former) and eliminates the name "dephlogisticated air."

In 1780, Dr. John Mudge believes he can cure tuberculosis with medicinal vapor inhalation.

Dr. Mudge's inhaler consists of a large-mouth glass bottle which holds about a pint of liquid solution. This container has a cork on top with two tubes in it. One tube reaches the bottom of the liquid, and the other is just below the cork. The tube just below the cork is connected to a long tube, which has a mouthpiece attached to it. The patient inhales from the long inside tube, which draws air through the solution and carries some of the vapor into the lungs. A prescription for an inhalation is as follows: (Fitch, Samuel Sheldon, AM, MD, Six Lectures Of The Cure For The Function Of The Lungs, S.S. Fitch and Co., 1856, p.355)

Iodine, gr. V. Potassae hydriodat, gr. Iii. Tinct. conii, 3vi. Water, (distilled), 5v. Alcohol, 3ii. A list of principal remedies: Saturated tincture of digitalis. Tincture of iodine. Tincture of conium. Saturated tincture of stramonium-prepared from dried leaves. Saturated tincture of belladonna, prepared from dried leaves. Hydrocyanic acid. Spirituous tincture of ipecacuanha, prepared roots. Sulphuric ether. Saturated tincture of Libelia inflata.

In 1783, Dr. Caillens of France is the first physician who gives daily inhalations of oxygen to a tuberculosis patient. This same year Dr. Francois Chaussier administers oxygen to asphyxiated infants.

As word spreads about this new oxygen gas, in 1799, Dr. Thomas Beddoes of England builds a pneumatic institute and gives short treatments of oxygen to patients. He provides this therapy to test the effectiveness of oxygen clinically. His institute, however, is converted into a regular hospital with the Typhus outbreak of 1800.

Chapter Four

Nineteenth Century

In 1858, Sales-Girons constructs a portable apparatus for the atomization of fluids and presents it to The Academy of Medicine in Paris. "The conclusions and practice of Sales-Girons, who is called the Father of Atomization thus receives the highest authority and rapidly spread over the civilized world"(Prosser, James, MD, The Therapeutics of Respiratory Passages, William Wood and Company, New York, 1884, p. 281).

In 1882, Dr. John Forbes institutes a series of experiments with the inhalation of iodine and conium. Dr. B. Maddock of London spends seventeen years of treating consumption by inhalation. In 1882, Pagenstecher advocates the inhalation of tar. Beginning in 1845, Dr. J. Evan Riadore practices several years with medicinal inhalation. He uses it for conditions such as heart disease, humors, gout, paralysis, scrofula, dropsy, diseases of the eye, bilious disorders, deafness, tres douloureux, and lung disease.

The respiratory therapy of medicinal inhalation is used extensively in the United States, England, France, and Germany. It is apparent that physicians in the eighteenth and nineteenth centuries do not have many curative remedies in their doctor's bag. However, that is all they have until the discovery of Mycobacterium tuberculosis and continued medical discoveries, treatments, and cures in the twentieth and twenty-first centuries.

In the 1800s, the chief methods for using oxygen therapeutically are inhalation via a paper funnel; subcutaneous injections for conditions such as pneumonia; intravenous infusion with oxygenated saline solutions; and oxygen infusion into the joints and major cavities, such as the abdomen.

In some arenas of medical practice, oxygen use is frowned upon because it does not appear to be of any clinical benefit. The following quote is from Dr. Henry Hyde Salter (Salter, Henry Hyde, MD, FRS, On Asthma: Its Pathology and Treatment, William Wood and Company, New York, 1882, p.107):

But there is one essential point that is overlooked, viz, that not only is there is [sic] a difficulty in getting oxygen in, but also an equal difficulty in getting carbonic acid gas out. I have tried it many instances, not only in asthma but in bronchitis and other apnoeal states, and I must say I have never seen any real and substantial benefit derived from it.

"Consumption"-caused by Mycobacterium tuberculosis-is one of the oldest diseases of humanity; it is a "big-time" world respiratory disease in the nineteenth and twentieth centuries. "Briefly, then, it may be stated, that consumption is essentially a constitutional malady, and it is intimately connected with perverted nutrition and imperfect sanguification" (Fuller, Henry William, MD, On Diseases of the Lungs and Air Passages, Henry C. Lea, Philadelphia, 1867, p. 358). The etiology of tuberculosis is still unknown until 1882, when Robert Koch identifies the Mycobacterium organism. It is also called "white plague," "white swelling" (tuberculosis of the bones), "king's evil" (tuberculosis of the lymph glands and neck), "phthisis" (original Greek name for tuberculosis), "scrofula" (tuberculosis of the lymph glands), "Pott's disease" (tuberculosis of the spine), "lupus vulgaris" (tuberculosis of the skin), and "mesenteric disease" (tuberculosis of the abdominal lymph glands, contracted from infected cows).

The treatment of tuberculosis consists of resting the lungs. There are several tuberculosis treatment facilities (sanatoriums) sometimes located in very cold climates (such as in Saranac Lake, New York), where patients with heavy coats and blankets sit outside in subzero weather for long periods of time. Other treatments consist of collapsing a lung (pneumothorax) with a needle to rest it; thoracoplasty, which removes ribs from one side of the thorax to permanently collapse the infected lung; collapsing parts of both lungs (bilateral pneumothorax); and filling the pleural cavities with gas to compress the diseased lung. Quack liquid medicines are packaged in small glass bottles with a label stating "consumption cure." Respiratory devices such as an "incentive spirometer" and "pursed-lip breathing" are deployed in helping to cure tuberculosis. Dr. Samuel Sheldon Fitch (Fitch, Samuel Sheldon, AM, MD, Six Lectures on the Uses of the Lungs, H. Carlisle, New York, 1846, p. 93) writes:

One inhaling tube is about 4 and 1/2 feet long, with an opening through its whole length, provided with a mouth piece to go between the lips. The patient sucks in, or inhales the air as long as he can (early pulmonary function maneuver) then blows it out again. By this process the chest will enlarge. These tubes are made of wood, ivory, India rubber, silver, or gold.

(Continues...)



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Table of Contents

Contents

Preface....................ix
Acknowledgments....................xi
Introduction....................xiii
1. Discovery: 6000 BC....................1
2. Evolution: First through Sixteenth Centuries....................5
3. Seventeenth and Eighteenth Centuries....................6
4. Nineteenth Century....................17
5. Twentieth Century....................28
6. Twenty-first Century....................89
Appendix A A Tribute to My Patients....................101
Appendix B General Chronological Events....................109
Appendix C Medical Definitions from the Year 1904....................119
Appendix D Patient Support Organizations....................123
Appendix E References....................127
Appendix F Internet Resources....................133
Appendix G Respiratory Therapy Manufacturers and Providers....................135

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