Asthma

“The disease called orthopnoia,” wrote Aretaeus, “is also called asthma because those who have parox­ysms pant for breath (asthmainousi).” The Greek term asthma, used by Homer for a gasping, painful breathing, had acquired a distinct medical sense by the time OfHippocrates.

The two terms asthma and orthopnoia are not uncommon in ancient literature, but on the basis of the adjectival form, asthmatikos, a nonmedical us­age (e.g., the labored panting of an athlete) may be suspected.

Like many diseases, the etiology of asthma was explained in humoralistic terms. “The cause,” Aretaeus states, “is the coldness and moistness of the pneuma but the matter is moist, cold, and gluti­nous.” Airborne pollen and dust do not seem to have been implicated in the sometimes sudden onset of an allergic reaction, the latter a concept not explicitly associated with asthma in classical texts. It may be significant, however, that Hippocrates notes that asthmatic attacks are frequent in the autumn.

Aretaeus’s account of the symptoms, the best sin­gle description in classical antiquity, refers in unmis­takable terms to the overt characteristics of asthma and emphasizes the dry wheezing, often unproduc­tive cough, inability to sleep in a prone position, and labored efforts to breathe leading to gulping or gasp­ing. He seems not to have recognized, however, the constriction of the lumen of the bronchi or the possi­bility of neurological or hereditary factors.