Asthma Through the Ages

June 7, 2012 7:31 AM

A Patient with Asthma Seeks Medical Advice in 1828, 1928, and 2012. As part of the New England Journal of Medicine's 200th Anniversary Articles, it has provided three snapshots of diagnosis and treatments of asthma throughout relatively recent history.

Find yourself sucking on an inhaler these days? Well, the Inhalatorium has a collection of the treatments used for asthma in the past. The carbolic smoke ball was good for humans and dogs, inhalers were a touch more decorative than they are these days, and one could always pay a visit to the actual, physicalInhalatorium. Why, even elephants could use some treatments!

Of course, when the asthma cigarettes fail you, there is always the good, old-fashioned whiskey cure.

posted by whitneyarner (48 comments total)

I thought that inhalers were illegal now, because of the fluorocarbon ban? Did they find an ecologically-acceptable propellant to replace the fluorocarbon propellant?
posted by Chocolate Pickle at 7:34 AM on June 7, 2012

They did! They aren't as effective and kind of suck, but yeah, you can still get them.
posted by whitneyarner at 7:37 AM on June 7, 2012 [2 favorites]

They did! They aren't as effective and kind of suck, but yeah, you can still get them.

And they taste bad, too.
posted by Pogo_Fuzzybutt at 7:38 AM on June 7, 2012 [4 favorites]

I've been prescribed inhalers with the new propellant, but I just can't use inhalers at all (some kind of mental block). I generally use a neublizer and a daily asthma pill.

But I've always had mild asthma, so I've been lucky, too, in that I've been able to be independent of an inhaler. Fascinated by the changes that have taken place just in my short lifetime.
posted by tilde at 7:39 AM on June 7, 2012

I saw this article a while ago and passed it around my fellow student friends...as someone who used to work in historical fields I loved it.
posted by cobaltnine at 7:40 AM on June 7, 2012

Ah, actually, I believe over-the-counter inhalers, like Primatene Mist, have been banned, but you can still get prescription stuff, like Albuterol, which have been changed to not use CFCs. This is not so great, because while Primatene was not so great for treatment of asthma, it was very useful for people unable to get a prescription/in that desperate emergency where you're out of your regular inhaler and are at a Walgreens somewhere in rural Pennsylvania. Naturally, this gets a big THANKS, OBAMA from your usual sources.
posted by whitneyarner at 7:41 AM on June 7, 2012 [2 favorites]

There isn't all that much fluorocarbon propellent inside inhalers, vastly more environmentally conscious nations still use them, like all of Europe

Inhalers were outlawed inside in America only because the drug company who patented using another propellent wanted the competition by generics outlawed.

You could buy the traditional fluorocarbon propelled inhaler from any pharmacy in France for maybe 5 euros.
posted by jeffburdges at 7:41 AM on June 7, 2012 [8 favorites]

We've had that discussion on the Blue before.
posted by Pogo_Fuzzybutt at 7:57 AM on June 7, 2012

Pogo_Fuzzybutt: "They did! They aren't as effective and kind of suck, but yeah, you can still get them.

And they taste bad, too."

That's the medicine, so there's not much to be done about that.
posted by IAmBroom at 8:00 AM on June 7, 2012

whitneyarner: "Naturally, this gets a big THANKS, OBAMA from your usual sources."

Obama does not control the decisions of the EPA.
posted by IAmBroom at 8:01 AM on June 7, 2012 [1 favorite]

Obama does not control the decisions of the EPA.

Oh, I know that! But, you know, the usual sources of folks who blame Obama for everything. It's a bit of a meme.
posted by whitneyarner at 8:10 AM on June 7, 2012

Ugh, yeah, the new inhalers are fucking pants. I'm lucky if I get 1 successful spray out of 5.
posted by elizardbits at 8:21 AM on June 7, 2012 [1 favorite]

That's the medicine, so there's not much to be done about that.

No, there is a different taste to the new ones and it is worse than the old ones.

On the plus side, all of the inhalers come with a counter on them now, so I know which one is the new one and which is the old one without having to pull out the canister and try to find the date.
posted by Pogo_Fuzzybutt at 8:33 AM on June 7, 2012

On the plus side, all of the inhalers come with a counter on them now, so I know which one is the new one and which is the old one without having to pull out the canister and try to find the date.

They do?! I haven't gotten a new inhaler in at least six months, so I haven't seen this, but that is a magical breakthrough if available everywhere. God, how I hate the 'shake shake shake oh please tell me you have enough juice left in you' game.
posted by whitneyarner at 8:40 AM on June 7, 2012

I got an inhaler from one of the nations largest hmo's, 2 months ago, and it didnt have a counter on it.
posted by couchdive at 8:43 AM on June 7, 2012

Fantastic NEJM article.

I said it on the previous thread and I'll say it here again: non-CFC inhalers are not the problem. We've had them here (UK) for nearly fifteen years now. The fact that pharmaceutical companies in the US redid them to be able to charge vastly more for them is the problem (and could this be why they don't work as well?).
posted by Coobeastie at 8:48 AM on June 7, 2012 [1 favorite]

Yeah, I'm looking at my inhaler right now and there's no counter on it that I can see, unless the little "200 metered inhalations" thing is what we're talking about. (I hope not; it would be pretty ridiculous to expect users to keep track of the number of inhalations.)
posted by elizardbits at 9:00 AM on June 7, 2012 [1 favorite]

They do?! I haven't gotten a new inhaler in at least six months, so I haven't seen this, but that is a magical breakthrough if available everywhere. God, how I hate the 'shake shake shake oh please tell me you have enough juice left in you' game.

Well, I guess I shouldn't say all - I haven't conducted any formal surveys.

But, I have albuterol and ventolin inhalers and my son has a (I forget offhand) one and they all have the counters on them.

So, all of the ones I am familiar with and use do.
posted by Pogo_Fuzzybutt at 9:01 AM on June 7, 2012

I have albuterol and it doesn't have a counter. I wish!
posted by brundlefly at 9:13 AM on June 7, 2012

My asthma treatment has ranged from having to sit over a basin of vinegar and boiling water with a towel over my head, to taking useless homeopathic powders (that tasted, oddly enough, of icing sugar) from some quack in our English village, to little Ventolin pills, to finally accepting the stigma of carrying around an inhaler, to these days being very well served by a combination of a steroid inhaler that I use just whenever I remember to use it along with, occasionally, a Ventolin generic that actually has a very nice fruit flavour.
It's been at least 12 years since I last had an attack that required a trip to the hospital (this occured during a thunderstorm in Calgary that delivered lots of ozone to ground level and sent scores of asthmatics to the city's emergency rooms). While the condition is still there for me, lurking in the background, I'm rather pleased with how things have come along.
posted by Flashman at 9:18 AM on June 7, 2012

Commenters on this post: least likely to get picked for kickball, ever.
posted by whitneyarner at 9:22 AM on June 7, 2012 [9 favorites]

My father has asthma, as do I. He's friends with a pharmacist who suggested that my father might actually be allergic to his asthma medication.

I don't know about the experiences of others in this thread, but in Canada the treatment is generally regular "puffs" from a turbohaler that dispenses powdered medication, rather than using an actual "puffer", which is reserved as a rescuer, never to be used to manage day-to-day symptoms.

Anyway, my Dad was taking daily does of Symbicort or whatever, but still suffered from asthma. Based on the suggestion of the friendly pharmacist, he stopped, and he's been fine ever since.

Except in grass season in late spring and early summer, and mold season in October.
posted by KokuRyu at 9:24 AM on June 7, 2012

I don't know if I have asthma or not. I did the blow test, and apparently I have above-average lung capacity. But then I never heard back from the doctors?

I have a sneaking suspicion that my real problem is that I'm terribly out of shape, and if I just did more cardio, I wouldn't have such a problem doing things, and that asthma is just a red herring for me. Not saying that's true for other people, just for myself.
posted by rebent at 9:37 AM on June 7, 2012

A Patient with Asthma Seeks Medical Advice in 1828, 1928, and 2012.

Huh. If that's the case, I want to seek medical advice from him.
posted by Jestocost at 9:41 AM on June 7, 2012 [9 favorites]

Is this not a double? Because I have totally seen this piece of awesomeness before and I uh only read MeFi...
posted by DarlingBri at 9:42 AM on June 7, 2012

I searched and didn't see anything! It's a three-month-old article, though...
posted by whitneyarner at 9:46 AM on June 7, 2012

I got a hfa inhaler that is not bad through a certain website that represents a party located in port Vila Vanuatu. If I buy the max amount of inhalers, it cheaper then my copay. hint=4corners

Many healthcare providers us proair-HFA inhalers and they suck bad, but are the cheapest, and don't have a counter on them.

Glaxo makes an albuteral inhaler that is pretty good in HFA form and that one does have a counter in the US.
posted by couchdive at 10:09 AM on June 7, 2012

Commenters on this post: least likely to get picked for kickball, ever.

I'm not sure what kickball is and given my aptitude for football I probably wouldn't be very good at it, but I was on the rowing team in high school (I stroked the men's heavy 8, har har) and rowed on the varsity team in University. Despite, or perhaps because of, my lung condition I've turned out to be very good at things requiring endurance and suffering.
posted by Flashman at 10:21 AM on June 7, 2012 [1 favorite]

I had a hunch the 1828 doctor would recommend smoking, but tobacco not thorn-apple. That it actually worked sometimes is rather surprising, too.
posted by tommasz at 10:26 AM on June 7, 2012

IANAD but unless your asthma is extremely severe, there's almost no reason to use a traditional rescue inhaler any longer--for me and many others, Advair has been a total game-changer. As a lifelong asthmatic, I love not having to carry the damned albuterol around anymore.

If you haven't tried Advair you're truly selling yourself short!! I can now enjoy (and own) dogs, which as a kid would have been unthinkable . . . God Bless modern medicine!
posted by eggman at 10:37 AM on June 7, 2012

Feh, I can kick the ball. I have to kick homers, though, or I get tagged out before first base.

Asthma didn't kick in severely (for all that it is still mild) until I was in high school, and even then it might have just been seen (well was) as a byproduct of living in an extremely smoggy-polluted environment. Now I'm just allergic to everything, which can trigger it.
posted by tilde at 10:42 AM on June 7, 2012

Those asthma cigarettes are a hoot. Active ingredients: Stramonium and belladonna. That's jimson weed and deadly nightshade to you and me. Presumably the main action, if any, was due to atropine.
posted by Sys Rq at 10:42 AM on June 7, 2012 [2 favorites]

I dunno, eggman. My doctor tried to tell me the same thing (along with saying I should cut down on my steroid inhaler to one puff a day)...boy, that emergency room visit a month later during allergy season sure showed her (and cost me $500 in copays, fees and meds).

Sucks to my ass-mar!

I just finished grad school and need to go health insurance shopping. I am so dreading finding out what ridiculuous monthly fee and deductibles they're going to charge me. Meantime, I'm rationing my inhalers, not being quite as physically active as I'd like, and am missing the crappy-but-better-than-nothing Primatene Mist back-up option.
posted by smirkette at 10:47 AM on June 7, 2012 [1 favorite]

Not sure if it's been mentioned....but you know you can (at least in the US) still get the old-style inhalers?

I tried the fancy new ones, discovered that not only were they ridiculously expensive, but they also completely sucked...and I went back.
posted by kaseijin at 10:56 AM on June 7, 2012

Also... Advair did pretty much nothing for my asthma, even when I was ratcheted up to the highest dose. Singulair and Zyflo were the same story.

Dulera, however, has been a godsend.
posted by kaseijin at 10:59 AM on June 7, 2012

Aside at Smirkette: When I was looking into buying my own insurance, my monthly fee was $850, IIRC. That or it was $550. I honestly can't remember, but I want to say it was the former. And asthma-related expenses would not be covered for the first 12 months. That was a while back, however.

It was dispiriting enough that I simply didn't bother. =/
posted by kaseijin at 11:01 AM on June 7, 2012

I have *rummages through pockets* a ProAir HFA inhaler as my rescue inhaler. I like it, overall. I find it just as effective as my old inhaler, despite the less strong aerosol, and when I can taste the asstastic medicine, I know that I got some. It's also shorter than my old inhalers, so it fits in my front pocket better.

However, it's lacking that all important counter.
posted by spinifex23 at 11:18 AM on June 7, 2012

(I'm also on Advair and Singulair, and both have been absolute godsends. But I still carry around the rescue inhaler and an Epi-Pen in case I run into random mold or a peanut.)
posted by spinifex23 at 11:29 AM on June 7, 2012 [1 favorite]

"Wow, that's the worst asthma I've ever heard in my whole career... it's a pity you don't live near a teaching hospital so they can the students listen to you!" ...is probably not the thing you wan't to he
posted by fearfulsymmetry at 11:52 AM on June 7, 2012

Still... yah, number one! (And to be honest it's pretty much seasonal and only gets super bad for a few weeks a year)
posted by fearfulsymmetry at 11:56 AM on June 7, 2012

Spinifex -

Wait till you feel the forceful puff, solid weight, and excellent body curves on the glaxosmithklen ventolin hfa inhalor.

Sure it's bigger and weighs more, but so does a Cadillac!
posted by couchdive at 11:59 AM on June 7, 2012 [3 favorites]

And they're big and solid and long! Just what a woman looks for in...an asthma inhaler.

I loved Ventolin when it was available before; I may have to try it again, if my insurance will pay for it.
posted by spinifex23 at 1:16 PM on June 7, 2012 [1 favorite]

Advair is the bomb. It makes it possible for me to live with two cats and pretty much forget that I have asthma at all-- and this after being asthmatic was one of the shaping forces of my childhood.
posted by jokeefe at 1:28 PM on June 7, 2012

grammar fail, ugh.
posted by jokeefe at 1:30 PM on June 7, 2012

I don't know about the experiences of others in this thread, but in Canada the treatment is generally regular "puffs" from a turbohaler that dispenses powdered medication, rather than using an actual "puffer", which is reserved as a rescuer, never to be used to manage day-to-day symptoms.

Man, I got my hands on one of those a while back. I agree: the burst of dust at the back of the throat was absolutely terrible.
posted by gjc at 4:47 PM on June 7, 2012

I agree: the brand name albuterol inhalers work better.

I also agree: fluticasone is da bomb.

Also. If you really need an inhaler to WORK, get your hands on a Combivent. The atropine might not be the best thing in the world for someone to be using unless they have to, but it works.
posted by gjc at 4:52 PM on June 7, 2012

I had nightly asthma and was using albuterol more than I should have been. Then I went on a high-protein, low carb diet. I haven't had any asthma since. Wheat? I dunno, but it's been a relief.
posted by Mei's lost sandal at 5:39 PM on June 7, 2012

Wait a second.

I think that she may benefit from smoking the leaf of Datura stramonium

Do they mean this Datura stramonium?

Datura intoxication typically produces a complete inability to differentiate reality from fantasy (delirium, as contrasted to hallucination); hyperthermia; tachycardia; bizarre, and possibly violent behavior; and severe mydriasis with resultant painful photophobia that can last several days.
posted by Philby at 6:51 PM on June 7, 2012