Asthma by Jackson Mark;

Author:Jackson, Mark;
Language: eng
Format: epub
Publisher: Oxford University Press USA - OSO
Published: 2009-11-19T16:00:00+00:00

11. An American magazine advertisement for stramonium cigarettes, c.1959. (Courtesy of the Advertising Archives, London)

New treatments for asthma were also derived either from plants or from human hormones during the late nineteenth and early twentieth centuries. Since antiquity, Chinese physicians and their patients had used ma huang, derived from a shrub commonly found in northern China, to relieve asthmatic paroxysms. In 1885, the Japanese chemist and pharmacologist Nagai Nagayoshi (1844–1929) successfully isolated an alkaloid from the plant and named it ephedrine, from which he also later synthesized methamphetamine. Evidence of ephedrine’s physiological actions was provided by studies into the Chinese pharmacopoeia carried out at the Peking Union Medical College in the 1920s by Carl F. Schmidt (1893–1988) and K. K. Chen (1898–1988), who demonstrated the ability of ephedrine to stimulate the heart, promote vasoconstriction, and relax bronchial smooth muscle.

First marketed by Eli Lilly in 1926 and endorsed by clinical trials coordinated by the Medical Research Council during the 1930s, oral and inhaled ephedrine constituted a popular prescribed treatment for respiratory conditions for many years. In his autobiography, published in 2008, the novelist and journalist Ferdinand Mount (b. 1939) recalled his own reliance on ephedrine to relieve acute episodes of asthma during his childhood:

When I have a bad asthma attack, about once a week at this period, he comes over from Warminster without a murmur. Together we go through the motions, I hitch up my pyjama jacket, he listens to my chest, depresses my tongue with the little wooden spatula before peering down my throat and then into my ears. All this I regard as merely the formal preliminaries before the real business of handing over the box of little yellow ephedrine pills—half a pill under the tongue magically soothes the tubes, nothing else works, certainly not the breathing exercises the nurses are always teaching me.45

In addition, ephedrine was often incorporated into remedies sold over the counter for asthma, hay fever, colds, and bronchitis, such as Franol or Franol Plus, which combined ephedrine with theophylline, an antihistamine, and a barbiturate and which was distributed by the Bayer Products Company well into the 1960s. As the radio commentator Tim Brookes recounts in a detailed exploration of his own asthma, although such cocktails of anti-asthma remedies could mitigate the severity of an asthma attack, they often caused intolerable side effects:

At first, my body started to feel heavy as the phenobarbital kicked in: my limbs felt abandoned, like stuffed bolsters of flesh lying here and there around me—but at the same time my pulse began to pick up and my mind started to race … I would lie there for four or five hours, waiting for the drug to be filtered out of my bloodstream, dragging myself out of bed every couple of hours to take a leak, as Franol also acted as a diuretic. The following morning I was a wreck.46

Prior to the marketing of ephedrine, growing pharmaceutical interest in synthesizing active compounds from hormones had already generated drugs capable of directly stimulating

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