Asthma: History and Discovery
Asthma was not invented or discovered by any single person, and it has no founder. It is an ancient affliction, and the word for it is older than our modern medical idea of the disease. “Asthma” began as a plain Greek word for hard, gasping breath — a symptom, not a diagnosis — and only across more than two thousand years did physicians slowly sharpen that loose symptom-word into the specific, chronic inflammatory airway disease we recognize today. This page traces those real milestones honestly: who described what, and when — while being clear that the modern disease concept emerged gradually, by accumulation, and not from one founding moment.
Table of Contents
- An Ancient Word, Not an Invention
- Greek Origins: Homer and Hippocrates
- Aretaeus and Galen
- Maimonides’ Treatise on Asthma (1190)
- Floyer, the Asthmatic Physician (1698)
- Salter and the Nineteenth Century (1860)
- From Bronchospasm to Inflammation: the Modern Shift
- Treatment Through History
- Modern Understanding
- Research Papers and References
- Connections
An Ancient Word, Not an Invention
It is tempting to ask “who discovered asthma?” — but the honest answer is that no one did. Asthma is an ancient disease with no single discoverer, inventor, or founder. People have gasped, wheezed, and fought for breath for as long as there have been people, and the experience was named long before anyone understood what caused it. What changed over the centuries was not the affliction but the understanding of it, built up slowly by many physicians across many cultures.
A crucial distinction runs through this entire history: the difference between the word and the disease concept. The word “asthma” is far older than our modern clinical entity. For most of its history the term simply meant labored, panting breathing — a symptom that could arise from many causes, including heart failure, infection, or exertion. It was not until comparatively recently that “asthma” came to name one specific disease of the airways. Reading the ancient sources, scholars often cannot tell whether a given author meant a distinct illness or merely the act of breathlessness; the boundary was genuinely blurry, and any honest history must say so.
So this is not the story of a discovery with a date and a name attached. It is the story of a slow sharpening — from a poetic word for gasping, to a symptom physicians grouped with others, to an early clinical picture, to a recognized spasmodic disorder, and finally, in the late twentieth century, to a chronic inflammatory disease. The milestones below are real and verifiable, but the reader should hold them as steps in a long, collective refinement, not as the work of one founding figure.
Greek Origins: Homer and Hippocrates
The word “asthma” is Greek — ἄσθμα (asthma), meaning “panting,” “gasping,” or “short-drawn breath” — and it is usually connected to the verb aazein, to breathe out hard with the mouth open. Its earliest known appearance is not in a medical text at all but in Homer’s Iliad, where it describes warriors left utterly breathless in battle. In Homer the term carries no idea of disease whatsoever: it is the gasping of an exhausted, gasping body. This poetic, purely descriptive origin is the bedrock fact about the word, and it explains why the term was so loose for so long.
The earliest text in which “asthma” appears as a medical term is the Hippocratic Corpus — the body of writings associated with Hippocrates and his school, conventionally dated to roughly the fifth and fourth centuries BCE (the texts are commonly placed in the range of about 420–370 BCE and were later assembled in Alexandria). Here “asthma” is used by physicians, but again chiefly as a symptom — difficult, gasping breathing — rather than as the name of one autonomous disease. Scholars studying these texts caution that it is genuinely difficult to know whether the Hippocratic writers meant a distinct clinical entity or simply the sign of breathlessness common to many illnesses.
What the Hippocratic writers did contribute was the beginning of observation: they noted breathlessness, linked it to other findings, and folded it into their humoral framework, in which disease arose from imbalances of the bodily humors. Asthma, in their hands, was sometimes associated with phlegm descending from the head onto the lungs. This was not the modern mechanism, but it was an early attempt to explain the gasping rather than merely to name it — the first small step from a poet’s word toward a physician’s concept.
Aretaeus and Galen
A sharper clinical picture arrives with Aretaeus of Cappadocia, a Greek physician usually placed in roughly the first to second century CE, who studied in Alexandria and practiced in the Roman world. Aretaeus is widely credited with one of the earliest detailed clinical descriptions of asthma — an account vivid enough that many historians call it the first description recognizable as the disease we know. He set down the cardinal features: tightness of the chest, cough, difficulty breathing, and the distress of the sufferer struggling for air, worse on exertion and at night. He located the trouble in the lungs and observed shrewdly that a patient with both asthma and heart disease fared badly.
Aretaeus deserves emphasis because his description marks a real advance: it moves “asthma” from a loose symptom-word toward a portrait of a recognizable illness with a characteristic course. It is worth noting a historical irony — Aretaeus was one of the least-known physicians of antiquity for centuries, and his writings only gained wide influence after a manuscript was rediscovered and published in Latin in the sixteenth century. His insight was excellent, but its impact on later medicine was delayed.
The towering medical authority of the era, Galen of Pergamon (c. 129–c. 216 CE), also wrote about asthma. Galen discussed it within his own elaboration of humoral theory, generally treating it — like the Hippocratics — in terms of thick humors or phlegm obstructing the airways and descending from the head. His numerous mentions of asthma broadly agree with the Hippocratic texts and, in part, with Aretaeus. Because Galen’s teachings dominated Western and Islamic medicine for well over a thousand years, his humoral framing of asthma became the default understanding inherited by medieval physicians — an inheritance that would shape, and in some ways constrain, the next millennium of thought about the disease.
Maimonides’ Treatise on Asthma (1190)
In the medieval Islamic world, the physician-philosopher Moses Maimonides (1135–1204) — rabbi, philosopher, and court physician to the family of the sultan Saladin — composed a dedicated Treatise on Asthma around 1190. Written in Arabic for a high-ranking patient who suffered from the condition, it is one of the earliest works centered specifically on asthma, and it is remarkably practical and patient-focused rather than purely theoretical.
Maimonides made an observation that still sounds strikingly modern: he advised that asthma should be treated according to the various causes that bring it about, recognizing that the condition was not one uniform thing with one fix. He pointed to factors we would now group under heredity, environment, climate, and what we would call comorbidities, and he stressed prevention through a healthy regimen — diet, sleep, moderate living, clean air, and the avoidance of known triggers. The treatise reads as much as a complete regimen of health as a narrow disease monograph.
His treatise was translated from Arabic into Hebrew within his lifetime and into Latin not long after his death, helping carry his counsel into European medicine. Maimonides did not “discover” asthma either — he inherited the Greek and Galenic tradition — but his insistence on individualized, cause-directed, preventive care was a genuine and humane contribution, and a notable waypoint between the ancient descriptions and the early-modern monographs that followed.
Floyer, the Asthmatic Physician (1698)
A landmark of a new kind came in 1698, when the English physician Sir John Floyer (1649–1734) published A Treatise of the Asthma — widely regarded as the first book in English devoted to the symptoms, causes, and treatment of asthma. What gives the work its enduring power is that Floyer wrote it as a lifelong sufferer. He opened by stating that he had endured “the Tyranny of the Asthma” for at least thirty years and therefore considered himself fully acquainted with the disease — one of medicine’s great early examples of a physician studying his own illness from the inside.
Floyer pushed the concept forward in concrete ways. He worked to separate asthma from other disorders of the lungs, rather than lumping all breathlessness together, and he attributed the difficulty of breathing to constriction of the bronchi — a contraction or spasm of the airways. This emphasis on bronchial narrowing as the immediate trouble was an important step toward the later “spasmodic” understanding of asthma. He also noted the influence of heredity and observed how the attacks could be provoked by weather, environment, and circumstances of daily life, recording how his own fits behaved.
It is fair, in keeping with honest history, to add that Floyer’s book was a product of its time: alongside his careful observation it retained older humoral notions and some beliefs we would now reject, and his proposed remedies were a mixture of the sensible and the obsolete. None of that diminishes its significance. As the first English-language monograph on the disease, written from hard personal experience, A Treatise of the Asthma is a genuine milestone in turning asthma into an object of focused study.
Salter and the Nineteenth Century (1860)
The nineteenth century’s defining contribution is Henry Hyde Salter’s On Asthma: Its Pathology and Treatment, published in London in 1860. Like Floyer, Salter (1823–1871) was himself an asthmatic, and he was a lecturer in physiology and medicine at Charing Cross Hospital. His book is generally recognized as the preeminent work on asthma of its era; it ran through multiple editions in Britain and America and was cited in essentially every subsequent treatment of the subject — even William Osler drew on Salter in his famous textbook.
Salter sharpened the definition. He characterized asthma as “paroxysmal dyspnoea of a peculiar character, with intervals of healthy respiration between the attacks” — capturing the episodic, come-and-go nature of the disease and distinguishing it from the steady breathlessness of chronic bronchitis. He understood asthma as a spasmodic narrowing of the airways and insisted, pointedly, that conjecture must give way to careful observation. Though the concept of allergy did not yet exist, Salter clearly recognized the hereditary tendency and the role of triggers — among them cold air, exercise, laughing, irritants, and the “emanations” of animals such as horses, cats, and dogs. In effect he documented allergic and exercise-induced asthma decades before the science of allergy could explain them.
Salter was also a careful observer of treatment. He catalogued what helped his patients and famously praised strong black coffee as one of the best-reputed remedies of the day — an observation that looks shrewd in hindsight, since caffeine is chemically related to theophylline, a bronchodilator used in twentieth-century asthma care. Worth noting, too, is the earlier work of Bernardino Ramazzini (1633–1714), the Italian father of occupational medicine, whose De Morbis Artificum Diatriba (“Diseases of Workers,” 1700) catalogued illnesses tied to specific trades and is credited with early recognition of occupational and exertional forms of asthmatic breathing — an insight that anticipated modern occupational asthma. Together, Ramazzini and Salter mark the point at which asthma’s triggers — work, environment, exertion, and animal exposures — came into clear view.
From Bronchospasm to Inflammation: the Modern Shift
For most of the nineteenth and twentieth centuries, asthma was understood essentially as a disease of bronchospasm — the airways’ muscular walls clenching shut. This view followed naturally from Floyer and Salter, and it shaped treatment: if the problem is muscle contraction, the answer is to relax the muscle and open the airway. Through the mid-twentieth century, therapy therefore centered on bronchodilators — drugs that widened the constricted airways and relieved the acute attack.
The decisive change came in the late twentieth century. Through the 1970s and 1980s, and crystallizing in the 1990s, researchers using bronchoscopy and airway biopsies found that even between attacks — even when a person felt well — the airways of people with asthma showed persistent inflammation. The wheeze was not the whole disease; it was the visible surface of an ongoing inflammatory process in the airway lining. This reframed asthma from a problem of intermittent muscle spasm into a chronic inflammatory airway disease, with bronchoconstriction as a consequence of the underlying inflammation rather than the root cause.
That shift — arguably the single most important conceptual change in the modern history of asthma — transformed treatment. The logic flipped: relieving spasm with bronchodilators eased symptoms but left the inflammation unchecked, so the new priority became controlling the inflammation itself, primarily with inhaled corticosteroids taken regularly to prevent attacks, rather than relying only on rescue bronchodilators to abort them. It is fair to call this a true paradigm shift — and, in keeping with this page’s theme, it happened by the accumulating weight of evidence across many laboratories, not by a single discovery on a single day.
Treatment Through History
The history of treating asthma is long and colorful, and much of it was empirical — people used what seemed to help, often centuries before anyone understood why it worked. A striking strand is the smoking of plants in the nightshade family, above all Datura stramonium (thornapple, or jimsonweed). Inhaling the smoke of stramonium for asthma is an old practice — with roots in traditional Indian medicine and popularized in the West in the early nineteenth century — and “asthma cigarettes” and powders remained in use into the twentieth century. We now understand the mechanism: these plants contain anticholinergic alkaloids (such as atropine) that relax the airways, making them genuine, if crude and hazardous, forerunners of modern anticholinergic bronchodilators.
The early twentieth century brought the first identifiable modern drugs. Ephedrine — the active principle of the herb Ma Huang (Ephedra), long used in Chinese medicine for breathing complaints — and adrenaline (epinephrine) were used to open the airways, the latter available as an aerosol by around 1930. By the mid-twentieth century, pressurized metered-dose inhalers delivered adrenergic bronchodilators directly to the lungs, and increasingly selective beta-agonists followed, culminating in widely used rescue inhalers such as salbutamol (albuterol). These drugs were excellent at relieving the acute wheeze — which, given the prevailing bronchospasm model, was exactly what they were designed to do.
The pivotal therapeutic development, in light of the inflammation story above, was the arrival of the inhaled corticosteroid. Beclomethasone dipropionate was introduced in 1972 as a steroid that could be inhaled directly into the airways, letting patients who had depended on oral steroids — with their heavy whole-body side effects — switch to a far safer inhaled controller. As medicine came to see asthma as fundamentally inflammatory, inhaled corticosteroids moved from a useful option to the cornerstone of long-term control. The modern division of asthma drugs into “relievers” (bronchodilators for the attack) and “controllers” (inhaled steroids and related agents for the underlying disease) is the direct, logical fruit of that change in understanding.
Modern Understanding
Today asthma is defined as a chronic inflammatory disorder of the airways, characterized by variable and recurring symptoms — wheeze, cough, chest tightness, and shortness of breath — together with airflow obstruction that is at least partly reversible and with bronchial hyperresponsiveness (airways that overreact to triggers). This definition unites every thread of the long history above: the ancient gasping breath, Aretaeus’s clinical picture, Floyer’s and Salter’s spasmodic, episodic disease with its hereditary tendency and environmental triggers, and the late-twentieth-century recognition of underlying inflammation.
Modern science has also dissolved the old idea of asthma as one uniform illness — vindicating, in a sense, Maimonides’ eight-hundred-year-old insistence that it must be treated according to its various causes. Researchers now speak of asthma phenotypes and endotypes: allergic and non-allergic asthma, exercise-induced and occupational asthma, eosinophilic and other inflammatory patterns, childhood-onset and adult-onset forms. This finer understanding has driven the newest treatments — biologic therapies (monoclonal antibodies) that target specific molecules in the inflammatory cascade for people with severe, hard-to-control disease — tailoring care to the individual mechanism rather than treating all asthma alike.
The honest summary, then, is the one this page began with. Asthma is ancient; it was named by poets and physicians millennia ago; and it has no single discoverer or founder. What we possess instead is the cumulative work of many people across many centuries — Homer’s gasping word, the Hippocratic symptom, Aretaeus’s and Galen’s descriptions, Maimonides’ regimen, Floyer’s and Salter’s monographs, and the modern recognition of inflammation — each adding to a slowly sharpening picture. That long, collaborative refinement, and not a single moment of discovery, is the true history of asthma.
Research Papers and References
The references below combine peer-reviewed historical reviews with curated PubMed topic-search links into the history and pathophysiology of asthma. Ancient and early-modern primary texts — the Homeric poems, the Hippocratic Corpus, the writings of Aretaeus and Galen, Maimonides’ Treatise on Asthma, Ramazzini’s De Morbis Artificum Diatriba (1700), Floyer’s A Treatise of the Asthma (1698), and Salter’s On Asthma (1860) — are named in the article as historical sources rather than as modern citations. Each link opens in a new tab.
- Marketos SG, Ballas CN. Bronchial asthma in the medical literature of Greek antiquity. Journal of Asthma. 1982;19(4):263-269. — PubMed: 6757243
- Marketos SG, Eftychiadis AG, Koutras DA. Aretaeus of Cappadocia and the first clinical description of asthma. American Journal of Respiratory and Critical Care Medicine. 2011;184(12):1420-1421. — doi:10.1164/ajrccm.184.12.1420b
- Sakula A. Sir John Floyer’s A Treatise of the Asthma (1698). Thorax. 1984;39(4):248-254. — doi:10.1136/thx.39.4.248
- Rosner F. Moses Maimonides’ treatise on asthma. Thorax. 1981;36(4):245-251. — doi:10.1136/thx.36.4.245
- Diamant Z, Diamant B. A century of asthma: from Salter to the present. American Journal of Respiratory and Critical Care Medicine. — doi:10.1164/rccm.200402-185OE
- Saketkoo L, Januzzi JL, et al. Evolving concepts of asthma. American Journal of Respiratory and Critical Care Medicine. 2015. — PMC5447293
- Holgate ST. A brief history of asthma and its mechanisms to modern concepts of disease pathogenesis. Allergy, Asthma & Immunology Research. 2010;2(3):165-171. — PMC2892047
- Jackson M. “Divine Stramonium”: the rise and fall of smoking for asthma. Medical History. 2010;54(2):171-194. — PMC2844275
- Brown HM, Storey G, George WH. Beclomethasone dipropionate: a new steroid aerosol for the treatment of allergic asthma. British Medical Journal. 1972;1(5800):585-590. — PubMed: 4335298
- Asthma etymology and the history of the word (Greek origins; Homer; Hippocratic Corpus) — PubMed: asthma history and etymology
- Ramazzini and the origins of occupational asthma (De Morbis Artificum Diatriba, 1700) — PubMed: Ramazzini and occupational disease
- From bronchospasm to airway inflammation: the modern paradigm shift in asthma — PubMed: asthma airway inflammation paradigm
- History of asthma therapy: stramonium, ephedrine, beta-agonists, and inhaled steroids — PubMed: history of asthma treatment
- Asthma phenotypes, endotypes, and modern biologic therapy — PubMed: asthma phenotypes and biologics
External Authoritative Resources
- NHLBI (National Heart, Lung, and Blood Institute) — Asthma
- MedlinePlus — Asthma
- PubMed — All research on the history of asthma