THE HISTORY OF THE CONCEPT OF BRONCHIAL ASTHMA

At all times diseases of the respiratory system remained an actual problem. The first ideas of lung diseases including bronchial asthma (BA) appeared as early as in ancient times. The beginning of study of this problem is associated with Hippocrates who first described clinical manifestations of BA. A Belgian scientist van Helmont first described asthma attacks provoked by inhalation of home dust. Later on, in microscopic examination of sputum, CharcotLeyden crystals and Curschmann spirals were described. At different times different theories of BA were proposed (neurogenic, endocrine, viral, anaphylactic, bacterial, allergic and occupational theories). With study of the etiology and pathogenesis, attempts were made to treat this disease. The most radical measures were considered to be chloral hydrate and morphine. Besides, asthma attacks were managed by inhalation of saltpeter or smoking special cigarettes. Starting from 1940 adrenaline began to be used for relieving asthma attacks. Later on glucocorticoids of systemic effect came into practice. In the mid-70s inhaled glucocorticoid was first applied. By 1983 Russian scientists developed the baseline methods of treatment of asthma attacks. In 1993 a working group was created for study of bronchial asthma who elaborated the program «Global Strategy of Treatment and Prevention of Bronchial Asthma» (Global Initiative for Asthma, GINA). Starting from 2002 the report of GINA working group has been annually revised. GINA principles are up to the present moment used in many national recommendations including recommendations of the Russian Respiratory Society.