When I teach about a topic to medical students or other doctors, I always like to start at the beginning. That means learning something about medical history.
A real scene from the late 1980s that happened to me many times over:
Me: “It would be good to quit smoking.”
My patient: “I gotta keep smoking. The smoke kills the PCP.”
For those who are too young to remember, PCP was the feared pneumonia that was the most common serious infection in people with AIDS in the bad, old days.
In truth, cigarette smoking massively increases the risk of almost every kind of pneumonia.
So where did this belief that smoke kills the PCP come from?
I’d like to spend the next couple of posts talking about the fascinating history of tobacco use that will bring us up to 2016.
The idea that smoke and other fumes can stop a plague is old—at least as old as the Bible itself:
Moses said to Aaron, “Take the fire-pan and put on it fire from the altar and place incense—and take it quickly to the assembly and provide atonement for them…the plague has begun.”… He placed the incense and provided atonement for the people. He stood between the dead and the living, and the plague was checked. [Numbers 17:11–13]
Also Homer, in ancient Greece:
As for Melanthius, they took him through the cloister into the inner court. There they cut off his nose and his ears; they drew out his vitals and gave them to the dogs raw, and then in their fury they cut off his hands and his feet.
When they had done this they washed their hands and feet and went back into the house, for all was now over; and Ulysses said to the dear old nurse Euryclea, “Bring me sulphur, which cleanses all pollution, and fetch fire also that I may burn it, and purify the cloisters.” [The Odyssey 22:493]
Are any of you out there scared to see your doctors? Look at what doctors wore during the Black Death in medieval Europe. They placed aromatics in bird beaks, which they wore on their faces to try to cleanse the air they were breathing and to protect themselves from bubonic plague. In the words of a medieval poem about plague doctors, “Their bills with antidotes all lined / That foulsome air may do no harm.”
THE TRUTH: Our lungs are built to breathe in clean, fresh air. Many fumes and smokes, especially cigarette smoke, are harmful. They do not protect against infection or anything else.
In the next post, I’ll continue this history and bring us up to the present day. In Part III, we’ll learn something about how the history of tobacco use intersects with modern medical practice, especially with HIV.
IF YOU SMOKE AND WANT TO QUIT, VISIT www.positivelysmokefree.com. IT IS FREE, IT IS HELPFUL, AND IT WILL ALLOW YOU TO CONNECT WITH OTHERS WHO ARE TRYING TO QUIT. ALSO, SPEAK TO YOUR PROVIDER ABOUT QUITTING AND CONSIDER CALLING THE NATIONAL FREE QUITLINE AT 1-800-QUITNOW (1-800-784-8669).
The information in this blog is for educational purposes only and is not provided as a professional service or medical advice, diagnosis or treatment for specific patients. It is not a substitute for professional medical care, and if you have, or you suspect you may have, a health problem you should consult your health care provider.
This blog represents the opinions of the writer and does not represent the views or opinions of Montefiore Medical Center, the Albert Einstein College of Medicine, the National Institutes of Health, or any other organization.