Have you ever wondered how people managed chronic diseases before modern medicine? Before insulin shots, blood pressure pills, and specialized treatments? The story of Kevin Houdeshell might make you think about this more deeply.
Kevin was a 36-year-old American who suffered from Diabetic Ketoacidosis (DKA), a dangerous complication of diabetes. Like many with his condition, Kevin needed daily insulin to survive since his body couldn’t produce it naturally. One day, when he went to refill his insulin prescription, the pharmacist refused—his prescription had expired, and pharmacy regulations prevented dispensing the medication without a valid script.
Kevin desperately tried to contact his doctor, but it was New Year’s Day and the clinic was closed. He returned home without his insulin. A few days later, when colleagues noticed he hadn’t shown up for work, they went to check on him at home. They found him dead. The cause? Insulin deficiency.
Kevin’s tragic story created such an uproar across America that it prompted new legislation. “Kevin’s Law” went into effect in March 2016, allowing pharmacists in Ohio to provide emergency medication to patients with chronic diseases even if their prescription had expired more than 30 days prior. Similar versions of this law have since been adopted in over 20 states.
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What Exactly Are Chronic Diseases?
Chronic diseases are those that stay with a person for extended periods—sometimes their entire life. People with chronic conditions need specific medications regularly and continuously. Stopping these medications can lead to serious, sometimes life-threatening complications.
That’s why those with chronic diseases typically require ongoing medical supervision. When someone discovers they have a chronic condition—like diabetes, for instance—they often need to completely overhaul their diet and lifestyle to prevent deterioration and maintain a relatively normal life.
Some of the most common chronic diseases include:
- Diabetes
- Hypertension (high blood pressure)
- Respiratory diseases like asthma
- Kidney and liver diseases
- Many others
Importantly, chronic illnesses aren’t limited to physical conditions. Mental health disorders like schizophrenia or bipolar disorder also qualify as chronic conditions. What all these diverse diseases share is the need for consistent, regular medication that patients simply cannot stop taking.
Ancient Approaches to Chronic Disease
So here’s an interesting question: how did people manage these conditions before modern medicine and today’s medications?
Looking back through history, we discover that chronic diseases aren’t new at all. Humans have suffered from them for thousands of years. While simple ailments like stomach pain or toothaches could often be treated with locally available herbs and plants, chronic diseases with persistent symptoms remained a mysterious puzzle.
Because of this mystery, many ancient cultures viewed chronic diseases as supernatural phenomena—divine punishment or curses placed upon the afflicted. This perspective led to some fascinating (if misguided) approaches to treatment:
- In ancient Egypt and Mesopotamia, people commonly used amulets and incantations to protect themselves from these “supernatural” ailments.
- Romans had “healing temples” where sufferers would create clay miniatures of their ailing body parts as offerings, then wait for divine intervention or dream-delivered cures.
- Some European cultures believed chronic illness resulted from evil spirits inhabiting the body. Their solution? Drilling holes in the patient’s skull to let the spirits escape! Archaeologists have discovered skulls with deliberate holes dating back to ancient times across Britain, France, parts of Europe, and the Americas. Believe it or not, this practice is still used today for headache treatment among some indigenous tribes.
Unfortunately, these methods rarely solved the problem, resulting in high early mortality rates among those with chronic conditions. This failure drove people to seek better solutions.
Early Understanding of Specific Diseases
The first step toward effective treatment was simply understanding the diseases themselves. In the Ebers Papyrus, written around 1550 BCE, ancient Egyptians documented over 700 diseases, including one they called “honey urine”—what we now recognize as diabetes.
The Egyptians noticed that people suffering from excessive thirst, fatigue, weight loss, and frequent urination (classic diabetes symptoms) had sugar-rich urine. They discovered this by observing ants and insects gathering around the urine of these individuals more than others. Their prescribed treatment? Drinking plenty of water and consuming cucumber skins and balsam wood.
Greeks and Romans also documented diabetes. Their explanation was that the flesh and fat in a person’s body were dissolving into their urine, causing weight loss and frequent urination. This was the view of the Greek physician Aretaeus of Cappadocia, who lived in the second century CE.
In India, diabetes treatments involved eating bitter foods like bitter gourd to counterbalance the sweetness in the body. Chinese healers viewed diabetes as an imbalance in the body’s energy and prescribed meditation as treatment.
Moving to heart disease and hypertension, ancient people observed symptoms like breathing difficulties, chest pains, dizziness, and persistent headaches. The ancient Egyptians created detailed anatomical drawings of the heart as early as the First Dynasty. They treated heart problems with dates and castor oil, believing these had healing properties for the heart and blood vessels.
Greeks and Romans attributed chest pain, fatigue, and heart disorders to imbalances in bodily fluids. According to their “Four Humors” theory, the body contained four main fluids—blood, phlegm, yellow fluid, and black fluid. They believed that withdrawing blood could rebalance these fluids and treat heart problems.
Indians prescribed herbs like garlic and ashwagandha for circulation and heart issues, while Chinese treatments included meditation, acupuncture, and herbal remedies.
Tuberculosis, a bacterial infection affecting the respiratory system that once infected over 10 million people annually, was known long before its causes were identified in the late 19th century. Hippocrates described it around 400 BCE as an illness characterized by coughing, fever, and bloody phlegm. He believed the blood came from leakage in the lungs and recommended regular milk consumption and breathing clean air in mountainous or coastal regions—a treatment that remained standard until the 19th century.
The Rise of Modern Medicine
Medical practices remained fairly primitive through the early Middle Ages, especially during Europe’s “Dark Ages” beginning in the 5th century CE. However, after the fall of the Roman and Persian Empires in the 7th century, Muslim scholars inherited, corrected, and significantly advanced medical and pharmaceutical knowledge.
For instance, the Greek physician Galen (3rd century CE) incorrectly claimed that the liver produced blood and that the heart’s septum contained holes for blood passage. Ibn al-Nafis, a Muslim scholar, debunked these theories and correctly explained pulmonary circulation as we understand it today.
Abu Bakr al-Razi discovered allergic asthma and was the first to explain that fever is actually a defensive mechanism of the immune system against disease and infection—not an illness itself. Ibn Sina’s medical encyclopedia, “The Canon of Medicine,” remained the most important medical reference for centuries and was taught in Belgian and French universities until the mid-16th century. UCLA and Yale still teach it in medical history courses today.
Muslim and Arab scholars also made tremendous contributions to chemistry and drug preparation. They were the first to separate pharmacy from medicine as an independent science and introduced experimental, applied sciences in laboratories—an important foundation for developing appropriate medications for diseases, especially chronic ones.
With the European Renaissance, drug manufacturing evolved rapidly, culminating in a breakthrough during the 19th century with the development of modern vaccines and the discovery of aspirin, insulin, penicillin, and antibiotics in general. These advances brought chronic diseases largely under control after they had been essentially death sentences in ancient times.
Today, people with chronic diseases can live with their conditions, recover from them, and continue their lives normally. What was once mysterious and seemingly supernatural can now be managed with proper medication and care.
The story of chronic disease management is really the story of human ingenuity and persistence. From drilling holes in skulls to precisely engineered insulin, we’ve come a remarkably long way. And while modern medicine isn’t perfect—as Kevin Houdeshell’s tragic case reminds us—our understanding and treatment options continue to improve with each passing year.
Let’s hope that with continued medical advances and more sensible healthcare policies, stories like Kevin’s become increasingly rare, and those with chronic conditions can access the treatments they need when they need them.
What chronic conditions have touched your life or the lives of those you care about? Has modern medicine made a difference? These are questions worth reflecting on as we consider how fortunate we are to live in an era where chronic doesn’t have to mean terminal.
