Asthma

“ Symptomatic asthma is a difficulty of breathing, the result of some interference with the circulation, as by heart disease, or with the oxidizing power of the blood, as by kidney disease, or various blood conditions, or from direct interference with respiration from some pulmonary affection. Essential asthma is not dependent on any organic condition, but is an interference with breathing without any distinct pathological condition in the lungs themselves or in the general circulation. ”

“ In every species of asthma, setons and issues have a good effect; they may either be set in the back or side, and should never be allowed to dry up. We shall here, once for all, observe, that not only in the asthma, but in most chronic diseases, issues are extremely proper. They are both a safe and efficacious remedy; and though they do not always cure the disease, yet they will often prolong the patient’s life. ”

“ But I fully agree with your correspondent that asthma is the most capricious disorder of the human organism, and that its study can never be exhausted. Most of his observations can be readily reconciled with the doctrine of my treatise; but, even in as far as they may represent the record of an exceptional experience, I consider them, on the whole, a valuable contribution to the pathology of the disease. ”

“ Even short attacks often lead to malignant aftereffects—insomnia, indigestion, headache, and a peculiar affection of the lungs that closely simulates the premonitory symptoms of pneumonia; after the asthma proper has entirely subsided, a new difficulty of breathing supervenes in the form of twitching pains in the pleura and the upper lobes of the lungs. Before the end of the second day, rest, embrocations with hot mutton-tallow, and a spare diet, generally relieve these symptoms, which follow more frequently after a drug suppressed case of asthma than after the pedestrian-cure. ”

“ It would be incompatible with the design of this pamphlet, and perhaps superfluous to enter minutely into a description of what Asthma is—especially as no disease shows itself more distinctly. The individual, occasionally attacked by wheezing, difficulty of breathing, and tightness of the chest, need not be assured that he is asthmatical; but it will be a source of consolation to inform him, that his case is really curable, by this valuable medicine, as experience in the worst cases has amply confirmed. ”

“ One of the most distressing ailments with which the human family is afflicted is asthma. Its symptoms are not to be mistaken. Suddenly and without apparent provocation the patient experiences the greatest difficulty in breathing. When warning is given, there is usually a sense of fullness in the stomach, flatulence, languor, and general nervous irritability. The countenance is a picture of anxiety and horror. The difficulty of breathing increases and the struggle for air commences. ”

“ Some asthmatics, with air-tubes more capricious and difficult to please than ordinary, make it the business of their lives to travel about in search of the air best suited to them. Thus, in their wanderings, they experience every conceivable degree of exasperation of, or exemption from, their disease; possibly in some lovely spot where the patient would willingly abide as in an earthly Eden, the asthma suddenly and rudely grips him by the throat and bids him depart or die. ”

“ We have seen that a strenuous physical effort can under circumstances become the direct cause of an asthma-paroxysm, yet under proper precautions exercise is the best corrective of an asthmatic disposition; for all vital vigor is based upon muscular strength. It would be a mistake to suppose that the invigoration of the lungs alone could be a protection against asthma. An asthmatic diathesis may coexist with a perfect freedom from the usual symptoms of weak lungs; nay, chronic asthma seems to counteract the development of pulmonary phthisis. ”

“ ASCITES, ANASARCA, and HYDROTHORAX.
§ 8. Under this complication, though the symptoms admit of relief, the restoration of the constitution can hardly be hoped for.
ASTHMA.
§ 9. The true spasmodic asthma, a rare disease—is not relieved by Digitalis.
§ 10. In the greater part of what are called asthmatical cases, the real disease is anasarca of the lungs, and is generally to be cured by diuretics. (See § 1.) This is almost always combined with some swelling of the legs. [196]
§ 11. There is another kind of asthma, in which change of posture does not much affect the patient. ”

“ The most common sequel of asthma is emphysema. The bronchial tubes being more or less completely closed, either by contraction of their muscular fibres or by plugs of thick, viscid mucus, the air pent up in the parts beyond the obstruction is subjected to the negative pressure produced by the exaggerated inspiratory act, becomes rarefied, and, in obedience to the diminished resistance induced by the partial vacuum in the thorax, causes distension of the air-cells. ”

“ On the other hand, all cases may be regarded as unfavorable in which the patient has reached or passed the middle period of life, has inherited a tendency to asthma, if the attacks are severe with short intervals, or if he has some one or more of the secondary affections of the disease. ”

“ The direct treatment of the respiratory tract to secure ease of respiration often does away with the liability to asthma by direct prevention. If patients, especially young patients, are mouth-breathers the clearing out of the throat and nose so as to insure normal breathing can naturally be expected to lessen any tendency to asthma. In the same way treatment of irritative or degenerative conditions in the throat and larynx, as well as in the nose, may be considered directly curative. ”

“ Asthma, when purely nervous, is almost invariably relieved, and sometimes cured permanently, though more often it reappears with a return to the atmosphere in which it was generated, the rest from attacks and improvement in the general health caused by the climate will, however, even then often ward off a relapse for some time. The elevation at which the greatest relief is afforded varies with the case. When there is much bronchitis and emphysema, or heart trouble, the asthma is often worse at first, though it may afterwards be relieved ”

“ The diet should be governed by amount of exercise, temperature, etc.
ASTHMA THE CAUSE
The cause of asthma is congestion in, or constriction of, the bronchial tubes. This congestion is usually caused by overeating and the excessive use of narcotics and stimulants such as tobacco, liquors, and beer. The excessive use of sugar and starches, or what is generally known as carbohydrates, will set up a form of difficult breathing, or at least augment asthmatic tendencies. This condition is more likely to occur among those whose lungs are weakened and who have a tendency toward consumption. ”

“ By recourse to these means, the lengthened fits of Asthma will be prevented; and if the disease be established in the constitution, a due perseverance with the remedy will effectually eradicate every symptom.
With regard to the course of life of the asthmatic—great care should be observed to choose a proper air; experience will soon point out what air is best, and no certain rule can be definitely given. Where the patient breathes most easy he ought to reside. He should lie with his head high, and not be too much encumbered with bedclothes; must avoid a stooping or a leaning posture ”

“ That death never occurs during the severe paroxysms of asthma may be due to the action of the deficiently aërated blood upon the respiratory centres, and bronchial spasm, causing relaxation when the symptoms have become most threatening. The asthmatic, if his case be incurable, may live for a number of years, and even attain to extreme old age, but his life will be one of intense suffering, which becomes more intolerable as he advances in years. Sooner or later, bronchitis, emphysema, or heart disease is developed, which in its turn may lead to renal disease and dropsy. ”

“ The phenomena of Asthma arises from increased excitement of the branches of the eighth pair of nerves, distributed over the larynx, and the internal membrane of the wind-pipe, and bronchiæ, brought on by a certain condition of the atmosphere, probably with respect to electric matter: for, opposite states of the air, with regard to its temperature, density, or humidity, do not disorder asthmatic subjects, so much as easterly or north-easterly winds. ”

“ The voice is hoarse, articulation difficult, breathing limited, noisy and wheezy. The wheezing is pathognomonic of the disease. It can only be confounded with croup, and then only in the young. In croup there is pain and difficulty in swallowing, fever and cough, which are usually absent in asthma. A severe paroxysm of asthma is very distressing to witness, and one unused to it might well suppose the sufferer to be in his last agonies. No definite limit can be assigned to the duration of the attack or of the disease. ”

“ In symptomatic asthma the only assured treatment of the condition must come through amelioration of the organic condition causing the symptoms. Cardiac and renal asthma respond promptly to remedies which relieve critical conditions that may be present in the heart or kidneys. It must not be forgotten, however, that respiration is readily disturbed by mental influences. Where cardiac or renal disease causes interference with respiration this is much emphasized by the patient's unfavorable mental attitude toward it, or much relieved by keeping him from worrying over his condition. ”

“ Heath, of Newcastle, surgeon: 'More than usually liable to asthma; mostly between thirty and forty years of age. A person always working in the broken would be more liable to asthma. Asthma is of very slow growth, and it is difficult to say when it begins. Custom and habit will not diminish the evil effects, but will diminish the sensibility to these evils.'—Ibid. No. 497, p. 665, 1. 10-14.
"Matthew Blackburn, driver, fifteen years of age, Heaton Colliery: 'Has felt shortness of breath. Helps up sometimes, but is bound to drive. Cannot help up sometimes for shortness of breath. ”

“ Every day in the United States— (A) 30,000 people have an asthma attack; and (B) 11 people die from asthma. (4) Nearly 5,000,000 asthma sufferers are under 18 years of age, and 1 out of every 10 school-aged children has asthma. ”

“ Asthma is a chronic affection, in which there is difficulty in expiration of air in breathing. In severe cases a contraction of the abdominal muscles is evident in forcing the air from the lungs. Asthma is more in evidence at night, and often birds apparently free from it during the day will wheeze when at rest. ”

“ The many remedies for asthma which have been lauded highly even by physicians, and that have cured or relieved a great many patients and yet after a while have proved to be without much beneficial effect, make it very clear how much the affection depends on the will power to face it and throw it off. Nothing will be curative in asthma unless the patient has confidence in his power and uses his own will energy to help it. He must overcome the element of dread which occurs in connection with all asthmatic attacks, even those due to organic disease of heart or kidneys. ”

“ As a rule, the worse these cases seem in their intensity and the more the patient is anxious, the more surely are they merely of functional nervous origin; above all, the more complaints of lack of air and of fear of impending death that are made, the more likely is the patient to be all right within a few hours. Asthma looks as though it must be due to some serious organic condition. Of course, in many cases of difficult breathing, even with asthma-like attacks, there are underlying serious conditions of heart and kidneys that are extremely dangerous. ”

“ I have known people with the dread of the dark to get an attack of asthma if they were asked to sleep alone after having been accustomed for years to sleep with somebody in the room. I have known even a physician to have attacks of asthma of quite typical character as the result of a dread of being {212} out after dark which had gradually come over him. I have had a physician patient who was very uncomfortable if alone on the streets of New York, even during the day, and whose symptoms at their worst were distinctly dyspneic or asthmatic. ”

“ It sounds almost absurd to say that such things will bring on hours, and even days, of suffering, but, nevertheless, it is a fact, and though the old adage says "Asthma never kills," still it is a very unpleasant ailment to suffer from in any form. ”

“ Of two cases of neurotic asthma in which no diagnostic differences can be found, one will improve at the seashore or on a sea voyage, while the other will be made worse by such a change though probably the asthma will be improved in the mountains or in some dry climate. Even moving from one part of a city to another has brought great improvement in asthma. ”

“ Spasmodic asthma may be relieved by the same treatment. It often comes on when lying down, and cold towels applied as above directed will generally relieve. Fomentations must be given to the feet and legs, if any feeling of chill is felt.
Where there is difficulty in breathing on lying down, usually the heart is at fault. Sometimes the heart is all right, and this hard breathing is nervous, caused by too sudden lying down. To lie down, propped up with pillows, which may be removed one by one, is often sufficient to cure it. ”