Asthma may be defined to be great difficulty of drawing in the breath, coming on suddenly, sometimes gradually, accompanied with a sense of extreme suffocation, and a desire for fresh air; continuing for a longer or shorter period, and then passing away, and leaving the patient a period of comparatively easy respiration.
Symptoms. There are sometimes no premonitory, symptoms, f ,he attack coming on suddenly, and without warnings but more frequently there are, for some days before the onset , loss of appetite, flatulence, belching of wind, irritability, languor, chilliness, oppression, and drowsiness. The hard breathing generally makes its appearance in the night, quite often at three or four o'clock in the morning, when the nervous system is at its lowest ebb. There is first a sense of tightness, or stricture, across the chest, which seems to expand with difficulty. The patient can no longer remain lying down; he rises up, draws up his knees, and, leaning forward, puts his elbows upon them, and his head upon his hands, and then struggles hard to draw in his breath; which, passing in slowly and laboriously, produces a loud wheezing sound. Sometimes he feels that he must have fresh air, and, rushing to a window, puts his head far out, to catch a stirring breeze. The bands an 1 feet are cold, the face haggard and distressed, sometimes a little red and swollen, but more generally pale and shrunk, the body wet with perspiration, the pulse irregular, feeble, and small, though sometimes not disturbed. These symptoms continue for some hours, more or less, when the breathing becomes more easy, and there is a little phlegm raised, sometimes considerable. This cessation of difficult breathing may be complete, or only partial; and lasts for a longer or shorter period, when the attack again recurs.
Causes. It is well known that Asthma has its cause mainly in the nervous system. The air tubes are encircled with a series of little bundles of fibers, which are, in fact, muscles, and like all other muscles have the power of contracting or shortening themselves. These muscles, too, like all others, have nerves distributed to them; and when these nerves becom3 diseased or irritable, they will become disturbed on certain occasion.~, and cause these small, circular puckering strings to contract and close up the air tubes near their terminations, very much as the puckering string closes the mouth of the work bag, so that very little air can pass into the air cells, and that little with great difficulty and slowness. When these contractions take place, and the air is thus shut off, the result is a fit of asthma. This disease may be brought on by any of those states of the atmosphere which disturb or irritate the bronchial surfaces, or by any of the numerous causes which mysteriously unbalance the nervous system. A fit may be brought on by whatever disturbs the mind.
In addition to this cause which is known as the bronchial type of asthma there are the cardiac and nephritic types. The so called cardiac asthma, in the early stages is perhaps more amenable to treatment than the bronchial type but its course would not be effected by the drugs given for the latter type and appropriate remedies for the heart must be given. In the nephritic type the asthma is due to the retention in the system of the poison which is prevented from passing out of the body in the urine because of disease of the kidneys.
Treatment. The disease has been regarded as extremely difficult of cure. There are certain remedies, however, which have a remarkable control over it, and, if skillfully used, will frequently bring it to a complete termination, and, even in the worst cases, to a state of very great mitigation and improvement.
Inhalation. The most important and certain remedy is the use of the Alterative Inhalant, described on page 273. 1 have with this article alone effected some surprising cures; yet it is well to combine other treatment with it. I have had several cases of a most distressing character, the attacks continuing night and day, in which the inhalation, judiciously administered, has caused the disappearance of the complaint within twenty~. four hours, and in which no return of suffering has occurred for several weeks, and then only in a modified form. This remedy should be used four or five times a day.
Iodide of potassium is a most valuable internal remedy in this complaint; indeed, in a certain sense, it is almost a specific. It should be used (prescriptions 101, 138, 140, 151) at the same time with the inhalation. The following preparation is a very good remedy for this disease: Ethereal tincture of lobelia, two ounces; tincture of asafcetida, one ounce; grindelia, one ounce; iodide of potassium, two ounces; simple syrup, four ounces. Mix. Dose, from a teaspoonful to a tablespoonful, every hour or two.
Several other remedies are used for asthma, with more or less success, such as electro magnetism, smoking stramonium leaves, burning paper dipped in a strong solution of nitrate of potash, and inhaling the smoke, etc., but none of these have as much value as the two remedies first named.
For the cardiac type strychnia, digitalis, spartine, strophanthus and cocaine in appropriate dosage must be given to effect an improvement. For the kidney type relief of the system by other channels than the kidneys, until they are in better working order will be necessary. This can be accomplished by the use of saline cathartics such as one or two teaspoonfuls of Epsom salts diluted with water, given often enough to cause two or three watery discharges during twenty four hours. In addition to this sweating of the skin by means of hot lemonade or small doses of Dover's powders in hot drinks may be given.
In as grave a complaint as a severe case of asthma, it is always well to seek the aid of a physician.
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