ALFRED B. OLSEN, M. D by Alfred B. Olsen

Review and Herald Publishing Association · Takoma Park Station, Washington, D. C. · May 2, 1912

ALFRED B. OLSEN, M. D

By Alfred B. Olsen

Asthma

ALFRED B. OLSEN, M. D

There are two varieties, bronchial or true asthma, and asthma that is secondary to some organic disease, such as that of the heart or kidneys. Asthma is characterized by a peculiar form of difficult breathing, which is believed to be due to spasm of the smaller bronchial tubes. It is not very well known just how this spasm takes place, nor what is the direct exciting cause; but we do know that persons of a neurotic, that is, nervous temperament, are most susceptible.

Symptoms

Little need be said of the symptoms, except that there is a characteristic gasping after breath, which is painful to witness at times, and which causes the patient a great deal of distress. The symptoms are aggravated by marked changes of temperature, and are often worse at night. An asthmatic attack may last only a few minutes, or may continue for several hours. It may return nightly for a few days or weeks, and then disappear altogether for months or even years. The onset is always sudden, but sometimes the patient has warning signs that an attack is approaching.

The Causes

We know almost as little of the actual causes of asthma as we do of the character of the spasm that takes place in the bronchial tubes. Climatic conditions sometimes seem to have a marked effect in bringing on an attack. A chill resulting from exposure to storm or wet will often precipitate an attack in one who is susceptible. Chronic bronchial catarrh is frequently associated with asthma, and probably is an exciting cause.

Some good authorities believe that diet has considerable to do with asthma. At any rate, a banquet or free feeding on any occasion is not unlikely to be followed by an attack of asthma. The use of alcoholic liquors and overeating, especially of rich, nitrogenous foods, can safely be regarded as predisposing causes. Those who are subject to asthmatic attacks would do well to avoid the use of flesh foods, and also to discard alcoholic beverages, tea, coffee, and cocoa. Constipation seems to be at least one of the minor causal factors, and overloading of the bowels, with the accompanying absorption of waste matter into the blood, will sometimes account for an attack.

It is worthy of note that gouty as well as neurotic persons seem to be peculiarly susceptible. Among other causes that are sometimes mentioned are worms and teething in the case of children, and certain disorders of the skin.

The Treatment

“There is probably no other condition in which so many drugs have been used; and it must be said at the outset, that a remedy which is immediately successful in one case may have no effect in another, and further, may prove quite useless in the same case at another time.” Such are the comments of one of the best authorities on the treatment of asthma, and the statement is true. In other words, there is no universal cure for asthma, and any one discovering a genuine cure for this common disorder would soon make a fortune. Pain-killers and paralyzing agents galore have been, and still are, administered as routine treatment, but always with uncertain success. It is marvelous what comparatively simple remedies have accomplished at times. Some of the drugs given, like morphia, are exceedingly dangerous, and it is seldom wise to take them; in any case, certainly not without a physician's prescription.

Various inhalants and fumigations are frequently employed, and not without considerable success, at least temporarily. Perhaps one of the simplest and at the same time most successful remedies for alleviating an asthmatic attack is the inhalation of plain or medicated hot, moist air. Every one subject to asthma should obtain a suitable inhaler, which is not an expensive affair, and have it ready for an emergency. Another simple remedy is the burning of niter paper, which is easily obtained. This can readily be prepared by soaking absorbent paper in saltpeter and then drying it. In the majority of cases the relief is both prompt and marked. If the stomach is overloaded, tickle the throat with a feather and relieve the stomach. It is a curious fact that the causing of nausea or vomiting often relieves an attack of asthma, even though the stomach is not particularly overloaded.

The diet is a matter of great importance. Food should be plain but nourishing, and all irritating articles, such as condiments, pickles, sweets, jams, marmalades, pastries, cakes, as well as those already mentioned, should be carefully avoided. A diet consisting largely of fruit, both fresh and stewed, can be highly recommended. Three meals a day are ample, and nothing should be taken between meals. All asthmatic patients should be very strict about guarding against overeating, which, of itself, is liable to bring on an attack, or at least aggravate the condition.

Fomentations to the chest or throat, sipping hot water, warm or hot baths, and similar hydriatic remedies are, as a rule, more effective in giving relief than are drugs. The moist abdominal girdle is particularly valuable when digestion is bad. To apply it, wring a linen towel of suitable size out of cold water, and fit it snugly around the trunk. Cover this moist towel with two or three layers of a woolen bandage, so that the air will be excluded from the wet compress, and fasten snugly with safety-pins. This compress is best worn at night. On removing it in the morning, bathe the parts with cold water, and dry well.

What to Avoid

In dealing with any case of asthma it is necessary to search for the cause, and if possible remove it. If this can be done, the cure is usually permanent; but it is often exceedingly difficult to find the direct cause of asthma. A sudden change of temperature is a matter of extreme importance in the case of all those who are liable to an attack. Simply going from a warm sitting-room or drawing-room to a cold bedroom undoubtedly accounts for many of the night attacks. The bedroom should be of the same temperature as the sitting-room, and it is well to moisten the air by having a small kettle of water on the register. While asthmatic patients require fresh air, all risk of a chill must be carefully avoided.

Noxious fumes, dust, and foul air must also be strictly avoided, for their irritating effect will quickly produce an attack in those who are susceptible. If the patient has adenoids or enlarged tonsils, these should receive prompt and efficient attention. Chronic nasal catarrh, as well as bronchial catarrh, is not unlikely to aggravate asthma.

As far as climate is concerned, a comparatively dry atmosphere, where changes are seldom marked or abrupt, is desirable. A moderate elevation above sea-level is considered advantageous.

Caterham, England.