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Encyclopedia Britannica - Main :: ARN-AUD |
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ASTHMA (Gr. avBa, gasping, whence lio-Ogaivw, I gasp for breath) , a disorder of respiration characterized by severe paroxysms of difficult breathing (dyspnoea) usually followed by a period of complete relief, with recurrence of the attacks at more or less frequent intervals. The" term is often loosely employed in reference to states of embarrassed respiration, which are plainly due to permanent organic disease of the respiratory organs (see RESPIRATORY SYSTEM: Pathology
The attacks occur quite suddenly, and in some patients at regular, in others at irregular intervals. They are characterized by extreme difficulty both in inspiration and expiration, but especially in the latter, the chest becoming distended and the diaphragm immobile. In the case of " pure " idiopathic or " nervous " asthma, there is no fever or other sign of inflammation. But where the asthma is secondary to disease of some organ of the body
The mode of onset differs very markedly in different cases. In some the attack begins quite suddenly and without warning, but in others various sensations well known to the patient announce that an attack is imminent. According to the late
auxiliary
pale , anxious, and it may be livid. The veins of the forehead stand out, the eyes bulge, and perspiration bedews the face. The head is fixed in position, and likewise the powerful muscles of the back to aid the attempt at respiration. The breath is whistling and wheezing, and if it becomes necessary for the patient to speak, the words are uttered with great difficulty. If the chest be watched it is seen to be almost motionless, and the respirations may become extraordinarily slowed. Inspiration is difficult as the chest is already over-distended, but expiration is an - even far greater struggle. The attack may last any time from an hour to several days, and between the attacks the patient is usually quite at ease. But notwithstanding the intensely distressing character of the attacks, asthma is not one of the diseases that shorten life.In the child, asthma is usually periodic in its recurrence, but as he ages it tends to become more erratic in both its manifestations and time ofappearance. Also, though at first it may be strictly " 'Sure " asthma, later in life it becomes attended by chronic bronchitis, which in its turn gives rise to emphysema, As to the underlying cause of the disease, one has only to read the many utterly different theories put forward to account for it, to see how little is really known. But it has now been clearly shown that in the asthmatic state the respiratory centre is in an unstable and excitable condition, and that there is a morbid connexion between this and some part of the nasal apparatus. Dr Alexander Francis has shown, however, that the disease is not directly due to any mechanical obstruction of the nasal passages, and that the nose comparatively rarely supplies the immediate exciting cause of the asthmatic attack. Paroxysmal sneezing is another form in which asthma may show itself, and, curiously enough, this fo m-occurs more frequently in women, asthma of the more recognized type in men. In infants and young
young
In the general treatment of asthma there are two methods of dealing with the patient, either that of hardening the individual, widening his range of accommodation, and thus making him less susceptible, or that df modifying and adapting the environment to the patient. These two methods correspond to the two methods of drug treatment, tonic or sedative. During the last few years the method of treatment first used by Dr Alexander Francis has come into prominence. His plan is to restore the stability of the respiratory centre, by cauterizing the septal mucous membrane, and combining with this general hygienic measures
painless and insignificant, is performed as follows:" After painting one side of the septum nasi with a few drops of cocaine and resorcin, I draw a line with a galvano-cautery point from a spot opposite the middle turbinated body
week 's time I repeat the operation on the other side." In his monograph on the subject, he classifies a large number of cases treated in this manner, most of which resulted in complete relief, some in very great improvement, and a very few in slight or no relief.End of Article: ASTHMA (Gr. avBa, gasping, whence lio-Ogaivw, I gasp for breath) If you wish, you can link directly to this article.
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