Clinical lecture on dysnoea, especially on the dyspnoea of asthma and bronchitis, and the effects of nitrites upon it / by Thos. R. Fraser.

  • Fraser Thomas R. (Thomas Richard), Sir, 1841-1920.
Date:
[1887?]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lecture on dysnoea, especially on the dyspnoea of asthma and bronchitis, and the effects of nitrites upon it / by Thos. R. Fraser. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    While the dyspnoea in each of these conditions would supply abundant material for full and elaborate discussion, my intention to-day is to consider with you in further detail some of the phenomena presented by it in bronchitis and asthma only. I make this selection because our atten- tion has been given in a more special .manner during the last few weeks to a consideration of the breathlessness of these two diseases. I group them together because the dyspncea frequently presents in them many points of simi- larity, and when it does so I believe that a large element in its production is an element operating in both diseases. It is in pure (or nervous) asthma that dyspncea assumes the most intense degree possible in disease of the respira- tory apparatus. When the paroxysm occurs at night, the patient may go to bed feeling quite well, but is awakened from sleep by a feeling of suffocation. He sits up in bed in various constrained positions, or he is impelled to leave his bed altogether and walk about, resting now and again to recover strength. He struggles violently for breath; inspiration and expiration succeed each other rapidly for a short time; then expiration becomes brief, the chest seems to become rigid in full expiration, violent respira- tory efforts are made, with but little change in the volume of the thorax, and the extraordinary muscles of respiration are brought into play with very inadequate results. After this state of distress has lasted for some time, it may be for hours, relief is obtained, and the patient returns to bed and usually soon falls asleep; but on many occasions this sleep may in a short time be again interrupted by a recur- rence of the paroxysm. The great difficulty in asthma seems to be to expel air from the chest, and the expiiatory muscles are strained to the utmost in the effort to accom- plish this. If the condition of the patient during the peiiod of dyspncea be further examined, several other phenomena