The dyspnoea of asthma & bronchitis : its causation, and the influence of nitrites upon it / by Thomas R. Fraser.

  • Fraser Thomas R. (Thomas Richard), Sir, 1841-1920.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The dyspnoea of asthma & bronchitis : its causation, and the influence of nitrites upon it / by Thomas 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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    sion of certain cutaneous eruptions is productive of asthma, revived in more modern times by Waldenburg,^ in his so-called herpetic asthma, and also by Sir Andrew Clark,^ in a paper published last year on the theory of bronchial asthma. The three explanations of the production of the asthmatic paroxysm, which seem at the present time to be maintained more than any others, are, therefore, embodied in the theory of bronchial spasm, in the theory of spasm of the diaphragm, associated, or not associated, with spasm of the other ordinary or extraordinary muscles of respiration, and in the theory of constriction of the bronchial tubes by swellings of a hyperaemic, herpetic, or urticaria-like character. The existence of these contending theories is a sufficient proof of the difficulties that are encountered in explaining the dyspnoea of asthma. The observation of symptoms, the assistance that has been derived from advancements in the physiology of the respira- tory and nervous systems, and the great increase in knowledge of the pharmacology of the substances that are used as remedies, do not appear to have entirely solved the difficulties. No doubt the second theory, that of Wintrich, has sustained from Biermer a more damaging criticism than either of the two others has yet met with; and it may be regarded as demonstrated that spasm of the diaphragm, combined or not combined with spasm of the muscles of respiration, is not the essential or primary cause of the symptoms of asthma, however such spasm, in some cases and in some degrees, may occur as a secondary condition during the paroxysm. That able and trained observers are divided in their belief as to the correctness of the other two theories, is shown by the statement of Dr Geddings,^ of America, that the retrocession of cutaneous eruptions as a cause of asthma, has of late years “ found but few advocates among intelligent physicians ; ” and of Biegel,^ that the several grades of asthma “ can be explained by the mere tumefaction of the mucous membrane, seems to me im- probable;” while, on the other liand. Sir Andrew Clark^ affirms “ that the bronchial spasm theory of asthma is either inadequate to explain the phenomena of the paroxysm, or is not in harmony witli the present state of physiological and pathological know- ledge.” It seems obvious that some additional facts are required before the truth can be arrived at. The obtaining of such facts is de- sirable, not merely because of the interest that is attached to the elucidation of the pathogenesis of this as of all diseases, but much ^ Berliner klinischc Wochevschri/t, 187.3. ^ 1 he International Journal of the Medical Sa‘e?iccs, Jainiary 1886, vol. xci. p. 104. > J > ^ Pepper’s Hystem of Medicine, 188.'}, vol. iii. ]>. 19,3. Ziein3.sen 3 Cyclopaidia of tJi,e I'ractice of Medicine, 1877, vol. iv. p. 554. Lo, ciL, p. 110. > > 1