Paroxysms of difficult breathing, sometimes associated with disease of the heart or chronic bronchitis, and sometimes purely spasmodic, without any affection of the lungs or bronchi. Asthma is often hereditary, and may attack persons of all ages, but is more commonly met with in age than in youth. The paroxysms come on suddenly, often in the night, with a feeling of suffocation and desire to take a long breath. All the muscles of breathing are brought into play, the patient sits up, the head is thrown back, the breathing is laboured, whistling and rattling sounds are heard all over the chest the patient asks for the doors and windows to be thrown open. The face is pale or livid; eyes anxious or protruding; forehead covered with profuse cold sweat. An attack may be brought on by several causes-odours, smoke, dust, irregularity of diet, over-exertion, mental emotions, suppression of accustomed discharges.
Diagnosis.-The diseases likely to be mistaken for asthma are bronchitis, croup, and spasm of the larynx. From bronchitis it is distinguished by the rapid disappearance of the rattling and wheezing on the chest after an attack; by the sudden appearance and disappearance of the attack; and by the fact that the breathing is slow, wheezy, and prolonged, whilst in bronchitis it is hurried. In croup and laryngeal spasm the age of the patient helps to distinguish, children being more liable to these than to asthma; also the character of the breathing; in croup and spasm of the larynx the difficulty is in drawing in a breath, in asthma it is in expelling it.
General Treatment. Relief may be obtained during an attack by plunging the hands into hot water; by bandaging the arms above the elbows, commencing with the left. If the attack is induced by the smell of ipecacuanha, camphor or sweet nitre should be given to smell of; if by inhaling fumes of sulphur, pulsatilla is better. When attacks come on immediately after a meal, chewing a little ginger will relieve. Patients subject to asthma should wear woollen clothing, rub the skin well with a coarse wet towel, and take warm drinks. Those who have dusty occupations should wear respirators.
Medicines.-(To be given in the attack every fifteen minutes until symptoms improve, and then less frequently. In the intervals two or three times a day.)
Ipecac. 3.-
Feeling of constriction about the chest; panting, rattling in the windpipe, as if full of mucus, which seems to be moving up and down. Patient gasps anxiously for breath; face pale, hands and feet cold.
Nux vomica 3.-
When the attack occurs early in the morning; when induced by disorders of the stomach or indiscretions in eating or drinking.
Lobelia 3.-
With nausea and great depression of the heart.
Arsenicum 3.-
Most violent attacks, especially those occurring in consequence of suppressed catarrh, moaning, groaning, uneasy tossing about; in old people who are attacked whilst walking, who can breathe but the distress continues.
Arnica 3.-
When the attack is induced by exertion, speaking, or even blowing the nose; respiration laboured or oppressed, with shooting pains in chest.
Sambucus 3.-
Especially in children, attacks beginning in the night, sweat on throat and neck.
Pulsatilla 3. In blondes, and persons of mild disposition; breath seems to be impeded in lower part of chest, drowsiness, free expectoration.
Sulphur 6.-
In chronic cases; after suppressed eruptions; patients who suffer from skin affections; who have flushes of heat and fainty spells; sinking feeling at the pit of the stomach, worse in the forenoon. The asthma may be dry or accompanied with profuse yellow expectoration.
