ASTHMA

New Zealand Listener, Volume 7, Issue 172, 9 October 1942, Page 10

ASTHMA

(Written for "The Listener’ by DR.

H.

B.

TURBOTT

Director of the Division

of School Hygiene, Health Department)

STHMA is a widely known and A tightly feared disease. Attacks often begin in the early morning, 2 am. or later, and sometimes in the daytime, too. The sufferer. wakes from sleep, has difficulty in breathing. He struggles with a sense of suffocation, makes loud wheezing sounds with his breathing, and is bluish round the lips. After a while, coughing develops and phlegm is brought up, the attack eases off, and disappears in anything from a few minutes to several hours. Often the attacks come back at the same time each night or day for some weeks. The disease is feared because experience in most families is that chronicity develops, and cures are few and far between. Most cases begin before the age of 25, and it certainly runs in families, All is not hopeless, however. There are several distinct types of asthma, some of the kind responding well to treatment. There is one big class of asthmatics in which factors outside the body bring on attacks-pollens, dusts, moulds, animal emanations (feathers, hair, dander, etc.), kapok, foodstuffs (egg, tomato, etc.). The other big type of asthmatics seem to have their attacks brought on by apparent or hidden causes within the body itself, such as any chronic infection, nasal sinus upsets, nasal polyps, and more obscure conditions. In the attacks with outside causes seasqgnal changes and environment play a direct part. For example, one district has a certain pollen or dust for one period of the year; a temporary change of district avoids this. Skin tests show reactions to pollens, dusts, etc., and the

outlook as regards cure is much better for asthma with external causes. Asthma with internal causes is unaffected by climate or season, skin tests are negative, and diseases of nose and chest are commonly present. All asthmatics are sensitive to stimuli -chemical, nervous and so on-that do not upset normal people. In a large proportion of cases, the stimulus is a supersensitiveness to some particular cause outside the body. If the cause is present, an attack is precipitated; should it be absent, there is complete freedom, This explains why sea trips, mountain holidays and changes of district or climate help asthmatics. It is very easy to test for the things outside the body that precipitate asthma; this state of hypersensitiveness is known~ medically as "allergy." Liquid extracts are made of the suspected causes, e.g., feathers, kapok, house dust, grass, pollens, etc., a scratch made on the cleansed forearm and a drop of the extract applied to the scratch, Thorough testing might involve the use of over 60 reagents, but, in most cases, as few as 20 tests suffice. Having discovered the precipitating cause of attacks, the next step is to de-sensitise the sufferer. Graduated doses of the offending substance or substances are given, the process requiring from three to six months usually. At the same time attention to diet, exercise, environment and general health routine is needed, plus the patient’s mental helpthe will to get better. Sometimes when no actual cause can be discovered, treatment is tried with non-specific "allergens" -- peptone, milk, tuberculin, vaccines. They often succeed, but are by no means so reliable as the "proven by testing" causes or specific "allergens," In asthmatic attacks, the doctor’s help will be needed. Most patients respond to adrenalin, by inhalation or injection. Ephedrine helps others, while medicines containing iodides bring improvement to some. But-if you have not yet been tested for causative factors outside the body, why not do so?