The identification of asthma with the phenomena which supervene upon the introduction of a foreign protein into the blood (anaphylaxis) has led to the discovery that asthmatic attacks often follow the ingestion of egg albumin. This has been demonstrated by rubbing unhoiled white of egg into the sound or lightly scarified skin of the forearm, when a smart local reaction and sometimes an asthmatic seizure follows. In sensitive persons other proteins may be the cause, and by careful experiments conducted on the same lines the offending material may be discovered and eliminated from the If we assume that such proteids may exist in the nasal, throat or bronchial secretions the visionary hopes of Vaccine treatment may become realised through the use of an autogenous culture. The writer's experience is confined to one case where this was perseveringly carried out without marked or lasting improvement. The value of vaccine therapy as of other methods is most difficult of determination in a disease which has such long periods of total quiesence, hence the necessity of caution in accepting the reports which of late have been flooding current literature. The injection of Normal or Horse Serum has proved curative in the asthma attacking grooms and persons living in close relationship with this animal. Autogenous f)efihrinated Blood has been claimed as curative, and Auld immunises patients by 5-15 gr. doses of Armour Peptone in 5-so c.c. water.
Treatment of the zIsthmatie of Amyl and Ethyl Iodide inhalation often gives speedy relief to some patients, and if at hand they should always have a trial; Chloroform may be used in the same way. A moderate dose of Morphia hypodermically always affords relief, but obviously its frequent use is unjustifiable; and the same may be said of Cocaine. Atropine l o, gr. is equally beneficial and not open to the serious objections which maintain in the case of opiates; it should be given hypodermically. Adrenalin, recommended by Cohen, has often a surprisingly rapid effect upon the spasm when given hypodermically in a dose of 5-so mins. (s in s,000 solution); when used as a spray its effects are also sometimes surprising. Where the attack is the result of an over loading of the stomach A gr. Apomorphine may be given, and it some times cuts short the spasm without causing vomiting.
The basis of nearly all of the innumerable fumigating compounds in tended to be used after ignition is Nitrate of Potassium. The simplest method of carrying out this treatment consists in burning blotting or coarse brown paper which has been previously soaked in a saturated solution of the drug and dried. As soon as the air of the patient's room has become permeated by the smoke of this combustible, so that an on looker begins to feel great difficulty in breathing the fumes, the asthmatic will simultaneously commence to show amelioration of his spasm and dyspncea. The common mistake is made of not burning enough of the
paper, and of not using a strong solution for its preparation. Huggin's Ozone Paper contains Iodide of Potassium along with the nitre, and Thorogood recommended the addition of Chlorate of Potassium in order to make it burn more actively. Infusions of Belladonna, Digitalis, Sage, Green Tea, and Stramonium have been also used as the solvent for the nitre.
Stramonium Leaves with Nitre form the basis of the majority of the powders used as asthma cures, as those known as Himrod's, Bliss's, Ellis's, Girdwood's, &c.; Sawyer recommended r oz. Nitre, 2 oz. Stramonium, and r oz. Anise fruit in coarse powder; and another formula of his con sists of Stramonium 16, Sublimed Sulphur i, Anise 7, and Nitre 8. The B.P.C. Pulvis Stramonii Co. is also prepared from a Sawyer's formula and contains the following powders: Stramonium 5o, Lobelia 6, Anise 12, Tea 6, Oil of Eucalyptus r, and Potassium Nitrate 25, and is perhaps the best of these compounds. It is used by pressing about a teaspoonful of the powder into a cone with the finger-tips, and lighting the apex with a lucifer match. A very convenient fumigation which can be easily prepared by the patient is Stramonium Leaves soaked in a strong solution of Nitre and dried; these can be lighted when required and the smoke inhaled.
Martindale's Compound Asthma Fluid is intended to be used by means of an atomiser, and as it contains some Atropine it may be used with benefit in those cases which yield to this drug when administered hypo dermically. Tucker's cure contains cocaine and nitrites and some atropine.
Some patients prefer to use stramonium and lobelia mixed with tobacco in a pipe or a 3 a cigarette, and the addition of tobacco and a little nitre intensifies the action of these drugs. Datura Tatula (a solanaceous plant) chopped up and smoked in a pipe sometimes relieves when other inhalants fail. Arsensic has been added to stramonium, tobacco and lobelia in the cigarette form, but its continuous use is open to serious objection.
Pyridine is an ingredient of tobacco smoke, and the purified liquid obtained from bone oil has been used by See for the relief and pre vention of Asthmatic seizures; a teaspoonful being poured upon a plate in a small room, the air soon becomes impregnated with its disagreeable odour, and the patient often finds relief by this nauseating atmosphere.
Steam, Oxygen, Compressed or Rarefied Air, sprays of Eucalyptus, Creosote, Cajuput, Friar's Balsam, Conium, Cocaine, Phenol, and Ultra Violet Radiations, &c., have their advocates.