The Treatment of Asthma
Authors: J. B. Berkart
Journal: BMJ (1880)

9so TI.A TDZ5rYSZW WALA -7.0VAL.ishi siniuttahieotssly coomplete d6Ing dfXhe plistir ' ahs&neiyn-6b!e waft ytung -childiren in khese ai i; that they-either Not ng1 ¶g6tson, or not tirftequeritly fMl asleep.When thb 1InddMse ly set (itnd -not'b&f*e,;frthe.pdtiehtt-h ~ria* oy4easrnable space of time),ithe wlidle 'hahimci&k and phtient ?re ~&eSi di4vn; the superflitous end §-te rtetlycutoff With'gcissois, Ai0x the *iFf ig isshOW in-the sketcht-akeniform myl;st pttknt(F9g.3Y; so R4n teSe instances-it may be l-teral* taid, and "Vihbut irreverence, k te ttp their bed and walk ; the canvas remnant aeting as an ot~1tSs0r~vest to the patient's'frme.-n i ' ; 3 .-+ ã t i e n t i n t h e -e r -e o t p o s t u r e ; t h e u p p e r a n d l o w e r è n d s o f t e c i v -having been neatly trirmed off.I am ready to endorse much that has been written by Dr. Walker, Surgeon to the Peterborough Infirmary, on the utility of the recum- bent posture (BRITISH MNEDICAL, JOURNAL, March ist, 1879); but think that my mnethod negatives NO. 4 conclusion in his summary: "The only way in which such a jacket can be applied with the patient recumbent is by the method which I have demonstrated."Mr. Cocking, the well-known felt manufacturer for spinal jackets, attended one of roy demonstrations in the theatre of Westminster Hos-- pital on May 18th, i88o; he consiclers that this bhammick-s4peus4c.i__~~~f may prove very convenient for the application of, hisft.pa; yet, he has only tried it in one instance.This harmm6_4c then, in my own Ipractice obviates all the inconveniences andrikt patients ; secures the advantages of Sayre's method ; facilitates the mainual procedures of the surgeon ; permits of quick and equable drying; and necessitates no change of posture between the application of -t~iL ¶2uq3orting bandage and its finalIe;itting.fflhashird poinit is-the weight of the plaster-6f-Paris.I axrs:ekperi- *mone now -on felt,bandages saturated with ,a qzickly, drying solgition, Perspiration increased, bathing the whore body.The patient was told to lie down and to rest' until-the effects of the ,drug had passed off; but he felt so.much better, that. he did' not think it necessary to wait.However,'on proceeding to dress, he became giddy.He was irnmediately placed upon, the couch, but had soon to get up to pass urine, which was done without.pain.On regaining the couch, giddiness continued.fe.'then complained of' nausea, and in a short time vomited, without effort, a great quantity of undigested food.Vomiting was repeated,,and nausea'adgidd'inss persisted.The patient moaned a great deal, and thought.he was dying.He had severe pain the left hypochondrium.The'body, previously in a glow,, was then with cold clammy perspiration.There was no pulse at the wrists, and the' cardiac action.was feebl; respiration Was superfici4l slow, and some tracheal rattling was .heard,There were, in fact, all the alarming symptoa,s of collapse, However, the injection of one drop of liquor atropiae (P.B.) changed' the scene almost instantaneously.The pulse at the wrists returned, the cardiac action became perceptible, the brea;thing deeper, and the patient declared himself free from 'giddiness nausea.Perspiration ceased, and he felt cold and' shivering, The breathin.g was easy; there was no cough-nor expectoration.At 4. 30 P.M., subjective and 'objective symptoms were greatly improved, and patient left the hospital.lie was ozdered to take an ounce of aqua menthae piperitie three.times a-day, ut aliquidfiat.February 27th, he reported.himnself greatly improved in health.lie hadfelt nothing but a.little'cold when he had returned home last week.The cough and expectoration-were gone.His breathing was quite easy.He had a good appetite-almost too g,od, he-added, for his He was cheerful, dressed in his Sunday.clothes, and thought of returning, to work.. There.was.still deficient resonanceand cooing at the left upper lobe; but the access of air to the rest of the lungs was unimpeded.He presented -himself, as I wished him, the same evening, before Mr. Reilly, who was thus able to observe the remarkable improvement.May. I879,. the patient returned to the hospital.He had resumed his work, but also hisdissolute habits.He had again some cough; but, in order to get rid of it as soon as.possible, he requested a certificate for admission into a seaside.convalescenthome.CASE IV.-J.B, tailor's.cutter,aged 27, with no hereditary disposi- tion to disease of the chest, enjoyed good.healthuntil he was.'seized at Glasgoow, in September i878, with nocturnal dyspncea, wheezing, and -Cough.These symptoms persisted in spite of treatment when I saw hUm on December 9th, 1S78.The patient was under-szed, very mus- cular, but pale, and his eyelids were baggy.HIe complained chiefly of the dyspnceal seizures, recurring almost every night, and accompanied by wheezing so loud as to be audible at a distance.His thorax was roomy,.and his vertebral,colaml straight and somewh.ttwisted to the left.there was deficient resonapce in the'left infraclavicular region.In suprascapular fossee, there was harsh respiration with dry rhonchus which, however, was copducted to them from the larynx, this being state of chronic inflammation.There were sonorous rhonchi bases.The rest of, the lungs, the-heart, all the abdominal organs, including.the kidneys, sseemed healthy.The treatment wag