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June 3, 1950


JAMA. 1950;143(5):490. doi:10.1001/jama.1950.02910400082022

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To the Editor:—  Dr. Piness's discussion of Dr. Rackemann's paper, "Other Factors Besides Allergy in Asthma" (J. A. M. A. 142:534 [Feb. 25] 1950), deserves further emphasis in view of the fact that the latter's concept of intrinsic asthma is widely shared by leading allergists and has resulted in confusion. How vaguely this syndrome is defined is indicated by the fact that the term was first adopted to indicate asthma with negative skin reactivity, which is observed in about 50 per cent of all asthmatic patients (Rackemann, F. M.: J. Lab. & Clin. Med.12:1185, 1927). Cohen (Ann. Int. Med. 20:590 [April] 1944) considered intrinsic asthma a disease with such a serious prognosis that treating it would be a waste of the physician's time and the patient's money. Rackemann on the other hand, notes in his present publication, that his patients recover. His basis of distinguishing intrinsic

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