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To the Editor:—
The editorial "Status of Surgery for Asthma," which appeared in The Journal, Oct. 15, 1955, page 682, was, I am sure, of widespread interest; however, I find two points of disagreement. First, complete epinephrine resistance should not, as is stated, bring up serious consideration of sympathectomy, even though this important drug is considered by most allergists as the premier one for the relief of bronchial asthma. Epinephrine resistance and fastness require the use of other drugs and measures, such as aminophyllin or the steroids orally or parenterally, to relieve the asthma without surgery. The group for which surgery (such as dorsal sympathectomy, vagotomy, or total pneumonectomy) is to be carefully studied embraces a type of asthma I classify as "chronic perennial asthmaticus persistans." As its name indicates, the sufferers have persistent, year-round cases, with hardly a week of respite, and have had every variety of therapy, such
Engelsher DL. SURGERY FOR ASTHMA. JAMA. 1956;160(1):76. doi:10.1001/jama.1956.02960360078021
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