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July 7, 1956


JAMA. 1956;161(10):937-940. doi:10.1001/jama.1956.02970100003002

• Asthma is the result of inflammatory disease of bronchi characterized by cellular infiltration, thickened basement membranes, hypertrophied bronchial smooth muscle, narrowed air passages containing mucus, and a bronchial lining raised in folds. The objective of treatment is, of course, cure. Although cure cannot be predicted, it can frequently be obtained, and its attainment depends on finding the causes of asthma and removing them, correcting complications, and cooperating with nature in its efforts to bring about healing in each case. In general, the causative factors are allergic, intrinsic, or neurogenic, singly or in combination. The precipitating factors may be respiratory infections; inhalant, food, and drug allergens; and such nonspecific irritants as cold air, exertion, coughing, smoke, other fumes and dust.

Prophylaxis of asthma depends on avoiding anything that induces coughing, such as colds, smoke, fumes, dust, exertion, sudden changes of temperature, and various allergens. If prophylaxis fails, the attack must be treated. Many patients learn how to avoid respiratory irritants, and these are the patients who are "cured" of asthma. For example, the obvious treatment of asthmatic bronchitis due to smoking is to stop smoking. The patients who do are among the most grateful a physician has.