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March 7, 1959


Author Affiliations


Clinical Professor of Medicine and Director, Lung Station (Tufts) and Department of Inhalation Therapy, Boston City Hospital.

JAMA. 1959;169(10):1063-1071. doi:10.1001/jama.1959.73000270005011

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Bronchial asthma is a distressing and common form of acute, recurrent, or chronic bronchial inflammation and obstructive emphysema, usually of allergic origin. The acute paroxysm of bronchial asthma may last for hours or recur in varying degrees of severity for days. Finally, a state of intractable asthma, during which the episode is continuous and refractory to treatment, may result. In this state the patient presents a picture of marked physiological imbalance. Evidence of hypoxia, cyanosis, dehydration, disturbed psyche, peripheral vascular collapse, and further disturbances may be noted because of changes induced by the widespread use of drug therapy. Death is more commonly due to asphyxia resulting from the plugged and obliterated bronchi and bronchioles and from oversedation; it is also due to the failure of endogenous discharge of adrenal hormones necessary in the defense mechanism against stress, and, in more recent years, particularly to steroid sequelae.

Medical Management  The successful

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