Samuel West, in his most excellent work "Diseases of the Respiratory Organs," says, after a careful survey of the various theories as to the nature of asthma:
Asthma must be regarded as a reflex neurosis, the symptoms of which are spasm of the bronchial muscle, of the diaphragm and other inspiratory muscles, associated with more or less of vasomotor disturbance in the bronchi.
While all this is true, it is my opinion that in all cases of true asthma there is also present a true bronchiolitis with exudate of mucin, which is eventually expectorated in the form of Lænnec's perles, each of which may be shown to be a very tightly rolled mass of Curschmann's spirals, which may also usually be found in the sputum. In order to find these, it is necessary to examine the sputum immediately after the attack, as it does not take long for them to
ROCHESTER D. THE TREATMENT OF ASTHMA. JAMA. 1906;XLVII(24):1983–1986. doi:10.1001/jama.1906.25210240017001e
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