It is with considerable temerity that I bring up this subject, probably the most difficult and disheartening in the whole domain of allergy. Still, it is one that all workers in this field occasionally have to face. I am referring to the ill, disabled person with chronic asthma—the chronic daily user of epinephrine, often in heavy dosages and often over a period of several years, with occasional exacerbations requiring the hypodermic administration of morphine, often for several days at a time. Nasopharyngeal operations have been performed, vaccines, pollen extracts and nonspecific therapy of all sorts have been employed, and various changes of residence and dietary measures tried, all to only temporary, partial or no avail.
The patients are usually over 20 years of age, ordinarily poorly nourished and in miserable general condition. Loss of weight is considerable, and hypotension is the rule. Physical examination usually shows no pathologic process other
KAHN IS. BRONCHIAL ASTHMA: THE SEVERE CHRONIC INTRACTABLE TYPE. Arch Intern Med (Chic). 1930;46(2):218–226. doi:10.1001/archinte.1930.00140140056003
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