6o 4 THE POPULAR SCIENCE MONTHLY. 



THE EEMEDIES OF NATURE. 



By FELIX L. OSWALD, M. D. 

 ASTHMA. 



IT has been said that no doctrine can ever attain a large degree of 

 popularity without containing some admixture of truth. The 

 rare exceptions from that rule do not include that most preposterous 

 of all medical theories, the " Brunonian System of Physics." John 

 Brown, M. D., of Preston, Scotland, divided all disorders of the hu- 

 man organism into " sthenic " and " asthenic " diseases : the f ormer 

 produced by an excess of vitality, and to be counteracted by bleeding 

 and cathartics ; the latter arising from a defect of vital power, and to 

 be cured by beefsteaks and brandy, etc. The grain of truth in the 

 chaff -barrel of absolute nonsense is the pathological influence of asthe- 

 nia, or a deficiency of vital power. Impaired vitality can not be re- 

 stored by alcoholic stimulants, but its causal connection with a large 

 number of functional disorders admits of no doubt. Every process 

 of the animal organism derives the impulse of its normal performance 

 from a reserve fund of vital energy and the depletion of this fund 

 impairs the efficiency of the organic functions. A man may be too 

 tired to sleep. A child may be too feeble to breathe, too weak to as- 

 similate its food. Exhaustion alone may lead to that total suspension 

 of the vital process which we call death. 



But generally asthenia is only a proximate cause of disease. It 

 reveals a pre-established morbid diathesis by affecting the weakest 

 part of the organism, and its influence becomes thus localized. The 

 affected part may become the center of attraction for a variety of 

 asthenic agencies, for each successive attack increases the morbid di- 

 athesis, and thus, as it were, confirms the pathological precedent. This 

 convergence of asthenic influences is most strikingly illustrated in the 

 pathology of the asthmatic affections. Asthma, or chronic dyspnoea, 

 a torpor of the semi-voluntary muscles which effect the process of 

 respiration, has thus far not been traced to its original cause. Pro- 

 fessor Reese ascribes it to a spasm of the muscular fibers inclosing the 

 bronchial tubes ; Dr. E. Bock defines it as a diminished elasticity of 

 the pulmonary air-cells, caused by an undue dilation of the lungs (as 

 in violent exercise). Villemin considers it as a purely nervous affec- 

 tion. In its most frequent form, however, it seems to be a legacy of 

 arrested tuberculosis an intermittent affection induced by a tendency 

 to a pulmonary torpor that may remain latent for an indefinite time, 

 but unmistakably connected with an asthenic proximate cause. Chronic 

 asthma, in the strictest sense of the word, occurs only during the last 

 stage of pulmonary consumption. When the lungs have been reduced 



