92 DISEASES OF THE TRACHEA AND BRONCHI. 



undergone an attack, fears that he will not live through the next, yet 

 in the disease itself there lies a remedy to allay danger as soon as it 

 arises. The moment that signs of carbonic-acid poisoning develop, the 

 spasmodically contracted bronchial muscles are relaxed, as are also the 

 muscles of the entire body, upon which the poisoning undoubtedly has 

 a paralyzing effect. 



TREATMENT. Where chronic uterine disease is the cause of nervous 

 asthma, the causal indication demands measures corresponding to the 

 hysterical nature of the attack. In general, we are unable to meet the 

 causal indication, the cause itself being unknown. 



The indications for treatment of the disease itself are, first, to arrest, 

 shorten, or mitigate the paroxysms ; and, second, to take measures for 

 the prevention of their recurrence. 



To attain the first object, before all else the patient must be freed 

 from all tight clothing, and his apartment supplied with pure, dry, warm 

 air. The most efficacious of all dietetic remedies (in the widest sense 

 of the word) is the respiration of compressed air, but it is rarely that 

 a patient has the opportunity to prove its value during an attack. Very 

 good results have been observed after a long abode in an institution pro- 

 vided with a well-contrived apparatus for this purpose. A gentleman 

 of my acquaintance, for many years a sufferer from asthma, has had an 

 apparatus constructed in his own house, within which to undergo his 

 attacks in greater comfort The great relief which asthmatic subjects 

 experience upon inhaling compressed air is easily accounted for. The 

 greater the pressure upon the gas which we respire, so much the more 

 of it is taken into the blood ; hence a moderate degree of obstruction 

 to respiration may be compensated for by augmentation of pressure upon 

 the gas respired. It is remarkable that this (in my opinion) principal 

 cause for the efficacy of the inhalation of compressed air, the great in- 

 fluence of which upon the inspiratory act has been proved by the ex- 

 periments of Hoppe-Seyler, is hardly referred to in his writings upon 

 this subject. 



The ancient and renowned recipe of a cup or two of strong Mocha 

 coffee (two ounces to the cup), and the exhibition of small pieces of 

 " water-ice," as recommended by Romberg, stand intermediate between 

 the dietetic and medicinal remedies. In some cases either one or 

 other of these articles will afford considerable relief; in others they fail 

 entirely ; and it is impossible to predetermine which of these results 

 will occur. Among the medicines in the narrower sense of the word, 

 the narcotics justly stand highest in repute. When the diagnosis is 

 certain, doses of opium or of morphine may be ordered boldly. Where 

 their internal administration fails, the experiment of a subcutaneous in- 

 jection of a solution of morphine may be made. 2 My own experience is 





