A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Science
A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Medicine -- Practice
All authorities agree that asthma is much more frequent among males
than females. Of Théry's cases, 60 were females and 80 males. The more
recent statistics of Salter show that the males exceed the females in
the proportion of two to one. This undue frequency of a purely nervous
disease among males appears at first to be at variance with the
generally-received opinion that such affections pertain rather to the
female sex; but on investigating the ages at which the attacks first
come on it will be found that between the fifteenth and thirtieth
years--that is, during the period when sexual function is most
active--the proportion is reversed, females being attacked much oftener
than males.
Asthma occurs more frequently in childhood than at any subsequent
period--a fact which may be explained by the great susceptibility of
young children to catarrhal affections of the air-passages and to the
frequent occurrence at that age of measles and whooping cough (Salter).
Of 225 cases collected by Salter, 71 occurred before the tenth year,
and of these, 10 began during the first year, the youngest of them
being only fourteen days old at the time of {191} the attack. From ten
to twenty it occurs less frequently than at any other period of life,
but from that age to the fortieth year there is a steady increase in
the number of cases. During the next decade, from forty to fifty, the
disease diminishes in frequency, and from that period on the number of
cases continues to grow smaller and smaller with advancing years,
comparatively few commencing after the fiftieth year.
The following tabular statement, compiled by Salter, shows the
comparative frequency of asthma during the various periods of life:
From 1 to 10 years, 71 cases. | From 40 to 50 years, 24 cases.
" 10 to 20 " 30 " | " 50 to 60 " 12 "
" 20 to 30 " 39 " | " 60 to 70 " 4 "
" 30 to 40 " 44 " | " 70 to 80 " 1 "
These figures demonstrate the fallacy of the popular idea that old
people are especially liable to asthma. Its prevalence during the later
periods of life is due to the fact that while, on the one hand, the
affection rarely causes death, on the other it is scarcely ever curable
except during childhood, and thus the cases contracted at different
ages accumulate and form a large aggregate as life advances.
Those cases occurring in childhood and late in life are likely to be
associated with more or less bronchial catarrh, while those which come
on when the body has attained its fullest development are almost
invariably purely nervous in character.
The period of life at which asthma commences is an important element in
the prognosis of the disease, the cases occurring in early childhood
being likely to end in recovery, while those coming on later in life
are exceedingly protracted in their course and liable to lead to
organic diseases of the heart or lungs.
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