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
Theodor Weber,[17] rejecting the above theories on the ground that
neither bronchial spasm nor tonic contraction of the diaphragm is
capable of explaining why catarrhal secretion should come on at the
close of an attack in which at the commencement there was no catarrh,
attributes the phenomena of asthma to sudden swelling of the bronchial
mucous membrane, the result of dilatation of its blood-vessels produced
through the agency of the vaso-motor nerves; thus reviving the
fluxionary theory of Traube. In support of this theory he cites the
result of Von Loven's[18] experiments, which prove that irritation of
the sensory nerves is followed by reflex engorgement of the territory
to which they are distributed. Weber considers that this engorgement of
the bronchial mucous membrane is somewhat similar to the acute swelling
and stoppage of the nostrils to which many persons are subject--a
closure which often does not last longer than a few moments, and which
is attended with increased redness and swelling of the Schneiderian
membrane. The mucous membrane of the nostril and that of the bronchi
being both parts of the respiratory tract, and somewhat similar in
structure, he concludes that the process in the nostrils is analogous
to that which occurs in the bronchi during the asthmatic paroxysm. As
additional proof of the correctness of his hypothesis he cites the fact
that such occlusion of the nostrils is often the precursor of the
asthmatic attack, and in some cases continues throughout the paroxysm.
See investigations of Daly, Roe, Allen, and Hack, further on.
[Footnote 17: "Ueber Asthma Nervosum," _Tageblatt der 45 Versammlung
deutscher Naturforscher u. Aertze in Leipzig, etc._, 1872, p. 159.]
[Footnote 18: _Naturforscher u. Aertze in Leipzig, etc._, 1872, p.
159.]
The idea that asthma is due to swelling and engorgement of the
bronchial mucous membrane appears to have been confirmed by the
tracheoscopic observations of Stoerk.[19] On examining the air-passages
with the laryngoscope, he could see the mucous membrane of the trachea
as far as visible (that is, to the bifurcation) grow red with the onset
of the paroxysm, and resume its normal appearance after the termination
of the attack. He opposes the spasm theory, denies the correctness of
Biermer's conclusions, and adopts Weber's explanation of the asthmatic
phenomena. He agrees with Wintrich that spasm of the diaphragm occurs,
but claims that it results from the tension to which it is subjected by
the inflated alveolæ: the diaphragm being forced downward by the
distended lung, its fibres are stretched, and the result is a tonic
spasm of that muscle. His objections, although well stated, are not
sufficiently conclusive to cause us to accept his opinion in preference
to that of Biermer and other supporters of the spasm theory.
[Footnote 19: _Mittheilungen über Asthma bronchiale, etc._, Stuttgart,
1875.]
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