Good Health and Bad Medicine:
Colds - Part 1
Colds - Part 2
Colds - Part 3
Mouth Washes And Bad Breath
Sinuses And Sinusitis
Asthma And Hay Fever
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Asthma And Hay Fever
( Originally Published 1940 )
BRONCHIAL asthma and hay fever are known as allergic disorders. Although they differ from each other in the kinds of discomfort they cause, they have a very fundamental thing in common. Both occur in people who are sensitive to sub-stances which, when given in similar amounts to other people, are harmless. In other words, these disorders are a clear illustration of the old adage—"One man's meat is another man's poison."
Most persons, for example, can eat an egg without any untoward symptoms. In sensitive or allergic individuals, how-ever, eating an egg may bring on an attack of asthma. Most normal people may have one or two colds a year and the rest of the time forget about their noses and eyes; allergic persons may suffer from perpetual colds (called "allergic rhinitis") because they may be sensitive to the dust in the air. Others suffer from attacks of hay fever during the summer or autumn because they are sensitive to pollens of various trees, grasses, and weeds—pollens which have no effect on other people.
Drugs and cosmetics as well as foods, dust and pollens can cause allergic disorders in sensitive people. In fact, there is almost no limit to the number of substances which can, in susceptible individuals, produce allergic reactions. The most innocent-looking substance can cause a mild or serious reaction in an allergic person.
In bronchial asthma, the bronchial tubes are the seat of the allergic disorder. In hay fever, the mucous membrane of the nose is the main site. But allergic disorders can manifest themselves in almost every organ and system of the body, including the skin, the digestive tract, and even the brain.
The diagnosis of an allergic disorder is often difficult; a great deal of patient work may be necessary before an offending substance can be tracked down. The treatment of hay fever has been more or less standardized, so that the majority of hay fever sufferers can get partial or complete relief by a series of injections before the season begins or all the year round. (Preparations of pollen extracts to be taken by mouth have not proven successful.)
For other allergic disorders the matter is not so simple. It may take weeks of diagnostic tests before those periodic mi-graine headaches can be shown to be caused by a particular food, before those recurrent attacks of hives can be traced to the eating of tomatoes, or before those frequent "colds" can be shown to be due to the dust in one's home and office.
The complexity of the subject and the great number of people afflicted with allergic disorders have not prevented the proprietary medicine interests from invading the field. It is estimated that to per cent of the population suffer from some allergic disorder. The temptation to exploit this large number of persons is naturally great.
Asthma is one of the commonest and most serious of the allergic disorders. It has to its credit a vast number of remedies advertised for its relief or cure. The rational and scientific way of treating asthma is to determine the cause of the attacks and to eliminate it, if possible. If the attacks are caused by sensitivity to feathers, for example, or to animal dander, the obvious treatment is to avoid contact with these substances. If the attacks are caused by sensitivity to dust or pollens, the proper treatment is to immunize or "desensitize" the patient by a series of injections employing dust or pollens, since it is difficult or virtually impossible to free the environment of these materials.
Many organic disorders, such as heart disease and tumors of the bronchial tubes or lung, can cause attacks resembling asthma. Therefore, a physician always makes certain that these organic diseases are not present before proceeding with allergic treatment.
In the light of these facts, it is obvious that no advertised remedy or drug can cure asthma or any other allergic disorder. Doctors also use drugs in the treatment of asthma, but these drugs are used simply as palliative or emergency measures until the cause is found. The most important drugs used for this purpose are epinephrine and ephedrine.
Ephedrine is the main ingredient of most asthma remedies on the market, particularly of those that are administered by sprays or nebulizers. Whether administered by cheap hand sprayers or mechanical or electrical "aerifiers," the action of ephedrine is the same. The Theodore Radin, Inc., for ex-ample, advertises Atmozon Aerifiers, and Silbe inhalation preparations for asthma and hay fever, The electrical apparatus costs $200, the pocket atomizer costs $3.75. Both are simply sprayers, and both produce the same effect. The medications sold by the company for use with the "aerifiers" have fancy names—Glycirenan ($2.50), Jadirenan ($2.50), etc. As the Journal of the American Medical Association stated, it is evident that these remedies involve nothing more than "the employment of semi-secret proprietaries to obtain the well-known action of epinephrine and ephedrine , . . when applied in the form of a spray."
Physicians have found sprays of epinephrine helpful in relieving attacks of asthma; manufacturers have gone them one better and erected "inhalatoriums" where asthma and hay-fever sufferers can sit and inhale, and exhale all sorts of odors and sprays. In these rooms, epinephrine, ephedrine, aromatic substances and even mineral waters in varying pro-portions are nebulized to form persuasive clouds of sprays that envelop devotees of the inhalatoriurn. The mental effect of dwelling in such an atmosphere is considerable and there are, no doubt, many asthma sufferers who feel better after a visit to a spray emporium. Unfortunately, however, the at-tacks will occur again, and will keep recurring until the cause of the asthma is found and eliminated.
In 1937, the front pages of many newspapers featured an article that must have brought hope to thousands of sufferers from asthma and diseases of the respiratory tract. The article described the wonders of the so-called Duke-Fingard method for the treatment of asthma, tuberculosis and other respiratory diseases. This new method was supposed to be a remark-able discovery which had been endorsed by political and financial notables and members of the European aristocracy. According to the American Medical Association, which was quick to expose the unscientific nature of the method in its Journal, '... the method involves the use of a cabinet containing 12 trays of a liquid which is an oily brown mixture in `carefully worked' proportions of creosote, phenol (carbolic acid), iodine, garlic, aromatic essences and essential oils and glycerin. Air is dried by passing through a short tube into a box containing calcium chloride, which is said to `filter off dust and microbes.' It is then sucked into the apparatus by a small electric fan and, after being heated to between 70 to 80 degrees Fahrenheit, is driven over the 12 trays of medicaments and out into the room. The patient breathes this mixture of air and whatever it can pick up, beginning with 3 hours a day and going on to 16 hours a day. It is alleged that by this method of treatment asthma is brought under control, recovery occurs in hopeless cases of tuberculosis, and patients with sinus trouble are freed of their disturbances."
The Journal further points out that the method is "secret in character, fantastic in its administration, unsupported by any scientific evidence, promoted by a chemist and financiers whose records are far from clear, and supported by letters of politicians, military officers and aristocrats."
Asthma powders and asthma cigarettes are also widely advertised. Almost all of them contain the drug stramonium, plus some more or less inert ingredients. Inhalation of stramonium leaves does relieve paroxysms of asthma in many people. However, some people are sensitive to other ingredients of stramonium cigarettes and may suffer from more severe attacks than before.
Asthma remedies in the form of capsules, tablets and liquids usually contain ephedrine, iodides, or both. Those containing iodine or iodides can cause harm to those suffering from tuberculosis or having skin eruptions.
Numerous air filters have also been devised for the relief of asthma and hay fever. The apparatus is usually expensive and gives relief only when the patient is in the air-filtered room. Filters are useful under certain circumstances, but they should never be made a substitute for planned, comprehensive investigation and treatment. The following air filters have been approved by the Council on Physical Therapy of the American Medical Association: Arnett Air Filter, Arnett Air Filter Co., Chicago, Ill.; Electrostatic Air Cleaner, Atmospheric Electric Filter Corp., New York City; Pollenex Air Filter, George W. Pollock Co., Milwaukee, Wis.
"Nasal filters," such as "Dr. Weaver's," which are inserted into the nose, not only cannot effectively filter out offending dust, pollen or other substances but are likely to cause irritation of the nasal passages. The futility of using such gadgets is apparent when it is realized that pollens, dust and other substances can enter the body through the mouth and eyes as well as the nose.
A popular remedy for hay fever in some sections of the country is honey. There is, however, no evidence that honey will favorably influence attacks of hay fever or asthma. As a matter of fact, many hay-fever sufferers cannot tolerate honey because it frequently contains a great variety of pollens.
The hay-fever patient will. get the surest relief if he is able to obtain a course .of injections employing the pollens to which he is sensitive. The pollens that are responsible for most attacks of hay fever are those of the ragweed, and various trees and grasses. Contrary to popular, belief, the rose, dandelion and goldenrod are rarely responsible for attacks of hay fever.
Eye-drops and nose-drops or sprays for the relief of hay fever usually contain epinephrine or ephedrine. If the hay-fever patient has been unable to obtain injections, or if the injections have not been successful (as occasionally happens), doctors prescribe solutions of epinephrine with perhaps a small amount of cocaine, for the relief of the intense congestion of the nose and eyes.
Next to epinephrine in effectiveness are isotonic salt solutions of ephedrine (1%), neo-synephrin (1 %) and propadrine 1%. One drop in each eye and three or four drops in each nasal cavity may have a relieving effect.
A Benzedrine inhaler is sometimes helpful, although not as useful as epinephrine solution. If used, directions on the tube should be scrupulously followed. Chlorine inhalations should be avoided. They do not relieve hay fever or asthma and are likely to increase the congestion of the nose and eyes.