Abstract
1. Asthma is a comparatively common disease in
British Guiana.
2. Clinically, asthma can be divided into two
types, one termed primary for convenience and in
which there is usually a family history of asthma,
hay fever or allergic manifestations such as eczema,
urticaria, cyclic vomiting or migraine. This type
usually begins in childhood. The other, termed
"secondary ", usually follows some respiratory
affection e.g. measles, whooping cough, bronchitis
or pneumonia and usually starts in later life.
Oriel and Knott have found in these two types
(38) (39)
biochemical differences which tend to support this
clinical differentiation.
3. In the diagnosis and treatment of the condition, Ascaris lumbricoides infection must be kept
in mind and stool examination for eggs of this
helminth should be practised as a routine in all
cases of asthma in the tropics if only to exclude
this condition.
4. A number of factors probably operate in the
production of this malady. The one constant factor
appears to be an inherited diathesis or predisposition,
though in some cases this predisposition may
be acquired. Other factors such as allergy, toxaemia,
reflex irritation, psychical disturbances,
biochemical changes and endocrine disturbances all
may play their role in the production of this distressing
disease. Only time and experience will determine
the relative merits of each.
5. Early treatment is of the greatest importance.
6. No one treatment is applicable to every case
of asthma. Each case requires thorough investigation
and individual treatment.
7. The most successful form of therapy is by
elimination, when applicable.
8. If the specific cause cannot be eliminated
or avoided, specific desensitisation should be
attempted.
9. If the specific cause cannot be determined,
recourse must be had to non-specific desensitisation
with peptone, milk, tuberculin or vaccines. It
is always worth while trying different forms of
treatment since in many cases where one form of
therapy fails another may succeed.
10. Psycho-analysis and endocrine therapy may
be indicated in individual cases.
11. In adults, arsenic in the form of neo-arsenobillon
intravenously the author has found of
benefit and often succeeds where other methods of
treatment fail.
