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Early insights into the characteristics of asthma 

Early insights into the characteristics of asthma
Chapter:
Early insights into the characteristics of asthma
Author(s):

Gailen D Marshall, Jr

DOI:
10.1093/med/9780199651559.003.0002
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date: 16 November 2019

Of the cases of asthma that have come under my observation since the publication of my work on that disease I have preserved full notes of upwards of a hundred and fifty. By the light of these I have become acquainted with several facts in relation to this disease that were previously unknown to me. They constitute a large mass of unpublished information on the subject and I propose in this and the following paper to give an analysis of them. The cases were all taken on a definite and systematic plan which has greatly facilitated the tabulation of their results and they include, each of them, some notice of almost all the clinical phenomena that are incident to asthma, as well as a great number of facts with regard to its treatment. The first point on which my notes furnish information is Sex. In my work on asthma I have stated that men are more liable to it than women in the proportion of two to one. My subsequent experience has been a remarkable confirmation of this estimate. Of 153 cases, 51 I find are females, and 102 males, which is exactly two to one. This is too striking and uniform a proportion, and my numbers are now too large, for it to be fortuitous. Why then, one cannot help asking oneself, are men twice as liable to asthma as women? The answer to this question-the only possible answer-is one bearing directly upon our notions of the etiology of the disease; it must be because the causes of asthma are such as men are more exposed to than women. . . . Age . . . my cases show the following facts:-That, dividing life into equal intervals of ten years, a larger number of cases take their commencement in the first ten years of life than in any subsequent equal period; that childhood is of all ages the most prolific of asthma. After childhood there is a sudden fall; during adolescence much fewer cases declare themselves. But from this there is a gradual rise up to forty.

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