Table 1.

Summary of Williams, 1874 (1).

Hereditary predisposition plays a part

Muscle spasm is a central component of the disease

Tenacious secretions and thickened walls

Catarrhal attacks commonly cause “spasmodic” asthma

[viral induced exacerbations-respond poorly to bronchodilators]

Environmental precipitants

pollens, dust, chemicals, cold air etc.

May also be triggered by emotion, indigestion

Infection may be one of the causes

[“but be careful as almost everything in this country is attributed to a cold”]

Different patterns in different subjects

Typically causes cough, wheeze & difficulty breathing

Pts find it more difficult to breath in than out during an episode

Reversible emphysema (hyperinflation)

Describes the refractory period and effect of a deep breath

Commonly co-exists with eczema

Avoidance of triggers such as hay is helpful

Smoky cities are good for asthma for people from country areas

Bronchodilators are helpful

Patients often know as much about treating their disease as doctors

“it is, happily, not a fatal disease, yet it is one which gives rise to a large amount of suffering”

Can be associated with hysteria

[dysfunctional breathing]