The Prognosis for Bronchial Asthma Arisen in Infancy, After the Nonspecific Treatment Hitherto applied

Summary. The writer's intention with the present work was to investigate the prognosis for infantile asthma after application of the therapeutic methods hitherto used in Denmark in order to obtain a material of comparison for the estimation of the effect of the specific, desensitizing treatment. For that purpose lists of queries were sent to 321 patients who had previously been hospitalised for bronchial asthma. v 298 patients (92.8 per cent) replied satisfactorily. 190 of them (63.8 per cent) were males, and 108 (36.2 per cent) were females. In the great majority of the cases the age of onset of the attacks of asthma was below 5 years. If the first attack of asthma proper was regarded as onset of the disease, 66.4 per cent of the cases commenced before the age of 5 years. If the inception of an eventually preceding bronchitis was regarded as onset of the disease, 78.4 per cent of the cases commenced before the age of 5 years. Most of the cases commenced at the age of 2–3 years. In 120 of the 298 patients the attacks had ceased (40.3 per cent); 15 of them had died (5.0 per cent), and 163 (54.7 per cent) constantly had attacks of asthma. In the boys the attacks mostly ceased at the age of from 12 to 15 years, whereas, in the girls, they generally ceased at the age of from 9 to 12 years. In 58 (41.1 per cent) of 131 patients who had reached an age of 18 years the attacks had ceased. In 46 (43.2 per cent) of 106 patients who had attained an age of 20 years or more, the attacks had ceased. That means to say that it may be reckoned with that some 40 per cent of the cases of infantile asthma are cured spontaneously or by the treatment which has hitherto been applied in Denmark. 41.7 per cent of the patients whose attacks of asthma had ceased reported that the cessation was due to removal or to sanitation of their lodgings. The average duration of the disease in the 120 cases in which the attacks of asthma had ceased, was 7.4 years (7.7 years for the boys, and 6.9 years for the girls). Some 44 per cent of the children whose attacks of asthma had ceased at the time of inquiry, had dyspnea, most of them, however, only on stronger exertion. In 71 per cent of the patients whose attacks had not ceased, they had become less frequent, and in 58 per cent of the patients they had become milder. Only in about 10 per cent of the patients the attacks of asthma had become both more frequent and stronger. The great majority of the patients who continued to suffer from attacks of asthma, felt well in the intervals between the attacks, some 47 per cent, however, suffered from dyspnea (mostly exertion dyspnea only), and some 41 per cent suffered from cough in the intervals. 5 per cent of the children had died before the time of inquiry, 5 of them (1.7 per cent of the total material of patients) in status asthmaticus. In 139 of the 298 patients (46.0 per cent) the school‐attendance was seriously interfered with on account of the disease. 33.6 per cent of the 116 patients who continued to incur attacks of asthma after their 15th year of life, or whose attacks had ceased after the 16th year, had, on account of their disease, to choose special professions, and 7 per cent of these were subsequently compelled to change their profession again. The writer gives a brief survey of the methods of treatment applied. It is emphasized that a more active therapy of infantile asthma is necessary in Denmark.