In 1933 Clarke1described status asthmaticus as a period of intense dyspnea which lasted a few days to a week (occasionally longer) and was caused by an outpouring of viscid mucus into the bronchioles, resulting in a serious loss of lung capacity and a corresponding failure to respond to the ordinary dose of epinephrine. Death more commonly results in this than in either of the other commoner types of asthma, acute bronchial asthma and chronic or intractable asthma. The last may be defined as a persistent and refractory type that is unyielding to presently available therapeutic measures. The patient is seldom free of symptoms, and the disease is usually associated with chronic bronchitis, bronchiectasis and emphysema. When an acute asthmatic attack fails to subside and becomes refractory to the usual palliative measures which in the past gave relief, the dyspnea becomes severer, cough is unproductive and epinephrine hydrochloride therapy
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George Piness (1950) studied this question.