Deaths from Asthma in England and Wales

It is known and accepted that asthma is a very common condition, and from a stirvey of the ill- nesses of the adult population of England and Wales (1944-7) by Stocks (1949) it has been esti- mated that asthma occurs in one in every 110 of the adult population, or, more correctly, in 904 per 100,000 of the adult population.The frequency of death from status asthmaticus in this common condition is, however, uncertain, and opinions differ.Witts (1936) has written: "When status asthmaticus persists for two days, the risk of sudden death should be seriously con- sidered.Experience of a large clinic at which several hundred patients are in regular attendance suggests that one or two of these patients may be expected to die of asthma each year."Coope (1948) writes: *' The prognosis of the acute attack is usually good.It is sometimes said that no one ever dies of asthma, but this is not entirely true."Young and Beaumont (1950) in Price's textbook of medicine write: ". . .Although in a severe attack of asthma the aspect of the patient may be so alarming that a fatal issue appears imminent, death rarely occurs."From the United States we read:" Traditionally, asthma is a disease causing pro- longed and recurrent disability, but not death....Many physicians of wide experience in the field have expressed the opinion that death from asthma is the result of mistreatment or even of the medication rather than the disease itself.For example, a recent textbook states that 'death in uncomplicated asthma is rare unless morphine has been used.' . . .In con- sidering fatalities from asthma it is at once apparent that the prognosis is very different in asthma due to demonstrable external allergens and in so-called ' intrinsic' asthma. . . .Patients with 'intrinsic' asthma, possibly resulting from infection, are more apt to develop symptoms in middle age and may succumb within ten years " (Sherman, 1952).From Canada Walton, Penner, and Wilt (1951) have written: " . . .It does not appear to be suffi- ciently widely appreciated that bronchial asthma is a disease which may be fatal in itself."McCracken