A young wife, who suffers from asthma, may develop a severe asthmatic attack when her mother-in-law comes visiting for the first time.
The attack is practically a certainty if the young wife feels helpless about the whole thing, feels left out in the cold, feels unable to cope with the situation.
Dr. Thomas H. Holmes III, professor of psychiatry at the University of Washington Medical School, cited this as an example of the role which emotions sometimes play in asthma.
Not that emotions tell the whole story, emphasized the Seattle Dsvchiatrist. Actuallv.
said Dr. Holmes, they are only a portion of the overall picture.
"Recently," explained the psychiatrist, "we carried on an extensive research study to determine the social, psychological and physiological factors involved in this disease. Our study showed there is no one thing which causes asthma. It's more an inter-relation of various factors." Dr. Holmes said an asthmatic does not necessarily need a psychiatrist; that asthmatics are not mental cases, "in the sense of being crazy."
"But since emotions can trigger an allergy, consultation with a psychiatrist might be of help to the asthmatic who has real insight into his or her problem," he added.
Dr. Holmes was a featured speaker at Thursday's session! of a post-graduate course being conducted at Tulane University Medical School.
The psychiatrist participated in a panel discussion entitled, "Asthma Is a Many-Splintered Thing." During this discussion and during the question and-answer period which followed panelists said also:
1. There is more than one source of air pollution responsible for New Orleans' asthmatic outbreaks.
2. Charity hospital records show that many asthmatics die as a result of indiscriminate use of sedatives.
3. One of the primary jobs of the internist is to keep the asthmatic away from the surgeon's knife.
4. There is a aeieci in me mucous membrane of asthmatics which caunes them to absorb pollens.
In discussing the young wife's reaction to her mother-in-law's Visit, Dr. Holmes said if the
young wife had felt like killing her mother-in-law she wouldn't have developed an asthmatic attack.
"She might have developed another ailment of course, but she wouldn't have been a true asthmatic," he explained. "Asth-
matics don't have yens to commit murder.
Dr. Holmes said "the reaction of the airways which produces asthma is itself very similar to the kind of reaction produced by air pollution." He then told of experiments being carried on in the asthma field at the University of Washington Medical School.
In one experiment, he explained, the participants were asked to breathe in ammonia a number of times.
Dr. Holmes said "immediately their eyes began to smart, their noses started running,1 they all began coughing."
"In other words," he added, "we got a. picture very similar} to that of asthma. In another experiment, metal bands were placed around the heads of the participants then tightened until they all developed severe headaches. Here the airways reacted just the same as they do in asthma."
Dr. Holmes sam wnen you combine an allergy, pain from an injury, an emotional reaction and an obnoxious agent, such as an air pollutant, "you are in business."
"Put them all together," he added, "and you're practically sure to get more and bigger asthma attacks." Dr. Vincent Derbes, another panel participant, described a study carried on to determine what caused asthma deaths at Charity hospital.
"Sometimes the deaths were due to improper use of oxygen," explained the panelist, who heads the dermatology department at Tulane. "Some-times they were due to fatigue. But one thing all of those who died had in common and that was indiscriminate use of sedatives."
Dr. Derbes said tranquilizers and antihistamines, of a sedative nature, contributed markedly to the death rate when used in excess. He then told of
an asthmatic patient who was given a sedative following his arrival at the hospital.
'Since this patient was still disturbed he was given a second tranquilizer 20 minutes later," the dermatologist added. "He took a few steps and dropped dead.
Dr. John Salvaggio, instructor dPThedicine at tne Louisiana State University Medical school, described a study carried on jointly by LSU and the Massa-
chusetts General Hospital in Boston to determine the basic difference between allergic and non-allergic people.
He said the study led the researchers to believe that there is a defect in the mucous membrane of allergic persons which
permits more efficient absorption of pollen. He said the non-allergic person could breathe in pollen and not be the least fit affected. Dr. Thomas E. Weill instruc-
tor in medicine at Tulane, described local investigation of asthma.
The study, he explained, showed that underground burnings of trash in city dumps were not the only sources of air pollution. He said patients involved in the outbreaks seemed to be evenly divided as regard to age; that patients involved were regarded as truly allergic; that! a relatively small percentages were cigarette smokers or had syptoms of chronic bronchitis. PHOTO: Panel Discussion at Postgraduate Session - CONDUCTING a panel discussion on asthma at the American College of Physicians Postgraduate Courses Thursday at the Tulane University School of Medicine are (from left) Dr. Hans Weill, Tulane; Dr. John Salvaggio, Louisiana State University; Dr. Thomas H. Holmes III, University of Washington, Seattle, and Dr. Vincent Derbes, Tulane. The panel discussion was on the morning program of the sessions.
