Asthma often begins in childhood. The disease often has a high nuisance value and if the child loses many days from school it is a great handicap. Repeated attacks bring about changes in the growing chest wall and spine. Pigeon chest, curvature of the spine and round shoulders may result.
Asthmatic children sometimes suffer from other allergic conditions such as eczema or a stuffy nose. There are many causes of asthma and no one special treatment is likely to be effective in every case.
Skin tests may show that the child is sensitive to some substance which sets off the attacks. Usually it is something which is inhaled such as house dust, a common offender, feathers, horsehair, down, kapok or a pollen.
In many cases the asthma comes on every time the child catches a chest cold. An attack of whooping-cough seems to be the starting point of asthma in other cases, which is a further argument for the value of immunization against the disease in early life.
As a rule in asthma the X-ray does not show any serious lung damage. In a few cases only there is serious disease of the bronchial tubes “T.B.” is rare in asthmatic children.
The treatment of asthma is seldom dramatic and is often difficult, taxing the patience of doctors and parents alike.
The family doctor is often called upon in emergency and often at night to give relief from an acute attack by injecting adrenaline. But a bottle of medicine or an injection of adrenaline is often only of temporary value.
The management of asthma may extend over years. The doctor must probe into the problems of every case and find out all he can about the individual who has this disease. He may seek the help of a specialist in allergic diseases or refer the child to a special clinic for asthma cases for investigation and treatment.
Treatment may take the form of medicines or drugs. In selected cases, depending on the results of skin tests and the medical history, a course of desensitizing injections may be given.
General advice is given about avoiding dust, fumes or smoke. In the latter instances, it seems just as important to avoid worry, over-tiredness and mental upsets which will bring on an attack.
At times the child is helped by correcting some trouble in the nose or throat. The tonsils may have to be taken out or pus washed from one of the sinus cavities. Older children may be taught breathing exercises to improve the faulty methods of breathing and to bring about good chest expansion.
Unhappy home or school surroundings seem to play a big part in asthma in children. It is very natural for the parents to become over-anxious about the child, and this only increases the feeling of invalidism.
With systematic treatment, patience and hope, the attacks may cease. The child seems to grow out of the disease. In other cases although the attacks persist they are fewer in number.