The Beat Generation And Bennies
Recreational use of Benzedrineor benniesbecame a popular part of Beatnik culture in the 1950s. Many so-called Beat Generation writers, including author Jack Kerouac and poet W.H. Auden, reportedly used artificial stimulants, including bennies.
But amphetamine use began falling out of favor in the late 1950s. In 1959, the FDA began to require prescriptions for Benzedrine.
It was also becoming apparent that amphetamines had many harmful effectsincluding delusions, paranoia, abnormal heartbeat and heart failureamong regular users and addicts.
In The 19th Century Hay Fever Was Known As An Aristocratic Disease
By the 1860s, hay fever and hay asthma had become widely accepted terms in the medical community. The condition was, however, almost exclusively associated with the elite. In 1873, Blackley observed in his paper Experimental Researches on the Nature and Causes of Catarrhus Aestivus that most of his patients suffering from hay fever tended to be either doctors or members of the clergy. It was an aristocratic disease, he said, that was almost wholly confined to the upper classes of society.
What Are The Consequences Of Overdiagnosis
One of the problems of misdiagnosis is that there may be an alternative diagnosis that is not made in a timely fashion. Some of the final diagnoses in the study by Aaronet al. , such as ischaemic heart disease, subglottic stenosis and pulmonary hypertension, were serious and could lead to patient harm if unrecognised. In addition to this risk, patients are often on long-term inhaled therapy unnecessarily, leading both to potential side-effects and significant ongoing healthcare costs as these drugs are likely to be issued for many years after a diagnosis of asthma. In the past, many mild asthma patients were simply on an as required SABA inhaler, but increasingly this is discouraged with daily ICS therapy recommended for all but a few . This represents a burden to the patient and could conceivably cause side-effects such as an increased risk of adrenal suppression, diabetes, cataract formation and pneumonia . If the wrong diagnosis is made patients are also likely to remain symptomatic, and potentially have their asthma treatment stepped up, adding to both the cost and the potential for side-effects.
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Diagnosing Asthma In Older People
Older people are more likely to have other lung diseases that also cause shortness of breath , so doctors have to determine how much of the person’s breathing difficulty is related to asthma and reversible with the appropriate anti-asthma therapy. Often, in these people diagnosis involves a brief trial of drugs that are used to treat asthma to see whether the person’s condition improves.
How Asthma Is Treated
While there is no cure for asthma, there are a number of treatments that can help control the condition.
Treatment is based on two important goals, which are:
- relieving symptoms;
- preventing future symptoms and attacks
For most people, this will involve the occasional or, more commonly, daily use of medications, usually taken using an inhaler. However, identifying and avoiding possible triggers is also important.
You should have a personal asthma action plan agreed with your doctor or nurse that includes information about the medicines you need to take, how to recognise when your symptoms are getting worse, and what steps to take when they do so.
These symptoms are often worse at night and early in the morning, particularly if the condition is not well controlled. They may also develop or become worse in response to a certain trigger, such as exercise or exposure to an allergen.
Read our page on the;causes of asthma for more information about potential triggers.
Speak to your GP if you think you or your child may have asthma. You should also talk to your doctor or asthma nurse if you have been diagnosed with asthma and you are finding it difficult to control the symptoms.
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Personal Asthma Action Plan
As part of your initial assessment, you should be encouraged to draw up a personal asthma action plan with your GP or asthma nurse.
If you’ve been admitted to hospital because of an asthma attack, you should be offered an action plan before you go home.
The action plan should include information about your asthma medicines, and will help you recognise when your symptoms are getting worse and what steps to take. You should also be given information about what to do if you have an asthma attack.
Your personal asthma action plan should be reviewed with your GP or asthma nurse at least once a year, or more frequently if your symptoms are severe.
As part of your asthma plan, you may be given a peak flow meter. This will give you another way of monitoring your asthma, rather than relying only on symptoms, so you can recognise deterioration earlier and take appropriate steps.
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Reactive Airways Dysfunction Syndrome
Reactive airways dysfunction syndrome is a rapid onset and persistent asthma-like disorder that occurs in people with no history of asthma. It is a form of environmental lung disease caused by a single large exposure to nitrogen oxide or volatile organic compounds . People have symptoms similar to those of asthma, including cough, wheezing, and shortness of breath. Treatment is similar to usual treatment for asthma.
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Evaluating An Asthma Attack
Because people who are having a severe asthma attack commonly have low blood oxygen levels, doctors may check the level of oxygen by using a sensing monitor on a finger or ear . In severe attacks, doctors also need to measure levels of carbon dioxide in the blood, and this test typically requires obtaining a sample of blood from an artery or, occasionally, a vein. However, carbon dioxide levels can sometimes be monitored in the person’s breath using a sensor placed in front of the nose or mouth.
Doctors may also check lung function, usually with a spirometer or with a peak flow meter. Usually, a chest x-ray is needed only when asthma attacks are severe, in order to rule out other serious conditions .
What Types Of Asthma Are There
Healthcare providers identify asthma as intermittent or persistent . Persistent asthma can be mild, moderate or severe. Healthcare providers base asthma severity on how often you have attacks. They also consider how well you can do things during an attack.
Asthma can be:
- Allergic: Some peoples allergies can cause an asthma attack. Molds, pollens and other allergens can cause an attack.
- Non-allergic: Outside factors can cause asthma to flare up. Exercise, stress, illness and weather may cause a flare.
Tobacco Smoking Was Believed To Help Relieve Symptoms Of Hay Fever
An article from the Petersburg Times, published on 11 September 1896, reveals that contemporary doctors recommended a number of ways to treat hay fever. Visiting the seaside; taking a trip on a yacht or burying oneself in a densely populated town were among the softer suggestions, but the method considered to be the most effective was decidedly more questionable: One of the best remedies is tobacco, the smoke being retained in the mouth as long as possible, and ejected through the nose, advises the journalist.
For 19th-century hay fever sufferers who didnt fancy this particular method , inhaling ammonium chloride was a recommended alternative. The method was not without its risks: you should exercise caution when using ammonium chloride, the Petersburg Times journalist writes it is, after all, a gateway to the vice of chloroform inhalation, which sometimes proves fatal.
Rachel Dinning is Website Assistant at History Extra.
Asthma Is An Allergic Disease: Yes No Maybe
In recent decades it has become routine to describe asthma as an allergic disease. A theoretical paradigm has evolved in which allergen exposure produces sensitisation to allergens, and continued exposure leads to clinical asthma through the development of airways inflammation, reversible airflow obstruction, and enhanced bronchial reactivity.
However, it has been acknowledged that not all cases of asthma fit this paradigm, for example, some occupational causes of asthma do not appear to involve allergy. In fact, it is now widely recognised that at most one-half of asthma cases, in both children and adults, involve allergic mechanisms. The majority of the cases probably involve non-allergic mechanisms, including non-allergic inflammation of the airways. These non-allergic mechanisms are currently not well understood.
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What Are The Signs And Symptoms Of Asthma Types
Symptoms may occur during the day or at night. If they happen at night, they may disturb your sleep.
Wheezing is the most common symptom of an asthma attack.
Current guidelines for the care of people with asthma include classifying the severity of asthma symptoms, as follows:
The exact cause of asthma is not known.
What Does Asthma Feel Like
There are three major signs of asthma:
- Airway blockage. When you breathe as usual, the bands of muscle around your airways are relaxed, and air moves freely. But when you have asthma, the muscles tighten. Itâs harder for air to pass through.
- Inflammation. Asthma causes red, swollen bronchial tubes in your lungs. This inflammation can damage your lungs. Treating this is key to managing asthma in the long run.
- Airway irritability. People with asthma have sensitive airways that tend to overreact and narrow when they come into contact with even slight triggers.
These problems may cause symptoms such as:
- Coughing, especially at night or in the morning
- Wheezing, a whistling sound when you breathe
- Shortness of breath
- Trouble sleeping because of breathing problems
Not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your symptoms may also vary from one asthma attack to the next, being mild during one and severe during another.
Some people with asthma may go for long periods without having any symptoms. Others might have problems every day. In addition, some people may have asthma only during exercise or with viral infections like colds.
When to see your doctor
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How The Treatment Goals Are Attained
Unfortunately, there is no magic bullet for asthma. While treatment can control symptoms safely and effectively for most patients most of the time, it is not a simple matter of the doctor writing a prescription and the patient taking the medication. Successful treatment of asthma is likely to require several steps on the part of physician. These include:
- Confirmation of the diagnosis
- Characterization of the asthma with regard to:
- Identification of triggers
- Identification of the components of airway obstruction
The diagnosis of asthma is suspected when a patient has a history of recurrent or chronic shortness of breath, labored breathing, or cough in the absence of any other obvious reason. The diagnosis is confirmed by obtaining evidence that there is airway obstruction that reverses either spontaneously or as a result of treatment with anti-asthmatic measures. The procedures used to make the diagnosis include a careful history, measurement of pulmonary function , and therapeutic trials of medication.
Triggers of asthma, those identifiable factors that commonly worsen symptoms include:
- Viral respiratory infections ;
- Airborne allergens ;
- Inhaled irritants ;
- Cold air
Patients with an intermittent pattern of asthma require only intervention measures.
Prevention By Maximal Exposure Limits
Reduction of exposure to factors associated with a disease does not necessarily mean reduction of the risk for the disease. Interventional studies are needed to test such hypotheses. However, exposureresponse relations have been regarded as sufficient circumstantial support for reducing occupational exposures. Traditionally, bakery dust was often regarded as general or organic nuisance dust with standards set at concentrations of 510 mg/m3. The reported exposureresponse relations have initiated risk assessments in several countries: in the USA the American Conference of Governmental Industrial Hygienists adopted a threshold limit value of 0.5 mg/m3, the Dutch expert committee has proposed a limit of 0.5 mg/m3, since January 2001 Sweden has set a limit of 3.0 mg/m3, and Germany is presently revising its 4.0 mg/m3 MAK value. These maximal exposure limits are eight hour time weighted averages of inhalable dust by personal sampling.
The risk assessment for an MEL for dust is somewhat restricted by the grouping strategies and analytical methods used in the studies. For example, some studies compare high exposed groups with low exposed, but not with non-exposed. Heederik and Houba applied generalised additive modelling and smoothed plots of individual data in order to look for a possible exposureresponse threshold for sensitisation to wheat. They concluded that there was no threshold and that sensitisation could occur at flour dust concentrations of 0.51.0 mg/m3.
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Why Does It Occur
Underdiagnosis may be due to medical professionals failing to recognise the disease, and perhaps attributing symptoms to obesity, deconditioning, cardiac disease or other causes. The patient may appear well with no abnormality on examination and if objective tests for asthma are carried out, particularly as a one off or when the patient is already on treatment, they may be falsely reassuring or misunderstood by the treating physician as excluding asthma. One might speculate that because asthma is so prevalent, patients are less likely to be referred to specialists for confirmation of the diagnosis when it is unclear, whereas patients with suspected diseases that are less familiar may be more likely to be referred.
How A Brilliant Quip Led To A Treatment That Helps Millions Every Minute
In April 1955, 13-year-old Susie Maison asked her father, the pharmacologist George L. Maison, whether there wasnt an easier way to treat her asthma. Like so many other people with the affliction, shed been using an awkward squeeze-bulb nebulizer, and she wondered why her medicine wasnt available in a spray can, like they do hairspray, she said. Though nebulizers of that era were more effective than the medicated asthma cigarettes previously in vogue, Susies father, too, had been frustrated by the cumbersome process of refrigerating the vials of medicine and loading them into the delicate contraption.
Maison was no stranger to innovation. As an Air Force lieutenant during World War II, he planned the first system for aerial rescue behind enemy lines and earned a Legion of Merit award for perfecting the anti-gravity suit. At the Boston University School of Medicine after the war, he developed Veriloid, the first widely distributed prescription drug to treat hypertension successfully.
It was a game changer, says Stephen Stein, a scientist at Kindeva Drug Delivery and co-author of a recent history of therapeutic aerosols.
Today, sales of pharmaceutical inhalers exceed $36 billion globally each year, and the device has puffed its way into medical history, improving the lives of millions: More than 2,000 people around the world use one every second.
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Monitoring Asthma At Home
Some people use a handheld peak flow meter to evaluate their breathing and determine when they need intervention, before their symptoms become severe. People who experience frequent, severe asthma attacks should know how to reach help quickly.
Peak expiratory flow can be measured using a small handheld device called a peak flow meter. This test can be used at home to monitor the severity of asthma. Usually, peak flow rates are lowest between 4 AM and 6 AM and highest at 4 PM. However, more than a 30% difference in rates at these times is considered evidence of moderate to severe asthma. People with moderate to severe asthma, particularly those who need daily treatment to control symptoms, often use a peak flow meter to take measurements and compare them to their personal best to help identify signs of worsening asthma or the onset of an asthma attack.
All people with asthma should have a written treatment action plan that was devised in collaboration with their doctor. Such a plan allows them to take control of their own treatment and has been shown to decrease the number of times people need to seek care for asthma in the emergency department.
Methamphetamines In World War Ii
During World War II, German pharmaceutical company Temmler marketed methamphetamine tablets as a nonprescription drug under the brand name Pervitin.
Methamphetamine triggers a response in the body thats similar to adrenaline, heightening alertness and a willingness to take risks.
Japanese, U.S., British and German military personnel are reported to have used the stimulant to enhance endurance and ward off fatigue on long campaigns.
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