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The literature dealing with psychological mechanisms in bronchial asthma and its psychological treatment is extensive. Monographs on psychosomatic medicine by Alexander and French (3), Weiss and English (20), Wittkower and Cleghorn (21), and Dunbar (5), to mention only a few, devote considerable discussion to bronchial asthma. Monographs by French and Alexander (9) and by Abramson (1) deal exclusively with this subject. However, the dramatic events leading up to the onset of the disease in the case to be described here, the theoretical implications, and the at least temporary cure of the asthma seem of sufficient interest to warrant a publication of this single case.
Presenting Illness. The 30-year-old married woman here concerned developed severe bronchial asthma four years before her admission to the Austen Riggs Center, having previously enjoyed moderately good health. Before her third pregnancy, she had a period of severe sinus trouble and pneumonia. During the pregnancy some of her friends noticed that she was wheezing, and soon afterwards bronchial asthma was diagnosed. The patient was in favourable financial circumstances and nothing was left untried in order to alleviate her condition. Many of the foremost specialists on the continent were consulted, but the patient remained greatly troubled by her asthma. There was at least one life-threatening episode when she lost consciousness during a severe expiratory spasm. Finally, only one measure was really helpful to her: continuous infusion of corticoid preparations. After treatment of this type, the patient could be free from her asthma for a few weeks, after which it would return with the same severity. Ten months before her admission she broke a rib during a coughing spell; the rib pierced the pleural sac, and she became ill with pleurisy. In order to decrease her pain she was started on Demerol injections. She became addicted to the drug and sought psychiatric help. After she had twice forged p