The Meaning of Asthma

The psychosomatic review of asthma provides the only satisfactory understanding of its symptomatology. This was first elaborated historically by the experimental, statistical and observational methods that came into medicine about 1936 (as a swing from the sterile neurological concepts) with the set-up of individual clinics in England and America for the intensive practical study of the asthmatic subject; and with the recognition of a more obvious interdependence of significant psychological factors was gaining ground. It gave equal cognizance to physiological and mental facts but no one was prepared to say that psychogenic forces were primary. Such equivocal concepts as “hypersensitivity” and “hyperexcitability,” awareness and idiosyncrasy of the organism, or of asthma as a “reaction-mode” to environment indicate both viewpoints, although authorities were not agreed on the order of precedence in the phenomena presenting. Some regard the psychic as primary and claim there is a hereditary mental predisposition to what are physical attacks (Gillespie); that the two manifestations occur concurrently or by way of reciprocal influence (Gutheil) or the physical may be consequential (Cobb) and as such, secondary. The conception of an organ-neurosis and a monistic view is now gaining ground. The significant contribution of Flanders Dunbar at this period, 1935, on the psychosomatic viewpoint, and the independent survey of Wittkower (less inclined to concede primary influence to the psychogenic factors); of Sampliner stressing its primacy, and more recently that of Alexander indicate the advances on this fundamental change of attitude since 1936.

The psychogenic proper approach attempts to estimate the deep personality factors operative and by their initial amelioration to cure the physical disorder. A hint as to the possible tie-up with psychic