How to differentiate cardiac asthma from other asthmatic seizures and what treatment to use

Prof. I. Donath (Dio Arztrliche Praxis, No. 5, 1929. Medizinisches Seminar) notes cases of the possibility of an easy delimitation of cardiac or pulmonary asthma from other types of suffocation, and at the same time cases where it is very difficult to make such a delimitation, as, for example, in old people-emphysematics with chronic bronchitis and a weak heart who have shortness of breath as a result of both heart and lung disease. In these latter cases, anti-broncho-asthmatic agents (astmolysin, lysostmin, belladonna and iodine) are successfully used simultaneously with cardiac ones. For pure cardiac asthma, morphine and its derivatives remain the best remedy. Since in some cases it is impossible to establish the absence of a pulmonary component in the etiology of this asthma, and morphine is contraindicated in pure pulmonary asthma, morphine should always be given in combination with caffeine or cardiazole. In many cases, seizures are stopped by injections of pituitrin, pituisan or pituglandol in an amount of 0.5 to 1.0 cm3, as well as nitrites, theobromine, and teominal. Cases of cardiac asthma, leading to symptoms of heart failure and pulmonary edema, are subject to cardiodiuretic therapy, and the best and fastest way is intravenous administration of digipurate in combination with aminophylline or salirgan.