Dyspnea Cat And Horse Asthma

There is a class of cases of difficulty of breathing allied to asthma

and often called by that name, the study of which throws light on the

origin and the relief of neurotic asthma. These cases are usually

accompanied by such a sense of oppression on the chest that breathing

becomes labored and, to some extent at least, the accessory

muscles of respiration have to be called into play. The most typical

cases are connec
ed with the mental influence produced by the presence

of some particular animal, the cat being the most frequent and the

horse not rare, or with emanations from these animals, when there

seems to be some physical nexus between the animal and the symptoms.

Cat Asthma.--The symptoms associated with cats are rather common, and

they occur at the sight or touch of the animal, but may be the result

only of its presence which in some way the patient is able to

recognize without sight of him. Shakespeare's expressions in a number

of places, such as "I could endure anything before but a cat" and

"some that are mad if they behold but a cat," shows that the affection

was commonly recognized at that time and that the reason for it was

considered unknowable, for Shakespeare says, "There is no firm reason

to be rendered why he cannot abide ... a harmless necessary cat."

Dr. Byron Bramwell in his "Clinical Studies," Vol. I, page 107, has an

interesting paragraph with regard to these curious asthmatic

conditions which develop in the presence of animals of various kinds.

He sums up many of the curious features of this affection as reported

by various good observers. Many more people than we would be apt to

think are affected by it. He says:

In some persons the smell of a horse or of a cat produces an attack

of asthma. Some years ago I repeatedly saw a young gentleman who

invariably had an attack of asthma if he went near a stable or a

horse. He was so susceptible that he was unable to drive in a cab or

a carriage; when traveling from place to place, while sending his

traps from the station to the hotel in a cab, he himself was obliged

to walk.

Dr. Goodhart mentions a similar instance which occurred in the

practice of Prof. Clifford Allbutt. Dr. Goodhart also mentions a

remarkable case of "cat asthma":

I have known of two cases of cat asthma. In one of them the

existence of cats is the bane of life, for before accepting an

invitation she is obliged first to ask, "Is there a cat?"

[Footnote 32] An attack of urticaria and coryza followed by asthma

has been noticed to come on within ten minutes of having stroked a

cat. At other times, sitting in a room in which there was a cat,

without any actual contact with it, was sufficient to produce a bad

attack, beginning within ten minutes of entering the room.

[Footnote 32: A case of this kind came under observation as this

book was nearly ready for the press. The patient, a young woman in

an office, had to refuse a vacation with a wealthy friend in

Florida, because she knew that friend could not be separated from

her pet cats, five in number, and the patient would have been

intensely miserable were she near them, so that even the joys of

Florida in the winter did not make up for the constant,

intolerable discomfort they would have caused her.]

There are two forms of this intolerance of a cat. One of them takes on

the character of a dread and is discussed in the chapter on Dreads.

The other is accompanied by dyspnea or asthma with a sense of

discomfort and tightness of the chest that cannot be overcome. It is

not merely an imagination, for sometimes even when they cannot see the

cat, or at times when friends have been careful to exclude cats from

the room, these people become impressed with the idea that a cat is

near and a search usually shows that their impression is true, though

just what was the means through which they came to know it is

difficult to understand.

Dr. Weir Mitchell's review of the subject of "Cat Asthma and Allied

Conditions" in a paper read before the Association of American

Physicians brought out many curious details. There is no doubt about

the power to recognize the presence of the unseen cat. Besides the

respiratory oppression, some patients develop urticarial lesions and

occasionally even conjunctivitis and a catarrhal condition of the

nasal mucous membrane. These seem to be due to the direct irritant

effect of animal emanations. As the symptoms of rose cold or hay fever

have sometimes developed after the sight of an artificial rose, or

even, it it said, the picture of a hay field, so, in some of these

cases, the sight of a picture of a cat has produced at least some of

these symptoms. Probably the most interesting feature of the affection

is that the large cats, the tiger and the lion, do not have any effect

on the patient. There seems to be no doubt, then, that the mind plays

an important role in the matter and that relief must be secured

through mental influence.

In some of these cases a careful searching of the past of the patient

will show that there has been some terrifying incident connected with

the cat. In one case in my own experience the patient's earliest

recollection, and the first time that death was brought home to her,

was when a favorite bird was killed by a cat. Ever after that she had

a horror of the animals, the family cat had to be disposed of, and her

family never had another. She used to suffer from a severe dyspnea at

the sight of a cat and was sure that she could recognize its presence

without having seen it. She mentioned a number of occasions on which

that had been true. The very idea of living where a cat could come

near her was appalling. She was sure that she was even waked by the

mere propinquity of a cat if by any chance one got into her room at

night, though without any noise.

A change in her material circumstances compelled her to teach in

private families. Under these circumstances her cat detestation made

difficulties for her. I suggested, since she had had no feeling toward

cats before the bird incident, that probably her symptoms were due to

suggestion and an acquired habit of mind and that she might by

discipline overcome them. She was sure that would be impossible. With

determined effort, however, and practice in withstanding her feelings

in the presence of cats she finally learned to overcome practically

all of her feelings so that though it still requires an effort she can

even pick up a cat and stroke it. I have had several other patients

with less marked forms of the affection who have by self-discipline

overcome their feelings to a great degree. It is always well to search

the past of these patients in order to find out whether there may not

be a dominant idea derived from some unfortunate experience, which

acts as an auto-suggestion in the production of their symptoms of

constriction of the chest and sometimes even the recurrence of the

swelling of the mucous membrane of the nose that produces difficulty

of breathing. Whenever this can be found, contrary suggestion can be

given and the patients can be persuaded to try, by frequently repeated

auto-suggestion, to relieve themselves of the trouble.

Occasionally these curious manifestations of a catarrhal or asthmatic

character in the presence of cats occur in people who like cats. Dr.

Taylor in his "Types of Habit Neuro-Psychoses" published in the

Proceedings of the Massachusetts Medical Society, 1896-98, tells the

story of a young woman in whom he saw conjunctivitis developing while

she was fondling a cat. In many cases besides the hyperemia of

the nose and of the respiratory mucous membrane generally there is

marked injections of the ocular conjunctiva. It is rather difficult to

understand the phenomena of asthmatic attacks in connection with cats

and other animals in terms of a habit formed, because at some time

asthmatic or hyperemic manifestations occurred in association with the

handling of these animals and that then, somehow, suggestion works to

reproduce the same symptoms in the presence of the animals later; but

this is undoubtedly the only rational explanation that we have for

many of these cases. It represents the most helpful explanation, so

far as treatment is concerned, for by means of suggestion either in

the waking state or in the first stage of hypnosis, in many cases

relief can be brought to these patients. Repeated profound hypnotism

is a vaunted remedy for these conditions in the hands of professional

hypnotists, but serious physicians who have tried hypnotism do not

recommend it. It helps for a time but relapse follows. Only continued

suggestion and a carefully cultivated habit of self-discipline and

control succeed.

Horse Asthma.--The cases of dyspnea in connection with horses are not

less interesting. Occasionally, even when all aversion is absent,

emanations from horses are capable of producing a curious effect on

certain individuals. How much of this is psychic is not clear. I was

once consulted with regard to a patient who suffered from asthma

whenever she went to a dance. It mattered not how careful she was in

not exposing herself to night air, or in wrapping herself up warmly;

invariably a few hours after her return home, she was wakened from

sound sleep by an attack of difficult breathing that required the

opening of windows and the use of the accessory muscles of respiration

in order to satisfy her air hunger, and even then her symptoms were

quite alarming to herself and her friends. At first, her asthma was

thought to be due to sudden changes of temperature in going out into

the air after the dancing, and various devices were tried to lessen

the shock of the cold to the respiratory mucous membrane. None of them

had any effect. Then it was thought that the dust of the ball-room

made the difference and so she was forbidden to dance. After a time it

was found, however, that if she went out in the evenings to social

functions, whether she danced or not, or though she avoided completely

being in dusty rooms or where many people were moving, she still had

the attacks a few hours after she returned home.

Finally it was noted that these attacks of asthma also occurred on

several occasions after she had been out riding during the day in a

carriage. Then one evening after a rather long intermission free from

attacks, in spite of directions and her fears, she went to a ball, but

owing to circumstances went and returned by trolley instead of, as

usual, in the family carriage. That night she had no attack of asthma.

Experiments were made then and it was found that whenever she rode

behind horses she suffered from an attack of asthma during the

following night. The attack was evidently not due to suggestion. The

story illustrates the necessity for carefully analyzing all the

circumstances of an asthma patient and making sure that some one of

these curious and unusual conditions are not at work, for if they are,

the only possible curative treatment is by influencing the patient's

mind, first by demonstrating the cause of the affection and then by

training in self-control to reduce the reaction.

Recently I have been consulted with regard to a physician who has

developed in a rather curious manner a sensitiveness to the presence

of horses. As an interne at a hospital during an epidemic of

diphtheria he took a dose of diphtheria antitoxin for immunizing

purposes. The amount injected was 750 units, the remainder of the dose

of 1,500 units contained in the phial being given to the nurse who had

charge of the cases. She suffered absolutely no ill effects, so that

the manifestations in his case were entirely due to idiosyncrasy and

not to anything in the serum itself. Within fifteen minutes after

taking the injection the mucous membrane of his nose became so

congested as to make it impossible for him to breathe through his

nostrils and the mucous membrane of his soft palate was seriously

disturbed in the same way. His face became much swollen, the edema

affecting particularly his eyelids and his lips and hundreds of wheals

appeared all over the body. Fortunately the edema did not affect the

larynx, or the issue might have been fatal, or would surely have

required intubation. His pulse became extremely rapid and weak, there

was marked dyspnea, and whenever the patient sat up there was fainting

or a distinct tendency to it.

Under active stimulation and elimination the symptoms rapidly passed

off so that the only noticeable edema the next morning was in the

eyelids and lips, which, however, also disappeared within twenty-four

hours. Up to this time the physician had never been bothered by any

tendency to hay fever or to asthma and there is no history of either

of these affections in his family. Thereafter, however, though quite

without his anticipating it, and, indeed, the first symptoms were

incomprehensible, he became extremely sensitive to emanations from

horses. When he rides behind a horse for some distance his

conjunctivae become injected, the nostrils become congested and

difficulty of breathing sets in with a sense of constriction of the

chest. These subside as soon as he gets away from the presence of the

horse and has washed himself thoroughly. He suggests that he has

become sensitized to horse serum and, as it did not exist before his

experience with diphtheria serum, he, of course, connects that

incident with the present tendency. It is easy for such a case to have

its real significance entirely missed and, of course, treatment by

prophylaxis, the most efficient form, would then be out of the


Other Forms.--Apparently at times human emanations or some peculiarity

of odor seems to influence asthmatic conditions. I have been told by a

good observer--a physician--of two brothers who had an attack of

asthma whenever they visited each other. At first this was attributed

to something in the air or some other condition of the visit. After a

time it was found to occur under varying circumstances, but that the

one essential was the association with each other.

Treatment.--The more one knows about asthmatic conditions the more

does it become clear that special study of individual cases is

extremely important for any definite knowledge of the causation in a

particular case. Without a knowledge of the cause the treatment is

very unsatisfactory and in the meantime the unfavorable suggestion of

the recurrence of the attacks acting upon the patient sometimes

disturbs the general health. To remove this unfavorable influence must

be the first care of the physician and then if the real cause can be

found, favorable suggestion and modifications of the mode of life,

with self-discipline and control of the mental attitude and of the

nervous system, may greatly aid in the reduction not only of the

number of attacks and of the severity of the symptoms, but finally

lead to complete eradication of the affection.

Mental control to some degree can be obtained and it has even been

suggested that if the emanations from an animal cause physical

symptoms, gradually increased dosage of them, beginning with very

small amounts, that is, short periods of association with the animals

in question, may gradually lead to the production of an immunity to

them as it does even to the much more serious results of snake poison.

Certainly some patients seem to have succeeded in bringing relief to

themselves by this means and it is worth while remembering in the

therapy of the affection, if for no other reason than the strong

suggestion that goes with it.