Asthma affects approximately 10 per cent of our children and 5 per cent of our adults. A very large number of people indeed! The incidence of asthma appears to be on the increase globally for reasons not clearly known. Many of the people need daily medication and quite a number of them consult medical practitioners and specialists regularly.
An array of pharmaceutical products and gadgets to deliver drugs has been invented and marketed by the industry, which at best can only control the disease. Despite all these, the fact that there is no definite cure for this age-old malady remains true even today.
Those who have taken a special interest in asthma believe that the best way to control this disorder is to educate the patients to handle their own disability and teach them how to use the various therapeutic modalities available to their best advantage and when to seek medical help. Successful realisation of this objective de-pends upon many factors. Doctors must have a clear understanding of asthma, and the indications, properties and side effects of all forms of treatment in use. They must be prepared to part with their knowledge and willing to educate their patients. Patients on their part must be willing to learn and be prepared to handle their disease intelligently and correctly. They should understand the enormous value of preventive measures and be prepared to be disciplined and not be negligent.
Originally (in 1982) this book was written mainly for the benefit of patients, graduate students, general practitioners and those who have an interest in the field of asthmology. Since then large amounts of scientific and experimental data have accumulated regarding the pathogenesis and management of asthma. This necessitated a complete overhauling of the text. Hence, this new edition. I have deliberately avoided an authoritarian approach although I have not flinched from introducing my own data and prejudices wherever I thought it helpful to the patients. If this book helps the reader to understand asthma and helps asthmatics to live normal lives without becoming doctor-dependent, it will have amply served its purpose.
Originally this book was written at the behest of my revered friend, the late Shri Krishna Kripalani. Prof. Ian Gregg (Cardiothoracic Institute, Brompton, London) went through the manuscript when he visited India and gave me valuable guidance. I am thankful to Dr R.A.L. Brewis (former editor of the journal, Thorax) who gave me an insight into the guidelines for the management of asthma prepared by him for the Global Initiative for Asthma (NHLBI/WHO). I remain thankful to the publishers, National Book Trust, India, for their support, specially to Ms Manju Gupta, who goaded me to revise the text.
This book is dedicated to my ailing wife, Chhaya, who even from her sickbed incessantly reminded me to read and write. She helped in preparing the manuscript of the first edition in 1981 and she remains the main source of my inspiration.
I am thankful to my son, Dr Balakrishnan Menon, for checking the manuscript, page-setting and computer-processing the script.
I have been a periodic victim of asthma for some years. During a recent prolonged attack, a friend advised me to consult Dr M.P.S. Menon of the Patel Chest Institute, Delhi. Since then, not only my asthma is under control, but my dread of it has disappeared.
There are thousands of others who, like me, are chronic sufferers of this ailment which is indeed an enigma. For, though its symptoms are obvious, its causes are hard to understand. Unlike me, these sufferers are not always fortunate in getting the advice and attention of the right physician. I was therefore glad when I learnt that Dr Menon has written a small book on the subject, to share his vast knowledge of this ailment with them and with the general practitioner who is normally called upon to treat this ailment, but who has no opportunity to study its vagaries in depth. In any case, as the author has point-ed out, no physician can know everything about an ailment, and a successful treatment is possible only when the patient and physician cooperate and the patient is helped to help himself.
Unlike many specialists, Dr Menon knows how little he knows, which is why one cannot help believing that he in fact knows much. In the very beginning of the book he quotes a Tamil saying which warns that what one knows is no more than a handful, but what one does not know is the whole world. This is the beginning and end of human wisdom.
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