Asthma
This allergic disease of the respiratory system primarily affects the lungs. At the end of each tiny air tube that reaches the lung is the alveolus, where gas exchange occurs. Here oxygen enters the red blood cells to be exchanged for carbon dioxide, which is then exhaled. The bronchial tubes that form the large and small air passages have a smooth specialized muscle in them that constricts under certain conditions. In contrast, with the smooth muscle of the artery walls, these bronchial muscles dilate in response to adrenalin and constrict in the presence of histamine as well as other chemical mediators of allergies. A condition described as bronchial asthma occurs when there is spasm of the bronchial tubes, leading to obstruction in the airway. Usually there is also excess mucus accumulation and thickening of the mucus’s making it more tenacious and difficult to clear.
The asthmatic patient, then, primarily has an air hunger, with musical wheezes in the lung. These can be heard easily with a stethoscope over the chest and in more severe asthmatic crises becomes audible to the unaided ear.
A number of conditions can produce these symptoms. There are certain drugs that can create an allergic reaction, as well as many industrial inhalants that irritate the lungs. A few people react to food allergies with the production of asthma’s though this is less common. Most frequently, the asthmatic sufferer reacts to inhaled particles in the air, called allergens, which may be of a biologic nature or inanimate particles. House dust is an example of the latter. Danders from cats, dogs, horses, feathers, or down also can produce wheezing.
Commonly seen in the spring, summer, and fall are allergies to various inhaled pollens. Although some people primarily suffer from hay fever (discussed below), others are affected in their lungs. The inhalation of pollens, such as those from pine trees in the spring, wildflowers in the summertime, ragweed or goldenrod in the fall, may produce characteristic responses. These are related to the number of particles inhaled and the efficiency of the nasal filtering mechanism.
Emotions can also trigger allergies. I remember vividly the experience of a teenage girl who suffered a violent asthma attack in a hospital when she remembered with nostalgia her dear pet cat at home alone! Moreover, numerous infections in the lung are seen in conjunction with asthma. These are usually termed asthmatic bronchitis. Frequently seen in childhood, they are often associated with an upper respiratory infection.
Treatment
A physiologic approach to asthma then involves several factors. The secretions should be thinned with a copious fluid intake’s preferably by the oral route. Inhalations of cool moist air can often help in the clearing of secretions and the thinning of this very sticky mucous material. Gentle coughing assists in expelling of the mucous plugs, but this should be done in combination with the inhalation of humidified cool air. The use of a stem vaporizer is to be discouraged, as this often adds to the swelling and edema formation in the bronchial tubes.
Hydrotherapy is important in the treatment of asthma. Often the adrenal glands can be stimulated early in the disease by a quick ice rub to the spine in the upper back, associated with brisk tapping (percussion) over the adrenal area. This stimulation of the sympathetic nervous system results in the discharge of enough adrenalin to counteract the acute effects in beginning stages, as well as induce dilation of the bronchial tubes.
Prolonged hot packs to the chest can sometimes be effective in relaxing both the respiratory muscles and the patient’s s nerves. This must be repeated several times, and will often abort the acute asthmatic attack and eliminate the need for medication. Inhalation therapy with the use of bronchial dilators and theophylline derivatives are often used in a hospital setting. Sometimes mullein tea or other teas containing theophylline can be used with some effectiveness to further aid in combating the bronchial spasm. As in any disease, a thorough attempt to discover the cause’s then as far as possible eliminate it’s will reward the asthmatic sufferer with an increase of comfort and removal of those conditions that progresses in the advanced case too often leading to emphysema.
