Asthma (cont.)
What is asthma?
Asthma is a chronic inflammation of the bronchial tubes (airways) that causes
swelling and narrowing (constriction) of the airways. The result is difficulty
breathing. The bronchial narrowing is usually either totally or at least
partially reversible with treatments.
Bronchial tubes that are chronically inflamed may become overly sensitive to
allergens (specific triggers) or irritants (nonspecific triggers). The airways
may become "twitchy" and remain in a state of heightened sensitivity. This
is called "bronchial hyperreactivity" (BHR). It is likely that there is a
spectrum of bronchial hyperreactivity in all individuals. However, it is clear
that asthmatics and allergic individuals (without apparent asthma) have a
greater degree of bronchial hyperreactivity than nonasthmatic and nonallergic
people. In sensitive individuals, the bronchial tubes are more likely to swell
and constrict when exposed to triggers such as allergens, tobacco smoke, or
exercise. Amongst asthmatics, some may have mild BHR and no symptoms while
others may have severe BHR and chronic symptoms.
Asthma affects people differently. Each individual is unique in their degree
of reactivity to environmental triggers. This naturally influences the type and
dose of medication prescribed, which may vary from one individual to another.
From the past to the present
Physicians in ancient Greece used the word asthma to describe
breathlessness or gasping. They believed that asthma was derived from internal
imbalances, which could be restored by healthy diet, plant and animal remedies,
or lifestyle changes.
Allergy jargon
Asthma is derived from the Greek word Panos, meaning panting.
Chinese healers understood that xiao-chiran, or "wheezy breathing," was
a sign of imbalance in the life force they called qi. They restored
qi by means of herbs, acupuncture, massage, diet, and exercise.
The Hindu philosophers connected the soul and breath as part of the mind,
body, and spirit connection. Yoga uses control of breathing to enhance
meditation. Indian physicians taught these breathing techniques to help manage
asthma.
Allergy fact
Maimonides was a renowned 12th-century rabbi and physician who practiced
in the court of the sultan of Egypt. He recommended to one of the Royal Princes
with asthma that he eat, drink, and sleep less. He also advised that he engage
in less sexual activity, avoid the polluted city environment, and eat a specific
remedy...chicken soup.
The balance of the "four humors," which was derived from the Greco-Roman
times, influenced European medicine until the middle of the 18th century.
In a healthy person, the four humors, or bodily fluids -- blood, black bile,
yellow bile, and phlegm -- were in balance. An excess of one of these humors
determined what kinds of disorders were present. Asthmatics who were noted for
their coughing, congestion, and excess mucus (phlegm) production were therefore
regarded as "phlegmatic."
By the 1800s, aided by the invention of the stethoscope, physicians began
to recognize asthma as a specific disease. However, patients still requested the
traditional treatments of the day, such as bloodletting, herbs, and smoking
tobacco. These methods were used for a variety of conditions, including asthma.
Of the many remedies that were advertised for asthma throughout the 19th
century, none were particularly helpful.
Allergy fact
As early as 1892, the famous Canadian-American physician Sir William Osler
suggested that inflammation played an important role in asthma.
Bronchial dilators first appeared in the 1930s and were improved in the
1950s. Shortly thereafter, corticosteroid drugs that treated inflammation
appeared and have become the mainstay of therapy used today.
Next: The scope of the problem »
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