Asthma - Reversible Obstruction

What is Asthma?

In contrast to our predecessors who could not treat asthma effectively, you and your child or relative who is an asthmatic patient can be treated effectively by modern medicine. The history of medicine is as old as the history of mankind. Symptoms such as coughing and wheezing (bronchi) and breathlessness are mentioned in historical scripts long before the famous Greek Doctor Hippocrates first used the term "asthma". This term has now been used for 2500 years and the medical definition has also changed very little. Hippocrates described asthma as characteristic attacks of breathlessness followed by periods during which the patient is free of symptoms. 
 

Only one sight change needs to be made in this definition today. We now know that breathlessness is caused by an obstruction of the respiratory path. The medical definition is the following : "Asthma is a reversible obstruction of the pulmonary airways with typical asthma attacks following intervals which are almost completely free of symptoms".

In recent years, the definition of asthma which had been left unchanged since antiquity has become controversial. Most asthmatic patients have hypersensitive bronchial systems which react to seemingly innocuous stimuli with spasms. International attempts have been made to base the definition of asthma on this hypersensitive nature of the bronchial system. Other researchers have a more narrow definition in mind and qualify only diseases related to allergy with the term asthma. I am certain that neither one of these extreme definitions will become standard because the former is so broad that all persons who are susceptible to develop asthma are included, whereas the later one is so narrow that only a small number of asthmatic patients would be included.

Let us permit Hippocrates definition to prevail for a while longer: anyone who suffers from attacks of coughing of breathlessness associated with bronchi or wheezing noises, particularly when exhaling, has asthma. For a long time, bronchial asthma was differentiated from cardiac asthma. The term bronchial asthma is no longer used, since all types of asthma are bronchial to some degree. Unlike bronchial asthmatics, cardiac 
asthmatic patients lend to suffer from breathlessness at night but do not develop the characteristic wheezing when exhaling. Anyone with these symptoms should consult a physician. Sometimes a doctor may find it difficult to differentiate between the two. 

The Greek Physician Galen, who lived 500 years after Hippocrates was the first to speculate on the causes of asthma. He believed that viscous mucus membrane flows into the bronchi from the brain and obstructs its lumen. Only the last few words of this phrase are correct. Galen was not completely wrong because psychological factors which may play a role in asthma originate in the brain. There is a distinct modern trend to attribute the cause of asthma to psychological factors. 

Although I will discuss this matter in more detail further on, I simply wish to reassure the asthmatic patient at this point : asthma is not a purely psychosomatic disease. The asthmatic patient will find evidence in his experience and in this book that psychological factors can influence the asthma both positively and negatively but are not causes of the disease.    More About Asthma