Simply, asthma is difficulty in breathing, a choking caused by obstruction of the small bronchial tubes. The lungs become distended, breathing becomes labored, the chest swells, the neck muscles strain, the sufferer gasps and wheezes, and, generally, can’t lie down.
Suffering is often severe and may last for hours, days, and even weeks.
Asthma spells may be frequent and may even become continuous, but although the patient suffers much distress the condition is rarely fatal.
One of the most important results of asthma is mental suffering, with loss of initiative and confidence. This is often a serious problem in the normal development of children.
An asthmatic child may miss school, be deprived of playmates and group activities, may suffer behavior and personality disorders.
He may become unmanageable, irritable, hostile, dependent, or may go to the other extreme and become aggressive, demanding, bullying towards his parents and other children.
There are several kinds of asthma.
One fairly frequent type, mainly in older people, is linked with heart trouble. Many other cases are caused by bacterial or virus infections, principally those involving the sinuses, throat, and bronchi.
But by far the most common is the type produced by an allergy. This is a condition of sensitivity which certain persons may develop to substances ordinarily harmless to the rest of the population.
These substances may be taken into the body by being inhaled, swallowed, by skin contact, or by being injected.
All these sensitizing substances are called allergens and can produce allergic symptoms, although not all cause asthma.
Common allergens are pollens, molds, house dust, skin or hair shed by dogs, cats, horses, and other animals, insecticides, feathers, orris root, corn starch, gums used in cosmetics and hair lotions, kapok, dyes, perfumes, metals, and chemicals used in industry, and many more.
Nylon stockings are allergens to some women, and so is the nickel in suspender belts.
Then there are foods like eggs, milk, nuts, wheat, fish, chocolate, and drugs like antibiotics, hormones, serums, and the sting of wasps and bees. Even heat, cold, and sunlight can cause allergic symptoms.
Bakers may develop a sensitivity to flour, furriers to fur, tobacco workers to tobacco.
An undertaker developed painful dermatitis whenever he handled chrysanthemums in funeral wreaths. A bank teller developed a similar reaction to coins.
When an allergen is taken into the body of a person who is sensitive to it, the tiny cells in the tissue may produce special substances, called antibodies, which attack it.
These antibodies may not be produced immediately, but only after repeated exposure to the allergen, or after a very heavy exposure.
But once these antibodies have been developed in the individual’s system, further contact with the allergen produces irritation in particularly sensitive tissues like the nose, eyes, skin, bronchial tubes, digestive tract.
Why some people are allergic or sensitive to a particular substance that is harmless to others is a medical mystery, but heredity has a strong influence.
In a big percentage of cases the asthmatic patient has relatives with asthma or some other allergic disease, like hay fever or eczema.
The allergy may be in the parents or it may skip a generation and have been in the grandparents.
Many members of the family who have no asthmatic or allergic symptoms may have inherited the tendency, but until they become sensitized to some particular substance and then develop symptoms there will be no sign they are allergic.
The allergen which most commonly causes asthma is pollen, and generally this pollen is from grasses, especially rye, and some trees, which are a contributing factor in the US.
Next to pollen as a source of allergy are the spores or microscopic seeds of molds known to every housewife as the fungus growths on stale bread, cheese, and other foods.
Although some people react to mildew on damp walls, these homegrown molds are relatively unimportant as causes of allergy. But molds which grow out-of-doors, on grains and grasses and leaves and even in the soil, send their windblown spores over big areas.
People inhale the spores and become sensitive to them – just as they do to pollen.
The treatment of asthma is seldom dramatic and is often difficult, taxing the patience of doctors and parents alike.
The family doctor is often called upon in an emergency and often at night to give relief from an acute attack by injecting adrenaline. But a bottle of medicine or an injection of adrenaline is often only of temporary value.
The management of asthma may extend over the years. The doctor must probe into the problems of every case and find out all he can about the individual who has this disease. He may seek the help of a specialist in allergic diseases or refer the child to a special clinic for asthma cases for investigation and treatment.
Treatment may take the form of medicines or drugs. In selected cases, depending on the results of skin tests and the medical history, a course of desensitizing injections may be given.
The general advice is given about avoiding dust, fumes, or smoke. In the latter instances, it seems just as important to avoid worry, over-tiredness and mental upsets which will bring on an attack.
At times the child is helped by correcting some trouble in the nose or throat. The tonsils may have to be taken out or pus washed from one of the sinus cavities. Older children may be taught breathing exercises to improve the faulty methods of breathing and to bring about good chest expansion.
Unhappy home or school surroundings seem to play a big part in asthma in children. It is very natural for the parents to become over-anxious about the child, and this only increases the feeling of invalidism.
With systematic treatment, patience, and hope, the attacks may cease. The child seems to grow out of the disease. In other cases although the attacks persist they are fewer in number.