Respiratory Diseases

When it comes to the lungs, everyone needs a healthy pair, for without air no one can live more than a few minutes. Of all the elements in nature, oxygen has to be most constantly supplied to the human system. With rare exceptions, more than 4-5 minutes without oxygen will result in irreversible damage to the brain and other vital organs.

For this reason, our bodies have been designed with a mechanism for constant exchange of air. Furthermore, the respiratory tract has been provided with marvelous safeguards to cleanse the membranes and prevent any entrance of infectious agents. The rapid growth of urban populations, as well as the use of tobacco, has produced a large number of respiratory diseases.

Still, most of the diseases of the respiratory system are of an infectious nature. In studies of mortality, the deaths due to pneumonia and tuberculosis have been replaced by an increasing number from lung cancer and emphysema. A few of the more common conditions will be dealt with below.

First, it is helpful to include a brief description of the proper mechanics of breathing. Correct posture is invaluable in allowing complete expansion of the lungs. It is proper to avoid tight-fitting garments, such as elastic bands about the chest and waist, all habitual stooping or a slumped sitting posture, all of which can prevent complete chest expansion.

The most efficient respiration utilizes the diaphragm. This is a large flat muscle that separates the chest from the abdominal cavity. Contraction of the diaphragm creates a vacuum within the chest, allowing entrance of air concurrent with the moderate protrusion of the abdomen. Sitting erect and standing with the shoulders back and the head up, together with a straightened position of the spine are all essential to deep, full diaphragmatic breathing.

The vital capacity is a measure of the greatest volume of air one can take into the lungs in a deep breath. Pulmonary function tests can also measure the timed vital capacity, which shows the degree of elasticity of the lungs, which is impaired early in the development of emphysema. Other breathing capacity measurements can be made and serve as predictors of the development of diseases such as asthma, emphysema, or other chronic conditions.

The examination of the chest and lungs, as well as brief comments on diagnostic x-rays are described in chapter one. Lung development just before birth coincides with the production of a detergent-like substance called surfactant. This is deficient in a premature baby and is one of the reasons why hyaline membrane disease may develop. Another enzyme that is usually present in the bronchial tubes is called alpha- 1antitrypsin.

Congenitally deficient in some people, this can lead to the development of early emphysema, particularly in smokers or people exposed occupationally to inhaled particles, such as asbestos or coal dust. A simply performed blood test can determine the existence of this hereditary enzyme deficiency. We turn now to consider some of the common diseases of the respiratory tract.

Emphysema

Pulmonary emphysema takes the lives of increasing numbers of people each year. Called chronic obstructive pulmonary disease, this condition develops insidiously in people exposed to heavy pollution of the airways. The commonest cause of emphysema today is tobacco smoking. Unfortunately, most individuals do not know that their disease has developed until it is too late to cure the condition.

The basic process involved in the development of emphysema first involves the destruction of elastic tissue in the bronchial tubes. Respiration becomes increasingly difficult. Then in later stages many tiny air sacs, called alveoli, lose their walls and coalesce, forming large air sacs or emphysematous blebs. The earliest symptom in developing emphysema is shortness of breath. This is commonly associated with exertion.

This exhibits disease risk with decreased ability to carry packages, climb stairs, walk rapidly, or engage in the usual sports. Advanced sufferers of emphysema may develop cyanosis, a bluish tinge around the mouth with a dusky appearance of the nail beds. This sign indicates advanced impairment of oxygen intake with a chronic deficiency in the blood.

There is abnormal shunting of blood across the lungs, with resultant deficient oxygenation. When chronic bronchitis or pneumonia are superimposed on the underlying condition, respiratory failure can develop. Heroic efforts are being made today in intensive care units to salvage individuals who would otherwise die in such a respiratory crisis.

Unfortunately, some hapless victims continue smoking after surviving an acute crisis. I have seen individuals who unfortunately were completely resistant to heroic educational efforts for improving their lifestyle and thus failed to avoid additional relapses. There is good news, however, for many people with mild to moderate emphysema.

Not all need to progress to the end stage, sitting beside an oxygen tank just to support life. Proper diaphragmatic breathing with learning to exhale forcefully through pursed lips constitutes a valuable way of retraining the respiratory muscles and improving the oxygen delivery to the blood and distant tissues.

Exercise programs with gradually increasing walking distance has, in my experience, enabled many patients again to return home, climbing stairs, mowing the lawn, working in the garden, or engaging in moderately active sports. It is certainly worthwhile to attempt rehabilitation of a patient with emphysema, at any stage. These efforts, in combination with a strict avoidance of tobacco and air pollution, will add quality to the life of many.

Pulmonary

Hygiene is also important. The individual with fragile or delicate lungs must avoid contact with people who have colds or other respiratory infections. For those producing large amounts of mucus, postural drainage treatment is a daily necessity. This can be done in the morning, usually after a few minutes of steam inhalation.

Bend over or lie with the head down, allowing gravity to help drain mucus from the chest. The side of a bed is a good place to do this drainage procedure. Calculated to drain the affected segments of the lung, these postural maneuvers are very effective. Clapping of the chest, inhalation therapy, and other specialized procedures may be prescribed by a physician to aid in the home care of the emphysema victim.

Pneumonia

Infection of the lungs is usually called pneumonia or pneumonitis. This results when harmful germs invade the upper respiratory tract and find their way down to the deeper bronchial tubes and alveoli. When the infection reaches the level of these air sacs (alveoli) pneumonia has developed. Sometimes the infection is very mild and may not even appear as a shadow on x-ray.

Coughing is the most common symptom. However, usually the individual will have fever and some shortness of breath also. Generalized chills, malaise, and apprehension appear frequently. Chest pain is of a pleuritic nature, involving the membrane lining of the lung. It is a sharp pain, well localized, and aggravated by breathing, coughing, or moving.

Usually pressure against the area, as well as moist heat is extremely useful in relieving the pain of pleurisy. Investigation should begin early to determine the cause of the pneumonia. The sputum can be cultured in the laboratory. If germs are present, a gram stain or bacteriologic culture will give the clue as to a cause.

Viral pneumonia usually shows a normal blood count with negative cultures, while bacterial pneumonia germs can frequently be cultured from the sputum. Unfortunately, the expectorating of cough material usually contaminates the culture with normal organisms resident in the mouth.

Doctors therefore attempt to aspirate the tracheal secretions, although this invasive procedure is not without hazards. The chest x-ray can be most helpful, as certain bacteria produce characteristic patterns in the lung. Alcoholics commonly develop pneumococcal pneumonia, while children are more likely seen with Hemophilus influenza or Staphylococcal organisms.

Individuals who are routinely taking broad-spectrum antibiotics may develop pneumonia caused by less common organisms such as Pseudomonas, Klebsiella, and Candida species. The latter is a fungus infection that is particularly difficult to treat and is often seen in those whose normal organisms have been artificially suppressed, or whose immune system was compromised by drugs such as Cortisone derivatives.

Even worse is the Pneumocystis carina pneumonia found in AIDS patients or HIV carriers. Once the diagnosis is established, specific treatment should be instituted promptly. Cooling measures can be used for high fevers. Pneumonia patients must be adequately hydrated. Usually this can be done by mouth. Water, fruit juices, and diluted soups are most helpful to maintain hydration.

These also enable the mucus to be thinned, making expectoration less difficult. Steam inhalation with a moist steam vaporizer is helpful to bring up the secretions. Eucalyptus oil or other inhalant additives can be used to enhance its value. Hot packs are extremely useful when applied to the chest in a manner similar to the general hydrotherapy approach.

These alternating hot and cold treatments may be repeated two to three times daily. In critical cases fomentations may be given more often for brief periods to enhance the circulation and clearing mechanism inherent in the lungs. Postural draining helps to clear secretions. A spare fruit and juice diet is advantageous in the early stages to enable the body to concentrate on attacking the invading germs and winning the battle for survival.

It is important to note that viral pneumonias are entirely unresponsive to antibiotics and most fungal infections respond poorly also. Because pneumonia is typically contagious, it should be diagnosed whenever possible and isolation measures instituted. Cough into a tissue and dispose of it immediately. That is usually sufficient to trap the expectorated germs and prevent contagion.

Adequate sunlight in the sick room helps to kill germs, as well as purify the air. Some fresh air should be circulating in the sick room, even if this means utilizing a little more heat. Cold drafts, however, should be kept away from the sick individual, as a chill may provoke a relapse more serious that the first infection. Persisting in these measures for many days can cure all but the most stubborn cases of pneumonia.

When complications such as advanced asthma, emphysema, or other chronic lung disease are superimposed on the underlying pneumonia, a physician should be consulted to perform the appropriate laboratory tests and supervise the treatment of any serious illnesses. It is so very rewarding to see these infectious diseases improve with the use of these simple treatments.

I have been impressed many times that patients treated naturally develop better resistance and more healthful, long-term consequences in their lungs that comparable cases where antibiotics and other drugs are used prematurely and without adequate consideration of the causes and abnormal physiologic mechanisms involved.

Tuberculosis

At one time a dread killer affecting most (80%) of the population, tuberculosis is thankfully less common, at least in the United States. Because of its profound influence on body metabolism, with a general wasting of flesh and muscles in the advanced states, this disease was early called consumption.

In spite of modern public health control with its improved sanitation, quarantine, x-ray screening, skin testing, and drug therapy, tuberculosis is still a problem in the United States and is a leading cause of death worldwide. Recent reports of resistant strains have caused renewed public health concern, especially in the ghettos and prisons of large cities.

The tuberculin skin test has become a very valuable screening test, demonstrating clear immune response to the tubercle bacillus after contact by a person. This does not imply that the condition is active. Many childhood infections heal with sufficient antibodies produced to prevent reinfection throughout the lifetime.

Circumstances, however, that cause an individual to lose the natural immune resistance may allow a tuberculosis carrier to become reinfected and contagious. Such habits as tobacco smoking and the occupational exposure to coal dust and other industrial pollutants produce a condition of lowered resistance in the lungs that makes active tuberculosis more likely.

Crowded living conditions may coexist with an infected carrier in the family. Exposure to contaminated air, as in hospitals, tuberculosis treatment centers, or large clinics in the underdeveloped nations where infected patients are frequently seen, carries with it a higher risk of contact and exposure.

The symptoms of tuberculosis are multiple. Most infections begin silently with a slight cough or fever, resembling a cold or flu-like illness. The presence of tuberculosis in the lungs, however, nearly always produces a cough. At time the erosion into a blood vessel may produce hemoptysis, the coughing of blood-streaked material, or actual pulmonary hemorrhage.

Lung abscesses can develop, while the residual germs multiply slowly in these pockets. Mucus is eliminated by coughing, thus cleansing the lungs of germs. Often the sputum is swallowed. Since tuberculous germs are quite resistant to acid, these may then pass into the intestinal tract and create infection there.

Formerly, in the United States a large amount of tuberculosis involved the small intestine, being acquired through the infection of contaminated milk. Modern pasteurization has eliminated most of this risk, but some intestinal tuberculosis is still seen. The organism can also involve the lymphatic organs or the bones. In less common cases nearly every vital organ can be infected.

Meningitis, kidney involvement, and draining sinuses from the skin can all be seen in advanced TB. It is important to recognize this illness as early as possible, since it is contagious. The use of prolonged moist heat over the lungs can aggravate tuberculosis. Cold compresses, on the other hand, can be much more helpful. Strict rest is necessary, while the body heals this invader.

No simple measure is more helpful in the treatment of tuberculosis than the liberal presence of sunlight. The tuberculosis germs are killed on contact with the ultraviolet rays. Even in widespread infections involving the bone, exposure to sunlight has been helpful in effecting a cure. Fresh air, proper diet, and public control measures of quarantine can also aid in the eradication of this difficult germ.

Many antituberculosis drugs are being used by health authorities. They certainly arrest the multiplication of germs so that recovery can be made possible. As with all drugs, these too have side effects, many of them serious. So the further exploration of natural approaches will be utilized to the utmost by those maximally interested in promoting comprehensive health.

Bronchitis

Inflammation of the bronchial tubes may be acute or chronic. A sudden onset of cough is frequently due to bronchitis. This is usually of viral or chemical origin. It affects the upper airways from the larynx down to the secondary divisions of the major bronchi. The cough is termed “brassy” and is usually not productive of mucus. Prolonged coughing can irritate the bronchial tubes enough to cause bleeding.

If hemoptysis occurs, further investigations should urgently be performed. With persistence of a bronchial cough, the upper chest may become sore, with pain on inspiration. There is seldom any fever or general symptoms. However, fatigue and sleeplessness may develop if the illness is prolonged.

Hot, moist compresses ordiathermy treatments over the upper chest are helpful. They work best when combined with expectorant cough syrups such as honey— eucalyptus and the use of steam inhalations. The earlier these treatments are started, the less severe the illness will be. Chronic bronchitis is common in smokers. It results from the accumulation of tar and numerous respiratory irritants over a prolonged period.

The typical “smoker’s cough” is an example of chronic bronchitis, which is typically productive of mucus. The sputum is usually white or gray, but at times may become infected. Then it would be thick, tenacious, and greenish or yellow in color. As in acute bronchitis, fever is seldom present. Many people “learn” to live with a cough when they could be healed, and live enjoyably without it. Strictly avoid all tobacco.

Then combine deep breathing exercises in combination with other pulmonary hygiene measures. The treatments mentioned under the treatment for pneumonia will bring considerable relief to bronchitis sufferers. The coexistence of emphysema naturally complicates the situation. However, with appropriate steam inhalation, postural drainage, and other hydrotherapeutic measures the bronchitis can usually be cleared without residual damage.

Bronchiectasis

A chronic condition of the lungs resulting from acute infection results in the disease called bronchiectasis. This involves the more distant bronchial tubes and consists of a tubular or saccular dilation of the terminal air channels. The copious production of mucus sputum, often pus-filled, may severely cripple a person’s efforts to speak in public, sing, or use the voice as formerly.

The above described pulmonary hygienic measures are helpful in both the control and treatment of this disease. Postural drainage, with manual clapping (percussion), are especially valuable. Many of these sufferers develop chronic changes which make long-term treatment mandatory. Lifelong adherence to a nonsmoking pattern, and a rural home location may be necessary.

Lung Cancer

The specific symptoms, signs, and diagnosis of lung cancer are well covered in Chapter 6 and will not be discussed at length here. Remember, however, that cigarette smoking still constitutes the largest single cause of this disease! Very little improvement has been seen in survival statistics over the past twenty years. In this largely preventable disease, the “ounce of prevention” is certainly appropriate.

Miscellaneous Conditions Which Mimic Lung Disease

Several diseases may affect the respiratory tract or cause symptoms in the chest. A hiatus hernia may mimic the pain of pleurisy or lead to expectoration of mucus. This occurs when the upper portion of the stomach protrudes into the chest cavity through a dilated portion of the diaphragm. Heavy meals, supine posture, tight garments, and obesity are predisposing factors to the symptoms of a hiatus hernia.

Characteristically called “heartburn,” these symptoms respond well to careful dietary measures, which will be described in detail elsewhere. Tracheobronchitis, also called croup, may be seen in children. It is often a source of deep concern to their parents. Considerable difficulty in breathing may occur, associated with an uncontrollable cough and the rapid development of fatigue.

Usually of viral origin, this croupy cough responds to the use of cold vapor, utilizing a humidifier. Moist steam packs on the chest are also helpful in rapidly restoring health to the irritated respiratory tract. Upper respiratory infections are frequently precursors to the lung diseases mentioned above and should be promptly treated to avoid complications.

Consult frequently the chapters on hydrotherapy and the specific discussion of these infectious diseases. This can aid in the home treatment of these annoying, but usually self-limited conditions. Furthermore, the prompt recognition of pulmonary complications in otherwise mild illnesses can be life saving when rational treatment is instituted in the home. Nature is thereby aided in her valiant efforts to combat disease and restore right conditions in the system.