DISEASES OF THE RESPIRATORY SYSTEM

The pneumonias and tuberculosis are spoken of above.

Common Colds.

It has recently been shown that these are initiated by an especial cultivable filtrable virus that is
demonstrable in the secretions of the upper respiratory tract; though, after the initial infection has
occurred bacterial infections that increase the severity of the cold and are responsible for complications
may be superimposed. Chilling of the whole body, or of parts of the body, predisposes to the infection, as
does living in dry overheated rooms.
In the treatment of the uncomplicated common cold, a hot bath, immediate rest in bed for one or two
days, and hot drinks are of more benefit than anything else. Medicinal treatment by mouth is also used.
Intranasal treatments, much resorted to, are better avoided, though the cautious inhalation of vapor
produced by a mixture of compound tincture of benzoin and boiling water will have a local soothing
effect.
In persons subject to recurrent colds, the paranasal sinuses should be suspected, as well as infected
adenoids or tonsils. After local infections have been overcome, the so-called 'cold vaccine,' consisting of a
sterilized mixture of the several bacteria most commonly met with in infections of the upper respiratory
tract, may be used in prevention. Though comparative control tests give but little if any experimental
evidence of the value of such vaccines, clinical experience of persons subject to recurrent colds and
bronchitis who appear to have been markedly benefited by the use of such vaccines would seem to
outweigh the negative experimental evidence.
Some believe that unsaturated fatty acids (chiefly linoleic and linolenic acids) in the form of so-called
'vitamin F,' for seven weeks, are effective in the prevention of colds.

Influenza.

This disease, formerly thought to be due to the Bacillus influenzae (Hemophilus influenzae), has since
1933 been known to be initiated by an especial filtrable virus that differs from the virus that initiates the
common cold in that it is pathogenic for ferrets. That the Haemophilus influenzae acts synergistically with
the virus to increase the severity of the infection and to cause complications seems probable. Attempts to
prepare a satisfactory immunizing agent against this virus have thus far been unsuccessful, though
persons vaccinated with a mouse-strain of influenza virus develop some immune substances in their sera
and seem to acquire increased resistance to influenzal infection. Ferrets receiving repeated inoculations of
influenza virus develop a cell-resistance to infection in the mucous membranes of the nose. The virus of
common colds can be cultivated under arobic conditions, whereas that of influenza requires anarobic
conditions.

Bronchial Asthma.

Though most patients can be satisfactorily relieved by protection from substances to which they are
allergic (or by desensitization to specific allergens) and by the use of injections of epinephrine or
ephedrine in attacks, the use of so-called 'slow adrenalin' (epinephrine dissolved in defatted peanut oil,
1:500) yields a prolonged effect.
A few exhibit constant and intense dyspnea, not relieved by these methods. In such persistent and
intractable asthmatic paroxysms, avertin with amylene hydrate, cautiously administered per rectum, will
make the patient sleep for from one to six hours, after which he may remain free from asthma for days or
even weeks.
Respiratory Distress Syndrome
Acute respiratory distress syndrome is one of two human diseases caused by hantavirus. Dust containing
virus-infected rodent feces becomes airborne and is inhaled. The virus embeds in the lungs where the
infection begins. Flulike symptoms appear in about a week, followed by the collection of fluid and white
blood cells in the lungs, causing respiratory failure, then death.

Altitude Sickness or Mountain Sickness, condition caused by reduced oxygen pressure at high altitudes,
occurring in hikers as a consequence of relatively rapid ascent to high altitudes. Altitude sickness
comprises a range of conditions, the most common being acute mountain sickness, which may be
followed by two more critical conditions: high-altitude pulmonary edema or high-altitude cerebral edema.

Common Cold, acute infectious disease of the upper respiratory tract, caused by more than 200 kinds of
viruses. The common cold is the primary cause of absenteeism in schools and the workplace. According
to the National Institutes of Health, American children have six to ten colds a year on average, while
adults average two to four colds annually. Children probably have so many because they spend time in
close contact in schools and daycare centers, making it easy for the virus to spread.

Croup, disease of the respiratory tract characterized by a harsh, barking cough and difficulty in breathing.
Recurrent croup may be due to allergy; usually each episode clears spontaneously. Croup with sudden
onset may be due to infection of the epiglottis by bacteria. This condition, called epiglottitis, occurs most
often in children of age two to five years and must be treated by a physician. Croup may also be caused
by virus infection of the lower part of the trachea. This illness is often preceded by signs of respiratory
infection and more often occurs between the ages of six months and three years. Usually viral croup will
respond to inhalation of warm, moist air. A crouplike cough may also signal the presence of a foreign
body in the airway.

Cystic Fibrosis, incurable hereditary disorder that causes the body to secrete an abnormally thick, sticky
mucus that clogs the pancreas and the lungs, leading to problems with breathing and digestion, infection,
and ultimately, death. Three decades ago most babies born with cystic fibrosis died in early childhood,
but advances in diagnosing and treating the disease have significantly improved its prognosis. Today
more than 60 percent of babies born with cystic fibrosis reach adulthood, and further advances,
particularly in the field of gene therapy, may produce even better treatments in the coming years.

Diphtheria, an acute and highly infectious disease, affecting children particularly, characterized by the
formation of a false membrane in the passages of the upper respiratory system. The cause of the disease is
Corynebacterium diphtheria, a bacillus discovered in 1883.

The diphtheria bacilli enter the body through the mouth and nose and attack the mucous membranes,
where they multiply and secrete a powerful toxin. The toxin damages the heart and central nervous
system, and can lead to death. Beginning about five days after exposure to diphtheria, a gray-white
exudate is formed where the bacteria attack the walls of the nose and throat. This exudate increases in size
and thickness, becoming a grayish false membrane, and it may block the air passages. Surgery may be
necessary to prevent asphyxiation
Silicosis, chronic disease of the lungs caused by prolonged inhalation of silica dust (see Silicon). It affects
persons employed in mining, stone cutting, metal grinding, and similar industries. See Occupational and
Environmental Diseases.

Sinusitis, inflammation of the mucous membranes of the paranasal sinuses located around the nose.
Normally the sinuses are filled with air and, communicating with the nasal cavity, produce more than 500
ml (more than 17 fl oz) of fluid secretions per day from the mucous membrane that lines them. The
paranasal sinuses include the frontal sinuses, in the forehead; the ethmoid sinuses, between the nose and
eyes; the sphenoid sinuses, behind the eyes; and the maxillary sinuses, under the eye sockets.

Evidence suggests that about 0.5 percent of common colds progress to sinusitis. Infection can also occur
if contaminated water is introduced into the sinuses; for example, when swimming in ponds or rivers.
Infections of the sinuses may be caused by bacteria or a virus, and one or more sinuses may become
infected. The infection causes the lining of the sinus to swell. This swelling traps the secretions, which
leads to increased bacteria in the mucus.

Suffocation, impairment of breathing, resulting in a lack of oxygen and a buildup of carbon dioxide and
other waste products in the blood and body tissues. Suffocation results from an obstruction in the air
passages to the lungs, which may be caused either by a foreign object or by swelling of tissues in and
around the throat. Suffocation also occurs when the air breathed contains too little oxygen. Drowning,
severe pneumonia, and congestive heart failure create excess fluid in the lungs, causing the lungs to stop
functioning. Prolonged suffocation from any cause leads to death.

Allergy, exaggerated and sometimes harmful reactions to external substances, called allergens. Allergy
may result from exposure to such common allergens as plant pollens from grasses, trees, or ragweed;
animal danders, which are tiny scales shed from the skin and hair of cats and other furred animals;
arachnids and insects, such as house dust mites, bees, and wasps; and drugs, such as penicillin. The most
common food allergies are caused by crustacean shellfish, eggs, fish, milk, peanuts, soybeans, tree nuts,
and wheat. Researchers estimate that at least 24 million people in the United States suffer from
allergiesabout 19 percent of the population.

Anthrax, disease of warm-blooded animals, including humans, caused by the bacterium Bacillus
anthracis. Anthrax most commonly occurs in cattle and other plant-eating mammals, but it can also affect
humans who come in contact with infected animals. The disease is not considered contagious, however,
and person-to-person spread of the disease is highly unlikely. Vaccines can protect against anthrax, and
antibiotics can treat the disease in its early stages.

Anthrax is a spore-forming bacterium. The spores have protective coats and can withstand extreme heat,
drought, and other harsh conditions. They can live for centuries in soil. Anthrax spores also have the
potential for use in biological warfare because of their ability to survive and because they spread easily in
air and can be inhaled. Once the spores are inside the lungs, the bacteria develop and begin to multiply
(see Chemical and Biological Warfare).

Apnea, cessation of breathing. Periods of apnea in which breathing ceases for a few seconds before
resuming may occur during sleep. When apnea alternates with periods of rapid, heavy breathing
(hyperapnea), such cycles are called Cheyne-Stokes respiration; they may be due to lack of oxygen in the
brain, accumulation of acid in the blood, increased pressure on the brain stem, or heart failure. Apnea may
be associated with such harmful conditions as irregularities in heartbeat, high blood pressure, and
decreased contractile force of the heart muscle. It has also been linked to some cases of sudden infant
death syndrome (SIDS).

Sleep apnea may be due to obstruction of the airway (obstructive sleep apnea), to some abnormality in the
part of the brain that controls respiration (central sleep apnea), or to both (mixed sleep apnea). Obesity
may be a contributing factor; people who suffer from sleep apnea are often advised to reduce, and also to
avoid sedative or hypnotic drugs. Researchers can sometimes trace the cause to damage in areas of the
brain involved with respiratory control.

Asphyxia (Greek, pulselessness, from a, not; sphyzein, to throb), unconsciousness or death

produced by failure of the blood to become properly oxygenated in the lungs. This failure may be due to
inability of air to reach the lungs, as in hanging, suffocation, or chest injuries; it may be due to paralysis
of the nerve centers that control lungs, either because of an inadequate supply of oxygen or because of
failure in the respiratory system (see Respiration). In most cases of asphyxia, artificial respiration, if
applied in time, will save the life of the victim.

Carcinoma, cancer that develops in the inner and outer surfaces of the body, such as the skin, the lining of
the gastrointestinal tract, the inside of blood vessels, and the lungs. Like all cancers, carcinomas are
malignant tumors in which cells grow uncontrollably, eventually crowding out normal cells. Also, like
other cancers, carcinomas often spread to other areas of the body or metastasize via the blood or
lymphatic system. Different kinds of carcinomas include breast cancer, cervical cancer, prostate cancer,
lung cancer, colon cancer, liver cancer, and skin cancer.

Carcinoma is one of four types of cancer. The other types are cancer in muscle, connective, or bone tissue
(sarcoma), cancer in blood forming, or vascular, tissues (lymphoma, leukemia, and myeloma), and cancer
in nerve tissues (neuroma, glioma, and neuroblastoma).

Cystic Fibrosis, incurable hereditary disorder that causes the body to secrete an abnormally thick, sticky
mucus that clogs the pancreas and the lungs, leading to problems with breathing and digestion, infection,
and ultimately, death. Three decades ago most babies born with cystic fibrosis died in early childhood,
but advances in diagnosing and treating the disease have significantly improved its prognosis. Today
more than 60 percent of babies born with cystic fibrosis reach adulthood, and further advances,
particularly in the field of gene therapy, may produce even better treatments in the coming years.

Epiglottitis, infection of the epiglottis by bacteria. The infecting bacterium is almost always Haemophilus
influenzae type b. Sudden onset of symptomsincluding sore throat, hoarseness, and usually a high
feveris followed by the development of respiratory distress. The affected person may tend to lean
forward and extend the neck in order to promote air exchange. Epiglottitis can quickly result in complete
blockage of the airway and must be treated by a physician immediately. Therapy involves using
antibiotics to combat the infection, and passing a tube into the airway to maintain breathing. In
emergencies a tracheotomy may be performed, whereby an opening is cut into the trachea through the
skin. Epiglottitis occurs most often in children two to five years old, but it can occur in people of any age.
Influenza vaccines have dramatically reduced the incidence of epiglottitis.

Legionnaires Disease, severe form of pneumonia, characterized by headache, chest pain, lung
congestion, and high fever. The name is derived from an outbreak at an American Legion convention in a
Philadelphia hotel in July 1976. The United States Centers for Disease Control and Prevention (CDC)
later succeeded in identifying the causative agent as a previously unknown rod-shaped bacterium
(Legionella pneumophila). Other local outbreaks were then linked to the disease. An estimated 8,000 to
18,000 people contract Legionnaires' disease in the United States each year, and about 5 to 30 percent of
affected people die. The bacterium is most commonly transmitted through contaminated water sources; it
is not readily transmitted from person to person. Treatment with the antibiotic erythromycin is effective.

Pleurisy, inflammation of the pleura membrane that lines the chest cavity and contains the lung. Most
cases are caused by infection, and many are associated with pneumonia in the underlying lung. Some
cases are caused by viral infections. Occasionally pleurisy may occur in other diseases such as
tuberculosis, systemic lupus erythematosus, rheumatic fever, and kidney failure. Pleurisy may develop in
conjunction with a blood clot on the lung; it may also be associated with the development of fluid in the
pleural space between the chest wall and the lung.

The characteristic symptom of pleurisy is sharp pain brought on by breathing and coughing. The patient
breathes shallowly. If considerable fluid accumulates, the pain may subside, but the underlying lung may
be compressed by the fluid and the patient may feel short of breath. On examination the doctor can
occasionally hear the inflamed surfaces of the pleura rubbing together and producing a rough sound.
Treatment of pleurisy attempts to cure the underlying disease causing it. The pain is controlled with
analgesic drugs.

Pneumoconiosis (plural, pneumoconioses), a general term for any one of several lung diseases caused by
breathing dust from industrial occupations like coal mining, sand blasting, and stone cutting (see
Occupational and Environmental Diseases). Years of continual exposure to industrial dust can cause the
formation of spots (macules), lumps (nodules), or fibrous growths in lung tissue, causing permanent
damage or destruction of these tissues. Smoking can complicate or worsen the conditions. Symptoms of
the disease include shortness of breath, labored breathing, coughing, and production of phlegm (mucus
secreted in the respiratory system when infections are present). Other, often fatal, illnesses such as cancer,
tuberculosis, emphysema, or heart disease may also develop.

Severe Acute Respiratory Syndrome (SARS), contagious respiratory illness that can cause a fatal form of
pneumonia. The illness first appeared in November 2002 in people living in Guangdong province in
southern China. Its cause was unknown and available treatments were ineffective. By February 2003 new
cases of the illness were reported in Hong Kong, Vietnam, Singapore, and Canada. The fast spread of the
disease, its deadly nature, and its unknown cause prompted the World Health Organization (WHO), an
agency of the United Nations, to issue a global alert in March 2003 designating SARS as a worldwide
health threat. The alert triggered governments around the world to establish infection-control procedures
to prevent the illness from reaching epidemic proportions. Despite these public-health measures, more
than 8,000 SARS cases were reported in 32 countries and the disease caused 800 deaths by the time the
outbreak was declared contained in July 2003.

Whooping Cough, also known as pertussis, common name applied to an acute, infectious disease of the
respiratory tract, caused by the bacillus Bordetella pertussis. The disease is characterized in its late stages
by a deep cough ending in a peculiar high-pitched whooping sound. Whooping cough occurs worldwide,
periodically in epidemics. Most cases occur in children under five years of age, and the disease is most
serious in children less than one year old. In the United States about 7,800 cases occur each year.