What do each of these individuals have in common: First, an 18-year-old suddenly develops

wheezing and shortness of breath when visiting his grandmother, who happens to have a cat.
Second, a 30-year-old woman has colds that "always go into her chest," causing coughing and
difficulty breathing. Lastly, a 60-year-old man develops shortness of breath with only slight exertion
even though he has never smoked. The answer is that they all have asthma. These are some of the
many faces of asthma.

We now know that anyone who is exposed to the "proper" conditions can develop the cardinal
symptoms of asthma (cough, wheeze, and shortness of breath). Most researchers believe that the
different patterns of asthma are all related to one condition. But some researchers feel that separate
forms of lung conditions exist.

There is currently no cure for asthma, and no single exact cause has been identified. Therefore,
understanding the changes that occur in asthma, how it makes you feel, and how it can behave over
time is essential. This knowledge can empower people with asthma to take an active role in their
own health.

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.