ALLERGIES & ASTHMA: THEIR PHYSIOLOGICAL, PSYCHOLOGICAL &

Asthma can be more accurately defined as a group of symptoms, the most common of which being shortness of breath, wheezing, coughing, and excess production of mucous. Shortness of breath and wheezing can be experienced when the smooth muscle that lines the trachea and bronchii go into spasm, causing the air tubes to constrict, allowing less space for air to move freely in and out of the lungs. This is called broncho- spasm and can be caused by a number of conditions, some of which are: Allergies (foods, pollens, medications, etc.), infections of the respiratory tract, smoking, second hand smoke, dust, exercise, hyperventilation, cold air, smog, ingestion of certain drugs, intense emotion, and household/occupational chemicals to mention just a few. In order to most effectively demonstrate the physiological components of an asthmatic individual, this paper will focus on allergies and their physiological relationship to asthma.

Another symptom mentioned that contributes to the difficulties in breathing that an asthmatic experiences is an increased production of mucous in the airways. Lining the trachea and bronchii are millions of tiny cells called goblet cells that in the "normal" individual serve to produce mucous in the airways to help fight infection and to keep the airways moist. In the asthmatic, however, these goblet cells seem to hinder rather than help their condition, in that they usually possess an abnormal plethora of these cells. This can cause an excess of mucous to build up in the airways, which can lead to clogging and therefore difficulty in breathing. In response to such build up, the person will usually cough, trying to dislodge the blockage so he or she can breathe more freely. It is not often the most elegant sound, but a necessary option for the afflicted. If there is such a severe build up in the airways that it obstructs the air flow completely, and the person doesn't receive immediate medical care, they can die.

There are by definition three types of asthma: Extrinsic, intrinsic, and mixed. Extrinsic ( ex being a preposition from Latin meaning out, away from) refers to those attacks that are triggered by exposure to external substances. For example, food, dust, pollens, etc. Extrinsic asthma usually is conceived in childhood, and can often be observed in persons suffering from eczema and hay fever. In addition, extrinsic asthmatics are also more likely to wheeze after exercise, perhaps due to the increased intake of air born allergens, since one is apt to breathe heavier and deeper during physical exertion. Intrinsic asthma, as its name implies, refers to those asthmatics whose attacks are triggered by infection, psychological or emotional stress, or changes in their environment (i.e. - moving to a different part of the country, changing occupation, etc. ) .

Mixed asthma quite simply is a combination of the two, where the person possesses symptoms of both extrinsic and intrinsic asthma.
Who suffers from asthma and how can one get it? To date there exists no concrete, scientific answer. Asthma is a dis - ease, this is true, but a dis - ease for what reason and why? Louise Hay, in her book, Heal Your Body, suggests the psychological/ metaphysical cause of asthma to be: "Smother love. Inability to breathe for one's self. Feeling stifled. Suppressed crying." And for babies and children Louise suggests: " Fear of life. Not wanting to be here". As treatment, Louise suggests replacing those negative ideas and feelings with positive affirmations, aimed directly at dissolving the negative thought.

Her suggestions are: "It is safe now for me to take charge of my own life. I choose to be free", and for children," This child is safe and loved. This child is welcomed and cherished". My feeling is that there are a great number of people that cultivate these fears about life - feeling stifled, not wanting to be here, etc. and yet their dis -ease does not manifest itself as asthma but some other ambiguous physical ailment. Why do these people choose asthma as their dis-ease? Why would they choose a physiological makeup that makes them vulnerable to such a disorder? There is never one definite answer to such a question - so many factors are involved: Is the person paying a karmic debt for a past life? Or is it simply an indication that our environment is becoming more polluted, and our respiratory systems are unable to compensate for the rise in toxins at this stage? Statistics state that asthma has increased by more than 30% since 1980, with the number of hospital admissions having gone up and the number of deaths from asthma nearly doubling since 1976. " The reasons f or these unsettling trends are complex," says Dr. Eric Gershwin in his book, Asthma: Stop Suffering, Start Living,

"Certainly degradation of air quality combined with continuing urbanization of the population is implicated. The increase in the number of poor people and the over-representation of children among them has made adequate medical care less readily available for the most vulnerable. Poor or poorly delivered medication bears some share of the blame as well." Ten million Americans are now suffering from asthma. Although not all sufferers experience an onslaught of acute symptoms, it is nevertheless a nagging inconvenience.

A primary trigger for an asthmatic is exposure to a specific allergen. Most people are not truly aware of what an allergy is. For example, if one enters into a room where one has never been before and suddenly goes into a sneezing fit, the afflicted will usually remark, " Well, I must be allergic to something in here." Physiologically, this may or may not be true. To dispel any myths, it is necessary to make a clear distinction between hypersensitivity to a certain substance vs. an actual allergic reaction. In an allergic reaction, there i s a specific, physiological change in the body which differs from a hypersensitive reaction. The distinction centers on IgE, or Immunoglobin E, an antibody that is released into the blood to help the body fight invading parasites or other such foreign material, especially in the gut or lung. Since most parasites enter and breed in the lung or the intestines of the individual, there are special groups of lymph nodes that line the interior surface of these organs which contain the cells which are capable of producing IgE. Although millennia ago when human civilization consisted of a cave for a house and a language where the word "shower" was probably obsolete, there was obviously a necessity for an abundance of antibodies to protect the body from the onslaught of various worms, parasites and other diseases. However, as civilization progressed, hygiene was introduced, and parasitic invasion and infection declined. The need for IgE became less important, and for most Westerners living today the need for IgE producing cells is essentially obsolete. However, these cells do continue to exist, and for the individual suffering from allergies, the presence of IgE has proven to be quite a hindrance. The reason for this is that those with allergies have been shown to manufacture large quantities of IgE in response to a substance the body may consider foreign. What determines whether an individual will have a tendency toward such a response has been demonstrated to be largely genetic, although it is possible though not probable to have such a composition without inheriting it. Individuals who do have a genetic tendency are classified as atopic. What happens physiologically in the body of an allergic individual is fairly simple to understand. Once exposed to the allergen, be it food or dust or pollen, etc., the bodies first priority is to breakdown the substance it believes is foreign. In the normal individual, this substance will be processed, broken down, and eliminated in a fairly routine fashion, usually without the knowledge of the host. However, in those prone to producing high levels of IgE, the body will routinely attempt to destroy it at the same time producing IgE to react against it. The body believes that by manufacturing this IgE, it will more efficiently eliminate the invader. Instead, the presence of this IgE triggers a different series of immune responses, whereby the IgE that is produced latches onto certain white blood cells called mast cells and basophils. These IgE antibodies travel through the body via these white blood cells looking for foreign bacteria. As soon as the IgE discovers the allergen in the body, it shoots holes into the white blood cell, and through these holes the white blood cell releases a bunch of stored chemicals, one of which is histamine. It is the release of this histamine and other stored chemicals that produces allergic symptoms. However, the process is still not complete. Once the IgE has made the holes, the white blood cells "synthesize" a whole new group of chemicals in the body, including substances known as Prostaglandins and leukotrienes, which may take several hours to several days to be produced. Once these chemicals are released, the host is apt to suffer severe allergic symptoms.

Another clarification that needs to be made on the subject of allergies concerns the classification of food allergies. Food allergies indicate that the person is not so much allergic to the food as he or she is to the additives in the food: Tartrazine ( found in food dye color #5 and yellow dye used in potato chips and other junk food) and metabisuliate, a preservative usually found in wine, are two culprits that seem to commonly cause an allergic reaction. Again, a distinction must be made here between the person who is truly experiencing an allergic reaction (atopic or IgE related), and the person who possesses a hypersensitivity to it. "Food hypersensitivity can be expressed as wheezing and shortness of breath. However there is no usual course and symptoms can vary dramatically in their severity" ( Gershwin, p.74). When a typically asthmatic reaction occurs in response to a certain food it is possible, although rare, that no IgE antibodies are detected even though it is still defined as an asthmatic attack. Any food is basically capable of setting off a reaction in a sensitive person, but technically if it is not IgE mediated, it is a hypersensitivity, not an allergy. In individuals with multiple allergies it is difficult to determine sometimes whether some food as well as the usual dust, pollen, etc., might be implicated. The best method to pin point a cause is to keep careful, attentive records observing one's own daily activities and exposures. Children with multiple allergies present a special problem anatomically because they frequently ingest small amounts of food that remain undigested. The body believes this undigested material to be foreign, produces IgE antibodies and the food allergy appears. Fortunately, as children mature, so does their GI tract, and food can then be ingested completely, and the reaction dissolves. Interestingly enough, in later years, if these children develop hay fever or some other type of sensitivity, their allergies may reappear.

In relationship to asthma, allergies to certain substances have long been noted to trigger an asthmatic attack. Individuals who find symptoms triggered by an allergic reaction are susceptible to developing a number of other allergic complications. Eczema, or Atopic Dermatitis, is one of these complications. Eczema is a skin disorder where the person is afflicted with such an intense desire to scratch their skin and when they do, an unsightly rash appears. This condition is more likely to appear in the second - first six months of life and unlikely to persist for an entire lifetime. If it does decide to make a comeback, it is usually in adolescence. Another common allergy associated with asthma is hay fever. one doesn't need to have asthma to have hay fever or vise versa. Hay fever usually arises later in life and, unlike eczema, does not disappear as one grows older.

Recurrent ear infections may also be an indication of an atopic individual. This person may also have a history of hay fever and/or asthma. Recurrent ear infections are especially prevalent in children, due in part to the fact that they have smaller eustachian tubes, therefore they clog up more easily.

Sinusitis, an inflammation and blockage in the sinus caves behind the nose, is a condition seen to occur more frequently in asthmatics as opposed to the general public. When sinusitis occurs, it may make the asthma more difficult to treat. In cases where the patient is suffering from persisting symptoms of asthma, sinusitis could be considered as a cause. An allergic condition found exclusively in those who have asthma is Acute Bronchopulmonary Aspergillosis, which is an extreme allergy to the mold aspergillus. IgE levels have been shown to be very high in response to exposure to this allergen. Although rare, this condition has been seen to occur at any stage in life. If not detected, persistence of this disorder can lead to destruction of lung tissue and cause abnormalities in the structure of the air tubes. Some symptoms of the allergy are: Developing a stubborn cough, difficulty in treating asthma with one's usual medications, and production of mucous. It is important to be aware of such triggering agents or possible developing conditions in order to have the tools to intelligently avoid serious complications. Having allergies and having asthma does not necessarily mean that every time one has an allergic reaction it will be followed by an asthma attack, but for the individual who possesses high levels of IgE, allergies will almost always provoke an asthma attack. Although physiologically the reader has witnessed how an asthmatic attack may occur, there is not yet any "scientific" evidence to support a psychological exacerbation of an asthmatic condition. There are some that say emotional responses can cause asthma, such as fear or anger, to which science states that although these emotions do not induce asthma, they often cause hyperventilation, which for those who suffer from bronchospasm, can end in an asthmatic attack. My response to this is that there is always some higher force at work - a higher self that knows exactly where it is best for its' soul to go - and therefore has chosen asthma as its current ailment in order to learn. Completely unscientific "they" would say.

Evidently, asthma still remains quite a mystery to the medical researcher. Although much progress has been made over the past ten years, no definite answers have come to pass. Statistics and articles and research books are still full of the infamous "However. . . ", always with a counter argument or an exceptional patient that seems to prove the whole system wrong. This only strengthens the metaphysical standpoint which claims only that asthma has been created on this planet to teach us all something about ourselves and the world in which we live, and are re - creating every day. Personally, asthma says something to me about the inability to breathe in life - the inability to inhale all of life's divine pleasures without guilt or fear or doubt. Granted asthma is a definite physiological condition, with a tendency to be genetic, but there have been cases where asthma has birthed itself for no genetic reason whatsoever. This fact alone says to me that asthma is neither a psychological or physiological choice, but a spiritual one.

BIBLIOGRAPHY & WORKS CITED
Hay, Louise L. Heal Your Body. Hay House Publishing Co., Santa Monica, Ca., 1988.
Jones, R.S. Asthma in Children. Publishing Sciences Group, Acton, Mass.,1976.
Gershwin, Dr. M. Eric. Asthma: Stop Suffering, Start Living. Addison-Wesley Publishing Co., Reading, Ma.,1986.
Clark, T.J.H. Steriods in Asthma. Adis Press, Auckland, New Zealand, 1983.
Lichtenstein & Atisten. Asthma: Physiology, Immunopharmacology & Treatment. Academic Press, New York, NY., 1977.