Diseases of the Lungs

There are various diseases of the lungs:

Asthma (Ḍīq al-Nafas)

There are three types:

1) Phlegmatic Asthma (Balghami Asthma)

In this disease, spasms develop in the fine air passages of the lungs, causing difficulty in breathing; therefore it is called ḍīq al-nafas (shortness of breath). Due to inflammation in these airways, mucus turns into phlegm that nearly blocks the passages. As soon as this material is expelled, breathing becomes easier. Sometimes the phlegm is thick and difficult to expel, and vomiting may occur before it comes out. Stool is poorly digested and urine appears whitish.

Causes

• Neglected or worsened cold/catarrh

• Excessive use of phlegm-producing foods

2) Dry Asthma (Sawdawi Asthma)

In Arabic it is called ḍīq al-nafas, in Urdu dry asthma, and in English Asthma.

The process of breathing involves the nose, mouth, throat, larynx, and lungs. Inside the lungs are tiny air passages that divide repeatedly into finer branches. The larger tubes are called bronchi and the smaller ones bronchioles. These passages carry air from the trachea to the alveolar sacs.

The walls of these respiratory passages consist of elastic fibrous membranes and circular muscle fibers. Stimulation of certain nerves causes contraction of these muscles, while others cause relaxation. The final branches are called terminal bronchioles.

Each terminal bronchiole opens into multiple cavities connected to air sacs. These structures contain muscular and elastic tissue. Further ahead, the muscular tissue disappears and the walls expand irregularly into small sac-like structures called air cells. Around these air cells is a network of capillaries.

Blood from the right ventricle of the heart continuously reaches the lungs. Gas exchange occurs through the thin capillary walls. Blood contains more carbon dioxide while the air sacs contain more oxygen; therefore hemoglobin releases carbon dioxide and absorbs oxygen, becoming oxyhemoglobin. Carbon dioxide enters the air sacs and is expelled during breathing.

Asthma can affect people of any age and gender, though in old age it becomes extremely distressing. It often begins with blocked catarrh. The body tries hard to expel it, causing repeated sneezing, throat irritation, and breathing difficulty. As night approaches, chest heaviness, tightness, and coughing intensify until an asthma attack occurs. Relief comes once the sticky mucus is expelled.

Some patients become sensitive to certain substances. Exposure to smoke, dust, fragrances, or other unsuitable materials may inflame the airways. This inflammation converts mucus into phlegm that blocks the air passages.

If the airways narrow and cannot accommodate enough air, breathing rate increases to compensate. Inhalation is called Inspiration and exhalation Expiration. Because exhalation often produces a whistling sound, repeated difficult breathing is termed asthma or ḍīq al-nafas.

Types of Allergy

1. Contact Allergen

Allergens that stick to the skin.

2. Inhaled Allergen

Allergens entering through breathing.

3. Injected Allergen

Allergens entering through injections, such as reactions to medicines.

4. Digestive Allergen

Allergens entering through food.

When these allergens enter the body, they activate the IgE immune system. IgE attaches to mast cells, causing histamine release. Histamine then causes:

Effects of Histamine

1. Vasodilation

Expansion of blood vessels and lowering of blood pressure.

2. Bronchoconstriction

Narrowing of airways leading to asthma.

3. Edema Formation

Swelling, chest fluid, mucus accumulation, and phlegm formation.

Causes

• Excessive use of cold and dry foods

• Cold climate

• Animal hair and feathers

• Strong fragrances

• Bad odors

• Chemicals

• Dust from carpets and bedding

• Allergic asthma due to deficiency of antibodies in some individuals

3) Renal/Bilious Asthma (Ṣafrawi Asthma)

When the mucous membranes and the functions of the liver and kidneys become impaired, the phlegm appears yellowish and thin or sometimes thick. Yellow discoloration is often visible on the face and in urine. Excess bile causes bitterness in the mouth, anxiety, nausea, and abdominal cramps. Burning urination and palpitations may also occur. Blood pressure rises and sleep becomes disturbed. Persistent coughing weakens the body until even walking becomes difficult and breathing becomes labored. Swelling under the eyes is often observed.

Causes

Excessive use of hot and dry foods and failure of the kidneys to remove waste products from the blood. Due to these impurities, oxygen absorption becomes impaired, increasing pressure on the lungs and causing difficult breathing.

Cough

The movement of the lungs to expel harmful material is called coughing. It has three forms:

1) Phlegmatic Cough

Due to nervous stimulation, phlegmatic secretions increase in the blood. This heavy blood reaches the lungs, interfering with nutrition and oxygen absorption. The body becomes cold, digestion weakens, urine increases and becomes pale, and these waste materials burden the lungs. The lungs repeatedly try to expel them, resulting in phlegmatic cough with white sputum. Severe cases may cause headache and vomiting from excessive coughing.

Cause

• Excessive use of cold and moist foods

2) Dry Cough (Sawdawi)

The muscles of the lungs become affected. Dryness dominates the body. Thick phlegm becomes difficult to expel. The face turns red during coughing, constipation develops, heartbeat increases, and abdominal gas accumulates.

Cause

• Excessive use of cold and dry foods

3) Bilious Cough

When the mucous membranes of the lungs become affected, the face and urine appear yellowish. Phlegm may be thick or thin. Nausea, dysentery, burning urination, and palpitations may occur.

Causes

• Hot and dry weather

• Excessive use of hot foods

• Indigestion

• Spicy foods

Tuberculosis (T.B.)

Tapp means fever and daq means emaciation.

In this disease, the patient has persistent mild fever that worsens in the evening. Severe wasting occurs and the patient becomes thin and weak. Cough starts mild and later becomes severe and dry. Sputum may contain dark material or blood. Appetite and sleep are lost, chest pain and weakness occur, and body weight continuously decreases.

Laboratory tests reveal Mycobacterium tuberculosis.

Normal ESR:

• Men: 5–7

• Women: 7–10

In tuberculosis, ESR rises three to four times higher.

X-rays show damaged lungs.

The Mantoux test may show red swelling after 72 hours. A diameter of 5 mm suggests tuberculosis bacteria.

Causes

• Hereditary tendency

• Excess mucus

• Excessive use of potatoes

• Excessive use of chemical ghee and sour/dry foods

• Malnutrition due to poverty

Hemoptysis (Spitting Blood)

Blood mixed with saliva may originate from gums, teeth roots, throat, lungs, stomach, or other organs. Blood from vomiting is dark in color and may contain food particles. Pain and burning usually occur at the site of origin.

Causes

• Electric shock

• Trauma

• Excessive use of dry foods

• Indigestion

• Ulcer

• Pyorrhea

• Tuberculosis

• Pleurisy

• Rupture of capillaries

• Menstrual suppression

Consumption (Sil)

“Sil” refers to a chronic wasting illness difficult to cure. It usually develops after pneumonia, tuberculosis, gastritis, or uterine inflammation.

Although tuberculosis and sil are often used interchangeably, tuberculosis does not always mean sil, but sil necessarily includes tuberculosis.

The text further explains classifications of fever and tissue involvement in traditional medicine.

Causes

• Tubercular toxins

• Excessive use of hot and dry foods

Pneumonia

Inflammation of the muscular covering of the lungs is called pneumonia.

Inflammation usually starts in the right lung. Fever rises sharply with chills, often reaching 103–105°F. Fever worsens in the evening. The skin becomes hot, nostrils flare during breathing, and breathing rate increases.

Pain occurs beneath the right breast or in the armpit. If the pleura also becomes inflamed, pain becomes severe, making breathing and speaking difficult. Sticky mucus remains lodged in the chest. Wheezing, restlessness, insomnia, thirst, and loss of appetite occur.

CBC shows increased neutrophils. X-ray reveals white opaque patches in the lungs.

Causes

• Cold climate

• Excessive use of cold foods

Whooping Cough

Usually affects children aged 2–8 years. Thick mucus sticks inside the air passages, causing repeated severe coughing spells.

Before a coughing attack, throat irritation occurs. Mild fever and cold symptoms appear. During severe coughing, the face turns bluish-red and eyes bulge. Vomiting with sticky mucus is common. A “whooping” sound occurs during inhalation.

In severe cases, oxygen deficiency may cause unconsciousness and bluish discoloration.

Causes

• Excessive use of cold and dry foods

• Cold weather

• Infection by Gram-negative Pertussis bacteria

Pleurisy (Dhāt al-Janb)

Inflammation of the membrane covering the left lung causes mild chills followed by fever. Tightness and stabbing pain develop below the breast, radiating toward the collarbone and armpit. Pain worsens during coughing and breathing.

The patient prefers lying on the painful side. The tongue becomes coated, pulse rapid, urine scanty, and the left cheek appears red. Fever ranges from 101–103°F or higher.

If no fluid forms, it is called dry pleurisy. If thick yellow sputum appears, it is moist pleurisy. Untreated cases may develop pus formation called empyema.

Stethoscope examination may produce a sound like two papers rubbing together. X-ray provides important diagnostic guidance.

Cause

• Tubercular toxins