Respiratory System Disorders and Therapy From a New - Louis Bolk ...

2. Clinical Signs and Symptoms in Patients
with Asthmatic Disease and Pneumonia
In this chapter, we will introduce three characteristic cases of airway disease. The first
patient has an acute asthma attack, the second patient is a chronic asthmatic, and the third
patient has acute pneumonia. Using their signs and symptoms and the pathophysiology
of asthma and pneumonia, we will explain the characteristics of asthma and pneumonia
as typical respiratory diseases. Evaluating the signs and symptoms in view of functions of
the respiratory tract, is the first step using the Goethean phenomenological method. It
places these diseases within a larger perspective of polarity.
2.1. The Acute Asthma Attack
A 40-year old slender woman is sitting up straight in her bed complaining that she can
hardly breathe. It is 11.30 PM. Her eyes are pronounced and she is wide-awake. She is
short of breath and looks anxiously to the people around her for support. The shortness
of breath forces her to speak in short sentences and, in between them, she needs to take
a breath. While speaking, she does not move much, and the little movement she makes
is brief and stiff. Her inhalation is eager. She cannot breathe out freely. Her expiration
is accompanied by a tight wheeze, takes a great deal of energy, and is ineffective. The
thoracic wall is caught in inspiration; it hardly moves. The breathing muscles and accessory
breathing muscles are clearly visible and feel tense. The musculature of neck, back, and
legs is also tight. She tends to have a constant, irritated cough that is not productive. The
excursions of her thorax are greatly diminished.
She is on edge and slightly bent forward. Even though she is obviously tired, she is not
able to fall asleep. When she speaks, her voice is strained. This is not her first asthma
attack. She has had severe asthma since childhood.
On auscultation, we can hear the typical wheeze, as well as dry, sharp, spastic-sounding