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

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2.3.2. Pathophysiology of Bacterial Pneumonia Macroscopically, a uniform, sharply demarcated area of the lung parenchyma with an infectious fluid exudate is found, that may progress to involvement of an entire lobe. It is harder to separate the airway walls from the airway space in this area. The typical shape of the lung is less distinct. The air in this region is displaced and the lung — or a part of it — is converted to an airless, watery organ. This part of the lung will sink when put into water. The infected area usually abuts the visceral pleura between the lobes or over the convex outer perimeter of the lung. The margin that does not lie next to the pleura is mostly well defined and the adjacent parenchyma is not involved. Larger bronchi within the infected area often still contain air, which creates the so-called air bronchogram on X-ray (fig. 2.2.). Microscopically there is alveolar capillary dilatation and alveolar edema. The exudate is initially relatively low in cells but contains numerous bacteria (Streptococcus pneumoniae or pneumococcus). Inflammatory cells such as leukocytes are sparse at first, but abundant later on, the microorganisms disappear. At a later stage, leukocytes disappear and macrophages take their place. There is no tissue necrosis. If the patient survives this infection, there is, normally speaking, a complete resolution and resorption of the exudate and a recovery of the histology of the lung tissue. Occasionally, the fibrinopurulent exudate results in a so-called hepatisation of the affected area. At this stage, the lung tissue becomes fibrinous (fig. 2.2.). Blood Serum Changes in Pneumonia In the serum of the patient with pneumonia in the acute phase, the alternative complement pathway is activated. There is then an increase in type-specific antibodies against a capsular mucopolysaccharide and an aspecific protein is present in the serum: C-reactive protein (CRP). There is usually a leukocytosis with a shift to the left and the appearance of immature leukocytes.
Fig. 2.2 Lobar pneumonia. Alveoli filled with exudate and grey hepatisation (from Boyd 1970) Conclusion The pneumonia patient is characterized by an increased dissolving immune and metabolic activity, which also shows itself in the dissolving shape of the lung and the immunological changes in the pathophysiology. 2.4. Framework for the Pathophysiology In this section, a first step is undertaken to organize the clinical and pathophysiological data. We can classify these data by contrasting them with the general process of infection or injury and healing. Bolk’s Companions RespiRatoRy system DisoRDeRs anD theRapy - 19
Page 1 and 2: I N S T I T U T E Respiratory Syste
Page 3: Respiratory System Disorders and Th
Page 6 and 7: Contents Acknowledgments 6 Preface
Page 8 and 9: Acknowledgments This Companion was
Page 10 and 11: 1. Introduction This Companion for
Page 12 and 13: 2. Clinical Signs and Symptoms in P
Page 14 and 15: c. Her muscle tone is increased thr
Page 16 and 17: Conclusion: In the acute asthma att
Page 18 and 19: 2.3. The Third Patient: Acute Airsp
Page 22 and 23: 2.4.1. The Physiological Healing Pr
Page 24 and 25: dissolution. These diversions can l
Page 26 and 27: Table 2.1. Pathophysiological chara
Page 28 and 29: 3. Characterization of Asthma and P
Page 30 and 31: 3.1.2. Breathing Problems The time
Page 32 and 33: Cough Sometimes, a persistent, dry,
Page 34 and 35: Muscle Ache The increased muscle to
Page 36 and 37: 3.1.4. Metabolic Changes Acidosis C
Page 38 and 39: Seasonal Influences The relation be
Page 40 and 41: it were, dynamically poisoned by th
Page 42 and 43: ut is normally different in the liv
Page 44 and 45: Abrogated Inhalation A patient with
Page 46 and 47: 3.2.4. Changed Awareness Sleepiness
Page 48 and 49: for years, if not a lifetime (fig.2
Page 50 and 51: Just think of the interface between
Page 52 and 53: Jetlag Who does not know the phenom
Page 54 and 55: Dissolving tendency Fig. 3.5. The d
Page 56 and 57: 4. Other Inflammatory Disease of th
Page 58 and 59: 4.3. Hay Fever Hay fever is accompa
Page 60 and 61: Lung fibrosis can be seen as an “
Page 62 and 63: developed acute asthma attacks as a
Page 64 and 65: factors: anxiety to meet certain pe
Page 66 and 67: In asthma, • There is an intensif
Page 68 and 69: from the mesoderm in the yolk sac v
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Fig. 5.2. Relation between ventilat
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5.4. A Dynamic Concept of Disease M
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complementary medications and thera
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Classical, individual homeopathy is
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Infection/Injury Acute Fase Reactio
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document the different methods of h
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them rhythmically. Normally, the in
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6.1.2. Therapy for the Hyperreactiv
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we may consider Pulsatilla. Sulphur
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If the patient is exhausted, bother
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In fig. 6.2., a dynamic diagram sho
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6.2.1. Therapy for the Dissolving D
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c. Treatment of the rising fever by
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d. Excess exudate is secreted in pn
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6.2.3. Therapy for the Decreased Re
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The various treatment modalities th
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Sarcoidosis of the lung is a diseas
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Fig. 7.2. Rhythm in nature: sand an
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already observed in fever. This als
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Appendix Therapeutic Methods The me
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2009; Chernyshov et al 2000; Kienle
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systematically noted and which can
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Study of Medicine. Louis Bolk Insti
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10.1186/1472-6882-7-10. Hamre HJ, W
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Nishijo K, Mori H, Yosikawa K, Yaza
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BOLK’S COMPANIONS FOR THE STUDY O
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The Healing Process I N S T I T U T
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Respiratory System Disorders and Therapy From a New - Louis Bolk ...

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