Fisica Ionica
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From French The Pavlov Leningrad Institute of Medicine, Leningrad, USSR. THE TREATMENT OF BRONCHIAL ASTHMA BY NEGATIVE AEROIONISATION P.C. Boulatov, Emeritus Master of Sciences of the USSR, Professor at the Chair of the Therapeutic Unit, Pavlov 1st Institute of Medicine, Leningrad. Bronchial asthma is an allergic condition in which neurogenic factors play a large part. In this paper we shall look at bronchial asthma in the context of neurotic problems. According to the teaching of I.P. Pavlov and S.P. Botkin one understands that reflex mechanisms are basic to the development of this condition and that in the pathological course of bronchial asthma three mechanisms come together:
Clinical experience and other observations indicate that the system is sensitised by centres of infection with seat in the respiratory system, by foreign tissue substances and by antigenic microbes. These substances are spread by the blood, inducing an allergic state in the bronchial muscles, the bronchial mucous glands, the pulmonary vessels and also the respiratory nerves system. These same toxic substances cause prolonged irritation of the interceptors, of the mucous membrane, the respiratory system itself and most often the bronchi. They irritate pathological interoceptor reflexes causing spasm in the sensitised bronchial muscles, promoting the secretory action of bronchial mucous glands and a change in the vascular system of the lungs. It is a typical picture of the disease. On the basis of the unconditioned reflexes conditioned exteroreceptor reflexes can be easily induced. From our observations, they continue even when the unconditioned irritant which caused the complaint, that is the toxic centre of infection, is no longer present. The nervous centres controlling the bronchi, the unstripped muscles, the mucous glands and their vessels are situated not only in the medulla oblongata and in the diecenphalon but apparently also in the higher part of the brain including the cerebral cortex. The sensitisation of the system and the pathological stimulation of the respiratory interceptors can cause a state of prolonged stimulation that is initial parabiotic arousal of the centres, thus creating the main pathological factor of bronchial asthma. Our knowledge of asthma as an allergic condition with this main pathological cause agrees with the experimental work on allergies of Dr A.D. Ado et al. which shows that the major part in the allergy is due to the sensitisation of the system via the intermediary of the central system. The work of Drs. N.S. Zvonitsky and A.N. Obrosov (1932) who obtained serions with the help of an electrostatic machine is important in the treatment of patients who have contracted bronchial asthma. Later Drs. J.E. Landsman (1934), E.I. Pasinkov (1934) et al. used this method of obtaining negatively charged aeroions. Drs. B.M. Prosarovsky in 1934 and F.E. Obrant in 1937 treated bronchial asthma with aeroions obtained by the Steffens method. In 1941 Dr. V.S Katz treated patients with bronchial asthma with heavy aeroions by using the Dessaouer method (the magnesium core was replaced with one of calcium). Most Russian researchers (L.E. Vasiliev, B.M. Prosorovsky, I.E. Landsman et al.) recommend the aeroionisation method in the treatment of bronchial asthma. But while appreciating the results it should be remembered that in obtaining the aeroions by the method of Steffens or Dessaouer or with the electrostatic machine, other substances are also formed. In 1934-36 Dr. Vasiliev treated patients with bronchial asthma for the first time with negative aeroions, using an aeroioniser of the A.B Verigo type with good results. We have been concerned with the treatment of patients with bronchial asthma since 1935 and we have also used negative aeroions produced by an A.B. Verigo type aeroioniser. During treatment the aeroion dose was calculated on the basis of the depth and frequency of the patient's breathing. One cc of air at a distance of 5 to 10 cm from the cylinder contained 2 million light negative aeroions. On breathing in 400-500 cc of air the patient received on average 800 million aeroions; breathing in and out 14-18 times a minute he received 10-15,000 million. The treatment consisted of 25-30 aeroionisations of 10 minutes each. To obtain the desired dose of aeroions, patients were always placed at the same distance from the aeroioniser. They were seated so as not to restrict their breathing. During the treatment they were asked not to alter their normal respiratory pattern. In order to halt the episodes of bronchial asthma it was necessary usually to carry out 2-3- courses of treatment with a break of 20-30 days between each. On the basis of our observations the dosage is 100,000-1,500.000 million light negative serions for each aeroionisation. During each course of treatment the same quantity of aeroions was always administered to the patient and it is only in severe cases that the dosage was increased to 200,000 million per session. We succeeded in preventing broncho-asthmatic attacks by giving a dose of 300-400,000 million per session. Over a period of 30 years aeroion therapy has been carried out in our unit on more than 3,000 patients with bronchial asthma, of whom 1,100 were men and 1,900 women; 714 men and 1,103 women as in-patients and 386 men and 887 women as out-patients. A third of the patients were aged between 31 and 40 and half between 31 and 50. Half had suffered from the disorder for 10 years and a fifth of the patients for five. On the basis of the known aetiology and pathogenesis of bronchial asthma we are able to divide this illness in three stages.
The first episode of bronchial asthma occurs during the period of infectious allergy due to the existence of an active nucleus of infection in the system. At this time the only cause of attack is, generally, acute inflammation of the respiratory tract. Sputum is present in large quantities. There is a subfebrile state with leucocytosis; the leucocytes show a shift to the left; at the same time one notes eosinophilia with an accelerated erythrocyte sedimentation rate (18-20 mm/hour). Quite often on the X-ray there are changes taking place in the lungs with an increase in the hilar glands as well as inflammation of the nasal sinuses. Generally the course of the inflammation decreases in the respiratory system, the attacks of breathlessness stop and remission sets in until the next inflammatory attack. We have established that this state of infectious allergy can last for months or for years. In the parallergic period the attacks are caused by acute infection of the respiratory passages by various substances to which the human system gradually becomes sensitised. These are allergens in the dust and the smoke of kitchens, occupational allergens such as sulphur gas, flour dust, petrol and turpentine fumes etc. Furthermore, the attacks of breathlessness are caused by effects mediated exclusively through the sense organs; among others by the influence of the weather. During this period one can see in the patients an increase in red corpuscles and haemoglobin concentration, sometimes marked leucopoenia or eosinophilia (at 30%), lymphocytosis, marked neutropenia and decreased erythrocyte sedimentation rate but levelling off. This period can last from several months to 15 years. The third period, that of the sequelae or complications is characterised by chronic bronchitis, chronic pneumonia, adhesive pleurisy, pulmonary emphysema, chronic maxillary sinusitis, frontal sinusitis and other lesions, which sensitise the system and contribute to the asthmatic state. The cardiovascular system is more or less affected, especially in the right side of the heart and in the vessels. Morphological changes in the lungs and heart cause difficulty with breathing and clearing the bronchi and then cardiac and respiratory insufficiency. The episodes of dyspnoea have various causes which influence the characteristics of the asthma. The psychic factor also plays a large part here: the patient is afraid of recurrences. Similarly the attacks can occur if the parasympathetic part of the nervous system is activated with no apparent cause in the middle of the night for example. The attacks are of a different type, are most often of long duration and can bring about a prolonged asthmatic state. In old age, they have signs of cardiac asthma. Patients at this stage are incapable of any physical or mental effort and most often require medical assistance. In the treatment with negative neurions the patients were observed during and after each session and also during and after the whole course of treatment. At these times a reduced pulse rate (by 5-20, on average 12 per minute) and a similarly reduced respiratory rate (by 2-8, on average 5 per minute) were noted. In those patients with the highest blood-pressure the drop was 5-10mm (average: 8mm of mercury); the lowest pressure was in the majority of cases more or less normal. By auscultation it was possible to more a diminution of dry and moist rales in the lungs. The vital capacity of the lungs was increased. From the first session of negative aeroionisation there was an improvement in the general state and in yawning; the patients felt their pectoral "spasms" disappearing, breathing became deeper. Those patients without complications (chronic vesicular emphysema, myocardial dystrophy with cardiac insufficiency of the 1st or 2nd degree) showed most clearly the signs described. Patients over 40 and having complications showed less marked improvement. During the course between the 8th and 15th sessions, in 15% of the patients expectoration was reduced, breathing became difficult and it could be seen how the attacks of asthma sometimes turned into an asthmatic state likely to last a week. At the same time the patients suffered from insomnia, loss of appetite, dyspnoea when walking became intense and breathing superficial and rapid(24-30 per minute). The erythrocyte sedimentation rate increased to 18-25 an hour and the pulse rate quickened (100-140 per minute). The drop in blood-pressure was 5-20mm of mercury (on average 12mm), and the lowest pressure was unchanged. We noted this condition at the time of the first stage, during the second and also during the period of the sequelae. This condition of temporary exacerbation seems to us very typical and peculiar to treatment with negative aeroions. On conclusion of the treatment an improvement in the general condition was noted in 90% of the patients; tiredness was reduced in 60% of cases and the nervous state disappeared in 44%; in 58% the capacity for work increased while improved sleep was noted in 80% of the patients. During and after the treatment the pulse and respiratory rate in the majority of patients returned to normal, blood pressure returned to its mean level if it had increased or fallen during the treatment. Towards the 8th-15th session expectoration diminished, as though "moist asthma" had become "dry". At the end of the course, towards the 25th-30th session, these phenomena are seen in 80-90% of patients. At the same time the eosinophils, the Curschmann spirals and the Chareo-Leyden crystals disappeared from the sputum (or became less easily seen); the appearance of the sputum altered; clear sputum took the place of muco-purulent sputum. Lung capacity increased. The quantity of air also increased, the minute volume went down and even reached a normal value in a third of the patients (in the first and second periods of the illness). Tympanitic resonance on percussion of the lungs was reduced and the extent of the dry and moist rales on exhaling was also diminished. Towards the end of the treatment it could be seen on the X-ray that the hilae were less distinct, that the opacity of the two pulmonary fields had increased and that the diaphragm was more mobile. In patients with chronic pneumonia combined with chronic vesicular emphysema the X-ray picture of the lungs and heart showed no significant changes. Towards the end of the treatment a more or less normal count of red cells could be seen in 80% of patients; haemoglobin remained unchanged. Leucocytes, which had increased during the first period of the treatment and then been moderately reduced in the second, became normal again at the end of the treatment in 90% of the patients. In 75% of patients there was an eosinophilia at the end of the treatment. The eosinophil count increased in the patients of the first group, while in those of the second group on the contrary it diminished. The basophil count remained normal. In 75% of patients the number of neutrophils reached the upper limit of what is considered normal. There was a qualitative reduction in lymphocytes while remaining within normal limits. The monocyte total which before treatment had reached the upper limit of the normal tended to go down after treatment. After the course of treatment a reduced E.S.R. was seen in 25% of patients; in 17% the figure became normal. In the 10% of patients suffering from complications the E.S.R. did not return to within normal limits after treatment. In 75% of patients the blood sugar was below normal after the treatment. Glycemia was noted in the majority of patients of the first group, while the blood sugar in the second group was reduced. The glucose tolerance curve returned to normal in 50% of patients, but during the period of sequelae glycemia remained important. After the treatment skin potential, vascular reactions and the rate of skin resistance and galvanic skin response in 80% of patients were clearly normal. Drs M.P. Beresine, V.K. Vasilieve (1953) and V.A. Leonova (1961) consider that negative aeroionisation is beneficial for the nervous system and normalises its functional condition. Dr V.P. Bourouchina (1955) established, while studying the general reactivity of the system with the help of cantharadin and trypanblue plaster, that after the course of treatment with negative aeroions the patients studied were close to normal in 80% of the cases of bronchial asthma. Dr T.S. Lavrinovitch (1955) studied the conditioned and unconditioned vascular reflexes in bronchial asthma with the help of plethysmography. Dr R.S. Lavrinovtich established that the conditioned vascular reflexes returned to normal first and the unconditioned later. Dr Z.B. Ivanova (1960) noted that the functional state of the capillary connective tissues became normal again during treatment. Patients with complications had permanent changes to these structures which did not return to normal after this treatment. Our observations showed that after 25-30 sessions of aeroionisation the increased stimulation of the higher sections of the nervous system disappeared and it was mainly the inhibitor processes which played a part in inducing sleepiness in the patients. Towards the end of the treatment, in most patients (80%), the simulant and inhibitor processes returned to their normal state in the higher sections of the central nervous system (J.I. Rodsolaillnen, 1964). In examining the results of treating the different groups of patients it was established that the attacks of asthma had disappeared within six months in the period of infectious allergy in 52% of patients, during the parallergic period in 40% of patients and in the sequelae period in 39% of the patients. The treatment had little effect in 8% of patients during the period of infectious allergy, in 4% of patients during the parallergic period and in 14% of patients during the sequelae period. After treatment an abatement of bronchial asthma was noted in 55% of patients for a period of 6 months to 10 years. In 35% of patients the attacks became less frequent during the month and definitely became less intense and prolonged. In 10% of the patients the treatment did not produce any results. The results obtained were recorded in 830 patients. In 470 attacks of bronchial asthma ceased during a period of: 6 months to 1 year 165 patients 1 to 2 years 173 patients 2 to 5 years 74 patients 5 to 10 years 58 patients In 360 patients the attacks occurred in the 2-3- months following treatment. In the sequelae period the treatment was less effective, as 97% of the patients were suffering from the chronic bronchitis, chronic pneumonia, marked vesicular pulmonary emphysema or showed cardiac changes caused by the existence of a centre of infection, by the asthmatic condition or by frequent attacks of bronchial asthma. A number of patients had arteriosclerotic and hypertensive cardiosclerosis. Thus our long and exacting studies enable us to draw the attention of doctors to the treatment of bronchial asthma with negative aeroions, obtained by the method of Dr A.B Verigo and to permit in depth studies on this subject. CONCLUSIONS 1) Light negative aeroions obtained by the method of Dr R.B. Verigo, which we have been able to study clinically without associating them with other chemical substances, have a certain physiological and therapeutic action on the system of the patient who has bronchial asthma. 2) Treatment with negative aeroions (therapeutic dose 100-150 million aeroions per session) leads to an improvement in the general state of the patients, a normalisation of the blood picture, of the vascular and respiratory reactions, etc. 3) A course of treatment must consist of 25-30 sessions. To obtain stable and lasting results, there should be 2 or 3 courses spaced 20-30 days apart. 4) Results of treatment: a) dyspnoeic attacks disappear in 55% of patients within 6 months; b) the intensity and number of attacks is reduced in 35% of patients; c) treatment is ineffective in 10% of cases. 5) Negative aeroions normalise the functional state of the central nervous system and in all cases the system of the patients with asthma. 6) We attach great importance to this study with the aim of seeing this treatment carried out widely in polyclinics and in therapeutic units. |