HIDDEN OR UNSUSPECTED BRONCHIECTASIS IN THE ASTHMATIC PATIENT

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Abstract
Chronic irritation causes muscle spasm, and prolonged muscle spasm augments chronic irritation. The bronchial musculature is not excepted from this inter-reactive phenomenon. The classical symptoms of bronchiectasis—cough, hemoptysis, and production of purulent sputum—are irritative factors that can, and frequently do, produce bronchospasm. Conversely, chronic or recurrent bronchospasm can produce bronchial obstruction and resultant infection. Whether it be the inaugurative or the secondary source of infection, bronchiectasis not only joins but also maintains this vicious disease cycle, although, unfortunately, its identity may be hidden behind the paroxysms of dyspnea and wheeze (often called bronchial asthma). The asthmatic patients we have seen at the Overholt Thoracic Clinic are classified as medical failures, since they have not responded favorably to conservative therapy. Their previous medical treatment has included bronchodilatory and expectorant drugs, desensitization measures, changes in climate, psychotherapy, antibiotics, corticotropin (ACTH), and cortisone. In addition, several have had surgical measures for asthma, such

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