A Supplementary Report of Studies on Bronchial Asthma

Part 5. The Relationship Between Pulmonary Tuberculosis and Asthma

Abstract

Many clinical reports have been made so far from various angles as to the relationship between tuberculosis and asthma. However, they do not seem to have reached any definite agrement.
The present study has been made, under M. Takino's suggestion, of 8 typical asthmatic cases complicated with pulmonary tuberculosis, 2 typical asthmatic cases of tuberculous origin and 5 atypical cases of asthma, i. e. asthmatic bronchitis. These cases have been observed from an angle of the mechanism of the occurrence of asthmatic attacks in reference to disorders of the autonomic nervous system concerning tuberculosis allergy. They have had a considerably long follow up. The results thus obtained are as follows.
1. Asthma, in view of its fundamental allergic constitution, does not seem to be a causative factor of pulmonary tuberculosis.
2. Constitutionally asthmatic patients may appear highly resistant against tuberculosis. But, once they are complicated with tuberculosis, an attack of asthma and various conditions accompanied thereby semm to hinder the localization of the lesion, giving an unfavorable influence upon pulmonary tuberculosis.
3. Contrary to infectious respiratory diseases of various kinds, pneumonia, whooping cough for instance, pulmonary tuberculosis generally does not seem to be a causative factor of typical asthma, even in those who come from the families with a positive history relative to allergic diseases or essential hypertension. Tuberculosis is rather considered to inhibit the occurrence of typical asthma.
4. Of course, typical asthma, though rarely, occurs in the tuberculous patients, only when a clinical course of the tuberculosis is very favorable. However, it seems that they come from the families with a positive history relative to essential hypertension or allergie diseases.
5. Asthma which is caused by pulmonary tuberculosis generally seems to take an aspect of atypical asthma with mucous symptoms, i. e., asthmatic bronchitis rather than typical asthma with an intensive bronchospasm.
6. Tuberculosis seems to influence asthma through specific changes of the parasympathetic nerve caused by tuberculosis allergy. An asthmatic attack of asthmatic patients complicated with tuberculosis is generally severe when tuberculous symptoms are improved, and is mild when the symptoms become worse, no matter whether the occurrence of asthma preceeds or follows that of tuberculosis.