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67
Between the two World Wars it was recognised that some
pneumonias differed clinically from the ordinary bacterial kinds
such as the pneumococcal and streptococcal types and were, as
such, referred to as primary atypical pneumonia. Subsequently, as a
direct result of progress in microbiology and virology, various
rickettsiae and viruses were revealed as causal organisms. For
example, it was discovered that the respiratory syncytial virus which
merely produces a common cold in adults gives rise to serious
conditions of acute bronchiolitis and bronchopneumonia in infants.
However, many other respiratory infections defy identification but,
today, some of these are known to be caused by a pleuropneumonialike
organism now officially designated as a 'mycoplasma'. Such
organisms, which stand somewhere between the bacteria and the
viruses, possess some characteristics of each and it is perhaps within
this sphere that our hopes for real improvement in the control of
chest infections lie.
Discovery of man's hypersensitivity to antigens from some
fungi (giving rise to such disabilities as Farmer's Lung) and from
avian excreta (the suggested name for which is Bird Breeder's
(Fancier's) Lung), shows that intensive research is gradually revealing
causes, hitherto unknown, of a number of respiratory complaints.
But when, despite thorough investigation, many chest infections
remain unidentified, preventive measures inevitably become circumscribed.
All available evidence points to the fact that cigarette smoking
is a major aetiological factor in chest diseases. It would seem that
smoking habits are developed early in life at school or elsewhere
and it is a matter of some urgency that the underlying motives be
ascertained and for the health educators to act.
Atmospheric pollution is an undeniable environmental hazard
in the production of respiratory disease and this was amply demonstrated
in the 'smogs' of 1952 and 1958/9 and which the Clean Air
Act seeks to remedy. Prevention lies in the acceleration of nationwide
smoke control including a sustained effort to reduce harmful
products of combustion emitted from motor vehicles.
In cold weather, sufferers from respiratory complaints are
advised to use warm rooms and to avoid sudden changes in temperature
when passing from one room to another. At times of 'smog' it
is advisable to keep all windows closed to prevent exacerbation of
an existing respiratory condition.
Unattended chest infection at the beginning of adult life often
leads to impaired lung function later on and it behoves everyone to
seek medical advice in the early stages. Prevention is all important
since once structural changes in the lungs and bronchi have taken
place treatment tends to be merely palliative and the disease progresses
if not to a premature death then often to permanent disability.