YATROGENIA

POTENTIAL CAUSES OF THE MEDICAL PRACTICE BAD RESULTS DERIVED FROM ERRORS IN THE TRADITIONAL INTERPRETATION OF THE RESPIRATORY FUNCTION AND PULMO-CARDIO-CIRCULATORY DYNAMICS

INTRODUCTION:

The Lung displays a structural and functional Design to work under Vagus Sympathetic co-ordination and command which must be re-interpreted now from the physic-mathematical perspective applied to physiological needs. To achieve this proposal, we must underline the following fundamental concepts:

The functional capacities of the airways as a whole as that of each specific segment, jointly with Force potential variations able to be generated by cyclic contraction-relaxation of their walls muscles, are correlatives to the atmospheric mass of air per volume unit at the organism's adaptation level. These capacities and force variations are also correlative to the integrated pulmo-cardio-circulatory dynamics, which must balance the fluids, blood and air at each side of the alveolo-capillary membrane.

THEREFORE:

1. The air-mass per volume unit at the level of the species and individuals natural adaptation is the PhysicAL-Natural Factor with which the pulmonary functional structure and extra-pulmonary airways work, under Vagus Sympathetic command, to achieve the natural integration to the Atmosphere at the very moment of birth and thereafter, for maintenance of Life on Earth.
2. Cultural knowledge of the Oxygen, jointly with errors in interpretation of its role as a proportional element of the air as a gas mixture to which living beings are adapted, has been and is, a cause of accidents, complications and even death.
3. Mountain sickness finds its scientific understanding in the above named concepts. Therefore, they are bases for its prevention and treatment.
4. Respiratory functional insufficiencies find their scientific reason in these dynamics. Hence, they must to be re-evaluated from the perspective of the Fluid's Mechanics, focusing the functional re-interpretation of the Lung and Lung-Heart dynamic integration in balance.
5. Air-blood pressure balance at each side of the alveolo-capillary membrane, during each and every alveolo-capillary cycle, is the result of an implicit equation, which most be solved by the Central Nervous System and carried out by visceral performance under Vagus Sympathetic command. Physiological success avoids pulmonary oedema or gaseous emboli, guaranteeing eupneic respiration.
6. As Lung and integrated pulmo-cardiac circulatory System obey the Vagus Sympathetic command, under Central Nervous System control and muscular contraction follows the specific mediators Acetilcholine and Adrenaline, it follows that medical use of these drugs, their antagonists and blockers, compete with the Nature of Life, distorting it, with consequent damage and even death.
7. I can say, without a shadow of doubt that all the death occurring during or immediately after Adrenaline injection has been produced because of its effects, bronchiolo-constrictor producing asphyxiation
8. Adrenaline is not a broncho-dilator as believed, which is an error of interpretation, probably the result of a false definition of bronchodilation as the cause of the expired air per volume-minute increase following its injection. Physiological amounts of Adrenaline increase the volume-minute of the expired air, by the same reason that it increases the volume-minute of blood ejected by the Heart, inotropic and chronotropic effects. Therefore, over physiological amounts of Adrenaline creates dramatic effects at the alveolo-capillary level, causing asphyxiation.
9. Drugs and pharmaceuticals such as d-Tubocurarine and the like, which compete with Acetilcholine as nervous impulse mediators, have been and are, used in anaesthesia for instance, having being the cause of apnoea due to the Lung's paralysis, sometimes causing decerebration and even death. These drugs cause paralysis of the Reissessen’s muscles, not only in their known ventilatory effects, which can be assisted by artificial ventilation, but also and mainly, by bronchiolar lobular paralysis, since, although its mediator is Adrenaline, it is well known today that Acetilcholine is mediator of the pre-ganglionic Sympathetic discharge. I have suggested, that the Sympathetic fibres in the Lung, mainly in the lobular structure, determine the cardio-pulmonary functional integration, at the lobular-alveolo-capillary units, determinant of the pulmonary respiration strictus sense.

DOMINANT BELIEFS THAT MUST BE SUBMITTED TO DISCUSSION.

1. The Lung is a passive Organ.

2. The Diaphragm is the motor of the Lung.

3. The respiratory muscles are the Diaphragm, intercostals and those known as auxiliary muscles.

4. Adrenaline is a bronchodilator.

5. All secondary concepts derived from the above named concepts.

FUNDAMENTAL CONCEPTS SUGGESTED TO REPLACE TRADITIONAL BELIEFS.

1. The Lung is an autonomic active Organ, under Vagus-Sympathetic command.

2. The Diaphragm is the main auxiliary muscle of the Lung, which responds to the Lung’s demand by a viscero-somatic reflex.

3. The Respiratory muscles are those of the airways or Reissessen’s muscles.

4. All other muscles recruited during each Respiratory Cycle are only reflex auxiliary muscles for viscero-somatic functional integration of the Trunk as a working unit.

5. Adrenaline is a broncho-constrictor. It shows positive inotropic and chronotropic effect, similar to cardiac effects, thus enabling their functional integration at the alveolo-capillary units.

6. The Thorax Walls. Diaphragm and Rib Cage, are exterior support of the Lung, to which they respond in an integrated chain of reflexes.

7. The Respiratory Apparatus of each individual starts working with its natural adaptation to the Atmosphere during birth, according to the following factors.

7.1 Mass of gases per volume unit constituting the atmospheric air at the level of our natural adaptation. This is the Physical-natural primary factor for the work of the Lung, enabling Pulmonary Respiration and consequently the cell’s Respiration.

7.2 Oxygen, a natural element in Gas State; specific for organic combustion, only constitute 21% of the a atmospheric air. Therefore, pure Oxygen is not apt for Respiration. Nitrogen constitutes 79% of the gaseous-mass demanded by the pulmonary structure to fulfil its mechanical function.

7.3 Pulmo-cardio-circulatory dynamics and mass of air per volume-unit constitute the fundamental equation for adaptation and maintenance of the new born life, that is to say for maintenance of Human Life on Earth, as well as of all similar species shearing our Habitat.

7.4 Dynamics leading to blood gas exchange is performed in multiple small units defined as lobule, of which the finest bronchioli contain the alveoli or surface units for selective gas diffusion leading to gas exchange with the blood. The pulmonary lobuli perform a rhythm commanded by the Sympathetic nerve on Vagus tone, just like the Heart, leading to the needed pulmo-cardiac functional integration.

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