INTRODUCTION TO DYNAMIC-FUNCTIONAL INTEGRATION OF THE LIVING-BEING
Index of this selection
DYNAMIC-FUNCTIONAL INTEGRATION OF THE LIVING-BEING
INTRODUCTION. The Man We Are
The Theory of the Dynamic Integration of the Living Being in the General Context of Science
PART I: EXPERIMENTAL DEMONSTRATION.
I. EFFECTS OF ADRENALIN INJECTION:
II. EFFECTS OF ACETILCHOLINE INJECTION.
Primary Respiratory Arest
III. EFFECTS OF HISTAMINE INJECTION.
IV. EFFECTS PRODUCED BY MECHANICAL DISTENSION OF THE TRACHEA.
Experiment Model # 11. Effects produced by Mechanical Distension of the trachea on the Respiratory Pulse
V. EFFECTS OF THE ELECTRICAL STIMULATION OF THE VAGUS.
Experiment Model #. 12. Effects of the Electrical Stimulation of the Vagus
PART II: EPILOGUE.
1. Mechanical Aspects of the Structural-Functional Design of the Trunk
2. The Trunk: Viscero-Somatic Integrated Unit
3. The Organism as a Integrated System of Fluids
4. The Lobule: Specific Dynamic-Functional Integrated Unit
5. The Respiratory Cycle. Critical Analysis of the Concepts Inspiration and Expiration
6. Law of Proportionality
7. Cyclic Homeodynamics
8. Critical Analysis About the General Interpretation of the Action of Adrenalin in the Organic Functions
9. Integration of the Cholinergic-Adrenergic effects for Phenomena of Vegetative Life
10. New Concepts for the Comprehension of the Neurological Coordination in the Visceral and Somatic Cyclic Dynamics of the Trunk
11. The Integrated Man-World System
12. Synthesis of Synthesis of Important Facts and Phenomena of the New Conception of the Respiratory Dynamics and the Integrated Dynamics for Functions Enabling Life in The Atmosphere of the World
13. Conceptual Synthesis
I. Reflections on Discussions Held in the IV PANAMERICAN
CONGRESS ON DISEASES OF THE CHEST
II. Résumés of papers discussed in the XIX CONGRESO LATINO AMERICANO DE ANESTESIOLOGIA
1. Effects of the Techniques of Anaesthesia with Gases on the Autonomous-Automatism of the Respiratory Function and Homeostasis. Artificial Respirators
2. Effects of Paralysing Drugs. The "Vagal Somatic Acetylcholine Working System" as a Coordinator of Pulmonary-Ventilatory Dynamics and Circulation
3. "The Sympathetic-Adrenaline Sub-System" as Integrator of the Cardio Lobular Dynamics on the Basis of Vagal-Somatic Dynamic Integration
4. "Role of the Pulmonary Ventilatory Dynamics on the Simultaneous Balance of Fluids Circulation in general, and Blood Circulation in particular
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IN THE X ANNIVERSARY OF THE DISCOVERY OF THE RESPIRATORY PULSE
This book, "The Dynamic-Functional Integration of the living Organism. The Man we are" is the conceptual epilogue of the logical and methodological procedure, with experimental demonstrations carried out on dogs, which was initiated by me more than fifteen years ago. The primary results constitute the first part of my first scientific book: "Fisiodinamica del Hombre en el Mundo", resulting from my decision to study the abdominal dynamics.
These studies led me to the fundamental hypothesis according to which the Lung ought to have an autonomic dynamics for its own function, as well as for the responsibility for the cyclic variations of pressure that I had graphed in the abdominal cavity, as well as in the hollow viscera.
The fundamental hypothesis was proved in a transcendental experiment, which allowed me to obtain the graph of the Resultants of the cyclic dynamics of the Lung. I named that Resultant RESPIRATORY PULSE, the first interpretation of which led me to the thought that gave title to the book in which proof of that pulse was first published. The terms I use express the idea of the Physiological Dynamics of the Human Organism, to accomplish the phenomena for vegetative life in the Atmosphere of the World.
This idea is more widely developed in my second book, which is the Theory of the manner by which the Lung accomplishes the Dynamics to integrate the Organism with its Atmosphere, satisfying the need of the organic design, to carry on, up to the lobular level, the required volume-mass of air, for a new dynamic integration at the alveolo-capillary level, for the exchange of gases with the blood, all being conditioned for an integral balance.
New questions were posed about how that balanced integration of the organic structure was fulfilled. This is the subject matter here clarified and demonstrated in the "Experimental Models".
This book is, consequently, the result of the work of a permanent up-dating and recycling of concepts for its own evolution; this is a permanent conceptual analysis and synthesis, with periodical experimental demonstrations. In this manner, the discussion is developed, under the title of "Theory of the Dynamic Integration of the Living Organism in the general context of Science"; in "The Method" and finally, in "Partial focuses of the living Organisms from the common perspective of its Integrated Functional Unit", this latter developed in the "Epilogue".
The three books form a unit, a trilogy in the evolution of the concepts that unveil the Functional Unit of the Organic Structure. The first book can be understood in itself, within its own limits and, clarifies a new horizon. The second book, as a complete analysis of the Respiratory Function, can also be understood in itself, clarifying additional new horizons, which is fundamental for the reader who wishes to interpret the graphs of the "Experimental Models" printed here in their complete development.
The present book has the virtue of focussing on a series of abstractions which are easily understandable, based on the two first books, which permit us to re-structure and conceptually understand the meaning of the Organism as a whole. Finally, the three books close the circle of the analysis and comprehension of the Organic structure for integrated actions and reactions, concurrent to the phenomena generating the functions for vegetative life and Life as an integral phenomena.
These three books are, consequently, the birth and evolution of an intellectual creature of Man, when trying to interpret secrets of Nature, made objective in the phenomena for maintenance of created Life. These books develop the biography of the Man we are, as a prototype of living beings, of the Being who makes himself in himself as well as in the Atmosphere of the World.
But also this third book is an expression of my existential anguish as the Author, with Scientific Reason, to try to succeed in getting the necessary rectification in the institutionalised medical practices as well as in social life, since as I have demonstrated, some of those conceptual mistakes prevailing today, are the basis of "Wrong practices developed in the name of Science", with negative consequences for Life and Health. This is the challenge we must accept with courage, for the benefit of Mankind.
In the last part of this book: "Appendix", I reproduce, in its original version, some criticisms against concepts and procedure exposed, during discussions at the IV Pan-American Congress of Diseases of the Chest, which took place in Caracas, on February 1st to 5th, 1987. Which I communicate afterwards as "Reflections on Discussions Held in the IV Panamerican Congress on Diseases of the Chest", addressed to those responsible at the Congress as well as to some Institutions and competent Organisms in this subject matter, in Venezuela and the World, looking for the agreement of concurrent actions for the necessary consensus of opinion which could lead to practical rectification. Its inclusion in this book has the same reason of being.
This Appendix also offers practical projections of the new knowledge, subject matter in which I have deliberately desired to be sparing in words, trying first to win the needed agreement in the theoretical scientific field.
Nevertheless, the time has arrived for practice, for the Common Good, since the fertile field is ready to demand just attention from those who have held public and private responsibilities in this matter.
With this publication, I reaffirm that need, inviting everybody to the study and action, since my discoveries are a heritage of Mankind, because they refer to the essence of living beings in their Natural Habitat; also, because they generate practical consequences for the preservation of Life and Health.
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THE THEORY OF THE DYNAMIC INTEGRATION OF THE LIVING ORGANISM IN THE GENERAL CONTEXT OF SCIENCE.
A theory about the dynamics fulfilled by the structures of the complex systematised organisation of viscera and soma of the living organisms, under reflex integration and co-ordination, using Man as a prototype, is in principle, a physic-biological theory and, by the same, it must satisfy the Laws, Principles and Axioms of Physics, both theoretical and practical, as well as those of Mathematics and Biology.
Einstein considers the Physical Theories of several classes (14) and emphasises that the major part are "Constructive", That is to say, "an intent to construct, from a formal basis, an image of more complex events by the synthetic method" and quoted: the kinetic theory of gases, which is "an intent to reduce the mechanical phenomena, thermic and those of diffusion, to movements of the molecules". Einstein expresses thus: "When it is said that a joining of processes of Nature has been finally understood", he meant that a "constructive theory which embraces those events has been found".
The complex events of the kinetic theory of gases are accomplished in the living organisms and are determinants in the events to be fulfilled by the functional pulmo-thoracic complex, leading to the Respiratory Function, to which concurs the whole Trunk, under co-ordination of the Central Nervous System and, by the automatism implicit in its own structural design and, in this way, to integrate the complete organic structure in that function, which is totalling and is also an integrator of the living organism to the dynamics and composition of the Atmosphere.
Einstein named, "Theories of Principles" to a second group of theories, which do not use synthetically methods but analytical, that is to say, they do not start from hypothesis and constructive elements, but from the results of experience. This is an empirical method, and concludes: The constructive theories have the advantage of their clarity, integrity and capacity for adaptation. Those of Principles, have the advantage of logical integrity and certainty of foundation.
Following this scheme I can now express: "The New Theory of Respiratory Dynamics" and "The Theory of the viscero-Somatic Dynamic-Integration of the Organism" constitute a complex theory in their development. "Constructive" and, "of Principles"; to understand them is thus necessary, first, to understand the formal basis on which they stand, remarking the general Principles of the Universal Dynamics, centred on Newtonian fundamental Laws.
The basic conception of Relativity. The concept of space-time as a dimension. The Laws of the behaviour of gases, and the properties of the gases that integrate the mixture which is the atmospheric air.
The qualities of the alveolo-capillary membrane enabling the selective passage of gases as well as the proportion of their diffusion, in concordance with the parameters relative to the composition of the blood and to the relative pressure of the two kinds of fluids, blood and air, in addition to the their simultaneous presence.
The behaviour of liquids and the physico-chemical qualities of the corpuscles in suspension must be known. The anatomic design of the Trunk in general, and especially that of the airways, the Lung and the thoracic walls, as well as the pulmo-thoracic anatomo-functional synthesis, mediated by the pleura must also be known. The circulatory hydraulic System, of which the Heart is the principal pump and, the pneumatic circulatory System of which the Lung is the principal pump.
It is necessary to emphasise here an anatomo-functional division of the respiratory tree: Laringo-tracheo-bronchial passages as far as the Centro-lobular bronchioli, that is to say, the whole broncho-pulmonary system, with the only exception of the lobuli or specific units of the Lung. The complex passages I assert, have as a mission the renovation of a volume-mass of air from the Atmosphere, as well as its transportation or circulation towards and, from the vicinity of the lobuli, which at the same time that they pressurise and acclimatise the mass of gases, also create the dynamic conditions of the structure and balance the general circulation of the organic fluids in their different compartments.
The area represented by the totality of the lobuli accomplishes its specific function for gas exchange with the blood, working on the dynamic conditions and supplies delivered by the pulmo- cardio-thoracic infra-structure in which its own dynamics is imposed.
The reason for the respiratory airways functional design must also be understood, with their potential possibilities for changing their sectorial capacities, increasing or diminishing the air pressure, for its circulation, also creating reflex effects, relative to the structure's tension degree, as well as the sectorial adaptation to the requirements.
In this context, it has to be known that the muscle fibres of the bronchi are disposed as a geodesic net (31) and that consequently, the effect of their contraction is simultaneously fulfilled in two directions; with effects in the bronchial diameter and length. These simultaneous effects are responsible for variations in capacity, and consequently, for the inversely proportional variations in pressure in the contained gases; but also, the decrease in length determine a very important parallel effect, which has formerly passed unnoticed, masked by the traditional conception of Respiration; this is the rhythmic contraction of the muscles of the airways, which generates simultaneous retraction of the pulmonary structure, also pulling from its exterior support, that is to say, from the thoracic walls, mediated by the pleural adherence.
Broncho-constriction and its simultaneous effects generate: first, the displacement of the air-mass contained in the lungs, "residual air", towards the vicinity of the lobuli, simultaneously pulling from the Diaphragm, to which they are physically adhered, in order to stimulate the Phrenic nerve to generate its reflex contraction, which will enable the expansion of the previously displaced and pressurised air. This expansion of gases towards the periphery, now simultaneous with the opening of the Larynx and the elastic expansion of the bronchi, formerly under constriction, determine the act for air renovation traditionally known as "inspiration".
The broncho-constriction generates a mechanical effect similar to that produced when the rubber balloon connected to the cuff of the apparatus used to measure the arterial pressure is pressed, which displaces the air contained in the balloon, a simile to the main bronchi, towards the cuff, a simile to the peripheral bronchioli, with the only exception of the lobular bronchioli.
When the balloon is released, it expands by elasticity and, thanks to its system of valves sucks atmospheric air and fills up to its own dynamic equilibrium. By analogy, when the primary broncho-constriction ends and, thanks to the system of "valves" of its structure, or muscle fibres disposed "Sphincter like" around the points where the brochi divide, and, because of their elastic expansion, air from the Atmosphere is sucked.
It is now clear that the air intake from the Atmosphere is the consequence of the primary act of broncho-constriction, which displaces first the retained mass of air, "residual air", also creating force and space to receive a similar mass of atmospheric air to renew the intrapulmonary store. The air now displaced by means of broncho constriction, and not that just inspired, will be used by the lobuli, by fractions, during each lobular-alveolo-capillary cycle.
"The New Theory of Respiratory Dynamics" can be considered as 1st. A restricted theory, limited to the dynamics of the pulmo-thoracic structure. 2nd. A wider theory concerning the dynamics of the Trunk as a whole, for modulation and balance of the circulation of the fluids, and especially, of the pumps Heart and Lung, in their inseparable reflex viscero-somatic dynamic-integration with the walls of the thorax and abdomen. 3rd. and lastly, a general theory, which explains the integration of the organic dynamic-integration with other natural forces, represented in the Universal gravitation, as it is manifested in the World's Atmosphere at the level of adaptation of each species, as well as in the relative composition of the air.
Einstein expressed the idea that to discover the movement of a body it is necessary to discover a referential second body, thus named System of Coordinates, and follows: "In order that the Laws of Mechanics have any validity, the movement of coordinates can not be chosen at random.... There is a system of coordinates admitted in Mechanics, named "Inertial System", and follows. "According to Mechanics, the state of movement of an Inertial System is not sufficiently determined by Nature" and considers "more valid the Law that establishes that a System of uniform movement of translation referring to an Inertial System, is at the same time, itself, an "Inertial System"
It is valid to highlight, in "The New Theory of Respiratory Dynamics", that the tracheo-broncho-pulmonary Unit, is an Inertial System of autonomic function, regulated by the Vagus nerve to satisfy the tissular demand, although it is only determined by the magnitude of the stimulus for the initial impulse, which generates the actions and reactions to be fulfilled in the whole Organism during each Ventilatory act, since the actions and reactions generated during each cycle, from that initial stimulus and the linked reflexes, are automatically predetermined by the forces generated by contraction of the bronchial muscles, the threshold of sensitivity of the specific receptors and the elastic properties of the parts constituting the System.
Another Inertial System for the reference we are explaining, would be constituted by the thoracic walls: Diaphragm and Costal wall, since the position and tension of the named structures, at each side of the System, are correlative, since the total cycle is "programmed" with exactitude, in the "Organic Model".
It is necessary to consider the range of the Inertial Systems, when we analyse the complexity of the organic conception leading to the maintenance of the created life. They must be inter- dependent to guarantee the result, considering "Lobar zone" individualised, with their own dynamics, since the lobuli constitute a supra-structure acting on the mechanical conditions offered by the infra-structure of the first named inertial systems, that is to say, The Visceral tracheo-bronchial System and the somatic Diaphragmatic-Costal System, under Vagal command and the mediation of the pleurae.
I will make reference now to the integrated Dynamics of the Vegetative Inertial systems, under sympathetic-adrenal co-ordination: The Cardiac dynamics and the pulmonary lobular dynamics, whose functional integration at the level of the alveolo-capillary membrane, in a close relationship with the Resultant of the pulmo-thoracic dynamics in the pleural space is, without doubt, the most important parameter to understand the Dynamics of the total integration of the Organism, since they determine the synthesis for the Organic regulation, because it is at the alveolo-capillary membrane where the alveolar and capillary pressures are balanced to achieve the selective diffusion of gases, relative to mechanical and biochemical conditions.
The System of Coordinates could look complete with the now mentioned. Nevertheless, I have shown factors demanding wider analysis, because they are themselves concurrent factors for the determination of the coordinates in reference. I want to refer here myself to the factor "atmospheric-air" which, from a layman's point of view, seems to exhaust its meaning, evidenced by the fact that the common language, as well as the "Scientific language" consider it analogous to say Oxygen, when referring to respiration, an error attributable to the impact produced by its discovery by Pristley, followed by its relation to Respiration, as any kind of combustion, by Lavoissier in the XVIII Century.
Now, The New Theory of Respiratory Dynamics establishes the link between the condition of the "Organic Design" for Life in the World, with the dynamic conditions and composition of the atmospheric air, which leads us to relate those dynamics with the Gravitational Law and their effect on the air-mass supplied by the Atmosphere for that Organo-physical interaction which we know as Pulmonary Respiration, in its new interpretation. The Theory of Respiration is thus directly related to the hypothesis of the molecular-movement according to which, "The theory of kinetics of gases intends to reduce the mechanical, thermal and, diffusion phenomena to movements of the molecules".
The New Theory of the Respiratory Dynamics is the interpretation of the theory of kinetics of gases, which would work, for its natural use on the dynamics of the elastic structure of the apparatus designed for that: the "Pulmo- Cardio Thoraco Abdominal "Apparatus" or "Complex System"; Therefore, the concept we are trying to interpret is now clearer.
The "Organic Design" demands simultaneous delivery of correlative masses of air and blood to the alveolo-capillary units, at balanced pressures and under uniform distribution in each cycle; this is the reason for that design, now interpreted (read re-interpreted). This re-interpretation is initiated in "The New Theory of Respiratory Dynamics" and is completed in the Theory of Dynamic-Functional Integration of the Trunk.
As it is now clarified, the title of "The New Theory" obeys a didactic purpose, since the "theory" surpasses the limits of the function for gas exchange and presents itself as a Theory of the Unitary Conception of Nature, and specifically of the Conception of the Living Organisms as Beings to maintain the created life in the World, for which we are designed. Therefore, the title of my first book: "Physiodynamics of Man in the World", as well as the other concept used in it: "The Organic-Vital Dynamic- System" is a wide vision of the panorama to be studied, and a departure point for the New Interpretation of Nature.
Following the concepts exposed by Einstein, I could say that the New Theory is a mixed theory. Constructive in its development, since it builds on a formal basis, "an image of more complex facts", being identified with its own example: the kinetic theory of gases, which is a determinant basis for the Theory of Integration with the World in its physico-natural space, as well as the same conception of the Living Organism for its own adaptation to the Atmosphere of the World, and thus, when I believe that "a joining of events of Nature has been finally understood" (I mean) that I have found a "Constructive Theory" that embraces those facts. Nevertheless it is also a "Theory of Principles", since it also uses the analytical method, as I draw upon the results of experience, as demonstration and complementation of the facts of Nature that I have been attempting to understand. I then use the empirical method and, from its principles I have been able to deduce criteria which I have formulated mathematically. Consequently, one day, during one of the final readings of the manuscript of my book "The New Theory of Respiratory Dynamics", while checking its printing, I experienced a light excitement and said to myself " I have been reading the text for a mathematical equation and I only lack the way to express it with the corresponding symbols" Therefore I wrote the chapter "Development of Equations for the Organo-physical Dynamic Equilibrium for Vegetative Life".
I believe that with the simultaneous and spontaneous use of the "Scientific methods" that characterises my natural way of thinking and developing my own thoughts, I have arrived at the same characteristics that Einstein attributed to each isolated method: Clarity. "Integrity and adaptation capacity", as well as "Logical integrity and certainty of foundations".
The system of coordinates selected in my theory, I believe honours the theory that establishes that a system of uniform movement of translation, relative to an "inertial system", is also itself an "inertial system", therefore I consider the "Laryngo-tracheo-pulmonary Unit" an inertial system in relation to the other system, constituted by the somatic unit "Diaphragm-Costo-abdominal walls" (walls of the Trunk). The application of this law to any phenomenon of Nature is named by Einstein "Principle of restricted relativity" and I believe this Principle is fulfilled by the theory exposed by me, therefore, any valid law of Nature, when applied to the system of coordinates K1: "Laryngeal tracheo-bronchial Unit" must also be valid for the system K2: "Walls of the Trunk", since they have, in physiological conditions, a reciprocal uniform movement.
I have introduced in my theory a more extensive application of the kinematics, that is to say, of the science concerned with space and time, from the physical point of view: hence, this enabled me to demonstrate that the events for the phenomena of life only make sense if they are referred to the same system of coordinates. In this case, the simultaneity of pulmo-thoracic facts refers not only to each one of those coordinates, but also to the other series of coordinates at the same time and, this is possible because the neurological coordination which integrates and modulates all the systems of coordinates we have selected to interpret the pulmo-thoracic kinematics in a restricted manner, and the pulmo-cardio- thoraco-abdominal events, for the organic universe; therefore, the patterns of measure, such as the velocity of the march of clocks (specific receptors, pace-makers, conduction ways, nervous centres etc) have to depend on their state of movement in relation to the system of coordinates.
The general theory demands that the Organism must be a complex of inertial systems coordinated in their cyclic activity, in intensity of the initial forces and the relative displacements of the parts; forces, and space-time relationship. The fibres of the Vagus nerve for pulmonary ventilation and parallel effects transmit the initial stimulus, being a common factor.
The receptors of stimulus in specific places of the system have their own particular characteristics, as they are the responses of the receptors and the reflex results. This fact has as an objective the accomplishment of local actions for partial phenomena and, the integration of partial phenomena for a global result which we can synthesise as the uniform circulation of fluids, liquids and gases, by the tissues, the objective of the dynamics for the maintenance of the tissular life.
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EFFECTS OF ADRENALINE INJECTION
EXPERIMENT MODEL # 2. (a selection)
METHOD. Injection of 0.5 mg of Adrenaline e.v. to a dog weighing 16 Kg. (tracheal tube). Channel 1: Respiratory Pulse. Channel 2: Aortic Pulse. Channel 3: Pneumogram.
OBSERVATIONS AND DISCUSSION.
Respiratory Pulse. (a) Is a referential average cycle. (b) Two "siamese" cycles, the appearance of which is due to the absence of the intervening pre-inspiratory relaxation between them, and consequently, the absence of the corresponding inspiratory impulse, both of which are due to the lack of the corresponding phenomenon can be observed in the pneumogram, since the costal expansion is prevented by the long lasting traction exerted by the pulmonary structure. (c) Beginning of a long lasting period of apnoea, of 64 seconds, due to bronchiolar or peripheral broncho-constriction, which prevents the inspiratory act.
Pneumogram. Simultaneous effects in the curve of the pneumogram, which mean in practice a maintained costal retraction, stronger to that of the initial retraction, which shows that this is exaggerated in strength and duration; absence of ventilatory cycles, presumably due to bronchioli constriction. (c-d) cyclic lobular inflexions are better defined, which means that an increase in pressure of the air in the lobuli is produced. The aortic pulse is also increased, with a slight dominance of the systolic pressure. The Pneumogram shows a mirror image of the happenings in the pulmonary dynamics due to the activity of the lobuli; that is to say, there is no costal expansion. (d) And onwards, a decrease in the card-lobular rhythm, very noticeable at the beginning and less so afterwards.
The systolic pressure remains uniform, but not the diastolic, which shows a marked pre-systolic descent, due to an exaggerated pulmo-diaphragmatic traction; a pressing action possibly due to an increase in the intra-pulmonary pressure, which then rises up to maintain itself steady. Simultaneously, the dichrotic wave be-comes higher in the graph. The lobular cycles are better defined, since the alveolo-capillary slope becomes more relevant, in relation to the arterial and lobular hypertension, over the pulmonary strength that enables it (note the ascending tendency of the sequence of the lobular pulses).
The Pneumogram shows (marked with an arrow), a step upwards which means a "step" of relaxation or a decrease in the pulmonary pulling by broncho-constriction. The effects of the inflexions of the lobular-alveolo-capillary pulse can be observed in the curve of the Pneumogram. It remains to be clarified whether this pulse, in the dominant conditions, is able to produce any degree of air renovation, or if there is only a recycling of the intra- pulmonary air. It is this latter that seems most likely.
Respiratory Pulse: Marked progressive increase in the inflexions of the lobular impulses, both, the broncho-lobular and the alveolo-capillary slope, although this latter is higher than the former (marked with arrows). The main downward inflexion or inter-cyclic lobular relaxation (small arrows) remains at its previous level, all of which suggest an increase in the cyclic contraction of the lobuli, with an average relaxation over an appropriate tension of the broncho-pulmonary structure, enabling the phenomena to be observed.
Aortic Pulse: The systolic pressure is uniformly sustained high, identifiable by the upper points on the graph, while the diastolic pressure increases steadily, with the following characteristics: The dicrotic wave (arrows) becomes higher, reaching a level close to the peak of the systolic pressure in each cycle, which is prolonged in an extensive plateau of about 0.5 seconds. The diastolic pressure is reduced to only a pre-systolic period of about 0.2 seconds (mechanical difficulties).
Pneumogram. The dynamic events of the lobuli are clearly shown, but this curve is newly raised (marked with an arrow), and shows a degree of costal expansion similar to the maximal cyclic expansion preceding the injection of Adrenaline, which now means that the Thorax is inflated like a balloon, due to the expansion of the gases trapped at the pulmonary periphery. The costal wall remains relaxed, due to the lack of the reflex contraction of the intercostal muscles, enabling any dynamic event from the pulmonary periphery to be graphed in the curve of the pneumogram.
The injection of 0.5 mg. of Adrenaline produced an effect, in the pulmonary area, manifested as a sustained peripheral bronchiolo-constriction and strong lobular activity. As a consequence, long lasting apnoea and costal retraction. A similar and parallel effect to that generated on the lobular area is produced in the right cardiac area and on that of the pulmonary artery, both effects will be increased by the mechanical consequences produced in the general blood circulation and the air circulation, due to pulmonary peripheral broncho-constriction.
The dramatic situation generated by the Adrenaline injection is locally initiated by the cardio-pulmonary dynamics and is a result of the dynamic consequences in the integrated cardio-pulmo-thoraco-abdominal system, leading to circulation of the organic fluids, air and blood, as their greatest exponents, in addition to the gas exchange at the alveolo-capillary level; in fact, the sustained constriction of the bronchioli impedes the phenomena for inspiratory broncho-constriction-relaxation which normally leads to air renovation from the Atmosphere; meanwhile, the increased activity of the lobuli also increases the intra-lobular gas pressure, and by extension, the pressure in the pulmonary periphery is also increased by the sustained traction from the costal wall due to lobular bronchiolo-constriction, and this is also manifested as an increase in resistance to pulmonary capillary circulation, with retrogressive hypertension, in the pulmonary artery and farther on in the venous circulation, as well as in the abdominal aorta and left ventricle.
The dynamic problem at the alveolo-capillary level makes the gas exchange with the blood more difficult, while the pulmonary hyper-activity and the resultant difficulty in circulation subsequent, as an integrated whole, contribute to increase the phenomenon of anoxemia, which will lead, in a vicious circle, to cardio- pulmonary failure and death, if the normal situation is not restored. The effect of Adrenaline injection in this example, lasted just up to the limit of irreversibility (see following experiments). Once the effect ceased, probably as a result of the metabolism of the Adrenaline, the dog recovered without any help.
During the 22 seconds graphed in fig 4, the bronchiolo-lobular and alveolo- capillary pressures are increased, as an effect of the exaggerated contraction of the bronchiolar lobular muscles, which is of such a magnitude, that the Lung maintains the costal wall retracted, while the inter-cyclic relaxation does not change, all of which is a cause of an increase in resistance to circulation along the pulmonary artery, with all its consequences, as observed in the diastolic pressure in the abdominal aorta, which means in practice that a delay in the venous circulation is produced. This process leads to disturbances in oxygenation and nutrition of the tissues, as will be evidenced farther on in their consequences on the Heart.
The injection with Adrenaline e.v. generates bronchiolo-constriction and an increase in the lobular dynamics, as well as on the cardiac area and pulmonary circulation, A fact which confirms those formerly shown, according to which the pulmonary lobuli and the right ventricle constitute an Integrated Dynamic Unit; therefore they respond in a similar way in each sector, as a guarantee for the necessary dynamic balance at the alveolo-capillary level.
The Resultant of the Pulmonary Dynamics is manifested as a difficulty for gas exchange with the blood, trapping of air in the pulmonary periphery, lack of air renovation from the Atmosphere and anoxemia. In parallel, resistance to the general blood circulation and failure of the Heart.
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