Many diseases of the chest bring about wheezing and difficulty in breathing. Examples of such diseases are allergy, chronic bronchitis, foreign bodies in the lungs, pre-emphysema, enlarged glands, and tumors in the chest.

When wheezing and difficulty in breathing are episodic, bronchial asthma is the cause. Bronchial asthma may be brought about by:

a. Allergy

b. Irritation of the mucosa of the lungs ñ Aspirin

d. Prolonged exercise

e. A combination of factors

To diagnose the cause of bronchial asthma, a doctor needs chest X-rays, a laboratory workup, and a diary which should delineate the weather conditions each day (temperature, humidity, cloudiness, sunshine, smog, rainfall), the symptoms of the illness each day (shortness of breath, wheezing, coughing), the general daily activity, the medications used during the day, any unusual events that have happened each day (exams, a party, etc.), and a list of all the foods eaten by the child that day.

Symptoms can be mild, moderate, or severe. Shortness of breath is mild if the child can carry on his normal routine even though his breathing may be difficult; moderate if the child is able to breathe while lying down but is unable to do any physical work; and severe if he can breathe only while in the sitting position. Wheezing is mild if it can be heard by placing the ear of a stethoscope over the chest; it is moderate if it can be heard from a distance of three feet; and it is severe if it can be heard from another room. The cough is mild if it is easy and productive; moderate if it is difficult and sporadic; severe if it is continuous.

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