What is Asthma?
Asthma is a chronic disorder in which there is inflammation of the bronchial tubes with prominent eosinophil infiltration causing variable airflow obstruction. It affects the airway that carries air to and from our lungs. Swelling and inflammation makes the airway extremely sensitive to irritation and increases susceptibility to an allergic reaction. As inflammation causes the airway to become narrower, less air can pass through them, both to and from lungs. The condition is clinically characterized by variable cough, chest tightness and wheeze.
Asthma occurs when the linings of the lung’s bronchial airway become inflamed or swollen, usually due to allergies, airborne irritants or cold weather. These airways carry oxygen to the blood, and the length of severity of an attack can be fatal. Physiologically, it is a complex cascade of conditions and interactions that lead to acute airflow obstruction, increased mucus production, bronchial hyper-responsiveness, and airway inflammation.
Each of these interactions and their manifestations can be slightly different depending on the individual and can even vary in severity in the same individual due to their internal physiological environment and external factors. It is these physiologic interactions that result in the wheezing and breathing difficulties that the individual experiences and we call asthma.
“The clinical characteristics of asthma are defined as the occurrence of symptoms and the presence of airway obstruction, inflammation, and hyper responsiveness”.
Causes of Asthma
According to the etiology, bronchial asthma is divided in the following groups:
1. Allergic (extrinsic/ atopic) – This type of asthma usually starts in childhood and is often preceded by eczema. But most of the young adults (<35 yrs) developing asthma also fall in this category. Genetic factors also play a significant role i this. In this type of asthma the allergen leads to production of excessive (IgE) immunoglobulins.
2. Infective or Intrinsic – This is not hereditary or allergic, but may be caused by, or at least associated with upper respiratory tract or bronchial infection which is usually viral.
3. Psychological factors (like anxiety, emotional stress etc) are often considered to be the sole cause of some asthmatic attacks, but it is still not certain whether it can be the sole cause or is only a precipitating factor.
4. Occupational asthma – This can occur in certain industries in which there is exposure to metallic dusts (esp. platinum salts), biological detergents, toluene diisocyanate, polyurethane, flour and dust from grains etc.
Symptoms of Asthma
Difficult breathing (dyspnoea) which produces shortness of breath, with or without tightness in the chest (a feeling of pressure on the chest), is caused by the narrowing of the bronchi and bronchioles. In young children who are unable to express what they feel, parents may sometimes notice fast breathing and “retractions” (the chest being sucked in as the child inhales).
Whistling sounds, or wheezing, may occur because of the decreased size of the bronchi.
Coughing can be severe. In some asthmatic patients, it is the main and sometimes the only symptom. Typically, the coughing occurs mostly at night or early in the morning.
Finally, asthma is often accompanied by bronchial secretions (coughing up mucus and phlegm)
Asthmatic patient do not all experience symptoms in the same way or to the same degree. If asthma is well managed, symptoms can be minimized or eliminated. In severe asthma or when asthma is inadequately treated, symptoms can be continuous.
Symptoms of asthma can be summarized as:
- Shortness of breath
- Chest tightness
- Rapid pulse
- Shallow breathing
- Feeling of suffocation
- Cold extremities
- Short inspiration
- Prolonged expiration
Diagnosis of asthma
The diagnosis of asthma is made on the basis of complete history, perceptible sign and symptoms, and proper laboratory investigations.
Family history – patients who have family history of asthma in close relatives are at increased risk.
Environmental factors – environmental factors like certain indoor allergens, animal dander, smoking (passive smoking) may act as a triggering factor for asthma
Occupational history – it is important to identify if the asthma could have been caused by exposure to such agents which can cause or initiate attack at work, by inquiring about previous and current jobs or occupation.
Investigations for asthma
Chest radiograph – may be normal, or show signs of segmental or lobar collapse
Full blood count – to evaluate eosinophilia
Skin prick test – may be performed to identify atopy and to detect particular sensitivity to a specific antigen.
Lung function test – measurement of airway obstruction using a peak expiratory flow meter or spirometer is done.
Airway responsiveness – airway responsiveness is measured by exercise test or exercise provocation test.
IgE and IgE specific antigen – elevation of total IgE supports diagnosis of atopy, and measurement of fractions of IgE specific to one allergen, Radioallergosorbent can be performed in some patients with specific allergic condition.
Bronchoscopy – should be done to assess inhaled foreign bodies, bronchial carcinoma, vocal cord dysfunction.
What can precipitate an asthma attack?
Finding its causal agent is the single most important step you can take toward controlling your asthma. Unless and until you know exactly what brings on your wheezes, you will have trouble treating them. A multitude of substances or bodily conditions precipitate asthma attacks. The most important once are:
– Cold or upper respiratory infections, especially in children
– Allergens (dusts, pollens, molds, animal dander, and so on)
– Foods, especially food additives
– Vigorous exercise
– Hyperventilation (fast, shallow breathing often associated with emotional or stressful experience)
– Certain drugs or medication, especially aspirin and ibuprofen (such as Advil and Nuprin)
– Air pollutants, including tobacco smoke, smoke from wood-burning stoves, and the by-products of automotive of industrial combustion like carbon monoxide, ozone, nitrogen dioxide, sulphur dioxide, and particular matter.
Homeopathy Treatment for Asthma
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc.
General Approach – As far as I know homeopathy is the only system of medicine which tries to ‘cure’ this disease, instead of trying to provide symptomatic relief. While dealing with a case of asthma, a homeopath not only records the symptoms of the disease but also studies the medical history, family history, physical and psychological characteristics of a person. This helps to find the cause, the precipitating factors, and the hereditary tendency etc. Of special interest to a homeopath is the history of suppression of skin disease. Homeopaths believe that when there is a tendency or predisposition for a disease – it first manifests on the less vital organs, towards the periphery (like skin). If this manifestation is suppressed than the disease shifts inwards, towards the more vital organs (like lungs, heart, brain etc).
The fact that in children asthma is often preceded by eczema is observed by the allopaths also. This fact is written in all their textbooks of medicine. They say that children often ‘move-out’ of eczema and ‘move-into’ asthma. But they are unable to make a correlation. Homeopaths believe that the suppression of eczema with topical preparations, does not cure the disease/sensitivity of the person, it merely drives it inwards.
Now after ascertaining the symptoms and the cause, the homeopath tries to find a medicine which matches the symptoms as well as the general characteristics of the person. The medicine so selected is administered to the patient.
It is often (not necessarily) observed by homeopaths that when a right medicine is given, the asthma disappears but the old eczema (if it was there originally) reappears for some time, before finally disappearing itself. This reappearance of old symptoms is seen as a reversal of disease process and is considered a very good prognostic sign by homeopaths.
For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Some important remedies are given below for the treatment of asthma:
Homeopathic Medicines for Asthma
Aconite, Kali Carb, Thuja, Natrum Sulph, Belladonna, Ipecac, Aspidosperma, Blatta O, Kali Bi, Kali Phos, Sulphur, Lycopodium, Lachesis, Arsenic Album, Bryonia, Antim Tart, Medorrhinum and many other medicines.
Aconite – excellent remedy during acute attacks of asthma, which will ease the breathing and cough. Symptoms of dyspnoea are often accompanied by marked anxiety, fear and restlessness.
Arsenic alb – Asthma with great anxiety and restlessness, often worse around midnight and lying down, better by sitting up and warm drinks.
Antimonium tart – is a good asthma remedy for children and the elderly especially useful when the asthma has been caused by an infection. The cough will have coarse rattling in the chest on both inspiration and expiration. The patient will be worse lying down and at night generally. They may be irritable and want to be left alone.
Aralia racemosa: Cough associated with constriction of chest, worse lying down, after the first sleep, has to sit up and cough violently; asthma, with oppression as from a weight on stomach, worse night on lying down, better by raising a little tough mucus.
Ephedra vulgaris: Mother tincture is used to control asthmatic attack; in reduced doses it is also helpful in pulmonary heart disease.
Ipecac -Asthma patients who suffer from coughing spasms resulting in vomiting or retching. Cough with violent wheezing; chest feels full of phlegm, but does not come out on coughing; acts well in cases of asthma in children, child becomes stiff with blue face.
Carbo veg – Severe acute attacks of wheezing with significant belching and flatus. Patient feels very weak and may collapse. Asthma in old patients; great perspiration; patient wants fanning all the time; cough spasmodic with vomiting and gagging all the time
Kali carb – this remedy often indicated when the attack comes at night, after midnight, from 2 to 4 am. Symptoms worse from 3.AM – 5AM; pain in chest with dry hard cough; scanty , offensive and tenacious cough; wheezing ameliorated in warm weather.
Belladonna – this remedy works when there are violent spasms of asthmatic breathing attended by constriction of chest. Redness of face during acute bout of cough.
Aspidosperma – It is often used as palliative. Stimulates respiratory center, and removes temporary obstruction, also useful in cardiac asthma.
Blatta orientalis – It is often used as palliative. Complaints get worse in rainy season, cough with much pus like mucus.
Justicia adhatoda: Violent cough with tough expectoration and tightness of chest; great fear of suffocation; usually cough associated with vomiting.
Pothos foetidus: Asthma worse from any inhalation of dust.
Lycopodium – Asthma due to excitement by anger or emotion with fan-like motion of ala nasi.
Pulsatilla – Cough with green discharge. The patient must sit up during the crisis and is better for fresh open air. Even fanning may help them feel better. Rich oily food aggravates.
Sulphur – this remedy acts well when asthma is due to suppression of eruptions. Asthma with difficult respiration; worse mid night and morning; craves open and fresh air.
Nux Vomica – attacks of asthma in the morning; with fullness of abdomen after eating.
Natrum Sulph – attacks during wet weather or in rainy season. This remedy acts well when the patient gets attacks every change of season. Cough is relieved by holding chest by hands; asthma with bronchitis; humid asthma; attacks in the morning with loose and copious cough.
Cuprum met – cough with gurgling sound, relieve by drinking cold water; vomiting of cough; attacks of suffocation aggravates 3 AM and cold weather.
Lachesis – asthma symptoms worse after sleep; after taking sour things.
Thuja – asthma in children; face become pale, sickly, and shiny; asthma following vaccination.
Medorrhinum – it is an intercurrent remedy for asthmatic complaints; when other well selected remedies fail to give relief. Cough with chocking; relieved by lying on the face; respiration difficult; wants fanning; feels cold yet removes clothing; complaints worse by damp, wet draught and thunderstorms.
Asthma – CONVENTIONAL TREATMENT
Bronchodilators, anti-allergic drugs, and corticosteroids are commonly used to provide symptomatic relief.
Asthma – Lifestyle & General Management
- Avoid the allergen you are sensitive to.
- Do regular light exercise like brisk walking or jogging. Heavy exercise can precipitate an attack of asthma, so always do mild exercise without putting too much strain on your body.
- Learn breathing exercises to improve your lung capacity. Of especial use is ‘pranayam’, a yoga exercise.
- Learn some stress relieving exercises, meditation, or yoga to minimize the psychological factors related to disease.
- Eat healthy, nourishing and well balanced diet.