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Bronchial asthma

DEFINITION

It is defined as a chronic inflammatory disorder of the airway characterized by trio of symptoms -

- Dyspnoea (difficulty in breathing)
- Cough
- Wheezing.

1) Reversible airflow obstruction causing cough, tiightness, shortness of breath and wheezing,

2) Increased responsiveness of the tracheobronchial tree (airway passage) to multiple stimuli.

The airway obstruction causes mismatch of alveolar Ventilation (inside the lung) and perfusion and increases the work of breathing which is more predominantly seen in expiration.
The normal bronchus can no longer effectively clear the mucus formed by the disease process merely by coughing and hence the bronchus gets obstructed due to the mucus plug.
Thus it hampers the inhaling and exhaling of air (in short the respiratory process) and the person has to exert more for taking in the same amount of air every time causing fatigue.

TYPES OF ASTHMA-

1) Allergic
2) Non-Allergic (Idiosyncratic)

1) Allergic Asthma -
There is personal or family H/O allergic diseases like Allergic Rhinitis, Urticaria, Eczema, positive skin reaction to intradermal injection of antigen, increased level of IgE in the serum.

2) Non-Allergic Asthma -
In this type of Asthma, there is no family H/O allergy, negative skin reaction, normal levels IgE of and therefore cannot be classified on the basis of immunological mechanism.

CAUSES-

The external stimuli increase the airway responsiveness and acute episode of asthma can be grouped into seven major categories: -

1] Allergens -
Most of the allergens which provoke asthma are airborne. It is frequently seasonal due to climatic change. Non seasonal form may result from allergy to feathers, animal dander's.

2] Pharmacological Stimuli -
The drugs which are commonly associated with are Aspirin, colouring agents like Tartrazine, Beta adrenergic drugs and drugs which are used in food and pharmaceutical industry or sensitizing and preserving agents.

3] Environmental & Air Pollution -
It is related to climatic conditions that promote concentration of pollutants and antigens, normally seen in heavy industrial and densely populated areas.

4] Occupational -
Exposure to large number of compounds used in industrial processes like metal salts, wood, vegetable dusts. Pharmacological agents or drugs like antibiotics, piperazine
Industrial chemicals and plastic
Biological Enzymes like laundry detergents.

5] Infection -
Respiratory infection are the most common stimuli for aggravation of Asthma.
In children - Para influenza virus
In Older children & Adults - Rhinovirus and Influenza virus.

6] Exercise -
It can cause worsening of Asthma, if done excessively.

7] Emotional Stress -
Psychological factors counteract with the asthmatic to worsen or ameliorate the disease process.

Asthma Triggers or Factor Aggravating Asthma -

1) Animals with fur
2) Cigarette smoke
3) Dust in beds and pillows/sweeping
4) Strong smells & sprays
5) Pollen from trees and flowers
6) Weather
7) Cold

How to Prevent these Triggers -

1) Keep the bed single - put dust proof covers with zippers on the mattress and pillow. Wash bed sheets and blankets in hot water.
2) Do not let pets in the bedroom.
3) Do not smoke.
4) Maintain good ventilation / Light.
5) Close the windows when the air outside is full of exhaust from cars, pollution from factories.
6) Air out the house before the person with asthma returns e.g. sweep, vacuum, paint, spray for insects, are of strong cleaners, cook strong smelling foods.
7) Asthmatic should use mask or scarf when working in the house and when going out.
8) Exercise regularly.


TREATMENT-

1) During the Attack
2) Between the Attack

During the attack one must decide whether -

a) Is it a mild attack
b) Is it a severe attack
c) Is it status Asthmaticus
d) Tropical Eosinophilia

a) During mild attack-
The patient does not look breathless and his respiratory muscles are not working.

b) During severe attack-
The patient is panting for breath and his muscles are working.

c) In status asthmaticus-
The picture is like the severe attack of Asthma, the attack may persist for few hours or day in spite of the injection of Adrenaline or Aminophylline.

d) Tropical Eosinophilia-
Should be diagnosed by doing a blood test (WBC Count)

 

HOMEOPATHIC APPROACH AND METHOD OF TREATMENT-


APPROACH
Now you know much about Asthma as it is given above. Since it is an allergic response of the lower respiratory organ i.e. the windpipe (trachea) and the air tubules in the lungs (bronchioles) to a particular allergens like
1) dust 2) odour 3) seasonal weather condition 4) fumes 5) smoke 6) perfumes etc. present in the respiratory passage.
This passage goes in spasm and the patient feels breathless.

Homoeopathy believes that there is one more strong causative factor which plays very important role in aggravating the condition of breathlessness i.e.-

STRESS FACTOR-

A] Emotional-

1) Anger, sadness, irritability
2) Emotional shock, Excitement

B] Intellectual-

1) Fear, Phobia
2) Stress, Workload
3) Mental fatigue.

METHOD OF TREATMENT
In Homoeopathy, there are at least 100 remedies, which are useful in treating Asthma.

As we have already read or seen in How homoeopathic cure takes place each and every causative factor independently can trigger asthmatic attack in an individual. Homoeopathy believes in eliminating that spasm by way of treating the immunity (not by immuno suppressant steroids) but by increasing resistance power of the body.

Homeopathic treatment for asthma can be of two types: -

1) Acute Treatment -
We have very excellent remedies, which remove the spasm and treat the attack in most ideal way. But these may be useful in treating acute attack only like that of bronchodilators. But they do not remove the tendency of Asthmatic attack.

2) Chronic Treatment -
The asthmatic tendency of individual may be a) hereditary b) After suppression of skin disease or acquired by any means like professional hazards or any other reasons. This is because of deeply affected immunity so to treat this disease completely constitutional remedy would be of great benefit, which will bring out complete cure (after at least 1-2 years).

The patient can assess the follow up by 3 major criteria's-

1) Frequency of attack - i.e. the frequency of attack starts decreasing from once in a week to once in a month to once in 6 months like that.

2) Duration of attack - If attack or spasm usually remains for 8 to 10 hours with homeopathic treatment it may get reduced to 6-4-2 hours.

3) Intensity of Attack - The severity of the attack giving rise to various symptoms starts decreasing.
Gradually all these start decreasing and cure will take place.
Breathing exercise and yoga can increase lung capacity and increase immunity.

HOMOEOPATHIC REMEDIES-

1) Antimonium tartarium-

A/F exposure in damp basement or cellar.
It depresses the respiration and circulation thus producing keynote of remedy which is Death rattle that is when patient coughs, there appears to be a large collection of mucus in the bronchi, it seems as if much would be expectorated but nothing comes out.
There is much drowsiness debility and sweat.
Attacks generally at 5 o' clock in morning.
The patient cannot breathe enough air.
It seems as if he would suffocate. MUST SIT UP.
Tongue is coated pasty thick while with red edges,
Thirst for cold water, little & often.
Desire for apple, fruits and acids.
Cough << eating with pain in chest and larynx.
Breathlessness >> eructation > lying on right side.

2) Arsenicum album -

A/F - effects of decayed food or animal matter.
Attack occur periodically with burning pain and soreness in chest. The attacks are << midnight after 12 O' clock << 1-2p.m.12-2 a.m. Unable to lie down for fear of suffocation.
Expectoration scanty frothy.
Darting pain through upper third of right lung.
Wheezing respiration.
Cough dry as from sulphur fumes after drinking.
Other features characteristic of remedy are great thirst for cold water, drinks often but little at a time.
Excessive exhaustion from least exertion.
Exhaustion not felt by the patient when lying still
But when he moves, he is surprised to find himself so weak. Mentally there is great anxiety and restlessness.
Irritable, sensitive peevish.
Fear of death; thinks it is useless to take medicine as his disease is incurable and is surely going to die.

3) Carbo Veg -

Remedy thought for Asthma in aged
When there is flatulence giving rise to breathlessness >> belching. A/F - Persons who have never recovered from effects of previous illness.
Asthma after measles or pertusis of childhood. never recovered from typhoid.
A/F from quinine, abuse of mercury salt, spoiled fish, meats or fats, getting over heated.
Cough with itching in larynx,
Spasmodic Cough associated with gagging and vomiting of mucus. Hoarseness << evening, talking Oppression of breathing,
sore chest < <evening.
Long coughing attacks with burning in chest
<< evening, open air, eating, talking.
Blue face, offensive expectoration.
Cold breath, must be fanned. Bleeding from lungs.

4) Ipecec -

Indicated in fat children and adults who are feeble, catch cold easily.
Spasmodic affection of chest.
Difficult breathing from least exercise.
Violent dyspnoea with wheezing and anxiety about stomach, Constriction in chest.
Cough incessant and violent with every breath.
Cough with rattling of muscles in bronchi on inspiration.
Chest seems full of mucus but does not come out.
Blue face, threatened suffocation from mucus.
There is constant nausea and vomiting.

5) Moschus -

Remedy suited to person who are sensitive, nervous hysterical. Tightness in chest with constriction of larynx and trachea.
Difficult respiration, chest oppressed, hysterical spasm of chest. Asthma with anxiety fear and smothering sensation.
Cough ceases but mucus cannot be expectorated.
Hysterical < cold < sensitive to air.
Along with this there is fainting and fits (convulsion).

6) Apis Mel -

Women especially widows, children and girls who though generally careful become awkward and let things fall while handling them.
A/F suppressed measles ,scarlatina urticaria, jealousy, fright, rage, vexation, bad news.
Hoarseness, dyspnoea, Breathing hurried difficult.
Feels as if he could not draw another breath.
Suffocation, short dry cough.
Mentally irritable, nervous fidgety, jealous hard to please.
Weeping disposition, cannot help crying.
Discouraged, cannot concentrate mind when attempting to read or study.

Specific Remedies-

1) Blata orientalis-

Especially suited to stout patients
Useful when asthma is associated with bronchitis
Cough with dyspnoea,
Pus like Mucus.

2) Pothos -

A/F inhaling dust.
Asthma with hysteria. Millar's asthma.
Spasmodic cough. Troublesome respiration.
Feeling of anguish and sweat.
Pain in chest with breathlessness.
Asthma >> stool.

3) Lobelia -

Light complexioned fleshy people.
A/F alcohol, suppressed discharge.
Dyspnoea from constriction of chest
<< exertion.
Sensation of pressure or weight in chest
>> rapid walking.
Asthmatic attacks with weakness in pit of stomach
Prickling all over before attack.
Lingering cough, short breathe.

4) Adrenaline -

Acute asthma.
Sensation of thoracic constriction with anguish.

5) Eucalyptus -

Asthma with great dyspnoea and palpitation.
Expectoration white thick mucus.
Profuse expectoration of offensive mucopus.
Irritative cough.

BIOCHEMIC REMEDIES

1) Natrum Sulph -

Very important remedy for Asthma occurring or aggravated in summer and rainy season.
Attack aggravated in morning about 4 to 5 o' clock with cough. Greenish copious expectoration
Always << in damp weather, hot rainy season (Cellars Asthma). Asthma in children.
Aggravated with every change in weather.
Loose mucus expectoration.

2) Natrum mur -

Bronchial asthma with yellow expectoration
<< in warm season or in hot atmosphere.
Rattling of mucus in chest aggravated after taking food.
Child coughs with mucus in chest but cannot bring out and then vomits.

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