Counseling Sheet

By Agatha M. Thrash, M.D.
Preventive Medicine

Asthma is a respiratory disease characterized by difficulty breathing - wheezing, coughing, clicks, and musical sounds produced by breathing. About 5 in 100 Americans have asthma. It is caused by a tightness in the tiny muscles around the bronchi and small air ducts, narrowing the air passages producing the difficult breathing. The acute attack often starts with a bit of tightness in the chest and inability to breath freely, progressing to greater tightness and fatigue from the effort to continue laboring for breath.‍

Treatments

‍There are two different phases in treating the asthmatic. The first is that of treating the acute attacks. The second is treating the patient between attacks, in an attempt to lengthen the time between the attacks, and eventually to eliminate them entirely as the patient learns more about how to control lifestyle.‍

Remedies have two objectives:

‍1. Locating and isolating the causes (elimination of the cause represents the very best treatment)

2. Relieving the symptoms

Allergies are the most important cause, and begin most often between the ages of 20 and 40, but may be found in children as well as in the elderly. Children living in homes where there is a smoker should be considered abused children. Probably 35% or more of childhood asthma is due to other family members smoking in the home.‍

Acute Attacks‍

• Since anxiety naturally accompanies the acute attack, allaying fear is the first step. Have the person bend over slightly and blow forcefully through a very tiny pinpoint hole made by putting the mouth against the closed fist on the thumb side where the index finger curls around leaving a tiny hole. The effort to blow through such a small hole will actually open up the bronchi a bit, and breathing is immediately a little easier.
• A glass of water every 10 minutes for a hour will often dilute allergens, and loosen secretions so they can be brought up more easily.
• Blend four cloves of garlic in a cup of lukewarm water until thoroughly blended. Pour the material into a cup and drink it rapidly. Most patients will have nausea and vomiting after drinking the solution, which assists greatly in loosening bronchial secretions, and makes coughing successful. This is an old-fashioned remedy once used in emergency rooms for asthma, using syrup of ipecac to induce vomiting. However, never use syrup of ipecac in asthma as it is a narcotic and reduces muscle stimulation in the chest. The breathing may improve with the garlic treatment alone. Vomiting loosens bronchial plugs and encourages watery secretions and coughing, bringing marked relief. Make a second cup of the garlic water, blending only one clove of garlic in a cup of cold water or tomato juice. Allow the patient to sip this cupful, or it can be quickly administered promptly after the vomiting has entirely stopped, during the "refractory phase," when vomiting usually will not occur. The active principal in garlic is excreted in the lungs, loosening secretions and improving the breathing.
• Boil 1-5 Aloe vera leaves in a pan of water and inhale the vapors with a towel over your head and the pot. You can also do the same inhalation treatment using a few boiled potatoes. Another variation of this treatment is two cups of water boiled with one tablespoon of thyme or a few drops of eucalyptus honey. Pour the boiling mixture into a basin and inhale.
• At bedtime, take 1 tablespoon of sunflower or corn oil before retiring. It helps breathing during sleep.
• Cranberry juice contains an ingredient that dilates bronchial tubes. Gently simmer one cup of cranberries in 1 quart of water for 5 minutes and mash the cranberries. Place in a tightly closed glass container and refrigerate. During an attack, add 3 teaspoons of the juice to a cup of hot water. Sip it while hot. Jude's Herbal Home Remedies by Jude C. Williams, M.H. 1996, Llewellyn Publications, P.O. Box 64383-869, St. Paul, MN 55164-0383
• Sleeping with a hot water bottle or electric heating pad under the feet and knees is a great help in relieving congestion of the lungs which asthmatics generally suffer.
• The use of hot and cold water applications will often bring an attack to a close in a few minutes.
  ▫ Very hot fomentations to the back of the neck and chest, the patient lying on them while other fomentations are applied to the front of the chest. At the same time, a hot foot bath is set in place. Keep the face and head cool. Some patients may need only the back packs which they lie upon. Cover the patient warmly in winter and lightly in summer, using a light fan directed to the face for comfort. The patient should lie quietly for 30 minutes. Finish the treatment with a cool sponge bath or an alcohol rub and coarse towel friction rubdown.
  ▫ Some attacks will be stopped by 1 gallon of very cold water poured over the back of the neck from the 24-inch level for 2 minutes, the patient bending over so the runoff water can be caught in a bucket or tub underneath the neck and chin.
  ▫ A neutral bath for 2 to 4 hours can be given at a temperature between 94 and 97°.
  ▫ Anything that increases perspiration of the skin will encourage increased activity of the mucous membranes. Since secretions become thickened and rubbery in asthma, the increased activity loosens secretions and promotes expectoration and clearing of the bronchial tree. Asthma may be relieved by the Russian bath, but will return with redoubled force if there is any inadvertent exposure to a draft following the bath.
  ▫ Cold water baths can ease asthma symptoms. Those with asthma should bathe in cold water for 1 minute, or take a 30-second cold shower each day. Professor Vijay Kakkar who had had asthma for 15 years began taking daily cold baths. After a few weeks he no longer needed to carry an inhaler. Thrombosis Research Institute in London. The Daily Mail, London, Spring 1999.
• Several massage strokes are helpful.
  ▫ Cupping: Locate the adrenals by estimating the distance midway between the lower angle of the shoulder blade and the waist. Just above the midsection of that line is the approximate level of the adrenals. A sharp smack with the cupped hand over the adrenal area, followed by brisk rubbing for about 10 seconds, and repeated on the opposite side 2 or 3 times, encourages the release of adrenalin, which dilates bronchi.
  Tapping briskly with the finger tips over the adrenal area for 1 minute on each side also causes the adrenals to react.
  ▫ Slapping the skin briskly over the adrenals with ice-cold towels, the patient sitting bending over, also stimulates the adrenals.
  ▫ A woman from rural Alabama told me of a remedy which she had devised for her husband in which she slapped her husband with her hands on his bare back across and below the shoulder blades. He got great relief after a few minutes of this.
  ▫ A 15-minute upper body massage helps to reduce chest tightness, wheezing, physical pain, and fatigue in asthma sufferers. Prevention, July 1995, p. 2310.

• Use a vaporizer in the room, cool air type, with some kind of medication such as menthol or oil of eucalyptus in the water.
• A neutral bath at around 95-97°, maintained for 1-5 hours encourages easy breathing in some patients.
• The acute asthmatic attack can often be relieved by the Heimlich maneuver, the same maneuver that has saved lives of people choking on food. This maneuver forcefully compresses the lower chest and pushes up the diaphragm. It helps asthmatics to expel mucus and excess air from the lungs, thereby making breathing easier. If performed several times a week, there is a good possibility it may help to prevent attacks. The Heimlich Maneuver is done by pressing one's fist into the abdomen over the stomach while standing behind the patient and reaching the arms around the patient, and taking the other hand and suddenly and forcefully squeezing the chest, pushing the fist with the opposite hand with all one's might in a sudden way, trying to get the patient to bend over at the same time you forcefully push your fist into the epigastrium. Almost always the diaphragm will be pushed upward rather rapidly, and the patient will do something similar to a cough. Since asthma is quite serious and widespread, even though there is some controversy among authorities as to the effectiveness of this maneuver, it is worth trying when things are not going well during an asthma attack. Modern Medicine 65 (2):28, 1997
• It is now estimated that about 10% of acute asthmatic attacks are caused by the use of pharmaceutical drugs. Asthma treated with steroids will result in a serious increase in the loss of bone mineral. The recent increased mortality rate in asthmatics is believed to be due to the newly developed asthma drugs. At Pennsylvania State University researchers have found aspirin and other non-steroidal anti-inflammatory drugs among the main culprits. Beta-blockers, used widely to treat heart disease and hypertension, are risky for asthma patients. About half of all asthma patients using beta-blockers will have adverse reactions. Comprehensive Therapy 22(6):339;1996. All drugs, but especially these listed, should be avoided if possible.

Avoid tartrazine (a yellow food dye), acetylsalicylic acid (aspirin like compounds), sulfur-dioxide, sodium benzoate, and sodium metabisulfite (found in commercial fruit juices, vinegar, syrups, and toppings, dehydrated vegetables, processed cheese, processed meats, and alcoholic beverages). Try to find other ways to treat illness than pharmaceuticals. If possible avoid all drugs, cortisone, and caffeinated beverages, even if decaffeinated. Long-term use of cortisone-like compounds increases many risks. Avoid antihistamines, as they dry secretions and increase difficulty in breathing.

A number of medications often used by asthmatics may produce a rebound similar to that produced by nose drops. Aerosol nebulizers induce a dependency, and may produce thick, dry, mucus plugs. Sodium metabisulfite is present in several medications used for asthma. Sensitivity to metabisulfite has caused many asthmatics to get worse.‍

Prevention of Asthma and Asthmatic Attacks

‍While this phase of treatment is not dramatic or distressing, it is actually the more important aspect. The objective is to completely abolish acute attacks.

• Hospitalization in childhood should be postponed, if at all possible, before the age of 2 years as it increases the risk of developing asthma at a later time in childhood. In hospitalized children, 13% later turn up with asthma, as compared to only 5% for those not hospitalized.
• Magnesium sulphate has been shown to reduce the rate of hospital admissions and improve pulmonary function in patients with severe acute asthma. Persons with hard to manage asthma are far more likely to be low in magnesium and vitamins A, C, and E than persons whose asthma is easy to control, or healthy persons. Clinical Pearls News, 9(12), p.233, 1999
• Country living in an area with minimal air pollution is advisable for all and especially asthmatics. Livestock and pets near the home increase the risk of getting asthma. Banish pets from the home, including birds and possibly fish, or close contact with animals. Compost piles, mulch and leaves around shrubbery growing close to the house, a large number of trees which shade the yard and house, may all encourage asthma.
• Living in homes having heavy drapes and thick carpets increase the likelihood of acquiring asthma. Ornate furniture, fabric upholstery of furniture, open closets and open book shelves, decorations with flowers, stuffed animals, many handcrafts, and objects which emit perfumes or flower odors, electric fans that stir up dust, and forced air heating and air conditioning, may all cause asthma. Fully 40% of patients with asthma are allergic to house dust, decomposing cockroaches being found to be an important cause of asthma. Houseplants and moldy bathrooms and kitchens may increase risk. The simpler and unadorned the home, and the more scrupulous the cleanliness, the better the atmosphere for the asthma prone person.
• Eliminate molds and yeast located on windowsills, picture frames, and dust on table tops and over mirrors. Avoid airborne chemicals such as hair sprays, other sprays used in the household for cleaning and for cosmetics. Make your house, or at least one room, free from fabric upholstery, and all surfaces kept dust free. All clothing should be kept carefully in closets with the doors closed, wool clothing kept in separate bags (with no mothballs, insect sprays, tar paper and camphor). Avoid carpeted floors (use linoleum or wood). Avoid stuffed toys, cosmetics, talc, perfumes, flowering house plants, synthetics, fuzzy fabrics for blankets and clothing, and covered pillows as they attract dust and other airborne particles.
• A bed having the mattress and box springs covered with plastic that can be dusted or sponged to remove dust frequently is a great help. Wet dust the room twice weekly using a mild disinfectant on the dust mop for floor surfaces and all surfaces above the floor. A disinfectant may be used to inhibit mold growth. Vinegar and chlorine bleach mixed half and half and wiped lightly on surfaces will be adequate. Apply with rubber gloves. Use an air filtration system, if possible. Avoid any kind of gas fumes in the home such as from kerosene or gas stoves, and the smoke from wood heaters or fireplaces. There are wood burning heaters equipped with a converter that eliminate the smoke. These may be tolerated by many asthmatics.
• Infants should be breast-fed, as cow's milk and soy milk can both develop allergic states in susceptible babies. Breast-feeding mothers may need to avoid all animal products, and the list of foods on the Elimination and Challenge diet which might cause the baby to react through the breast milk.
• The sulfurous compounds and mustard oils in onions help prevent inflammation that leads to asthma attacks and other respiratory disorders, even tuberculosis and whooping cough. If one drinks onion juice before an exposure to irritants, it reduces asthmatic attacks by 50%. One-half an onion cooked and one-half raw with a meal is the dosage. Onion juice can relieve an acute asthmatic attack. Crush or blend in a blender enough to make one-quarter cup of juice. Sip it over a 5-10 minute period. International Archives of Allergy and Applied Immunology 94:262-65; 1991
• Childhood asthma may be linked to too much sugar and fat in the diet. Andrew Bowser, 1996 Medical Tribune News Service, 5-14
• Children with severe asthma were given a vanilla scent along with their asthma medication. Eventually they started responding to the vanilla scent alone and were helped as much as by the medication. There are several pathways linking mental states to physical health. Calming thoughts slow the production of harmful stress hormones. Mental states can profoundly influence the immune system as well as trigger the release of the endorphins which are internally produced pain killers.
• Persons who are overweight are more vulnerable to developing asthma. Doctors analyzing weight and health information on almost 90,000 women in the Nurses' Health Study found after four years the overweight women were three times as likely to develop breathing disorders as the thinnest ones. Tufts University Health and Nutrition Letter reported in Reader's Digest around 1997. Excess weight worsens the condition.
• We have found that most asthmatics will respond very nicely to a program in which all food substances to which they are allergic are removed from the diet. Even if the asthma is known to be associated with airborne allergenic substances, a serious attempt should be made to discover and avoid all foods to which the person is also sensitive. Carefully perform an Elimination and Challenge diet. If the total number of allergenic substances in the blood can be reduced, the airborne substances, which cannot be controlled very readily, will not cause as many difficulties.
• Try eliminating nuts, shellfish, tomatoes, strawberries, dairy products (carefully reading labels). Take a diet free from free-fats. Avoid foods containing additives, yellow or red food dyes, acetyl salicylic acid, sulfur dioxide, sodium benzoate, and meta-bisulfite, alcohol in all its forms. Also avoid syrups, toppings, processed meats, vinegar, dehydrated vegetables, alcoholic beverages, and processed cheese. In ragweed-sensitive persons, bananas and melons may also need to be removed from the diet, as there is often a cross sensitivity.
• Avoid foods likely to contain yeast or molds.
  Following is a list of many of these:
  Baked goods containing yeast
  Mayonnaise
  whey or other dairy products
  Mushrooms
  Buttermilk, yogurt, cream cheese
  Pickles
  Canned tomato juices or any food held in the refrigerator more than a few days
  Relishes
  Sausages
  Catsup
  Smoked meats
  Cheese
  Sour cream
  Cider
  Sauerkraut, Kim Chee
  Corned beef
  Soy Sauce if fermented & similar seasonings
  Cottage cheese
  Dried fruits
  Spoiled leftovers
  Green olives
  Vinegar
  Hot dogs
  Wine, beer, any alcoholic drink
• Adequate exercise and good physical conditioning are protective.
• Singing lessons, or trumpet playing, or other wind instruments, can improve the breathing capacity.
• To prevent acute attacks of asthma, give fever treatments one to three times weekly while the patient is not in a severe attack.
• Find all known causes for asthmatic attacks and eliminate those promptly.
• Avoid mouth breathing and practice abdominal breathing at all times with the nose filtering out dust, etc. Sleep on the stomach to aid drainage and encourage the mouth to remain closed. A sponge rubber neck collar can also encourage a closed mouth. About 90% of asthmatics are mouth breathers.
• Some will need to avoid breathing cold air. All should avoid chilling of the extremities. Dress warmly.
• Drink sufficient water to stay well hydrated to keep secretions from thickening.
• Avoid crowds and other sources of infection.
• Sleeping outdoors in nature is more beneficial to some persons than sleeping indoors, even with the doors and windows open.
• Breathing exercises. Each exercise should be performed 5 or 6 times twice a day, and at the first sign of an attack. Always breathe in and out through your nose unless instructed otherwise.
  ▫ To achieve full expansion stand tall with hands on shoulders, elbows together in front of you. As you breathe in, stretch your elbows backward, and bring them together again as you breathe out.
  ▫ Maximal lateral rib expansion is achieved by standing straight, one arm at your side, and the other curled over your head. As you breathe in slide the hand beside you down the side of your leg, and back up as you breathe out. Reverse arm position and repeat.
  ▫ Standing tall with shoulders back and breathing deeply will develop proper breathing techniques.
  ▫ Maximum lifting of the rib cage may be achieved by kneeling so you sit back on your legs. While breathing in, stretch both hands up as you come up on your knees; breathe out while sitting back on your legs and lowering arms.
  ▫ Lying face down with a clean towel spread under your face, clasp your hands together over your hips. Lift your head and shoulders while breathing in, relax as you breathe out.
  ▫ Turn over on your back, with your arms above your head. Breathe in as you lift both legs; lower them as you breathe out. This gives abdominal muscle control.
  ▫ Still lying on your back, bend your knees with feet on the floor. Lift your hips up as you breathe in. Lower them as you breathe out.
  ▫ Lie on your back with arms at your side, and your feet slightly apart. Breathe in as you lift your arms up and back over your head; breathe out as you sit up to reach toward your toes. Breathe in while lying back and breathe out as you relax.
  ▫ For 10 minutes, and at the first sign of an asthmatic attack, sit up straight in a chair. Inhale through your nose and exhale forcefully through tightly pursed lips. Pursing the lips assists in opening the bronchial tubes. Medical Self-Care, Summer, 1981, pp. 44-47
  ▫ Postural drainage will assist in clearing the mucus from the lungs. Lie face down with your head and chest hanging over the edge of your bed. Bring up the sputum by coughing gently for two to three minutes. During an attack some people cannot tolerate this position, and they may lie face down in bed with two or three pillows under their hips. Ibid.
  ▫ Lie flat on your back in bed with knees bent. Slowly raise the right knee to the chest while breathing out and tensing the abdominal muscles; lower the right leg, inhale, and relax abdominal muscles. Repeat procedure with the left leg. Pediatric Clinics of North America, 16(1):31-42, February, 1969
  ▫ Breathe in slowly as you raise your hands over your head and rise on your toes. When you think your lungs are full, exhale slowly as you bend over to touch your toes and come down on your heels. When you think you have fully exhaled, force out three more quick coughs. Repeat several times, and go through the exercise several times a day (7-10 times).
  ▫ Exercise-induced asthma can be eliminated by a 15-20 minute continuous warm-up before beginning vigorous exercise that customarily brings on asthma.
• Spiritual aspects of the treatment of asthma should not be overlooked. These include Bible study, meditation, and prayer.
• If you have asthma you should reduce the amount of salt you eat as too much sodium aggravates asthma.
• Learn sleep breathing - slow and deep on the first phase with a three second pause at the top of inspiration, and at the end of expiration.
• Grapefruit skin boiled in water on the stove can be used for asthma or hay fever. Take a tablespoonful or two several times a day. Use the skin from one grapefruit in one half-gallon of water boiled for half an hour.
• Tryptophan constricts bronchi, the gastrointestinal tract, and blood vessels, and worsens asthma.
• Avoid chewing gum having chicle as the base, as some are allergic to it.
• Reduced asthma symptoms were observed in asthma patients who took in foods high in omega-3 fatty acids. The best sources of omega-3 fatty acids are walnuts and flaxseed, but other nuts and seeds contain some also.

Herbal teas for Asthma

• Chamomile tea has an anti-asthmatic action. A cup taken in the morning and in the afternoon, may prevent an acute attack. Anise tea taken daily helps many asthmatics avoid acute attacks. These teas may be given a cupful each hour or less during an attack.
• Administer a variety of herbal teas such as catnip tea, mullein, fenugreek, comfrey, Aloe vera, black cherry bark, and white oak bark. A cup of tea from among this list should be given each hour, or if no tea is available, substitute a cup of hot water with nothing in it.
• Anise, coltsfoot, ginkgo, and the common grocery store tea, green tea, black tea, pekoe tea - can be helpful in acute attacks. Do not use it between attacks as a beverage, as it will lose its effectiveness.
• Licorice root tea has a slight cortisone-like effect and can be helpful to prevent attacks. It is more effective the longer it is taken, reaching a good effect after a month or more. Use about one tablespoon of the powder to a quart of water and simmer gently for 10-15 minutes. Take the quart in four doses throughout the day. Make up freshly each day.
• Ephedra has a slight adrenalin-like action and can be helpful in acute attacks. Use a tablespoon to a quart of water, simmer gently for 10-15 minutes, and take one cup four times a day.
• Peppermint may reduce the tightening of your airways during an attack.

Changing the diet to induce a change in bowel micro-flora may be effective in reducing asthma symptoms. A group of patients in Sweden were placed on a vegan diet (no milk, eggs, or animal products) for a period of one year. The average patient in the study had suffered from asthma for nearly 12 years, and for about half of these patients allergy tests had not been helpful. The study group represented a group of patients with quite advanced disease. The diet had no coffee, tea, chocolate, sugar and salt. Cereals were very limited but buckwheat, millet and lentils were accepted. Citrus fruits and apples were not permitted. Patients were encouraged to drink water or herbal teas up to 1.5 liters every 24 hours. The patients were to spend some time every day in physical activity out-of-doors. Over 70% of the patients reported improvement or disappearance of symptoms after four months on the program, while after one year 92% were improved or well. The group as a whole reported a decrease in the number of asthmatic attacks, and less severe symptoms in the attacks that did occur.

Interestingly, many of these patients had associated diseases such as rheumatic symptoms and they reported that these problems were lessened or cured. The group also reported a decrease in the frequency of infectious diseases they suffered. Blood pressure was decreased, vital capacity and physical working load both improved, and body weight decreased. Some of the patients in the study were able to completely give up their asthma medication, and others reduced medication use to up to 50% of the original dose. Journal of Asthma 22(1)45-55, 1985, November, 2007