ASTHMA

Emily Kane ND


INDEX


Please note: This is a two part article because of the length. The link to the second part is at the end of this article.

Asthma is a frightening condition. It is a hypersensitivity reaction causing brochospasm, swelling of the mucous membranes and increased bronchial mucous secretion leading to respiratory distress. Asthma is a reversible inflammatory airway disease. Treatment of asthma MUST include agents or methods that not only cause bronchodilation, but also reduce inflammation. Beta-agonists, typically given in conventional therapy (such as Albuterol, Prednisone, etc.) notoriously do not significantly reduce inflammation, although they are effective bronchodilators.

What kind of Physical Medicine can help asthma? One of the fundamental philsophical tenets of Yoga, an ancient east Indian meditative exercise technique, which means "union" (of body and spirit), is that the most important part of our bodily function to control is the breath. The Sanskrit word for breath is "prana" which also means life force, or spirit. What this is leading up to is that control of the breath is crucial for optimal health and well-being, and a good place to start when life or health is out of balance. Breathing exercises are extremely helpful for asthmatics, because they:

* strengthen respiratory muscles
* eliminate inefficient use of accessory muscles of respiration (such as abdominal or neck muscles)
* replace forceful breathing, which compresses airways, with relaxed breathing
* can reduce hyperventilation by increasing expiration
* can reduce the sensation of breathlessness by increasing the functioning of the diaphragm
* can enhance clearing of airways
* can give you the confidence to withstand breathlessness

To help control an acute attack, sit leaning forward with your head on arms, arms resting on a table. Or, try lying semiprone, with arms and legs slightly bent and relaxed, body and limbs well supported by pillows.

One of the frustrating aspects of asthma is that it can be induced by exercise. Therefore, if you are prone to asthmatic attacks mild aerobic exercise, such as swimming, is best for you. However, some asthmatics are allergic to chlorine, which means swimming in a public pool is out.

Another useful Physical Medicine technique is that of Hydrotherapy, discussed at length in the Introduction to Modalities section. Placing a hot, wrung out towel over the chest can relax the breathing muscles and restore normal breathing. For an acute asthma attack try a steam inhalation (draping a towel over your head and a bowl of hot water) with a few drops of eucalyptus oil in thewater. Be careful that the water is not so hot that the steam burns your face. Some doctors recommend taking baths with a cup or so of 3% hydrogen peroxide in the water to bring extra oxygen to the entire surface of the skin, thus making the lungs somewhat less oxygen hungry. This method can be performed preventively. Another technique for an acute attack is to drink some hot water with the juice of one clove of garlic.

It may be useful to assess the alignment of your spine. Often the upper thoracic vertebrae will be out of alignment after an asthma attack, which will ultimately put pressure on the lungs and possibly precipitate another attack. Getting regular maintainance soft-tissue work (massage), specifically between the shoulderblades, followed by a Chiropractic adjustment to the thoracic vertebrae, can reduce the frequency of attacks in chronic asthma, and the severity of attacks in acute asthma.

Can the way I eat help control asthma?
Yes, absolutely. In general, the eating principles for reducing the number of asthma attacks are a diet which is:
* moderately low fat
* low sugar
* high complex carbohydrates, such as whole grains and starchy vegetables
* making protein, preferably vegetable protein, only 12-15% of the diet, and decreasing foods high in arachidonic acid (red meats and dairy products). Animal protein tends to be inflammatory.
* vegan cleansing diet or alkaline juice fasts (3-7 days), followed by a vegetarian diet with emphasis on alkaline forming foods, such as fruits and vegetables.

Specific therapeutic foods for controlling asthma are:
* from a Chinese medicine perspective, you want to eat foods that enhance the moisture (or Yin aspect) of the Lung. These are juicy, pungent foods such as garlic, onions, leeks, turnips, grapes, pineapple, green leafy vegetables, apricots, apricot kernels, almonds, walnuts, carrots, pumpkin, sunflower seeds, figs, daikon, lychee, tangerines, loquats, honey, molasses, mustard greens, and sesame seeds
* Other good foods to reduce inflammation as well as for dilating the bronchi are collard greens, cauliflower, garlic, onions, turnips, endive, apricots, cherries, elderberries, green vegetables, raw nuts and seeds, sprouted seeds and grains.
* increase omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil, black currant oil. Take at least 1 T of one of raw oils daily to minimize bronchial inflammation.
* foods high in flavonoids and carotenoids such as dark green leafy vegetables and deep yellow and orange vegetables,

For those of you into juicing fresh vegetables and fruits, the following drinks, preferably taken on an empty stomach each morning, will help prevent asthma attacks:
* celery and papaya
* celery, endive, and carrot
* spinach and carrot
* lime, horseradish, and garlic
* carrot

Some more specific food remedies:
* for shortness of breath: l lb. salmon, 2 oz. garlic, 1/4 oz. fresh ginger, salt and tamari. Place seasonings over salmon and steam. Divide and eat three times daily to reduce inflammation.
* eat mango fruit and the skin three times daily.
* take 120 g of dried lychee, discard skin and stones, steam in a covered pot then mash and serve (Yin-fang and Cheng-jun, p. 57)
* for asthma of elderly, cough with thick phlegm: take 2 dried persimmons and 30 g candied honey. Add water, steam in a covered pot, mash and eat twice daily.
* take a fresh lemon and add 1-2 tbsp. honey. Steam in water, with the skin, until soft, mash and eat twice daily.
* take 3 fresh peaches, peel and simmer with 30 g honey in a covered pot. Discard the stones and eat daily.
* take 30 g of walnut kernels, 15 g honey and 6 g turnip seed. Steam for 30 minutes and eat twice daily.
* take 60 g of walnut kernels and 3 g red ginseng. Cover with water and simmer into a soup. Serve twice daily for 3 days.
* take 60 g of fresh chestnuts and 4 pieces Chinese date plus a small amount lean pork. Add water and simmer until cooked, eat once daily.
Foods to strictly avoid: are the mucus forming ones, such as:
* cow's milk and other dairy products, white bread, refined foods, processed foods, sugar and sweets, tofu, tomatoes, meat, ice cream, shellfish, watermelon, salty foods, cold foods, bananas, mung beans. Asthma attacks may be brought on by allergenic foods. The most common ones are milk, chocolate, wheat, cheese, bananas, peanuts, citrus, and food colorings (tartrazine). If possible, eliminate the use of aspirin and non-steroidal anti-inflammatories, such as Ibuprofen.

Sometimes diet alone is not enough to help an illness. Specific vitamin and mineral supplementation to consider with asthma is as follows:
* Vitamin B12 1000 mcg injected intramuscularly, daily for 7 days.
* Vitamin B6 50 mg twice daily
* EPA (found in fish oils) 3 g daily
* flax oil 1-2 Tbsp. daily
* bioflavonoids, especially quercetin or hesperidin, 400 mg 15-30 minutes before meals
* Beta carotene 100,000 I.U. daily
* Selenium 250 - 400 mcg daily
* Vitamin E 800 I.U. daily
* Vitamin C 1-2 g daily
* Magnesium 400 mg daily
* digestive enzymes can help reduce mucus formation and prevent undigested food from "leaking" into the blood stream, which would cause a systemic inflammatory reaction.
* N-acetyl cysteine (an amino acid that works well to digest mucus) 500 mg twice daily.
* pantothenic acid (vitamin B5) 500 mg morning or afternoon

What herbal medicine therapies are helpful for asthma?
A vast array of plant medicines can help to heal asthma. Be sure to consult with a qualified herbalist or naturopathic physician to find the herbs that are local, readily available to you, or processed by a conscientious herbal supplier. Your local herbalist will help you determine the best form and dose for the therapy. The following herbal medicines are particularly useful for asthma.
* Ammi visnaga, an East Indian plant
* Brassica spp. (mustard): use in a warm chest compress or as a foot bath for asthma accompanying bronchitis or as foot bath
* Commiphora myrrha: (Myrhh) works well for asthma with profuse secretion which is expelled with difficulty.
* Convallaria majalis (Lily of the Valley - beware this can be toxic in relatively low doses) is indicated for cardiac asthma, and combines well with Leonurus cardiaca (Motherwort).
* Datura stramonium (Thorn apple, toxic!) for chronic asthma
* Ephedra vulgaris: (Ephedra, the herbal Pseudofed) relieves bronchial spasm. Combines well with Lobelia inflata and Grindelia robusta
* Euphorbia hirta: works well for bronchitic asthma, especailly combined with Grindelia robusta
* Grindelia robusta: is given for asthma with a dry cough, sense of soreness, rawness. May be best as fresh plant preparation.
* Lobelia inflata (toxic) for spasmodic asthma with secondary bronchitis. Combines well with Capsicum frutescens, (Cayenne pepper), Grindelia robusta, Drosera rotundifolia, Euphorbia hirta, Ephedra vulgaris
. * Marrubium vulgare (White Horehound) for asthma with moist expectoration, loss of the voice and difficulty breathing.
* Polygala senega (Milkwort) is for bronchitic asthma; combines well with Euphorbia hirta and Grindelia robusta .
* Sanguinaria canadensis (Bloodroot, beware, it's toxic) reduces bronchial spasms and combines well with Lobelia inflata .
* Selenicereus grandiflorus (toxic) for asthma with cardiac symptoms.
* Symplocarpus foetidus: (Skunk cabbage) is a traditional anti-asthma remedy because it reduces bronchial spasms and relieves cough.
* Thymus vulgaris: (the culinary herb, Thyme) breaks up mucus secretions in the bronchii.
* Verbascum thapsus: (Mullein) is very soothing when inhaled from a steaming broth.
* Viburnum opulus: (Cramp bark) reduces spasms all over the body, including the lungs.
Some traditional asthma remedies using a combination of herbs include:
* for paroxysmal cough and dry mucous membrane use Eriodictyon californicum plus Grindelia robusta. * for a severe attack, when you feel pressed for breath and are wheezing use Gelsemium sempervirens (Yellow jasmine, toxic) plus Ferula sumbul .
* Verbascum thapsus plus Grindelia robusta
Two more old-fashioned, highly effective herbal remedies worth mentioning are:
For an acute attack:
- Cramp bark 7.5 mL of tincture
- Ephedra 5 mL
- Skunk cabbage 5 mL
- Thorn apple 3-5 mL
- Lobelia 7.5 mL
- Cayenne pepper 5 mL
Mix these ingredients together and take 2-3 dropperfulls every 20-30 minutes until the attack subsides. For chronic asthma, mix equal parts of Cramp bark, Mullein, Grindelia, Plantain, Elecampagne, Hyssop and Horsetail tinctures and take 3-5 dropperfulls daily.

How can Traditional Chinese Medicine help my asthma?
One important aspect of TCM (Traditional Chinese Medicine) is the vast field of Chinese medicinal herbs, which are brewed together in individualized combinations to form a thick tea, or "soup." Asthma is not a single diagnosis in TCM. There are many "patterns" of disharmony which could produce the symptom of wheezing, shortness of breath, or other manifestations of what we call asthma. Your licensed or certified (through the NCCA) acupuncturist or Oriental Medical doctor (OMD) will first determine your TCM diagnosis, then choose herbs or acupoints accordingly. Some patterns of lung dysfunction to be considered are Lung Deficiency, Kidney Deficiency, Phlegm Heat; Liver Fire Insulting Lung; Wind and Cold in the Lung; Lung Invaded by Wind-Heat; Lung Qi Stagnation; Lung Obstructed by Damp-Phlegm with Spleen Yang Deficiency; dysfunction of the Conception Vessel; Excess of the Yin Linking Vessel. If you really want to understand these diagnostic terms more fully, please consult with a good medical library, or consider enrolling in acupuncture school! TCM is an extremely comprehensive field of medical knowledge, and it would be impossible to give explain it in this essay. After your acupuncturist figures out your diagnosis by asking questions, observing you, looking at your tongue and feeling your pulse, herbal and/or needle therapy would be offered. Chinese herbal formulae which would be considered by your local acupuncturist or Chinse herbalist are:
* Ma Huang and Apricot Seed C. (Ma Xing Shi Gan Tang): Lung Invaded by Wind-Heat: wheezing, coughing, labored breathing, nasal flaringand pain, yellow tongue coat
* Licorice and Ma Huang C.: If Ma Huang and Apricot Seed C. is not effective after one or two doses
* Minor Blue Dragon C. (Xiao Qing Long Tang): Wind-Cold; helps prevent asthma during change of seasons; add apricot seed (xing ren) and poria (fu ling) for chronic asthma with chill/weakness
* Ma Huang C. (Ma Huang Tang); Ping Chuan Wan (patent): Wind-Cold.
* Cinnamon C. (Gui Zhi Tang) plus magnolia bark (hou po) and apricot seed (xing ren): Wind-Cold:weak constitution, spontaneous sweating.
* Ophiopogon C. (Mai Men Dong Tang); Ma Xing Zhi Ke Pian (patent): Wind-Heat.
* Hoelen and Schizandra C. (Ling Gan Wu Wei Jiang Xin Tang): Lung Obstructed by Damp-Phlegm with Spleen Yang Xu (Deficiency): Delicate constitution, including the elderly; COPD; coughing with profuse sputum that is thin, watery and white with feeling of discomfort in the chest
* Citrus and Pinellia C. (Er Chen Tang); Su Zi Jiang Qi Wan (patent); Chuan Bei JIng Pian (Fritillaria Essence Tablet) (patent); Pinellia 16 (patent): Lung Obstructed by Damp-Phlegm with Spleen Qi Xu (Deficiency): coughing with copious, white sputum that is easily expectorated,palpitations, nausea or vomiting, dizziness.
* Minor Bupleurum F. (Xiao Chai Hu Tang) plus Pinellia and Magnolia C. (Ban Xia Hou Po Tang); Chuan Bei Jing Pian (patent): Liver Invading Spleen with Liver Qi Stagnation: pediatric cough/asthma; to improve general condition and prevent recurrence in strong constitution: use for at least one year
* Ma Huang and Magnolia C. (Shen Mi Tang): Liver Qi Stagnation: dyspnea, wheezing, unproductive cough with uncomfortable sensation in chest, difficult breathing especially when lying down; pediatric asthma
* Xing Shi Gan Tang); Chuan Bei Jing Pian (patent): Lung Heat: Asthmatic cough with mucus in strong patient, thirst, wheezing, coughing, labored breathing, yellow tongue coat
* Six Major Herbs (Liu Jun Zi Tang): Spleen Qi Deficiency with Phlegm: poor appetite, bloated abdomen, loose stools, asthma after overeating or after rich food, gurgling with breathing during asthma attack
* Sheng Mai San; Li Fei (patent): Lung Qi Xu (Deficiency): chronic cough with sparse sputum that is difficult to expectorate, shortness of breath, spontaneous sweating, dry mouth.
* Ma Huang and Gingko C. (Ding Chuan Tang) (available as patent): Lung Obstructd by Phlegm-Heat: coughing and wheezing with copious thick yellow sputum, labored breathing
* Phellodendron C.; Li Fei (patent): Lung Yin Xu (Deficiency)
* Rehmannia Eight F. (Jin Gui Shen Qi Wan) plus Shen Jie San: long-term asthma, more trouble inhaling, skinny, spontaneous sweating, feels cold
* Rehmannia and Schizandra C. (Du Qi Wan); Qi Guan Yan Ke Sou Tan Chuan Wan (patent): Kidney Yin Xu (Deficiency)
* Perilla Fruit C. (Su Zi Jiang Qi Tang): Lung Obstructed by Damp-Phlegm with Kidney Failing to Grasp Qi: coughing and wheezing with watery, copious sputum; shortness of breath with labored inhalation and smooth exhalation, white greasy tongue coat
* Ma Huang and Morus C. (Hua Gai San): Lung Invaded by Wind-Cold: long term treatment, in children; poor appetite, GI distress.
* Bi Min Gan Wan (patent); Pinellia 16 (patent) plus Xanthium 12 (patent): Asthma due to allergy.
* Pinellia 16 (patent): Phlegm; plus Gecko A (patent) for Kidney Xu (Deficiency); plus Xanthium 12 (patent) for allergic asthma; plus Cyperus 18 (patent) for anxiety; plus Ginseng 6 (patent) for dryness The word "patent" as it appears above refers to the prepared Chinese herbal formulations which are available in pill or tablet form. If there is a "Chinatown" or international district near where you live, you may well be able to find these patent medicines, as well as loose herbs to make into your "soup" therapy.

Another aspect of TCM is the insertion of ultra fine needles into specific acupoints, to stimulate the vital force (called Qi -- pronounced chee) to flow smoothly and restore balance and optimal functioning to the internal organs, emotions and musculo-skeletal structures. Some of the most important points in controlling asthma lie, naturally, along the Lung meridian, which flows from just under the lateral collarbone, down the arm, and ending on the edge of the thumb nail. The Kidneys are also crucial in lung functioning, according to TCM, because the Kidneys draw down the Qi of the Lung and convert the inhaled air into physical nutrients. Your acupuncturist will likely choose points from the Kidney meridian also. These points run from the bottom of the foot, up the inner leg, across the abdomen and end under the collar bone, just medial to where the Lung merdian begins. Other points may include:

* Kidney-3 (at the inner ankle) and Lung-5 (in the crease of the elbow) for asthma with difficult inhalation
* Spleen-4 (along the inner arch of the foot) and Lung-5 for asthma with difficult exhalation
* Bladder-13 , Bladder-20 (along the spine) and Stomach-36 (a very important poitn just below the knee on the outer leg) for prevention of asthma before seasonal occurence
* Kidney-27, Kidney-26, Kidney-25 and Kidney-24 (about one inch apart between the ribs near the center line at the top of the chest, below the collarbones) relieve acute respiratory distress; relieve constriction in chest; resolve Phlegm (the TCM term for mucus); and stimulate Kidney's function of reception of the Lung Qi
* ding chuan (a special asthma point on the upper back, right next to the protrusion of the 7th cervical vertebra), Conception Vessel-22, CV-21 and CV-17 (along the spine, also on the upper back) for bronchial asthma; also consider Stomach-40 (on the foot), Large Intestine-4 (one of the most needled points, in the web of the thumb), Conception Vessel-4 (along the spine near the base) and Stomach-36

Link to Part Two


Emily Kane ND practices in Juneau, Alaska and can be reached at: (907)586-3655


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