Asthma is one of the most aggravating diseases that humans may suffer. It involves the very breath of life. One of the characteristic features of this disorder is that between attacks the victim may appear and feel as normal as anyone else and yet in a very short time may be in an attack so severe as to cause him to wish for the end of life.
Asthma is a paroxysmal difficulty of breathing resulting from sudden spasm of the bronchial tubes or their minute branches, or sudden swelling of the mucous membrane of these tubes. What produces the hypersensitiveness of the respiratory membrane, which is necessary to the production of asthma, may be difficult to determine. It is associated, however, with heart disease (cardiac asthma), kidney disease (renal asthma) or some outside irritant (hay asthma), or from minor causes. A protein sensitization often underlies the condition. Bronchial, nervous or essential asthma is a form for which a leading cause cannot be discovered, though usually there has been inherited a neurotic temperament.
The symptoms of asthma are comparatively similar in the majority of cases. The spasmodic attacks come on suddenly, but without regularity as a rule. Any condition which gives rise to excitation of the nervous system may cause the attacks. Sometimes these paroxysms develop more gradually and are preceded by a sensation of oppression in the chest or frequent or increased urination or a belching of gas, etc. When the attack comes on, breathing is very difficult, particularly the exhalation of each breath. In severe cases the patients often sit with elbows on a chair or desk or table or stand with the elbows elevated by some object in order to be able to use to the fullest all of the auxiliary muscles of breathing.
In these severe attacks the lips become blue and the cheeks pale, the nostrils are dilated and the eyes bulged and the entire facial expression is one of anxiety. The pulse is rapid and the perspiration is copious. The breathing is not rapid, but is difficult and wheezing. There is a sensation as if one is being choked or smothered. Often it is necessary to open a window, or to sit in the open window to secure all the fresh air possible. There often is a cough, which may continue for quite some time before any matter is brought up for expectoration. This matter is tenacious and stringy.
The attacks may subside gradually, but often pass quite suddenly. Their duration may be a few minutes only or many hours. They may be repeated every night or quite frequently or not for several weeks or even for several months. Irritating vapor or fumes or a damp atmosphere may help produce or prolong an attack. Attacks frequently come on at night.
Hay asthma is quite different from the ordinary varieties. It is excited by such irritating substances as plant pollen, dust, animal emanations and such. The first symptom resembles an acute catarrh of the respiratory passages, which causes sufficient swelling of the mucous membrane to interfere with breathing.
Asthma primarily is a nervous disease, but when continued for many years in a severe form the patient may become gaunt, sallow and hollow checked, and the chest may become deformed.
Treatment. This is another constitutional disease, hence must have constitutional treatment. Because of the underlying neurotic or highly nervous temperament this condition may respond less readily than do many other diseases, but there have been numerous cases where all symptoms have disappeared permanently. Numerous factors may be necessary in the treatment, but diet will be the first factor in most instances. In any case it will be necessary to build up the nervous energy and to detoxicate as completely as possible.
The most reliable treatment is an absolute fast, which if necessary may continue for as long as twenty, thirty or more days, depending upon the patient’s weight, strength and energy. After the fast or in cases where the fast cannot be used the citrus fruits, particularly the grapefruit, will be of very great benefit. This fruit particularly seems to aid in clearing the bronchial tubes of accumulated mucus and in bringing new mucus-forming elements to the tubes by the blood-stream.
After the fast or fruit diet the milk diet may be used with considerable benefit by a great many patients, particularly those who are below normal in weight and those whose nervous energy seems much below normal. But in a fair percentage of cases this diet seems to disagree. Temporarily it does tend to cause the throwing off of mucus, through its effect in speeding up the circulation, alkalinizing the system and aiding in throwing out waste products. But this eliminative effect is so pronounced occasionally that the patient’s breathing is interfered with to such an extent that another diet may have to be considered.
There is no specific diet for treating this disease, but a great many cases do well with two or three light meals a day of the simplest combinations of fruits, vegetables, whole-grain cereals and milk. The whole grain cereals preferably should be in the form of dry toast. This diet should include citrus fruits, berries and melons, but white sugar should be rigidly avoided and brown sugars should be used sparingly, and all of the fruits and berries should be used wholly unsweetened.
It is necessary that asthmatics live as nearly as possible out of doors. Not only must their lungs receive an abundance of fresh air, but they must be lightly enough dressed that the entire body is air-bathed regularly. However, it is important that they avoid chilling. Warmth of the body is important to prevent an internal congestion that may light up or aggravate an attack. Clothing should be loose at all points – no constriction even of the extremities being permissible.
Between attacks moderate exercises will be very beneficial. No specific exercises are required, but all active sports that the patient can indulge in or general setting-up exercises that involve deep breathing and the arm and chest muscles should be used. Spinal compresses and massage and spinal manipulations, particularly those in the nature of osteopathic treatments, will be of great benefit in many of these cases. Many attacks of asthma cm be checked or shortened by properly given packs or manipulations. Packs over the front of the chest, over the upper half of the back, or the cross-chest pack over the shoulders and involving the entire rib area, may be used with great relief and benefit. These cross-chest packs should be applied cold and covered thoroughly with dry flannel. Heat by any continuous means to the upper spine or the upper chest will give relief as a rule. The drinking of an abundance of hot water is relaxing and often will help to abort or shorten an attack. Inhalation of steam from a tea-kettle by the use of a suitable funnel may be of help in relieving the spasms.
In many cases it is necessary to avoid cold applications until considerable general improvement has been secured. Many attacks have been produced by cold applied to the chest or upper back, and yet some of the best ultimate results have been obtained where this treatment has been employed. Much depends upon one’s individual response to such treatment. If it can be used without starting an attack it can be considered a very beneficial type of treatment. The electric cabinet bath relieves very quickly in many cases because of its sweat-producing, relaxing effect. It should be followed by a tepid shower or sponge, terminated by the cold shower or sponge if possible.
The use of vapors for the specific effect of quieting an attack of asthma should be avoided if possible, also the injection of adrenalin chloride. These remedies for the attacks have no effect upon the underlying conditions and often interfere with the progress of the case under natural treatment. However, there are attacks so severe or patients in such an exhausted condition that such relief is preferable to a continuation of the attack when any natural procedure will not give the desired relief. Adrenalin is an internal secretion production, hence is not wholly foreign to the body and may be considered much better than the leaves and powders that arc used by burning.
As invaluable for their palliative effect as these remedies are in relieving acute attacks, constitutional treatment as outlined is vitally important and must be depended upon if a permanent cure is to be established. In a great many cases all that is required is the proper diet and adequate elimination, with improved skin activity. It is necessary also that the patient should cultivate relaxation, not only physical but mental and emotional. This will help a great deal in preventing attacks, and during an attack. If the patient can secure mental relaxation much will be done towards hastening the termination of the attack.