COPD

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==================================================== IBIS: (emphysema)

Definition:
Distention of the air spaces in the lungs distal to the terminal bronchiole with concurrent destruction of the alveolar walls. Emphysema is, with chronic bronchitis, a disease termed "Chronic Obstructive Pulmonary Disease" (COPD).

Etiology:
Emphysema apparently is related to the effect of proteolytic enzymes on the alveolar septa. These enzymes are released by WBCs during their response to inflammatory processes. The leading factor that leads to a state of chronic inflammation in the lungs is smoking. In homozygotic alpha-one-antitrypsin deficiency, patients develop emphysema at a young age because they are lacking in the substance that inhibits proteolytic enzyme activity, even if the enzyme is not markedly increased due to inflammation. COPD is a major cause of disability and death in the U.S., second only to heart disease as a cause of disability. Men have been affected much more than women in the past, no doubt due to their more marked smoking; however, with the advent of increased smoking in women, the disease prevalence in females is also increasing.

Somatic Therapies:
• breathing exercises • aerobic exercise: mild as tolerated, build up gradually

Nutrition:
eating principles: • moderately low fat • low sugar • high complex whole carbohydrates • protein 12-15% diet • vegetarian cleansing diet or short fasts • foods rich in Vitamins A and E

therapeutic foods: • garlic, onions, leeks, turnips, grapes, pineapple, honey, green leafy vegetables (Jensen, p. 61)

fresh juices: • carrot • carrot, parsnip, potato, and watercress (Walker, p. 136)

avoid: • food intolerances (Rowe. Dis. Chest 1965;48:609.) • cow's milk and other dairy products, white bread, refined foods, processed foods, sugar and sweets, catarrh-forming foods: oranges, tofu, tomatoes; meat, ice cream, shellfish

Botanicals
• Ammi visnaga: cor pulmonale patients with long-standing emphysema (Weiss, p. 222) • Aspidosperma quebracho-blanco: dyspnea (Ellingwood, p. 248) • Conium maculatum (toxic): for difficult breathing (Ellingwood, p. 105) • Ephedra vulgaris (Weiss, p. 218) • Euphorbia piluliferae (Felter and Lloyd, p. 751) • Grindelia camporum (Harper-Shove, p. 126) • Inula helenium (Priest and Priest, p. 93) • Lycopus virginicus: chronic irritable cough, chronic lung troubles (Ellingwood, p. 224; Felter and Lloyd, p. 1215) • Physostigma venenosum (toxic): with great muscular relaxation (Ellingwood, p. 189) • Scilla maritima (toxic): chronic cough with scanty tenacious sputum (Felter and Lloyd, p. 1736) • Selenicereus grandiflorus (toxic): as a heart tonic (Ellingwood, p. 212) • Thymus vulgaris: oil, tea (Weiss, p. 209) • Tussilago farfara: chronic, silicosis, eases persistent cough (Priest and Priest, p. 95; Weiss, p. 196)

Chinese Formulae
• Bei Mu Gua Lou San; Ping Chuan Wan (patent): Lung Dryness: cough with deep-seated sputum that is difficult to expectorate, wheezing, dry sore throat, red dry tongue with little coat. (Bei Mu Gua Lou San: Yeung, p. 45; Bensky and Barolet, p. 439; Ping Chuan Wan: Zhu, p. 96) • She Gan Ma Huang Tang: Lung Invaded by Wind-Cold: cough, asthma, dyspnea, wheezing, white frothy scanty sputum, white or cyanotic face. (Yeung, p. 198; Bensky and Barolet, p. 39) • Hoelen and Schizandra C. (Ling Gan Wu Wei Jiang Xin Tang); Su Zi Jiang Qi Wan (patent): Spleen Yang Xu (Deficiency) with Lung Obstructed by Phlegm-Heat: coughing with profuse watery sputum. (Hoelen: Hsu, 1980, p. 556; Yeung, p. 147; Bensky and Barolet, p. 444; Su Zi Jiang: Zhu, p. 72) • San Zi Yang Qing Tang: Lung Obstructed by Damp-Phlegm due to Stomach Food Stagnation due to Spleen Qi Xu (Deficiency): coughing and wheezing with copious sputum, loss of appetite, digestive difficulties, white greasy tongue coat. (Yeung, p. 190; Bensky and Barolet, p. 445) • Baked Licorice C. (Zhi Gan Cao Tang): Qi Xu (Deficiency) with Heart Xue Xu (Blood Deficiency): palpitations with anxiety, irritability, insomnia, emaciation, shortness of breath, constipation, dry mouth (Hsu, 1980, p. 529; Yeung, p. 291; Dharmananda, 1986, p. 247; Bensky and Barolet, p. 257) • Minor Blue Dragon C. (Xiao Qing Long Tang): Lung Invaded by Wind-Cold with Lung Obstructed by Damp-Phlegm: fever and chills without sweating, sputum that is copious, white, stringy and difficult to expectorate, sensation of body heaviness. (Hsu, 1980, p. 43; Yeung, p. 261; Dharmananda, 1986, p. 127; Bensky and Barolet, p. 38) • Astragalus 16 (patent) plus Restorative Tablets (patent): chronic lung disorders with weakness (Dharmananda, 1990: Astragalus, p. 80: Restorative Tablets, p. 24) • Belamcanda 15 (patent): Lung Obstructed by Phlegm-Heat, coughing (Dharmananda, 1990, p. 64)

Acupuncture
after assessing the person and palpating, consider these patterns: Lung Yin Xu (Deficiency); Lung Qi Xu (Deficiency); Lung Heat; Spleen Xu (Deficiency); Kidney Xu (Deficiency); Ren Mai (Conception Vessel) disorder

» illustrative combinations: • Lu-11 and LI-1; Lu-1 and Lu-2; CV-13, CV-16, CV-20 and CV-21; Kd-3, Ht-3 and Lu-7; UB-17, UB-18 and UB-22 for emphysema (Mann, p. 94) • CV-17 and CV-22 to treat dyspnea and cough (Ellis, et al, 1988, p. 360) • CV-17 and PC-6: broaden the chest, descend Rebellious Qi, release depression and stop cough (Finkelstein, p. 91)

» note: acupuncture can assist in resolving phlegm and aid in making breathing easier, but acupuncture alone will usually not lead to cure

Homeopathy
• Ammonium carbonicum: copious mucus in lungs, < physical effort, entering a warm room; cough continual but raises nothing, < 3 to 4 a.m., with rattling of large bubbles; feel faint from effort to breathe; drowsy and cyanotic • Antimonium tartaricum: excessive dyspnea, must be supported in sitting position in bed; difficulty in expiration; breathing rapid, short, heavy and anxious; rattling mucus below larynx, gasping for breath at beginning of coughing spell • Arsenicum album: highest degree of dyspnea, even to suffocation; great anxiety, restlessness; tightness of chest as bound in a hoop, burning in chest, face cyanotic and covered with cold perspiration • Belladonna: short, hurried, anxious breathing, heavy and stertorous; dizziness, headache, palpitations of heart; fullness of abdomen • Bromium: after pneumonia, asthma; cough dry whistling, tickling in larynx; gasping for breath; spasmodic closure of glottis, cannot inspire deep enough; pressure in stomach, must sit up in bed • Camphora: dyspnea < after exertion; cough from talking • Carbo vegetabilis.: often after ars.; neglected bronchitis with emphysema; great dyspnea and anxiety, no restlessness; cough in violent spells; watery, profuse expectoration; breathing short with cold hands/feet; blueness of skin; > from fanning • Chlorum: easy inhalation, exhalation impossible; face turgid, convulsive movement; expiration difficult • Digitalis: complication with heart disease; respiration slow; paroxysms early in morning, < cold weather and walking, > lying perfectly quiet in a horizontal position • Hepar sulphur: bronchial chronic catarrh, < from slightest exposure; cough < from midnight until morning; sleep with head thrown back • Ipecacuanha: dry spasmodic cough of old people; collection of mucus difficult to expectorate • Lachesis: constriction of chest in morning when sitting up quickly; breathing becomes slow, difficult, whistling, chest stuffed; cover around neck, even chest unbearable; stool smelling badly • Lobelia inflata: contraction of chest with deep inhalation; impossible deep inspiration; inclination to sigh or to get very deep breath; burning feeling in chest passing upward; dry tracheal and bronchial catarrh. • Natrum muriaticum: attacks of suffocation, breathing anxious, oppressed, short on walking fast, > in open air and when exercising arm

Subtle Support
• notes: A, A#, B, C, C#, D, D#, E, F, G, G#

• chords: dominant 7th, diminished 7th, diminished 8th, A Major, A# Major, C Major, G Major, G# Major (Gimbel, p. 116)

Mind/Body
• Fear of taking in life; not worthy of living. (Hay, 1984, p. 163)

• Lung ~ Fei is the home of the Po (Corporeal Soul); governs the Qi; facilitates the immune function by assisting the dispersal of the Wei (Protective) Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; relates to strength and sustainability; moves and adjusts fluid metabolism. » Healthy expressions are righteousness and courage. » Weakness, dysfunction, and illness are associated with excessive grief, sadness, worry, and depression. Worry depletes the Lung Qi. » Lung Xu (Deficiency) signs include cold shoulder and back; changing complexion; inability to sleep (Seem, p. 28); shortness of breath; changes in urine color; rumbling in the bowels with loose bowel movements; pallor; malar flush; chills; sniffles; sneezing; light cough; and sensitivity to cold. » Lung Shi (Excess) signs include panting; yawning; sneezing (Seem, p. 28); pain in the upper back, shoulder, and chest; colds with stuffed nose; hoarseness; wheezing respiration; frequent urination with small amounts; heavy chest; reduced lung capacity; coughing; and nasal discharge. Deficiency of Lung Yin can lead to the buildup of an excess state of Lung Heat.
 * Chinese psychophysiology:**

• Spleen ~ Pi governs digestion and manifests in the muscle tissues; resolves Dampness and Phlegm; and relates to the ability to assimilate, stabilize, and feel balanced and centered. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; easy bruising; pale lips; loose stools; muscular weakness; and, indirectly, obesity. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen. This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise, overexposure to external Dampness, and excess consumption of sweet and/or Cold foods will also deplete the Spleen.

• Kidney ~ Shen houses the Zhi (Will); expresses ambition and focus; and facilitates inspiration by grasping and pulling down the Qi of the breath. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); hearing loss; fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency).

Integrative Therapies
Emphysema is characterized by destruction of the lung tissue, leading to shortness of breath and difficulty in breathing. Most often, it is caused by cigarette smoking or inhalation of other irritants.

Although some of the lung damage is irreversible, the following approach is used to help greatly reduce the symptoms.

THE FOLLOWING SUPPLEMENTS ARE USED FOR EMPHYSEMA AND CAN BE TAKEN UNTIL SYMPTOMS IMPROVE:

1. Beta-carotene – 100,000 Units twice a day. Pregnant women (or women who may become pregnant) should not take more than 15,000 Units per day.

2. Vitamin C – 1,000 milligrams, 4 times a day.

3. Bioflavonoids – 1,000 milligrams, 2 times a day.

4. A multivitamin and mineral – taken according to the manufacturer's directions. Make sure it is free of sugar and artificial ingredients.

5. DMG – 50 milligrams, 2 times a day. DMG may help increase oxygen delivery to the tissues.

6. NAC (N-Acetyl Cystein)- 600 milligrams, three times a day.

THE PROPER DIET FOR EMPHYSZEMA WILL INCLUDE THE FOLLOWING:

• Plenty of fresh fruits and vegetables. Eat at least 1 salad and 2 pieces of fruit a day. One yellow vegetable, such as carrot, sweet potato, or squash, needs to be eaten daily for vitamin A content.

• Avoid the following foods:

1) All dairy products such as milk and cheese. Dairy products produce mucus, which makes respiration more difficult.

2) Sugar-containing foods. These slow the healing process. Replace candy and pastries with fruits and diluted fruit juices.

3) White flour products.

HERBS FOR EMPHYSEMA:

• Quebracho is specifically used for emphysema. Use the tincture, which is a liquid herbal extract – 20 drops, 3 times a day in 1/4 cup of hot water.

• Coltsfoot and Licorice can be taken as a tea. Drink 2 to 3 cups throughout the day. Use 1 tablespoon of the herbs per cup of boiling water. Simmer 5 minutes, then steep 15 minutes.

• Coriolus Avenalla - this herb has traditionally used to decrease fibrosis inthe lung tissue. As a tincture- use 40-60 drops, three times a day.

THE FOLLOWING PHYSICAL THERAPY MEASURES CAN BE USED FOR EMPHYSEMA:

• Postural drainage can be done once or twice a day to help expectorate the mucus in the lungs. Lay on a bed face down with the upper part of the body hanging off the edge of the bed. Use the forearms for sup-port. Have someone tap on the back with a flat hand. Put a basin on the floor near the head to cough into. Do this for 5 to 10 minutes. This procedure requires assistance.

• Steam inhalation helps expectorate phlegm from the lungs. Breathe over a pot of steamy hot water with a towel draped over the head and the pot to prevent steam loss. A few drops of Eucalyptus oil should be added to the water. If you are not using a commercial steam inhaler, be careful not to burn yourself.