Asthma

Western Diagnosis
Reversible airways obstruction, inflammation, hyperresponsiveness

**Pathophysiology**
1. bronchospasm 2. edema of airways 3. inc mucous secretion 4. eosinophilic infiltration of airways walls 5. injury and desquamation of airways epithelium 6. true inflammatory disease rather than just bronchospasm - extent of infl seems to correlate with amount of bronchoconstriction hyperresponsiveness 7. mast cells -acute 8. eosinophils -chronic 9. inflammatory mediators -bronchoconstriction, mucous secretion, vascular leakage -edema -inc airways resistance -inc hyperresponsiveness 10. histamine, aa metabolites -leukotrienes, pg’s, platelet activating factor 11. neuropeptides from sensory nerves-substance P, neurokinin A, calcitonin related peptide

Etiology
1. 3% of general population 2. children under 10 3. **extrinsic -IgE mediated (outside of the lung)**: allergens - animal dander, house dust mite, mold, pollen, foods 4. **intrinsic (affecting the lung tissue):** a. cigarette smoke, odors, fumes, b. changes in temp, pressure, humidity c. aspirin, sulfites, NSAID’s, tartrazine (FD&C yellow dye#5) d. cold air, exercise e. emotional upset f. sinusitis correlations

Signs and Symptoms
1. some symptom free with occasional mild brief episode 2. others mild coughing and wheezing much of the time with severe signs following exposure to allergens, viruses, exercise, irritants, psychologic factors 3. wheezing, coughing, SOB, dyspnea, tachypnea, tightness in chest, audible wheezes 4. non-productive cough initially, then tenacious mucoid sputum 5. sitting upright, leaning forward, anxious 6. accessory muscles of resp, struggling for air 7. prolonged expiration with wheezes in inspiration and most of exp 8. if severe -unable to speak more than a few words at a time. fatigue, cyanosis. decreased wheezing 9. may develop pneumothorax, atelectasis 10. status asthmaticus -emergency: severe obstruction persisting for days or weeks

Laboratory
1. eosinophilia 2. ABG’s and pH: decreased Pa o2, inc Pa co2 , decreased pH   3. sputum analysis a. tenacious, rubbery, white b. eosinophils c. Charcot-Leyden crystals d. phagocytic cells -PMN’s, histiocytes 4. allergy testing

Imaging
1. chest x-ray: normal to hyperinflated G. pulmonary function tests

Diagnosis
1. wheezing, esp beginning in childhood or early adult 2. family history of asthma or allergy 3. differential diagnosis a. foreign body obstruction i. esp in children with sudden wheezing without hx of resp sx b. viral uri -croup, bronchiolitis i. epiglottitis ii. Hib iii. sudden onset -fever, sore throat, hoarse
 * 1) resp distress -leaning forward, hyperextend neck
 * 2) emergency room -don not try to visualize throat
 * 3) c. bronchitis, pneumonia
 * 4) d. COPD
 * 5) e. Ht failure

Treatment
1. avoid allergens -extrinsic: animal dander, house dust mite, mold, pollen, foods 2. avoid irritants -intrinsic: cigarette smoke, odors, fumes, changes in temp, pressure, humidity, aspirin, sulfites, NSAID’s, tartrazine (FD&C yellow dye #5), cold air, exercise, emotional upset

a. B-adrenergic agents i. bronchial smooth muscle relaxation ii. epinephrine, metaproterenol, terbutaline, albuterol b. theophylline i. bronchial smooth muscle relaxation c. corticosteroids d. cromolyn sodium: for maintenance tx, inhibits mediator release & reduces airway hyperreactivity. safe e. anticholinergic agents: block cholinergic pathways -atropine
 * drug treatment **

1. elimination diet 2. often dairy, wheat, chocolate, citrus, peanuts 3. decreased fat, sugar, protein 4. avoid arachidonic acid -red meat, dairy, chicken 5. no refined foods or additives 6. salmon, mackerel 7. EPA -3 gm/d 8. flaxseed oil -1-2 tbs./d 9. canola oil -no other cooking oils 10. bioflavonoids -hesperidin, quercetin ­400 mg before meals 11. Beta-carotene -100,000 IU/d 12. vit. E -800 IU/d 13. vit. C -2 gm/d 14. Se -200-400 mcg/d 15. Mg -400 mg/d 16. vit.B6 -50mg bid 17. vit. B12 -in kids 18. HCl
 * Diet & nutrition **

b. breathing exercises c. yoga d. biofeedback e. adrenal support: E & cortisone stim B-adrenergic receptors f. western botanicals g. homeopathy

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==================================================== =Asthma/Xiào Chuăn= Asthma/Xiào Chuăn is a common illness characterized by repeated attacks of paroxysmal dyspnea with wheezing.

Xiào and Chuăn refer to different clinical manifestations that historically were considered separate diseases in Chinese medicine. Xiào is translated as wheezing and is characterized by short, rapid breathing with wheezing. Chuăn is translated as breathlessness or panting and is characterized by labored breathing to the point that the patient cannot lie flat, breathing through the mouth, raising the shoulders and flaring of the nostrils during inspiration.

The classic state: “Chuăn is characterized by the manner of the breathing; Xiào is characterized by the sound of the breathing.” Clinically, Xiào and Chuăn often present together and are difficult to differentiate, and in recent centuries have been considered to be one condition; for this reason, they are discussed together in relation to asthma, though in fact other biomedical disorders such as bronchitis, pneumonia, and COPD (to name a few) may have a similar presentation.

Etiology and Pathogenesis
-Exogenous pathogenic factors: Wind-Cold, Wind-Heat, pollen, dust, and smoke can invade the Lungs and stir up latent Phlegm. Together, these exogenous pathogens plus Phlegm obstruct Lung Qi and impair its dispersing and descending, resulting in asthma.

-Improper diet: excessive consumption of cold, raw, sweet, or greasy food impairs the Spleen’s function of transformation in transportation. Over time, this can result in the production of Phlegm, which gets stored in the Lungs.

-Emotional stress: anger, irritability, depression, or frustration can result in Liver Qi stagnation leading to upward counter flow of Qi. This, in turn, can impair the dispersing and descending function of the Lungs.

-Aging, congenital vacuity, chronic illness, or overwork: these etiologies can result in Lung and Kidney vacuity. Zheng Qi vacuity can allow for invasion of exogenous pathogens; furthermore, Qi vacuity causes impairment of fluid metabolism, resulting in the production of Phlegm.

For the appropriate treatment of Asthma/Xiào Chuăn, a clear distinction must be made between acute exacerbations and the chronic, remission phase. In general, during the acute phase one follows the article of treating the Branch manifestations by expelling pathogenic factors, transforming Phlegm, and restoring the dispersing and descending function of Lung Qi. During the acute phase it is imperative to differentiate between Cold and Heat patterns.

During the chronic phase, treatment is focused on the Root and attention is paid to supplementing the Zheng Qi, particularly that of the Lungs, Spleen, or Kidneys. In some cases, Root and Branch may need to the addressed simultaneously. http://www.wikispaces.com/_/ad4b0f60/i/c.gif

Cold-Phlegm
rapid breathing with wheezing at a feeling of force and oppression in the chest, cough with scanty, clear or white sputum; symptoms aggravated by exposure to cold Herbal Treatment:She Gan Ma Huang Tang(Belamcanda-Ephedra Decoction) [Ma Huang (Ephedra stem) 12 g, Xi Xin (Asarum) 9g, Sheng Jiang (Fresh Ginger rhizome) 12g,She Gan (Belamcanda rhizome) 9g, Ban Xia (Pinellia tuber) 9g, Zi Wan (Aster root) 9g, Kuan Dong Hua (Coltsfoot) 9g, Da Zao (Jujube) 3pcs., Wu Wei Zi (Schisandra fruit) 3g]
 * Additional Symptoms:** dull, pale/bluish-white complexion, no thirst or desire for warm drinks, aversion to cold and cold limbs
 * Tongue:** white, moist coat
 * Pulse:** wiry, tight or floating, tight or slippery, tight
 * Treatment Principles:** Warm the Lungs, scatter Cold, transform Phlegm, calm wheezing

Phlegm-Heat
loud wheezing with breathlessness, choking cough with rattling sound in the throat, fake, sticky, yellow sputum that is difficult to expectorate Ma Huang (Ephedra herb) 9g, Zi Su Zi (Perilla seed) 6g, Kuan Dong Hua (Tussilago flower) 9g, Xing Ren (Apricot kernel) 4.5g, Sang Bai Pi (Mulberry root bark) 9g, Huang Qin (Scutellaria root) 4.5g, Fa Ban Xia (Processed Pinellia tuber) 9g, Bai Guo (Ginkgo seed) 9g, Gan Cao (Licorice root) 3g]
 * Additional Symptoms:** sweating, irritability, anxiety, thirst, headache, sensation of heat
 * Tongue:** read with yellow, greasy coat
 * Pulse:** slippery, rapid or slippery, wiry
 * Treatment Principles:** Clear Heat, restore the descending of Lung Qi, transform Phlegm, stop wheezing
 * Herbal Treatment:** Ding Chuan Tang (Panting Stabilizing Decoction)

Lung Qi Vacuity
chronic, slight wheezing sound in the throat, slight cough with thin, clear sputum, shortness of breath [Huang Qi (Astragalus root) 30g, Bai Zhu (Atractylodis rhizome) 60g, Fang Feng (Saposhnikovia root) 60g]
 * Additional Symptoms:** spontaneous sweating, weak voice, fatigue, aversion to wind or worsening of symptoms with exposure to wind, tendency to catch colds, stuffy or runny nose with clear discharge
 * Tongue:** pale with thin, white coat
 * Pulse:** weak
 * Treatment Principles:**Supplement the Lungs and consolidate the exterior
 * Herbal Treatment:** Yu Ping Feng San

Spleen Qi Vacuity
chronic, slight wheezing sound in the throat, slight cough with thin, clear sputum, shortness of breath [Dan Shen (Codonopsis root) 3g, Bai Zhu (Atratylodes rhizome) 6g, Fu Ling (Poria) 6g, Zhi Gan Cao (Honey Prepared Licorice) 3g, Ban Xia (Pinellia tuber 3g, Chen Pi (Tangerine peel) 3g]
 * Additional Symptoms:** poor appetite, epigastric and abdominal distention, loose stool, fatigue
 * Tongue:** pale with white, moist or thin, greasy coat
 * Pulse:** weak or soft
 * Treatment Principles:** Supplement the Spleen, boost Qi,transform Phlegm
 * Herbal Treatment:** Liu Jun Zi Tang (Six Gentlemen Decoction)

Kidney Qi Vacuity (Kidneys not Grasping the Qi)
chronic, slight wheezing sound in the throat, shortness of breath, more difficulty inhaling than exhaling, symptoms worse with fatigue or exertion [Shu Di Huang (Cooked Rehmannia root) 24g, Shan Zhu Yu (Cornus fruit) 12g, Shan Yao (Dioscorea root) 12g, Ze Xie (Alisma tuber) 9g, Mu Dan Pi (Moutan root bark) 9g, Fu Ling (Poria) 9g, Rou Gui (Cinnamon bark) 3g, Pao Fu Zi (Blast-fried Aconite) 3g]
 * Additional Symptoms:** sore and weak low back and knees, tinnitus, spontaneous sweating (aversion to cold with cold limbs and impotence if more Yang vacuity)
 * Tongue:** pale
 * Pulse:** deep, weak
 * Treatment Principles:** Supplement the Kidneys, boost the Qi, stop wheezing
 * Herbal Treatment:** Jin Gui Shen Qi Wan (Golden Coffer Kidney Qi Pill)

Kidney Yin Vacuity
chronic, slight wheezing sound in the throat, shortness of breath, more difficulty inhaling than exhaling, symptoms worse with fatigue or exertion [Shu di huang (Cooked Rehmannia root) 24g, Shan zhu yu (Cornus fruit) 12g, Shan yao (Dioscorea root) 12g, Ze xie (Alisma tuber) 9g, Mu dan pi (Moutan root bark) 9g, Fu ling (Poria) 9g, Zhi mu (Anemarrhena root) 9g, Huang bai (Phellodendron bark) 9g]
 * Additional Symptoms:** sore and weak low back and knees, tinnitus, sensation of heat, night sweating, malar flush, insomnia
 * Tongue:** red with scanty coat
 * Pulse:** thin, rapid
 * Treatment Principles:**Supplement the Kidneys, nourish Yin, drain Fire, stop wheezing
 * Herbal Treatment:** Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill)

Acute Phase:
Cupping on upper back and chest. Plum Blossom needle: lightly tap along the paraspinal muscles of the upper back and/or along the course of the Lung channel (thenar eminence, forearm) and bilaterally over the SCM muscle until skin is red.
 * Basic Points:** CV22, Dingchuan, CV17, LU1, ST40, BL17, PC6
 * Points based on pattern:**
 * Cold:** LU7, LI4, BL12
 * Heat:** LU5, LU6, GV14

Remission Phase:
Summer moxibustion: apply 3-5 cones of moxa on sliced ginger to BL13, BL43, GV14, BL20, BL23 until skin becomes red at each point. Do this daily, with 10 times equaling 1 course of treatment. Do one course each month for three months before the asthma season begins ( i.e., fall/winter). PARQ conferencing is essential.
 * Basic Points:** BL13, LU9, CV17, ST40, LU1, Ding Chuan
 * Points based on pattern:**
 * LU Qi Xu:** CV6, BL43, ST36, SP3
 * SP Qi xu:** BL20, ST36, SP3, CV12
 * KI xu:** BL23, KI3, CV6, CV4

Cupping: sliding cups along upper back until skin becomes dark red. Do this once a week, four times equaling 1 course of treatment. Do this two months before the asthma season begins. Suppurative moxibustion: direct, rice grain moxa at BL12, BL13, BL43, GV14, ST36. PARQ conferencing is essential and care must be taken that skin does not become infected.

Herbal Therapy for Asthma/Xiào Chuăn
Supurative herbal therapy: Bai Jie Zi 12g Yan Hu Suo 12g Xi Xin 12g Gan Sui 12g She Xiang 0.15g Grind the above herb into a fine powder, mix with fresh ginger juice, shape into small cones and apply with a plaster onto the following points: BL13, BL43, and GV14; remove after two hours. Apply three times in August, ideally over consecutive days.

Many modern TCM respiratory specialists add Wind-extinguishing, insect medicinals to formulas for the treatment of acute asthma. These include Quan Xie, Wu Gong, Di Long, Jiang Can, and Chan Tui. Their use is based on the statement that, “Enduring disease enters the collaterals.” From a modern pharmacological perspective, these herbs have spasmolytic properties.

Pharmacotherapy for Asthma/Xiào Chuăn

 * ** Long-term Control Medications ** || ** Quick Relief Medications ** ||
 * * Inhaled corticosteroids (e.g., Azmacort, Vanceril, AeroBid, Flovent)
 * Leukotriene modifiers (e.g., Singulair and Accolate)
 * Long-acting bronchodilators (e.g., Serevent)
 * Mast cell inhibitors (e.g., Cromolyn sodium [Intal] or nedocromil sodium [Tilade])
 * Aminophylline or theophylline (not as commonly used as in the past) || * Short-acting bronchodilators (e.g., Proventil, Ventolin, Xopenex)
 * Systemic corticosteroids (e.g., prednisone or methylprednisolone) ||

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============================================================ IBIS:

Definition:
A hypersensitivity reaction causing brochospasm, mucosal edema and increased bronchial mucous secretion leading to respiratory distress.

Etiology:
Asthma is most common in children under 10 years old, and is twice as common in males. It affects about 3% of the general population. Factors involved with asthmatic reactions include a variety of stimuli: URI; exercise; emotional upset; food sensitivities; inhalation of cold air or irritating substances (smoke, gas fumes, paint fumes); suppression of previously more minor diseases such as eczema or otitis media with drug therapy; and reactions to specific allergens, such as pollens.

There are two types of asthma: • extrinsic asthma: Also called atopic asthma, this is considered to be IgE-mediated. Attacks are mostly initiated by exposure to allergens: dust, molds, pollens, animal dander, and foods.

• intrinsic asthma: This type does not seem related to an antigen-antibody complex. Rather, the bronchial reaction is due to other factors as mentioned above: cold air, exercise, infection, emotional upset and irritating inhalants.

Most patients seem to have a mixture of the two types, although it is thought that the allergic type is the more common asthma in infants and children.

Somatic Thrapies:
• mild aerobic exercise: esp. swimming • breathing exercises: principles - - strengthen respiratory muscles - eliminate inefficient use of accessory muscles - replace forceful breathing, which compresses airways, with relaxed breathing - gross hyperventilation can be reduced by increased expiration - reduced sensation of breathlessness increased diaphragmatic excursion - enhance clearing of airways - give patient confidence to withstand breathlessness • help control acute attack: - sit leaning forward with head on arms, arms resting on table - lying semiprone, with arms and legs slightly bent and relaxed, body and limbs well supported by pillows - qigong: pronunciation exercises - qigong: relaxation exercises

Nutrition:
eating principles: • Decrease consumption of foods with arachidonic acid (red meats and dairy products). Amino acids are the major substrate for lipoxygenase which results in increased levels of leukotrienes. It should be noted that safflower, sunflower, and other oils contain high levels of linoleic acid and small amounts can get converted to arachidonic acid (via D 5 desaturase in the presence of stress) after their conversion to DHGLA. (Marz, 321, 1997.) • Increase consumption of foods containing flavonoids and carotenes. Both inhibit the action of lipoxygenase. Yellow vegetables and other leafy vegetables contain abundant amounts of these important nutrients. (Marz, 321, 1997.) • Increase consumption of EPA and linolenic acid sources such as flax oil, canola oil, walnuts, cold water fish, herring, sardines, and salmon. EPA selectively inhibits lipoxygenase by binding onto the enzyme and forming the 5 series of leukotrienes which have little broncho-constricting properties. (Marz, 321, 1997.) • Onions and grape skins contain quercetin which has the effect of stabilizing mast cells, inhibiting lipoxygenase, and increasing cAMP levels. (Marz, 321, 1997.) • Avoid excessive calcium sources and bananas as these potentiate phospholipase. (Marz, 321, 1997.) • Vegan diet: No meat, fish, eggs, dairy products, coffee, ordinary tea, chocolate, sugar, salt, tap water, apples, citrus, soybeans and peas. Grains and potatoes either very restricted or eliminated. (Lindahl J. Asthma 1985;22:45-55.) • Moderately low fat • Low sugar • High complex carbohydrates • Protein 12-15% diet, decreasing foods high in arachidonic acid (red meats and dairy products) • Vegan cleansing diet or alkaline juice fasts (3-7 days), followed by a vegetarian diet with emphasis on alkaline-forming foods • Elimination/rotation diet, rotation diet, rotation diet expanded

therapeutic foods: • Foods that tonify the Lung, tonify Lung Yin, pungent foods • 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, sesame seeds (Ni, 106.) • Collards, cauliflower, garlic, onions, turnips, endive, apricots, cherries, elderberries, green vegetables, raw nuts and seeds, sprouted seeds and grains (Jensen, 61.) • 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 • Fruit rich in Vitamin C: Italian researchers report that children who consume vitamin C-rich fruit are less likely to experience wheezing. In the study, youngsters who ate kiwi or citrus fruits 5 to 7 times a week were about 30% less likely than other children who ate fruit less than once a week to suffer from wheezing, chronic coughing or nighttime coughing, (Forastiere F, et al. Thorax. 2000 Apr;55(4):283-288.) • Foods rich in Manganese, Calcium, Iron, Silicon (Jensen, 61.) • Foods high in flavonoids and carotenoids: dark green leafy vegetables, deep yellow and orange vegetables

fresh juices: • celery and papaya (Jensen, 50.) • celery, endive, and carrot (Jensen, 50.) • spinach and carrot (Walker, 123.) • lemon juice in water (Shefi) • lime, horseradish, and garlic • carrot (Walker, 123.)

specific 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. (Butt, Bloomfield, 124.) • steam 120 g dried lychee and eat once daily (Lu, 82.) • eat mango fruit and the skin, three times daily. (Yin-fang, Cheng-jun, 35.) • take 120 g of dried lychee, discard skin and stones, steam in a covered pot then mash and serve (Yin-fang, Cheng-jun, 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 (Yin-fang, Cheng-jun, 63.) • take a fresh lemon and add 1-2 tbsp. sugar. Steam in water until soft, mash and serve, including the skin, twice daily (Yin-fang, Cheng-jun, 64.) • take 3 fresh peaches, peel and simmer with 30 g sugar in a covered pot. Discard the stones and eat once daily. (Yin-fang, Cheng-jun, 69.) • take 30 g of walnut kernels, 15 g sugar and 6 g turnip seed. Steam for 30 minutes and serve twice daily (Yin-fang, Cheng-jun, 106.) • 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 (Yin-fang, Cheng-jun, 106.) • 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. (Yin-fang, Cheng-jun, 108.) • take 10-15 g loquat fruit stones and crush them. Add 3 g fresh ginger, cover with water and simmer 1 hour. Serve twice daily (Yin-fang, Cheng-jun, 48.) • for 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 (Yin-fang, Cheng-jun, 63.) • take a fresh lemon or orange, slice and add 15 g sugar. Steam in water until soft, mash and serve, including the skin, twice daily (Yin-fang, Cheng-jun, 64, 84.) • take 50 g of shelled peanuts, add water and boil, then mash. Drink the broth and eat the peanuts twice daily (Yin-fang, Cheng-jun, 97.)

avoid: • Eliminate food allergies: - Immediate sensitivity reactions are usually caused by (in decreasing order), eggs, fish, shellfish, nuts, and peanuts. - Delayed sensitivity reactions are caused by (in decreasing order) milk, chocolate, wheat, citrus, and food colorings (tartrazine), but really any and all foods can cause or add to the allergic burden. (Rowe AH, Young EJ. JAMA 1959;169:1158.) • 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, watermelon, salty foods, cold foods, bananas, mung beans • Aspirin, non-steroidal anti-inflammatories • Avoid tryptophan which is converted to serotonin, a bronchoconstrictor (Marz, 321, 1997.)

also: • Eliminate environmental allergies: Eliminate rugs, wall hangings, cats, feather pillows and clean air filters for heating and cooling systems. Use environmentally sound cleaning solutions. Wet mop walls, floors, ceilings and use special high quality vacuum. Consider using an ionizer and/or ozone generator. Consider a formaldehyde bomb or shots. (Marz, 1997; Spurlock B, Daily T. N Engl J Med, Dec 27 1990;323(26): 1845-1846.)

Botanicals
• Aloe spp.: oral administration of Aloe over a six month period can be effective in the treatment of chronic bronchial asthma; the extract must first be kept refrigerated (4° C) and in the dark for seven days before administration in order to produce a change in the glycoproteins and polysaccharides (Shida, T, et al. 1980, pp. 47-51; Shih, T, et al. Plant Medica. 273-275, 1985) • Ammi visnaga: (Weiss, p. 221) • Brassica spp. (mustard): chest compress for accompanying bronchitis or as foot bath (Husemann, p. 393) • Commiphora myrrha: profuse secretion expelled with difficulty, restrains mucus discharge (Felter and Lloyd, p. 1300) • Convallaria majalis (toxic): cardiac asthma, combines well with Leonurus cardiaca and Selenicereus grandiflorus (toxic) in heart disease (British Herbal Pharmacopoeia, p. 74) • Datura stramonium (toxic): chronic, purely asthma (Weiss, p. 219) • Drosera rotundifolia: with dry, irritable, persistent cough or spasmodic, hoarse, explosive cough. Combines well with Euphorbia hirta, Grindelia robusta, Polygala senega (British Herbal Pharmacopoeia, p. 80; Ellingwood, p. 251) • Ephedra vulgaris: relieves bronchial spasm, see contraindications. Combines well with Lobelia inflata, Grindelia robusta (Weiss, p. 218; British Herbal Pharmacopoeia, p. 83) • Eriodictyon californicum (yerba santa): weak, dissipative cough (Wood). • Euphorbia hirta: bronchitic asthma, with Grindelia robusta (British Herbal Pharmacopoeia, pp. 88-89) • Gecko: traditional Chinese materia medica; indicated in "Kidney asthma," when the lungs close up from below, patient grasps for breath; usually no congestion. Make a tincture by soaking 1 gecko in a half quart of vodka (Wood) • Ginkgo biloba • Grindelia robusta: with dry cough, sense of soreness, rawness. May be best as fresh plant preparation (Felter, p. 397); dried out, tenacious mucus (Wood) • Lobelia inflata (toxic): spasmodic asthma with secondary bronchitis. Combines well with Capsicum frutescens, Grindelia robusta, Drosera rotundifolia, Euphorbia hirta, Ephedra vulgaris in asthma (British Herbal Pharmacopoeia, p. 153) • Marrubium vulgare: with moist expectoration, aphonia and dyspnea (Priest and Priest, p. 93) • Polygala senega: bronchitic asthma; combines well with Euphorbia hirta and Grindelia robusta in asthma (British Herbal Pharmacopoeia, p. 196) • Sanguinaria canadensis (toxic): spasmolytic; combines well with Lobelia inflata (toxic) in asthma (British Herbal Pharmacopoeia, p. 188) • Selenicereus grandiflorus (toxic): with cardiac symptoms (Ellingwood, p. 212) • Sticta pulmonaria: chronic (Priest and Priest, p. 95) • Symplocarpus foetidus: antispasmodic, antitussive, traditional remedy (Anderson Geller) • Thymus vulgaris: bronchiolytic (Weiss, p. 209) • Urginea maritima (toxic): asthma with bronchitis (British Herbal Pharmacopoeia, p. 224) • Verbascum thapsus: inhaled, soothing (Felter and Lloyd, p. 2055) • Viburnum opulus: antispasmodic (Felter and Lloyd, p. 2059)

Chinese Formulae
» formulae for asthmatic attacks: • Ma Huang and Apricot Seed C. (Ma Xing Shi Gan Tang): Lung Invaded by Wind-Heat: wheezing, coughing, labored breathing, nasal flaring and pain, yellow tongue coat (Hsu, 1980, p. 68; Yeung, p. 157; Dharmananda, 1986, p. 126; Bensky and Barolet, p. 88) • Licorice and Ma Huang C.: If Ma Huang and Apricot Seed C. is not effective after one or two doses (Terashi p.40)

» formulae to improve the constitution: • 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 and weakness (Minor Blue Dragon C.: Hsu, 1980, p. 43; Yeung, p. 261; Dharmananda, 1986, p. 127; Bensky and Barolet, p. 38) • Ma Huang C. (Ma Huang Tang); Ping Chuan Wan (patent): Wind-Cold. (Ma Huang C.: Hsu, 1980, p. 76; Yeung, p. 156; Dharmananda, 1986, p. 124; Bensky and Barolet, p. 33; Ping Chuan: Zhu, p. 96) • Cinnamon C. (Gui Zhi Tang) plus magnolia bark (hou po) and apricot seed (xing ren): Wind-Cold:weak constitution, spontaneous sweating. (Hsu, 1980, p. 63; Yeung, p. 115; Dharmananda, 1986, p. 99; Bensky and Barolet, p. 35) • Ophiopogon C. (Mai Men Dong Tang); Ma Xing Zhi Ke Pian (patent): Wind-Heat. (Ophiopogon C.: Hsu, 1980, p. 537; Yeung, p. 159; Dharmananda, 1986, p. 283; Bensky and Barolet, p. 165; Ma Xing: Zhu, p. 73) • 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 (Hsu, 1980, p. 556; Yeung, p. 147; Bensky and Barolet, p. 444) • 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. (Citrus and Pinellia C.: Hsu, 1980, p. 551; Yeung, p. 88; Bensky and Barolet, p. 432; Dharmananda, p. 131; Su Zi: Zhu, p. 72; Chuan Bei: Zhu, p. 71; Pinellia: Dharmananda, 1990, p. 53) • 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 (Minor Bupleurum: Hsu, 1980, p. 91; Yeung, p. 255; Dharmananda, 1986, p. 133; Bensky and Barolet, p. 136; Pinellia: Hsu, 1980, p. 395; Yeung, p. 42; Dharmananda, 1986, p. 226; Bensky and Barolet, p. 291; Chuan Bei: Naeser, p. 72) • 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 (Hsu, 1980, p. 401; Bensky and Barolet, p. 301) • Ma Huang and Apricot Seed C. (Ma 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 (Ma Huang: Hsu, 1980, p. 68; Yeung, p. 157; Dharmananda, 1986, p. 126; Bensky and Barolet, p. 88; Chuan Bei Jing Pian: Zhu, p. 71) • Six Major Herbs (Liu Jun Zi Tang): Spleen Qi Xu (Deficiency) with Phlegm: poor appetite, bloated abdomen, loose stools, asthma after overeating or after rich food, gurgling with breathing during asthma attack (Hsu, 1980, p. 242; Bensky and Barolet, p. 238; Yeung, p. 150; Dharmananda, 1986, p. 242) • 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. (Sheng Mai San: Yeung, p. 207; Bensky and Barolet, p. 245; Li Fei: Zhu, p. 86) • Ma Huang and Gingko C. (Ding Chuan Tang) (available as patent): Lung Obstructed by Phlegm-Heat: coughing and wheezing with copious thick yellow sputum, labored breathing (Ma Huang: Hsu, 1980, p. 407; Yeung, p. 84; Dharmananda, 1986, p. 206; Bensky and Barolet, p. 300; patent: Zhu, p. 96) • Phellodendron C.; Li Fei (patent): Lung Yin Xu (Deficiency) (Hsu, 1980, p. 199, Dharmananda, p. 174) • Rehmannia Eight F. (Jin Gui Shen Qi Wan) plus Shen Jie San: long-term asthma, more trouble inhaling, skinny, spontaneous sweating, feels cold (Rehmannia Eight: Hsu, 1980, p. 250; Yeung, p. 138; Dharmananda, 1986, p. 173; Bensky and Barolet, p. 275; Shen Jie San: Yeung, p. 200) • Rehmannia and Schizandra C. (Du Qi Wan); Qi Guan Yan Ke Sou Tan Chuan Wan (patent): Kidney Yin Xu (Deficiency) (Rehmannia and Schizandra: Hsu, 1980, p. 226; Yeung, p. 87; Dharmananda, 1986, p. 173; Bensky and Barolet, p. 264; Qi Guan: Zhu, p. 93) • 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 (Hsu, 1980, p. 405; Yeung, p. 224; Bensky and Barolet, p. 299) • Ma Huang and Morus C. (Hua Gai San): Lung Invaded by Wind-Cold: long term treatment, in children; poor appetite, GI distress. (Hsu, 1980, p. 47; Dharmananda, 1986, p. 207; Bensky and Barolet, p. 35) • Bi Min Gan Wan (patent); Pinellia 16 (patent) plus Xanthium 12 (patent): Asthma due to allergy. (Bi Min Gan: Zhu, p. 55; Pinellia: Dharmananda, 1990, p. 53; Xanthium: Dharmananda, 1990, p. 94) • 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 (Dharmananda, 1990: Pinellia, p. 53: Gecko-A, p. 17: Xanthium 12, p. 94: Cyperus, p. 45)

Acupuncture
after assessing the person and palpating, consider these patterns: Lung Xu (Deficiency); Kidney Xu (Deficiency), esp. Kidney Failing to Grasp Qi; Phlegm Heat; Liver Fire Insulting Lung; Wind and Cold in the Lung; Lung Invaded by Wind-Heat; Lung Qi Stagnation; Yang Ming (Large Intestine); Tai Yin (Lung); Lung Obstructed by Damp-Phlegm with Spleen Yang Xu (Deficiency); dysfunction of the Ren Mai (Conception Vessel); Shi (Excess) of the Yin Wei Mai (Yin Linking Vessel)

» illustrative combinations: • Kd-3 and Lu-5 for asthma with difficult inhalation; palpate and apply pressure to test for response before needling (Matsumoto) • Sp-4 and Lu-5 for asthma with difficult exhalation; palpate and apply pressure to test for response before needling (Matsumoto) • UB-13 (D), UB-20 (D) and St-36 (D) for prevention of asthma before seasonal occurrence (McWilliams, et al, Lesson 31, p. 29) • Kd-27, Kd-26, Kd-25 and Kd-24 (=): relieve acute respiratory distress (Serizawa, p. 186); relieve constriction in chest; resolve Phlegm; stimulate Kidney's function of reception of the Qi • UB-11, CV-17 and St-40 for asthma (Shanghai, p. 196) • UB-38/43, CV-22 and ding chuan for asthma (Shanghai, p. 201), and St-40 (Shanghai, p. 174) • CV-12, Lv-14 and St-37 for asthma (Shanghai, p. 179) • UB-13, UB-12, Lu-5 and St-40 for asthma due to External Cold or External Heat; also consider UB-11, CV-17, CV-12 and Lu-8 (McWilliams, et al, Lesson 31, p. 28) • CV-22, CV-17, Lu-7, St-40 and UB-12 for asthma due to Heat (McWilliams, et al, Lesson 31, p. 29) • CV-22, Lu-7, CV-12, UB-13 and St-36 for asthma due to Cold (McWilliams, et al, Lesson 31, p. 29) • CV-17, ding chuan, CV-22 and PC-6 for bronchial asthma (Shanghai, p. 177) • UB-13, CV-17, Lu-1 and PC-6 for bronchial asthma (Shanghai, p. 198) • Lu-1, ding chuan, PC-6 and CV-17 for bronchial asthma (Shanghai, p. 177) • ding chuan, CV-22, CV-21 and CV-17 for bronchial asthma; also consider St-40, GV-14, LI-4, CV-4 and St-36 (Lee and Cheung, p. 237) • ding chuan, CV-17, PC-6, GV-14, gan re xue and St-40 for bronchial asthma (Lee and Cheung, p. 240; Shanghai, p. 594) • UB-10, GB-20, St-13, SI-14, UB-11, UB-12, UB-13, UB-14, UB-15, UB-36/41, UB-38/43 and LI-4 for bronchial asthma (Lee and Cheung, p. 240) • UB-13, UB-16, CV-22, CV-17, GB-21, CV-12, CV-6, Lu-7, St-36 and Sp-6 for bronchial asthma (Lee and Cheung, p. 240) • Ht-9 and Ht-4; SI-14 and SI-15; Lu-1 and Lu-2; GV-17 and CV-18 for cardiac asthma (Mann, p. 118) • UB-13 (D), UB-38/43 (D), CV-22, CV-17, CV-12 (D), Lu-7, St-36 (D) and St-40 for asthma due to Lung Cold-Phlegm and Spleen Yang Xu (Deficiency) (Jirui and Wang, p. 30) • UB-43/48, UB-23, Kd-27, CV-4 and St-40 for asthma due to Kidney Qi Xu (Deficiency) or other internal insufficiency (McWilliams, et al, Lesson 31, p. 29) • GV-14, UB-11, UB-23, UB-21, CV-6, CV-4, PC-6 and St-36 for Xu (Deficiency) asthma (McWilliams, et al, Lesson 31, p. 29) • Lu-2, St-9 and Kd-25 for revolting cough and persistent asthma (Lee and Cheung, p. 240) • CV-22 and CV-20 for fulminating asthma; UB-37/42 and Lu-1 for continuous asthma; CV-17 for cough and asthma; CV-21 for severe cough with laryngeal stridor; LI-3 for dyspnea (Lee and Cheung, p. 240) • CV-22, CV-21, CV-20, CV-17, St-18, Lv-14, CV-6, locus below the 7th spinous process for bronchial asthma (Lee and Cheung, p. 240) • Kd-27, CV-22, CV-17, UB-13, St-36, CV-12, UB-38/43, CV-6, CV-4 and St-18 for bronchial asthma (Lee and Cheung, p. 240) • CV-22 and St-40: dissolve Phlegm, smooth Qi circulation, pacify breathing and relieve asthma attacks (Finkelstein, p. 22) • UB-13, CV-22, Lu-9, UB-11 and St-36: expand the esophagus, reduce asthma (Finkelstein, p. 39) • Lu-9 and Lu-5: clear Heat and facilitate Qi to stop cough and soothes asthma and benefits skin (Finkelstein, p. 4) • Lu-1, Lu-2, Lu-3, CV-20 and UB-13 (D) for wheezing (Shanghai, p. 595) • UB-60, GB-41, Sp-9 and Ht-7 for wheezing (Shanghai, p. 282) • LI-18, CV-22 and Kd-3 for wheezing (Shanghai, p. 165) • Lu-7, Lu-9, si feng, ding chuan, chuan xi and CV-17: to treat shallow wheezing (Flaws, 1989, p. 97) • St-18 and Kd-27: treat cough and wheezing (Ellis, et al, 1988, p. 123) • GV-14 and LI-4 (-): dispel Wind and Cold, use with persistent wheezing • CV-12 and St-36 (+ and D): strengthen Spleen; warm Spleen Yang; transform Dampness • CV-4 and St-36 (+): tonify Qi, esp. Spleen and Kidney; nourish "source" • PC-6 and Sp-4: open the Yin Wei Mai (Yin Linking Vessel) for which dyspnea and oppression in the chest are symptoms of Shi (Excess) • navel treatment a la Matsumoto for weak connective tissue and/or Xu (Deficiency) of the Kidney and/or Spleen due to birth trauma induced by improper severing of the umbilical cord causing damage to the ligamentum teres hepatis (Matsumoto)

Homeopathy
• Aconitum napellus and Ipecacuanha: to be given alternately during attack; it will act as palliative, will ease breathing, cough; acon. is useful for asthma of millers • Alumina silicata: breathing arrested by coughing with rattling in chest; difficult breathing from coughing • Ambra grisea: in old people and children; dyspnea with little exertion • Ambrosia artemisiaefolia: with fever, due to observing the pollen of ragweed • Ammonium carbonicum: with dyspnea < in warm room until suffocation is imminent; cough from 2 to 5 a.m. • Antimonium tartaricum: difficult breathing with suffocating cough, anxious oppression of front chest from excessive phlegm; aged people, children; respiration, rapid, painful, noisy • Aralia racemosa: with coryza; loud wheezing, whistling respiration coming on lying down or at midnight, after short sleep; sputum warm, salty; cough by tickling in the throat and constriction of chest, has to sit up to avoid choking • Arsenicum album: in acute and chronic cases with labored breathing, extreme agitation, moaning, restless, great exhaustion and anguish as if dying with cold perspiration; breathing < walking, going uphill or up stairs; attacks at retiring or first part of night; midnight aggravation associated with emphysema, hay asthma, after suppression of eruption • Belladonna: violent spasms of asthmatic breathing attending by constriction of chest and a sense of constriction of throat as if would suffocate; antispasmodic remedy • Blatta orientalis: dyspnea, thick purulent mucus • Bryonia: in obstruction breathing at night or toward morning, with frequent cough, pain under short ribs, > on back < talking, movement; tracheal or bronchial irritation • Chloralum hydratum: with wheezing respiration; when lying inspiration through nose and expiration blown from lips • Colocynthis: asthma with indigestion and flatulence, < seaside; feels cold even in hot weather • Cuprum metallicum: same symptoms as mosch. but given only if latter fails • Drosera rotundifolia: asthma of consumptives; oppression < by heat of bed; dry cough with no expectoration; if fails try meph. • Dulcamara: wet weather or living on wet basements • Graphites: eruptions alternating or co-existing with asthma • Grindelia: abnormal accumulation of mucus, breathing stops when asleep; emphysema with dilated heart; asthma of old people suffering from bronchitis which causes paralysis of pneumogastric nerve; good remedy to bring back appetite, reduce palpitation and dyspnea • Hypericum perforatum: asthma < foggy weather; attacks relieved by copious expectoration, and profuse perspiration • Ignatia: asthma aggravated by emotions, by cares and repeated griefs • Ipecacuanha: spasmodic form with great weight on the chest with anxiety, wheezing, shortness of breath, feeling of suffocation < movement; constant cough causing vomiting; chest full of phlegm, cold sweat on hand, feet; asthma with skin diseases • Kali bichromicum: attacks caused by or following coitus; early morning <; ropey expectoration is characteristic which comes in abundance • Kali carbonicum: when attack comes after midnight; it compels patient to sit giving better relief; sensitive to change of temperature, draughts of cold; irritable, full of fears and imaginations • Kali nitricum: excessive dyspnea, faintness, nausea with dull stitches, burning pain in chest • Kali phosphoricum: nervous asthma; give 1M as an intercurrent remedy; expectoration • Kali sulphuricum: yellow expectoration, much rattling in chest, labored breathing, talking almost impossible • Lachesis: when aroused from sleep by paroxysm, cough watery phlegm with relief; < during and after sleep • Lobelia inflata: tightness of chest, tickling of the trachea, laborious breathing with mouth open to breathe; tickling under breast bone on taking a big breath; no cough or expectoration; < in cold or tobacco fumes, whose smell is unbearable • Lycopodium: excitement by anger or emotion with fanlike motion of alae nasi; nervous asthma; chilly patient, always catching cold, easily tired, exhausted; when catch cold, phlegm settles down affecting right lobe; with burning arising from epigastric area and going up the esophagus with eructations • Medorrhinum: intercurrent remedy when well-indicated remedy fails to act or give complete relief; choking cough, no air can enter, > lying on face; < lying down; want to be fanned; feels cold yet throws covers off; < heat, wet, damp, draught, thunderstorms, daylight to sunset, > evening; alternate or coexist with rheumatism • Mephitis putorius: asthma of drunkards • Moschus: mostly for hysterical women or children from exposure to cold as if caused by sulphur vapor • Naja: difficult breathing, cannot lie down; breathing > by intense sneezing; dryness of lungs with difficulty of breathing; pulse slow • Natrum arsenicosum: asthma alternating with urticaria; produced by inhalation of coal dust • Natrum sulphuricum: during wet weather, rainy seasons; get attacks every change of season, early morning; cough loose, humid, copious,viscid, greenish-yellow phlegm; rales, rattling, noises, expectorating white mucus thick, ropy; holds chest with hand which gives relief to cough; asthma with bronchitis, deformity of chest; associated with or alternating with rheumatism; if fail to relief give med. as intercurrent remedy • Nux vomica: asthma of digestive origin; nocturnal attacks preceded by disagreeable, anxious dreams; > on back, changing sides, sitting up; flatulence; epigastrium very swollen • Opium: congestion of blood or pulmonary spasms with deep rattling breathing; anguish, suffocation during sleep, nightmare, bluish redness of face • Phosphorus: for asthma of humid variety; violent thirst, cold water, vomited as soon as it warms in stomach; diminution of urine with albuminuria • Phosphoricum acidum: should be tried when phos. fails; given in 3X, then 200C • Psorinum: > lying with arms wide apart; < winter and cold seasons; secretions tenacious, offensive; asthma of old men • Pulsatilla: timid, irritable, changeable mood, laugh, cry easily, loathe fat, fear of dark, death, suspicious, dream of cats • Sabadilla: hay asthma with oppressive sneezing, watery discharge • Sanguinaria: asthma < by or due to odors; cough is hoarse, hard, dry • Silicea: sycotic, chilly patients; catarrh of chest, asthmatic wheezing, inability to move; after suppressed GC • Syphilinum: asthma returning every summer • Thuja occidentalis: following vaccination; warts on and off; dry cough in afternoon; infantile asthma with cough dry or loose; oezena with thick, yellowish-green discharge • Yerba santa: when relieved by expectoration

Subtle Support
• Fa (Hill, p. 46)

• Mi (Gardner, p.72, 78)

• Fa# (Gardner, p. 82, 87)

• 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
• Attacks may be more frequent from midnight to 3 AM due to normal circadian rhythms. (Rossi, 1986, p. 166) • Maybe associated to dependency issues, particularly related to struggles for independence from maternal influence. (Epstein, p. 65) • Severity of asthma attack is directly related to the amount of fear and anxiety felt by the patient. Anxiety causes further bronchoconstriction. Therapy should be directed to reducing anxiety. (Locke, 1986 p. 3) • Childhood asthma may have an important role in maintaining family homeostasis. Since recovery of the child would endanger the family's security, intrafamilial forces are inhibiting the child's recovery and play a role in the precipitation of the asthmatic attacks. Furthermore, many emotional conflicts between the parents and siblings often get avoided or diffused due to everyone's overriding concern over the asthma situation. The patient may serve as a "conflict avoidance tool" and a protection for other family members and their submerged problems of functioning well as a unit. (Locke, 1986, p. 10, 52) • Mothers of asthmatics suffered more depressive illness than controls. (Locke, 1983, p. 132) • Fear of estrangement from mother and inhibition of crying may play etiologic roles. Such emotional factors and allergic factors complement each other in precipitating asthmatic attacks. (Locke, 1986, p. 44) • Asthmatics are often highly sensitive to the loss of love and appreciation from meaningful figures. This hypersensitivity is generally associated with strong feelings of dependency and compliance, which may alternate with unregulated expression of anger. (Locke, 1986, p. 53) • A 15 item MMPI (Minnesota Multiphasic Personality Inventory) scale has been developed that relates to the reported frequency of panic-fear symptoms on the Asthma Symptom Checklist (ASC). High scales scores describe fearful, emotionally labile individuals who profess to be more sensitive than others, and are unable or disinclined to persist in the face of difficulty. (Locke, 1983, p. 133) • Anxiety in asthma exists as two separate types of anxiety, with different implications in treatment prognoses. MMPI Panic-Fear scale is a measure of general, non-illness specific anxiety (or trait anxiety, a characterological and pervasive anxiety, or lack of basic ego resources); and the Panic-Fear symptom scale of the ASC is a measure of asthma-specific anxiety focused on the anxiety attack. Unusually high or low panic-fear personality styles are maladaptive; the former characterized by anxious, helpless dependency, and the latter by extreme counterphobic independence. When high characterological anxiety coexisted with high asthma-specific anxiety, medical outcome following intensive long-term medical and psychotherapeutic treatment was exceptionally poor. In contrast, when high asthma-specific anxiety coexisted with average levels of characterological anxiety, medical outcome was exceptionally good. (Locke, 1983, p. 134, 136, 137) • 155 hospitalized asthma patients in 1976 were administered the MMPI in order to evaluate the existence of common personality characteristics. Findings refute any stereotypic asthmatic personality. The single most frequent pattern observed was a 'neurotic triad,' which is also characteristic of other chronic illnesses and seems to represent a defensive stance in coping. It appears more profitable to investigate individual personality patterns associated with coping styles and their relationship to the illness via behaviors that either maintain or delimit the effects of chronic asthma. (Locke, 1983, p. 136) • Child's repressed aggressiveness within the family and pathological fixation on mother. • Repression of the feelings of longing for more affection, fear of losing the mother, and anger at the deprivation experienced and expected. (Locke, 1986, p. 46, 54) • Cry for mother's love. (Locke, 1986, p. 49) • Bronchospasm in children may be brought on by crying. (Locke, 1986, p. 2) • Theories of initiation refer to the immediate post-nasal breathing pattern of an infant, whose first gasps of air are exhaled against upper respiratory tract resistance without effective contraction of the vocal cords, giving rise to the 'unvoiced' birth cry. It is noted that this innate reflex behavior is associated with pulmonary capillary dilation and the affects of fear, anger, and depression which may be associated with birth. (Locke, 1983, p. 138) • There is some "the chicken or the egg" controversy on emotional aspects of asthma; some say pathologic emotions are an etiology while others say they are secondary to the disease. (Locke, 1986, p. 48) • Fear of life; not wanting to be here. (Hay, 1988, p. 15) • Fear of maternal separation. (Alexander, p. 244) • Generalized fear, anger, and anxiety. (Alexander, p. 243) • Personality Traits: marked egocentricity, impulsive behavior, impatience, domineering, inflexibility, stubbornness, need for love and affection, jealousy, late bloomers. (Jores, p. 286) • Dependency was not found to be associated with the severity of asthma, but was associated with family relationship patterns in a study of 60 children which questioned whether childhood asthma produced increased dependency. (Locke, 1983, p. 138) • Asthma patients feel unloved, left out, or ignored, and wants to screen out another individual or situation. (Gentry, p. 43) • Associated with disturbance in attitude including attitude toward father, heterosexual relationships, and own abilities. (Locke, 1983, p. 131) • The arrival of a new family member, or a period of 0-3 years in marriage, were connected with insidious asthma most frequently. (Locke, 1983, p. 142) • Asthmatics are intelligent but inhibited. They have covert aggression, neurotic construction and marked affectional and dependency needs. They have excessive dependency on mother and sexual disturbance. They have considerable anxiety, irrational fears, guilt feelings, and insecurity. When high goals were set, they were unable to achieve them. (Locke, 1983, p. 139) • Among the psychic factors, introversion in particular is probably important in the combination of factors affecting the inception of asthma. (Locke, 1983, p. 141) • Poor psychosocial adaptation, obsessive neurosis, immature personality, and alcohol problems are associated with static or deteriorating trends in asthma. The patients who were the most extroverted and/or lacked psychic symptoms almost always fell into the group with favorable prognoses. (Locke, 1983, p. 141) • Individual feels left out, unloved or ignored, and wants to screen out another individual or the situation, and not have anything to do with them. (Gentry, p. 43) • Psychotherapy in asthma-prurigo syndrome in children: in all cases the asthma responded sooner than the eczema. (Locke, 1986, p.77) • Children with asthma/enuresis appear to be at high risk for lower levels of self-esteem, poor quality of life in the past year, self-complexity, and parental preference for their siblings. (Locke, 1983, p. 138)

• 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; extends through the skin, controls the pores, and manifests through the body hair. » 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.
 * Chinese psychophysiology:**

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; maintains smooth flow of Qi; controls the muscles, especially their contractility; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. » Liver Shi (Excess) signs include discontent; anger; pain in lumbar region and genitals (Seem, p. 28); muscular tension; excessive sex drive; insomnia; moodiness; excitability; genital diseases; red, tearing eyes; compulsive energy; and bitter taste in the mouth. Liver Shi (Excess) can produce Liver Fire which often will "insult" the Lung causing constriction and a dry, teasing cough.

• Spleen ~ Pi governs digestion and manifests in the muscle tissues; resolves Dampness and Phlegm; maintains upbearing; 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); 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 and excess consumption of sweet and/or Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; facilitates inspiration by grasping and pulling down the Qi of the breath; relates particularly to chronic conditions because it carries the constitutional endowment from the parents; and and displays the effects of aging, overwork, chronic degenerative processes and extreme stress. » 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
The symptoms of asthma are shortness of breath, tightness of the chest, and wheezing (which comes about because of constriction of the bronchial tubes). There may be a buildup of mucus that is hard to expel. Asthma is often associated with respiratory allergies or food sensitivities, or it can be brought about by an infection or stress. A severe attack of asthma can be life threatening and should be referred to the nearest emergency room.

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

1. Beta Carotene – 100,000 Units 2 times per day for an adult. For children – 15,000 Units per year of age, up to 150,000. Pregnant women (or women who may become pregnant) should not take more than 15,000 Units per day.

2. Vitamin C – 1,000 milligrams, 3 times a day for adults and 500 milligrams per year of age up to 3,000 milligrams for children, in divided doses.

3. B-complex – 50 milligrams 3 times per day for adults. For children, 25 milligrams once or twice a day.

4. Vitamin B6 – 100 to 200 milligrams 2 times per day for adults. For children, 25 milligrams a day.

5. Vitamin B12 – 1,000 micrograms daily.

6. Calcium and Magnesium Supplement – 800 milligrams of calcium and 400 milligrams of magnesium for an adult. For children, the dose is decreased in proportion to their weight.

7. Selenium – 250 micrograms per day.

8. Adrenal extract – 1 tablet, 3 times per day with meals.

THE PROPER DIET FOR ASTHMA WILL INCLUDE THE FOLLOWING:

1. The first and most important dietary change that may relieve asthma symptoms and prevent further attacks is to avoid all milk and dairy products (such as cheese, yogurt and buttermilk). Other foods to cut down or avoid are sweets (such as candy and pastries) and artificial colors and preservatives, especially sulphites found in wine, beer, and salad bars.

2. Another consideration is food allergies. Certain foods seem to be more likely to cause or aggravate asthma. Eliminating these foods from the diet is a good way to determine if one or several of them are responsible for the problem. The main problem foods are dairy products, eggs, wheat and other gluten containing grains such as barley, rye and oats), corn, and sugar. After eliminating all those foods from the diet, and the symptoms have gone away, one food at a time can be reintroduced to see if the symptoms reoccur. A new food would be introduced each week. If you need more information, listen to our program on food allergies (number 366).

3. For chronic asthma, which doesn't respond to treatment, consider a Vegan diet. This means avoiding all animal products, including milk, meat, eggs, and chicken and replacing them with vegetables, fruits, whole grains, beans, sprouts, and soy products.

HERBS USED FOR ASTHMA:

1. Mix these herbs in the following proportions:

• Licorice Root - 2 parts • Grindelia or Gum Tree - 2 parts • Ephedra - 1 part • Khella- 1 part • Lobelia - 1/2 part • Cayenne Pepper - 1/8 part

Take 30 drops of the tincture, which is a liquid herbal extract, 3 to 4 times per day. You can prepare these herbs in their dried form as a tea by using 1 heaping tablespoon of the mixture per cup of boiling water. Simmer 10 minutes, cool, and drink 1 cup, 3 times per day.

2. Green tea, available at oriental grocery stores, can also be helpful.

ADDITIONAL MEASURES FOR ASTHMA INCLUDE:

1. Avoid dryness in your environment by using a humidifier.

2. Drink plenty of liquids, at least 8 cups per day.

3. Exercise your lungs by blowing up balloons, daily.

4. Take 1 to 2 minute intervals 4 times a day to do deep breathing or to sing loudly.

5. Stressful situations have been known to start asthma attacks. Consider counselling for both adults and children.

HOMEOPATHY:

Homeopathy can be extremely helpful in treating asthma, but it usually requires the aid of a trained homeopathic or naturopathic physician. From the following homeopathic medicines, choose the one that best matches your symptoms.

• Arsenicum album 12C: For asthma that is worse at night, with restlessness and if it is relieved by warm applications to the chest. This is the most common remedy. Dissolve 3 pellets under the tongue 2 times a day for 1 week or when needed.

• Antimonium tart 12C: For asthma with excessive mucus in the chest that is hard to cough up. Dissolve 3 pellets under the tongue 2 times a day for 1 week or when needed.

=
=========================================================================================== =Orgonomic Perspective of Etiology= In the asthmatic, parasympatheticotonia occurs in reaction to an underlying sympathetic excitation. The parasympathetic nervous system contracts the bronchioles and stimulates mucous production, thereby interfering with expiration. Although many cases of asthma are associated with external allergens or infection the underlying cause is, indeed, biopathic. This is demonstrated by the clinical observation that with elimination of the biopathy, external agents are no longer capable of inducing an asthmatic attack. Since hypertension and asthma both involve the thoracic segment, the question arises: What factors determine the formation of which biopathy? In hypertension, sympatheticotonia predominates and the chest appears tense and hard. In asthma, there is an overlying parasympathetic excitation and the chest appears softer. Crying, regularly seen in the mobilization of the asthmatic chest, may be the emotional manifestation of clonic parasympathetic excitation of the respiratory system.[|1]

=Treatment= = =

Dietary Recommendations
Drink a lot of water. Suck on a sugar cube with a few drops of tincture of garlic added to it. Drink a teaspoon of clay w/ water every morning for one week. Stop drinking tea and coffee. Stop eating white bread, fatty meat, ect. Watch intake of eggs, fish and delicatessen meats. Drink plenty of juice and vegetable broth. Eat plenty of stewed fruit, honey, whole wheat bread, herbs and all types of fruit.

Recommended Minerals
-Sulfur (allergy-induced) -Manganese

Orthomolecular Treatment
-Cysteine (cystine) -Betain HCl

Ayurvedic Recommendations
Coleus Forskohlii

Prescription
Noon: Ribes Nigrum D1, 50 drops Supper: Viburnum Lantana D1, 50 drops