Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Three factors are instrumental in preventing an impending asthmatic attack. These include the avoidance of environmental factors, the performance of certain exercises, and practicing special breathing techniques. Dietary modifications and an ideal lifestyle will often relieve the chronic bronchitis that accompanies asthma. The causes of asthma are infection, allergy, smoking, air pollution, strong odors, cold air, strong emotion, and overexertion. Fear and anxiety aggravate bronchospasm once an attack begins. Ninety percent of asthmatics are mouth breathers, increasing the likelihood that dust from the air and germs in the mouth and pharynx will be transmitted to the lungs, and that cold air and allergenic particles can reach the lungs. Artificial feeding with cow's milk has been incriminated in the cause of infantile asthma. Also, general anesthesia in infancy, especially during the first two years of life, has been reported as a factor in the production of both asthma and hay fever, and in the development of other allergic respiratory diseases.

‍The treatment of asthma involves both the acute attack and the interim health of the person. Every effort must be made to live day by day in strict accordance with the laws of health. Following are suggestions for both general maintenance of the asthmatic and treatment of the acute attack:

• Sleep on the abdomen to encourage drainage and keeping the mouth closed during sleep.
• Good posture is essential. Proper positioning of the pelvis brings other body parts into proper alignment. Sit with the feet flat, propped on a low stool, and flatten the shoulders against the chair back. Practice breathing deeply from the diaphragm. In speaking, contract the diaphragm actively while speaking, allowing the strain to fall on the diaphragm and not on the organs of speech.
• Take a dry brush massage daily, using a very stiff brush. Begin at the fingertips and brush to the shoulders in long strokes. Cover every inch of skin, brushing always toward the heart. Spend about five minutes in the massage.
• Next, take a regular shower which ends with a 30-second cold spray to the shoulder blades to stimulate the adrenals.
• Be unusually careful about clothing the extremities. Two or more layers of clothing should be worn on the arms and legs at any time the temperature is below 65° Fahrenheit. When below 50°, three, four, or more layers of clothing may be needed on the extremities. Keep the feet warm and dry, even in warm weather. Keep the ears and neck warm in cold weather.
• Special care must be exerted to avoid dust, cats, dogs, mold or feathers in pillows and upholstering, fumes, and all odors except natural odors of fresh, green leaves and flowers. Rotting leaves, dusty rugs, draperies, cosmetics, perfumes, and cleaning compounds should be avoided. Use plastic covers on mattresses and pillows. Thoroughly ventilate bedrooms day and night, but avoid drafts which chill the skin.
• Overeating must be strictly avoided as the ciliated lining cells of the bronchial passages and the macrophages that form a part of the defense mechanism of the respiratory tree are inactivated by overeating. Use only two meals daily, breakfast and dinner. A purely vegetarian diet is best.
• It is well to fast occasionally. A day or two of fasting each week will do most people more good than any amount of medical advice or treatment.
• Keep well hydrated. The bronchial secretions must be kept loose. Gauge the amount of water needed by the color of the urine. Keep it pale.
• At the beginning of any attack immediately do "sleep-breathing," which is slow and deep with a 3-second pause at the height of both inspiration and expiration.
• Physiotherapy. Perform each of the exercises listed below five times daily for three weeks initially, then once daily for maintenance. Aim at increasing chest expansion on inspiration by four inches.
• Insist on learning nasal breathing at all times.
• Practice postural drainage for ten minutes while having steam inhalation.
• Arm exercises: Repeat each of the following five times daily:
• Stand tall with hands on shoulders, elbows together in front. Stretch elbows back while breathing in, bring together again in front while breathing out.
• Stand tall, feet apart, one arm at side and one arm curled over head. Slide the hand at side down the side of the leg during inhalation. Slide back up during exhalation. Change sides and repeat the exercise.
• Stand tall, shoulders back, hands flat on sides at waist. Take a full inspiration and hold while slowly counting to twenty. Exhale fully through the nose, pressing hands against sides to empty lungs. Hold breath out while slowly counting to ten. Breathe in through the nose and repeat.
• Kneel and sit back on legs. Stretch both hands up over head while breathing in and standing up straight on knees. Sit back on legs while exhaling. Repeat.
• Place a lighted candle level with the mouth 5 inches away. Blow the flame toward the horizontal position without extinguishing. Practice for 3-5 minutes daily, increasing the distance between the mouth and the flame by 4 inches daily until the candle is 3 feet away.
• Lie on back, place a book weighing a few ounces on the abdomen and pant through the mouth, raising the book with each panting action so that it moves up and down. Pant about twice per second. Continue the exercise 1-5 minutes.

Twelve recommended treatments for acute attacks:

• Use steam or vapor in room. May add menthol or oil of eucalyptus. Air should be cool, not warm. May try cold air as some get benefit.
• Administer by mouth one clove garlic blended well in one cup water. If vomiting occurs, that event will loosen secretions and aid in cleaning bronchi. Immediately after vomiting give a second cupful while patient is in refractory period. Garlic oils are excreted in the breath and loosen secretions.
• Give one cup of water, catnip tea, hot lemon water (1 T. lemon juice in 1 C. water), or mullein tea on an alternating schedule each hour.
• Use hot footbath, alternating hot and cold to chest with a hot fomentation to the spine and cold cloth to face and temples.
• Give a cold shower to back between lower edges of shoulder blades. Continue to tolerance up to 15 minutes. Alternative is ice cold compresses across the back beneath shoulder blades.
• Use a vigorous foot rub for relaxation if needed.
• If needed try a hot sitz bath or hot foot bath prolonged for half an hour.
• Tapotement to the adrenal area, especially when combined with a cold shower or ice cold compresses across the back as described above may stimulate the adrenals.
• The neutral bath (temperature between 94-97° F) is helpful to some. Have the patient lie in the tub for 20-120 minutes.