Bronchial Asthma

Dr. G.P. Agrawal, MB, BS, Athnair

Asthma is a disease of the lower respiratory tract brought on by obstruction due to parasympathetic over activity which, in acute attacks, causes narrowing of the bronchioles and outpouring of excessive mucus into the lumen of the bronchioles.

Causes

  • Emotional disturbances
  • Allergy
  • Heredity

These three play an important role, and

  • Respiratory tract infections
  • Exertion are important factors predisposing bronchial asthma.

The homeopathic view is that asthma is caused by intestinal dyscrasias (buddock). The yogic view is that it is caused by emotional factors.

Types of asthma

  1. Episodic or allergic: generally occurs in early age, especially in males.
  2. Chronic asthma: occurs later and generally in females. The cause of this may be hereditary.

Clinical features

  1. Episodic or allergic asthma
    Allergic asthma is sudden in onset, and may come at any time. It is associated with a feeling of tightness in the chest and intense expiratory dyspnea. Expiration becomes exhausting; inspiration is short and gasping. Wheezing expiratory sounds are heard; unproductive, coughing usually occurs. Pulse is rapid and central cyanosis may also be present.
  2. Chronic asthma
    Clinical features of chronic asthma can be described as continuous wheezing with breathlessness on exertion. Cough, mucoid sputum, and recurrent episodes of respiratory infection are common features. Sometimes chronic bronchitis also occurs.

Physical signs

  1. During attack
    Chest remains in the position of full inspiration. On percussion, hyper-resonant breath sounds are vesicular in character with prolonged expiration. In severe asthma, air flow is sufficient to produce rhonchi.
  2. Between attacks
    No abnormal signs except rhonchi are generally found in chronic asthma. Childhood asthma may cause pigeon chest deformity.
  3. X-ray
    -normal
    -sometimes signs of emphysema
    -occasional opacities from lobar collapse

Medical management of bronchial asthma

Asthma can be managed in the following ways:

  • Inhalation of bronchial sympathomimetic agents
  • Oral bronchodilator
  • Injections of theophylline or aminophylline in dextrose
  • Management of allergy by corticosteroids
  • Management of respiratory tract infection by antibiotics
  • Prophylactic control of exertion asthma by inhalation of sodium chromoglycate
  • Emotions can be managed by diazepam tablets or injections.

Recent research findings

A number of experiments have revealed that asthma can be either cured or the patient's condition vastly improved by yoga practices.

Dr. Bhole, M.D. of Lonavala Institute, who has investigated the influence of yogic pranayamas in normal and asthmatic individuals*1, has reported the following findings:

  1. Minute volume decreases in deep breathing and pranayama practice, but in forced breathing and hyperventilation, minute volume increases.
  2. Decrease in minute volume (M.V.) is more in pranayama than deep breathing.
  3. Suitable type of pranayama automatically reduces rate of breathing and leads to a condition of respiratory standstill for some length of time.
  4. Tidal volume values (T.V.) are less in pranayama in comparison to deep breathing.
  5. Carbon dioxide levels in the blood increase during pranayama breathing while other metabolites do not increase in the body due to relaxed general condition of muscles. Gradual rise of carbon dioxide levels in the blood should have beneficial psycho-physiological effects on the individual.

Yogasanas strengthen the abdominal wall, pushing it inside so that the diaphragm rises further into the chest. This helps the lungs to empty efficiently.

Relaxation during asanas removes tensions in the respiratory muscles which, in turn, helps the asthmatic patient to breathe more efficiently. This is reflected in increased breath holding time.

Kapalbhati is one of the hatha yoga shatkriyas which is directly concerned with breathing. Forced, efficient exhalation, with passive inhalation, is its special feature. It produces a strong current of expelled air, helping to expel bronchial secretions and strengthen the expiratory phase of the breathing cycle.

Pranayama, neti and especially kapalbhati directly influence the respiratory centres of the brain. By this powerful voluntary influence upon the brain activity, the patient gains a higher level of control over the movements of the respiratory muscles and the patterns of thought, feeling and general behaviour. This is fundamental in the management and cure of asthma by yoga.

Neti kriya cleans nasal passages, releasing constricted upper airways and increasing the flow of breath. It should be routinely performed in cases of asthma (especially of allergic origin).

A one month treatment program for asthma, which includes asanas, pranayamas and cleansing kriyas, substantially increases the breath holding capacity in normal resting conditions.

Dr. G.C. Sepaha of J.N.M. Medical College, Raipur conducted an experiment with 27 cases of bronchial asthma which revealed that 62.5% of the patients showed improvement in ventilatory function tests (VFT) following yogic training.*2

Improved respiratory function as well as additional symptomatic advantages like sense of wellbeing, comradeship of group therapy and better exercise tolerance suggest that if these practices are done regularly and persistently, vast improvement, often amounting to complete or partial cure of the condition, will occur.

Yogic treatment

In view of these and other experiments, it is now widely recognized and accepted by doctors and therapists, that bronchial asthma can be effectively managed by yoga. The following line of treatment can be adopted:

  1. Mild to moderate physical and mental activity.
  2. Diet should be vegetarian, simple and light, and should not produce mucus. Milk and rice as well as heavy, oily preparations should be avoided.
  3. Neti and kunjal kriya each morning.
  4. Practise laghoo shankhaprakshalana at least once a week to avoid constipation.
  5. Asanas: surya namaskara, shashankasana, paschimottanasana, sarvangasana, bhujangasana, dhanurasana, ardha matsyendrasana, yogamudra, shavasana.
  6. Pranayama: ujjayi, nadi shodhana, bhastrika, kapalbhati.
  7. Meditation: ajapa japa and yoga nidra.
  8. Amaroli brings immediate relief from asthma.

If these yogic practices are learned under supervision for one month, and then incorporated into the daily lifestyle at home, the severity and frequency of asthma attacks diminish progressively and cure is possible in the majority of cases. Drug therapy can be discontinued as response to yoga practices occurs and confidence in their efficacy grows.

References

*1. M.V. Bhole and M.L. Gharote, 'Effect of yogic treatment on breath holding time in asthmatics', Yoga Mimamsa, 19 (1), Apr. 1977.
*2. G.C. Sepaha, 'Effects of yoga on bronchial asthma', Yoga, 17 (2), Feb. 1979.