Bronchitis and Eosinophilia

Dr. Swami Karmananda Saraswati, MB, BS (Syd)

Bronchitis is infection and inflammation of the mucus lining of the trachea and bronchi. It exists in both acute and chronic forms and usually develops as a sequel to upper respiratory infections such as cold or influenza. Other factors predisposing to bronchitis include cold, damp living conditions, foggy and dusty atmospheres, smoking and chronic mouth breathing, which allow unfiltered and un-warmed air to enter the bronchi. The condition occurs most frequently amongst elderly people, children and smokers of any age.

Bronchitis would be rare if people ate the right foods and their systems were not filled with mucus and poisonous waste matters, and if they were properly clothed. Where there is bronchitis there is invariably stomach trouble and constipation. It is brought on by changeable weather, catching cold, exposure, wet feet, chilling and insufficient ventilation.

Bronchitis becomes chronic when acute bronchitis is not properly treated and relieved. When a cold is allowed to run, it gets down into the bronchial tubes and lungs and becomes chronic. Often if it is not cured, it will finally go into consumption or tuberculosis of the lungs.

Clinical features of bronchitis

The initial symptom is an irritating, unproductive cough, accompanied by upper chest pain. As the bronchi become extensively involved, a sensation of tightness in the chest develops, and wheezing respiration and shortness of breath may also occur. This group of symptoms is also sometimes termed as 'eosinophilic' or 'wheezy bronchitis'. Respiratory distress and shortness of breath may be particularly severe when acute bronchitis complicates underlying chronic bronchitis or emphysema.

Sputum is at first scanty, mucoid and difficult to bring up. Occasionally it may be streaked with blood. One or two days later it becomes thick and micro-purulent. As the inflammation descends down the bronchial tree, a moderate fever usually develops. The vast majority of cases recover over the next four to eight days, without the patient ever becoming seriously ill.

Occasionally, the condition fails to resolve itself, and shortness of breath and other symptoms worsen, and fever continues to rise. This reflects that the body's vital resistance is lowered, so that inflammation has continued into the alveoli and lungs themselves. The patient is then suffering from pneumonia, and should be managed with high doses of antibiotics under a doctor's care.

Eosinophils

Eosinophilia is a respiratory disorder with symptoms in common with both asthma and bronchitis and it is often difficult to decide which diagnostic label to assign to individual sufferers. The disorder is usually interpreted as a transition stage in respiratory diseases, when the sufferer from chronic cold or bronchitis is gradually evolving into a full blown state of asthma.

Eosinophilia is diagnosed when the percentage of eosinophils in the blood of the sufferer becomes elevated. Eosinophils are the white blood cells which mediate allergic and hypersensitivity reactions, and an elevated level suggests that the asthma like symptoms of the disease are an immune reaction by the lungs.

The cause of eosinophilia

The disorder is thought to be an allergic response to various foreign proteins and drugs, and in tropical countries it appears as a complication of filaria and helminth infections. The disorder is common in industrial areas where air pollution is believed to be the major initiating factor. It is frequently diagnosed in children following investigation of persisting or recurrent cough and cold symptoms.

Medical management

Medical treatment of eosinophilia is far from effective. The drug diethylcarbamazine is prescribed where filarial infection is suspected, but this drug is minimally effective in the long term. Where drugs or medicines are likely initiating factors, they must be discontinued. Frequently the condition is indistinguishable from chronic asthma.

Yogic management of chronic bronchitis and eosinophilia

Yoga therapy provides effective relief in cases of chronic bronchitis and eosinophilia and provides techniques for strengthening the weak and hypersensitive respiratory system. However, during an acute cough, cold or bronchitis, no asanas should be practised at ail and complete rest is necessary. Adopt the practice program gradually after the acute bout has subsided.

  1. Asanas: Commence with pawanmuktasana series. Sufferers who are elderly or weak should practise only this series along with makarasana. Others are recommended to select a suitable practice program from amongst the following asanas in this order: Shakti bandha series, surya namaskara, vajrasana series (shashankasana, shashank-bhujangasana, ushtrasana, majariasana, supta Vajrasana), pada hastasana, bhujangasana, dhanurasana, kandharasana, chakrasana, paschimottanasana, ardha matsyendrasana, baddha padmasana, sarvangasana, halasana, matsyasana. Simhasana is especially recommended. Standing and bending asanas including trikonasana, hasta uttanasana, dwi koriasana, lolasana, etc. will strengthen the chest.
  2. Pranayama: All pranayamas will enhance and develop the respiratory capacity and resistance. Especially recommended are ujjayi, kapalbhati, bhastrika and nadi shodhana (up to stage 3).
  3. Mudras and bandhas: Yoga mudra, prana mudra, jalandhara bandha and moola bandha.
  4. Shatkriyas: Neti should be practised daily and kunjal kriya should be performed daily for one week.
  5. Relaxation: Yoga nidra provides deep relaxation and develops awareness. Often chronic cough becomes a characteristic habit and part of the personality of the sufferer from chronic bronchitis. In the beginning, cough may worsen when yoga nidra is practised. This is usually a psychological reaction. One who has become accustomed to the habit of coughing does so unconsciously as a means of tension release. When all such activities and movements cease in yoga nidra, the psychological cough commonly asserts itself and the impulse to cough becomes prominent. The sufferer can learn and evolve beyond this disease rapidly if he can recognise the action of this coping mechanism in his lifestyle, and learn to resist and overcome it.
  6. Meditation: Ajapa japa, with khechari mudra and ujjayi pranayama, rotating awareness from navel to throat and throat to navel in the frontal psychic passage, is also most valuable in helping to gradually recognise and leave behind a chronic cough and respiratory weakness.
  7. Diet: During an attack it is best to only take fruit and vegetable juices. Then barley water and watery kichari or vegetable broth can be taken. Avoid cold drinks and foods. Eat plenty of vegetables raw, steamed or lightly boiled. Citrus fruits help to loosen and cut the phlegm, as do onions, radishes and garlic. Hot milk with a little ginger and black pepper will also loosen the phlegm and facilitate its removal. This can be taken at night instead of the evening meal.
  8. Fasting: This is highly recommended. If a full fast cannot be undertaken it is advisable to miss the evening meal each day.

Further recommendations

  1. Avoid stuffy, overheated and unventilated rooms. Keep the chest and throat warm, but always ensure adequate ventilation, especially while sleeping. Don't sit on cold floors and avoid draughts.
  2. Bronchitis sufferers should not take cold morning showers, and during the time of attacks, a hot steamy bath should be taken.
  3. Cough should not be suppressed, as it is nature's way of clearing the phlegm and infective material from the bronchial tree. Removal of phlegm can be promoted by hot fomentations to the back and chest, then finishing with cold.
  4. Smoking should be given up as it directly irritates the bronchial mucosa. Without leaving smoking behind, no measures will prove very effective in overcoming chronic bronchitis or eosinophilia.
  5. Daily walking is beneficial, and deep breathing should be practised at intervals throughout the day.
  6. Steam inhalations at night are very helpful and hot foot baths with a tablespoon of mustard in water often give great relief.
  7. If a person is gasping for breath, rub the arms or feet hard towards the heart.