BRONCHIAL ASTHMA AND HOMEOPATHIC MANAGEMENT

                                               BRONCHIAL ASTHMA

Definition:-

               Bronchial asthma is an allergic disorder characterized by paroxysmal attacks of expiratory dyspnoea due to paroxysmal narrowing of the bronchial tubes.

Types:-

              There are two types of bronchial asthma they are 

                         a. Extrinsic asthma (also called episodic asthma).

                         b. Intrinsic asthma (also called chronic asthma).

A. Extrinsic asthma:-

               It is the classical type of asthma.It is characterized by paroxysmal attacks of airway obstruction which is reversible,It reappears in normal position (on/off).This type is very common in children s and adolescents age,patient feels free in between the attacks.

B. Intrinsic asthma:-

               It is very common in old age persons,In these type of asthma,attacks are persistent with paroxysmal exacerbation  the attacks do not follow the on and off pattern as in case of extrinsic asthma but there is some amount of airway obstruction always present.(i.e. the airway obstruction is not completely reversible).

Pathology behind asthma:-

                A paroxysm of asthma  is characterized by paroxysmal narrowing of the bronchial tubes primarily due to spasm of their smooth muscles,other aiding factors include blocking of the airway by plugs of thick mucus secreted by the bronchial glands and o edema of the mucosal lining.In chronic asthma there is some amount of secretion and mucosal swelling always present due to inflammatory changes inside the bronchial lumen. Even though some allergic reactions will irritates in these manner like fatigue chill or infection.During a paroxysm when bronchial tubes are narrowed,air can be inhaled with effort(aided by accessory muscles of respiration) but cannot be expelled out since expiration is a passive process dependent on the elastic recoil of the lung alveoli).This results in expiratory dyspnoea.Due to incomplete expiration,some amount of air is always left behind or trapped inside the lung alveoli resulting in over stretching of the alveoli,If  its persists for long period then person will goes under some complications.

Aetiology:-

   1. Family history - it main cause by heredity some persons who are allergic to same allergen yet they suffer from some other allergic disorder such as urticaria or hay fever.

   2. Age - The disease usually starts in young age,mostly before the age of 25.now a days for children s its more prone,males are affected more than females.

   3. Allergy - main factors are dust,pollen,animal furs,face powder,perfumes,flowers etc. Mainly it become occupational disease like cement workers,factory workers,etc.

   4. Habits - The main habits which it triggers the disease is cigratte smoking. 

   5. Precipitating factors - Stress,nervous shock,emotional upsets,physical factors (eg, fatigue,exertion,sudden change of climate,chilly weather,tobacco,smoke,etc).

Symptoms:-

 The only main symptom is Dyspnoea. second one is cough,

      The person may free from dyspnoea now but may become severe in an hour later.A phase of dyspnoea may be short or long.The attacks most commonly occurs late in the night (2 AM or later).sometimes it occurs in daytime.The patient wakes up suddenly with a feeling of suffocation or tightness in the chest,coughs and gasps for breath.The expiration is prolonged and noisy(Wheezing).The patient sits up and clings to the surrounding objects in an attempt to bring into play the accessory muscles of respiration.

      That time the patient looks pale,anxious and sweating,the lips looks dusky,but the attack may last only for a few minutes or may be prolonged for several hours.

       The wheezing and dyspnoea will fluctuates in severity depends on the severity of the respiratory tract infection at any time.

       Rhonchi and crepitations are present bilaterally and symmetrically all the time more so during an acute affects.

Investigations.

     A. Blood count.

     B. Radiology.

     C. Pulmonary function test.

     D. Skin sensitivity test.

Complications:-

     - Emphysema.

     - Right sided heart failure due to  chronic cor pulmonale.

Allopathic managements:-

       - Salbutamal drug is more effective when given by inhalation.

       - Asthalin inhalers twice in a day.

       - Roto caps also will be suggest able.

       - Drowsiness is main side effect.

Diet management :-

       - Avoid all icy items like ice creams,cold water,ice cubes,chocolates,cool drinks.

       - Avoid grapes,oranges,water millon,etc.

       - Avoid head bath repeatedly and avoid ciggrate smoking.

       - Try to cover your face by keep some mask to prevent from dust. 

Homeopathic Management:-

  

                      homeopathy has wonderful medicines for asthma,some are below

1. Aconite:-

          If  caused from exposure to dry,cold winds or from an existing bronchitis.Full,hard and bounding pulse,great fear and anxiety,sudden impulse,sudden onset,thinks he is going to die.chilly

2. Am bra graesia:-

         Asthma with cardiac symptoms.Wheezing in the chest.Violent palpitation,with pressure in the chest,as if a heavy lump lay there,it is chilly drug.

3. Ars album:-

         For night attacks. He awakes with spasmodic constriction in the chest,seems as if he would suffocate,panting and wheezing respiration,must incline the chest forward,extreme exhaustion,anguish,restlessness,chilly patient and fear of death.Cannot lie down for fear of choking.Attacks from waking fast or ascending stairs.

4. Belladonna:-

           As a palliative in acute cases,when accompanied by symptoms of congestion to the head.

5. Bryonia:-

           From suppressed rashes,the attacks are preceded by catarrhal symptoms.Aggravated by night and motion,decided pain in the chest,stitching character,inability to lie on the right side,hard cough with  little expectoration.

6. Cup rum metallicum:-

            When the asthma is associated with spasms in other parts of the body,chilly patient.Very rigid and hard by look but so soft on mental.

7. Hepar sulph:-

              In cases depending upon chronic bronchitis,The attack awakens the patient from sleep,with a rattling cough,constriction of the chest,and severe dyspnoea.beautiful  look and chilly patient.

8. Ipecacuanha:-

               To be given during an attack of asthma,violent constriction of the chest,threatened suffocation  worse from any motion.The face is very pale and cold,wheezing and rattling in the chest.The cough is very loose and rattling but there is no expectoration,disposition to vomit.

9. Antimonium tartaricum:-

             Paralysis of lungs with edema. Unequal breathing, suffocative shortness of breath, before cough or alternating with cough  Hoarseness. Great rattling of mucus, but very little is expectorated. Feels as if would suffocate, must sit up. AsphyxiaNeonatorum, child  pale when born. Bronchial tubes overloaded with mucus. Coughing and Gasping.Cough and dyspnoea better lying on right side opposite of badiaga.. Coarse, loose, rattling Expectoration thick. Velvety feeling in chest. Child bends backwards with cough.

10. Kali bich:-

             When based upon bronchiectasis,worse after midnight (2-3 am),must sit up and bend forward, expectoration are tough,stringy mucus,asthma worse after sex.

11. Lachesis:-

             In women at the climacteric age,greatly aggravates after sleep,the throat is very sensitive,cannot bear to be touched,great relief from expectoration of watery phlegm,hot patient,loquacious,suspicious.  

12. Lobelia:-

            Spasmodic or nervous asthma,aggravates from motion,attack preceded by sensation of prickling over the whole body.There is a feeling of great weakness in the stomach,sensation of lump in the throat.

13. Lycopodium:-

             Asthma from any digestive disorders when there is a great accumulation of gas in the abdomen,and relief by its  passage.

14. Nux vomica:-

             Simple spasmodic asthma due to gastric irritation,there is oppression and constriction of the lower part of the chest,attacks occurs after eating or at night,patient is very irritable,restless,chilly pt,constant urging for stools.

15. Pulsatilla:-

             In women with menstrual difficulties,particularly amenorrhoea or when caused from abuse of sulphur water,The  expectoration is greenish yellow and cough.

16. Sulphur:-

             A most universal remedy for asthma,there is scarcely a case of asthma where sulphur is not used.For chronic cases of asthma.There is oppression of the chest and shortness of the breath,on bending the arms backwards.Constant heat on the top of the head,feels weak and faint at eleven A.M.