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One Hundred Years of Treating Asthma
An essay by Jennifer Worth
Prize Winner in the AAA Essay 2000 competiition
Judge Sarah Myhill commented: "I love this essay. It illustrates perfectly in a common sense way, which people can understand and follow, the most important aspects of treating asthma... Jennifer rightly points out that the conventional medical approach for treating asthma is seriously flawed because it does not look for the cause of the asthma, merely suppresses symtoms with drugs. The long-term effect of this has been, I suspect, to increase the instance of severity of asthma"
In 1935, the year I was born, an asthmatic child from an asthmatic family, there were none of the modern drugs for controlling asthma.  I learned how to cope from my mother  (born 1914) and grandmother (born 1875), who had learned from her mother (born 1840).  Thus I have inherited a family knowledge of living and coping with asthma which dates back at least 160 years, and probably longer.
This essay is an attempt to reconstruct these old and natural remedies for a condition that has reached epidemic proportions in the last 30-40 years, in the hope that some of them may be helpful to those who do not want to fill themselves or their children with powerful drugs.
My grandmother was a formidable old lady.  Strong willed, commanding, sometimes peevish, in her tiny frame she housed a will of iron, and she ruled her family with undisputed control.  No small child would mess around with grandma.
When I had an asthma attack she would sit me on a hard chair leaning on a table and instruct me in breathing control - leaning forwards is important.   She would place her hands over the small of my back, below the rib-cage, and say:
"Now breath slowly in through your nose, down to my hands.  Keep your shoulders quite still.  Try not to move your chest.  Just breath in slowly down as far as my hands.  Now breath out slowly.  Not too fast.  Breathing out is the hardest part of all.  Keep it slow, and don't breath in till I tell you to."
She would pause for a few seconds, then continue:
"Now breath in again, slowly."
Breathing through the nose is very important, because the nasal passages are a filter, and warm the air before it enters the lungs.  Mouth breathing is bad for asthma.  Nasal breathing is also slower that mouth breathing.
The slow breathing had a calming effect.  Breathlessness is inclined to induce panic, which makes asthma worse.  The steady breathing, plus my grandmother's competent and re-assuring voice, would instantly allay any panic that I might have experienced, and I never remember any feelings of fear during an asthma attack, even though they were sometimes very severe, and today would justify hospitalisation.
This method of breathing, called abdominal or diaphragmatic breathing, is the first secret of how to cope with asthma.  However, it does not come naturally to most people, and has to be learned.  Most people breath into the upper lobes of the lungs only, leaving the lower lobes of the lungs unused.  The diaphragm, which will draw air into the lower lobes, must do all the work.  If the muscles of the upper chest, shoulders  and throat are used for breathing, it will make an asthma attack worse.
Alexander Technique teaches correct breathing, and so do Yoga and some oriental therapies.  But for the best one-to-one instruction  in how to breath correctly, no-one, in my opinion, can touch a good classical singing teacher.  Those who have never considered the breath control required to sing accurately the most rudimentary aria of Bach or Handel would do well to contemplate the difficulty and strive to match it!  I have sung all my life.  Had I not done so, I think I would have been an asthmatic cripple by now.
Whilst I was getting my breathing under control my grandmother would massage the back of my neck (more of massage later).  Then she would say:
"Breathe in, then out, and do not breathe again whilst I count ten."
I would do as she instructed. Then she would increase the counts to twelve, fifteen, twenty, thirty  before she allowed me to breathe in again.  It always worked.  The asthma attack subsided.
A few of years ago there was a television programme about a Russian doctor  named Butyeko who was teaching a new method of breathing to control asthma.  I watched the programme and can assert that his teaching was much the same as that which my grandmother taught me sixty years ago, and that it will work if correctly carried out.
My grandmother was taught this breathing technique by her mother and grandmother, reaching back to the 1820s.  These wise women had no scientific knowledge and no special training.  They just knew that it worked for easing an asthma attack.
Dr. Butyeko and others have explained scientifically that carbon dioxide is not just a waste product to be exhaled.  Carbon dioxide is essential to body function.  Most asthmatics hyperventilate, taking in too much oxygen and depriving themselves of carbon dioxide.  The simple expedient of slowing the breathing and delaying inhalation will restore the oxygen/carbon dioxide ratio in the body, and control asthma.
This method of breathing needs to be learned and practised when breathing is normal, or near normal.  It will do no good 'trying it out' in the middle of an attack.  An asthma attack can be a terrifying experience.  You feel you must get more air into the lungs, or you will choke.  To do the opposite - ie to breathe out and then hold the lungs empty  - seems impossible.  So the technique needs to be carefully learned beforehand.  Then it will work.
I had the benefit of being taught by my grandmother.  The Breath Connection,  which teaches the Butyeko method, at the Hale Clinic, London (020 7631 0156), and also holds courses in all parts of the UK, and a book and audio tape are available.  
My grandmother kept a sweetshop, beloved of small children.  Many times I went into the shop to find her sitting behind the counter, breathing in and out of a paper bag!  Her eccentricity was, apparently, well known, because most of her regular customers had seen her at it.  I asked her why she did this.  
'I was feeling a bit wheezy, dear, and this helps.  I can do it in the shop quite easily.'
I thought no more about it.  Funny old grandma!
When I saw the Butyeko programme, the penny dropped.  By breathing in and out of the paper bag, she was increasing the carbon dioxide intake. Wise old grandma!
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My grandmother was very fond of steam.  She said it  'cleaned out the lungs'.  I don't know whether it does or not, but an inhalation of steam certainly helps asthma.  Sometimes she put a teaspoonful of Friars' Balsam (tinc Benzoine) in the water, but steam is the main helper.  Of course, I had to breathe slowly, as described, and she would massage the back of my neck.  It would generally make me cough and bring up phlegm, and within 10-15 minutes the asthma would go.
If I had bronchitis (a regular visitor for any asthmatic) my mother and grandmother would erect a 'steam tent'.  I can't tell you how they did it.  It was a  contraption made with chairs and broomhandles and draped with heavy linen.  I remember feeling secure and cosy sitting inside this small white world, hearing the steam kettle bubbling away nearby, and watching clouds of frothy white steam  puffing into my tent.  As far as I know I was in this steam tent for many hours coughing and spluttering, especially at night when breathing is hardest.  I always emerged pink and wet, and feeling better.
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From my earliest days I can remember my grandfather massaging my grandmother's neck and shoulders.  She would sit at the big wooden kitchen table, leaning forward on her arms.  At first she would be fighting for breath, but, as he massaged, her breathing would gradually become easier.  After about fifteen minutes she would smile and say:
"That feels better now.  Thank you, Arthur."
And, invariably, he would reply:
"A pleasure, my dear," and kiss the nape of her neck.
My grandmother also would massage the back of my neck and shoulders when I had an asthma attack.  The asthma always went away.  Once I asked her about it.  She said:  "Well, my grandmother used to do it to me when I was a little girl, like you, and that is how I learned the trick."
Her grandmother was born in the 1820s.  And how did she learn the trick?  Was it from her grandmother, born about 1760?
Old wives' tales go back into the mists of time.  Some of them are nonsense.  Others are wise and true, and I can say from years of experience that shoulder massage will always ease an asthma attack.  I have experienced it myself, countless times, and I have done it to others, who always exhibit incredulity bordering on disbelief  that the asthma has gone away.  
Asthmatics become tense in virtually all muscles of the upper chest, the shoulders, and the neck.  This tension, whilst not the cause of asthma, can make it worse, and can prolong an attack.  In the struggle to breathe the sufferer can get increasingly anxious, even panicky; breath is hard to draw in and even harder to push out, the muscles get even tighter, and a vicious circle is set up.  Mental and emotional stress will also cause tension around the neck, and tension will cause asthma, which creates more tension.  Another vicious circle.
To loosen these muscles is the first essential of massage.  It is not difficult, and anyone can do it.  A person who is in any doubt about how to apply this massage should consult a qualified masseur.  The movements can be learned quite easily, and the benefit to a suffering asthmatic will more than repay the time and trouble.  Steady massage can also have a calming effect.  To keep calm, and avoid panic, is essential in the treatment of asthma.
Massage is particularly effective for children, and I would advise any mother of an asthmatic child to learn how to do it.
The obvious disadvantage of massage is that it cannot be self-administered.  I  despaired of being able to massage my own neck and shoulders - until I came across the TENS 200 machine.
At the time, I was having regular treatment from a physiotherapist for tension in the neck, shoulders and upper back, which was making my asthma worse.  It was he - the physiotherapist - who advised a TENS.  This machine emits a pulsating electrical  charge to the muscles and tendons, thereby relieving tension.  I was able to use it at home, at any time of the day or night, and the purchase price  was about the same as four physiotherapy sessions.  I tried it out, with complete success.  The asthma eased , and I would strongly advise any asthma sufferer to try it.  However, for someone who is not accustomed to the feeling the pulsating current can be a bit alarming.  Therefore I advise trying it out on the arm or leg in order to get used to it  before trying it on the neck and shoulders during an attack.
My grandmother did not have the opportunity  to try a TENS machine.  What would have been her reaction?  I can only say that she was a real sparky old lady who would have a go at anything.  If she had found it beneficial, she would have continued with it, and my grandfather would have been out of a job.  But perhaps not, entirely.  After all, a machine cannot place a gentle kiss on the nape of the neck, can it?
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My grandmother would never eat after 5.00 pm, saying that it would give her asthma in the night.  She never over-ate either, for the same reason.
Also, I remember my grandmother saying:
"No dear, I won't have one.  I like strawberries, but strawberries don't like me.  They give me asthma."
She would say the same about oranges, prunes, pineapple and sherry.  It seems that my grandmother was food allergic/intolerant, but she would not have recognised the phrase.  She simply knew from experience that certain foods provoked asthma.
Most asthmatics are food allergic or intolerant but do not know it.  Also, sadly, most doctors and asthma clinics underestimate the role that food plays in causing asthma.  But do not be fooled.   Food and chemical additives are a major provocation of  asthma.  The most common are dairy produce, wheat, chocolate, oranges,  alcohol, and additives.  Identifying the cuprits can be very hard, and the most bewildering part of it all is hidden or masked food allergy.
My grandmother never said that milk or bread did not agree with her.  Yet she had asthma all her life.  Could it be that she had a masked food allergy to dairy produce and/or wheat, and did not know it?   It is probable, because she ate these foods everyday,  and masked food allergy is very common.
A young lady of my acquaintance, in her thirties,  had asthma since childhood.  In her early twenties she developed stomach and bowel problems, and was advised to eliminate wheat.  She did, and not only did the intestinal problems clear up, but so did the asthma.  For ten years she has had no asthma, and she never eats wheat.
Masked food allergy is an interesting phenomenon.  Usually it is the food that the victim craves the most,  feels better for eating it, and thinks he/she could not  do without it.  It is an addiction that can be likened to smoking, ie nicotine addiction.  After just a few cigarettes,  the body craves the nicotine, and feels  ill and tense without it.  So another cigarette is smoked, and the person feels relaxed and comfortable, yet all the while the nicotine is acting as a mild poison.
The most baffling and insidious part of masked food allergy is that it really does make the victim feel better, for a short while, whilst causing, or contributing to the trouble in the long term.
I was recently travelling in a train which had stopped at a station.  Just as the doors were about to close a young woman rushed onto the train.  She sat opposite me.  She was palid, perspiring around the forehead, her eyes were anxious,  she was gasping for breath, and her shoulders were heaving.  In other words, she was displaying the classic symptoms of an asthma attack.  With shaking hands and awkward movements she opened a bag and produced from it three very large oranges and a knife.  With difficulty she peeled the first orange and gobbled it down as though her life depended on it.  She peeled the second orange whilst she was scoffing the first, which she also ate.  More slowly, she then peeled the third, which she ate in a leisurely fashion, and with enjoyment.  Whilst eating,  her breathing had gradually become easier.  When she had finished the third orange she was relaxed, comfortable, and breathing  normally.  She leaned back and went to sleep.
That was an example of masked food allergy; the cause of the asthma masquerades as the cure.  
Food allergy and intolerance is very complex, and expert guidance is required to sort it out.   Anyone with asthma should take very seriously the possibility of food intolerance, and consult an expert. Action Against Allergy can give reliable information - 020 8892 4949.
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The only drugs available for my grandmother were Potter's Asthma Cure and ephedrine.
Potter's Asthma Cure.  Can anyone remember the alarming fumes, with the whole house smelling of the stuff?  It was a greenish powdered concoction, obviously made from dried herbs, which were set alight!  The herbs crackled and hissed, and clouds of strong-smelling white smoke leaped towards the ceiling.  These fumes my grandmother then proceeded to inhale.
Inhaling smoke for asthma?  What next?  It sounds like suicide; yet it worked.  I recall on countless occasions going into my grandmother's kitchen to find her bent over this strong-smelling smoke, gasping and coughing in a most alarming manner.   It looked like a rehearsal for the witches in Macbeth.  Yet every time it worked.  The asthma cleared within a few minutes.
Potter's Asthma Cure is no longer available.  The Company tells me that it was withdrawn in 1988 because the Department of Health  would not renew the licence for production .  However, the spokesman  for the company told me that there are, undoubtedly, herbs which are effective in treating asthma.  Whilst none are sold over the counter as proprietary medicines, the company advises anyone interested in herbal treatments to consult a qualified herbalist.
Ephedrine is, basically, a Chinese herbal medicine.  In the 1890s the British government  sent a team of scientists to China to investigate herbal remedies.  One of the herbs they brought back was a treatment for asthma.  It was analysed scientifically and prepared chemically, and then sold under the name of ephedrine hydrochloride.  A small dose  will stop an asthma attack.
Ephedrine is now available only on prescription, and is well worth trying.  However, it is a powerful drug which will make most people feel shaky.  To avoid this feeling, epehdrine should be taken with a small dose of the anti-histamine Phenergan.  Ephedrine also makes the heart race.  I understand that this is not necessarily dangerous, but it can be alarming if it is unexpected.  I doubt if any doctor would prescribe ephedrine to a patient who has even a mild heart problem, though.
Incidentally, ephedrine, although effective, cheap and readily available, is not widely prescribed because no drug company has the patent.  It is too cheap!  Therefore, a treatment which has been tried and tested for more than a century is barely  prescribed because no drug company can make a profit.  O Tempora, o Mores!
My grandmother had no other drugs to use.  She was severely asthmatic but she controlled it by the natural methods of breathing exercises,  massage,  steam inhalations, avoiding cold,  and avoiding known allergens, such as dust, cats, pollens, moulds, etc.  She always said:  'no-one ever died from asthma.  I may be a creaking old gate but I'm very tough.'   She had a very full life, bringing up seven children and running her own shop.  She died at the age of seventy-four.
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In 1970, when my daughter was about six , she developed asthma.  Thinking that my grandmother's old-fashioned remedies would not be  good  enough for my daughter, I took her to the doctor, confidently expecting him to prescribe the latest miracle drugs.
To my astonishment he prescribed swimming, singing and a wind instrument, explaining that to promote lung function was the first aim in coping with asthma.  
What a wise man, and how lucky my daughter was.  In 1970 children were just beginning to be prescribed ventolin for wheezes, whether they needed the puffers or not, and  childhood dependence on drugs was just starting.
Within a week of the doctor's advice my daughter started swimming lessons, recorder lessons, and she joined the church choir.  She continued  these activities throughout childhood.  I cannot remember her ever using a ventolin inhaler.  Today, at the age of thirty-five,  she still has minor bouts of asthma, but she is a powerful athlete (racing cyclist); she plays first clarinet in the local orchestra; and she sings in a choir.  Sometimes she uses drugs, but she knows that the best way to control her asthma is exercise.  She takes a 20-30 mile cycle ride  two or three times a week, and says that if she slacks off at all, the asthma returns.
Paradoxically, physical exercise can cause asthma, but can also control it.  Sudden sharp movements, especially when associated with cold, will bring on an asthma attack in seconds.  However, steady, regular exercise which promotes full lung expansion, will control it.  Of all exercise, swimming is probably the best.

I do not recall my grandmother ever taking any exercise beyond that of walking from her house to her shop, a distance of about two hundred yards.  Perhaps no-one ever suggested it.  She certainly could not swim, and had never tried.  Victorian ladies did not do that sort of thing!  Had she been able to swim, I can visualise her in a striped knickerbocker swimsuit, her small grey bun up on the top of her head, valiantly doing the breast stroke, and spluttering: "I'll do twenty lengths if it kills me."
In my early fifties, at  a time of unprecedented stress, my asthma was very bad, occurring every night and most days.  So I took up serious, daily swimming.  At first I really thought it would kill me, but gradually the asthma cleared at each swimming session, and after about a month of daily swimming it went away altogether, and my chest was completely clear, day and night.
I know a man who developed asthma for the first time in his life at the age of fifty.  Within three years it was so bad that he was regularly hospitalised, was on a barrage of drugs, and could scarcely walk  from his front door to the car.  He was advised to swim.  He didn't  believe that it would help but was prepared to give it a try.  It took about three months, but gradually each swimming session was less traumatic, gradually his breathing became easier, one by one he came off the drugs, and, after six months, he was completely free of asthma.  He continued daily swimming for years to keep himself free of the dreaded complaint.
I would recommend swimming to anyone.  Of course it has to be hard, strenuous lane swimming for at least twenty to thirty minutes.  No benefit will be gained from splashing around feebly, kidding yourself that you are swimming.  The lungs have to be really expanded and pushed to the limit.
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Asthma is an allergic disease.  My grandmother knew this and avoided the things that caused her asthma. There are thousands, perhaps millions, more allergens in the environment today than there were for earlier generations.  Consequently the numbers of asthmatics has increased proportionately.  One cannot avoid all allergens, but to avoid as many as possible is sensible.
The old,  natural allergens, (grass, dust, pollens, etc.) still remain,  but there are now far more which are man made.  Many millions of  chemicals are now recognized as being present in our  environment, to which we have no natural immunity.  Few have been adequately tested for toxicity to man, and  there has been little study on the effects of combinations  of different  chemicals, either concurrent or consecutive.
Many of these chemicals are in the home.  House dust is recognized as a powerful allergen for asthma, but, in my opinion, chemicals in cleaners, sprays, carpets, perfumes etc., are just as bad.  They should be eliminated as far as possible from any home where an asthmatic lives.  This is especially important with children.  There is no treatment, including powerful drugs, that would be effective if an asthmatic person is always in contact with chemical toxins in the home.
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There are a few other natural ways of coping with asthma, all of them unknown to my grandmother, that I have tried and found effective, and which I would therefore like to include in this essay.
Acupuncture will reduce asthma, but not cure it.  The aim is to improve the energy capacity of the body to activate the lungs.  Acupuncture will also improve the homeostasis of the body to stimulate the immune system and increase resistance to the multi-allergens in our modern environment.  A course of four to six treatments from  a qualified acupuncturist is necessary, and should be repeated each year.
Acupressure is akin to acupuncture.    There are many acu-points on the body to which steady pressure can be applied with the finger tips, in order to affect another part of the body.  Two such points, which affect the lungs, lie about half an inch on either side of the seventh cervical vertebra (the most prominent bone at the base of the neck).  If pressure is applied to these points, it will  relieve an asthma attack.  Using a TENS 200 machine, if the electronic pads are placed over these points, it will be equally effective.
The ayurvedic medical approach is widely based.  It is a combination of acupuncture, acupressure, massage, cupping, diet, inhalations, oils, and  herbal medicine.  There is no standard or single approach.  Every patient will be treated differently.  It will take 2-3 months to be effective. The Hale Clinic in London can advise.
                                                  ________________                   A good physiotherapist can be very helpful for asthma.  If the muscles of the neck and shoulders have become so tense and knotted that breathing is almost permanently impeded, professional treatment will probably be needed.  Physiotherapists also have  sophisticated electrical  equipment , such as the interferential current, which penetrates deep into the muscles.  Many physiotherapists are helping asthmatics these days, and I am one who has benefited.
            Magnesium is a mineral salt, essential to correct body function.  A low level of magnesium in the body will contribute to the start of an asthma attack, and to the continuation of that attack, for two reasons:
1.  The level of intracellular magnesium prompts the central nervous system  to respond to changing oxygen levels in the blood.  If magnesium is low, the CNS does not respond and asthma can develop.
2.  Magnesium affects muscle function.  Calcium is required for muscle contraction; magnesium for muscle relaxation.  If magnesium is low, the muscles that contract in order to inhale will not be able to relax properly, and breathing out will be difficult.  So the asthma gets worse.
Many asthmatics are found to be deficient in magnesium.  Some hospitals (but not all) are now testing for intra-cellular magnesium levels, and it is worth while for any asthmatic to ask his or her GP about the possibility of an NHS appointment.   I was tested privately at Bio-lab Medical (020 7636 5959), and   was found to have about half the level of magnesium required by the body, and  I take daily supplements.   There has been  very little study of the need for magnesium in asthmatics.
                                        Asthma is an allergic disease.  To desensitise the patient from the allergens that cause the asthma is one of the best and most effective ways  of dealing with the condition.  Currently there are two methods of desensitising which are safe and effective:  Enzyme Potentiated Desensitisation  (EPD),  and Neutralisation.   Both methods were developed in the 1960s, and are now used worldwide.   Action Against Allergy can supply a list of practitioners in all areas of the UK  (020 8892 4949).
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Asthma is becoming increasingly prevalent  in our modern society.  There is no single cause and no single answer.  Drugs have their place, and no asthmatic should ever be without them for use in an emergency.  If asthma attacks get out of control , and status asthmaticus developes, life may depend upon the prompt use of modern drugs.
However, it is easy to over-use drugs, and drug-dependency may become a way of life, but all drugs have side effects, some of them very nasty.  In this essay, I have given about a dozen alternatives, starting with my doughty old grandmother, and ending with my daughter.  Some of my suggestions are ancient, some new.  All of them, in my experience or observation,  will be effective for those who want to avoid drugs as far as possible.  A combination of my suggested treatments is probably the best way.
                                  Jennifer Worth, SRN, SCM

Jennifer Worth is a retired nurse and midwife.  She is author of ‘Eczema and Food Allergy’ (Merton Books) and writes extensively about allergic diseases.  Her book ‘Call the Midwife’ will be published by Merton Books in March.