A worldwide problem

Asthma is a chronic inflammatory disorder of the airways. It can manifest itself in wheezing, tightness of the chest, or breathlessness. It can begin in childhood, adolescence or adulthood, and may improve or deteriorate with age.

Asthma is a problem worldwide. It affects an estimated 339 million people and causes 417,000 deaths a year, or more than 1,000 per day. Absence from school and days lost from work are substantial social and economic consequences of asthma. The World Health Organization has estimated that 15 million disability-adjusted life years (DALYS) are lost annually due to asthma, representing 1% of the total global disease burden.

One way of looking at the problem of asthma might be to say that, if the price of controlling asthma seems high, the cost of not treating asthma – in time lost from work, hospital admissions, and premature death – is even higher.

What causes asthma?

The cause of asthma is one of the greatest unanswered questions in medicine. Some experts say that in future we will speak of ‘asthmas’ – or varieties of asthma – rather than asthma, since many factors seem to be involved.

These factors can be divided into two main camps: ‘host factors’ and ‘environmental factors’. Host factors include those related to genetic inheritance, obesity and gender. Environmental factors include allergens, respiratory infections, tobacco smoke, exercise, strong emotional expression, air pollution, diet and drugs (such as aspirin and beta blockers).

Although host factors are often intractable, it is possible to address environmental factors to improve asthma. Measures can be taken to control house dust mites, for example. Control of pets and other sources of allergens may also be recommended. Exercise-induced asthma can be addressed by various methods, including regular cardiovascular workout.

Medication for asthma

For many people, control of the risk factors will not be sufficient to control asthma. The ‘preventer’ drugs, such as inhaled corticosteroids, can be taken regularly to minimize attacks. The ‘reliever’ group of drugs, such as beta-2 agonists, can be taken when an asthma attack is in progress, though these are now largely discouraged in favour of so-called 'combination' therapies consisting of a combined preventer and reliever.

Asthma treatments in traditional medicine

Cambodia

The traditional Cambodian healer is the /krou k’mai/. One woman with asthma flew back home from America for two weeks to get treatment from a /krou k’mai/. She had to drink a blood-coloured thick liquid and swallow baby mice seven times to be cured. (The 'traumatic' nature of some traditional cures seems to be related to their perceived efficacy). Her symptoms subsequently improved for 1 year. 

One man with asthma also saw a /krou k’mai/ in a Thai refugee camp who gave him a liquid to drink which consisted of red wine with /grong/ (a type of ant with a red colour), seven toads which were fried/burned, and /tk gai/, which is a type of animal. This mixture has a sour taste and is taken 3-4 times/day. It is said to clean up the lungs. His wife reported that it could be found in Cambodian grocery stores but was very expensive ($300/jar). She had also heard of drinking blood from a black dog with wine to treat asthma.

(from Cambodian Asthma Cultural Profile - EthnoMed)

India

Thousands of people from across India gather at the Nampally Exhibition Grounds in Hyderabad to gulp down a medicine-infused murrel (or snakehead murrel) fish medicine that will supposedly cure them of asthma. Popularly known as fish prasadam, this ritual has been continuing for 173 years now. This year, the event began on June 8 and like every year, it was administered by the Bathini family.

This ritual takes place every year during the arrival of monsoon. The members of the Bathini family drop a live murrel fish filled with a yellow herbal paste into the throats of patients suffering from respiratory illnesses. If the patient is a vegetarian, the medicine is given with jaggery instead of fish. They also prescribe a particular diet and are asked to take the fish prasadam for three consecutive years.

From Asthma patients, now you can swallow this ‘fish prasadam’ to cure the disease | Health News - The Indian Express)

UK

In the early and middle years of the twentieth century in the UK, there was no effective medication for the control of asthma. Patients, especially children, were asked to lie down on the dinner table, on their back. A half lemon would be suspended on a string from the ceiling, and set to rotate over the mouth. The vapour from the lemon would supposedly descend upon the patient and cure them.

The thought of this useless operation being performed on a frightened child having an asthma attack is awful to contemplate. However, precisely these sorts of misconceptions now afflict children in the developing world.