I have suffered from asthma through life but with occasional bursts. I might have been walking rapidly, or picked up fumes or smoke. I also seem now to get it at night, using an inhaler then.

Asthma has been documented through history. The function of breathing in oxygen was only properly understood by Lavoisier in the eighteenth century. It was often thought that breathing cooled the blood (as by John Floyer and Thomas Willis in the seventeenth century, who described the condition well enough but whose misunderstandings meant they could not consider effective treatment). Moses Maimonides in the twelfth century recognised asthma as a complex phenomenon, the limitations of treatments and recommended a holistic approach. Indeed it is complex and can have many triggers.

The question remains whether asthma is a disease or a symptom of a variety of disorders regarding the difficulty of breathing as a result of reactions in the bronchial tubes. Asthma may be too broad a description for a series of diverse triggers. These triggers can vary from one attack to another and these change over periods of time. It is easy to describe the symptoms but difficult to get at the cause. The sensations of asthma lead it to be confused with the sensations of heart disease but asthma is not related to heart disease - the heart may be strained by asthma but there is no direct connection. Also emphysema, where lungs lose their normal resiliance (due to smoking, coal dust etc.) is not asthma.

Asthma is the narrowing of the lungs´ airways due to spasm of the muscle walls. Other elements can be mucus and the swelling of the lining. Around the bronchial tubes the smooth muscle is oversensitive. Released histamine, in an unbalanced reaction to triggers and brain signals, makes the muscle walls contract. The triggers can be allergies (pollens, mites and moulds), chest infections, stress, emotion, fumes and even laughing. The defective responses may come from a genetic element which is complex in its inheritance (more than just chromosome 11 from the affected mother) but this does not have to be the case. There is an association with hayfever and ecsema, of course. In my case the likely inheritance of eczema and asthma (my sister grew out of asthma; she never had eczema) is down my mother´s side (as it must be) and although my father suffered from hayfever I have not.

Half of children with asthma lose the condition into adulthood. Others who keep the condition may find improvement (as I have). Non-allergic asthma often begins over the age of 40.

Asthma is often worse at night and early morning, especially if it is warm and dry. So warmth and ventilation is useful. Avoid even small whiffs of perfume, fire-smoke, pollutants, that which gives allergic reactions, and overweight. Eating too much pushes the stomach against the diaphragm and this can become more noticable lying in bed, thus triggering asthma at night.

If there is an asthma attack, as well as medication, then lean forward on elbows wiith knees a little apart. Alternatively lean back against a wall for support, head and arms downwards at the front.


Knight, Allan (1981), Asthma & Hayfever: how to relieve wheezing and sneezing, Sydney: Methuen Australia.

Lane, Donald J. (1996), Asthma: the facts, 3rd edition, Oxford: Oxford Medical Publications, Oxford University Press.