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There is no universally accepted definition of asthma. The Concise Oxford Dictionary describes it as ‘a disease of respiration characterised by difficult breathing, cough etc.’. Any good medical book will describe it in more technical terms but ‘difficult breathing’ is the part with which any asthma sufferer is familiar, even if it varies from mildly uncomfortable to life-threatening. Asthma is news now. There was a dramatic increase in the condition in the late twentieth century to the extent that an estimated 100 to 150 million people in the world are now affected by it, but it is not a recent phenomenon.

The term ‘asthma’ is a Greek translation of gasping or panting, and the problem was treated as far back as 2000 BC by Chinese doctors with the herb Ma Huang. The first known recording of the symptoms was about 3,500 years ago in an ancient Egyptian manuscript called Ebers Papyrus. Throughout the ages, asthma has received varying degrees of attention; the symptoms and their accompanying anxiety have been described by many prominent historical figures, including the famous Greek physician, Hippocrates.

Over the centuries, there has been an assortment of different theories about the causes of asthma, and so an eclectic range of remedies has been advised, including horse riding, strong coffee, tobacco, faith healing, chloroform and even drinking the blood of owls in wine, as practised by the ancient Romans. Van Helmont who lived in the early part of the seventeenth century claimed that asthma was epilepsy of the lungs due to the sudden and unpredictable nature of an attack. Based on his own experience of asthma, English physician Thomas Willis said that ‘the blood boils’, and that ‘there is scarce anything more sharp or terrible than the fits thereof ’. It was not until the eighteenth century that Lavoisier provided the first real account of the functioning of the lungs, thereby providing the basis of modern-day under- standing of the respiratory system. Prior to this, it was commonly believed that air was drawn into the lungs to cool the body. Lavoisier’s contribution was that air is drawn in to be converted to energy by the metabolism, and that carbon dioxide and heat are produced as end products of the process. Lavoisier’s work recognised that oxygen is essential to sustaining life.

Asthma now affects more people throughout the world, particularly in more developed countries, than at any other time in evolution. It inflicts greater economic and social damage in Western Europe than either TB or HIV, according to the World Health Organisation’s (WHO) April 2002 report on the links between ill health in children and the deteriorating environment. The position in selected developed countries may be summed up as follows (all figures are approximate):

 

 

Asthma Diagnosed

(millions)

 

Population

(millions)

 

%

 

USA2

 

22

 

307

 

7.0

UK3

5.7

60

9.5

Australia4

2

19

10.5

Ireland5

0.4

4

10.0

 

According to the 1998 International Study of Asthma and Allergies in Childhood (ISAAC), the countries with the highest twelve-month incidence of asthma were the UK, Australia, New Zealand and the Republic of Ireland followed by North, Central and South America. The same report found that the lowest rates were in centres in several Eastern European countries, followed by Indonesia, Greece, China, Taiwan, Uzbekistan, India and Ethiopia. Other studies show that the rate of asthma among rural Africans who migrate to cities and adopt a more ‘western’ urbanised lifestyle increases dramatically. According to the UCB Institute of Allergy in Belgium, the incidence of asthma in Western Europe has doubled in the last ten years.

In the Western world, asthma crosses all class, race, geography and gender boundaries. Although it causes persistent symptoms among seventy per cent of all people diagnosed with it, asthma causes only minor discomfort to the majority. In fact, some of the most influential people of our time in all walks of life were asthmatic, including Russian Tzar Peter the Great, actors Liza Minnelli, Jason Alexander and Elizabeth Taylor, revolutionary Che Guevara, and former US presidents John F Kennedy, Calvin Coolidge and Theodore Roosevelt. All these have lived life to the full or are still living it.

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