Smoking is the major cause of emphysema. It’s also possible that emphysema is a type of end stage response to different kinds of assaults on the lungs (Ann Rev Med, 1989; 40: 411-29).

Studies have shown that significant deposits of cadmium are found in the lungs of emphysema patients (Lancet, 1988; i: 663-7), with cigarette smoke being the most obvious source (although air pollution also contributes). The amount of cadmium in the lungs relates directly to the severity of the emphysema (Ann Rev Med, 1989; 40: 411-29).

For anyone who smokes and has emphysema, there’s no substitute for quitting. However, several other factors will affect the course of your recovery. In looking for an effective treatment for emphysema, it’s helpful to view it as part of the spectrum of diseases which comes under the term Chronic Obstructive Pulmonary Disease (COPD). This includes asthma, chronic bronchitis and emphysema.

Treatments which are helpful for asthma and bronchitis, and even those used for lung cancer, are likely to be helpful for the emphysema patient.

According to a recent American study at Ohio State University, exercise may reduce anxiety and depression as well as improve endurance in those with COPD (Health Psychol, 1998; 17: 232-40). This is contrary to the usual advice given to COPD patients to limit their physical activity due to shortness of breath.

Other studies have shown a similar positive effect from exercise, which seems to strengthen the muscles supporting the lungs (Eur Respir J, 1996; 107: 2590-6).

The benefits of exercise can be greatly reduced if the emphysema sufferer has a poor diet (Chest, 1995; 107: 1206-12). Research into diet and lung function has been patchy and tends to focus on single nutrients. Antioxidants, such as vitamins A, C and E, are known to play a role in preventing damage due to free radicals (Bull Eur Physiopathol Respir, 1998; 279: 253s-255s). Of these, vitamin A and beta carotene (a pre cursor of vitamin A) are perhaps the most important, since they help build strong skin both inside and outside of the body. Smoking and high alcohol consumption will significantly reduce levels of carotenoids in the blood, and so elevate the risk of lung disease (Jpn J Cancer Res, 1987; 78: 1049-56).

One Japanese study of 265,000 people found that there was a significant association between low beta carotene intake and the incidence of lung cancer (Princess Takamatsu Symposium (US), 1985; 16: 41-53). In fact, the risk of developing lung cancer in the trial was the same between those who smoked and had a good daily intake of beta carotene and those who didn’t smoke but had a low intake of the nutrient.

One study by the National Cancer Institute, however, reported a 28 per cent increase in the incidence of lung cancer in smokers given beta carotene (New End J Med, 1996; 334: 1150-5). In both this and the Japanese study, however, the number of reported cases was small five and six cases per thousand, respectively. Perhaps more importantly, those who gave up smoking during the trial and took beta carotene were 20 per cent less likely to develop lung cancer. Although not directly concerning emphysema, the findings are relevant since the damage caused by other milder forms of lung disease, like emphysema, can increase the risk of later lung cancer (Am J Epidemiol, 1995; 141: 1023-32). (But see p11.)

In a recent study of 816 individuals, mostly smokers or ex smokers who were exposed to asbestos, beta carotene and retinol (a common form of vitamin A) were shown to protect against loss of breathing function (Am J Respir Crit Care Med, 1997; 155: 1066-71).

Two years ago, a small study reported that when rats with emphysema like lung damage were injected daily with the vitamin A derivative, retinoic acid, their respiratory function improved. Their lungs also returned to normal size and regained elasticity. Even new alveoli the lung’s air sacs that take up oxygen from each breath had grown (Nature Med, 1997; 3: 675-77). Although this research may not be applicable to humans, it does point the way towards possible effective nutritional treatment of emphysema.

Vitamin C has been shown to prevent bronchial constriction in asthmatic patients by reducing histamine and by normalising fatty acid metabolism, which in turn reduces free radical damage. It might be worth upping your intake of this vitamin and other antioxidants (Ann Allergy, 1990; 65: 311-4; Am J Epidemiol, 1990; 132: 67-76).

Omega-3 fish oils may also be beneficial, particularly eicosapentaenoic acid (EPA), which can be found in cold water fish. One study showed that the higher a person’s dietary intake of fish, the less likely he was to suffer from bronchitis or wheezing (Am J Epidemiol, 1990; 132: 67-76).

You may want to include more spicy foods in your diet. Anecdotally, foods like garlic, onion, chilli peppers, horseradish and mustards all play a role in helping to relieve wheezing and coughing. Onions have been shown to relieve bronchial obstruction (Int Arch Allergy Appl Immunol, 1987; 82: 535-6).

It’s also a good idea to rule out food sensitivities, which will reduce any further strain on your lungs if you tend to be asthmatic (Ann Allergy, 1987; 58: 164-72).

>From the herbal pharmacy, antioxidant herbs, especially grape seed extract, have been found to reduce coughing, wheezing, weakness, mucous and recurring respiratory infections usually associated with emphysema. Grape seed extract contains a powerful bioflavonoid complex known as a procyanidolic oligomer (PCO), an antioxidant thought to be 20 times more potent than vitamin C and 50 times more potent than vitamin E. PCOs help to conserve and regenerate vitamins C and E. In cases of lung disease, they appear to work by reducing inflammation and damage to the air sacs.

You can take it as a supplement (the standard therapeutic dose is 150 to 300 mg per day), as well as including PCO rich foods in your diet, such as grapes, blueberries, cherries and plums. Supplementing with immune boosting herbs such as echinacea, golden seal and liquorice root, particularly during changes in seasons, may help you stay well. Emphysema patients are particularly at risk if they contract colds. Their inability to breathe properly, and their already weakened immune systems, make viral infections harder to fight off.

* I recommend Buteyko breathing exercises. My asthma was really bad, and I had a severe breathing block in my sternum. I got the book Breathing Free by Teresa Hale and did the exercises. My wheezing stopped, I could walk further without having to stop to catch my breath, and the sternum block disappeared. I haven’t done the exercises since, and my breathing continues to improve. – Carol Crow

The technique, lung volume reduction surgery, is dangerous under normal circumstances, but can be fatal if patients with severe disease undergo it. A safer option is standard medical care.

These alarming findings, first announced by the National Emphysema Treatment Trial (NETT) last October, have raised protests among the medical profession in America, where the trial was based.

Doctors are claiming the treatment is relatively safe and has improved the quality of life of many patients.

One doctor reckons it is all about money. Medicare, the health-insurance provider in the US, refuses to pay for the procedure – and the NETT findings provide further information to support this position (N Engl J Med, 2002; 346: 860-1).

I also believe that the current violent behaviour – terrorism, road rage and the like – are due to thought waves transmitted via the Field and picked up by receptive individuals who then, via their own thought transmissions, influence others. This would account for crowd violence and riots, where normally inoffensive people are drawn into situations they would usually avoid.

The reason for this letter is to tell you about a new arthritis treatment. There is a plant I have learned about from one of my clients, David Cowles, a businessman who lives in Las Vegas. If you log on to http://www.nesgadol.com, you can download his essay on marsh pennywort (Hydrocotyle umbellata).

He is trying to find someone who will analyse the plant to discover its constituents because he has discovered that it has remarkable curative powers. He has cured himself of arthritis, gout, scleroderma, emphysema and Raynaud’s disease. It heals the kidneys, too.

His wife, who suffered from cystitis for 30 years – which no amount of expensive medical treatment had managed to cure – ate just two leaves of pennywort a day and, after five weeks, she was completely cured.

Finally, Russ Maslen, the author of the book Arthritis BC: Before Centella that I published, has discovered that he is suffering from pancreatic cancer. But because he has been eating Centella asiatica (gotu kola) leaves for the past 11 years, the tumour has stopped growing and is now about the size of a walnut.

His oncologist thinks he may have had this tumour all that time and – get this – Russ has foregone all forms of conventional therapy, has not lost weight and is still functioning normally. When I met him recently at his home in New South Wales, Australia, he was fit enough to take my son and me out and about to show us the sights. – Kenneth V. Jackson, Centella Probe (UK), via e-mail

Signs and Symptoms


Emphysema takes a number of years to develop. Early symptoms can be easily missed. Symptoms to look out for include:

• Breathing through pursed lips
• Shortness of breath on exertion
• Wheezing
• Fatigue
• Slight body build with marked weight loss and barrel chest

Emphysema is often accompanied by chronic bronchitis. Together they are called chronic obstructive pulmonary disease (COPD). Persons with chronic bronchitis have symptoms of coughing and excess sputum.

Treatment and Care


A doctor can diagnose emphysema based on your medical history, a physical exam, a chest X-ray, and a lung-function test (spirometry). By the time emphysema is detected, however, anywhere from 50Ð70 percent of your lung tissue may already be destroyed. At that point, your doctor may recommend the following:

• A program to help you stop smoking
• Avoidance of secondhand smoke
• Avoidance of dust, fumes, pollutants, and other irritating inhalants
• Physical therapy to help loosen mucus in your lungs (if chronic bronchitis accompanies the emphysema)
• Daily exercise
• A diet that includes adequate amounts of all essential nutrients
• Prescription medication which may include a bronchodilator, steroids, and antibiotics
• Annual flu vaccinations
• A pneumonia vaccination given once as recommended by your doctor
• Supplemental oxygen as needed

Emphysema can’t be reversed, so prevention is the only real way to avoid permanent damage.

{Note: Persons with emphysema having severe symptoms may need emergency care.}

(See “Places to Get Information & Help” under “Lung Diseases” on page 376.)

Breathing problems also affect people who are very allergic to some types of shellfish, nuts, medications and insect bites. These people can suffer an allergic reaction called anaphylactic shock. This reaction begins within minutes of exposure to the substance causing the allergy. During this type of allergic reaction, the airways narrow, making it difficult to breathe. Soon, the heartbeat races and blood pressure drops. Anaphylactic shock can be fatal if a person is not treated within 15 minutes.

Breathing problems from some things may require emergency care.

In children they include:

• Wheezing (see page 263)
  
• Croup, a virus with a “barking cough” common in young children (see page 255)
  
• Diphtheria, which is a very contagious throat infection
  
• Heart defects children are born with
  

• Severe allergic reactions
  
• A face, head, nose or lung injury
  
• Carbon monoxide poisoning
  
• Harsh chemical burns in the air passages
  
• Epiglottitis, which is inflammation of the flap of tissue at the back of the throat that can close off the windpipe
  
• Choking (see page 298)
  
• Drug overdose
  
• Poisoning (see page 322)
  
• Asthma (see page 76)
  
• Bronchitis (see page 81)
  
• Pneumonia (see page 369)
  

• Emphysema (see page 348)
  
• Congestive heart failure
  
• Heart attack (see “Chest Pains” on page 150 and “Coronary Heart Disease” on page 343)
  
• Blood clot in a lung
  
• Collapse of a lung
  

• Avoid allergic substances or agents that induce asthma, if you have it.
  
• Do not walk, run or jog on roads with heavy automobile traffic.
  
• If you have a gas furnace, install a carbon monoxide detector.
  
• Never leave your car running in a closed garage.
  
• Make sure immunizations against childhood diseases, especially diphtheria, are up-to-date. This is part of the Diphtheria, Tetanus, Pertussis (DTP) vaccination. (See “Immunization Schedule” on page 18.)
  
• If you smoke, quit.
  
• Keep small objects a child could choke on out of reach and do not give gum, (especially bubble gum), nuts, hard candy, or popcorn to children under 5 years old.
  
• Lock up all medications and poisonous substances so small children can’t get to them.
  

Has breathing stopped and is there no pulse?
Has breathing stopped, but there is a pulse?
Has breathing stopped due to choking on an inhaled object?
Are there signs of anaphylactic shock? Difficulty breathing Swollen tongue, eyes, or face Unconsciousness Difficulty in swallowing Dizziness, weakness Pounding heart Itching, hives
Are any of these problems present with difficulty in breathing? Signs of a heart attack such as chest pain, pressure, or tightness; pain that spreads to the arm, neck or jaw; irregular pulse. Serious injury to the face, head, or chest Signs of a stroke such as blurred or double vision, slurred speech, one-side body weakness or paralysis Signs of drug overdose such as drunkenlike behavior, slurred speech, slow or rapid pulse, heavy sweating, enlarged or very small eye pupils
Is it so hard to breathe that the person can’t talk (say 4 or 5 words between breaths) and/or is there wheezing that doesn’t go away?
Is blood being coughed up?
Does the difficulty in breathing occur with a cough in a baby and does it make the baby unable to eat or take a bottle?
Are any of these signs present? Breathlessness at night or at rest Pink or frothy phlegm being coughed up and/or A high fever along with rapid and labored breathing
Is a green, yellow, or gray mucus being coughed up?

• Wear a face mask that covers the nose and mouth, when outdoors. Most hardware stores carry inexpensive ones.
  
• Don’t smoke. Avoid secondhand smoke. This applies to anyone with breathing difficulties.
  
• Install an electronic air filtering system or use an air purifier in your home, especially in the bedroom. Tests show that air filters help clear the air of allergy-causing agents.
  

Breathing problems can be avoided or lessened if you:

• Do not rake leaves that have been on the ground for awhile. Molds and mildew grow on leaves after they’ve been on the ground for a few days.
  
• Keep your basement dry, well ventilated, and well lit. Use dehumidifiers and exhaust fans to reduce moisture in the air.
  
• Get rid of house plants.
  
• Avoid barns, chicken coops, damp basements, and attics.
  

See also: “Asthma” on page 76, “Bronchitis” on page 81, “Common Cold” on page 83, “Coughs” on page 85, and “Flu” on page 87.

Emphysema, which often accompanies chronic bronchitis, is damage to the elastic walls of the sac-like alveoli in the lungs. This is caused by constant coughing to try to dislodge the bacteria and mucus blocking the swollen bronchi. Microscopic hairs called cilia which line the airways act as a respiratory `escalator’ pushing out particles of dust, soot, and bacteria. In chronic bronchitis the cilia become paralyzed due to the constant secretion of viscid mucus. Smoking and to a lesser degree alcohol exacerbate this state.

Actions Indicated for the Processes Behind this Disease

Pulmonary tonics are important in long term strengthening of the lungs, but will do little in short term relief of an attack.

Expectorant remedies will be essential to ensure that there is the minimum of build up of sputum in the lungs. Stimulant expectorants are necessary because of the lessening of tone in the alveoli walls.

Demulcents will be soothing and support the relaxing expectorants.

Anti-spasmodic plants will ease the spasm response in the muscles of the lungs.

Anti-microbial support is called for if there is potential for secondary infection, which is too be guarded against at all costs.

Anti-catarrhals will aid the body in dealing with any over production of sputum in lungs or sinuses.

Cardio-Tonic herbs will support the heart in the face of lung congestion or strain.

Nervine support is always appropriate either because stress is a trigger in some form or because the asthma becomes a source of stress and concern which then in turn triggers attacks.

Dyspnoea mixture

Sanguinaria canadensis

Inula helenium — — — equal parts of tincture to 5ml. taken three times a day.

Pulmonaries (Inula helenium, Lobelia inflata)

Expectorant (Sanguinaria canadensis, Inula helenium, Grindelia camporum, Euphorbia pilulifera, Lobeliainflata, Glycyrrhiza glabra)

Demulcent (Glycyrrhiza glabra)

Anti-spasmodic (Inula helenium, Sanguinaria canadensis, Grindelia camporum, Euphorbia pilulifera, Lobelia inflata, Prunus serotina, Glycyrrhizaglabra, Pimpinella anisum, Ephedra sinica)

Anti-microbial (Inula helenium, Sanguinaria canadensis, Pimpinella anisum)

Anti-inflammatories (Glycyrrhiza glabra, Pimpinellaanisum)

Anti-catarrhals (Inula helenium, Pimpinella anisum, Ephedra sinica)

Cardio-Tonic (Leonurus cardiaca)

Nervine (Lobelia inflata, Leonurus cardiaca)

Papaveraceae

Names : Red Root, Red Indian Paint, Tetterwort.

Habitat : N. America and Canada.

Collection : The rhizome is unearthed in early summer (May to June) or in autumn when the leaves have dried. It should be dried carefully in the shade.

Part Used : Dried rhizome

Constituents :

• Isoquinoline alkaloids, including sanguinarine (:1%), chelerythrine, sanguidaridine, oxysanguinaridine, sanguilutine, berberine, coptisine, chelilutine, protopine, sanguidimerine, sanguirubine, [[alpha]]-and [[beta]]-allocryptopine and others.
  

Indications : Blood root finds its main use in the treatment ofbronchitis. Whilst the stimulating properties show in its power as an emetic and expectorant, it demonstrates a relaxing action on the bronchial muscles. It thus has a role in the treatment of asthma, croup and also laryngitis. However, by far the most important contributionSanguinaria has to make is in chronic congestive conditions of the lungs including chronic bronchitis, emphysema andbronchiectasis. It acts as a stimulant in cases of deficient peripheral circulation. It may be used as a snuff in the treatment of nasal polypi.

Ellingwood considered it specific for “harsh, dry cough with relaxed tissues of the pharynx, larynx and bronchi, with a sense of constriction and constant irritation and uneasiness or tickling of the throat. “In addition he recommends it for the following pathologies : congestion of the lungs, bronchial coughs, stridulous laryngitis, membranous croup; externally for otitis media, indolentulcerative conditions, nasal catarrh, anal fissure, epithelioma, lupus.

King’s Dispensatory describes this herb as being specifically indicated in the following symptom picture: “Sensation of burning and itching of mucous membrane, especially of fauces, pharynx, Eustachian tubes and ears; less frequently of larynx, trachea, and bronchia, occasionally of stomach and rectum, and rarely of vagina and urethra. The mucous membrane looks red and irritable. Sometimes the redness will be of the end of the nose. Nervousness, redness of nose, with acrid discharge, burning and constriction in fauces of pharynx, with irritative cough and difficult respiration.”

Combinations : It combines well with Horehound and Elecampane for congestive complaints. In pharyngitis it combines well with Red Sage and a pinch of Cayenne.

Preparations & Dosage : Decoction: put l teaspoonful of the rhizomein a cup of cold water, bring to the boil and leave to infuse for l0 minutes. This should be drunk three times a day. Tincture: take 1-2 ml of the tincture three times a day.

Citations from the Medline database for the genus Sanguinaria

Blood RootFrankos VH Brusick DJ Johnson EM Maibach HI Munro I Squire RA Weil CSSafety of Sanguinaria extract as used in commercial toothpaste and oral rinse products.

J Can Dent Assoc (1990) 56(7 Suppl):41-7Hannah JJ Johnson JD Kuftinec MM Long-term clinical evaluation of toothpaste and oral rinse containing sanguinaria extract in controlling plaque, gingival inflammation, and sulcularbleeding during orthodontic treatment.

Am J Orthod Dentofacial Orthop (1989 Sep) 96(3):199-207Harkrader RJ Reinhart PC Rogers JA Jones RR Wylie RE 2d Lowe BK McEvoy RMThe history, chemistry and pharmacokinetics of Sanguinaria extract.

J Can Dent Assoc (1990) 56(7 Suppl):7-12Harper DS Mueller LJ Fine JB Gordon J Laster LL Effect of 6 months use of a dentifrice and oral rinse containing sanguinaria extract and zinc chloride upon the microflora of the dental plaque and oral soft tissues.

J Periodontol (1990 Jun) 61(6):359-63Harper DS Mueller LJ Fine JB Gordon J Laster LL Clinical efficacy of a dentifrice and oral rinse containing sanguinaria extract and zinc chloride during 6 months of use.

J Periodontol (1990 Jun) 61(6):352-8Karjalainen K Kaivosoja S Seppa S Knuuttila M Effects of sanguinaria extract on leucocytes and fibroblasts.

Proc Finn Dent Soc (1988) 84(3):161-5Kopczyk RA Abrams H Brown AT Matheny JL Kaplan AL Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use.

J Periodontol (1991 Oct) 62(10):617-22Kuftinec MM Mueller-Joseph LJ Kopczyk RA Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short-and long-term trials.

J Can Dent Assoc (1990) 56(7 Suppl):31-3Laster LL Lobene RR New perspectives on Sanguinaria clinicals: individual toothpaste and oralrinse testing.

J Can Dent Assoc (1990) 56(7 Suppl):19-30Lobene RR Soparkar PM Newman MB The effects of a sanguinaria dentrifice on plaque and gingivitis.

Compend Contin Educ Dent (1986) Suppl 7:S185-8Mallatt ME Beiswanger BB Drook CA Stookey GK
Jackson RD Bricker SL Clinical effect of a sanguinaria dentifrice on plaque and gingivitis in adults.

J Periodontol (1989 Feb) 60(2):91-5Miller RA McIver JE Gunsolley JC Effects of sanguinaria extract on plaque retention and gingivalhealth.

J Clin Orthod (1988 May) 22(5):304-7Nikiforuk G The Sanguinaria story–an update and new perspectives (overview of theToronto symposium).

J Can Dent Assoc (1990) 56(7 Suppl):5-6Parsons LG Thomas LG Southard GL Woodall IR Jones BJ Effect of sanguinaria extract on established plaque and gingivitis when supragingivally delivered as a manual rinse or under pressure in an oralirrigator.

J Clin Periodontol (1987 Aug) 14(7):381-5Schwartz HG Safety profile of sanguinarine and sanguinaria extract.

Compend
Contin Educ Dent (1986) Suppl 7:S212-7Southard GL Harkrader RJ Greene JA Efficacy and compatibility of a toothpaste containing sanguinaria extract and fluoride.

Compend Contin Educ Dent (1986) Suppl 7:S189-92Southard GL Parsons LG Thomas LG Woodall IR Jones BJ Effect of sanguinaria extract on development of plaque and gingivitis when supragingivally delivered as a manual rinse or under
pressure in an oralirrigator [published erratum appears in J Clin Periodontol 1988Jan;15(1):83]

J Clin Periodontol (1987 Aug) 14(7):377-80Walker C Effects of sanguinarine and Sanguinaria extract on the microbiota associated with the oral cavity.

J Can Dent Assoc (1990) 56(7 Suppl):13-30

Acute inflammatory conditions of the respiratory system are primarily treated
with mucilage rich demulcents, acting as they do to soothe the inflamed
tissue It would be inappropriate to use the stimulating, saponin containing
expectorants in all cases, as they are best for sub-acute or chronic bronchitis
where an active expectoration is required. Any increased irritation in chronic
bronchitis will indicate the need for increased demulcancy. This facilitates
differentiated stages of cough therapy that can rapidly ameliorate the symptoms