David L. Hoffmann BSc Hons MNIMHA condition associated with prolonged exposure to non specific bronchial irritants and accompanied by mucous hyper secretion and certain structural changes in the bronchi.
Chronic bronchitis is a long-term condition without fever. It is characterizedby a permanent cough with sputum, due to continual over-production of mucus. Healthy lungs normally produce a small amount of mucus all the time, and this is constantly swept up the bronchi by the cilia. This process goes on all the time without us noticing it, as the amount of mucus is very small, and it is swallowed imperceptibly with our saliva. But when irritation of the bronchi, due to infection, air pollution, smoking, or other external irritants, provokes the production of abnormally large amounts of mucus, this literally swamps the minute cilia. The deep layer of mucus covers the cilia, so they can no longer propel it upwards. Then the body can only get rid of the mucus by coughing.
Chronic bronchitis may be classified into three grades of severity –
- simple chronic bronchitis, which is mild but persistent with clear sputum:
- mucopurulent bronchitis, in which the sputum is occasionally or continually thick and often yellowish, due to the presence of pus caused by bacterial infection
- obstructive bronchitis, which occurs when structural damage has been caused by continual infection, inflammation and coughing. The bronchi become narrowed because the membrane that lines them gets thicker and scarred. The lungs lose some of their elasticity, so breathing becomes more difficult, as greater effort is needed to get a sufficient volume of air into the lungs. The amount of alveolar tissue is reduced, due to damage. This is the very thin membrane through which oxygen passes into the blood, and carbon dioxide and other waste material is extracted. Eventually the heart may be over-strained in trying to maintain sufficient circulation within the lungs.
This is often a completely preventable condition, with the primary etiological factors being a range of pollutants. Climate and air pollution are serious factors, especially when the two combine to produce fog, but the two most important factors are smoking and bad nutrition.
Actions indicated for the processes behind this disease:
Pulmonary are essential in supporting the health and general tone of the lungs and respiratory function.
Expectorant – stimulating will be especially important in the more productive cases
Expectorant – relaxing will not be as important for chronic as they were for acute bronchitis, however they often provide good support remedies in some cases.
Demulcent will be of help if there is much irritation involved.
Diaphoretic are of help in cases of feverishness, but are not as important as they were for acute bronchitis.
Anti-spasmodics may be helpful in severe coughing or breathless.
Anti-microbials helps the bodies attempts to rid any accompanying infection, if present.
Cardio-Tonic herbs are essential for supporting cardiac function in anyone with weak hearts, long term chronic bronchitis or the elderly.
Nervine support and even adaptogens may be helpful in some cases.
System Support
In this chronic and debilitating condition, tonic support is vitally important. An inherent strength of herbal medicine reveals itself here in plants that may be selected that not only address the symptom picture well but are also appropriate tonics. Systems that should be focused on include the respiratory and cardio-vascular, however the immune functions of the body should be enhanced as well.
Specific Remedies
Please refer to the section on specific remedies given for acute bronchitis. Also the information concerning steam inhalations and Aromatherapy is relevant to chronic bronchitis.
One possible prescription: For Chronic recurrent bronchitis associated with debility:
Inula helenium
Cetraria islandica
Tussilago farfara
Verbascum thapsus — — — equal parts to 100g 1 teaspoonful to a cup of boiling water. Infuse for 20 minutes. 3 cups daily.
This combination is formulated for a patient who is becoming debilitated and weakened by their chronic problem. Thus there is a blending of stimulating and relaxing pulmonary tonics. Cetraria has long been used in Britain(the worlds capitol of chronic bronchitis!) as a nutritive support in such cases. To this may be added whatever else is appropriate for the individual concerned, whether it be Crataegus spp., Eleutherococcus senticosusor Galium aparine. If the reasons for these suggested additions is not immediately clear, please refer to your Materia Medica notes.
This combination supplies the following actions:
Pulmonaries (Inula helenium, Tussilagofarfara, Verbascum thapsus)
Expectorant-Stimulating (Inula helenium)
Expectorant-Relaxing (Cetraria islandica, Tussilago farfara, Verbascum thapsus)
Demulcent (Cetraria islandica, Tussilago farfara, Verbascumthapsus)
Anti-microbial (Inula helenium)
Anti-catarrhals (Inula helenium, Cetraria islandica, Tussilago farfara, Verbascum thapsus)
Diaphoretics (Inula helenium)
One possible prescription: For Chronic recurrent bronchitis associated with infection:
Inula helenium
Echinacea spp.
Marrubium vulgare
Verbascum thapsus — — — equal parts of tincture to 5ml. taken three times a day.
This combination supplies the following actions:
Pulmonaries (Inula helenium, Verbascumthapsus)
Expectorant-Stimulating (Inula helenium, Marrubiumvulgare)
Expectorant-Relaxing (Verbascum thapsus)
Bitter (Marrubium vulgare)
Anti-spasmodic (Allium sativum)
Anti-microbial (Inula helenium, Echinacea spp., Alliumsativum)
Anti-catarrhals (Inula helenium, Echinacea spp., Verbascumthapsus, Allium sativum)
Diaphoretics (Inula helenium, Allium sativum)
Cardio-Tonic (Allium sativum)
One possible prescription: For Chronic recurrent bronchitis associated with dyspnoea:
Inula helenium
Dyspnoea mixture
Marrubium vulgare
Verbascum thapsus — — — equal parts of tincture to 5ml. taken three times a day.
For details of the components and actions of the Dyspnoea mixtureplease refer to the section on asthma that follows. In addition to the contribution of the dyspnoea mixture, this combination supplies the following actions:
Pulmonaries (Inula helenium, Verbascum thapsus)
Expectorant-Stimulating (Inula helenium, Marrubiumvulgare)
Expectorant-Relaxing (Verbascum thapsus)
Anti-spasmodic (Allium sativum)
Anti-microbial (Inula helenium, Allium sativum)
Anti-catarrhals (Inula helenium, Verbascum thapsus, Allium sativum)
Diaphoretics (Inula helenium, Allium sativum)
Cardio-Tonic (Allium sativum)
One possible prescription: Chronic recurrent bronchitis associated with excessive congestion:
Inula helenium
Sanguinaria canadensis
Marrubium vulgare
Verbascum thapsus — — — equal parts of tincture to 5ml. taken three times a day.
This combination supplies the following actions:
Pulmonaries (Inula helenium, Verbascum thapsus)
Expectorant-Stimulating (Sanguinaria canadensis, Inulahelenium, Marrubium vulgare)
Expectorant-Relaxing (Verbascum thapsus)
Bitter (Marrubium vulgare)
Anti-spasmodic (Sanguinaria canadensis, Allium sativum)
Anti-microbial (Inula helenium, Sanguinaria canadensis, Allium sativum)
Anti-catarrhals (Inula helenium, Echinacea spp., Verbascumthapsus, Allium sativum)
Diaphoretics (Inula helenium, Allium sativum)
Cardio-Tonic (Allium sativum)
Broader Context of Treatment
Much of the information given for acute bronchitis is relevant for chronic bronchitis as well. Smokers are still more likely to die from chronic bronchitis than from lung cancer, and to give up smoking is the first and most important preventive measure. The other is to improve the level of nutrition, and particularly to cut out or greatly reduce those foods which encourage the production of mucus. These are, for most people, dairy products and refined starches. Of the two, dairy products seem to be the worst culprits, and cutting them right out of the diet for a time – maybe several weeks, or months if the bronchitis is of long standing – will often bring about an improvement. After that, cheese, milk, etc., may be cautiously reintroduced but in very small amounts only. For some people, it may be necessary to omit them from the diet permanently.
Goats milk is often found to be less mucus-forming than cows milk. Starches also provoke excessive mucus production, and refined starches (white flour and all products made from it) are far worse than unrefined grains. Additives, such as chemical flavorings, colorings and preservatives often trigger mucus excess as well, and should be avoided. The best and simplest rule is to eat foods in a state as near as possible to that in which they were grown, i.e., not processed, dried, frozen, packaged or pre-cooked, and as often as possible eat them raw or very lightly cooked.
Jim Strohecker
Daniel Redwood DC