The Lower Respiratory System

Actions and herbs for the Lower Respiratory System

Pulmonary : Inula helenium,
Verbascum thapsus


Expectorant Stimulating:
Marrubium vulgare,
Cephaelis ipecacuanha, Sanguinaria canadensis

Relaxing : Tussilago farfara, Lobelia inflata,
Grindelia camporum

Demulcent: Plantago spp., Pulmonaria officinalis, Cetraria
islandica, Asclepias tuberosa

Anti-spasmodic: Euphorbia pilulifera, Drosera spp.,
Papaver spp., Prunus serotina, Lactuca virosa

Anti-microbial: Allium spp., Echinacea spp., Eucalyptus
spp., Thymus vulgaris

Anti-catarrhal: Hyssopus officinalis, Tussilago farfara

Cardio-Tonic: Crataegus spp., Leonurus cardiaca, Tilia europaea

Nervine: Hyssopus officinalis, Leonurus cardiaca, Lobelia
inflata
, Lactuca virosa

There is a great deal that Phytotherapy has to offer in the treatment of
respiratory disease. However, a major obstacle to correct use lies in the
language herbalist’s use to describe them. What follows here is a brief recap
of the expectorant section in the Actions chapter. Please refer back to
it for more details of secondary actions etc..


Expectorants are herbs that help the body to remove excess mucous from the
lungs. However, it is a very badly used and mis-defined term that is often
used to mean a remedy that `does something’ for the Respiratory system.
To further elucidate the activity, and thus the therapeutic indications,
of the various remedies called `expectorants’ they are subdivided thus:


Expectorant

– Pulmonary/Tonic

– Stimulating expectorant



    • alkaloid containing

    • saponin containing

    • volatile oil containing


– Relaxing expectorant


    • demulcent

    • anti-inflammatory (often also anti-microbial)

      – usually with volatile oil

    • anti-spasmodic – alkaloid containing

      – volatile oil containing




The stimulating expectorants can act in different ways to produce
the same effect, and it is not always clear how a specific remedy is working,
but current ideas suggest the following processes:

  • irritation of the bronchioles to stimulate the expulsion of any material
    present.

  • liquefaction of viscid sputum so that it can be cleared by coughing.
    The sputum is moved upwards from the lungs by the fine hairs of the ciliated
    epithelium lining the bronchiole tubes. Reducing the viscosity through expectorants
    facilitates this transport.


Most stimulating expectorants contain alkaloids, saponins or volatile
oils
. However not all chemicals in these groups, or plants with these
constituents have this activity.


The relaxing expectorants would seem to act also by reflex but here
it is to soothe bronchial spasm and loosen mucous secretions. This loosening
is occasioned by producing a thinner mucous, lifting the stickier stuff
up from below. This makes them useful in dry, irritating coughs. You will
notice that this action is similar in some respects to the demulcents, and
both actions owe a lot to their content of mucilage and occasionally volatile
oils.


The pharmacopeias abound in plant remedies and most of the herbs still in
the British and American official lists are expectorants, anti-tussive or
decongestants. However, the allopathic focus on effect has meant the dropping
of the tonic remedies. Pulmonaries provide Phytotherapy with the possibility
of strengthening both tissue and function in addition to addressing the
symptoms of respiratory disease.


Tonics for the Lower Respiratory System

Herbs that are known as pulmonaries, or amphoteric expectorants have a
beneficial effect upon both the tissue of the lungs and their functioning.
Important remedies include


Inula heleniumVerbascum thapsus Tussilago farfara


The differential indications will be found in the materia medica for
each of the remedies. A generalizationcan be made based upon
Inula
having stimulating expectorant effects whilst Verbascum
is more of a relaxing expectorant. Tussilago is the best of the three
for children.


Maintenance of Respiratory Health

Much of the disease commonly associated with both upper and lower respiratory
systems is preventable. Air quality is the key. By avoiding particulate
air pollution and chemical irritants such as sulphur dioxide, many of the
disabling conditions of the lungs would not develop. Thus smoking, both
active and passive, as well as urban and industrial pollution are important
issues for the therapist and the patient. This need not be developed
here, but anyone concerned about the health of their lungs should become
active in Friends of the Earth!


Patterns of Disease

There are five primary symptoms in this system, and whilst each may be treated
effectively with herbs, they must be seen as signposts to the underlying
pathology. These symptoms are

  • Cough, defined as a sudden explosive expiatory maneuver that
    tends to clear material from the airways. This will be caused by irritation
    somewhere within the respiratory tract, and is discussed below.

  • Dyspnoea, or breathlessness of some degree, is discussed under
    asthma. It is defined as an unpleasant sensation of difficulty in breathing,
    and has a range of clinical manifestations

  1. Physiological Dyspnoea: This is the commonest type of breathlessness
    and is associated with physical exertion. Ventilation is increased and maintained
    through an augmented respiratory stimulus provided by metabolic and other
    factors. Dyspnoea is common during acute hypoxia (oxygen lack), such
    as at high altitudes, where the increased respiratory stimulus is in part
    the effect of arterial hypoxia on the carotid bodies. These are receptor
    sites in the carotid arteries that monitor the concentration of gases in
    the blood.

  2. Pulmonary: The two major causes here are a restrictive
    defect which lessens the lungs or chest wall from efficient movement (e.g.
    pulmonary fibrosis), or an obstructive defect which increases resistance
    of flow in the airways (e.g. asthma)

  3. Cardiac: In the early stages of heart failure the availability
    of oxygen to the tissues of the body via the blood fails to keep pace with
    increased metabolic need during exercise. As a result respiration is increased
    because of tissue and cerebral acidosis, causing hyper-ventilation. In later
    stages the lungs are congested are congested and edematous, the capacity
    of the stiff lungs is reduced and the effort needed to breath is increased.
    Cardiac asthma is a state of acute respiratory insufficiency often
    very similar to other types of asthma but it originates from left ventricular
    failure. Orthopnea, or breathing discomfort that occurs while laying
    flat, is usually symptomatic of a cardiovascular basis to dyspnoea.

  4. Circulatory (air hunger): is often a medical emergency due to
    lack of oxygen following blood hemorrhage. It may occasionally be associated
    with anemia.

  5. Chemical: related to uremia or diabetic acidosis.

  6. Central: connected to cerebral lesions.

  7. Psychogenic: Know as `hysterical over breathing’.

  • Chest pain, is a common presenting symptom and calls for skilled
    differential diagnosis. Cardiovascular causes must be distinguished from
    the range of pulmonary problems that might be implicated.

  • Wheeze, describes an awareness of noises associated with breathing.

  • Hemoptysis, or the coughing up of blood, is a sign that skilled diagnosis
    is called for.



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David L. Hoffmann BSc Hons MNIMH Written by David L. Hoffmann BSc Hons MNIMH

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