Asthma is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Common symptoms include wheezing, coughing, chest tightness, and shortness of breath.
Bronchial asthma is an inflammatory disease of the respiratory airways. People who have asthma are usually allergic to a combination of substances, such as pollen. When exposed to these substances, they begin to experiencing wheezing, difficulty breathing, chest discomfort and episodes of coughing. If treated properly, asthma rarely causes long-term complications, but if left untreated the disease can cause a variety of complications.

Asthma can occur at any age. But the Child hood asthma or children asthma is the most common health problem in the present day society. Similarly chronic bronchitis is also another major respiratory problem frequently occurs in children at any age groups. If this chronic bronchitis is not treated properly with constitutional homeopathic treatment then it may turns into bronchial asthma in the future. The common symptoms of chronic bronchitis and child asthma are - frequent attack of cough, cold, fever, tightness of chest, shortness of breath with wheezing sound on respiration, easy fatigue and loss of appetite. The prevalence of asthma is increasing especially in the children. That episodic attack of child asthma and chronic bronchitis can be cured completely and permanently by constitutional homeopathy treatment.

The chronic bronchitis and bronchial asthma are not only limited to children but in adult case also. But in comparison to adult the children are more suffer with chronic bronchitis and asthma because children are exposed to more and more allergens such as dust, air pollution, and second-hand smoke. Their immune system is not so much stronger to resist those infections. Another factor is decreasing rate of breastfeeding to the children that deprives the essential substances required for a healthy immune system of a child. So it is also another major factor of weak immune system of the child. Now a day the children more like to all types of junk and fast foods that also one factor of deprivation of essential micro nutrients needed to build up a healthy immune system. The others causes are the genetic or hereditary factors.
CAUSES OF CHRONIC BRONCHITIS AND ASTHMA
The external environmental factors: Those are - exposure to dusts and pollen, secondhand smoke, faulty diet habits, food allergens, chemicals (pesticides), environmental factors (dust mites, cats, cockroaches, fungi) and temperature intolerance are major factors of creating chronic bronchitis and asthma. Physical exertion or exercise also influences to induce asthmatic episode. Certain infections such as viral, bacterial, or fungal infections often lead to asthmatic breathing too.

The Internal Immunological or hereditary factors: Besides the external stimulatory factors, the low immune system of the child also plays an important role in manifesting the symptoms asthma and bronchitis in child cases. There are many factors responsible for weak immunity of a child. Among them decreasing rate of breast feeding that deprives the required essential substances for a healthier immune system, habits of taking more junk and processed foods that also deprives the essential micronutrients required to build up a healthy immune system plays the most important role in developing chronic bronchitis and asthma. Thus the weak immune system of the child is very prone or susceptible to any change in the atmosphere or slightest exposure to any infection may be viral or bacterial or fungi lead to develop respiratory problems.
CHANGES OCCUR IN THE RESPIRATORY TUBES OF AN ASTHMATIC CHILD
Asthma is a respiratory disorder caused by the inflammation in the airways called the bronchi that lead to the lungs. This inflammation can constrict the airways and tighten, which blocks air from flowing freely into the lungs, making it hard to breathe. Symptoms include wheezing, shortness of breath, tightness of chest, and fatigue on little exertion or play, shortness of breath and cough at night or after exercise/activity. The inflammation of the bronchus makes them very sensitive, resulting in spasm of the airways that tend to narrow, particularly when the lungs are exposed to any allergens, cold air, any smoke, infection and exercise. Things that trigger asthma differ from person to person. Some common triggers are allergies, viral infections, exercise, and smoke. When asthma patient is exposed to a trigger, their bronchus become inflamed, swell up, and fill with mucus. In addition, the muscles lining the swollen bronchus tighten and constrict, making them even more narrowed and obstructed. The inflammation of the bronchus, excess mucus secretion, narrowed airways or bronchoconstriction are the three major changes that occurs in asthmatic bronchus. Anyone can have asthma, including infants and adolescents. The recent scientific reports suggest that patients with asthma are likely to develop more severe problems due to H1N1 infection.

Thus for a permanent cure to chronic bronchitis and child asthma conditions, the treatment should be aimed to build up a healthy immune system. If the immune system is healthy and strong enough that can be able to protect the child from various allergens and infection that are suppose to give bad impact in their body. It can only be possible by the constitutional homeopathy treatment.

How you can know your child has bronchitis or asthma

Runny nose
Frequent coughing generally occurs at night, while playing or laughing. In early stage cough is the only symptoms present
Malaise (feverishness)
Sometimes sore throat and headache with body pain
Less energy during play
Rapid breathing and complain of chest tightening
Cannot sleep at night with difficult breathing and cough
Whistling sound (wheezing) when breathing in or out
Feeling of weakness and tiredness
No appetite
Please note that all the symptoms mentioned above are not similar to all child it can vary from child to child. The symptoms are also not same in every time the child get the bronchitis and asthma episodic attack. Some symptoms may not come.

PATHOPHYSIOLOGY
When we inhale the air it goes through the nose then through the air tube called trachea that bifurcates into two tubes called left bronchus and right bronchus which supply to the respective left and right lungs. Each bronchus then branches to number of small tubules called bronchioles. Each bronchiole end with a terminal sac like structure called alveoli. It is elastic in nature. The alveoli is surrounded and covered with network of blood vessels. When we breathe in the air with oxygen entered into the bronchus then to the bronchioles then to alveoli. The oxygen is transferred to the blood at the alveolar portion through the network of blood vessels and simultaneously carbon dioxide is received from the blood to the alveolus and is expelled out when we breathe out. This ingoing and out coming of air through the bronchioles and bronchus occurs in a smooth and rhythmical way when the bronchial tubes are free and clear. If there will be any constriction of bronchial tubules due to inflammation of inner bronchial layer, the spasm of bronchial tubules occurs that obstruct the smooth passage of air and the person will face difficulties taking the air in or leaving out. This is the condition called asthmatic condition. Due to the passing of air in a constricted tubules the whistling sound comes which is called in ronchi.
DIFFERENCE BETWEEN BRONCHITIS AND ASTHMA
Asthma is a condition where the bronchial tubes go into spasms. When this happens there is coughing, tightness of chest and has difficulty breathing, and wheezing can often by heard as air attempts to get through the narrowed bronchi. There is often no mucus. Bronchitis is inflammation of the bronchi. The patient with bronchitis always has a cough, dry in the early stage and with of sputum in the later stage. There is no tightness or constriction feeling on chest. It can be due to smoking, or any number of illnesses like colds, or flu.
COMPLICATION OF BRONCHITIS:
1. Patients suffering from bronchial asthma often develop a decreased ability to exercise or perform other physical activities

2. Bronchial asthma can cause a permanent change in the respiratory pathways. This process is called airway remodeling, and is a complication of untreated asthma. The constant inflammation causes the airways, or bronchi, to narrow. This adversely affects the patient's breathing efficiency. If asthma causes airway remodeling, then the patient will need to be monitored for difficulty breathing and decreased oxygen content of the blood.

3. Severe, chronic cases of bronchial asthma commonly prevent patients from getting adequate amounts of sleep. This is because the disease often manifests at night, which causes patients to wake up; the hormones that cause the inflammation of the airways can be released even when patients are asleep. This causes patients to wake up wheezing, coughing or breathing heavily.

HOMEOPATHIC MANAGEMENT:
There are two main variations of the classical approach of homeopathy treatment. One approach applies homeopathic remedies to disease classifications or pathology. This is the so-called clinical approach. The second variation is purely symptom similarity from totality of symptoms i.e. constitutional approach. Current research indicates that the constitutional and clinical approaches are about equally effective and are the preferred classical methods. Genetic Homoeopathy applies both the clinical and constitutional approach of homeopathy treatment.

Ankylosing spondylitis (AS) is one of the many types of arthritis. "Ankylosing" means joining together or stiffening; "spondylitis" means inflammation of the vertebral bones of the spine. Inflammation of the bones in AS can lead to degeneration, pain, and loss of joint motion. AS typically affects the spine but can been seen in other areas, especially the hips. Ankylosing spondylitis can range from a mild to more severe disease in patients. Ankylosing spondylitis is approximately three times more common in males than females. It is usually diagnosed in young adults, with a peak onset between 20 and 30 years of age. Children may also be affected by a form of AS termed “juvenile ankylosing spondylitis”, seen in children younger than 16 years of age. There is evidence suggesting a strong genetic component in the development of the disease.
AS is a type of arthritis of the spine. It causes swelling between vertebrae, which are the disks that make up your spine, and in the joints between spine and pelvis. Ankylosing spondylitis is an autoimmune disease. This means immune system, which normally protects body from infection, attacks body's own tissues. The disease is more common and more severe in men. It often runs in families.

Early symptoms include back pain and stiffness. These problems often start in late adolescence or early adulthood. Over time, ankylosing spondylitis can fuse vertebrae together, limiting movement.
ETIOLOGY of Ankylosing Spondylitis
Evidence points to autoimmune etiology.
Positive family history.
CLINICAL FEATURES of Ankylosing Spondylitis Prodorme
Malaise.
Tiredness.
Anorexia.
Symptoms
Onset: insidious.
Pain in back, buttocks.
Morning stiffness, better with activity.
Weight loss.
Fatigue.
No movement possible.
Gradual involvement of:
A) Whole vertebral column. B) Hips.
Signs
Tenderness at sacro-iliac joint.
Cervical, thoracic spines become tender.
Restricted movement.
Patient cannot erect spine.
Sits, walks with flexed spine.
Chest expansion diminished.
Complete rigidity of spine & involved joints.
Kyphosis (curve in spine).
COMPLICATIONS of Ankylosing Spondylitis
Aortic incompetence (calcification of valve).
Recurrent chest infection.
Atlanto-axial subluxation.
INVESTIGATIONS for Ankylosing Spondylitis
Blood
Hb% : low.
ESR: raised.
HLA-B-27: positive.
CRP: raised.
Rheumatoid factor: negative.
ANA: negative.
X-Ray findings of sacro-iliac joints
Early
Narrowing of joint space.
Haziness of joint margins.
Marginal erosions.
Marginal sclerosis.
Late
New bone formation.
Bridging of joint cavity.
X-Ray vertebral column
Ossification of spinal, para-spinal ligaments.
Squaring of vertebrae.
Ossification of intervertebral discs.
Bamboo spine (fusion of entire vertebral column).
GENERAL MANAGEMENT for Ankylosing Spondylitis
Before ankylosis takes place:
Provide straight back chair for sitting.
Firm bed with one pillow at night.
Encourage swimming.
Extension exercises.
Encourage lying in prone position.
Stop smoking.
Homeopathic Remedies for Ankylosing Spondylitis
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. None of these medicines should be taken without professional advice.

It is difficult to distinguish between allergy symptoms allergic rhinitis and sinusitis. This is no small problem. Of all the chronic diseases from which we suffer, allergic rhinitis is the most common. Approximately 30 million Indian or 15% of the Indian, population suffer from allergic rhinitis. Sinusitis, on the other hand, is one of the most common complications of allergic rhinitis. The problem with differentiating these two conditions occurs, because allergic rhinitis and sinusitis may both present with the same symptoms, such as fatigue, runny nose, chronic cough, congestion, post nasal drainage, headaches, facial or teeth pain, loss of taste or smell, and difficulty sleeping. Asthma, the other major complication of allergic rhinitis, is a lower airway lung disease that may present with cough, shortness of breath, and chest tightness, and in some studies, up to 40% of patients with allergies, have asthma.
Think then of a triangle: with allergic rhinitis on the left, causing sinusitis on the right, and both conditions causing asthma on the bottom. All three conditions can occur separately, but are closely interconnected. Remember that sinuses are simply empty cavities that surround the eyes. Air must be present in the sinuses to allow the linings of the sinuses to breathe and this is accomplished via small openings from the sinuses into the nasal passages. These openings also allow mucous from the sinuses to naturally drain into the nasal passages. If anything causes a blockage of the openings, the lack of air causes linings to use up the surrounding air supply, and like a vacuum, the resulting negative pressure will draw fluid out of the sinus linings. Fluid may then collect and fill the sinuses, which allows for bacteria to grow and cause infections. This can lead to facial pain, infected post nasal drainage and headaches. With increasing inflammation and thickening of the sinus linings, swollen tissue may round up and form nasal polyps that may cause and lead to loss of taste and smell. Allergic rhinitis and common viral colds are the leading causes of sinusitis, and the history and physical examination will help your provider distinguish the two conditions. Allergic rhinitis may be seasonal, lasting weeks, months or even year round, and is caused by pollen, dust mites. Fever and discolored nasal drainage are uncommon, unless sinusitis is also present. Conversely, typical viral colds last 3-7 days, so any fever, discolored drainage, sore throat, headache or fatigue lasting longer that 7 days is very unlikely to be a simple viral cold, and is most probably sinusitis. On physical examination, patients with allergic rhinitis and sinusitis may both have dark circles under the eyes (shiners), swollen, pale nasal tissue, congestion and discharge. Patients with sinusitis, however, may also have discolored discharge. Studies have shown that greater than 50-75% of allergic adults and children with asthma have abnormal sinus, and asthmatic symptoms did not improve until the sinusitis is treated completely.
ALLERGIC RHINITIS
Most patients 10-20% of the population with sneezing, congestion, runny and itchy nose rhinitis, postnasal drip and itchy, red eyes during spring and fall have allergies to seasonal pollens. A high percentage of allergic individuals will be children. Whether someone will develop

Allergies depends on two factors: (1) Hereditary - Is there a family history of allergy?
(2) Environmental- Is the individual old enough and been exposed to enough pollen? Symptoms due to allergies may be severe enough to cause a loss of time from work and school.

Interestingly, a percentage of patients with classic symptoms will be absolutely and unequivocally negative on skin testing. Allergy injections are not indicated and not possible, because these patients are not allergic. And yet patients are just as symptomatic, and just as miserable as the rest of us. How is this possible and what treatment is available?
Definition and Pathophysiology
The diagnosis of rhinitis without positive skin tests is divided into two subgroups. One subgroup, non-allergic rhinitis with eosinophilia, presents with allergy symptoms in addition to conditions such as nasal polyps and nasal eosinophilia, asthma and frequently sinusitis. The other subgroup, vasomotor rhinitis, presents with symptoms, especially congestion, but lacks other associated conditions.

The nasal mucosal lining has a rich blood supply that is under the control of the nervous system called the autonomic nervous system. Nonspecific stimuli such as rapid changes in weather, temperature and humidity, drafts, exposure to chemicals, odors, perfumes, smoke and dust, emotions or stress may increase blood flow to tissue, resulting in swelling, congestion and rhinitis. A significantly deviated septum may induce changes in the mucosa, worsen the non-allergic or vasomotor rhinitis and cause more nasal congestion and drainage. Hormonal changes that occur with pregnancy, menstruation, menopause, hypothyroidism and oral contraceptives may cause symptoms of chronic non-allergic rhinitis.
Clinical Features
Patients complain of chronic nasal congestion, rhinitis, postnasal drip and sneezing. Congestion and blockage may alternate from side to side and are usually constant, though seasonal weather changes may trigger symptoms that mimic dust allergies. Symptoms may be worse upon awakening in the morning. Examination reveals marked pink or pale nasal swelling obstruction and thick nasal secretions. In all cases, skin tests are negative. Patients with non-allergic but not vasomotor rhinitis will have eosinophils present in nasal secretions and frequently nasal polyps complicating the obstruction.
SINUSITIS
Sinusitis
Sinusitis is an infection or inflammation of sinuses. Sinuses are the air-filled pockets or spaces found in the bones of face, around eyes and nose. They produce mucus, which, under normal circumstances, drains into the nose. Normally the sinuses produce about 1.5 litres of mucus a day and the quantity increases during allergy, inflammation and infection and this also changes the character of the mucus. Infection of sinuses is one of the common health care complaints.

Pathology
Sinusitis occurs when the mucus-producing lining of sinuses become inflamed and block the opening of the sinuses. Due to this, foreign material cannot get out, oxygen levels drop within the sinus and bacteria in the nasal cavity slither into the sinuses causing the sinus walls to swell and fill with pus. If the infection does not subside, the body sends in disease-fighting cells to kill the bacteria, which in turn can do considerable damage to the sinus walls. These defender cells can damage the cilia, the hair-like structure in the sinuses that help expel foreign matter. In addition, scarring can be caused which can result in the formation of sores.
Causes of Sinusitis
Infection due to bacteria, virus, fungi
Allergy: Most commonest causes are dust, animal dander, smoke, food and pollutants
Upper respiratory tract infection such as common cold or flu
Nasal polyps
Nasal Septum deviation
Chronic tonsillitis and adenoiditis
Climatic factors like sudden temperature changes
Swimming in infected water
Low immunity
Dental causes like an abscessed or badly decayed tooth, following dental treatment
Diseases like diabetes and HIV can create a predisposition to sinusitis
Symptoms of sinusitis
Nasal congestion leading to nasal obstruction, difficulty breathing through the nose
Thick nasal discharge (may be yellowish or greenish in colour in case of infection)
Sensation of fullness in the face
Sensation of pressure behind the eyes
Postnasal drip
Cheeks feel tender and pain may be similar to toothache in upper jaw
Mild fever and headache over one or both eyes (if frontal sinuses are affected)
Headache is usually worse in the mornings and made sharper by bending forwards
Sore throat
Foul smell in nose
Nasal sounding speech
Possibly, pus-like nasal discharge
Dry tickling cough
Tiredness
Asthmatic Attack
In the initial stage there is an asthmatic aura sometimes sneezing, flatulence, Drowsiness or restlessness irritability will be present. There can be a dry cough along with wheezing breathlessness these are some of the symptoms before the actual asthmatic attack.
Sense of oppression in the chest suddenly in the middle of the night is experienced.
There is a sense of suffocation and the patient leans forward fighting for his breath; or he may go to the open window to relieve the suffocation.
Anxiety, perspiration, cold extremities and cyanosis might be present.
Wheezing is present and can be heard from a distant.
In severe airways obstruction airflow maybe so reduced that the chest is almost silent on auscultation.
Inspiration is short and high pitched while the expiration is prolonged. On auscultation there are plenty of rhonchi and rales heard.
Termination is spontaneous or due to medication. As the bronchial spasm is less the patient is able to breathe and he can also cough which brings out viscid sputum which relieves him.
The duration of the attack varies from a few minutes to hours. The attacks can last for many hours in paroxysms this state is known as Status asthmaticus. In this state the patient has to be admitted to the hospital so that he can be supplied with oxygen and other auxiliary methods of treatment
For many patients with asthma, the concern that this “reversible” though serious, potentially life-threatening persistent lung disease may progress into emphysema, is real and worrisome. After all, asthma along with emphysema and chronic bronchitis, the latter two conditions known as Chronic Obstructive Pulmonary Diseases (COPD), all have inflammation with airway narrowing, mucus production and airway obstruction. Homeopathy Management

Suppression of colds by high doses of conventional medicine leads to recurrent attacks. When you use a groom to clean your room, do you push all the dust in a corner of the room or collect it and throw away? It is a common sense that if you push to the corner of the room, in due course the dust will spread in the entire room again and make it dirtier. Same is the case with the disease affecting your body. If you suppress the disease, where will it go? It will remain in dormant state inside the body and express itself again when the body meets any of the allergic triggers. The homeopathic medicines however through the principle of “like cures like” stimulate the vital force and immunity in order to enhance the body’s capacity to repel further allergies and infections. The constitutional medicines that are found by considering the physical, mental, and emotional aspects of an individual can only lead him on the road of permanent recovery from those allergic spells. Not only these medicines cater the problem of allergy but also impart great health on all planes, as it treats the patient as a whole and not just his disease.