Asthma is characterised by difficulty in breathing, caused by muscle spasm in the small passages (bronchi) of the lungs. This narrows the space available for air to make its way out of the lungs, and breathing out is always more difficult than breathing in. This produces the wheezing sound associated with asthma attacks. Because the passages are narrowed and air flow reduced, mucus also builds up in the lungs, and this makes it even more difficult to breathe. The mucus is also a breeding-ground for bacteria, so attacks of bronchitis may arise as a complication of the asthma. Many asthma attacks are triggered by allergens, such as dust, mould spores, mites, animal hair or feathers but the onset may equally be caused by cold air, or it may be preceded by an infection such as a cold. Certainly, stress and more specifically acute anxiety are known to be the immediate trigger for many attacks, and this can sometimes give rise to a vicious circle of asthma - anxiety about the asthma - further attacks.

Given these assorted facts, it is clear that the aromatherapist's approach will need to be flexible and varied according to the immediate circumstances of the asthma sufferer. During an actual crisis, inhaling an antispasmodic oil is the only practical help, and direct sniffing from the oil bottle, or some drops put on a tissue or hankie, will be safer than a steam inhalation, as the heat of the latter will increase any inflammation of the mucous membranes and make the congestion even worse. Moisture, however, is helpful, and a humidifier with a few drops of essential oil added is a good idea.

Unless the asthma sufferer is a member of the therapist's family or a close friend, treatment is more likely to be given between attacks. The whole thoracic area - back and chest - should be massaged, with particular emphasis on strokes which open out the chest and shoulders. The Shiatsu pressure point Lung No. 1 should be gently pressed for a second or two at a time during the massage. The choice of essential oils will depend on many factors, such as whether or not there is infection present, whether the asthma is known to be an allergic response, or whether emotional factors are involved. Bergamot, Camomile, Clary Sage, Lavender, Neroli and Rose are all antispasmodic oils which happen also to be antidepressant, so they offer a wide choice if you know that stress and anxiety are factors to be considered. Of these, Bergamot and Lavender are also good for chest infections and Camomile is always associated with the treatment of allergies. Another oil, which is not described by any of the standard reference works as being used for asthma, but which f have found very helpful indeed, is Frankincense. Frankincense is often used in treating bronchitis and catarrh, so it can help where there is congestion and/or infection present, but I think that a more important factor is that it is known to slow and deepen the breathing, which is why it is often used as an aid to meditation. This has a very calming effect, and I have found it one of the most beneficial oils of all for asthma sufferers.

Yoga and other forms of gentle exercise which improve posture and help to open the lung are usually very helpful, and in many cases improved nutrition will reduce the number and severity of attacks.