Alternative and complementary medicine for asthma.

Alternative and complementary medicine for asthma Readers of the review by D J Lane and T V Lane (November 1991;46:787-97) might conclude that hypnosis has little to offer asthmatic patients.Although the report of Ewer and Stewart' is quoted as showing improvement in symptom scores and some peak expiratory flow rates and decreased use of bronchodilators, no mention is made of a 74-9% improvement (p < 0-01) in the degree of bronchial hyperresponsiveness to a stan- dardised methacholine challenge test.These authors state that "while our hypnotic tech- nique does not eliminate bronchial hyperresponsiveness it does provide a clinically useful and non-toxic adjuvant to drug treat- ment that might benefit about half of the asthmatic population."This approach could well reduce the use of the toxic drugs, such as troleandomycin, gold, azathioprine, and methotrexate, mentioned as steroid sparing agents by Shiner and Geddes.2The British Tuberculosis Association's study3 did not report negative results as stated in the review.On the contrary, "independent clinical assessors considered the asthma to be much better in 59% of the hypnosis groups and in 43% of the control group, the difference being significant."These results were obtained by using only direct suggestion under hypnosis plus autohypnosis daily; more advanced methods, such as reciprocal inhibition, were not used.In my own study4 it was possible to with- draw oral prednisolone or to reduce the dose in 14 of the 16 patients treated by hypnosis.The number of hospital admissions during the first year of hypnotherapy fell to 13, compared with 44 during the previous year.This represented a reduction of 249 hospital days, which, at 1988 costs (£170 per day), saved the NHS £42 330.As some 55 000 adults are admitted each year for asthma, savings to the NHS could be considerable if hypnotherapy were to be used more widely.