One of the biggest medical failures of recent years is treatment for asthma. Despite greater diagnostic skills, better identification of causes of the disease and ever whizzier drug cocktails to treat it, doctors and asthma associations are stymied by the fact that the epidemic incidence of asthma and asthma related deaths are continuing to go up. Indeed, many authorities in medicine admit the cure is infinitely worse than the disease and that the drugs developed to alleviate symptoms of asthma are mainly behind the sharp rise in deaths.

Things have reached such crisis proportions that last April a UK task force on asthma was set up by the National Asthma Campaign to investigate why deaths are going up and how safe or appropriate the drugs are for relief of the problem. A similar study is also being conducted with participating medical centres from New Zealand, Germany, Britain and America. Here is the latest about the dangers of conventional treatments and a variety of alternatives for controlling your symptoms without drugs.

As with most allergies, cases of asthma are sharply on the rise. In a recent study of children in Aberdeen, cases diagnosed as asthma had more than doubled over a similar survey in the same area conducted 25 years ago. (The researchers said that part of the increase may be due to changes in diagnostic labelling that is, more wheezing identified as asthma and heightened awareness by GPs of respiratory symptoms.) But other enquiries suggest the real percentage increase may be higher; the UK asthma taskforce disclosed that treatment for asthma has doubled in the past 10 years. During that time, hospital admissions have trebled for all victims and risen fivefold among young children. In Britain alone, the number of deaths rose to 2000 in 1988 and has only fallen slightly since. This compares to a death rate of virtually zero before the 1950s.

Allergist Dr David Freed quotes a 1929 medical textbook (J J Conybears' A Textbook of Medicine, published by Livingstone in Edinburgh) as saying, "It is doubtful whether death has ever been caused by uncomplicated asthma [ie, asthma without emphysema]." The rise of asthma corresponds to an epidemic of all forms of atopic (hypersensitivity) disease, including hay fever and eczema.

Why is this happening in such epidemic proportions? No one doubts that the hypersensitivity causing the muscles of the little bronchioles to constrict (and the tubes to become inflamed and filled with mucus) has to do with allergies. The conventional view maintains that the main culprits are grass pollen or the house dust mite Dermatophagodies pteronyssinus. This little creature is much more prevalent in homes today because of fitted carpets, heat and insulation, according to Sporik et al, writing in the New England Journal of Medicine in 1990. It is also believed to be genetic. One third of patients have a relative who has suffered from asthma, according to Dr Ruth Lever in A Guide to Common Illness (Penguin 1990).

In people prone to asthma, the low ozone levels of urban environments can make things worse, according to a Canadian study in the Lancet (27 July 1991). A recent study from France also showed that bronchospasm can be triggered by commercial polyurethane foam for insulating homes. But house dust mites seem to be a very small part of the story (see box, p 3 for other prevalent causes).