The research establishment won't fund it. The medical establishment won't countenance it. In GP surgeries up and down the land it's been dismissed as irrelevant. But among the people, among those patients who - despite the best efforts of the cleverest people in the medical profession - still can't breathe properly and are frittering away their health on increasingly noxious asthma drugs, the Buteyko method is not so easily patronised. Now at last these people have a champion. Dr Gerald Spence, a 43 year old GP in the East End of Glasgow, has spent the last year considering the claims of the Russian Professor Konstantin Buteyko that Western medicine has got the approach to asthma all wrong. He has become increasingly convinced that. Buteyko is right to see asthma as a breathing disorder which can be corrected by retraining our breathing .
When The Herald first brought the claimed successes of the Buteyko method to public attention more than a year ago, Dr Spence - virtually alone among his profession - was concerned enough at his own impotence in treating asthma effectively to attend a Buteyko workshop and see what was going on.
At Shettleston Health centre we spend £100,000 a year on asthma treatment - that's a tenth of the whole budget." he says "But it's not working. Constantly we have to increase the potency of the medication, and it's very distressing to see patient's intake go up and up, without them getting any better."
What he found at the Buteyko workshops was asthmatics of every shape, size, age and degree of severity, all but a few declaring themselves hugely better and able within days to reduce the sometimes vast amounts of medication previously needed to control their asthma symptoms. He was interested, but profoundly sceptical. Nobody teaches Buteyko's theories in this country's medical schools. The Siberian born physician, whom the medical committee of the Russian Parliament is currently considering for nomination for a Nobel Prize in Medicine, argues that all our ideas about deep breathing being good for us are fatally flawed. He argues that the more you breathe, the less oxygen actually gets to the cells of your body. This is because the air around you contains a much smaller proportion of carbon dioxide than your own body. Carbon dioxide is essential for the body's uptake of oxygen. Breathing too much results in a deficit of carbon dioxide, which reduces the level of oxygen in the blood and tissues.
According to this theory, asthmatics are breathing two, three, sometimes even four times as much as they should, and constriction of the airways is the body's defence. The body is asking to be given less air, not more. Reliever drugs to open the airways will, therefore, give temporary relief, but will soon force the body into stronger defences, which leads to more drugs, and so on, in an increasingly vicious spiral.
Barely able to believe that the answer to asthma could be that simple, Dr Spence was nevertheless spurred on by the results he was seeing. He decided to follow the progress of 60 asthmatics who had paid £290 to learn how to retrain their breathing. Of the 41 who responded to his survey over a six month period (27 females and 15 males aged from six to 77 years) 34 had continued with the exercises and reported significant reductions in asthma medication; indeed 12 people no longer used preventer or reliever at all. A further two had stopped the exercises but concentrated on breathing through their nose; both had stopped their reliever inhaler and one the preventer. Five people had abandoned the breathing method and described their asthma as unchanged.
"I am amazed at how well people have done" says Dr Spence. "I didn't expect these results. People were writing huge screeds on the back of the questionnaires, saying they had never felt better in their lives. I don't need fancy statistical techniques to see their is something very important going on."
In the letter he sent with the latest part of his survey he wrote, "Although this questionnaire does not have the rigour of a clinical trial, I feel that it provides very strong evidence that Buteyko breathing exercises, if continued, can control the symptoms of asthma and that medication can be reduced and in many cases stopped without apparent harm.
*Boosted by the results of the survey, Dr Spence has begun teaching his own asthma patients the Buteyko principles. When I joined him on his afternoon off he was sitting in a room in the surgery with a group from his asthma list, discussing how they were progressing after five days of breath-holding exercises and shallow breathing. All were enthusiastic. Mary Lafferty, so disabled by asthma that she can't take a job and is hooked up permanently to a drip which she carries in a pouch round her waist, was telling him she was amazed at how much better she felt. She spend s her time in and out of hospital. "I've been dead about 10 times"- and said this week had seen a great improvement in her condition. "I want to get rid of this bag" she said. "That's the first step"
Dr Spence nodded. "If Buteyko is correct she'll be off that bag before long", he said "because what we are trying to do here is make medication redundant. With asthma., you go by symptoms. If a patient is feeling better, you begin carefully to reduce the medication. A doctor doesn't need double-blind trials to see whether a patient has improved or not."
Therese Donaldson, 23, an administration officer from Barlinnie, said her asthma had become agonisingly bad over the past few months. But this week had been "amazingly helpful", and in consultation with Dr Spence she had already been able to reduce the high doses of medication. Rita Nimmo, a marketing distribution manager, said "It's been a definite help in five days. I couldn't believe it. I had all the girls in my department helping me with the exercises, because it's hard to hold your breath for long periods. I'll certainly continue because I feel in control of my asthma for the first time"
Leslie Gibbons, a police support officer, talked of shallow breathing being a "tremendous help". Support worker Kevin Patterson was delighted with the start he had made.
Dr Spence himself was surprised at how quickly they had all managed to reduce their breathing. As a group they were well motivated - so scunnered by the increasing amounts of medication needed to control their asthma that they were ready to work hard at self-help. He realises that other patients may not yield such good results, but has seen enough now to be convinced that Buteyko has got it right and his own profession's indifference is a dangerous misjudgement.
"We doctors check patient's weight, blood pressure, all sorts of things. What we never check is how much they are breathing or how fast they are breathing. The trouble is that hyperventilation, or overbreathing, is taught at medical school as an acute condition. The effects of chronic hyperventilation are never studied, as far as I can recall .
"Doctors ignore breathing and concentrate on the amount of stuff they can get into the asthmatic chest. Buteyko says the opposite - that only by reducing the drugs that open the airways, and by reducing the air, will asthma go away.
"There's a staggering amount of research money around. It's time some of it went into researching this theory. Their reluctance to take it seriously brings into disrepute the whole research establishment. As doctors we tend to be influenced by individual things that happen to our patients, not by fancy medical trials. I have seen this work, therefore I am going to promote it".
At his surgery in a part of Glasgow where there is much deprivation and where asthma is on the rise as it is everywhere - partly, he believes, through over prescription of drugs - Gerald Spence is now preparing for battle. With nobody in the UK apparently prepared to do the rigorous trials that would settle the matter conclusively, he has only one small weapon: he has seen it work.
He is depressed by the continuing indifference of his fellow health professionals, although some may respond to an invitation from Buteyko practitioner Christopher Drake to watch the method being taught to asthmatics every evening this week at a workshop in the Health and Stress Clinic in Glasgow's Clarkston Road. Dr Spence now believes with some passion that doctors who want the best for asthmatic patients should consider the Buteyko insights on shallow breathing.
"Any GP surgery could do what I'm doing" he says. "Any asthma nurse. And in the long run this would not be a job for doctors at all, but for nursery nurses and gym teachers, parents and everyone. They should be saying all the time "Mouth shut". All that 'Take a deep breath, fill your lungs with air' - it's a load of rubbish."
He knows there is a great deal of hostility to Buteyko, especially among hospital doctors. "I feel despondent at the thought of the battle that's ahead ," he says, "but I'm ready. The man who came up with the theory that germs caused ulcers was laughed at once."