Yoga and Bronchial Asthma

In an earlier letter I referred to the use of Neti, Nadishodhana.

Kapalabhati, etc., for keeping the upper respiratory tract in good

condition and being able to deal with many upper respiratory ailments

like sinusitis, rhinitis, chronic sneezing, etc. Neti uses water or a

twine to cleanse the upper respiratory tract and Nadishodhana in a way

is neti using air as the cleansing medium. The lower respiratory tract

has its own idiosyncrasies. The air warmed and moistened in the upper

respiratory tract enters the trachea and flows through the bronchial

tubes to the lungs. The bronchial tubes are a sensitive pair and tend

to contract and dilate during the breathing cycle . Some yogis who

have one foot in yoga and the other in modern medicine have suggested

that the Kurma nadi mentioned in the yoga texts refers to the

bronchial section of the respiratory system—nadis are after all tubes.

This sensitive nadi causes problems in certain people. The bronchial

tubes tend to dilate and contract respectively during inhalation and

exhalation in normal people at normal times. But in certain people

they tend to contract during expiration but do not dilate sufficiently

or remain contracted even during inhalation restricting the free

passage of air. Because of the narrowing of this section of the

airway, we hear the unique whistling sound as we find among

asthmatics. These constrictions in certain advanced cases can be

continuous but with many asthmatics it is intermittent.

The cause of this is usually attributed to allergens. Some allergens,

like pollen, dust, peanuts, cat’s hair or the spouse’s dandruff,

produce a reaction in the respiratory center due to which the impulses

coming from the Vagus nerve which control the bronchial tubes tend to

produce bronchial spasm. While in most people this does not happen,

this overreaction takes place in asthmatics. The conventional approach

to deal with this problem is two fold. One is to find out those foods

and pollutants which produce this condition and develop vairagya

towards them. Avoidance, a yogic trait is recommended. .”Keep away

from the offending allergens” is the dictum.  Another related approach

is to find out the various substances that one is allergic to and then

inject small doses of the allergens into the system. Hopefully over a

period of time the patient will develop some immunity to these

substances which she or he did not have. Related to this is to use

temporary medication to mainly dilate the bronchial tubes. Such

medications are available with allopathic doctors, ayurvedic vaidyas

and also as home remedies. My grandmother used to make a concoction of

several herbs (I do not remember the English names of them), turmeric,

black pepper, basil, cinnamon and a piece of dry date (to make it

palatable). So avoidance, developing artificial immunity and temporary

palliatives are the cures available for the millions of those who

suffer from the debilitating condition called bronchial asthma.

But the Yogis go one step deeper and say it is a functional disorder.

Even though allergens are the precipitating cause the root cause is

said to be sudden abnormal activity in the broncho-motor of the vagus

nucleus of the medulla. The external protein, the offending allergen,

excites reflectively in an asthmatic when the vagus motor nucleus is

irritable and unstable and produces the spasm of the bronchial tubes.

The lower tone of the sympathetic also contributes to this condition.

It is the malfunctioning of the respiratory center. In yogic parlance

it is the disturbance (prana prakopa) of the pranamaya kosa.

So rather than dealing with this problem empirically the yogic

procedures directly attempt to deal with and try to correct the

abnormality. One of  them is a unique procedure called Ujjayi

breathing. In this the vocal cords are approximated using the deep

throat and vocal chord muscles and the subject breathes through the

constriction produced, creating a unique sound, the Ujjayi hissing

sound. Normally we do not use these muscles in this particular way.

While yogis are familiar with this breathing for many others it is

unfamiliar. But since we keep the vocal cords together for a

considerable amount of time, breathing in and out, we tend to gain

control over these muscles.  Since the bronchial tubes are also

controlled by the same vagus nerve, one  would gain control over the

muscles activating the bronchial tubes. In fact the effect is optimal

if one does the Ujjayi correctly by using proper jalandhara bandha. In

this the chin is brought way down and placed against the breast bone

and the whole rib cage pulled up by straightening the spine, giving a

very powerful bandha. In such a lock, one is able to breathe,

controlling the breathing way down in the respiratory tract, very

close to the bronchial tubes, the kurma nadi. A few days of attentive

practice of this unusual procedure will bring very good control over

the lower respiratory tract musculature. Ujjayi breathing will appear

very unusual for non yogis. Further the prolonged, deliberate

constriction of this area will also stimulate the sympathetic to send

impulses to open the bronchial tubes and tone of the sympathetic also

will be improved. A better tone of the sympathetic will help dilate

the bronchial tubes during normal breathing. Without getting much into

technicalities it may be said that this reprogramming done for a

sufficiently long time will help the asthmatic have improved breathing

and less severe and less frequent attacks, and in some cases complete

normalcy. With proper care of food, reduced stress levels and other

yoga friendly life style changes and regular practice one could,

hopefully, be free of the debilitating asthmatic attacks. Ujjayi

closely resembles asthmatic breathing. Another concomitant problem is

the dry chronic cough. For this Bhastrika, which simulates a cough,

should be  practiced .

The other exercises that may be beneficial are, as you can guess, the

inversions, especially head stand. Once the patient is reasonably

healthy and strong the head stand or its variants with or without help

or props may be attempted. Headstand as it has been mentioned in

earlier articles, helps to direct the CSF into the ventricle in the

brain to stimulate the pituitary the secretions  which help produce

adrenalin, a hormone which used to be given in the olden days for

asthmatics. Further it nourishes the spinal nerves which will help the

proper functioning of the autonomic nervous system thereby giving a

healthy control over the bronchial tubes. A short stay in Sarvangasana

also is helpful as  it gives a natural jalandhaarabandha and the

quality  of Ujjayi breathing is also good. Assisted

sarvangasanaViparitakarani) can also be attempted

It is also a good practice to work on the accessory muscles to

breathing. In an asthmatic the chest muscles tend to be rigid and

breathing shallow. Arm exercises and thoracic exercises are very

helpful to free the tightness of the chest. Please refer to the hasta

vinyasas and the Parsva bhangi vinyasas in the Tadasana sequence in my

book “The Complete Book of Vinyasa Yoga”. Many of these exercises can

be done even sitting, and some even lying down depending on the

condition of the patient. Singing (perhaps in the bathroom), full

throated chanting (prabalam adhiyita)and reading aloud (with or

without an audience) are also helpful.

Yoga can be very useful for asthmatics as an adjunct therapy, one may

continue with medical treatment one is undergoing like allopathic,

ayurvedic or any other. Normally it will be a good idea to start

treating an asthmatic during the season when the atmospheric

pollutants are the least troublesome and asthmatic attacks minimal.

One may start with the accessory muscle exercises and then teach

Kapalabhati, then Bhastrika and Ujjayi breathing with Kumbhaka withing

one’s capacity. Some kind of assisted  inversion can be attempted

after the participant feels more comfortable. Over a period of time

with  regular practice almost everyone shows improvement. The

frequency and severity of the attacks come down.

When I started teaching way back in the mid seventies, with the

blessings of my guru, I taught yoga to a bunch of asthmatics in a

nearby hospital. The patients varied from about 8 years to about 60

years. I met each one individually once a week for about 8 weeks,

teaching them slowly and progressively. I did not keep any records but

later when I met the doctor he looked quite pleased. He mentioned that

many had shown improvements over a year and it was possible to reduce

and in one or two cases suspend medication. Their vital capacity

showed significant improvement. One important aspect of yoga therapy

is that the patient gets fully involved in it. When you give medicines

alone, the patient is a passive helpless participant. In yoga chikitsa

the patient is fully involved and when she/he sees improvement there

is a psychological boost– a feeling of achievement is there which

will help them practice regularly and take care of themselves. They

are slowly able to overcome the despair and helplessness associated

with these attacks and start becoming more positive. They start

feeling equal to the challenge.

When anyone asks me if yoga cikitsa works for bronchial asthma, I say

yes. Because I was an asthmatic as a teenager. Since I started

studying with my Guru I have been—touch wood– free of attacks, for 50

years now. Children from families who have asthmatic members may

benefit immensely from relevant yoga practice if they could start

appropriate yoga early in life.

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