Dr.

BREATH
,,
THE STORY OF BREATHING

COORDIN AnON

by Carl Stough
'"
with Reece Stough

William Morrow and Company, Inc.

New York, 1970
f1lf7
LlHJ

ROD156 93232
 This book is for our beloved daughter,
LEE,
Copyright © 1970 by Carl Stough and Reece Stough
without whom it would never have been written.
All rights reserved. No part of this book may be repro-
duced or utilized in any form Or by any means, elec-
tronic or mechauical, including photocopying, recording
Orby any information storage and retrieval system, with-
out permission in writing from the Publisher. Inquiries
should be addressed to William Morrow and Company,
Inc., 105 Madison Ave., New York, N.Y. 10016.

Printed in the United States of America by

American Book-Stratford Press, Ine., New York, N.Y.

Library of Congress Catalog Card Number 73-119847

TABLE OF CONTENTS

Prologue The Elusive Quarry 9

I Dr. Breath '3
2 What Is It? 25
3 Over the Shoulder 37
4 The Witch Doctor 49
5 Search for an Answer 61
6 Exploring No-Man's-Land 73
7 A Battle Is Fought 85
8 The Common Factor 97
9 A New Direction III

10 Metamorphosis 12 3

]] Growth and Development '35

12 The Trailer in the Lonesome Pines '45
13 Slaying the Dragon '53
14 A Look at the Athlete 161
15 The Sounds of Tahoe '7'
16 Devils and Fiends '79
17 Troubles in Small Packages 187
18 Ounces and Pounds '95
19 Half a Loaf 203

20 A Swing of the Pendulum 211

7
 Contenu

21 The Master Switch 219

22 Where Danger Lies 229

23 The Crystal Ball 239
2'1 Dr. Breath Tums the Last Stone Prologue

THE ELUSIVE QUARRY

In the year 1968, while continuing pursuit of the

elusive quarry I have sought for the better part of a lifetime,
I had the privilege of serving the United States Olympic
Committee as respiratory consultant in preparation for the
high altitude competitions of the XIX Olympiad in Mexico
City. I came into that position through circumstance which
created for me an unusual profession and resulted in an un-
usual discovery.
The elusive quarry I have pursued is no common variety of
game; it is, rather, answers to the many problems involved in
the seemingly ordinary, taken-far-granted act of breathing.
Far from being ordinary, the act of breathing is a transform-
ing potential, as the following account of several phases of
my pursuit of the elusive quarry will indicate.

8
DR. BREATH
The Story of Breathing Coordination
 1
DR. BREATH

On certain afternoons in the spring of 1968, vis-

itors to the fieldhouse at the Yale University track in New
Haven, Connecticut, might have read this cryptic legend
scrawled across the bulletin board:
DR. BREATH IS HERE TODAY!

And they might have heard the colorful comments of athletes

trying to unriddle words which only the initiate could have
interpreted.
The first time I saw it, I was transfixed. I felt that it should
convey some sort of meaning. A second reading stirred up a
vague restlessness at the back of my mind. The third time
around delivered the message. Being quite alone at that mo-
ment, I could afford to risk my dignity with loud, soul-satisfy-
ing laughter.
"Dr. Breath is here today!" I struggled to recover my corn-
posure and get on with my business. Marvelous how five
simple words could reduce high purpose to absurdity. I won-
dered whose creative mind had produced that sparkling wit.
Before I could clear the fieldhouse, a group of athletes
burst in and paused to skim the bulletin board for the instruc-

13
 Dr. Breath Dr. Breath
tions of the day. The "Dr Br " But now that I had been dubbed "Dr. Breath" in all the
as at first it had I' eath bafBed them as completely
grandeur of the fieldhouse bulletin board, I was in. I had
them but I d ided could have solved the mystery for
, eCI e to let th d made it over the psychological hurdles. Dr. Breath could go
went on out to th t k em 0 that for themselves. I forth to meet the challenges of the afternoon, secure in the
"Dr. Breath" Ie rae and left them to their speculations.
, repeated Wh b knowledge that for once the odds were in his favor.
undergraduate could have' 0 ~t a supposedly serious As my new title indicated, I dealt with the process of
bered that I wa come up WIth that one? I rernern- breathing. Since there are many methods of breathing and
could never agatn sbuppo~edto be serious, and I knew that I many exponents of each of the methods, the mere mention
, e quite so seri b f
with the fieldho b I' IOUSas e ore my encounter of breathing is likely to prompt a humorous dismissal or a
I use u letin board
was Dr. Breath . heated controversy, The subject is delicate, possibly because
Undeniably, the ~itle was '. " very little scientific exploration has been conducted in the
not a doctor of a ki d descnphve, If inaccurate. I was field. Breathing is too obvious to arouse much curiosity, and
ever, always mindfnyI m f nor was I lik ley I to be one. How- curiosity is the soul of investigation.
u 0 small blessi I
my medical degree ' d essmgs, determined to take Most of my adult life, then some twenty years, has been
many things in th mgoog race. I' mIght have dreamed of concerned with the process of breathing and its effects upon
th em was not a medi e course
I d of my lifI e, b ut certainly one of
ca the various actions and reactions of individuals. For ten
University. Alth h Il egree conferred upon me at Yale years I had been working with the breathing problems of
I oug would f '
p eased nonethel esstoh, orego Its use in public , I was the desperately iII, and for seven years I had been engaged
needed to know b ave receIved it. It told me all I in a medical study at the West Haven Veterans Administra-
I a out my work t Y I
was no longer an 0 tsid a a e. I had a nickname. tion Hospital in West Haven, Connecticut. The afternoon of
SUSpIClonskept'
" , U I er to be vi
rewed WIt ' h suspicion
, IClsmd'd' . my elevation to the brotherhood of the fieldhouse elite I had
customed to a cert ' I not disturb me. I had grown ac- just come from the West Haven VA Hospital, where I had
a am amount d
s one of the hazards f an was prepared to accept it been working with patients in the advanced stages of emphy-
glad to be past it be my profession. However I was always sema. I looked forward to my encounter with the young ath-
d'ffi
I cult. I, ecause'tI made my work ' unnecessarily
letes, whose problems were less complicated.
Compared with what I h d b For several weeks I had been coming to Yale to work with
was pure pleasure. Still a een doing, the project at Yale select members of Coach Robert Giegengack's track team. I
atmosphere. I did not reedvestige of reservation hung in the was engaged in an unusual athletic study of breathing effi-
me wh t nee a qu tit '
th . ,a the uninitiate an 1 y of Imagination to tell ciency for my own organization, The Stough Institute, in
were
e 11lItiatetheir polite h thmking, nor did I begrudge cooperation with the United States Olympic Committee,
wh en observed from a di eSltahon ' M Y achvltIes' , , looked silly
whom I served as respiratory consultant. The project was one
outset t o th e person withIStance
h ' a nd t h ey seemed silly at the of mutual interest. The Institute wanted to find out as much
w om I worked.
1'1 15
 ---~~ - --~ - -

Dr. Breath Dr. Breath

as possible about the respiratory condition and habits of ath- time required for warm-up and recovery. To everyone's
letes at the peak of condition, and the usoc wanted to know amazement, including my own, the benefits of breathing
to what degree an athlete might benefit from the use of a coordination spilled over into wholly unanticipated areas.
new method of breathing called SIMBIC or "breathing co- Athletes and coaches involved in the initial studies were
ordination." elated to find that performances invariably improved as soon
My job for the Institute was to examine the respiratory as a certain stage of development had been reached. SIMBIC
pro.cesseso~~he.subjects at the outset to determine any faults could not give anyone an ability he did not already possess,
or megulanhes m the breathing mechanism or the breathing but it could enable him to use his ability to his full potential.
patte.m. That done, SIMBIC instruction could begin. Faults The temptation to emphasize the increase in performance
and Irregularities could be corrected as the instruction pro- ability brought about by breathing coordination was great,
ceeded and the subject developed his coordination. The end but I decided on a course of resistance. Performance improve-
pro~uct of such training and development was maximum ment is an immediate, indisputable advantage and certainly
efficiencyof breathing achieved with minimum effort. Obser- a gratifying one. However, it should not obscure the long-
vations and exchanges throughout would indicate the effect range benefits in terms of health and well-being. I was as
of
. the b ~eathimg m. oth er than strictly respiratory areas. The pleased by the disappearance of muscular spasms and nervous
mformahon so obtained would later be correlated with other stomachs as I was by the appearance of new records. I hoped
material to build t oward b roa d er understanding
. of breathing
. tha t SIMBIC would become a way of life for my trainees, not
in relationship to total body function. just a means to an immediate end.
~e Olympic Committee was interested specifically in in- When the incorporation of breathing coordination into
~reasm.g breathing efficiency. The specter of high altitude the Olympic High Altitude Training Program came to con-
.reathmg problems was troubling the sports world as the sideration, my chief concern was in the area of recovery. I
time of the 1968 Olympic Games in Mexico City drew had observed that in recovering from performance, athletes
nearer. .Increased breathing efficiency would enable athletes tended to adopt the same breathing characteristics as those
to provide their b di .h the emphysema patient exhibited. Enough emphysema pa-
I 0 ies Wit an extra margin of energy that
cou d mean the difference between victory and defeat. If tients who had been former athletes had cometo me for
SIMBIC supplied th t t . SIMBIC instruction to convince me of a link between emphy-
I a ex ra margm of energy one of the prob-
elms w~uld be solved and, in all likeliho~d several others sema in later life and excessive demands on the respiratory
a ong with it. ' mechanism in youth. The decreased oxygen content of the
. My earlier work' in a thleti
etics h ad turned out some interest-
. atmosphere at high altitude would compound greatly the
mg results which I h d normal problems of recovery.
th ' ope to reproduce at Yale. My original
eory
. . was that by b reathimg Wit . h maximum efficiency an d The pilot study at Yale involved a qlantity of planning
mlmmum energy di and expense for the Institute; therefore;' I was particularly
expen iture the athlete could reduce the
16 17
'.
 - ----~-----

Dr. Breath Dr. Breath

eager for it to go well. The key figure in the undertaking was teaching jaunt. I had commitments which kept me in the
Robert Giegengack, head coach for the 1964 Tokyo Olympics Northeast and would have necessitated constant commuting.
and then vice chairman of the Men's Olympic Track and Even if a venture of that nature had been possible, time
Field Committee. Breathing coordination results with ath- had run out. Although Dr. Stiles and I had been considering
letes had already convinced the Olympic Medical Training and working toward the project since 1966, a series of set-
and Services Committee, headed by Dr. Merritt Stiles, then backs had delayed it. We seemed to have moved from one
usoc second vice president, of the value of incorporating cancelation or postponement to another.
SrMB1Ginstruction into the high altitude program for the Originally, the exploration of the possibilities of breathing
Olympic candidates. The final decision, however, lay with coordination was to have begun in January of 1967, using the
the coaches. The object of the Yale project was to demon- Yale swimming team as subjects. Had the outcome been
strate with action what at that time, to any practical-minded favorable, a follow-through with other Olympic coaches
coach, amounted to little more than hearsay. Coach Ciegen- across the country would have been scheduled. Ironically,
gack's skepticism was understandable. He had to pass judg- Professor Robert Kiphuth, the mentor of the USOG,died two
ment on an intangible that might be influenced by anyone days before the meeting set to discuss my proposals for pro-
of a number of factors. cedure. He was an important figure in my particular area of
If I had been advocating the use of a new-model track operation, and his sudden death necessitated many revisions
shoe or some form of equipment, I could have tested my in Olympic planning. What should have been completed in
wares at Yale. If they had proved to be successful there, I the spring of 1967 had to be postponed until midwinter of
could have shipped them across the country for other coaches 1968. Nothing more could be done about it.
to try with their teams. Each coach could have judged my When midwinter of 1968 finally came around, Coach
product on its merits as he saw them, and a decision to accept Giegengack agreed to let me work with his trackmen. He was
or reject could have been reached easily enough. familiar with the preliminary athletic studies and with the
Unhappily, such was not my good fortune. I was not dem- medical background of SrMBIGand was ready to try anything
onstrating the merits of track shoes. No tangible product was that might be good for his athletes. I realized very soon how
involved. I was attempting to introduce a new idea: that fortunate I was to encounter a man so willing to give a new
manner of breathing was of vital importance both to the
idea a chance. His initial skepticism did not influence his
athlete's performance and to his health and general well-being.
observations and evaluations.
Furthermore, the new idea involved a number of complex-
The instruction schedule had to be tight because every-
ities, not the least of which was a new method of teaching.
body's time was at a premium. I projected ten individual
To carry the complication one step more, only I could teach
the new method. instruction sessions for each man over a period of five weeks.
At the end of that period a valid evaluation could be made
It was not humanly possible for me to go on a crosscountry
19
18
 Dr. Breath
Dr. Breath
could have sounded the unvoiced question: This is breathing
and future procedure could be determined. "Gieg," as the
instruction? The only indication of anything out of the
Yale men called him, approved this schedule.
ordinary, though, was a few protracted seconds of awed hush
Considering how the instruction began at the "Cage," the
before the effort to restore normalcy began.
Yale indoor track, I would not have been surprised by any-
First sessions are an unknown quantity. Progress depends
thing that might have happened. It is a tribute to the cour-
upon the physical and mental state of the subject. I had not
tesy of the track team that I survived the first session. hoped for much progress in my initial public appearance at the
Although Gieg had a conventional office elsewhere, at the Cage, but I might have spared myself this pessimism, for my
Cage his informal "office," so termed by the track wits, was young man was completely receptive and responded quickly
a set of high steps against the wall, from which vantage to instruction. When I could feel his body relaxing beneath
point he could keep an eye on everybody and everything. My my touch, I knew the battle was half won. Absurd as the
own officewas of similar informality: a table a few feet away, maneuvers may have appeared to onlookers, breathing coor-
in full view of every passing runner. dination had been established and the subject was aware of
Time and circumstance had made me a master of improvi- the change within himself.
sation, and I was not given to shyness; even so, I did usually At the end of the session he slid off the table and stretched.
have a certain semblance of privacy in my work. But if that "I never felt so relaxed in my life," he announced jubilantly
could not be, it could not be. Before I could think twice, to the apprehensive trackman next in order.
Gieg had summoned a runner and introduced us. As we The beginning was over! By the end of the afternoon the
proceeded to my office, the young man was politely attentive, inner circle had gathered about the table to watch my final
and the atmosphere of the Cage became charged with session with Team Captain Mark Young, who had an obvious
curiosity. breathing problem and exhibited serious, unsuspected breath-
I knew how ridiculous the next scene would appear, and I ing faults. While I corrected his breathing pattern, his team-
could guess how foolish my first subject was sure to feel. As mates kidded him mercilessly.
briefly as possible, I explained purposes and procedure, then "Hey, Mark! You're not even breathing," someone called.
I asked him to lie down on the table. Only a split-second of hesi- "How do you manage to get around the track? Think you
tation and he stretched out full-length under the questioning can finish today?" needled another.
gaze of his teammates. Silently, I accorded him a share of the Their easy humor assured me that I was well on the way
pity I was meting out to myself. toward my goal. Later Gieg's satisfied expression confirmed
Palpation, or touch, is essential in determining the existing my belief. The seeming handicap of my private office in
state of the respiratory muscles and the structure of the chest. public view had proved its advantages. Because each of the
Having no alternative, I began to move my fingers lightly over runners could see for himself what was happening to the
his chest. The corner of his mouth twitched uncertainly. I others, instruction became progressively easier. The reserve

20 21
 Dr. Breath Dr. Breath

had vanished by the time I got to Mark and I was able to had not worked in the field of athletics long enough to make
work with him much more effectively than I might have been any kind of predictions. On the basis of my experience in
in other circumstances. other areas, I knew what was reasonable to expect. I would
After two sessions I could discern the improvement in just have to wait to see whether my expectations would be
breathing and the steady response to the coordinated pat- fulfilled and whether that fulfillment would be sufficient to
tern. The athletes were attending my instruction sessions influence the decision of the Olympic coaches.
faithfully and doing their best to incorporate the new mode
of breathing into their total daily activity. The speed of
their development astonished me. Their bodies were so well-
coordinated to begin with that they were able to achieve
quickly the new coordination of the respiratory muscles.
By the third sessions the athletes themselves could identify
a change in habits and sensations. One discovered that he had
been holding his breath in class, particularly during examina-
tions. He also confessed sheepishly to abandonment of his
practice of taking sugar cubes and "over-ventilating" prior to
racing, a futile and dangerous folly often exercised in the
hope of gaining extra energy and oxygen. (Gieg's face took
on an explosive purple hue when he learned of this secret
sin.) Another found that he no longer had trouble falling
asleep at night. A third noted relaxation of customary ten-
s~ons.Still another, an asthma sufferer plagued by dust irrita-
tion, reported pronounced improvement in his condition.
Soon after these. subjective improvements began to appear,
Dr. Breath came into being. No one ever addressed me in
that fashion, but if anyone had, I would not have been
off~nd~d. I accepted the title as an indication of rapport,
which ISex~emely important to the learning process.
That point marked the end of the introductory phase of
the Yale .pro)'ect . Subijectiive Improvements
. were increasing
from session to sessiion, aII reservations
. had been removed
and degrees f i ,
o Improvement were noted in performance. I
22
23
 --- - ~ ---- --

2
WHAT IS IT?

"\I\i:iting-for transport, people, events-has been

one of the few certainties of my life. As a matter of preserva-
tion of sanity, I have had to learn to wait creatively. When
nothing I can do will hasten the desired result, I try to use the
time between to advantage. While I was waiting for the Yale
athletes to develop their breathing coordination, my mind kept
turning to a familiar problem that I had not solved to my com-
plete satisfaction. I decided to work on it as a worthwhile
diversion.
In teaching a new pupil breathing coordination, I generally
follow a more-or-less regular pattern. Since most people are
rather vague about the respiratory system and its functions, a
brief description of what breathing involves is the starting
point. After that comes an outline of procedure, then I set
about establishing breathing coordination.
Once breathing coordination is established, I can say with
complete aplomb, "There you are. That's breathing coordina-
tion."
Having just transferred from one state to another, the pupil
has the experience of a distinct sensation and can say wisely,
HOh."

25
 ...",- .... '"

Dr. Breath What Is It?

Chances are that he will not pursue the subject further at both voluntary and involuntary, and provides the most effi-
this point of learning. He knows from his personal experience cient deflation and inflation of the lungs with the least
what breathing coordination is and in what way it is different amount of effort.
from previous experiences and sensations. Until he has pro- People have been breathing for a long time, for so lon~ th~t
gressed to a much higher stage of development, he is not likely . to wh a t h e I.
no one pays much attention is doing.' Breathing IS
to ask himself, or me, for a definition and explanation of equated with being alive, and like being alive, It has been left
breathing coordination. Even then he will be satisfied easily to the sages to ponder. Philosophies have cent~red about
because he will be dealing with a known factor. breathing. The profundity of breathing is honored in the com-
The unknown provokes curiosity and leads to pursuit of sat- monplaces of everyday speech. .
isfaction. The person who has not experienced breathing co- Cliches abound. How many people have "caught their
ordination is the one who poses the question "What is it?" breath" in surprise? How many patients have been ,:old t~
That is a forthright question which merits a forthright answer. "take a deep breath"? Those who run will surely be out 0"
Denied a forthright answer, the questioner may well doubt the breath." Anything of great import is "the very breath of life.
validity of what he cannot experience for himself. For some Children used to "hold their breath" to bring round stubborn
time prior to the Yale project I had been trying to define and parents and nurses. The mate hl ess b eau ty of the heroine takes
h"
explain SIMBICfor those whom I could not teach. I wanted to away the hero ,s breath. 0 n teo
h th er h an,d her "bad breat
nail down with ~nmistaka~le terms all the elusive ideas com- can take away the hero himself. . h fi t
pounding breathmg coordination, Therein lay my problem. It I
Everywhere constant y, peop e are I breathing . It IS t e rs
was quite large enough to occupy the waiting gap in the Yale
project.
thing they do' when they come into the world. It becomes 0:
habit. When they break the habit, they very speedtly dep.art in
Breathing coordination can be defined very readily, but it . "b rea th e ou t", that I'S.,Yet from the first
explre- . breathing . un-
ca~not be explained with matching ease. Part of the difficulty to the last breathing out, few think about their breathmg f
anses from a lack of appropriate terminology. SIMBICis new. less it troubles them. Even those who deal with the act id
The terminology having to do with respiratory functions car- .
breathing are often Ignorant 0 f t h e mec hani
am cs of breathmg .' an
nes WIth It overtones and implications which create prejudice . t C versely SCIentIsts
the functions of the respiratory sys em. on '. f
and obscure the ideas presented. New terms have had to be in- who deal with the mechanics of breathing and the functions 0
vented to convey the new thought in breathing.
the respiratory system seldom h ave muc h time I to
. spare . for in-
.
"Breathing coordination" itself is a new term conceived to hi . elatlOnshlp to ItS
vestigation of the act of breat mg m r
embody the thoughts, observations, and conclusions of two
influence on the whole individual. . lif f
decades of investigation of the human respiratory process. By
Breathing is the unknown quantity separatmg I e Irom
defimtlOn,breathmg coordination is breathing in that individ- . . t stem. t re-
death. It is the major function of the respira ory sy . b
ualistic pattern which engages all the muscles of respiration, . les those whIch can e
quires the use of both voluntary muse ,
26
27
 Dr. Breath What Is It?

controlled at will, and involuntary, those over which no con- short periods. Happily, life depends not upon breathing coordi-
trol can be exercised or which can be influenced only indirectly nation, only upon breathing. The body's marvelous ability
by other muscles or forces. In the act of breathing the muscles to compensate weakness in one area with strength in another
compel the lungs to contract and expand to move air out and keeps the respiratory muscles functioning in spite of any stress
in. Once the air is taken into the lungs, various physiological or damage. Since altered breathing patterns have served the
processes occur, but they do not fall within the province of human race through the ages, it would be a little foolish to sug-
breathing. gest that they be jettisoned now.
Breathing coordination deals strictly with the movement of The difference in breathing in the coordinated pattern and
ai: out and in the lungs. As the term implies, it has to do in an altered pattern is the difference between operating at
Withthe working together of all the muscles involved in the act peak efficiency and just getting along. An engine does not have
of breathing. A normal, healthy infant is born with breathing to be in tip-top condition to work, but it gives a better per-
coordination, with his own particular pattern of breathing in formance if it is. When the breathing potential is fulfilled,
which the muscles function synergistically to produce a greater potentials in other areas are fulfilled; hence, the importance of
flow of air out and in the lungs than could be achieved by hreathing coordination to athletes, especially. The body's en-
a~y other ~attern. Somewhere along the paths of childhood he ergy derives from the oxygen in the air breathed; the more
Willlose his breathing coordination for one reason or another efficient the breathing, the more oxygen will be delivered to the
Work with hundreds of children over a period of more than body. Breathing puts gas in the tank, so to speak, and it is wise
fifteen years has revealed the loss of breathing coordination as to keep the pump working.
early as the age of two-and-a-half years. Follow-up studies have Although the muscles of breathing will not of themselves
failed to show a single case of permanent restoration. Often, return to the abandoned coordination of infancy, they can be
~hyslcally well-coordinated persons, athletes in particular, will
trained to function again in the original synergistic pattern of
"appen upon breathmg coordination and will identify it as
breathing coordination. A person who has been properly in-
gettmg the se~ond wind." Others will fall into it by chance
structed and who can exercise self-discipline can maintain his
an.d.Will expenence a high sense of well-being. When the
original pattern breathing coordination indefinitely. Breathing coordination is
. has been lost ' the probability
I I 0f regammg
.. .
It a physical discipline which must be constantly attended, as any
krmanently ISremote. Although the sensation may be remem-
N red cl~arly, the knowledge necessary to achieve it is lacking skill must be.
o.routme has ~et been developed to enable an individual t~ The muscles of breathing cannot be brought into the indi-
~rnve at breathmg coordination without the aid of a skilled vidualistic pattern of breathing coordination by the exertion
mstructor. of force, either that of the voluntary muscles or applied ex-
losWhen breathing coordination is lost, it would seem to be ternal force. They respond only to light external pressure in
t forever, except for occasional, fortuitous restoration over combination with the pressure of the air within the lungs.

28 29
 Dr. Breath What Is It?

Herein lies the distinction between breathing coordination and means taken to improve breathing habits will pay dividends in
the many, varied schools of breathing techniques. good health. Those who are in poor health or who suffer respir-
Exponents of the various systems of breathing deal, know- atory disease or disorder should take great care in the method
ingly or unwittingly, with the voluntary muscles, which can be followed to improve their breathing. Practices which impose
controlled at will and can effectively influence the passage of undue stress on any part of the respiratory apparatus are sus-
air out and in the lungs. Since most people breathe at the low- pect. Where there is existing weakness, they can cause dam-
est level of the body's demand for oxygen, anything they do to age; where there is already damage, it may become more so.
improve their breathing habits is worthwhile. Thousands of No one would consider attempting to run with a broken leg,
people who adhere to a breathing regime can attest that they nor should anyone with respiratory damage consider vigorous
feel better when they pay attention to their breathing and are exercises calculated to improve breathing. The resulting harm
soon aware of a change for the worse when they neglect it. to weakened areas would outweigh any smaJJ measure of good.
Everyone has had the refreshing experience of taking several Encounters with young and old, sick and well have made
'~good,deep breaths." Breathing is the most important act in me acutely aware of the prevalence of respiratory problems and
hfe. To neglect it is unwise. the ramifications of respiratory disorders. Quite apart from
In contrast to the other systems, breathing coordination confirming statistics, I have observed a steady rise in respira-
bears significantly upon the involuntary muscles. Lying as they tory complaints since the late 1950'S. The increasing pressures
do be~ond the control of the will, the involuntaries respond to and tensions of a highly commercialized society have pro-
t~e stimulus of the total respiratory condition at any given duced corresponding pressures and tensions within the body.
time. Just as the digestive processes of the stomach and the Body irregularities manifest themselves almost immediately
~at of the heart cannot be willed into action, neither can the in the breathing. Knowing the key role that breathing plays
Illvol~ntary muscles of respiration. They must be activated by in the interactions of the body systems, I have become
a dehcat~ balance of pressures within the respiratory system. more and more concerned by the seeming indifference of
The ~allltenance of that delicate balance is one aspect of the influential to the need for research and education in the
breathmg coordination.
field of breathing. Nothing exceeds in importance how and
Bec~use of the body's ability to compensate weakness what one breathes. All of life's problems halt abruptly when
b:eathmg goes on in spite of any damage sustained by the res: breathing stops. Yet, practicaJJy anything else is given prec~-
piratory mechamsm. Respiratory injuries can remain unde- dence. At one extreme is the individual who would rather die
tected for a lifetime and can produce endless b m' I' of emphysema than give up smoking. At the other ar.e ~he in-
ti ' a mg comp 1-
ca Ions. In the process of establishing breathing coordination dustrial interests, large and smaJJ, that befoul the au III the
respiratory damage and faults become apparent and can be name of commerce and for the sake of the economy.
managed effectively.
If any doubt exists as to the increase in respiratory irritation
For the well who are in good physical condition, almost any and infection, a visit to any public place and notation of the
30
31
 I .. __ ,
' -

Dr. Breath
What Is It?
number who cough or clear the throat or labor at breathing
should dispel it. After the opening of the Verrazano Nar- irregularities of the well. Having seen two-thirds of the respira-
rows bridge between Brooklyn and Staten Island, the incidence tory spectrum, I had a gnawing curiosity about the other third,
of respiratory infection in one Brooklyn community tripled the physically superior. I had worked with sportsmen and knew
within the first six months. Engine exhaust from the increased that their tendency to possess a higher degree of physical co-
flow of traffic through the community robbed the residents of ordination than most enabled them to adopt a new respiratory
their health. Respiratory infections have a cumulative effect. pattern very readily. I wanted to find out whether the superior
Most respiratory patients exhibit a background of infections athlete in top form had retained the rare ability to breathe in
and illnesses. From such minor occurrences major difficulties his original, perfectly coordinated pattern.
arise, because these seemingly minor irritations inflict a certain Breathing was a topic of considerable interest to the world
degree of damage every time they occur. of athletics even in the early winter of 1966 because of the
After the confirmation of the discovery of breathing coordi- anticipated problems of breathing in the high altitude of Mex-
nation in 1964, my concern for the general indifference in ico City at the 1968 Olympic Games. When I asked Dr. Mer-
the field of breathing had reached such a degree that action ritt Stiles for permission from the usoc Medical and Training
became imperative. In the late fall of 1965 The Stough Insti- Services Committee to audit projected symposia on breathing,
tute was incorporated under the laws of New York State as a he became interested in snrarc and its possible application to
non-profit membership organization with tax-exempt status. Olympic team candidates. The eventuality of Institute research
The manifold purpose of the Institute was designed to include work with Olympic candidates arose. Pleasing as this develop-
research and education in the field of breathing, development ment was, it implied a necessary delay in moving through of.
of methods of improving breathing habits, and stimulation ficial channels, and I was eager to begin the athletic study.
of thought and interest in the field. At that time the medical Although I had never worked with athletes seriously engaged
study of emphysema was in progress at the West Haven VA in competition, I felt certain that SIMBIC instruction would
Hospital and occupied my attention entirely. When that be of advantage to them. What I was not so certain of was its
particular program went into the final phases several weeks effect on the training program and possible interference with
later, I could begin to think about projects for the new performance timing. While I was waiting to hear from Dr.
Institute. So much needed to be done that I hardly knew Stiles, I decided to undertake a preliminary study to quell my
where to start. . uncertainties. I got in touch with Coach Frank Stellato of the
For a number of years my primary interest had been in the Boys' Clubs of New York, a former coach in all sports at West
breathing problems of the chronically iII, principally emphy- Point Military Academy, and outlined my proposal to him.
sema sufferers. I was thoroughly familiar with the breathing He was enthusiastic.
patterns and habits of the most hopeless of the advanced At the outset the main object was simply to determine the
emphysema patients. I was equally familiar with the faults and effect of SIMBIC on the athlete's warm-up and recovery. My
32 theory was that increased efficiency of breathing would reduce

33

..
 Dr. Breath What Is It?
warm-up time and conserve energy for performance. Similarly, aside any hesitations I might have had about the benefit of
recovery time would be cut. The young athletes assigned to SIMBIC to the athlete.
the breathing program were the club's finest. One was the My interest in the Olympic candidates became twofold. Not
Golden Gloves champion; another, a Golden Gloves run- only was I curious about their breathing patterns and habits,
ner-up. All participated in track and basketball. They had had I also was convinced that breathing coordination would pro-
no form of breathing instruction previously and were not aware vide a very definite health and safety factor at high altitude and
of a particular pattern of breathing either under normal con- that it would exert a favorable influence on performance. I
ditions or during sports participation. They seemed to be in sent off a report on the preliminary athletic study to Dr. Stiles
excellent condition. with the notation that SIMBIC could be incorporated into ath-
My first shock came when SIMBIC instruction began. Their letic training programs with considerable benefit.
physical condition belied their respiratory condition. Far Additional investigations in the field of athletics strength-
from being in the superior state I had expected, they all ened my convictions. When Dr. Stiles notified me of my
exhibited respiratory faults and weaknesses in varying degrees appointment as respiratory consultant to the Olympic Com-
of seriousness. However, their basic muscular coordination en- mittee, I set about formulating plans for projected instruction
abled them to learn rapidly, and after the emphysema patients, programs and was hoping to be able to begin immediately.
working with them was a joy. No sooner was all in readiness than the delays set in, and I was
The next several weeks were a series of shocks and revela- still waiting in the spring of 1968, the Olympics only months
tions. All my preconceived notions about the respiratory condi- away, to do what had for me become a sort of obsession.
tion of athletes were shattered. I was particularly disturbed
when I found that the stress of recovery after extreme exertion
throws the athlete into an aberrant pattern of breathing, for
such stress over a period of time could cause irreparable res-
piratory damage.
On the positive side, SIMBIC exhibited the anticipated
effects of releasing tensions and improving general health.
Warm-up and recovery times were reduced significantly. These
results alone would have been sufficiently gratifying, but there
was also the big, beautiful bonus of improved performance. My
apprehension that changing breathing patterns might disturb
performance was unnecessary. Other dramatic, positive results
of the study combined with the respiratory findings swept
34
35
 3
OVER THE SHOULDER

Often, as I shuttled between the West Haven VA

Hospital and the Yale track, from one extreme of my interests
to the other, I experienced a momentary loss of identity and
had to ask myself: "Who are you? What are you doing here?"
Who was I indeed? To my Yale men I was the amiable Dr.
Breath who appeared at appointed hours, performed a few
mystic rites, and somehow enabled them to convert the air
they breathed into physical power. To my West Haven men,
all advanced emphysema patients, I was their last hope, a kind
of combination Svengali-Simon Legree who could keep them
breathing after everything else had failed. To myself I had
become an enigma.
During the ten years prior to 1968 I had moved so swiftly
from one new situation into another that I had hardly had an
opportunity to adapt to one before another was thrust upon
me. Unsuspectingly, I had entered a world totally foreign to
me for what was to have been a limited visit and had remained
indefinitely. I was still there-more at ease, to be sure, but
never at home. A layman in the world of medicine is like a
mouse in a cage of tigers. I had not been devoured, but the
roaring had often rattled my bones. Frequent glances over the

37
 Dr. Breath Over the Shoulder
shoulder were necessary to reassure me that the cage had a pared myself as best I could and bravely set out for East
door through which I had entered, by invitation, and through Orange.
which I could leave, by choice. The antiseptic atmosphere of a hospital alone was enough to
Looking over my shoulder into the past, I am always startled jar my courage. The politely aloof reception of my future col-
by the number of situations to which I have had to orient my- leagues served to complete the job. When I got to the patients,
self quickly in spite of my confusion. Among the worst was I was operating on reflexes developed over the years of teach-
my first day at the East Orange, New Jersey, VA Hospital. I ing. Somehow I survived my introduction into the alien world
have become accustomed to hospitals, but I never will like of medicine and went on from bad to worse.
being in them, in any capacity. That day was something of a Within a short period I learned through the hospital under-
trauma. Had my faculties not been entirely numbed, I prob- ground that the physical therapists were grinding their axes
ably would have turned and walked out into more compatible because of a conflict of methods. Having no desire to bring
surroundings. I remained, however, and in all innocence discontent into the physical therapists' camp, I was happy
launched into the impossible. when Dr. Small suggested abandonment of the original project.
Early '958 marked the beginning of an adventure I never I would gladly have gone back across the Hudson to Manhat-
could have anticipated. Dr. Maurice J. Small, chief of tu- tan, but he had other plans to propose. Nothing was being
berculosis service at the East Orange VA Hospital, was looking done for emphysema patients; therefore, he reasoned, I might
for some form of breathing therapy to aid pre- and post-opera- as well have a try with them. Anything that could be done to
tive TB patients. Concurrently, a New York organization with help relieve their breathing difficulties would be of value.
which he was associated was seeking to extend the range of Emphysema was a word which then had not yet found its
services provided by its therapists. My work in the area of way into the general vocabulary, certainly not into mine. I
breathmg was familiar to the group, for I had achieved a repu- went back again to the library and I conferred with Dr. Small
tation as an mnovator of breathing technique for the produc- to learn as much as I could about something nobody seemed
tion of sound. I was asked to try to develop a method of to know very much about. Heretofore my objective had been
breathmg mstructlOn for the ill which therapists could be to get air into the lungs. In dealing with emphysema I found
taught to practice. I agreed. that I was expected to get it out, for emphysema is a condi-
My ignorance of the nature and complications of the disease tion in which air becomes trapped in the lungs and cannot
libr total. For several weeks I spent long hours in the medical be expelled as in regular breathing.
ibrary, a~d Dr. Small assured me of any aid I might require. Feeling somewhat at cross-purposes 'with myself, I let my
The respIratory mechanism can readily be damaged by misuse interest in breathing lure me from the relatively tranquil world
ds well as by abuse. I did not want to risk inflicting further of the well into the troubled atmosphere of the desperately ill.
amage upon those who had already suffered too much. I pre- The first patients assigned to me were all bed-patients in ad-
vanced stages of emphysema. They had been given every medi-
38
39
 Dr. Breath
Over the Shoulder
cation known for the disease and been written off as hopeless.
No one really expected anything to come of the project, for at hand on his chest and applied a little more pressure than usual.
that time emphysema was considered the end of the road. to try to make the chest descend into a more nearly normal po-
These men had reached the dead end. I could not succeed, sition. To my amazement, I could detect a slight relaxation
for there was no way to restore lung tissue. Nor could I fail, of the taut pectoral muscles and an ease in the breathing.
for the disease itself was the final failure. I could hope only to "Can you feel that?" I asked quickly.
help. He nodded. As I continued to apply gentle pressure to the
When I began to teach the emphysema patients how to upper chest, the relaxation continued and the breathing eased.
breathe, two facts were foremost in my thoughts: these men I followed the same procedure with the other patients, who
had lost their ability to breathe in an effective pattern and responded similarly. I realized then that for these men I could
their breathing mechanism was severely damaged. They could not use the devices employed to teach the well. They lacked
not tolerate excessiveexertion of any kind. Whatever was done the physical ability to assume attitudes and follow verbal in-
for them would have to be done without force and with great structions designed to produce certain effects on the breathing
care. If I had been cautious, I would have let well enough mechanism. They were supine, which fact alone necessitated a
alone, but I had become curious. There were many things I different approach, because the respiratory system responds
wanted to know. differently in the different physical positions and my instruc-
I particularly wanted to know why the emphysema pa- tions were geared principally to the upright position. Talking
tient's chest was raised. Upon inquiry, I was told that the raised to them was not sufficient; I would have to rely on touch. Un-
chest compensated weakness in other areas of the respira- like the well, they had no memory of the sensations of easy
tory mechanism and was a characteristic of the advanced breathing.
stages of the disease. The raised chest disturbed me endlessly When I agreed to accept the East Orange project, I thought
because I knew it to be so wrong and I wanted to put it right. naIvely in terms of adapting regular instruction procedure to
I used to go home from East Orange and observe the regular the particular needs of the individual. Each session with a bed-
breathing of my infant daughter as she slept. Her chest rose patient who could hardly speak above a whisper and who might
and fell effortlessly in a perfectly coordinated pattern. When I be taking oxygen throughout the session made increasingly
placed my hand upon her chest, I could feel the muscles re- clear to me the need to develop an entirely new method of
laxed beneath my touch. That was what I wanted to feel when teaching the technique of efficient breathing. I had not consid-
I placed my hand on a patient's chest. Instead, there was the ered this possibility. However, I was not expected to succeed.
tensed knotting of muscles laboring exhaustingly to perform I had been asked only to try. The least I could do was that. My
the act of breathing. misgivings were legion. .
Finally one day I could no longer resist the temptation. As I have wondered often what I might have done at that point
I was talking quietly with a patient to help him relax, I put my if I had not had my infant daughter to serve as a norm. I
strongly suspect that I would have abandoned East Orange

41
 Dr. Breath Over the Shoulder
and that my career would have gone quite another way. Con- back and totally lacking the energy for any exertion perform
stant observation of her breathing at rest kept firmly in my exercises? The answer came swiftly: they cannot. This left me
mind the impossible goal toward which I had to guide the exactly nowhere.
emphysema patient. Comparison between the perfect and the Since exercises were impossible, the only thing I could think
imperfect supplied a gauge of progress. of was to encourage the men to talk while I continued the
Little by little I came to recognize the distinguishing physi- light pressure over the stress areas of the chest. The procedure
cal characteristics of the emphysematous chest. I also noted worked well enough, but I was so busy trying to figure out what
that the breathing difficulties and physical irregularities dif- was happening physically that I could not be attentive enough
fered from patient to patient and that each had to be dealt to keep up a running conversation. I also noticed that as the
with according to his differences. By some instinct which I men tried to think of something to say or drifted to a painful
could not possibly explain, I was compelled to apply gentle subject, they tended to tighten the muscles. I began to make
pressure to any part of the chest which was not functioning up sentences for them to repeat and added words aud phrases
in a normal pattern. The rnuscles always tended to respond as their ability to extend the exertion increased. I encouraged
and breathing became easier. With light palpation of the
them to follow the practice between sessions, always striving
various areas of the chest I could establish a pattern of easy to keep the sensation of the easy breathing achieved with my
breathing similar to the regular pattern of my daughter. Once aid. To my utter amazement, it worked!
the patient had learned to recognize the feel of the new pat-
Soon the patients began to give indications of improvement.
tern, he could breathe without my aid until he began to move
The signs were not dramatic, but they were there. I could de-
or to speak. As fast as I solved one problem, another arose.
tect a loosening of chest muscles, with slight lowering of the
Inquiries about the effect of speech and motion on the pa-
shoulders, and various patients reported sleeping better. Some
tients' breathing failed to elicit from my medical colleagues
who had had difficulty eating were able to swallow with greater
either explanation or theory. Mine was a carefully supervised,
ease. One patient who was living on six liters of oxygen a day
stnctly dO-It-yourselfjob. I did my own theorizing and arrived
began to decrease his consumption. Another who had been
at what now seems a simple, common-sense answer: the res-
bedfast was able to get up and move about.
piratory muscles were too weak to support the increased breath
From time to time doctors and therapists came to me smil-
demands of speech or motion, and the stress of effort caused
ing. "What are you doing to those emphysema patients?" they
the patient to lose the new breathing pattern. Next question.
inquired. "I hear you're having great success. Even getting old
The next questIOn followed with horrifying rapidity. How
Frank down on the oxygen. Great!"
could those muscles, some of which did not function properly
oth~rs of which could not be controlled, be strengthened; They went away scowling because I could not tell them a
Agam the answer was obvious: by exercise. Next question. This single thing. I honestly did not know what I was doing to get
one was a real challenge. How do men lying helplessly on their a response where others had none. I know now what I was
doing, but then I was venturing into the unknown. I was too
42
43
 Dr. Breath
Over the Shoulder
occupied with immediate concerns to reflect and analyze and
One elderly man who had not been able to walk across the
correlate. I was constantly learning from the doctors and nurses
room not only could walk but could walk up the hospital stairs,
and from the patients themselves the peculiar psychology, the
a remarkable feat for an advanced emphysema patient. Sev-
needs, the paralyzing fears, and the complicated problems of
the emphysematous. eral developed to such a stage of self-management that they
were discharged from the hospital and could go back to mod-
My manner of teaching was continually developing toward
erate work. A doctor told me that a patient under his care had
a definitive method. After a patient learned to maintain his
shown a marked improvement in coronary condition. Ulcers
breathing pattern in a supine position, he had to be taught to
of long duration began to disappear. The patient who could
maintain it sitting, then standing, then moving about. Every
not breathe comfortably for more than fifteen minutes without
increased demand on energy affected breathing and required
oxygen was able to go without it for as long as eight hours and
an adjustment to the new situation. I had to find a way to
could get out of bed and move about the hospital. He aston-
make the necessary adjustment. When a patient reported the
ished the nurses by pushing a wheelchair along the corridors
effectiveness of some personal experimentation, I passed the
for Support and balance to help maintain his breathing pattern
information along to the others. Depending upon the con-
while walking.
sensus, I incorporated it into my teaching or filed it as a good
Perhaps the most dramatic episode was that involving a
suggestion for given circumstances. One suggestion in particu-
lar developed into an important teaching device. fifty-five-year-old patient who had suffered the advanced stages
Although the use of contrived sentences to produce sound of emphysema for eight years. After his discharge from the
had achieved a gratifying measure of Success, I was not wholly hospital he undertook to pilot a boat down the Inland Water-
satisfied with it. I cast about for something better but found way from New Jersey to Florida. A violent storm caught him
nothing. When a resourceful patient told me he would rather off the Carolinas, and he spent the long night battling the
count than recite sentences, I decided to use numbers with the raging wind and waters. The following morning he had such a
other men. They were approved unanimously and in the course severe attack of dyspnea (breathlessness) that he was rushed to
of time have been elaborated into a precise method for physi- a Charleston, South Carolina, hospital for emergency treat-
cal development and for the measure of degree of development. ment. By the time he reached the hospital, he had regained
To many they have become a distinguishing characteristic-or control of his breathing sufficiently to refuse oxygen therapy.
perhaps idiosyncrasy is a more accurate word-of my teaching Instead, he insisted upon being left undisturbed for a short
method. while. During that time he was able to recover himself by use
Not long after the introduction of sound as an exercise de- of the system we had worked out for just such an emergency,
vice for my emphysema patients, their improvement became and he walked away to continue the journey to Florida. This
dramatic. They could tolerate more physical exertion and per- was a man who had exhausted his private resources in search
form tasks which had been impossible for them previously. of relief from the terrible breathlessness of emphysema and
. who had come to the East Orange VA Hospital as a last resort.
44
45
 - -- - ------

Dr. Breath
Over the Shoulder
In the beginning each success brought a flurry of enthusiasm
was connected with my inability to explain what I was doing.
from the hospital staff, and a few more patients were shunted
I had been causing something to happen within his respiratory
to me for instruction in breathing. Dr. Small was quick to note
mechanism. Now, a change within him since his illness was
the improvement, but he could no more account for it medi-
canceling what I did and making impossible the occurrence of
cally than could I. The improvements simply would not show
that inexplicable something. Quite by accident I noticed that
up in the standard tests. In one report he commented, "We
his lower abdomen protruded when he talked. I placed my
have a hunch that many of the tests we are utilizing are rather
hand upon it as he continued and pressed lightly to make it
gross for our purposes." While I worked with him, he never
descend with his speech. A few sentences later he became
gave up the hope that whatever I was doing could be deline-
aware of a lessening of pain. In a short period of time his pain
ated and defined precisely.
disappeared and his improvement resumed.
His charity, however, was not equaled by others of my col-
Again I had stumbled across another piece in the respiratory
leagues. I could sense about me a building atmosphere of hos-
puzzle that my teaching of the diseased had become. This one
tility, and I suspected that many a difficult patient was sent to
I could explain. The diaphragm had not risen into the pul-
me in the expectation that I would fail. My situation was not
monary cavity as it should have when the patient exhaled. It
eased by my ignorance of the physiological effects of my overt
had descended erratically into the abdominal cavity, thereby
actions. I could and often did describe in detail what I did in
creating in the lower abdomen pressure which in turn caused
instructing a patient, but I could not explain why those par-
pain. I could now identify a weakened diaphragmatic muscle
ticular actions produced such phenomenal results in respira-
tion and so many assorted side-effects. The description without immediately by the protrusion of the lower abdomen upon
the exhale.
an explanatory follow-up provoked a state of intense irrita-
tion. Everyone felt that I was hoarding a secret. No one would Enough clues had accumulated by merest chance for me to
believe that it was a secret even to me. realize that I was on the trail of something or other. I had
Finally my chain of success snapped and the atmospheric next to no scientifically measurable data to present, but I
pressure dropped accordingly. One of my patients who had hoped that the subjective and objective improvement of the
made significant improvement contracted pneumonia and had patients would be sufficient to enable me to go on with the
a great deal of difficulty with his breathing afterward. I could work that had begun so haphazardly.
not help him regain the ground he had lost during his illness. So little was being done about the breathing problems of the
Working with him became problematic because of his constant emphysema patient in the late 1950'S that any advance would
complaint of abdominal pain. His doctor could find no cause be worthwhile. Mine was a halting advance; nevertheless, it
for the pain and could devise no cure. Meanwhile, the pain had possibilities. I began to cast about for means of seeing it
continued and I kept trying. through to a logical conclusion.
For some reason I felt that my inability to help this patient

47
f

4
THE WITCH DOCTOR

After a year-and-a-half in the East Orange VA

Hospital with patients continuing to improve mysteriously, I
became more and more self-conscious about my inability to
explain what I was doing. I felt like some sort of witch doctor
who conjured effects with strange numerical incantations. I
am sure there were those who considered me closer to voodoo
than to science. If I did not produce a few solid scientific
facts Soon, I might very well find all my work in emphysema
jeopardized.
Whatever I had done for patients, I had failed to accom-
plish my primary task. I had not developed a teaching method
which therapists could utilize, and my sponsors were becom-
ing impatient. The two-year grant for the project was nearing
the end. To receive another, I would have to have some in-
dication of progress toward the assigned objective.
Chief stumbling block to progress was that I had no
formula for altering the breathing pattern of the emphysema-
tous. My management of every patient was different. I knew
that something similar was happening to them all, but I had
not the faintest inkling what it was. How could I possibly
tram anyone to teach when I could not tell him specifically

49
 Dr. Breath The Witch Doctor
what he was to achieve? Going through a series of motions, familiar with the disease and its effect upon the respiratory
which was all that Icould describe, would produce haphazard system, my practices would be little more than just that-
results. At best, the patients would receive only temporary witchcraft-and just as unlikely to produce positive results.
relief from their breathing difficulties; at worst, further dam- For many, the end results of my instruction were sufficient.
age could be inflicted upon the respiratory mechanism. They were willing to concede that I must be doing something
An unexpected turn of events rescued me from my di- right. Others, however, were less charitable; some were openly
lemma. Some of my patients had been undergoing the hostile. The uncommon success of the East Orange emphy-
standard tests for emphysema and showed an improvement sema project soon became well known enough for the editor
over their condition prior to breathing instruction. Dr. Small
of a pharmaceutical company's house organ to be interested
wrote the magic words: "If additional studies in more of the in an article for his magazine. I was pleased because I hoped
patients now receiving instruction do show these small in- that awareness of the work being done might bring the
creases to occur consistently, they may give us a clue to
Support needed to intensify it. The article was prepared
significant improvement in some measurable parameter." On
and submitted to hospital officials for approval. That was the
the strength of his report and the case histories of my patients,
end of it. Opposition to publication was too strong. The
a grant was obtained for further investigation into the use of
reason given was that the inevitable inquiries could not be
breathing patterns in the management of emphysema.
answered for lack of sufficient scientific documentation and
Time and again Iheard, "What do you do that is so differ-
the hospital might be embarrassed. More than ever I felt
ent from what everybody else does?" To all appearances,
like the weird witch doctor weaving his spell.
what I did was not drastically different from other ap-
Even so, the luxury of self-pity did not tempt. me long. I
proaches to breathing. Only the results were different. De-
had learned that seeming dead ends can be turns m the road,
pen.d~ngupon the. severity of the disease and the ability of the
to be approached more in curiosity than in des~~ir. If sci-
individual to discipline himself, those whom I had instructed
entific documentation would satisfy the opposition, then
could manage their breathing independently without artificial
scientific documentation would just have to be obtained.
aids. Follow-up of emphysema patients who had been dis-
Knowing the difficulties involved, I did not bother to ask
charged showed many of them to be in better physical condi-
myself how. Oddly enough, at that time the demand for
tion than before the onslaught of the disease. This was not
proof of my work was a demand for analysis of the results
true of other methods of breathing.
rather than analysis of the means used to achieve the results.
If, then, I could determine precisely what I did and de-
Conviction that I was stubbornly guarding a secret was so
scnbe exactly how I did it, I would have something to teach
strong that the thought of analyzing my procedure did not
aspmng mstructors. This happy thought served as a tem-
occur. The main objective seemed to be to prove that the
porary relief from the pressure to begin training others in my
results had little or no scientific validity and that Improve-
Ownparticular brand of witchcraft. To anyone not thoroughly
ment which could not be measured on standard charts and
50
51
 Dr. Breath The Witch Doctor
graphs was no improvement worth the mention. I wondered maxing in breathlessness and the feeling of suffocation. No
how I could have generated so much furor when all I wanted patient could put forth his maximum effort under such cir-
to do was what I had been asked to do-help people breathe. cumstances. The whole procedure was diametrically opposed
Early in 1960 the opportunity to extend the breathing in- to everything I taught. My objective was to teach the patient
struction to the Naval Hospital in Philadelphia came about how to relax his tensed muscles so that they could function
and I accepted it. There I worked with a group of Navy doc- in a pattern of relaxed breathing. If he were tense, he could
tors who were very much interested in the effect of breathing not breathe efficiently, and if he could not breathe efficiently,
techniques on the progress of emphysema and in the manage- the test results were invalid as far as the measurement of my
ment of other respiratory diseases and disorders. Conferences work was concerned. Moreover, the tests required forced
with them taught me a great deal about respiratory diseases breathing at maximum effort, whereas my patients were never
and ~isorders which I was able to incorporate into my own permitted to force an exhale or to exert their breathing be-
thmkmg. I had dealt only with emphysema and was not fa- yond the limits of ease. I suggested certain changes which
miliar with the many manifestations of respiratory damage. were adopted with notable alteration of test results.
The knowledge was valuable. In another familiar area of tension I was not so inventive.
Meanwhile, the work at East Orange continued. As my The demand for trainees had become imperative. Although
early patients came back for checkups, the long-range effect I was convinced of the futility of the undertaking, I agreed to
of their breathing instruction could be observed unmistak- begin the long-evaded task. I had had two years of intensive
ably. Their emphysema, which is an irreversible progressive work and study in the area of emphysema, and all of that
disease, had not progressed, but the standard tests failed to time had been required for me to become acquainted with
show results of appreciable significance. There was no way to the nature of the disease and the complicated problems of the
measure the removal of the terrible fear of suffocation or to patients. Beyond that, I had no ready formula of instruction
determine the vast consolation of being able to manage the to communicate. Yet I was expected to take trainees totally
breathmg process unaided.
ignorant of the ramifications of the disease and the respiratory
The Navy doctors were quite advanced in their approach difficulties involved and to teach them an undefined method
to emphysema, and some of their comments set me to think- of instruction. If try I must, try I would. I had run out of
mg about the standard tests. The chance remark of a patient arguments.
that the tests exhausted him kept returning to my mind. The trainees came and the trainees went, of their own
While I was observing the tests one morning, I realized accord. The complexities of dealing with the chronically ill
what was wrong and wh th I .
Y e resu ts were always a disappoint- were discouraging enough, but the highly technical approach
ment to me The atm h f h .
.. osp ere 0 t e entire procedure was one to the process of breathing was too much. The trainees were
of tension, which is among the chief enemies of the emphy- accustomed to the relatively simple respiratory problems of
sema sufferer. Tension builds into more tension, finally cli- the well who want nothing more than to extend their breath-
52
53
 Dr. Breath The Witch Doctor
ing capacity. To deal with a gasping bed-patient who might read like advertising copy for a potent patent medicine. They
very well suffocate before the session ended was completely were unbelievable. So, nobody really believed them. That was
unnerving to even the most intrepid. They resigned, freely a mistake discernible only in the field of action, as this latest
admitting that the job differed considerably from what they training casualty had discovered for himself.
had expected, Paradoxically, a barrage of criticism was leveled For a while after the Philadelphia episode there was a lull
at me for failing to do what I had already warned I could in the training demands. I could devote my thought and ener-
only fail to do because of the limitations of my present knowl- gies to the innumerable respiratory problems which my mere
edge. Although I understood the frustration I had uninten- presence seemed to create. Patients were continually coming
tionally aroused, it was no less unpalatable. to me with assorted questions about the respiratory mecha-
There had to be at least one, and there was-an aspirant who nism and the process of breathing. Their ignorance of their
was convinced that his empathy and inborn sense of humanity own bodies always surprised me, because I foolishly had as-
was sufficient to plug all the gaps in knowledge. Far be it sumed that everyone had at least a rudimentary knowledge of
from me to shatter dreams. We set out together upon the physiology. Even more foolishly I had assumed that a univer-
pathway of emphysema headed in the direction of hope. The sal awareness of the importance of breathing existed. Nothing
Journey was not without mishap and misgiving, but we pressed could have been farther from the truth.
On bravely. One fine spring day we came to the awesome cita- Discussing breathing with the Philadelphia doctors one
~el of the Philadelphia Naval Hospital and plunged directly afternoon, I noted the general lack of information on the
mto a conference with the doctors. On the schedule were subject and asked why this was so. Why was the process of
some particularly knotty problems, and the discussion veered breathing not explained to respiratory patients and why were
off into technical areas. I was called on for a number of deci- they not cautioned about the serious consequence of faulty
sions involving patient w If d .
, e are an respuatory management. breathing habits?
I ~as too preoccupied to notice my companion. "Because most of us don't know that much about breath-
ater, when we had left the conference and were ready to ing," a brisk young captain replied. "We're too busy special-
~egm ~ur round of patients, he turned to me hesitantly. izing in respiratory diseases and finding ways of treating them
There, s no need for me to go on. It would just be a waste of to think about breathing."
tIme: I d n~v.erget through one of those conferences." "Nobody ever thinks about breathing until he can't, I sup-
HIs humilijv made m d b
e very sa, ecause he should never pose. Then it's a little late. Sometimes too late."
~~e had to humble himself so. His original confidence in his "Do you know what you ought to do? You ought to go over
a l;ty was entirely justified by what he had been told upon to the University of Pennsylvania Graduate Medical School
~~~t~~tiO~f~~the training. No one who was not directly con- and talk with Dr. Arthur DuBois. He's in research and can
Wi e work could or would concede th t it . give you some good ideas."
any way out of th di a I was III
e or mary. The case histories of my patients Forthwith, the doctor who had made the suggestion called
51
55
 Dr. Breath
The Witch Doctor
Dr. DuBois and arranged an appointment for me. Dr. Du-
subject was broached, St. Albans officials had entered a re-
Bois received me graciously and listened attentively while I
quest for respiratory services as soon as there was an opening
elaborated my work and findings. He took particular interest
in the schedule. I regretted leaving my kindly colleagues in
in my observations and conclusions concerning the effect of
Philadelphia, but the trip from Manhattan to St. Albans was
various breathing patterns on areas of the body other than the
quicker at a time when I never seemed to have enough time.
respiratory system. Suggestions he made during the meeting
As fast as one thing ended, another began.
led me later into a series of research and study projects. If I
Just prior to the start of the breathing program at St.
had not met him at that precise time, my career would have
Albans Hospital, I was drawn into an area which I had not
been altogether different. He gave me some good ideas and
considered before. I was called upon to provide private breath-
prompted me to think in terms I had not considered previ-
ously. ing instruction for the ill. Private breathing instruction for the
well is one thing; for the ill it is quite another. I was not
Although the work at the Philadelphia Naval Hospital went
certain that I wanted to place myself in so vulnerable a posi-
well and I had a splendid opportunity to broaden my knowl-
tion. Doctors with whom I was directly associated in teaching
e~ge of the latest respiratory concepts and practices, the situa-
patients and in exploring the possibilities of breathing in the
tion then :xisting within the hospital management was not
management of disease never paused to consider my lay status.
entirely satIsfactory. A rather rapid turnover of staff made the
I knew my business of breathing; they knew theirs of medi-
c?nti~Uity of work difficult and necessarily consumed a lot of
time m repeated briefings. Finally, a doctor with whom I cine, and that was that. Other members of the profession,
often conferred advised a transfer of the Philadelphia pro- however, were often incensed by what they considered to be
my poaching on the domains of medicine.
g~m to the St. Albans Naval Hospital on Long Island. He
pam ted out that St. Albans Hospital had one of the largest My investigations always remained strictly within the field
respIratory departments as well as out-patient clinics on the of respiration, a legitimate branch of science. At no time had
East Coast and that it served all branches of the Armed I ever suggested that breathing instruction could substitu~e
Forces. It would be ideal for a continuation of the exploratory for the medical knowledge and skill required to treat a dIS-
work I had begun in th I" . eased condition. It might aid in the management of a dis-
. e app ication of my particular tech-
mque of breathing management to the management of em- eased condition, but certainly it should never be interpreted
physema. and other respiratory complaints. The prospect was: as a medical treatment for that condition. Nevertheless, I
challengmg. frequently encountered the animosity of doctors who refused
By whatever mysterious communication system it is that to believe I accomplished anything out of the ordinary. My
keJ:s the personnel within a given field informed of activities lack of standard scientific documentation and my inability to
WI. m t~at field, accounts of the East Orange and Philadel- present a formula for teaching made me highly suspect.
phia prOJects had long since reached St. Albans. Before the Because of my work in hospitals, I had fallen in~~ t~e eas!,
habit of referring to those whom I taught there as patients,
56
57
 Dr. Breath
The Witch Doctor
The well whom I taught were "pupils" or "students"; I inter-
changed the terms loosely. The ill were automatically "pa- technicians were placed at my disposal, and I was free to con-
tients." Such verbal slips made in the wrong place could have sult with the medical staff of the respiratory department.
unpleasant consequences. There were many who belittled me, I had, in effect, a clinic for the handling of breathing prob-
but I did not believe anyone would go out of his way to lems. Here was my golden opportunity to obtain scientific
harass me. Even so, I wanted all my activities to be open and documentation of my work. The facilities were much more
well defined. I conferred with several doctors, and the con- extensive than those at East Orange and could carry my
sensus was that breathing instruction given in cooperation investigations much farther. The possibility was suggested
with the patient's doctor surely could arouse no objection. that the breathing technique and the teaching method I had
However, if the patient's doctor were not in accord, the pa- developed might be used as a standard procedure in the man-
tient might be caught in a dilemma detrimental to him. agement of respiratory disease and disorder. That was an
With that solid advice serving as ground rules for operation inspiring thought but it was a long way from realization.
None knew better than I.
I accepted as a pupil an emphysema sufferer referred to me by
a former East Orange patient. Once I had begun to work Before anything could become standard procedure, some-
~ith the man, I realized that he was opening for me a door body had to find out exactly what it was and how it worked.
into another room of the twilight house of breathing. His After that, somebody had to find a way to train instructors
psychology was drastically different from that of the hospital who could make it available to those in need of it. A large
patient. Since his psychology and his breathing were inter- order for somebody, especially when I was that somebody.
acting forces, my approach and management had to be dif-
ferent. The hospital patient was recognized as being sick by
virtue of bemg In the hospital. This man did not want to
admit illness because it was a nuisance. He would overexert
himself and inflict further damage rather than limit his activi-
ties. I had a new category to explore.
When the program began at St. Albans I had many new
categories to. explore. The doctors in the ~espiratory depart-
ment were highly receptIve to new ideas and possibilities and
proposed making the range of my work as broad as possible. I
would deal not only with emphysema but with the manage-
ment of all breathing problems. I would have a chance to
s~udy the effect of my instruction on every kind of respiratory
disease and disorder. Laboratory facilities and the services of
58
59
 5
SEARCH FOR AN ANSWER

"R ow can anything so good cause so much trou-

ble?" I often asked myself during the latter days of my tenure
at East Orange when the controversy over my work had
reached its zenith. An aura of the absurd hung about the
stubborn insistence for measurable scientific proof of the im-
provement of bed-patients who could get up and walk and
perform acts of which they had been incapable for years.
Absurd or not, there it was and it would not go away when I
closed my eyes. I counted myself vastly fortunate to have at
St. Albans Hospital the means to search for an answer to the
questions posed by my entry into the respiratory field. The
outlook for the future was encouraging.
Despite the frustrations encountered at East Orange, a
significant achievement had come out of the work there.
What had begun merely as a service to try to ease the discom-
fort of the emphysema patients had developed into a distinc-
tive breathing technique with an equally distinctive method
of teaching. Of all the breathing techniques employed to
relieve the breathlessness of respiratory conditions, this was
the only one that enabled the patient to breathe without
artificial aids and to maintain himself independently-some

61
 Dr. Breath Search fOT an Answer

patients took care of themselves for as long as six months and to find answers to the questions that had been plaguing
without seeing me-once he had mastered the technique. me since my first patient showed signs of improvement. In my
Moreover, a follow-up of patients showed enough incidence of most recent forage for funds, I had secured a sum of money
arrested progress of the disease to warrant the hypothesis that for just such a study, but I had not completed the necessary
the breathing technique had caused the arrest. arrangements. Although St. Albans offered me splendid oppor-
In both East Orange and Philadelphia the efficiency of the tunity for independent research, it was not geared to con-
technique had been demonstrated repeatedly. At neither trolled study. I had to look elsewhere.
place, however, had a concerted effort been made to describe When I had had occasion to discuss my work in emphysema
it or to find the means of teaching it. The East Orange doc- with Dr. James Meneffee of the Duke Medical Center in Dur-
tors wanted scientific documentation of results', whereas the ham, North Carolina, he mentioned the possibility of interest-
Philadelphia doctors, though personally interested in my theo- ing Dr. Nicholas D'Esopo of the West Haven Veterans Ad-
ries and accomplishments, were professionally interested only ministration Hospital in such a project. I approached Dr.
in the solution of their patients' immediate breathing prob- D'Esopo with my proposal and, intrigued by the potential, he
lems. At St. Albans I would have for the first time the com- agreed to undertake it.
plete professional cooperation required to conduct a proper Preparation for the study took me into the technical area of
investigation of the breathing technique I had developed over respiratory function that lay beyond the scope of my knowl-
a period of two years of work with scores of advanced emphy- edge. I needed advice on tests and testing procedures most
sema patients. likely to provide the scientific data required to document my
While I.was cheering myself with that thought, two pain- work satisfactorily. Another of Dr. DuBois' many courtesies
fully practical matters presented themselves. Again, money had been to refer me to Dr. Andre Cournand and Dr. Harry
was runnmg out and I would have to do my share toward ob- W. Fritts of Bellevue Hospital in New York City, whose work
tammg more for the continuation of the work. My sponsors
in the respiratory field is classic. I conferred with Dr. Fritts
had entertained a singular displeasure with me in the wake of
and received his expert answers to the procedure problems.
my failure to fulfill the initial commibnent to train teachers.
His interest and encouragement heightened my own en-
They were not con~erned with scientific progress or advance
thusiasm for the complicated enterprise my work was fast be-
of knowl~dge and did not permit themselves to be persuaded
easily
. ..' to invest in either For a bleak interl u de th e financia
. I coming.
cnsis hung like a thunderhead on the horizon before resolving My first eight months at St. Albans were concurrent with
and freemg me to attend to the other matter. my final months at East Orange. All the while, I was arrang-
I The other matte.r ,had to do with scientific procedure. Fol- ing for the long-sought project at the West Haven VA Hos-
owmg Dr. DuBOIS suggestion, I had begun to think in pital and seeing emphysema patients referred to me by people
terms of a controlled study series to settle a num b er 0f Issues
. with whom I had worked or by doctors who knew of my work.
62
63
 Dr. Breath Search for an Answer

The small snowball of East Orange was generating an ava- breathing patterns had been changed and developed, improve-
lanche. ment was dramatic. Although the doctors were familiar with
When the medical study began in West Haven in April the earlier results, they invariably were surprised to observe
1961, my association of more than three years with the East similar results in their own patients. As always, hearsay was
Orange VA Hospital ended. So much had happened to me at one thing; personal observation was another. Enthusiastic
East Orange that I came away with a distinct sense of leaving from the start, they became even more so with the continuing
behind some essential part of myself. I had seen men die improvements the patients showed.
there of the various complications of disease. I had seen others Because the respiratory department and out-patient clinic
who had given up hope go out into a new life. Most impor- at St. Albans were extensive and accessible to all branches of
tant, I had carried my interest in breathing into an area of the Armed Services, all sorts and conditions of men were
great human need and had received an opportunity to make a shunted to the clinic set up for the handling of breathing
contribution of knowledge in a field far too long neglected. problems. I saw such a wide variety of respiratory sufferers
Leaving my East Orange patients was like abandoning that I eventually reached the stage in which nothing perturbed
trusting children. Some of them were in too advanced a state me. I was mentally prepared to deal with anyone. Or, at least
of illness to hope for more than relief from the sensation of I thought I was until I walked into my office one afternoon
breathlessness; others were well able to take care of them- and found an attractive, middle-aged woman sitting there
selves if they applied themselves. By this time I had worked quietly waiting. Very definitely I was not mentally prepared
~th more than a hundred advanced emphysema patients, and for this.
was certain that most of the East Orange men could get The Veterans Hospital had conditioned me to think in
along without me. The purpose of my instruction was to terms of men as victims of respiratory disorder. The thought
enable them to regain control of their breathing and learn to that women, too, suffered respiratory complaints never oc-
manage themselves independently. In final reassurance I told curred to me. Simple-minded, but true. For a moment I was
them to get in touch if ever they needed me. That was the
nonplnssed, then habit took over and tended the routine,
weapon they required in the relentless battle against the terror
of breathlessness. while I considered the next move. I had instructed women
in breathing technique, of course, but those women had all
When the study began at West Haven, the program at St.
been well, and my instruction had been verbal. This unsuspect-
Albans had been underway for some time and proved to be
ing woman would be the first upon whom I exercised my new
a~ .excellent supplement. The St. Albans doctors and tech-
rucians worked in close cooperation with me and we were technique involving palpation. I was concerned not so much
abl.e to obtain much corroborative data. The subjective- for myself as for her. I wondered how she wonld react. Since
objective .results of th e b reathimg instruction
. were exactly I had no alternative, I continued the routine and asked her
what I might have predicted from experience. As soon as the to lie down on the examining table.

65
 Dr. Breath
Search for an Answer
"Of course, Doctor," she replied and promptly did as she
was bidden. I grew accustomed to seeing all stages of respiratory disease
and could recognize a respiratory sufferer almost at a glance.
To her this was as impersonal as fitting a pair of shoes. Re-
One of the curses visited upon the diseased is that the un-
lieved by her offhand response, I explained to her that I was
discerning eye fails to notice anything unusual, and even an
not a medical doctor but a respiratory specialist who would
advanced emphysema patient can pass for normal among close
teach her a new pattern of breathing to relieve her dyspnea,
or state of breathlessness. friends who do not know of his condition. The trained eye,
however, reads the signs and identifies the patient. When an
She accepted my explanation but persisted in calling me
erect young Marine presented himself to rne for breathing
"Doctor," as did numerous patients and many of the hospital
instruction, I looked him over and mentally questioned his
staff who had difficulty learning the pronunciation of my
presence. He proved to be a remarkably novel case.
name. She was the wife of a naval officer, therefore was
eligible for hospital services. Like my first private pupil, she As he told me of his background, his distress and tensions
prompted me to consider my work from a new angle and to became evident in his inflection. He had been in service for
reexamine some of my concepts. From her I learned more some time and had wanted to reenlist for another tour of
about the effect of tension on the emphysema sufferer. Her duty. He enjoyed athletics and kept himself in prime physical
responses to instruction were different from those of most of condition by taking part in a nurnber of sports. He had no-
the men I taught, and I was impressed again by the influence ticed that he got a little winded occasionally after particularly
of multiple factors upon the respiratory system. -vigorous activity but thought nothing of it. Then he had gone
Not only did Ilearn to teach women from the officers' wives for his reenlistment physical exarnination. The medical ex-
~ho came to the clinic, I also broadened the range of applica- '( aminer announced to him that he had advanced emphysema,
tion of my breathing technique through the variety of respira- and before the bewildered young man could identify his
tory diseases and disorders I encountered. The St. Albans condition, he was shipped immediately to St. Albans for treat-
docto~s were inte~ested in the practical application of the ment and possible medical discharge. The intensity of his
techmque and assIgned me a new problem every time one emotion almost broke through his Marine discipline. I could
arose. Men came to me with chronic bronchitis, lung damage believe his account, but I could not bring myself to believe
fr~m tuberculosis scar tissue, asthma, lobectomies, whatever his emphysema. Nevertheless, I began instruction.
mIght affect the respiratory system and make breathing diffi- His manner of breathing indicated that some kind of irreg-
cult. The approach to each condition had to be different but ularity was causing the sensation of breathlessness. I con-
the results were always the same. As Soon as a certain point of • ferred with his doctor, who was as puzzled as I. A series of
developme.nt of the new breathing pattern was reached, the conferences with other doctors yielded no solution to the
breathmg Improved and the condition itself showed improve- mysterious malady. After several instruction sessions, the
ment.
breathing difficulty showed marked improvement. Still, no
66
67
 Dr. Breath Search for an Answer
consensus could be reached on the nature of the respiratory have resulted from extensive lung damage caused by "walk-
disorder.
ing" pneumonia, we all paused to consider. This man phys-
Nor was a definite decision ever agreed upon. The staff ically could not afford to have another case of pneumonia, but
remained divided pro and con emphysema. The young man he was in such a state of susceptibility that he could very
simply refused to accept any form of illness. The desire of his easily go into another from a slight cold. He worked with
life was reenlistment. He applied himself faithfully to the me regularly and made steady progress in his respiratory de-
development of his new breathing pattern, and his respiratory velopment. He was kept under careful observation so that any
condition improved accordingly. Within a few months he infection could be treated immediately. The precaution was
Surprised everyone except me by passing his medical examina- unnecessary. Within six months his condition had improved
tion for reenlistment in the Marine Corps. enough for him to be discharged. We later learned that he
Working with him made me wonder about the effect of had become a detective.
faulty breathing plus constant, excessive exertion upon the We all decided to become detectives and make an investi-
r~spiratory mechanism. At East Orange I had had a few pa- gation into the effects of breathing patterns upon the inci-
tients w~o had been professional athletes in their youth, but dence of respiratory infection. A check of old cases and
at that time I was too busy with the urgencies of the moment observation of new ones indicated a correlation, whereupon
to search ~e past for causes. Now I knew a great deal more the doctors began to talk enthusiastically about exploratory
about respiratory problems and was beginning to think in projects and introduction of breathing instruction into the
tenus of causative factors. Among my St. Albans patients and area of prophylaxis. I was very much pleased by their en-
my pnvate pupils were former sportsmen and athletes. Some- thusiasm, but I could not undertake any more projects, tempt-
day, I promised myself, I would look into the breathing pat- ing as they were. I should have liked to. There were many
terns. and habits of athletes and examine their respiratory things I wanted to do and would have done if only I did not
condItion.
get tired.
Time and again emphysema patients came to me with long Work at the St. Albans breathing clinic became so generally
case histories of recurre t . '.
. . '. n pneumoma and respiratory infec- known that doctors from other hospitals in the vicinity came
tions which had mfhcted irreparable damage upon the tissue to confer and to observe. I was called upon frequently for
of. the lungs, resulting finally in emphysema. For a while
demonstrations of my management of breathing problems.
neIther the doctors nor I gave the matter particular attention. With each new group I always hoped that there would be
A new brea thmg pattern w dId '.
'. as eve ope ; the patient Improved Some wise one who would know and could explain the tech-
and m due time was discharged.
nical complexities involved in my actions. There never was.
d~en an ex-FIying Tiger of the Second World War was Although the process of breathing involves both anatomy and
a mltted to the hospital and his emphysema was found to
physiology, neither branch of science has claimed it for thor-
68
69
 Dr. Breath Search for an Answer
ough exploration. It was a little-known territory waiting to be last there was visible proof of the extraordinary occurrences
mapped and charted. If I wanted a map, I would have to within the respiratory mechanism brought about by the
make my own.
change in breathing pattern. I had a firm support for my
Sometimes the zeal of my St. Albans colleagues was over- theories and conclusions. I had escaped the narrow confines
powering. As the numerous side-effects of the breathing tech- of subjective-objective reports.
nique on other systems of the body were noted, a resurgence Most dramatic of the earlier documentation were the inhale-
of interest in prophylaxis occurred and a plan was devised to exhale X-rays. Before beginning instruction the patient was
bring the high-ranking service personnel to the hospital for a
X-rayed On the inhale and on the exhale. After a given period
regular program of instruction. I was flattered but not par-
of instruction he was X-rayed again in the same fashion. The
ticularly happy. So much of my time was already consumed
two sets of X-rays were superimposed to determine the motion
by instruction that I often chafed at the slow advance of the
of the diaphragm in performing those respiratory functions.
research. Furthermore, experience with older service officers
They showed quite clearly an increased excursion of the dia-
had taught me to approach them with a certain degree of
phragm that could have been brought about only by the
trepidation. Try as I would to ease around the problem, there
strengthening and developing of the involuntary muscles
was no way to avoid imparting the unwelcome information
through the change in pattern of breathing.
that their method of attaining their military posture was detri-
The standard medical opinion then was that involuntary
mental to breathing efficiency. I had had a variety of reactions.
After the atmosphere had cleared and communication could muscles cannot be developed. If I thought for one moment
be reestablished, I explained that the abnormal raised position that contradiction of standard medical opinion is a desirable
of the chest placed the respiratory structure out of alignment contribution to science, I could not have been more remote
and made proper functioning impossible. The point was con- from reality. I had fallen squarely into a hornets' nest and was
ceded as instruction got along, but I did not relish the thought in danger of being stung to death. Once more, those who were
of indefinite repetition of the experience. Shortly after the there to witness accepted the evidence. Those who were not,
start of the program a crisis in Washington brought it to a refused to believe that what had happened either had hap-
close. I had no regrets. pened or could happen. The diaphragm, I found out too late,
I never regretted having more time available because some- was sacrosanct in the field of medicine. It was governed by
thing was always waiting to be done. With 'the aid of the established laws and would not suffer tampering, certainly not
various technicians and the cooperation of the doctors, I had by an intruder upon the profession.
been able to utilize testing procedures that Dr. Fritts had sug- The previous controversy I had aronsed was naught com-
ges~ed. The results of the tests were exciting. They were pro- pared to this. Almost anybody who could spell diaphragm
viding the long-sought documentation needed to differentiate had a great deal to say. Conventional thinkers made mince-
and establish the breathing technique I had developed. At meat of me. Doctors and professionals who had heard of my
70
71
 Dr. Breath

work at second and third hand were not averse to belittling it.
A high time was had by all.
As time does, that time, too, passed. I was shaken, but not
for long. Other areas in my research were opening, and I
was constantly coming upon new ideas to incorporate into my 6
teaching and thinking.
EXPLORING NO-MAN'S-LAND

~en I entered the medical world, I had already

done a quantity of research in breathing for my own personal
interest and for use in teaching the well how to breathe more
efficiently. I had observed the breathing habits of hundreds of
people of all ages, noting their common tendencies as well as
their uncommon aberrations. I was fully aware of the influence
of breathing habits on individual health and well-being. One
point, however, had long troubled me. Nowhere could I find
a complete definition of "correct breathing."
Many activities require excessive use of the lungs in their
performance, and most of those who engage in them have
an individual concept of "correct breathing." Certain cults
achieve physiological and psychological effects by a controlled
breathing which limits the supply of oxygen to the body.
There are advocates of "belly breathing," "diaphragmatic
breathing," breathing through the mouth, breathing through
the nose, breathing through the pores, and to its exponents
each form of breathing is correct. As far as the maintenance
of life is concerned, any form of breathing will do.
More and more I came to think of the act of breathing-
the manner in which the muscles are engaged to move air out
72
73
 Dr. Breath Exploring No-Man's-LAnd
and in the lungs-as a no-man's-land waiting to be explored "common factor," as I suspected it might be, I wanted to
and concealing who knows what discoveries to be made. The isolate and identify it and put it to work.
process of breathing was to me like a mountain. Each person One of the hospital doctors, Dr. James Ledwith, shared my
had his own view of it, and each was so content with his own enthusiasm for my private project and set up special studies
view that no one had bothered to explore the mountain to with his patients to explore the effects of the new breathing
discover its true nature. Teaching had often shown me that pattern on the diaphragmatic muscle. Although it was heresy
what was "correct" for one was not necessarily so for another. at the time, the X-rays gave undeniable proof that the weak-
Yet, I reasoned, everyone has the same basic respiratory equip- ened diaphragm, characteristic of the emphysema patient, had
ment; there must be a common factor. In spite of my efforts been developed by the new pattern of breathing. The ortho-
I could not determine that factor. dox view was that development of involuntary muscles is
Before I began to teach the chronically ill at the East not possible. Fortunately for me, the hospital staff with which
Orange VA Hospital, I had no way of knowing how deranged I worked was not committed to orthodoxy. We all went
the human respiratory mechanism could become and con- merrily on doing what we were not supposed to be able to do.
~inue to function. As I taught and the men began to show Exciting as the X-rays were, they paled in comparison to
Impro~ement in the ease of their breathing, their pattern of cinefluography, a process of photographing the action of the
breathmg tended to resemble that of the well. I was convinced diaphragm as the patient breathes and speaks. The cineflu-
that a common factor existed and, if ever discovered, could ography equipment had not been available in the early stages
be used to remedy the respiratory faults which lead to or com- at St. Albans, and I had never thought so superior a means of
plicate disease and disorder. documentation would be at my disposal. Dr. Ledwith intro-
Not until the superimposed X-rays at St. Albans did I duced cinefluography into the studies, thereby enabling US to
have a. chance to look inside my patients and see what was extend considerably our range of exploration and examination.
occurnng there. The most maddening aspect of work in the When I saw my first film, I was almost overcome with the
field. of breathing is the extreme difficulty of ever knowing wonder of witnessing the invisible parts of the body perform-
precisely what takes place in the process of breathing. Internal ing their specific tasks. I had served as the norm for the em-
exa.mmatwn of a live subject is problematic; of a dead one, physema patients, and I felt very odd as I watched my own
futile. B~mg able to examine those X-rays and see for myself diaphragm rise and descend. Comparing the distinct line of
the positive effect of the breathing instruction amounted to a my diaphragm with the diffused lines of the patients' dia-
sort of conversion. I was no longer content just to teach and phragms, I had a heightened concern for the liability of the
pursue the research for sweet knowledge's sake. I felt that I
had pIcked up the trail of something very important and I , weakened diaphragm to damage. The weakened muscle is not
detected readily and can be injured further without the indi-
wanted to follow it to a logical conclusion. If it were my vidual's awareness.
74
75
 Dr, Breath
Exploring No-Man's-Land
Cinefluography provided valuable documentation for my
ous to the absurd. Greek and Latin dictionaries were dusted off
observations and served as a rallying point for avant-garde
and searched diligently for an appropriate combination of
thought in the respiratory department. After the film-viewing words.
sessions, which always provoked discussion, doctors and tech.
"If 'dyspnea' means 'difficult breathing,' " one doctor rea-
nicians lingered to exchange ideas. Often, passing doctors
soned, "wouldn't 'eupnea' mean 'good breathing'? Why
would join the group. For me, those discussions served as a wouldn't that be a good name?"
university in miniature. I would go home in the evening, my
"Because nobody could pronounce it," was the quick reply.
head bursting with information and ideas. Never had I under-
"Well, who can pronounce 'dyspnea'? But patients feel
gone so intensive a period of learning.
better about having something unpronounceable. Ordinary
Early in my work with emphysema patients I had believed English doesn't make much of an impression."
that I was doing something quite different from the usual
There was more truth in that last observation than would
practices, but I did not know what it was or how to describe
bear admitting, but the obscurity of root combinations was
it. For want of more explicit terms I referred to what I taught
not what was called for in an area already too obscure. The
as the "~ew breathing technique." That served well enough
name should carry within it a capsule explanation of the tech-
for a while, but at best it was makeshift. It begged questions
nique. Like any cautious parent, I did not want to saddle the
and sooner or later prompted the annihilating wit, "What's
so new about breathing?" new with a cumbersome name which might later prove to be
a handicap. Once the deed was done, it could not be undone
The X-ray studies at St. Albans indicated that the "new
easily. I culled my notes and thoughts for a solution.
breathing technique" was not only new, it was unique in its
Countless times I asked myself, "What do you do?" I could
ability to do to the respiratory mechanism what, according to
describe the motions employed in teaching a patient to
medical record, had never been done. Cinefluography verified
breathe in a new pattern more efficient than his old, but I
further that it promoted the development of the weakened
could not find a name to encompass them. The more I
diaphragm m the chronically ill. Long-sealed doors were be-
thought, the more I came to understand that the principle did
gmmng to creak open in the general respiratory field as well as
not lie in what I was doing. The importance of all my work
in my own field of br~athing. The "new breathing technique"
was what I made happen within the patient himself. The
could not contmue with so nondescript a designation. Some-
thmg better would have to be devised. question, then, was, "What happens?"
Although I was thoroughly familiar with the mechanics of
Before 1961 was far advanced, I began to think earnestly
breathing, I was not about to rush in where the experts tread
about terrnmology. Finding a name for what I did was fraught
with all the hesitatIOns, reconsiderations, apprehensions and lightly. The functions of the muscles of breathing have been
assorted mental pangs f . hild ' described insofar as is possible, and I could hardly add any-
'. 0 nammg a C I ,My colleagues parti-
cipated m the enterprise, and the mood ranged from the seri- thing more to the description. Besides, I knew from observa-
tion that my technique did not require overuse of any muscle
76
77

r
 Dr. Breath
Exploring No-Mans-l.and
or set of muscles. In developing the technique I had instinc-
tively avoided placing unequal stress on any part of the respira- inwardly when someone who could not possibly have known
tor hani I h its tortuous evolution referred to it with the offhandedness
. Y mec arnsrn, ad observed the easy breathing of my
infanr daughter at rest long enough to be certain unequivo- accorded standard medical practice. I hoped that someday it
cally th~t the natural pattern of breathing employed the total might become standard medical practice both in prophylaxis
mechamsm in a mutually complementary action. Unequal and in the management of respiratory and related diseases and
stress on any part over a period of time alters the pattern and disorders. That day, however, lay far, far in the future with a
depending upon the nature of the alteration can injure the vast amount of work and research in between.
mechanism My goal ith . ' Giving the technique a name simplified many matters. The
. WI my patients was always to restore
the b~eathing pattern to the completely coordinated unit I name seemed to clarify it and make it familiar. It was no
knew It should be. longer a mysterious, unnamed something that I did, It was
With such reasoning I could finally answer the question. breathing coordination. When asked what I did, I could say
What happened was that in the instruction of patients I directly, "I teach breathing coordination." Natural reluctance
brought all the muscles of breathing back into a coordinated to display a lack of knowledge being what it is, I generally
pattern and relieved the stress on anyone muscle or set of could count on that statement to spare me a tedious attempt
muscles. I taught coordi ti f b . at explanation,
, far more effi' ina
synergIsm t thIOn 0 reathmg to produce a
Embodying the idea in a name made discussions easier for
or muscles. cren an overuse of any single muscle
the doctors, Until the naming, an unavoidable personal aura
Well, that was what I taught. I still needed a name for it, had pervaded the new breathing technique. With my per-
a n~me to dlstmgUIsh it from other forms of breathing I sonality removed, breathing coordination could be consid-
have ered and evaluated for what it was of itself rather than as
cou '?b called it "coordination of the muscles of brea~h-
mg, ut that seemed a bit I "B " something I did to bring about the phenomenal changes in
tt " long. reathmg m a coordinated
pa "ern prompted the same objection. "Coordinated breath- the condition of the respiratory patients. The patients them-
mg sdeemed much better, but this was not quite what I selves seemed to be more at ease with a proper designation
wante . After a wearisome t ti f p
for their new mode of breathing. A name may not change the
I came around at last t "b es mghi0 sounds and meanings ,
essence, but it has a marked effect On the human response to
. 0 reat mg coordination." That that essence,
so~nded nght. That was the name!
Breathmg coordination" was introduced in th . f Now endowed with the dignity of a designation, the studies
1962 and accepted im di I e spnng 0 in breathing coordination continued at St. Albans, and an-
to the proble W'th~e late y as the only possible solution
m. I m a few weeks th e t erm h ad b ecome other effect of breathing coordination as singular as the
incorporated int th
o e vocabulary com I tIS ' development of the diaphragmatic muscle was noted. One of
bandied about as if it had ist d si pee y. oon It was the characteristics of the disease of emphysema is the raised
exis e smce HIppocrates. I smiled
78 chest. In the struggle to breathe, anyone experiencing breath-

79
 Dr. Breath
Exploring No-Man's-Land
lessness will tend to use the muscles of the upper chest area,
came less pronounced. Such an occurrence was supposed to be
the pectoral and the neck muscles, to empty and fill the lungs.
impossible, but there it was on the X-rays. The potentials of
This tendency is called "accessory breathing," and despite its
breathing coordination were opening so rapidly that it very
total inefficiency, it creates the illusion of immediately supply-
ing the body's insistent demand for oxygen. often was difficult to grasp their significance. They were al-
most too good to be true. This abundance of benefits aroused
The emphysema patient constantly experiences that de-
skepticism among those who had not participated directly in
mand for oxygen and constantly satisfies it as quickly as he is
the breathing coordination studies.
able with accessory breathing. Reliance upon these accessory
One somewhat startling benefit of breathing coordination
muscles gradually draws the rib cage upward from its normal
was improvement in the voice, which I had expected from the
position, causing in the sternum, or breastbone, the develop-
beginning and had observed at East Orange but which had
ment of a protruding angle at the juncture of the upper seg-
been overshadowed by the more dramatic developments of
ment. The sternal angle, as it is sometimes called, can alter
direct advantage in the relief of breathlessness. The St. Albans
permanently the pattern of motion of the rib cage.
doctors noted with interest the unmistakable voice improve-
Alteration of the chest was accepted as part and parcel of
ment, because advanced emphysema patients often can speak
emphysema. Conventional thought was that such alterations
only a few sentences at a time and the voice is weak and in-
were the body's way of compensating the weakness of various
distinct. When such patients can sustain speech in an ap-
respiratory muscles and that once altered, the chest could
preciably louder and clearer voice, the change is obvious. Im-
not be changed. The altered chest was the unmistakable ab-
provements in voice and speech are corollaries of the develop-
e~ation of the emphysema patient at the East Orange Hos-
ment of the muscles of exhale, particularly the diaphragmatic
pital which prompted me to use palpation in teaching breath-
mg. My uncontrollable desire to return the raised chest to a muscle. As the muscles are able to support the increased air
more nearly normal position was the starting point of breath- pressure of speech without tensing or inverting, the voice be-
mg coordmahon. comes stronger and speech can be prolonged. The voice im-
Complete attention could be focused on the upper chest provement of one seventy-two-year-old man paralleled his in-
when the. flurry caused by recognition of changes in the dia- creased diaphragmatic motion as shown by cinefluography
phrag:nahc muscle had subsided. X-rays taken before and and the improvement of his performance of standard respira-
tory function tests.
after mstruchon showed that the raised chest had been low-
ered into a more nearly normal position. By distributing the The patient's ability to produce sound served a very practi-
work of breathmg among all the patient's respiratory muscles, cal purpose of which I had become aware only after my
breathmg coordination had removed the excessive strain from method of teaching breathing coordination had developed far
the access~ry muscles. As the tension was released over a enough for me to begin to explore cause and effect. I had
period of time, the chest descended and the sternal angle be- asked my early patients to make sounds because that act
sustained the exhale and achieved the desired end of moving
80
81
 Dr. Breath
Exploring No-Man's-Land
~ir out of the lungs. From sound-making the system of count-
reasoned, understandably, that they had certain measures for
mg evolved into a simpler means of prolonging the exhale. As
strengthening the diaphragm. Why, then, should they not be
I continued to observe the improvement in voice, I realized
eligible to teach the emphysematous how to breathe? Once
tha t t~e effort of sustaining the exhale provided a self-
more, the old question: "What do you do that is so different
regulatmg force against which the diaphragm could act. The
from what we do?" The answer might have been that work
length of a single count, the volume of the voice and the
with the emphysematous was in the field of medicine, whereas
ability to repeat a count or to extend its length were all self-
their technique and thinking were geared to the field of music,
regulatmg stimulants for the diaphragm and the other muscles
and the two were worlds apart. That, however, was not a
of exhale, The moment the patient tried to force the count or complete answer.
e~hale beyo~d the ability of the muscles to support the exer-
Although breathing coordination does promote the develop-
tion, the dIaphragm moved paradoxically and the excess
ment of the diaphragm, that development is only one part of
pressure showed immediately in the protrusion of the lower
abdomen. the total achievement. The unique aspect of breathing coor-
dination is that it recognizes the individualistic pattern of
From the length of time a patient could count on a single breathing which distributes the work of breathing equally over
exhale, I was able to judge exactly how much physical effort
the entire respiratory mechanism. In a period of time, the
he. ~ould exert. I used his counting ability to determine his
constant, undemanding use of weakened muscles enables
abilIty to maintain his breathing coordination in the various
them to develop gradually according to the individual's ability
pOSItiOnsof the body-lying, sitting, standing, walking-and in
to produce sound without causing a diaphragmatic inversion.
the pe,rformance of physical tasks. The counting finally devel-
Exercises designed to promote exclusively the development of
oped mto such an accurate gauge of the patient's physical
any respiratory muscle or sets of muscles hold the inherent
endurance that the St. Albans doctors required a checkout
danger of damaging weakened muscles and throwing the
through the breathing clinic before a patient was released
from the hospital. respiratory mechanism further off balance.
During the period the "diaphragmatic breathing" ad-
herents were insisting upon the inclusion of breathing co-
AI~bsorbed as I was by the varied developments of the St.
ordination instruction within their range of activities, Frank
ans studies, I was for a time more or less inattentive to the
everd' 'I Chapman, former Metropolitan Opera singer and husband of
-WI enmg eire e of controversy over breath' di
ti mg coor rna- Mezzo-Soprano Gladys Swarthout, came to me for private
IOn. My happy unconcern had to end. Emphasis on the de-
breathing coordination instruction. He had advanced emphy-
velopment of the diaphragm through brea thing coordination
eventually brought a sp t f i t ' sema and was particularly interested in the St. Albans work.
a e 0 merest and mquiries from many Upon request he agreed to participate in certain phases of the
~p?,nents of the various schools of "diaphragmatic breath-
program. His extensive knowledge of various breathing tech-
mg, partIcularly in the field of music. Teachers of singing
niques made him especially alert to the similarities and differ-
82
83
 Dr. Breath

ences of breathing coordination. After undergoing a series of

instruction sessions and the subsequent physical improvement
produced by breathing efficiency, he informed the doctors that
breathing coordination was unique in his experience. Later, he
confessed to me that he had expected to learn nothing new, 7
but I was not offended. I had expected him to expect just
that.
A BA TTLE IS FOUGHT
Interest in the work at St. Albans also brought a number of
requests for demonstrations and discussions of breathing co-
ordination. Because of the numerous benefits to respiratory
sufferers, breathing coordination became a sort of beacon to
persons and organizations dedicated to the relief of such suf-
ferers. The hope usually was that teachers could be trained
In the early 1960's so much was happe~ing in the
various areas of my life that I seldom had the leisure to ap-
quickly and put to work relieving respiratory distress. Al-
praise my activities on the basis of their direct benefit to me. I
though breathing coordination was nowhere near the teacher-
training stage, demonstrations occasionally were given for had become caught up in the excitement of findmg. some-
organizations interested in keeping up with the latest develop- thing new that was potentially of great value to the respiratory
ments in the field. One such organization was the Queens field. I had also had the infinite satisfaction of domg what I
County Chapter of the National Tuberculosis Association. enjoyed doing. More than that did not concern me, a~d the
The demonstration was well received and widely publicized, cost in time and energy went undetermined. Occasionally
because the national organization at that time was extending someone suggested that my know Ie dge 0 f breathing could turn .
the scope of its activities to emphysema. Since I was not in a a neat profit, but to my financial detriment, I had more scien-
position to undertake any additional programs, I did not think tific curiosity than business sense and I never got around to
of it further than to be pleased that it had been successful the profit.
and had acquainted more people with the work in breathing Eight months after I began the program at the St. Albans
coordination. Little did I know how much thinking I very Naval Hospital, the medical controlled study was started at
soon would be called upon to do.
the West Haven VA Hospital on a note of high enthusiam.
Results from East Orange, Philadelphia, and St. Albans had
contributed to the optimism and interest with which the ~ew
project got under way. For the West Haven doctors ~he pnme
advantage breathing coordination afforded was that It enabled
the patients to maintain themselves independently after Ill-
84
85
 Dr. Breath
A Battle Is Fought
struction ceased. In other forms of breathing the patients re- West Haven nothing that I had not done dozens of times at
verted to their old habits when instruction ended.
East Orange and Philadelphia and was still doing at St. Al-
If I had paused to think, I might have wondered why the bans. The difference was the use of controls, which at that
West Haven staff paid little heed to the St. Albans documen- time seemed to be the approved procedure for testing the
tation of the physical changes breathing coordination effected. efficiency of a practice. I believed in the practice I had
Those busy days were not given to reflection' so I launched developed during the sometimes very long, always intense ses-
blissfully into the study I had long desired a~d iong sought. sions with people whose every breath was a struggle. I believed
As ongmally plan~ed, ten emphysema patients with varying in it and I was convinced that it could be of inestimable ad-
degrees. of disability were to be instructed in breathing co- vantage to the medical world.
ordmatIon and ten similar patients were to be selected at My belief and conviction, plus a total familiarity with hos-
random. to serve as controls. The second group was to con- pitals and the ill, obscured for me the fact that I was a layman.
tinue w.lth the conventional regimen for emphysema. At the I had been coming and going among medical personnel so long
conclusIOn of a given time the two groups were to be com- that I had little awareness of status. I reasoned rather simply:
pared to determine wherein my patients differed from the If in pursuit of my interest in breathing I came upon some-
controls.
thing of use to someone else, the someone else would be glad
Numerous tests were to be administered to measure the ex- to receive what I had found. That was very simple reasoning
tent of the differences. If the group instructed in breathing co- indeed. Although I had many friends and colleagues in the
ordination showed improvement, the control group was to medical profession, far more considered me an impertinent in-
recel~e some form of breathing therapy, such as intermittent truder upon an exclusive preserve. Even so, I could not per-
posItIve. pressu~e breathing. I felt rather odd about going into .suade myself that a good idea would be suspect because it
compet~tlOn with machines, but that was the way it had to be. originated outside the profession. I interpreted the endless test-
So be It! Should man triumph over the machine-that is ings and retestings to be the cautious procedure requisite to
should the breathing coordination group progress beyond th~ scientific certainty.
control gro.up-there would then be a solid basis for consider- The work in the hospitals preceding West Haven had been
mg breathmg coordination for possible inclusion in stand- directed principally toward helping the patient. If the objec-
ard practice .for the management of emphysema and other
tive were achieved, that, supposedly, was sufficient. What I
pulmonary dIsorders involving the distress of dyspnea.
failed to realize at the time was that no one expected the ob-
The study w?uld continue for approximately two years. In jective to be achieved. When it was, great excitement ensued
~e ~vent that It proved the efficiency of breathing coordina- and the medical batteries were drawn up to test and measure
tion III th~ management of emphysema, I stood to gain directly
and examine and try to determine what had happened. When
only.the intense personal satisfaction of finishing the job be-
the patient continued to improve and when those capable of
gun III 1958 at East Orange. Essentially, I would be doing at sustained effort went on to maintain themselves without me,
86
87
 Dr. Breath
A Battle Is Fought
the excitement cooled and caution set in. Here was an un-
improved." The incongruity of the situation might have
known quantity. Valuable or not, it was unknown. Fortunately
provided some slight amusement had not so much been. at
for me, I encountered enough unconventional thinkers who
stake. West Haven was the culmination of years of practice
shared my curiosity to be able to explore beyond the limits of
and thought in the field of breathing. I had been frustrated
standard practice. While the cautious were flexing their skep-
ticism, we were documenting the impossible. frequently by clashes with orthodox thinkers ~ut never when
the consequences might make further progr.ess Impos~lble.
West Haven was different. For all of the initial enthusiasm,
After six months of steady improvement m the patients, the
the study was scientifically staid and was not given to the
original controlled study was abandoned ~ecau,se "it was pos-
bursts of excitement which a new development occasioned at
sible that a considerable part of the patients Improvement
St. Albans. Dr. Robert C. Nims, medical supervisor of the
might be due to attention, encouragement, and increased mo-
work, indulged in as much latitude as was possible but not
much was possible. tivation given to them by a dynamic instructor." I suppose I
should have been happy to think of myself as such a large
My patients at West Haven followed the familiar pattern.
charge of dynamite, but I knew that the dynamite could very
Within a few breathing coordination instruction sessions they
well blow breathing coordination sky high. I felt like a latter-
showed marked improvement. The official hospital report read:
"... surprisingly good symptomatic results from patients who day Don Quixote tilting at medical windmills, and I am sure
had considerable respiratory disability. That is, patients be- that to many my lay findings appeared just as absurd ..
lieved that they were improved and attested that they could do To intensify matters already too intense, at that )unc~ure
certain types of activity that they had found impossible or very the term "breathing coordination" had gathered about It a
strenuous previously." number of practitioners who reputedly coordinated the breath-
One of the patients who "believed" he was improving was ing. Although there could not possibly have been any likeness
a proud man who had been forced to sell his small business to my work, a distinction had to be drawn to prevent :onfu.
because of his physical disability. When all of his reserves- sion. The distinction had to be obvious. Unfortunately, It also
some seventeen thousand dollars-were exhausted , he entered had to be made odious by the introduction of personality into
the Veterans Hospital as a last resort and was unofficially as- an atmosphere supercharged with personality. No longe~ able
signed to the "hopeless" category. After a COurseof breathing to travel alone across the unexplored reaches of SCIence,
coordination instruction, he was discharged from the hospital "breathing coordination" became for purpose~ of in~~stiga.
and was able to take care of himself. tion "The Stough Method of Breathing Coordination. .
At St. Albans we were documenting physical changes in the The second West Haven study was to determine the main-
respiratory mechanism and employing the latest available tenance of improvement after the period of instruction con-
equipment to do so, while at West Haven, hospital authorities cluded. Previous investigators of various breathing therapies
were noting circumspectly "patients believed that they were had found that upon conclusion of the instruction period the
patients reverted to their former degree of disability. Although
88
89
 Dr. Breath
A Battle Is Fought
the ability of patients to maintain their improvement had
questioning of results continued. I appreciated the scien-
been the very feature of breathing coordination to interest
tific caution and I wanted all doubt to be removed, but I
the hospital authorities originally, now it was to be investi-
sensed that the real interest was shifting subtly to another area
gated again. Two reliable social workers were assigned to in- while Iwas kept busy repeating myself.
terview the patients and elicit from them progress reports
Despite the initial good intent, the attainment of the desig-
possibly more accurate and objective than I might obtain.
nated goal of the study did not bring about a cordial reception
There were then East Orange patients who were maintaining
of breathing coordination into medical practice. It was for-
their improvement and holding jobs after having been hos-
mally declared to be of great value in the management of
pitalized three years or so earlier. I wondered if ever an end to
emphysema and other pulmonary disorders involving dyspnea,
proving would come.
but its introduction into practice assumed an importance sec-
Because breathing coordination was a brand-new thing
ondary to the mounting interest in determining precisely what
which Ihad come upon through years of thought and practice, occurred within the respiratory mechanism and precisely how
experiment and study, no certificate could be awarded me to
the occurrence was induced. For better or for worse, breathing
attest my qualifications to do what I said I could do and
coordination was being removed from the patient and into the
what I already had done hundreds of times before. In an age
realm of pure research. Although I was pleased with the op-
accustomed to certificates and diplomas and awed by titles and
portunity to delve into canse and effect, the postponement of
degrees, I cut a puny figure with my unadorned name. West
practical application was disappointing.
Haven with its due process was my hope that once and for all
While the clouds were gathering above West Haven, the
the efficiency of breathing coordination could be established.
breathing coordination program at St. Albans was attracting
Once established as standard practice, it could be put to work
the interest and attention which resulted in the demonstration
where It was needed and I could do something other than
for the Queens County Chapter of the National Tuberculosis
prove that It would work. A perfectly good medical tool would
Association. The metropolitan press had been invited by hos-
not be limited by the failure of its fashioner to have acquired
a proper title. pital authorities to the demonstration and had given it a grati-
fying amount of publicity. Through some confusion the New
The necessity of referring to my work as "The Stough
York Times was not represented at the demonstration. Shortly
Method of Breathing Coordination" was exceedingly unfor-
thereafter, a Times reporter called for a personal interview,
tunate. The continual use of my name galled, and the study
took on characteristics more of a trial than of an investigation.
which appeared in the paper the following Sunday. The in- I
terview mentioned that "The Stough Method of Breathing
I began t~ ask ~yself if I were developing paranoia. At any
Coordination" was under investigation at the West Haven
rate, I built a high degree of oversensitivity when every suc-
VA Hospital.
cess evoked question and further challenge. Long after the
With the appearance of the Times story, the storm broke
obJectrve-mamtenance of improvement-was achieved, the
over West Haven. The pent-up antagonism arising from the
90
91
 Dr. Breath A Battle Is Fought
personality factor was unleashed, and I was sternly repri- and devices. What impressed me even more was the realization
manded for personal self-seeking in the midst of scientific that commercial interests hover like vultures above the suffer-
research. Simultaneously, internal problems at the hospital Ing.
reached a crisis. The ensuing tumult threatened to inundate The availability of time limited the number of breathing
the breathing coordination study. As a final touch to the snarl coordination pupils accepted from among the inquirers. Those
of events, The Reader's Digest published its first general article accepted for instruction were chosen for several reasons: the in-
on emphysema, which at that time was an unpronounceable terest of their case histories, their particular need, their per-
word to the public and an enigma to the medical profession. sistence in applying for instruction, their adaptability to my
The work described in the article was counter that at West schedule. Some came hoping for a series of miracle exercises
Haven and gave small comfort in an area of serious distress. to solve their problems. Some came expecting sleight of hand
In the wake of the Times interview came a flood of assorted to restore their damaged respiratory mechanism. Some were
inquiries ~oncerning the application and availability of breath- curiosity seekers. Others genuinely wanted help and were pre-
mg ~oordmatlon. I had become accustomed to inquiries but pared to discipline themselves to obtain it. These last were the
~ot In this number nor in such an extensive range of applica- ones who could be taught breathing coordination and devel-
tion. There were, of course, numerous emphysema sufferers oped to the point of maintaining themselves independently.
who s~ught relief. There were also many people with chronic While the crisis was under way in West Haven and in-
breathing problems who had tried everything and who were quiries were pouring into New York, St. Albans was having a
graspmg for any possible help. Some sought merely to improve staff changeover which drastically affected the work there. Al-
their health through an improvement of their breathing. The though the development of breathing coordination represented
numbers who wanted and needed to know more about their a singular achievement, my sponsors had become thoroughly
breathing overwhel~ed me. I could not have imagined that disillusioned by my failure to devise a teacher-training program
so many knew so little about this most important of their and could no longer be interested in continuing either the
body's functions.
medical study program or the hospital service program under
Along with the inquiries were a number of solid business any circumstances. The grant for both West Haven and St.
propositions from manufacturers of breathing machines and Albans was terminating. When it expired, I would have to
devices to aid the breathing of emphysema patients and others unearth new funds for any further exploration of breathing
who suffered from respiratory disorders involving breathless- coordination.
ness. One letter stated candidly, "After all, you and I know For almost a year I had been working seven days a week try-
that.~hey are all going to come back to the machines eventu- ing to fulfill all the demands upon my time. I had believed that
ally. That struck me with forceful irony. The writer did not the documentation at St. Albans in combination with the
kno~ that breathing coordination gives the individual the study at West Haven would be sufficient to establish breath-
ability to manage his breathing without the use of machines ing coordination medically and that subsequent interest would
92
93
 Dr. Breath A Battle Is Fought
provide the financial means for training medical personnel to at which curiosity became a luxury well beyond my means. On
teach breathing coordination in hospitals. I had been very the other hand, a professional practice in management of
sadly mistaken. My error brought me up shortly to a con- breathing problems was almost an assured success. From the
frontation with myself. Times inquiries alone I could have set up a thriving practice
St. Albans had been a service project with the research and and dispensed with the erratic schedules, loss of personal priv-
study there a happy adjunct brought about by existing circum- acy, and unending demands on time and energy occasioned
stances. When the circumstances no longer existed, further by research.
time a~St. Albans would be a waste as far as the exploration of For several weeks the battle raged. One day I felt that I had
breathIng coordination was concerned. West Haven for all put too much of my life into breathing coordination to aban-
its tu~moil, w~s otherwise. Dr. Nims had developed; height- don it. The next day I felt that I had put entirely enough of
ened Interest In breathIng coordination when his work took my life into breathing coordination and could not continue
him from the laboratory into the ward. As he came into direct without some remuneration. Research certainly would bring
contact with the patients, he could consider the effect of me no financial reward. In fact, finances would have to be
breathing coordination in human terms as well as scientific sought to continue it. Thinking strictly in terms of personal
terms. His enthusia~m increased accordingly, and he proposed advantage, I could make only one choice-to open a profes-
that we try to obtain funds to continue the study along dif- sional office and go into the breathing business. Everyone told
ferent lines after the current grant expired. me I could make a fortune. I had no doubt that I could.
Meanwhile, two emphysema sufferers who had been referred I wish I could say that I did not choose to open a profes-
t~ me mu.ch earlier .and who had arrested the progress of the sional office because of humanitarian considerations, that my
disease with breathing coordination offered to help me if I awareness of breathing coordination's potential benefits to
should want to open an offi t t h b' ..
. '. ce a eac reathIng coordination mankind prevented my capitulation to the temptations of fi-
on a profeSSiOnalbaSIS.Like Dr. Nims' proposal for continued nance. I wish I could, but I cannot. The honest truth of the
research their offer was u t dB' .
. '. nexpec e. ecause of certain restnc- matter is that I was too stubborn to let my ideas be turned
tion~ of tlme~ I could not accept both. I would have to choose, aside by barriers of conventional thought. No amount of
and In choosing I would d t . h di .
. e enmne t e irection of my career. money would ever allay the frustration of failure to explore
The forces aligned for my battle with myself were form ida- breathing coordination as completely as possible.
~le.. I was physically ti~ed. I was discouraged by delays and Thus the battle was fought. I did not know for sometime
ndlfference. I had w~aned of fighting lost causes. Despite all whether I had won or lost.
the ~dvances made In breathing coordination my hope of
~edlcal acceptance seemed no nearer fUlfiIlm~nt and addi-
tional research appeared to be an exercise in futility for the
satisfactIOn of curi ity I f
nosrtv, was ast approaching the point

95
 8
THE COMMON FACTOR

Having filled a variety of roles in the serpentine

course of my career, I decided in the winter of 1963 to turn
super-sleuth. A mystery hung in the air and required, quite
obviously, a bit of Sherlock Holmesing to undo it. Clues were
in abundance, like a ring of keys with no lock to fit. The assign-
ment, then, was to find the lock, fit the key, and discover what-
ever it was waiting to be discovered. I set about my latest role
with cool objectivity.
For a long time before the work with the emphysema pa-
tients began at East Orange, I had been thinking about the
curious similarity of effect that a particular manner of breath-
ing had upon every temper and type of individual. The well
and their breathing for maximum efficiency were my sole con-
sideration in those days. I had observed in them a tendency to
relax and breathe with greater ease and efficiency when a cer-
tain point in the instruction session had been reached. Al-
though I could see it happening, I did not know why it
happened nor did I have a formula for making it happen.
Each pupil responded differently and required an individual
approach.
My purpose was to teach the pupil to use all his muscles of

97
 Dr. Breath The Common Factor
breathing in a unified pattern without calling upon one muscle parents, who had been consulting specialists here and abroad
or set of muscles to bear more of the workload of breathing for six years. Her breathing was deteriorating at an alarming
than another. I instructed orally and suggested various maneu- pace, however, and more satisfaction was to be gained from
vers and attitudes to make the pupil aware of the muscular effort than from caution. This case was a very real challenge
action. When I came to the ill and had to devise a new method to all my knowledge and experience.
of teaching, I had expected to achieve the same purpose, but I The child had no external sensations from the neck down.
was not prepared to observe the same reaction. When it oc- She could not so much as distinguish between hot and cold.
curred, I concluded that a common factor existed not only She relied upon a respirator at night and during part of the day.
among the well but also between the ill and the well. In her breathing she used accessory muscles and gulped in air
As my method of teaching the ill evolved, I decided to apply in a manner known as "frog breathing." To speak one com-
it to the well to determine what effect, if any, it would have plete sentence on a single breath lay beyond her respiratory
upon their breathing. The results caused me no little surprise. ability.
The point of relaxation was attained much more rapidly and Her personal charm and valiant effort diminished to incon-
breathing efficiency increased markedly. Of greater impor- sequence the difficulty of instruction. Within eight breathing
tance, I was able to detect unsuspected faults in the breath- coordination sessions, she developed a complete awareness of
ing mechanism and go about correcting them. Freedom from the coordinated pattern and could control it. Arrangements
respiratory disease, I very quickly learned, did not necessarily were made to take her to the West Haven laboratory for
mean freedom from respiratory faults. respiratory tests a month after instruction began then again
No matter how Widely divergent the physical condition of three months later. In the interim she developed more nearly
the individuals, a common factor existed in their manner of regular breathing and showed a significant increase in dia-
using their breathing mechanism. No two of them used the phragmatic excursion-in fact, a greater increase than that
breathing mechanism in exactly the same way, yet the results achieved with the electrical stimulus of specialized breathing
were always parallel. Try as I would, I could not ferret out that apparatus. Her comprehension and discipline were such that in
common factor from among all the accumulating data. time she became able to maintain herself independently for
Each new pupil, particularly one with an unusual case his- periods as long as thirty-six hours. With this achievement she
tory, I regarded a possible lead to the answer. Perversely, new could fly to Rome with her family for a summer holiday on the
pupils seemed to serve only to deepen the mystery. When I Mediterranean.
was asked to undertake to aid the breathing of an eleven-year-
old paral~zed from the neck down since the age of five as result , . Her progress pleased me immensely. It also perplexed me.
Where did she, a severely handicapped child, fit into the pat-
of mfechon by an unknown virus, I hesitated because I was not tern? I did not know, yet I had observed and documented with
sure I could help her. I knew I could not possibly harm her, her the same remarkable effects breathing coordination pro-
but I was reluctant to raise her hope or that of her desperate duced in everyone else. Long discussions with Dr. Nims and
98
99
 Dr. Breath
The Common Factor
others gave me a keener insight into her respiratory condition
While the consolidation of the ramified breathing coordi-
and her many physical problems, but they did not explain the
nation findings was in progress, another opportunity arose to
similarity of effects of breathing coordination. There had to be
an answer somewhere. test the flexibility of application of breathing coordination to
respiratory problems. Much to the bewilderment of the West
After the grant for St. Albans and the initial West Haven
Haven VA Hospital staff, a former service nurse applied for
studies had expired, additional funds became available for fur-
admission to the emphysema ward. She had learned of the
ther probing into the nature and potentials of breathing coor-
work in breathing coordination and had promptly set abo.ut
dination. Dr. Nims as medical supervisor was especially in-
arranging her infiltration of this traditionally male domain.
terested in breaking down my method of instruction into its
When the shock of having a woman about the place had worn
components to determine precisely what I did in establishing
off the men On the ward were rather pleased with the novelty
breathing coordination. He felt that such an analysis would
of the situation. Her case was not especially novel of itself but
facilitate the development of an instruction formula for the
subsequent developments were.
medical profession and would serve to explain breathing co-
ordination. Although I did not share his viewpoint, the line of A heavy smoker in her early forties, she had contracted a
investigation proposed would leave me free to sort and study serious respiratory infection which left extensive lung damage.
data and try to answer the questions which nagged at my She was not aware of any respiratory difficulty until she ex-
mind. perienced a rather sudden loss of breath and found that ~he
Before any new areas were explored at West Haven, the St. could no longer sustain her customary activities. She was diag-
Albans findings were reviewed, verified, and documented by nosed as having advanced emphysema. When she entered the
Dr. Ledwith for medical presentation. At last all the necessary hospital, she was gasping for breath and was never comfortable
charts and graphs were available to prove that what the patients in any position. She could not walk nor could she speak a com-
said was happening and what any observer could plainly plete sentence. Her use of accessory muscles for breathing was
see was happening had happened indeed. St. Albans had docu- further complicated by the contraction of the upper abdomen
mented the effect of breathing coordination On various seg- on the inhale.
ments of the respiratory mechanism but not on the total me- Within five breathing coordination sessions she changed
chanism. In the West Haven laboratory, pneumographs and completely to a coordinated pattern and could breathe freely.
roentgen-kymographs were employed to document the syn- A throat congestion cleared, the voice improved, and she was
ergism resulting from breathing coordination. A weakness in able to walk about a hundred feet and take care of her personal
any area was clearly indicated by alteration of another. The grooming. Before she had time for the muscles o~ breathing to
prior work and theories stood up beneath the scrutiny of the develop sufficiently to sustain her increased activity, she left
latest techniques and devices for measuring change in respira- the hospital because of personal matters. Her pnvate sltuatI.on
tory condition. was such that the tensions produced by it aggravated the exist-
ing respiratory condition of emphysema. Over a relatively short
100
101
 Dr. Breath The Common Factor

while she had a series of secondary illnesses which put her in a A week later the patient was off the critical list. In two weeks
critical condition. she had recovered, and in a month she was walking. Her ex-
Her return to the hospital, which she had left too soon, was perience that desperate afternoon left me with the feeling that
almost too late. This trip was by ambulance and with the ad- somehow I had come a step closer to an answer. I had seen
minist~ation of oxygen. She had not eaten in days, and when something I should have recognized but had not because I
~hearnved, she was more nearly dead than alive. She had lapsed was expecting something else.
Into unconsciousness, her respiratory rate was dangerously low, So far, my super-sleuthing had added up to a lot of sus-
and she ~as not responding to medication. The hospital staff picions but no real evidence. Practical laboratory work, how-
was at an Impasse because administration of additional oxygen ever, turned up a quantity of valuable material. To eliminate
could cause suffocation and use of the iron lung standing the subjective element and make the evaluation of the em-
ready outside her room could shock her into a heart attack. physema patient's condition wholly objective, the treadmill
Since ~he had not developed her respiratory muscles as fully was employed. This test measured the length of time the
as she might have, the illnesses had altered her breathing, and patient could remain on a treadmill and the amount of energy
her latter state was worse than the first. Midafternoon I be- he burned when he breathed oxygen and when he used breath-
gan working wi~h her, using palpation and light massage to ing coordination without oxygen. The results with breathing
keep the abdominal muscle and the pectorals relaxed in order coordination proved superior to those with oxygen. With
to reestablish her breathing coordination. Although she was breathing coordination the patient could tell the moment he
only semi-conscious at times, her earlier training enabled her had reached his maximum exertion, stop before he went into
to respond. She was being fed intravenously all the while. accessory breathing, and thereby avoid dyspnea and panic.
For five hours, under the observation of doctors who were With oxygen he had a false sense of capability and overex-
powerless to help, she lay between life and death. When her erted before he was aware of what he had done. He then went
respiration faltered, I was able to stimulate it with a light into accessory breathing and on to exhaustion and difficult
touch and keep t~e respiratory mechanism functioning in her recovery.
pattern of breathing coordination. Further tests involved spirometry to measure forced breath-
Lat~ in ~he evening after she had passed the crisis and was ing against breathing coordination. Here, too, the results were
~reathIng I~ her coordinated pattern, quietly, unaided, I went better with breathing coordination, because the respiratory
orne to think. What was the common factor between a dying mechanism always responds more efficiently in a state of re-
woman in a Connecticut hospital and every other person I had laxed effort than in a state of tension, as is induced by forced
taught, Sickor well? What was there in breathing coordination breathing. Another new element introduced into the study
th~t it functioned effectively even when the user was uncon- was the voice tape to document the changes in the voice
SCIOUS? St~lI,I h~d no answer. I had witnessed the happening as breathing coordination developed. Such changes had been
as I participated In it, but I could not explain it. observed previously but had never been documented. The tapes
102
103
 Dr. Breath
The Common Factor
strikingly illustrated the changes in voice timbre and degree of
pediment which threatened the whole structure of his adult
intensity. They also showed the increase in ability to sustain
life and forebode even more complicated psychological prob-
speech and the elimination of coughs, throat clearing, and
lems than he had already experienced. The impediment had
various conditions which had gone unattended. No longer was
not appeared until the latter part of childhood, but it h~d be-
reliance on observation alone necessary. Here was proof re-
come steadily worse as he grew older. Although I ordinarily
corded.
would not suggest breathing coordination as a panacea for
The stockpiling of documentation should have cheered me
speech defects, the circumstances of his case persuaded me
and it did, but not as much as it might have if I had not
that it might help him.
kept wondering how all these things fit together. I could not
When he was not quite ten years old, he had almost
escape the feeling that I was staring at something quite
drowned in a public swimming pool. The children were play-
obvious but to which, for some reason or other, I was com-
pletely blind. I had often been bitterly frustrated in my dis- ing noisily and the lifeguard was inattentive. By the time the
cussions with doctors when I realized that their mental bent boy was missed, his body had submerged and a pulmotor was
and medical indoctrination made impossible their compre- required to revive him. After a week in an oxygen tent and
hension of certain aspects of breathing coordination. I remem- nearly a month in the hospital, he went home for a recuper~-
ber well the doctor who stood up after a fully-documented tive period of a week or so before going back to school. HIS
lecture-demonstration and commented, "This has been most parents were so thankful for his survival that they were n~t
interesting, bnt, of course, we all know that once the chest has unduly concerned by the slight stammer in his speech. HIS
been raised, the lower, more normal position cannot again be condition was thought to be nothing more than a natural nerv-
established." What he had witnessed had not penetrated his ous reaction to a harrowing experience which he would out-
original convictions. He could not believe in anything con- grow eventually. Meanwhile, he attended speech classes in
trary to what he had once learned and accepted as final author- school to help him overcome his difficulty.
ity. His purblind ness was exceeded only by my own as my mind Instead of disappearing, the stammer became steadily worse.
kept traveling round and round breathing coordination, failing The boy received special instruction, but that did not improve
to identify anything I did not know already from experience his speech. One doctor who was consulted in the case attrib-
or inference. uted the problem to shock and recommended private school.
Into this interim of intensive study and exploration wan- When private school failed to solve the problem, speech and
dered another desperate individual with an unusual problem. voice therapy had a turn but produced no lasting benefit~.
He came not long after the introduction of the voice tapes, Over the years the deterioration of the boy's speech affected hIS
and the nature of his problem was such that I decided to have schoolwork so severely that he was not expected to be gradu-
a go at it despite an overcrowded schedule. s-
ated from high school. He was rejected for military servi.ce
The young man, then in his late teens, had a speech im-
because of his inability to repeat commands, and hIS SOCial
10"1
105
 Dr. Breath The Common Factor

contacts narrowed almost to nothingness as communication ation and release of tension, the same muscular development,
became increasingly more painful for him to attempt. the same voice improvement, if something were not the same
Since the condition had arisen from an accident involving among them all.
the respiratory mechanism, I suspected that damage to the I pondered. I probed. I puzzled. I pored over everything at
mechanism might be the cause of inability to sustain speech. my disposal. I prayed for insight into the mysteries of breath-
I knew what I was looking for and I found it almost immedi- ing. Leisurely, like a cloud shaping on the horizon, an idea
ately. When the young man spoke, the abdomen protruded. began to take form in my mind. Indistinct at first, it separated
From the work in emphysema I had learned that the protru- ( itself gradually from the accumulated mass of thought on the
sion of the abdomen in the effort of speech is the sure sign of subject of breathing and breathing coordination. The edges
a weakened diaphragm. A weakened diaphragm cannot support rounded out and, slowly, it drifted free to stand alone in monu-
the air pressure required for speech but will invert, causing mental grandeur. Its utter, beautiful simplicity astonished me.
pressure in the lower abdomen and the subsequent pro- What astonished me even more was the realization that my
trusion. common factor had been lying in plain view all the time. It
Too much damage had been incurred over too long a time was so obvious that I, in expectation of the recondite, had
for the speech fault to be eliminated entirely, but the improve- failed repeatedly to notice it.
ment was great. With the redevelopment of the diaphragmatic After all the years, there it was, my long-sought common
muscle through breathing coordination, the young man learned factor: nothing other than breathing coordination itself!
to manage his breathing well enough to maintain himself un- When I had recovered from the unique experience of dis-
der conditions of stress and prevent the former incoherencies covery, I was able to identify the error in my thought which
of his speech. He could then go about his life in a normal had obscured the obvious for so long a time. Since the results
manner. were identical, I had expected the cause to be identical. I
After my experience with the young man, I returned, some- was looking for something with no variation from individual
what the wiser, to my pursuit of the common factor in breath- to individual. The variances had deceived me. In spite of my
ing which I believed to exist among all people regardless of constant awareness of individual differences, I had fallen into
physical condition. Because I knew what I was looking for the trap of thinking conventionally that everything can be
in the case of the young man, I was able to succeed where reduced to a convenient formula. Nothing could be more
others had failed. What, I asked myself, was I looking for now? highly individualistic than the manner in which a person
Essentially, I was in search of a norm, a "correct" pattern of breathes to fulfill the unique requirements of his body at a
breathing against which I could measure the progress and de- given moment.
velopment of my pupils. They all had to be doing something Breathing coordination is the correct pattern for a particular
nght, or the results of their breathing coordination could not individual, not a general pattern which can be applied to every
have paralleled. They could not all have had the same relax- individual.

106 107
 Dr. Breath
The Common Factor
To verify the discovery, Dr. Nims and I worked through the
system just as digestion is the intended function of the diges-
data step by step countless times, always with the same conclu-
tive system.
sion. In early 1964 we were able to state unequivocally that
Unfortunately, the discovery of breathing coordination was
there is no absolute "correct" method of breathing; there is
complicated by the attempt to explain my method of estab-
only breathing coordination. The muscles and sets of muscles
lishing it. The Stough Method of Breathing Coordination was
of the human respiratory mechanism are designed to operate
taken as an entity rather than as components. Breathing co-
in a perfectly coordinated synergism to give the individual the
ordination is. It exists. It existed before I discovered it and will
maximum breathing efficiency of which he is capable and to , continue to exist long after I cease to practice The Stough
give it to him with a minimum expenditure of energy.
Method. The Stough Method is what I do to cause the muscles
Regardless of respiratory handicap or damage, the mecha-
to function in the originally intended pattern of breathing
nism can be trained to function in a coordinated pattern with
coordination. The method is the instruction technique I use
the work load of breathing evenly distributed over the operable to establish breathing coordination. Others may develop other
portions of the mechanism. Each person, according to his methods. Methods will change, but breathing coordination
physical structure, has his own individualistic pattern of breath- will remain.
ing for maximum efficiency with minimum effort. If he suffers My long, sometimes discouraging, always exciting search was
any form of respiratory damage, his muscles can be retrained ended. Now came the arduous task of making the findings
to compensate the disability without overuse of any single known.
muscle or sets of muscles. Breathing coordination can exist
under any respiratory condition.
Slowly, my mind encompassed and digested the staggering
realization. All the years-then some sixteen or so since I had
begun to look for a common factor-all those years of thought
and experiment and development had been climaxing before
my very eyes and I had not seen because I had been in search
of something else. A new continent had been reached, and I
had thought I was coming round to the Indies.
Contrary to my previous notions, breathing coordination
was not the name of something I did. It was a physiological
fact, heretofore unknown, which I had discovered in my ef-
~orts to help emphysema patients breathe more easily. Breath-
mg coordination is the intended function of the respiratory

lOB
109
 9
,.' A NEW DIRECTION

Before the formal medical presentation of the work

III breathing coordination could be made, a considerable
amount of research remained to be done, Like it or not, I had
to accept that fact So I did, but not very gracefully, I was not
a doctor, nor was I under any direct obligation to the medical
profession. I chafed against the pedantry which delayed the
progress of the investigations into the many applications of
breathing coord ina tion. Medical acceptance of my discovery of
a new physiological fact would have slight effect upon my
career other than to eliminate a certain degree of skepticism.
On the other hand, the new physiological fact would be of
immense benefit in the practice of medicine. I could not bring
myself to stand about and wait patiently for all the formalities
of presentation, deliberation, and acceptance to be fulfilled.
While Dr. Nims continued his analysis of The Stough
Method for inclusion in the medical report on the work in
breathing coordination, I advised major figures in the respira-
tory field in this country and abroad of the discovery. A series
of informal reports detailing study procedure and documenting
results served to bridge the anticipated gap between the con-
clusion of the research and the publication of the report on the

111
 Dr. Breath
A New Direction
work. The response to these initial communications was grati- hundreds of people of varying degrees of respiratory disability,
fyingly cordial.
and I had learned more about human beings and the way they
Preparation of the medical material proceeded at what for breathe than I would ever have imagined possible six years
me rivaled the pace of a lame snail. The complications were earlier. Repeatedly, the results had been tested and confirmed.
legion because of the radical nature of the subject. In the year From my six years in hospitals and my prior experience and
1964 there were areas of conventional thought which made experiments in the field of breathing, I had come to a deep-
~he scholasticism of the Middle Ages seem avant-garde, and ening realization of the profound effect of the act of breathing
into these areas had to be introduced ideas completely counter on the total human being. I had also learned, with mounting
accepted concepts. So little creative thought had been applied distress, how very little is known of the manifold effects of the
to the process of breathing that few were aware of the poverty act of breathing on the several systems of the body and ho~
of knowledge of the subject. Error had been laid upon error very little attention is paid the respiratory system until It IS
and passed on as fact.
damaged. The need for broader knowledge of breathing is great
Although I had not the least desire to clash with standard among medical men and the public alike. The need for re-
teaching, breathing coordination was hurtling me headlong search into the ramifications of the act of breathing is even
into conflict. First of all, my lay status generated prejudice. greater.
That ~nyone other than a medical man could think of any- Knowing that breathing coordination is an immediate aid in
thmg in the realm of physiological functions was past compre- respiratory problems and a potential aid in numerous other
hension for some. To compound the difficulty, the conven- areas of human disorder, I became more and more impatient
tional termmology of the respiratory field carried with it with the niggling over The Stough Method. Here was a ~hole
overtones and implications which misled and confused in the new world to explore, and attention focused not upon It but
consideration of a new subject. Here were two obstacles to Upon the means used to get to it. I had the smothering sensa-
surmount before approaching the heart of the matter and tion that breathing coordination could be buried forever ~e-
boldly setting forth ideas counter the conventional. Two of neath sheaves of medical papers. Some sort of conclusive action
the startling achievements of breathing coordination were the
had to be taken to forestall that possibility.
development of involuntary muscles and the alteration of chest While the medical work went on leisurely, I began to cast
position, both of which had been considered impossible. In about for ways of extending investigations into the applica-
numerous instances, visible proof had failed to dismiss skepti- tions of breathing coordination and of disseminating the Ideas
crsm.
already gleaned. My several interests were now concentrated
At this juncture in my career, I had been a laborer in the
in breathing coordination, and I wanted some vehicle to con-
~e1d of medicine for six years, four of which had been spent in
vey them all. I wanted to put myself in a position not only to
mtensive formal research and all of which had been under
Conduct research and explore the field of breathing further but
constant medical scrutiny and advisement. I had instructed
also to stimulate thought in the area of breathing, to instruct,
112
113
 Dr. Breath
A New Direction
and to make breathing coordination available on as extensive a
basi~ as possible. The more I thought, the keener became my Regardless of the nobility of purpose served, long names are
realization that I could not accomplish my purpose alone. I like elephants in traffic; they impede the movement of a high-
needed a great deal of help. speed civilization. The long name of the new organization
Setting up a professional office and hiring a staff was an ob- had to be changed to something more wieldy. For practical
vious answer to my need, but to me it seemed inappropriate. A use, therefore, it was neatly trimmed to The Stough Institute.
professional office smacked too much of commerce, a possi- The same held true for The Stough Method of Breathing Co-
bility which I had already dismissed as incompatible with my ordination. That was reduced to initials, 5MBC, and trans-
basic interests. What was required was some sort of organiza- formed into phonetics as SIMBIC.Operations could now pro-
tIO~ to embody and perpetuate the idea of breathing coordi- ceed without undue delays arising from tongue-twisters.
nation, an organization that could grow and make a significant Officers and advisers of the Institute were either pupils or
contribution in the field of breathing. associates in breathing coordination. The principal officers
After a period of deliberation and consultation I concluded were emphysema sufferers in whom breathing coordination had
~hat.my purposes could be served best by the founding of an arrested the progress of the disease. Because breathing co-
mstitute for research and education in the field of breathing. ordination had been discovered in the search for relief of the
Such an institute would have to have a name of course and dyspnea 0£" emphysema, early interest in the Institute tended
like everything else in my life, that name wo~ld have t~ en- to Concentrate in the application of SIMBICto that disease.
compass multiple considerations. It would have to single out Work at both St. Albans and West Haven and in my private
breathing coordination from among the other schools and instruction alone had indicated that SIMBIChad far more
practices of breathing. Further, it would have to distinguish uses. However, before I went into formal investigations of
The Stough Method of Breathing Coordination from other the numerous applications of SIMBrc, I decided to indulge
methods of teaching breathing coordination, which conceiv- myself a bit and satisfy a curiosity I had entertained for a long
ably may be developed in time, and from other methods of time. .
teaching other forms of breathing. As early as East Orange I had had among the advanced
Once again, to protect important considerations, the final emphysema patients former athletes of varying degrees of pro-
re~ort was the o~ious introduction of personality into what ficiency. Because of their basic muscular coordination which
might have remamed to advantage an impersonal area. The ~nabled them to excel in athletics, they usually were easier to
newly-found institute was dubbed The Carl Stough Institute Instruct and quicker to learn than most of the others. Working
of Breathing Coordination and duly incorporated. The incor- with them, I often wondered about the breathing patterns and
poration proceedings came about with the aid and advice of habits of first-rate athletes in prime condition. I fancied that
?reathing coordination pupils and persons interested in breath-
, some of them might have retained into adulthood the natural
mg coordination. breathing coordination with which most people are born but
tend to lose in infancy and childhood. I had seen the worst of
114
115
 Dr. Breath A New Direction

respiratory conditions and I wanted to round out my experi- convinced of the value of S1MB1C to his men, no chance ex-
ence with the best. isted that the other Olympic coaches ever would be.
The files of the new Institute were filled with case histories After an agonizing stretch of time, I learned in a very casual
of respiratory disease and disorder and with accounts of the manner that something of significance had occurred. Since
effects of S1MB1C upon the well-that is, persons free of respira- trackmen for the most part are self-contained and not given
tory complaints. For purposes of comparative study, data on to talk about their accomplishments, I rarely had any in-
the respiratory condition of the physically superior would be formation from the runners themselves about their personal
highly worthwhile. As administrator of the Institute, I pro· performances. The report was almost certain to come from
posed that the initial project be an investigation of the respira- someone else. In this instance, all that I could find out imme-
tory condition and breathing habits of athletes. I was eager to diately was that some personal performance records had been
take a new direction in my thoughts and in my activities. broken. That gave me hope to go on.
Happily, I set out on the path which led me to the United Later, when I received my copy of Cieg's report to Dr. Stiles
States Olympic Committee, through the Boys' Club of New of the Olympic Medical and Training Services Committee, I
York, and on to Coach Giegengack of Yale, to whom I had to read: "After eight breathing coordination sessions and all to-
prove the increase in respiratory efficiency brought about by gether on the same date all four of my men produced their best
SIMB1C. By the time I had reached Yale, I was a few years older lifetime performances. I would like to think it was my training
and. wiser and perhaps a little less impatient, but I still chafed methods but it is too dramatic to call it coincidence, especially
against the ever-present necessity of endlessly proving the ef- since men who were not put through this routine did not show
fectiveness of S1MB1C. such dramatic improvement." In another communication with
Despite the.1elative brevity of the Yale project, so little time Dr. Stiles, Gieg further attested: "In the case of my own men,
remained until the Olympic High Altitude Medical Testing our recovery time has been halved. Men now effectively double
and Study Program at South Lake Tahoe, California, that the in twenty-five minutes who usually needed fifty." Whatever I
weeks seemed eternal. The Yale men developed steadily and had anticipated, this was even more.
showed .all the side benefits of S1MB1C,but Gieg remained Gieg was very deliberate in his decisions, but when he had
emgm~tlc. When openings in the schedule permitted Gieg made up his mind, he proceeded with hurricane force and
and Bill Dayton, his trainer, to have S1MB1Cinstruction and monumental determination. During his enigmatic period his
to experience for themselves the effects, their interest and mind must have been clicking away like a calculator, totaling
enthusiasm increased. Still, I had no inkling of Gieg's thoughts all the factors involved in the inclusion of S1MB1C in the 1968
on the proposal to incorporate S1MB1C into the regimen of the Olympic program. I was certain that one of the most im-
01ympic. can did
I ates as a health and safety measure, quite apart pressive factors was not the performance record but the re-
from the probability of improved performance. If he were not duction in recovery time, for Gieg had an uncommon concern

116 117
 Dr. Breath
A New Direction
for the health and safety of his men. Convinced that SIMBIC
would be of advantage to the U.S. Olympic candidates, he Accustomed as I was to waiting for decisions, I knew I could
immediately put into motion the complicated machinery re- not afford the luxury of indolence while the course of the fu-
quired to persuade the other Olympic coaches that SIMBIC ture was determined. I had to assume the positive and be
would be a good thing. He himself had been persuaded both prepared for it; otherwise, I could not act upon it with the
by his personal experience and by the experience of his track- speed the waning time demanded. If I got a negative, I would
men. He would have undertaken the removal of mountains if have time in abundance to plot my next course of investiga-
the removal of mountains had been required. tion of the respiratory conditions and habits of athletes.
Unfortunately, the effects of SIMBIC always sounded too With the accrual of the beneficial results of SIMBIC to the
good to be true, because the requisite to the achievement of Yale trackmen, word of the breathing project circulated
those effects was seldom taken into consideration. At the men- through the Athletic Department, and an opportunity arose
tion of breathing, most tend to think of a given series of to work with the swimming team. It proved to be the per-
calisthenics of one sort or another to bring about an im- fect solution to the immediate problem of preparing for the
provement in respiratory function. Before SIMBIC can be un- future. It also gave me a chance to check on the respiratory
derstood, that concept has to be dismissed entirely. SIMBIC is status of swimmers and observe their response to SIMBIC.
not a magic formula for good breathing. It is a carefully dis- Gieg and I had discussed the probable conditions which
ciplined process of retraining the muscles of respiration to would exist at South Lake Tahoe during the Olympic high
operate in a synergistic pattern for peak efficiency with mini- altitude program. In all likelihood my schedule would call for
mum effort. Once the discipline is achieved and the respira- SIMBIC instruction for some eighty athletes a week. Each ath-

tory muscles have developed sufficiently, the benefits are in- lete would require an individual session, because breathing
numerable. The too-good-to-be-true effects begin to appear coordination can be taught only on an individual basis. I had
only after the initial conditions have been fulfilled. never undertaken so extensive a teaching project in so limited
In presenting SIMBIC to the Olympic coaches, who had no an amount of time. I was not at all sure how I should go about
prior knowledge of it nor any reason to think it other than an- it.
other variety of breathing measure, Gieg ran into a mountain The Yale swimming team entered the scene at precisely the
of skepticism. He was equal to the challenge. He wrote letters right moment. The track team was going to be away at the
and the Institute supplied reports on athletic and other in- time the swimming team was readying for competition. I
vestigations preceding the Yale project. Our combined mail- could work with the swimmers while the trackmen did not
ings that spring were considerable. Convincing people at hand need me. Since the period of SIMBIC instruction was to be lim-
is difficult enough; convincing them long distance is a her- ited, I would be able to determine how rapidly I could handle
culean task. But, Gieg had espoused SIMBIC, and long after I individual sessions, how rapidly the athlete could assimilate
had run out of answers, he still had a few left. instructions, and at what pace physical development might be

118 119
 Dr. Breath A New Direction
expected under such circumstances. All of this information was and planning, not to mention a sizable portion of Institute
vital to the planning of an instruction program for the Olympic funds, had gone into the Olympic program. Not to be able to
candidates. fulfill it satisfactorily would be extremely disappointing.
The swimmers benefited from their accelerated course and Mail sped back and forth across the country as I busied
so did I. I learned much about the respiratory condition and myself in practice of the virtue of patience. I was not without
habits of swimmers and accumulated an amount of data for other preoccupations in the interim, fortunately, but none of
Institute purposes. Most important, I found out what I needed them seemed to be of sufficient magnitude to block out my
to know in order to draw up an instruction pIOgram plan for concern for the Olympic program. I could understand the
South Lake Tahoe. However, I failed to discover among the reservations in appraising something new by long distance, but
swimmers what I always hope to find in working with persons my understanding failed to bring me any consolation. The
in superior physical condition-someone with perfect breathing thought of being so near yet so far from realization of a great
coordination and without respiratory faults. effort and a great desire created almost un bearable tension.
When the track team returned to New Haven with fresh Many times when I have been in tense situations-and those
triumphs, I had the instruction program pretty well formu- times have been numerous-I have known that without my
lated. Gieg and I worked out the details while we waited for own development and practice of breathing coordination to
the response of the coaches to the proposed SIMBIC project. dissipate the tensions, I should long ago have fallen victim to
Since the project was a cooperative undertaking to be spon- ulcers, heart disease, and all the other attendant evils of life
sored jointly On a mutual interest basis by The Stough Institute in a progressive civilization. If for no other reason than self-
and the United States Olympic Committee, conceivably it preservation, I consider all the years of research well worth the
could proceed without the approval of the coaches, but then effort.
the full burden of sponsorship would fall on the Institute. During the crisis of the coaches, breathing coordination
Furthermore, the extent of success under those conditions served me admirably. My nerves stretched and frayed, but they
would be highly questionable. did not quite snap. Each day I told myself in utter seriousness
I needed the approval and the cooperation of the coaches to what I frequently told my pupils and patients in jest: "Keep
accomplish all that I hoped to accomplish for the Institute breathing!" I did, as the hours agonizingly spun out into eons.
and for the Olympic Committee. Few athletes were likely to
take an interest in any measure their coaches did not endorse.
Regardless of my convictions or desires, I could not teach any-
one who did not want to be taught. Nor could I find out a
great deal about the respiratory condition of anyone who
would not work with me. Two years or so of preparatory study

120
121
 ------

10
METAMORPHOSIS

On the whole, Olympic coaches are not prone to

snap judgments. They approached SIMBIC with abundant cau-
tion and weighed me in the balance with great care. I was no
stranger to the judgment scales, but I had never found them
particularly comfortable for protracted periods. I wondered
why I permitted myself to climb into them so readily.
I could have done other gainful things with my life than
deal in the vagaries of breathing. At least, I like to think I
could have, but I am not entirely certain. The metamorphosis
was so subtle that no line could be drawn at any single point in
my life to divide one interest, one career, from another. Each
derived from the other and complemented the other.
Breathing, whether an area for scientific research or for in-
struction in practical application to the production of sound,
is admittedly a rather unusual subject with which to become
involved. It leads to no end of tedious, albeit well-intended
jokes which automaticaIly stifle the development of further
Conversation along that line. Occasionally it does elicit chal-
lenging questions with answers too personal or too involved
to make. Every now and again it will generate a query that

123
 Dr. Breath Metamorphosis

lingers in my mind long after and compels me to consider it in which the muscles employed in the exhale could work and de-
a different light. velop. If I had been a medical doctor, I should have reasoned
Persons who are familiar with my work in the medical field solely in terms of forced movement of volumes of air in and
and who are disconcerted by my lack of a medical degree are out the lungs, for that would have been all that concerned me.
wont to ask such questions. One that is directed to me with Yet, unregulated and ungraded force on the exhale can dam-
almost predictable regularity is, "If you're not a doctor, how age muscles already weakened and ultimately do more harm
did you get into breathing, anyway?" than good.
Oddly, the comprehensive reply is not a forthright account Awareness of the quality of the voice in sustaining sound
of the events leading to my entry into the medical field. After further drew my attention to the protrusion of the abdomen
much thought, I have concluded that the answer should run on the exhale as an indication of diaphragmatic weakness and
more like this: "If I were a medical doctor, I should not be in inversion under pressure. If I had been a medical doctor, I
the field of breathing at all. My studies and orientation would would have been occupied wholly with the principal muscles of
have faced me in another direction. I would be, instead, in the breathing and the function of the respiratory system entire. In
respiratory field treating respiratory diseases and disorders. If all probability the abdominal protrusion would have seemed
~ had been absorbed in the treatment of respiratory disease or of small significance, and certainly it would not have been re-
m the several functions of the respiratory system, I would lated to the accompanying tension in the upper chest area. I
never have discovered breathing coordination." was accustomed to suspecting an error in the breathing when
I came into the field of breathing through the only door the sound of the voice altered and to inventing ways of elimi-
open to me. I came by way of sound. Until I worked with the nating the error.
emphysema patients in East Orange, my thoughts on breathing Sound was one of my most reliable guides through the maze
were always in terms of the production of sound, primarily the of respiratory complications. Before I ever began working with
sound of the human voice. I had observed certain psychologi- a pupil or patient, I could determine his general physical con-
cal and physiological effects of breathing in a given fashion, dition by the sound of his voice. The respiratory system is the
~ut my chief concern was the sound resulting from that fash- balance wheel of the body, and sound is the gauge of the
IOn of breathing. My ear was acute, and I could detect the :espiratory system. When the breathing is aberrant, the body
moment the breathing had gone wrong and changed the sound. IS affected. Conversely, something amiss in the body will affect
At East Orange my preoccupation with the sound of the the breathing. The same, of course, is true of psychological
v?ices of the emphysema patients prodded me to the realiza- pressures as well as physical.
tion that the ability to sustain sound was in direct correlation The Whole reason for my being consulted and brought into
with the ability to exert physical effort. From that point I rea- the medical work at East Orange in 1958 was that I had then
soned that the air required to produce sound of a given length developed an effective method for teaching the well how to
and quality would serve as a self-regulating graded force against breathe with increased efficiency for the production of sound.
124 125
 Dr. Breath
Metamorphosis
Sound, at that point, did not enter the medical scene, but the
my voice. From that awareness grew my interest in the in-
increased efficiency of breathing did. I had been dealing with
tricate relationship between breathing and the sound of the
various problems of breathing among the well for a number of voice,
years and had evolved an instruction technique for correcting
A question sometimes put to me by former classmates is,
flaws in the breathing pattern and for using the breathing
"What do you know that we don't know?" The logical impli-
mechanism with a higher degree of efficiency than had been
cation is: "After all, we attended the same classes, heard the
possible previously. An important element of my technique was
same lectures, read the same books. How could you have found
the use of sound to detect and correct errors in breathing. My in those sources something we missed?"
acute physical sense of hearing was augmented by a mental
I have learned to dismiss such questions with a light remark,
quirk which enabled me to hear sound not only as it was
for answering becomes too tedious to be worthwhile. As so
actually but as it should be. When I listened to a voice, I did
logically implied, what I received from the classroom was
not hear the voice alone. I heard also the voice as it should
basically the same. I was not an assiduous student. With only
be, properly developed, and I generally knew almost im-
the least effort, anyone could have acquired a great deal more
mediately what was wrong with it and how to correct it.
general knowledge than I did from formal schooling. The dif-
For me, the voice was not an entity that required breath for
ference lay in my attitude toward the sound of the voice.
its activation and embellishment. The voice was the breath
For me the classroom was primarily a training ground, a
acting upon tissues and passages of the body to produce sound.
place in which I was taught the routine concepts and proce-
The sound so produced bore a direct relationship to the effec-
dures followed in the choral profession. I did not really begin
tive function of the respiratory system. The sound could not
to learn until I tested those concepts and procedures in an
be correct unless the breathing were correct.
actual situation. Even as a student I had a chance to do that
Just when in my life I became intrigued by the sound of the
by filling the post of weekend choir director in nearby Trenton
human voice, I could not say. As a child I had a pleasing voice
and Philadelphia churches. What was of no value to me I
and ample opportunity to use it. Possibly, fascination with my
quickly discarded. What I could use I explored and elaborated
own voice was the beginning. At any rate, my voice, my keen
upon and shaped to suit my particular need. I was constantly
aural sense, and an amount of musical talent eventually preci-
trying to match the choral tone I actually heard with my ear
pitated my enrollment in Westminster Choir College, Prince-
to the tone sounding insistently in my mind.
ton, New Jersey, in the mid-1940'S. There I sang with West-
The choirs I worked with were made up of volunteers, most
minster Choir and worked with the late Dr. John Finley
of whom were vocally and musically untrained. I realized very
Williamson, whose passion for choral tone, achieved by the
qUickly that I had set an impossible goal for myself, that I
development of individual singers to professional soloist abili-
would do well even to approach the desired choral tone. If I
ties, made a deep impression on me. Dr. Williamson also
wanted to hear the ideal sound, I would have to find some way
made me aware of the effect of my breathing on the sound of
of producing it from the voices at my disposal. To that end, I
126
127
 1
Dr. Breath
Metamorphosis
gave private voice lessons to the choir members and had the
At that time I had not entirely given up the idea of a career
satisfaction of hearing unmistakable improvement in the
in voice, and I continued to explore the possibilities of my own
choral tone.
voice while I was teaching my new choir members, many of
Graduation came none too soon for me. I was eager to be them not only voice but the fundamentals of music as well.
off and away in pursuit of my several theories of creating As I worked on my own problems of breathing for the pro-
plural tone with individual voices. Again my master plan was duction of sound, I could observe the same problems in the
to take each voice, analyze it, and proceed to develop it to- people I taught. Both in myself and in others I found that
ward its highest potential. I believed that voices so developed emotion produced a breath-restricting tension and altered the
and trained to sing together would be like an orchestra, each sound. I invented various physical maneuvers to eliminate the
instrument at its best attuned to the others. Such a group tension and free the breathing. Always, when the, breathing
should produce a choral tone of surpassing virility and beauty. fell into an unrestricted pattern, the pupil relaxed and could
Of the job opportunities open to me after graduation, the begin to achieve his voice potential.
one that seemed most likely to permit me the freedom to test With this system of individual teaching augmenting the
my ideas was the First Presbyterian Church in Rocky Mount, overall choir instruction and rehearsal, I came even nearer to
North Carolina. The church had no choir program and would the choral tone which was persistently in my mind. The ex-
be happy with anything I could do to provide one. The choir citement of watching the choir grow and hearing the voices
was composed of considerably less than a dozen members, change stimulated the community. That Christmas I was able
but, I told myself cheerfully, that could be remedied. The to put together a community choral group for the presentation
remedy required several foot-tours of the business district to of the first part of Handel's Messiah. In the late 1940'S, such
persuade the men of the church to have a try at the choir. The a presentation was a stellar achievement. From the success of
ladies of the church were somewhat more musically inclined. the Christmas performance grew the idea of a community
During my years at Westminster I had experimented choral group for those who enjoyed choral singing and who
enough with my own voice and breathing to believe that only were willing to make the usual bargain with me-voice lessons
defects of the throat or ear prevented singing. To build my in exchange for faithful group membership. Eventually, the
new choir, I announced with infinite calm that I positively membership was stabilized at forty.
would teach anyone to sing who did not have a limiting physi- My theory of training voices individually and combining
cal defect. Service in the choir was the only other requisite to them to achieve a superior choral instrument with a unique
free instruction. The challenge was designed to stir up the tone was realized in both the church choir and the community
spirit of the young and lighthearted. It did, and a few weeks choral group. News of the group's exceptional ability spread
and scores of voice lessons later the church had a choir of some abroad rapidly, and in the first season we were invited to re-
thirty enthusiastic members. place the Westminster Choir in special performance of Paul
Green's outdoor music drama, The Lost Colony, in Manteo,
128
129
 Dr. Breath Metamorphosis
North Carolina. That was the era of the Robert Shaw Chorale other networks, and I was soon in a position to take a chance
and other such personalized choral organizations; so, my group On organiz.ing a professional group in New York to present a
quite naturally became the Carl Stough Chorale. sImIlar senes. The temptation was too much for me, particu-
The four years I spent in Rocky Mount were filled with all lar!y w~en it was accompanied by the opportunity to study
the high excitement and adventure of youthful testings. I was voice with the late Paul Althouse. One hot Sunday morning in
practically unrestricted and could experiment to my heart's mId-August of 1953 I got married and set out that afternoon
content with tone and breathing and the production of sound. for New York City.
Somewhere in among those years I began to realize that I did Totally innocent of the vicissitudes of the fair island of
not have the true musician's approach to choral work. Al- Manhattan, I arrived upon its shores with an abundance of
though I selected the best of choral repertoire for both the plans and projects and promises and a glaring insufficiency of
church choir and the Chorale, I was not the least interested in wherewithal. I began work immediately with Mr. Althouse.
the exploration of recondite works and the presentation of His dynamic approach to teaching so intrigued me that the
elaborate choral programs. My interest lay, rather, in the total other events of the time appeared far less fonnidable than they
choral sound produced in the combination of voices individ- actually were. Under his tutelage I was freed of my tendency
ually trained to their greatest potential. The absorption with to analyze myself constantly, and I began again to have
sound brought me back to the development of the individual thoughts of a concert career.
voice, which took me even farther back to breathing as the Simultaneously, I was conferring with radio and television
basis for the correct production of sound. My interest in music network officials and potential sponsors about an elaboration
did not match my interest in the sound of the human voice of the Chorale's Liberty series for the following season. While
and the influence of breathing upon it. the Columbia Broadcasting System was considering an option,
The Chorale achieved an extraordinary tone which was ap- an abrupt change in network policy and personnel ended that
preciated if not perceived by those who heard it. The group project. The National Council of Churches toyed with the idea
enjoyed a considerable degree of renown in the Upper South of maintaining a professional choral organization but that,
and toured as extensively as was then possible for amateur too, failed to materialize. My finances were fast dwindling as I
singers with jobs to consider. We had a return engagement began to perceive an indefinable change in the atmosphere of
with The Lost Colony, an appearance at the Mosque in officesand conference rooms and in the attitude of execntives
Richmond, Virginia, other appearances around North Caro- who received me. The time was not right for the projects I pro-
lina, and concerts and oratorio performances in Rocky Mount. posed, regardless of how attractive they might be. I indulged
The crowning accomplishment was a season of a half-hour mys~lf in a moment of pure panic before settling down to
sustaining broadcast on Sunday evening over the now-defunct ConSIderthe state of poverty I was about to enjoy.
Liberty national network.
. My Work with Althouse gave me a focal point, and I con-
The Success of the Liberty broadcasts drew the attention of VIncedmyself that all was not disaster. Of course, I had no job,
130 131
 ----------

Dr. Breath Metamorphosis

very little money, and a lease on an apartment I could not af- over two dozen. With the aid of the Choir Guild, which had
ford, but surely, if r dug about, something would tum up. I remained more active than the choirs, r was able to assemble
began to dig. I called Dr. Williamson, who was still president nearly two hundred children, young people, and adults for the
of Westminster Choir College and who had followed my work service. The Candlelight, as the occasion is termed, was not a
in the South with interest and encouragement. He knew of no major musical triumph, but from the standpoint of logistics
opening for a choir director in the metropolitan area, but he and of the vitality it poured back into the congregation, it was
promised to keep me advised of any possibilities. I could teach a singular success. This was not the job r might have antici-
voice production and breathing technique, but building a ros- pated, but at least r finally was more or less gainfully em-
ter of pupils would take months and years which I currently ployed. r agreed to accept certain financial arrangements with
.did not have to spare. I adopted the time-honored custom of the understanding that I be free to determine my own work
reading the "Help Wanted" ads. My youth had not been schedule and to augment my income in any manner I chose.
afllicted with aflluency and there were many things I could do. r chose to offer private instruction in voice production and
I was negotiating a job as display manager in a men's cloth- breathing technique. With the church stipend as a basic in-
ing shop when Dr. Williamson telephoned late one evening to come r could take the time necessary to establish a reputation
tell me of a potential opening for a choir director in Bay Ridge, and a following, and I would have a latitude of freedom in
Brooklyn. The Evangelical Lutheran Church of the Good which to develop my interest in sound, both choral and in-
Shepherd wanted to reactivate its former Westminster pro- dividual, and in breathing.
gram of integrated choirs and was in search of a director will-
ing to undertake the reorganization of choirs of all age levels.
I wasted not a moment in making an appointment with the
minister of the church. My background so impressed him that
he assured me of the job as soon as a few necessary details were
attended.
Time required for the necessary details wore on and on.
When I was near desperation, the call came to ask if I could
have ready for the traditional Christmas Candlelight Service
an integrated choir program involving six choirs, ages three-
and-a-half years on up. r looked at the calendar. The service
was slightly more than four weeks away.
Necessity being what necessity is, r figured that not trying
was worse than failure. After r had agreed to attempt the task,
I found that active membership in the six choirs totaled a little

132 133
 ----~~ -

11
GROWTH AND DEVELOPMENT

Although my swift descent upon New York had

seemed a near catastrophe, I found during the next several
years of growth and development that what I had thought I
wanted would have been the catastrophe. The times were
changing and I was changing with them. I had to abandon
Some old ideas for new and clarify my thoughts on a number
of points. When my personal ambitions began to conflict
with One another, I had to pause for inventory and reorienta-
tion.
After the big roundup for the Candlelight Service at the
church came an intense moment of cold reckoning. Many
years prior to my arrival the church had had an excellent choir
program, but over at least a decade the program had deteri-
orated for one reason or another. Older members of the Con-
gregation, remembering the days of glory, resisted the plain
facts of the present. My freedom of operation did not fit their
Concept of wages and hours, and the financial fray began al-
most before the wax of the Christmas candles had hardened.
In happy contrast, those who had been caught up in the
enthusiasm of the sudden revival of the music rallied to my
support. From the conglomeration of souls participating in the

135
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Dr. Breath Growth and Development

Candlelight Service I sorted out six choirs according to ages have condemned this practice in anyone of my pupils, for a
and began to organize a program of instruction for each. The performer's whole attention must be focused on what he is
idea behind the Westminster integrated choir program is that doing, not how he is doing it. Little by little I was forced to
children be taken at an early age (three-and-a-half years in the conclude that in spite of vocal potential I lacked the tempera-
Good Shepherd Cherub Choir) and trained musically and ment of the performer. My analytical tendencies served me
vocally for choral work to the end that the church have a self- well as a teacher, but they were detrimental to the performer.
perpetuating adult choir. As the children grow up through the I continued to do an amount of solo work, but I abandoned
choirs, their musical knowledge and vocal ability increase. thoughts of a professional concert career. The best part of my
The church, I soon learned, was seething with controversy. decision was that I could give up my laborious and incom-
Indifferent as I was, my task of reviving the defunct music patible study of foreign language, an evil necessary to a serious
program became more difficult because of it. I was not as free artist.
as I had been promised. Nor were existing conditions precisely In the mid-1950's the musical climate grew cool to the prD-
as they had been described to me earlier. I had frequent occa- fessional choral conductor, and I had to accept the fact that
sion to ponder the wisdom of trying to develop anything from my major reason for coming to New York would have to be
such a snarl. My reassurance came from the choirs them- shelved indefinitely. Organization of the kind of choral group
selves, for they began to take on a life apart from the conflict I had wanted would have been sheer folly. I had neither the
within the church organization. finances nor the inclination to indulge myself in an ultimate
Throughout this period and possibly because of it, I thought futility.
more seriously in terms of 'an independent career for my- The elimination of a professional vocal career and a profes-
self. My study with Althouse and my analysis of my own si?nal career as a choral conductor left me with my job as
breathing had enabled me to exceed my previous vocal accom- ?lIector of the Good Shepherd Choir School and my private
plishments. I was beginning to weary of having to cope with Illstruction. Wisdom advised concentration of effort in these
large numbers of people, and the idea of only myself to man- areas. The more I worked with voices of all ages, the more I
age became, accordingly, more attractive. Before I could take observed and learned about breathing and the more interested
decisive action, Althouse, who had long been in failing health, I became in the functions of the respiratory system. I found
died. I was stunned by his death and for a while was incapable that a particular pattern of breathing enabled children to
of personal planning. avoid the throat tension which causes the shrill, piping quality
By this time I had a number of pupils of my own to con- III young voices. I began to observe more closely the interplay
sider. As I analyzed their voices and breathing patterns, I be- of the various muscles of breathing and the subsequent effect
gan to notice how consistently I did the same thing to myself. On the sound of the voice. As my knowledge broadened, my
When I sang, a part of my mind was trying to listen, and, teaching improved and I began to deal increasingly with
simultaneously, another part was trying to analyze. I would breathing problems in relationship to the production of sound.
136 137
 Dr. Breath Growth and Development

By the second Christmas Candlelight Service regular choir order upon the respiratory mechanism. I was not certain I
membership had settled at two hundred. The quality of the wanted to become involved with the ill. The well were diffi-
work had gained sufficient attention both in and outside the cult enough. While hesitation occupied the fore of my
immediate Bay Ridge community for the various choirs to thoughts, curiosity sat spiderlike in a dark corner waiting for
receive invitations to participate in the larger Brooklyn com- the moment to ensnare.
munity programs and in a C.B.S. national television program. Even as I hesitated, I began to wonder how the breathing
The stimulative effect was great, and as I tightened the disci- of the ill differed from that of the well, whether there were
pline, to sing in the choirs became a privilege. I worked with points of basic similarity, if certain effects could be an-
the members of every choir weekly to check their breathing ticipated among the ill as among the well. Inch by inch,
and their voice production. The choral tone of the choirs hesitation drifted toward the web and in an unguarded mo-
individually and in unison gave me a large measure of satis- ment was devoured by curiosity. When I had overcome the
faction. major problem of adapting my schedule to additional activity,
By 1958 the Good Shepherd Choir School had a firmly I spent a number of weeks in the medical library familiarizing
established reputation for excellence and was recognized in myself with respiratory diseases and disorders and exploring
church music circles as an extraordinary achievement for a further the literature on breathing and the mechanics of
church in the metropolitan area. My own study and explora- breathing. To my surprise, I found that very little attention
tion of breathing habits and respiratory function in relation- had been accorded the act of breathing and its influence on
ship to the production of sound had led me farther into the the body since the latter part of the nineteenth century.
field of science and had extended my profession from that of From the beginning I had been assured that medical con-
a teacher of voice production to the role of consultant in sultation would always be available to me and that I would be
breathing problems among individuals having no respiratory under the constant supervision of medical doctors. My great
disease or disorder. I never dealt with respiratory problems in- Concern was that I not unwittingly inflict damage upon an
volving physical disorder because I knew enough to know already damaged respiratory mechanism. If err I must, I
how much I did not know. I had witnessed too much damage wanted it to be on the side of overcaution. When I felt
caused the well by faulty breathing habits to run the risk of sufficiently prepared academically, I made the first of my
dealing in an area with which I was unfamiliar. I suspected numerous journeys to East Orange and began the work which
that many of the maneuvers devised to make the well aware I~d to the discovery of breathing coordination and the evolu-
of a pattern of breathing might be too strenuous for the ill. tion of 51MBrc.
When I was asked at this time to undertake the project at In 1958 I began to live a sort of double life with a triple
East Orange, I hesitated because I did not feel adequate for career that was sometimes confusing to me and, as a rule,
the task. I disliked hospitals intensely and I knew very well totally baffling to those who knew me in a single capacity.
that I was ignorant of the specific effects of disease and dis- DUring all the years of medical study and research in breath-

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Dr. Breath Growth and Development

ing, I was still serving as director of the Good Shepherd and how desperately people needed to know about the influ-
Choir School and teaching voice production and breathing to ence of breathing upon health and well-being.
private pupils. As disparate as those occupations might seem, Although the Choir School continued to grow and thrive
they were not so at all. My method of teaching voice produc- in the early 1960's, the church itself was racked within by
tion, whether for choral or individual work, derived from the dissension and threatened without by the shift in the com-
use of the muscles of breathing in a particular pattern. Breath- munity which the construction of the Verrazano Narrows
ing and its effect upon the production of sound were my Bridge brought about. Beset with problems both at the church
principal interests. In the adaptation of my teaching methods and in the medical work in breathing, I often considered very
for the well to the requirements of the ill, I was always listen- seriously resigning my post at the Choir School and devoting
ing to the sound of the voice. I am convinced that nothing my time solely to private teaching and research. Each time I
other than the sound of the voice could have elicited the phys- came to the moment of decision, I realized that working with
ical responses and subsequent observations responsible for the the great music of the church had a profound influence on my
discovery of breathing coordination. life and thought. I did not know where to turn for an adequate
I learned to move with ease and freedom back and forth substitute, and I would be the poorer for the loss. I had been
between the world of the well and the world of the ill. My associated with church music for so long that I could not
observations in one served to heighten my awareness in the imagine passing the Sundays without it. At this point I always
other. I found that I could adapt practices from one to the decided to endure a little longer in the hope that eventually I
other. What was effective with emphysema patients had an might extricate myself from the church's internal affairs and
application in correcting breathing faults of the well. I began operate the Choir School independently of them.
to note among my choir members and private pupils irregu- In 1964, the same year the discovery of breathing coordina-
larities I could identify in the patient as a sure sign of a par- tion was announced, the Good Shepherd combined choirs ac-
ticular fault or weakness. cepted an invitation to provide the choral music for the
The Choir School became a sort of laboratory in which I dedication of the Protestant-Orthodox Center at the New
had the extraordinary opportunity to observe and analyze the York World's Fair. Everyone thought that was the year of
breathing habits of every age level. I could put my medical matchless glory. So did I.
findings into immediate practice and correlate the responses. I We all were wrong. Heights still remained to be scaled. In
did the same thing with my private pupils. To my extreme 1965, the year The Stough Institute was founded, the Good
satisfaction, I saw the breathing improve, with subsequent Shepherd combined choirs were invited to participate in the
physical benefits, and I heard the improvement in the sound brotherhood program sponsored by the National Conference
of the voices. Sometimes my mind raced so that I could of Christians and Jews in the Singer Bowl of the World's
hardly keep my jumble of thoughts sorted. Always I was im- Fair. The occasion was unique in that it was the first ecumeni-
pressed by how little was known of the potentials of breathing cal choral concert to be presented after the Roman Catholic

140 141
 Dr. Breath Growth and Development

restrictions were relaxed. Both racial and religious integration would be the unmistakable indication that the time had come
contributed further to the singularity of the concert, which I for me to stop.
was asked to coordinate. That year the Good Shepherd com- Basically, there was nothing wrong with that reasoning
bined choirs were also included in the recording "Great Choirs insofar as I could see. My only error was that I had failed to
of New York," made as a special commemorative album for reckon on the unexpected. I did not expect the unexpected,
the Protestant-Orthodox Center at the Fair. and, naturally, the unexpected came to pass. The Manhattan
As I had hoped, each successive choral achievement drew Division of the Protestant Council of Churches asked me to
the Choir School more and more apart from those church accept the responsibility of the choral music for the 1967
affairs with which it had no direct concern. Through the years Easter dawn service at Radio City Music Hall. I quite hon-
I had developed a training program and a loyal group of vol- estly did not have the time to do the job. On the other hand,
unteer aids that made possible the efficient operation of the knowing what it would mean to the Good Shepherd choirs to
school on a concentrated schedule; otherwise, I should never sing at Radio City Music Hall, I could not in conscience
have been able to continue the choral work, regardless of my refuse.
desire. For the Good Shepherd choirs to appear at the Music Hall
After the Institute began operations and entered into in- was not just an exercise in self-gratification. It was rather a
vestigations of the breathing habits of the physically superior, curious culmination of circumstance in the life of the church.
the weeks never seemed to be long enough for all that had to When the church had enjoyed its original successful choir
be crowded into them. The Choir School received invitations program some thirty years earlier, the highlight was participa-
to participate in a variety of activities, and whenever possible tion in a choral program in Radio City Music Hall. The
I accepted because of the stimulus the young and the old alike wheel had come full circle, and who was I to say nay? I did
derived from public appearances. However, the regular church not know how I would manage to get the program organized
schedule was so demanding that very little time remained for and presented, but I accepted. Later, I was glad that I had.
outside activities. The experience proved to be a high adventure for everyone.
When the Institute went into the athletic studies in coop- During those scrambled years of shuttling back and forth
eration with the Olympic Committee, I again thought of from one career to another, the chief hazard was one not of
resigning the Choir School, but the enthusiastic support the passage but of identification. Because no one could accept the
choirs received plus my old personal considerations made me field of breathing as a legitimate field of science in critical
decide to continue as long as was feasible. I reasoned that there need of exploration, no one could understand how I could
would be no outside activities and that with careful planning deal on the one hand with the sound of the human voice and
I should be able to maintain the high standards I demanded ?n the other with the respiratory problems of the chronically
for the regular program. If I had to lower the standards, that 111.The bridge over which I passed quite readily from the

142 143
I i
i
 Dr. Breath

world of music or sound into the world of medicine or disease

was the act of breathing. In the world of music I used breath-
ing as a control for sound. In the world of medicine I used
breathing and sound to relieve the distress characteristic of
respiratory disease. But what was I? Who was I? 12
I certainly was not the usual musician absorbed in musical
scores. Nor was I a doctor absorbed iu medicine. No one from THE TRAILER IN THE
either field could do what I did, aud no one from either field
LONESOME PINES
was aware that I was working assiduously in a third field, the
field of breathing, which had significant application in both
the others. Until the medical research that resulted in the
discovery of breathing coordination and the development of Late spring of 1968 was a frenzied time for every-
SIMBIC, the field of breathing was an uncharted territory one connected with Olympic planning. The days were flying
of assorted theories and practices and very little scientific by and each that passed unfulfilled was a treasure lost.
investigation or exploration. My identification as a respiratory As the Olympic coaches deliberated the inclusion of SIMBIC
consultant baffled the people who knew me only in my ca- in the high altitude regimen, Giegengack's impatience sur-
pacity as Choir School director although they might be well passed my own. He was going to participate in the South
aware of my work in medicine. People in the medical field Lake Tahoe program and was as eager as I to know what it
who did not know how I had got there in the first place would include. One by one the coaches accorded SIMBIC their
were equally bafHed. All in all, I was for a long time a source enthusiastic approval until finally only one remained for the
of perplexity for friends, acquaintances, and colleagues required unanimity. When I was completely numbed by the
equally. suspense, the crucial consent was given.
As the importance of breathing patterns and habits in a The ideal procedure would have been for me to have in-
civilization of ever-mounting respiratory hazards has become structed the coaches in SIMBIC and for them, in turn, to have
more generally recognized and stressed, my role of respiratory instructed the athletes. However, that was not possible be-
consultant has taken on a new significance. Dyspnea-breath- cause of the intricacies of establishing breathing coordination.
lessuess-cannot be medicated, nor can consistent sound be I had not had the time necessary to develop a teacher-training
produced without proper management of the breathing mech- program, and I knew from my work with doctors that learning
anism. Between those two boundaries lie all the intricate how to breathe in a properly coordinated pattern did not
ramifications and countless applications of breathing coordi- qualify an individual to teach. Clear as that fact was to anyone
nation. familiar with SIMBrC, it was difficult for others to accept, par-
tIcularly so when it limited the numbers to be taught.
144 145
 Dr. Breath The Trailer in the Lonesome Pines
Gieg, continuing in his accustomed role of SIMBIC inter- the highlands. At that time, entry to South Lake Tahoe was
preter, dispatched this bulletin: "I have undertaken some ten through Reno, Nevada, aboard an airport service conveyance
sessions of this remarkable procedure with Mr. Stough, and which operated irregularly on a regular schedule. The vehicle
our very knowledgeable trainer, Bill Dayton, has had some broiled in the July sun for an hour past its scheduled departure
fourteen sessions. Despite this instruction and despite our own while waiting for an overdue plane from Denver. The internal
very sizable improvement in vitality, neither Bill nor I feel temperature must have been in the range of 120 degrees
that we are well enough educated in this procedure to make Fahrenheit when the passengers took their seats and the
us teachers of it. Consequently, it appears to be of no value driver, starting the motor, issued strict instructions to keep the
to have Mr. Stough instruct some of our coaches, and I am windows up for speedy air conditioning. The wonders of the
convinced that he himself must directly instruct the individual Nevada terrain were wasted on me that trip in the wheeled
athletes if we are to realize the real benefits." oven, but by the time we were curving around the mountains
The final hurdle cleared, planning could get down to the in approach to Lake Tahoe, the speedy air conditioning had be-
details. Since my principal work in athletics had been in track gun to work and my sensory receptors were reactivated. The
and field and Gieg was vice chairman of the Men's Olympic lake lying among the majestic mountains beneath a cloudless
Track and Field Committee, quite naturally I was assigned to blue sky intensified the blue in its waters. Towering pines
this event. Instruction would begin with athletes who re- stood like august sentinels across the mountain slopes and
quired more than two minutes of maximum effort and quicker along the shores. The incredible beauty was then and later a
recovery and would be extended as the schedule permitted source of deep refreshment.
to other areas according to exertion and! or recovery needs. I never recovered from the utter grandeur of the mountains
Some eighty athletes would require from five to eight sessions and the sparkle of sunlight in the clear dry air. Conditioned
of thirty to forty-five minutes each over a period of six weeks. as I was to the dull yellow light of the metropolitan gas
I would be instructing from eight to twelve athletes daily, chambers, I felt that I was participating in a recurrent miracle
seven days a week. I was so pleased to come at last to my each day. The overpowering natural beauty all about made
long-desired exploration of the respiratory condition and possible a Concentration of effort which otherwise would have
habits of human beings of superior physical endowment, been liifficult to maintain.
world champions and potential world champions, that I did
Gieg had preceded me and at 8: 30 on the morning after
not pause to consider the prodigious amount of work before
my arrival was ready to be off and running. I had antici-
me. Whatever had to be done, I would find a way to do.
pated a fast start but his pace exceeded my expectations.
Upon that happy note of resolution I charted my course
Without SIMBIC to cut my own warm-up time, I should have
for South Lake Tahoe in 'the High Sierra of California. My
dropped with the starting gun that day. He had scheduled an
previous travels in the Far West had been limited to the
Instant orientation program calculated to put me three days
coastal area; therefore, I was unprepared for my experience in
ahead by noon of the first day. I made a mighty effort to
146
147
 Dr. Breath The Trailer in the Lonesome Pines

absorb all the sights and sounds and to try to remember some was about to receive. While the trailer was adequate for teach-
of the names. I received a briefing on Tahoe topography, an ing purposes, it had none of the specified office facilities re-
introduction to local officials involved in the high altitude pro- quired for the maintenance of Olympic records and accumu-
gram, an introduction to Olympic officials, coaches, doctors, lation of Institute data. I had hoped to have working space
and trainers, a quick glimpse of my living quarters, and a tour for a secretary who could have relieved me of the paper
I , of the areas of athletic activities. routine, but the restrictions of dimensions made such an ar-
When I had sat in New York and contemplated the sum- rangement impossible. I would have to do the job myself in
mer project, I had envisaged a sort of neat compound with all the evenings after I had finished teaching. Not a bright pros-
facilities within convenient walking distance. The only thing pect, but it would work.
within convenient walking distance was my rented car, which On the day following the instant orientation, I settled into
carried me faithfully up and down and around all the moun- a schedule of srxrsrc instruction and related activities that con-
tains separating the Olympic facilities one from the other. tinued unabated week after grinding week. I taught breathing
Dependent upon the flow of traffic, travel time from my quar- c~ordination, gave lectures and demonstrations, attended spe-
ters to my office could be forty-five minutes, as the snake cial meetings and required social functions, met the press,
crawls. The magnificence of the scenery staved off madness appeared on television, served as resuscitator at track meets,
in the winding procession of cars and trucks and buses. and explained repeatedly the functions of the respiratory mus-
The Olympic track, a replica of the track in Mexico City, cles. I also learned much that I had not known and would
was located above the sprawling friendly community of South never have suspected.
Lake Tahoe at Echo Summit, an elevation of some seven Although the prior athletic studies had shown unmistakably
thousand-plus feet above sea level. My office occupied not ~at the best of athletes have respiratory faults and difficul-
quite so exalted a position. It was in a place a few hundred ties, I had continued to cherish the notion that in the topmost
feet lower, known as "The Trailers." Here in long trailer units echelons the physical superiority surely would have a parallel
the bachelor athletes lived and froze in the brisk mountain respiratory superiority with accompanying breathing efficiency.
air. My office was in the very last unit of the very last trailer It was not precisely so. World champions and potential world
among the tall, lonesome pines. I shared the site with a family champions proved to be as susceptible to respiratory weak-
of five frisky chipmunks who lived in a hollow pine opposite nesses as any business or professional man, possibly more so
my door. In due time the formal designation of "office" wore because of the unrelenting demands made upon the respira-
down to the simpler term "trailer." tory system. These weaknesses in combination with the de-
When Gieg first took me to the trailer to inspect the provi- creased supply of oxygen in the air at high altitude posed a
sions made for SIMBrcinstruction, athletes were there before very real problem for men whose performance ability de-
me waiting to begin. Their enthusiasm cushioned the blow I pended on the amount of oxygen available to the body for

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Dr. Breath The Trailer in the Lonesome Pines

energy. Here at the opposite end of the pole from the em- night, yet there was not time enough to see everyone who
physema patient the need for breathing efficiency was equally should have had SIMBIC instruction. After the Tahoe program
as great. got under way, the need for SIMBIC in the recovery period
I searched continually for the perfectly coordinated, fully regardless of the duration of exertion became apparent. I
developed breathing mechanism, and I came very close to it found myself assuming responsibility for the respira tory condi-
upon occasion. Even in those rare cases of perfectly coordi- tion of the entire contingent of Olympic candidates, particu-
nated breathing, the respiratory apparatus was not developed larly as I grew to know them well.
to full potential, and improper management under the stress .In physical make-up Olympic candidates do not differ ap-
of extreme exertion destroyed the coordination and intro- preciably from any well-trained and well-disciplined athlete.
duced a breathing pattern of damaging inefficiency. Although They are not perfect. Far from it. They bear the same scars of
everyone associated with athletics was aware of the importance the unending respiratory battle from birth to death as does the
of breathing in athletic performance, no one whom I met, in- ordinary citizen. They have their share of coughs and colds,
cluding coaches, trainers, and attendant physicians, had more and they are just as liable to structural faults and deficiencies
than a passing acquaintance with the sketchiest of fundamen- as anyone. Case histories of those in the SIMBIC program re-
tals of the respiratory system and the mechanics of breathing. vealed a variety of respiratory disturbances: allergies, pneu-
For most, the lungs were a kind of oxygen-supplying machine, monias, bronchitis, asthma, recurrent and constant colds.
and as long as they supplied oxygen on demand, nothing more Weakened diaphragms were not uncommon, and tensions
could be of great consequence. The prevailing ignorance of were prevalent.
the profound relationship between the basic mechanics of . The distinguishing characteristic of the Olympic candidate
breathing and the other body functions troubled me con- IS a demoniac drive to excel himself and to win. Physical pain
stantly because it fostered a thoughtless abuse of the respira- ~sruled out completely. A runner will run when he should be
tory system. In some, the threat to health and safety under ~n bed because of his physical condition. A jumper would
the stress of extreme exertion at high altitude was immediate. Jump with a broken leg if he could. Nothing short of com-
In others, long-range damage to the respiratory mechanism plete immobilization keeps these men from performance. The
was a definite possibility, agonies of recovery from extreme exertion are known only to
Despite all my former notions, I had to acknowledge that themselves.
physical superiority does not predicate breathing efficiency, The men were good SIMBIC pupils. Because of their excel-
that development of voluntary muscles rarely has a corre- l~nt muscular coordination they learned breathing coordina-
sponding development of the involuntary muscles. That reali- hon very readily and were able to incorporate it into their
zation certainly did not contribute to my happiness. On performance rapidly with sometimes astonishing results. One
the contrary, it filled me with an uneasy sense of urgency. decathlon man left a SIMBIC instruction session, went up to the
I taught seven days a week all day long and often into the track to work out, and broke his previous performance record.

150 151
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Dr. Breath
Another broke his lifetime record in four events in his practice
sessions. A five-thousand-meter man who had been training for
only seven months because of injuries was soon running less
than sixty seconds off the world record. Most of the men re- 13
ported increased relaxation during workouts, even at maxi-
mum. SLA YING THE DRAGON
After the SIMBrcprogram was under way, the trailer in the
lonesome pines was seldom lonesome. Athletes came with all
manner of breathing problems to be remedied, some serious,
some not so serious. Before the first week was out, the compre-
hensive view of the human respiratory condition which I had
hoped to achieve was complete. I marveled that mortals so "Within a matter of days the tall-timbered slopes
totally dependent upon oxygen for life could be so carelessly of Echo Summit became the "Summit," or more simply, the
"track." There the wind kicked up dust devils and shook out
free of regard for the process of breathing.
dry needles from the pines. There from early morning until
the last slanting of sun over the mountains men ran and
. '
Jumped and vaulted and hurled with incredible endurance.
There also lurked a dragon. Not a terrible fire-breathing, tail-
lashing, snorting sort of dragon, but a very small, quiet dragon
sat in the shadows and waited. Everyone knew of him. No
one spoke of him.
My busy schedule did not often permit me to go up to the
track, but I suppose I knew more about the dragon than any-
one else. He could engender a paralyzing fear in the best of
runners and throw a hurdler off pace. He did not have to do
anything. The mere fact of his being shriveled away resolu-
tion. He needed to be slain. Although I was not given to going
about the country dragon-slaying, I decided that something
very definitely had to be done about this fellow.
In extreme physical exertion of the kind that took place at
the track was the ever-present danger of incurring an oxygen
debt. As the name suggests, an oxygen debt is an amount of

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.~

Dr. Breath Slaying the Dragon

oxygen the body owes itself after having spent in performance known of the muscles of breathing. Closely associated as it is
more than it could supply for that performance. To suffer an with respiration, it has fallen victim to simplified textbook
oxygen debt at sea level is an excruciating experience. No one illustrations of the respiratory system. Often it appears to be a
knew what the effect of the rarefied atmosphere of high alti- hump under the rib cage to the front of the body. This view
tude would be. This fear of the unknown was the dragon that of the diaphragm fosters the idea that it operates like a rubber
caused the stoutest heart to tremble. With the proper weapon band, pulling the ribs in and out. Another concept, arising
the dragon could be slain. from observation of the mid-regions of the body during breath-
The proper weapon with which to slay the dragon was ing, is that the protrusion and recession of those regions are
breathing coordination. Athletes who knew how to manage due to the outward-inward motion of the diaphragm. Obser-
their breathing during the crucial recovery period following vation of external body movements may be accurate, but the
performance could avoid an oxygen debt. Freed of energy- inference of the internal diaphragmatic motion is not.
absorbing anxieties, they would have an extra measure of en- Generally conceded to be the principal muscle of breathing,
ergy to put into performance. The first thing I had to do in the diaphragm extends through the body and divides the
instructing Olympic candidates at Tahoe was the first thing I thoracic cavity, which contains the rib cage, the lungs, and
had to do with all pupils: make them aware of the breathing the heart, from the abdominal cavity, which contains the
mechanism and its functions so that they would understand other vital organs. In addition to its role in breathing, it also
what they were doing and be able to maintain coordination has the important function of regulating the pressure between
under varying conditions. When they knew what to do during the thoracic and abdominal areas. It can be made to act by the
recovery and could do it, they could escape the psychological force of voluntary muscles, such as the abdominal, upon it,
shackles forged by fear of the unknown and pace themselves but it cannot be controlled by the will. For this reason, breath-
at their best.
ing exercises which increase diaphragmatic motion by use of
Breathing coordination can be taught to pupils who do not other muscles can have only a temporary effect on the dia-
have the foggiest notion of the structure of the respiratory phragm and can cause further damage in the case of a weak-
mechanism or of the muscles of breathing. Usually, however, ened diaphragm.
a rudimentary knowledge of what is going on inside the body Motion of the diaphragm is downward toward the ab-
makes both teaching and learning easier. At one time I had dominal cavity on the inhale and upward into the thoracic
assumed that everyone knew a little something about breath- cavity on the exhale. In the exhale position, which is the
ing. Experience compelled me to revise that assumption and relaxed position of the muscle, the diaphragm is like a dome
provide an introduction to the mechanics of breathing. When rising into the rib cage to aid in the expulsion of air from the
a pupil can visualize the operation of a muscle, he can bring lungs. On the inhale the dome tends to flatten. If the dia-
about a response with increased speed and ease. phragm has become weakened through injury of any sort, it
The diaphragm is perhaps the best known and the least does not rise dome-like into the thoracic cavity on the exhale
15i 155
 =

Dr. Breath
Ij
Slaying the Dragon

but lies flattened like a piece of rubber that has lost its elas- reduced. When the removal of the old air is insufficient to
ticity. Often a weakened diaphragm will buckle on an exhale meet the bodts demands for new air, a smothering sensation
and move downward, causing a protrusion of the lower results and tnggers a frantic drive to take in more air before
abdomen. the lungs are properly emptied. This is the state of dyspnea
Other muscles of breathing fall into two groups: those used or bre~thlessnes~, experienced by emphysema patients and
primarily for inhale and those used primarily for exhale. All Olympic champions alike.
of the muscles of breathing were intended to operate in a In the trailer at Lake Tahoe the Olympic candidates
synergistic pattern with the stress of the work load distributed learned as rapidly as I could teach them to prolong the exhale
evenly among them. This is breathing coordination, which and empty the lungs as nearly as possible before trying to re-
provides the maximum efficiency of the particular mechanism fill them. Some developed their breathing coordination to
with the minimum expenditure of energy. When the muscles such a degree and so incorporated it into their performance
are not so coordinated, they function in varying patterns with t~at they were in effect recovering during performance and
varying degrees of efficiency. The variances may be due to any did not come to a state of extreme depletion at the end. Others
number of causes, and they can have any number of effects. who had not achieved such a state of development or who
Chief among the effects is the reliance upon accessory muscles had temporarily lost their coordination because of some Con-
of breathing, with the use of voluntary muscles to force res- ?ition of performan.ce knew what to do with their breathing
piratory action and with risk of subsequent damaging alter- In the recovery period to restore coordination and ease the

ations of the respiratory mechanism which will increase sus- recovery.

ceptibility to respiratory infections and pave the way for res- One of the best aids I had in teaching was a set of clinical
piratory disorder and disease. photographs of an advanced emphysema patient who had been
In operation, one group of involuntary muscles acts with the subject of a specialized study completed at the West
the descending and flattening diaphragm to bring about the Haven hospital a few months earlier. The photographs showed
expansion and inflation of the lungs with air. The other group the patient pnor to breathing coordination instruction, a
produces the exhale or expulsion of air from the lungs and is drawn, wasted figure with chest and shoulders raised, neck
aided by the return of the diaphragm to its upward or dome- and upper chest muscles taut in effort to breathe, and ab-
like position. Weakness in any of the muscles will affect the d?men grotesquely distended. In the comparison views taken
breathing and decrease the efficiency of the respiratory func- rune months later at the conclusion of the SIMBIC study,
tion. Contrary to popular belief, the more important phase of the man was almost unidentifiable as the same person. The
breathing is the exhale. Stale air containing the waste products muscular distortions had disappeared, the chest and shoulders
of the body must be removed from the lungs before new air were lowered, the abdomen had flattened, and the skeletal
containing oxygen can be taken in. When the removal of the appearance had been transformed.
old air is inefficient, the supply of new air is proportionately When an athlete began SIMBIC instruction, I had him take

156 157
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Dr. Breath Slaying the Dragon

a look at the photographs and remarked, "Those 'before' around the track elbow to elbow while the officials gasped
photographs are you at the end of competition, grabbing for and the spectators guffawed nearly destroyed my composure,
breath, trying to recover. There is no difference between you but I assured him that I would be on hand in case of emer-
in recovery and an advanced emphysema patient trying to gency.
breathe." I fully intended to be on hand because I knew the weak-
The effect was powerful. Any lingering doubts about the nesses of the men I worked with, and I anticipated that some
necessity of intelligent management of breathing were. dis- of them would have difficulty maintaining their coordination
pelled. My emphysema patient, who could never have survived during recovery. I also wanted to discourage the use of oxy-
the rigors of Echo Summit, became a driving force for ~he gen as a recovery aid. Far from being an aid, it increases the
intrepid young men who aspired to the gold medals of MeXICO gas content of lungs already overdistended with unexpelled
City. He made my point for me more dramatically than a air and provides a very real threat of suffocation.
thousand words of explanation. Directly from my final session with an edgy runner I went
Within a dozen days or so after activities began at South up to the track on my mission of mercy and started out across
Lake Tahoe the first track meet was scheduled in order to the finish line in the direction of the green medical tent in the
give the men an opportunity to compete under high altitude infield. I had not taken a dozen steps before an imposing
conditions and to enable the staff to observe the effects of polrce officer confronted me, took one look at my drab civilian
competition. I could hear the little dragon stirring in the garb, and advised me to clear the track. That was my first
pines, moving in closer to the track to watch and wait. He was taste of the efficiency of the local security. Although it com-
not without his victims. One eastern collegiate champion p~lled my admiration, it also exhausted my ingenuity, for I
who was not then in the SIMBICprogram had not been able to failed altogether to convince the man of the legitimacy of my
equal his sea level time in practice because he was relucta~t presence. I verged on withdrawal when a friendly official spot-
to push himself at altitude. Others came to me with thell ted me and swooped down to the rescue, hustling me over to
fears about the consequences of extreme exertion, and my the medical tent with the advice that I had better get myself
schedule was filled up to starting time with extra SIMBIC an official suit. I never did get an official suit, but Gieg, then
sessions. serving as coordinator of the usoc Medical Testing and Study
During a pre-meet session a walker whose enthusiasm for Center, lent me the jacket he had worn as head coach of the
SIMBICalmost matched his enthusiasm for his sport instructed 1964 Tokyo Olympics. That turned the trick and spared me
me to "be right out there along side of the track, and if you further encounters with conscientious guardians of the local
see me do anything wrong, you just come on over and walk regulations. I had attained identity.
next to me and get me straightened out." The results of the first track meet of the high altitude pro-
He was a walker of international reputation and could set gram were very encouraging. Six of the men in the SIMBIC
a mean pace. My mental view of the pair of us swinging project reported faster recovery than they had experienced

158 159
 Dr. Breath

before at sea level and marveled at their newly-acquired

ability to control their breathing under stress. Three w~re
winners in their events. The effects of SIMBIC were becommg
increasingly apparent, particularly under the stringent de-
mands of competition. 14
After the first track meet the atmosphere cleared. The wind
seemed freer and the deep pine shadows less ominous. SIMBIC A LOOK
had overcome the fear of high altitude effects of oxygen debt
AT THE ATHLETE
and had slain the dragon.

~en the dust of the first Tahoe track meet had

settled, I took a long appraising look at the athlete and his
problems of breathing. The day was fast approaching for a
SIMBIC progress report to the Institute and the Olympic Com-
mittee, and I needed to sort my thoughts and observations in
preparation for the task. I had been so absorbed in starting the
SIMBIC instruction that I had had very little opportunity for
reflection.
Training at high altitude, I realized, held a curious advan-
tage for many athletes. The men themselves were not aware
of it, because they were not looking for that kind of advantage.
Most thought of breathing primarily in terms of how much
air they could inhale to fill their need. Altitude, then, would
be considered a foe rather than a friend because it limited the
supply of available oxygen. The unrecognized beneficial effect
was that altitude served as a giant magnifying glass to ex-
aggerate all the breathing problems which would have re-
mained obscure at sea level.
Eighty-six per cen t of the men with whom I worked were
ignorant of the existence of a problem, yet over half of
them had abnormally raised chests and most were breathing
160 161
 Dr. Breath
A Look at the Athlete
entirely with accessory muscles during maximum exertion.
Inevitably breathing faults or irregularities are accentuated
Twenty per cent had pronounced sternal angles. These abnor-
in performance because the voluntary muscles which under
malities duplicate those of the respiratory patient. At sea
other conditions would lend support to the involuntaries are
level conditions the athlete might have continued for an
actively engaged in performance and the burden of breathing
indefinite period without consciousness of any irregulari~, but
falls to the involuntaries. Any weakness in the involuntaries
a problem would have arisen eventually when the resplrat?ry
will be increased by the constantly repeated demands of ex-
system became severely overtaxed. At altitude with breathing
treme exertion. Even the well-coordinated "natural" athlete
more difficult, the problems showed immediately and could be
corrected. who may have unusually well-coordinated breathing can lose
his breathing pattern under the stress of exertion. Unless he
Apart from all the specific concerns related to athletes and
can manage his breathing intelligently, he will go into ac-
their breathing, I was most troubled by the lack of accurate
cessory breathing to supply the increased need of his body for
knowledge of breathing. Misconceptions abounded, as did
oxygen.
practices more harmful than beneficial. The most prevalent
false assumption was that what comes easily must be all nght. SIMBICbegins with correction of breathing faults and de-
If breathing presented no immediate problem, it was put m velops the involuntary muscles to sustain the breathing during
the "all right" category and dismissed. Thus was much energy perfoImance. If the coordination is lost in some erratic move-
wasted, much unnecessary damage risked and often incurred. ment of exertion, the athlete trained in SIMBICis aware of the
The existing respiratory condition of the athlete was ne:ver loss and knows how to regain his coordination without falling
taken into consideration as the prime requisite for adaptation into accessory breathing and jeopardizing his recovery.
to high altitude. Various theories posited concerning the :ase At Tahoe breathing faults and irregularities were the rule
and rate of adjustment encompassed everything but breathing. among the athletes. I found very few who needed only to
yet adjustment ease and rate are in direct ratio to the func- develop their breathing coordination, and even they were
tional efficiency of the breathing mechanism. One athlete managing their breathing by chance rather than by accu-
could adapt to altitude in a day or so with no difficulty. An- rate knowledge of what they were doing. One of the most
other of the same general physical condition and performance Common faults was the use of the voluntary muscles to force
ability needed more time. The difference, which went com- the operation of the involuntaries. So-called "diaphragmatic"
pletely unrecognized, was in the state of the respiratory.~ech- and belly breathing rely on the use of the abdominal muscle
anism and the effectiveness of its operation. The capability of to pump air out and in the lungs. This maneuver serves to
some athletes to adjust readily often requires others who can- exert an excess of pressure on the diaphragm and to promote
not adapt with equal ease to perform too soon. Failure to further weakness where weakness already exists. Moreover, in
consider respiratory condition is always a potentially danger- performance the abdominal muscle is involved in other activ-
ous omission.
ity and cannot be employed fully in breathing. If the muscles
162 163
 Dr. Breath A Look at the Athlete

of breathing are not properly developed, they cannot support i~mediate .inhale. Effectiveness of the change in practice was
the additional work load. evident in Improved performances.
Another tendency was to carry the shoulders high, a posture . W~latev.er the breathing fault, once the Olympic candidate
which distorted the muscular pattern and restricted the ex- had It pointed out to him, he could make the correction
pansion of the rib cage. Accessory breathing was inevitable un- rapldl~. As the men in the srxrarc program developed their
der such conditions. Athletes susceptible to this fault cut their breathmg coordination, they began to recover faster and could
oxygen intake and made themselves candidates for oxygen take more strenuous workouts more frequently than they
debt. Many men held their breath at some point in perform- could at sea level. When they had integrated SrMBrCinto their
ance. Breath-holding is a state of suspension in which the performance, they could pinpoint their breathing problems
gaseous wastes of the body's activities accumulate as the ox- and solve them satisfactorily.
ygen supply is cut off. Indicative of a lack of body control, it Within two instruction sessions Rick Sloan, a decathlon
contributes to build-up of tensions and creates within the lungs man, was able to correct himself as he began to grab for breath
air pressure damaging to the alveoli, or air cells. For efficient and lapsed into accessory breathing during a workout in the
function of both body and mind, breathing should be con- hills, Reestablishing coordination, he ran up the hill for the
stantly maintained in a rhythmical pattern according to phys- first time and thereafter could take the ascent in stride. He
iological requirements. had easy recoveries and in a day or two broke his life records
Opposite breath-holding is hyper-ventilation, a malpractice for three events. He adapted his breathing very quickly to
frequently employed in a misguided attempt to increase the the demands of the various events and could manage far more
body's supply of oxygen for performance. Ironically, the net strenuous workouts than he had been able to previously.
result of the attempt is a build-up of carbon dioxide, the very A four-hundred-meter hurdler came to a srxrarc session with
waste product of which the athlete needs to rid himself. the problem of inability to maintain his breathing coordination
Hyper-ventilation fills the lungs with unusable air, taxes the from warm-up through the start of the race. After he was over
respiratory mechanism with the expulsion of the excess air, the third hurdle, he could regain his coordination and keep it
and abuses the breathing muscles by forced breathing. The throughout the competition, but until that point he floun-
practice achieves nothing resembling the effects of a coordi- dered and cut his speed. On analyzing his problem, he found
that he was holding his breath in the blocks waiting for the
nated pattern.
Swimmers, in particular, are given to the combined evils of sta~ting gun. I suggested that he try a long, relaxed exhale
hyper-ventilation and breathing suspension, thereby necessi- while waiting, then at the gun the inhale would be automatic
tating both an exhale and an inhale on the tum. After the and his rhythmical pattern would be established. We also dis-
Yale swimmers had developed their breathing coordination, cussed several other possibilities, and from these he was able
to handle his problem successfully.
they used a prolonged exhale before the inhale for the dive
and exhaled as they swam. On the tum they were ready for an Not only did the first track meet emphasize various faults

165
164
 4,.hiCL ... !.L"".... iii.

Dr. Breath
A Look at the Athlete
in breathing, it underscored the dangers of oxygen debt and
instinctively. It tends to nauseate, and it holds the ever-present
the necessity of intelligent recovery management to avoid the
threat of suffocation by additional filling of lungs already con-
serious possible consequences of such a debt. An even greater
gested with unexpelled gases. Dyspnea, or breathlessness, in
need was intelligent handling of athletes who did not know
athlete or respiratory patient requires for relief an emptying
how to manage their breathing and who had difficulty in re-
of the lungs through prolonged exhalation, not further filling.
covering from an oxygen debt. I had witnessed their agonies
Another revelation of the first track meet was that sprinters
and had been appalled by the unintelligent management.
were particularly susceptible to oxygen debt. In their short
During recovery from extreme physical exertion an athlete
period of violent exertion the body had no chance to feed
who cannot breathe efficiently enough to meet his body's in-
back into itself any part of the oxygen expended in the effort
creased need for oxygen to avoid toxic build-up will go into a
of competition. When the race was run, they were left gasp-
painful and dangerous state of oxygen debt. The condition
ing in the thin air, and most had no idea what to do other
can continue for a longer or shorter period of time, according to
than gasp until the body's demands for oxygen were met.
its management. In the initial stages the athlete suffers such
The SIMBIC program had been premised upon the endurance
severe leg pains that he cannot stand without support. He needs of athletes exerting energy over a span of time. No one
must be kept in motion, for loss of consciousness with result- had foreseen that the longer span of endurance would act in
ing immobility makes possible a toxic accumulation capable of
the athlete's favor by enabling him to apply SIMBIC and, in
causing kidney damage or heart attack. In this stage he should effect, make a constant recovery during performance. My
be encouraged to extend the exhale as long as he can and
schedule would have to be expanded to include more men.
keep his back muscles operative to permit expansion of the
Watching the effects of SIMBIC over the early days of the
rib cage.
program, I became more acutely aware of the far-reaching in-
In the intermediary stages the athlete experiences extreme
fluences of breathing on the other actions and reactions of the
nausea. At this point he may lie down, but he must keep
body. With the establishment of breathing coordination and
the back motion of breathing, for this motion can be felt
the subsequent development of the muscles of breathing,
and can serve as his guide in maintaining a rhythmical pat- many of the complaints of the athletes disappeared. I could
tern. Severe headache characterizes the final stages of oxygen Conclude from my knowledge of the respiratory development
debt and may be accompanied by blurred vision or difficulty and from the disappearance of the complaint what had caused
in focusing. One athlete described his vision reaction as, "it the complaint originally.
looks like the ground is coming up at you in angles." Here I found a surprisingly common respiratory deficiency
a pattern of steady rhythmical breathing is essential to resto- among athletes to be diaphragmatic weakness. It shows up
ration of oxygen balance and speed of recovery.
under exertion as side stitches, abdominal pain, and nausea.
Administration of oxygen as an antidote for oxygen debt is It can be detected by protrusion of the abdomen on the ex-
a dangerously unwise measure. Many athletes will refuse it
hale. When the diaphragm is weakened, it is unable to support
166 167
 Dr. Breath A Look at the Athlete

the pressures of breathing and to maintain stabilized pressure Breathing efficiency is not a normal condition to be ex-
in the abdominal cavity. As pressures build in the abdominal pected of the athlete. Next to the respiratory patient, the
area and center upon various points, the familiar side stitches, athlete who is endl~ssly making exorbitant demands upon his
abdominal pain, and nausea of exertion result. With the de- respuatory mechanism, often under the most adverse of cir-
velopment of the diaphragm through SIMBIC they disappear. cumst~nces, is in greatest need of accurate knowledge of
Two of the top five-thousand-meter men suffered side breathmg and proper breathing practices. Too many former
stitches and abdominal pain. One was compelled to drop out athletes have developed into respiratory patients in later life
of two races because of severe upper abdominal pain with side to ignore the warning signs.
stitches in the lower left quadrant. After three SIMBIC sessions Proper breathing management is not only an essential
each of the men reported that he no longer experienced pain health and safety measure for the athlete, it is his prime source
while running. of energy for performance. His respiratory check-out is as im-
The many and various side effects of SIMBIC seemed like a portant as his general physical examination.
kind of witchery to the Olympic candidates, who had expected
only to be taught a new pattern of breathing to speed their
warm-up and recovery and perhaps aid their performance.
Word spread around that a good thing was going up there in
the last trailer at the Summit. I never knew when a strange
face would appear around the door frame and request "some
of those breathing lessons." Often one enthusiastic athlete
would bring a friend for instruction. The openings in my
schedule were filled before they occurred.
I had only to consider my own initial errors in thinking of
athletes to understand the errors of sports personnel. Supe-
rior physical development and coordination would seem to
indicate that the breathing must be in good order although the
opposite is too frequently true. Muscular overdevelopment,
particularly in the chest area, can restrict breathing by hinder-
ing the motion of the rib cage. The involuntary muscles of
breathing cannot be developed by any applied external force,
muscular or otherwise, and it sometimes happens that a supe-
rior physique houses a weakened, inefficient breathing mecha-
nism.

168 169

I
 15
THE SOUNDS OF TAHOE

After the rumble and the roar of New York the

sounds of Tahoe were exotic. The ordinary sounds of traffic
and daily activities were muted by the vast surrounding space,
and in among them were the unexpected: the lowing of cattle
in a nearby pasture, the snorting of pack horses along a
mountain trail, dry rustling of a giant pine cone shaken
free by the wind, soft lapping of Tahoe's icy blue waters
against the shore. I grew accustomed to these. ,
I also grew accustomed to the silences of the Summit in-
terrupted only by occasional voices and the restless wind
among the pines. New sounds startled. None was ever so
startling as the precise measure of a Bach fugue which floated
down from the track area on the warm, dusty air one afternoon.
I had gone up from my trailer to watch a runner work out and
was rounding the curve to the security checkpoint when the
austere music so totally foreign to the folk style of the region
infiltrated the quiet stirrings of the forest.
Unbelieving, I paused, then curiosity hurried me on. Seated
upon a rock was a small, wiry, bearded young man playing a
cello with considerable skill. A SIMBIC pupil, he greeted me
gravely and explained that music was a pleasant pastime for an

171
 44.. ;C&*;;-"

The Sounds of Tahoe

Dr. Breath

otherwise dull job of security guard. I agreed, commenting h~mming: singing-tend to promote the breathing. The hum-
that Bach was a welcome relief to the native beat. Whereupon ming or Singing of people at work maintains the exhale-inhale
he promptly offered me a choice of tape recordings plus re- cycle and improves the work performance by providing oxygen
corder which he had brought with him from the East to meet for energy and reducing tension. A lonely person talks to him-
just such an emergency. I accepted gratefully. se!f as much in a compulsive attempt to release the air pressure
Of all the sounds of Tahoe, undoubtedly the most provoca- WIthin the lungs as for companionship. Like any muscles of
tive were those which issued from my busy trailer at the end of the body, the muscles of breathing must have appropriate ex-
the line. Here, daily, might be heard a rich assortment of voices ertion to retain their tone. The baby, who cannot speak, cries
not only to voice his protest against the indignities of the world
chanting mystically like some Aeolian priests invoking the
but to develop his respiratory mechanism as well.
winds. Actually, they were invoking the winds after a fashion
Ironically, good may bear evil. Many things which are of
and with success. In srMBICthe ability to produce sound is the
benefit properly used can become harmful through improper
gauge of the condition of the muscles used for breathing.
use. Sound in relationship to the respiratory mechanism is no
Breathing is the physical function without which nothing
exception. For those in a state of respiratory health, the pro-
is. To make certain that the breathing is continued, the body
duction of sound can serve as a stimulus to the breathing
has been provided with various devices, some completely be-
mechanism. For those with a respiratory problem, sound pro-
yond the control of the will, others within the power of the
d~ction can impose intolerable strain. For anyone, whatever
mind to operate. Most useful of the devices is the production
hIScondition, violent or excessive use of the voice is potentially
of sound. Breathing can exist without sound, but there can be
damaging to the breathing.
no voice sound without breathing. The human voice is the
When a voice sound is employed in SrMBrC,the vocal cords
flow of air over the contracted vocal cords. In the production
are the isometric resistance against which the muscles of
of sound the respiratory muscles are compelled to move air
breathing must act. The resistance of the vocal cords to the
from the lungs, simultaneously releasing tension and pre-
column of air expelled from the lungs confines the activity of
paring for the inhale.
the muscles to the limits of their strength. As soon as the res-
The first cry of the newborn infant begins the lifelong oper-
piratory muscles are no longer capable of supporting the pres-
ation of the respiratory mechanism. All during life the sharp
sure of the air necessary to make sound, the sound weakens.
outburst, as before the shot put, the karate blow, or the com-
Efforts to force the sound will damage muscular tone over a
bat charge, serves to relieve the resistant, energy-absorbing in-
time just as will enforced operation of any muscle of the body.
ternal pressures which impede action and to sustain the exhale-
Because of the direct relationship between the ability to
inhale cycle. When the breathing mechanism functions with
produce sound and the condition of the respiratory muscles,
a. balance of exhale-inhale, the body can operate more effi-
the trained ear can determine the general state of the muscles
ciently than with erratic breathing patterns.
by the quality and intensity of the voice. Body fatigue and
All forms of voice sounds-speaking, shouting, mumbling,
173
172
 Dr. Breath
The Sounds of Tahoe
stress also affect the operation of the respiratory mechanism cated by duration of count on a single breath, the voice began
and are reflected in the voice. A failure of the voice is a sure to acquire fundamental pitch and took on an intensity previ-
indication that something has gone wrong somewhere in the ously lacking. The pronounced change in voice always surprised
breathing. The most common cause of extended vocal failure both the patient and his doctor.
is the weakened diaphragmatic muscle. Temporary failure of The use of sound to develop the muscles of breathing is
the voice may be due to anyone of a number of physiological fundamental to SIMBIC. As the efficiency of breathing im-
or psychological causes which in turn exercise a debilitating proves, the ability to produce and sustain sound increases and
effect on the breathing. There are, of course, various throat can be a gauge to determine the ability to perform work. The
conditions unrelated to breathing which influence the sound respiratory mechanism can support work performance in direct
of the voice and can be identified as such. ratio to voice production. Breathing coordination is self-regu-
Having dealt professionally with voice sounds all my adult lating and within the respiratory limits of the individual will
life, I was acutely aware of the sound of the voices of the supply the breath required for a particular task. These are the
emphysema patients at East Orange and of the inability of the basic principles of SIMBIC.
patients to sustain sound. From that awareness arose the line Breathing coordination cannot be taught with complete
of exploration and investigation which resulted in the discovery success unless sound is used. One of the most difficult assign-
of breathing coordination. An emphysema patient might have ments I ever had was instruction of a man whose larynx had
breathed easily, but the moment he began to speak, the ab- been removed. I could establish his breathing pattern and cor-
domen protruded, indicating that the diaphragm could not rect his breathing faults, but without the voice there was no
support the pressure of the air against the resistance of the accurate gauge of the strength of the respiratory muscles nor
vocal cords. Instead of rising into the thoracic cavity on the was there the isometric resistance needed to develop the mus-
exhale, the diaphragm moved downward beneath the air col- cles. Between us we worked out a system of slow exhale, but it
umn, thereby creating pressure in the abdominal cavity. Use was never entirely satisfactory. Other patients failed to realize
of the abdominal muscle in an attempt to force the voice only their full potential because they could not understand the
weakened the diaphragm further. In some patients the voice ! principle of sound production. They complained that the
had faded almost to a whisper. device of counting made them feel foolish and that they were
If the diaphragmatic muscle were to regain tone, it had to afraid of being overheard. As a result, their muscles of breath:
be opposed by an isometric force in a mild exercise. The vocal ing could not be properly developed. At best they could avoid
cords were the force, and the system of counting was the "exer- panic in case of breathlessness, for they knew how to manage
cise." However, the diaphragm was not being exercised inde- themselves, but they could tolerate only limited activity.
pendently in the counting. It operated in a synergistic pattern In contrast to these was the young girl paralyzed below the
with the other muscles of breathing. When the respiratory neck. She not only learned to manage her breathing satisfac-
muscles could sustain a certain amount of air pressure, indi- torily but developed her respiratory muscles to such a degree
174 175
 Dr. Breath The Sounds of Tahoe

that she could sustain the long sounds and different pitches for basically, is speaking on pitch. When the breathing is coordi-
singing the songs she enjoyed. One Christmas she recorded a nated, the singer has his "natural" voice; that is, the sound
selection of her songs as a gift for her friends. Hers was a re- individually his own. The "natural" voice is distorted as the
markable achievement by one who prior to SIMBIC had dif- singer tries to imitate a desired sound rather than develop the
ficulty speaking and had spent much time in a respirator. sound uniquely his own. Accessory muscles are used to alter
Singing has become a particular pleasure for her because it is the sound and in time the breathing pattern is altered; where-
something done without aid from another. upon, the singer begins to experience the problems of voice
The basis of all my choir work is SIMBIC. Every choir mem- production and later may lose his voice.
ber is checked at every session for proper breathing habits, and Modern amplification methods destroy the sound of the
over the years the voice development has been rewarding. With natural voice by compelling the singer to make a particular de-
proper breathing, the production of sound involves none of the sired sound rather than the sound resulting from his proper
difficulties associated with the training of immature voices. breathing and vocal equipment. Many voice teachers whose
The voice develops in direct measure to the ability of the res- knowledge of respiratory management is sketchy do the same
piratory muscles to sustain the production of sound. As a small thing. Countless singers never know the sound of their natural
bonus for the choirs, their respiratory habits have helped to voice because their breathing is faulty and because they at-
improve their health. tempt to make a sound pleasing to themselves and to their
Certainly, none of the Olympic candidates in the Tahoe listeners.
SIMBIC program was prepared for the surprising changes which A number of the athletes at Tahoe had made voices for
occurred in their voices with the development of their breath- themselves by imitating a voice sound which to them seemed
ing coordination. Whatever they may have expected of their to be desirable. As their breathing coordination developed,
SIMBIC training, that was not it. Athletes who had weakened their voices altered and were more to their liking than the
diaphragms were especially subject to marked voice changes. artificial sounds they had been using. The making of a voice
Their voices had a thin, breathy quality of sound and tended mayor may not be a conscious effort to reproduce a given
to be of a higher pitch than would have been anticipated from sound. In breathing coordination the sound is the result of the
their well-developed physique. As the muscles of breathing action of the air against the vocal cords and is independent of
were able to sustain increased air pressure, the voice became the ear.
fuller and deeper. Release of throat tensions produced by ac- Sometimes athletes who followed one another in their
SIMBIC sessions did not recognize the changed voices and
cessory breathing also contributed in a degree to the im-
provement in the voice. In some instances the change was so would peer cautiously through my doorway to see who was in-
noticeable that the athlete's associates commented upon it. side. At the sight of a friend, the jaw would drop slightly and
the eyes widen. An exchange of appropriate comment was
Voice is always the product of the breathing. The so-called
"singing" voice is the same as the speaking voice, for singing, sure to follow. Athletics being among the most competitive of

176 177
 Dr. Breath

life forms, the question was inevitable: "Well, what's your

count?" Translated roughly, that meant "How good is your
breathing?" as indicated by the length of a count achieved on
a single breath. And count matching began.
I never did succeed in persuading all the men that the
16
count was not competitive. Because some counted faster than
DEVILS AND FIENDS
others, it was not how high but how long that mattered. The
voicing of numbers was nothing more than a means of pro-
ducing sound over a measurable period to promote the develop-
ment of the coordinated respiratory muscles. It was self-limit-
ing because the voice weakened with the exhaustion of the
breath. Since each individual differed appreciably, competition Hidden among the mountains about Lake Tahoe
was not possible. But the athletes did not see it that way, and are smaller, tranquil lakes and highland meadows of great
tall tales abounded. I did not have the heart to tell them that beauty. Rustic cabins nestle in the pines along the lake shores
I was timing them all the while and that an excellent high, and cling to the mountain slopes. Trails wind in and out nar-
attained without any of the boosters they had devised, would row passes through the great rocks and disappear mysteriously
have been in the neighborhood of two hundred on a single into the forests. The vastness of the mountains engulfs the
exhale, timing to some thirty or forty seconds. thousands of campers who come to enjoy the beauty and the
The last I heard, a self-declared champion had reached a peace and to escape their troubles.
peak past four hundred. I solemnly congratulated him, for he Of my first impressions of Tahoe, the most vivid was the
had made good respiratory progress in attaining that giddy prevailing atmosphere of unperturbable calm. The expanse of
height. earth and sky would seem to swallow all the devils and fiends,
the pressures and tensions, that tormented "down below," as
the uplanders designated the lowlands. I could think of no bet-
ter place in which to exorcise the demons spawned of the bustle
and the hurry of contemporary life. I was not long, however,
in discerning the presence of the evil host in our midst. The
devils and fiends had come right along with the baggage, and
after they had recovered from the jolt of the mountain air,
they went about busying themselves with their wicked ways.
The athletes were especially susceptible to the ill effects of
tension, both of body and of mind. The physical fatigue which

178 179
 i!!U'i_iiW_'"

Dr. Breath Devils and Fiends

they experienced after a day of workout was not a pleasant ecstatic over the possibilities which SIMBIC opened to him. He
exhaustion calculated to give a good night's rest. Too many had been ill the year before and had been warned that the out-
waste products within the body sensitized the nervous system look on his athletic achievement was not overly bright. He
and made relaxation impossible. Too many pressures and became a very faithful pupil and soon belied the prophets.
anxieties of top-level competition disturbed the mind for sleep Because of the interrelationship of the respiratory system
to come readily. A major complaint of the men was sleepless- and the nervous system, the condition of one influences the
ness which led to further exhaustion and on to more sleepless- condition of the other. Tension directly affects the breathing
ness and on and on. Caught up in an endless round of fatigue mechanism and tends to damage it, causing susceptibility to
producing fatigue, they fell ready prey to destructive tensions. respiratory complaints and disturbing other systems of the
When my SIMBIC pupils clambered the precarious steps to body in turn. As tension mounts, muscles tighten and destruc-
my trailer, their devils and fiends crept over the sill behind tive air pressure builds within the lungs. Unless the pressure is
them and settled comfortably around the instruction table. released, nervous mannerisms are manifest and a disturbing
Beneath my fingertips I could feel the tense muscles. The voice interaction of one system upon another is established.
betrayed the pressures which had accumulated within the Like the athletes, most people have become so accustomed
body. As the session progressed and the breathing fell into the to their tensions that they are unable to relax. Tension is ac-
coordinated pattern, one by one devil and fiend slid quietly cepted as a normal condition of contemporary life and is in-
off the table and disappeared. Relaxation was nearly always directly perhaps the greatest of the destroyers. Speech
the first impressive sensation of breathing coordination. For expressions indicate tension and the need for release. Being
many of the athletes, complete relaxation had become a lost "up tight" is a common condition of mankind. Human beings
art. They had grown so accustomed to their tensions that the can exasperate one another until "steam comes out of the
feeling of being relaxed was a marvelous new experience for ears" and they are "red as a beet" or lobster or something
them. equally as vivid. Nerves are "on edge" or "drawn out to thin
A determined young runner who not only was concerned wires." Given enough pressure, a person is "ready to explode,"
about his performance in competition but had personal prob- "blow his top," "flip his lid," "burst a blood vessel," or what-
lems as well lay upon my table in an early SIMBIC session and ever the current expression is. To avoid such consequences, he
is advised to "cool it," "keep calm," "simmer down," '(take it
pronounced the ritual of numbers. As his count lengthened, his
breathing deepened and his eyes closed. Suddenly he spoke. easy"-all very good suggestions very hard to follow.
''I'm floating!" he announced. "Now I'm floating away! The Today the mere fact of being alive is the principal cause of
table's floating, too. We're floating in circles. I never felt like tension. The complexities of modern living breed tension and
this before in my life!" Eyes still closed, he queried, "Am I nurture it. Overcrowding, unending competition for necessities
here? Am I in the trailer?" and pleasures, ceaseless attempts to fulfill artificial desires give
When he returned from his voyage of relaxation, he was rise to anger, frustrations, and anxieties which play havoc with

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Dr. Breath Devils and Fiends

the body and mind. Environmental conditions and dietary As tensions increase, air pressure in the lungs increases. All
synthetics add their poisons to the body systems and set in rna- the forms of producing voice sounds are a natural response to
tio~ the forces of destruction. The deemphasizing of individ- the necessity of releasing the air pressure. The long sigh helps
uahty has brought about a loss of regard for self as an inde- to empty the lungs of waste products and stimulates the breath-
pendent force in society. Coupled with the grinding drive for ing, which will give a sense of relief. A nervous person or one
success and approval, the loss of self-regard is a guaranteed ill at ease often tends to laugh too much when laughter
source of frustration. Life styles and habits have changed faster is not required, and an excited person will frequently chatter
than the mind can make satisfactory adaptations. With the volubly when only a few words are necessary. Crying, with its
aggregation of pressures and tensions, the old outlets for them sometimes rending sobs, leaves the body relaxed by exhausting
have narrowed correspondingly. of air pressures. Easygoing people will whistle or sing or hum.
As direct physical action has become more limited, repre- The continual expulsion of air establishes a breathing rhythm
sentative action and speech have become more violent. Since which adds to the original sense of well-being. A person in
men no longer club one another to death, they seek to destroy pain may moan or groan to lessen the internal tensions created
by social, financial, and psychological means. They vie with by the pain. Sound is the safety valve of the body.
each other in minor sports competitions which assume pro- Silence is fraught with potential dangers. Maintained over a
portions. of major military campaigns. They match extrava- period of time without a pattern of rhythmical breathing, it
gance with extravagance and race one another down the high- builds air pressure into a compulsive force. After the silence of
ways in their big cars. Reason has gone out of fashion and a lecture or a concert or any public assembly the crowd will
negotiations are conducted in shouts and threats. burst spontaneously into a wild clamor of comment. The si-
The descriptive language of violence is substituted for the lence of a tense moment in a sports competition is always
act of violence. Those who would not kill freely will declare in split by an uproar. Children who have maintained a relative
a moment of anger, "I'll kill him," or "I'll knock his teeth quiet during the school day scream and shout in celebration
d.own ~is t.hroat," or "I'll beat him to a bloody pulp." The de- of their freedom. Strangers caught in a tense situation will bab-
SIre to inflict the forbidden punishment or pain is reflected in ble like old acquaintances.
the.speech. In such an atmosphere of suppressed emotions and Without the release of the air pressure which the mainte-
desires, tensions thrive and must have some form of release. nance of long silence builds, unexpelled waste products ac-
Most obvious forms are the artificial. Chemicals, alco- cumulate in the lungs, the breathing process itself slows, and
hols, and drugs induce a certain sense of relief from tension the oxygen supply to the body is reduced accordingly. All of
by th:ir ac~ion upon the nervous system and upon the mind. these factors are damaging to the respiratory system and to
Smokmg gives a feeling of relaxation with the long exhale of other systems of the body as well. Internal air pressure often
~m~ke from the lungs. However, the permanent damage often has an overt effect in the physical sensation of tightening across
inflicted is hardly worth the temporary relief. the upper chest area. When the advice, "Get it off your chest,"

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 Dr. Breath Devils and Fiends
is given, it can be taken quite literally. By helping to expel air a sensation of complete relaxation, as the athletes experienced.
from the lungs, speech relieves the pressure and brings about The immediate general response to the release of tension is to
a marked physical awareness of relaxed chest muscles. Confes- talk freely. Some of the hard-topped tables I have used in the
sion is good for the soul and even better for the body in that course of my instruction have proved to be a sort of dual psy-
it terminates the tension-producing silence. chiatrist's couch and confessional. Problems cause tensions
Nowhere is the danger of prolonged silence more apparent and tensions cause problems. Release of tension is part of the
than in dealing with the mentally disturbed. A patient who solution to almost any problem. One pupil's entire problem
does not make voice sounds is restricting his breathing and was tension produced by physical factors in combination with
creating physical tensions which will further complicate the ex- overmedication. Psychiatric treatment and SIMBIC instruction
isting mental problems. In a period of work with mental pa- were given simultaneously, and, to the amazement of everyone
tients, I had opportunity to observe the explosive violence of involved, the pupil upon relaxation was telling more to me
voice sounds and sometimes of actions after prolonged silence. than to the psychiatrist.
When the patients could be induced to make any sort of voice Tension has more bizarre effects upon the body than can be
sound to break the silence and relieve the tension, violence delineated. A suggestion of its potential was evident in the
was unlikely. case of an internationally-known artist-philosopher who came
Breathing patterns are of particular importance in the man- to me at the suggestion of her physician for relief from the
agement of schizophrenic children. I have observed that these dyspnea of emphysema. A highly controversial figure in the
children are inclined to a restricted accessory breathing, which art world, she had been subject to extreme mental pressures
contributes to an increase in the body tensions. Of those under for a number of years, and as her physical condition grew
my surveillance, the most receptive hummed or made some worse, she despaired of being able to continue her creative
voice sound while engaged in activity. Even that slight release work. When I met her, she had just come through a severe ill-
of pressure was sufficient to alter their response to their en- ness which very nearly ended her life, and she was a tangle of
vironment. The silent ones, I noted, went through intervals of tensions. With SIMBIC she succeeded in releasing pressures she
breath suspension and had no means of releasing tension- had come to accept as normal, and gradually she could resume
producing pressures. Poor breathing patterns multiplied the her creative activities. A careful review of her case history re-
problems of the schizophrenic children by adding to their al- vealed no immediate cause for the development of emphy-
ready intolerable physical tensions and by reducing the oxygen sema but did indicate that tension had contributed largely to
supply which their body, particularly the brain, so desperately the destruction of lung tissue and could very well have been
needed. the prime factor in the disease.
Poor breathing patterns can be calculated to manufacture Corrosive effects of tension showed as surely in the athlete's
tensions and contribute further to existing difficulties. In performance as in the artist's ability to create. Accordingly,
SrMBIC the establishment of breathing coordination results in the Tahoe athletes were jubilant when they reached a given

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Dr. Breath

point in SIMBIC development and could release the tensions

robbing them of their rest and plaguing them especially before
competition. Used as part of the warm-up procedure, SIMBIC
often presented the odd sight of a full-grown man stretched
17
out on the grass chanting numbers to the sky. Strange conver-
TROUBLES IN SMALL PACKAGES
sations were also the order of the day.
"What do you think you're doing there, man? You sound
like crazy," a new Tahoe arrival interrupted a SIMBIC veteran.
"I'm breathing, man, I'm breathing. It helps me run."
HYeah?H
HYeah." Ehaps because everything about Lake Tahoe is im-
"Where do you get this breathing stuff? Maybe I better have mense-the lake itself, the mountains, the trees, the desert to
the east- I began to notice little things. Dusty little flowers
me some."
bloomed by the roadside beneath gigantic pines. Small donkeys
"See the Doc in the last trailer."
grazed contentedly in the meadow unaware of their measure
HYeahr'
against the great mountains. Inconspicuous brown rabbits nib-
"Yeah.~'
In a day or so an unfamiliar face appeared in my doorway, bled in the thickets along shallow streams bearing presumptu-
and another SIMBIC pupil soon began shaking free of his devils ous titles. Round and round the corral patient ponies plodded
WIth their joyous young riders, to whom all the circumstances
and fiends.
of the celebrated Olympics were no more than a good excuse
for a glorious vacation.
Little things did not necessarily mean unimportant things. A
few tiny rocks jarred out of place could bring a boulder crash-
ing down the mountain. Those would-be cowboys clucking to
their ponies had problems to match in importance any of those
of a gold medal aspirant. Troubles bundled into small pack-
ages can often be more serious than the larger sizes. When
I watched the children of the Olympic personnel and of the
community and when I listened to their voices, I could detect
the warning signs of respiratory problems. Neglected, as they
undoubtedly would be through ignorance not lack of concern,
the incipient problems could affect the entire lives of the chil-

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Dr. Breath Troubles in Small Packages

dren and no one would ever know what really happened. sports. From feeding to teething to toilet training, the infant
For over fifteen years hundreds of children from three years is poked and prodded to hurry, hurry, hurry.
of age-some only two-and-a-half-to young adults have Little ones are encouraged to get to one goal so that they
trooped past my piano at the Good Shepherd Choir School. can rush on to the next. Time and accomplishment bring no
I have observed their breathing and I have heard their voices. letup in parental ambition for progress. Little systems rebel.
Some of their problems I have dealt with professionally as a Muscles tense and tighten. The sensitive respiratory system
respiratory consultant; others I have handled as best I could responds and trouble begins. A few colds may not seem to be
within the framework of the choirs; still others I have watched important, but when they are followed by a few more, a fault
with sadness because 1 was not in a position to forestall the in the breathing can almost certainly be suspected. Since the
inevitable consequences of respiratory ignorance. So little is respiratory mechanism makes possible human functioning in
known about breathing that very little is done about it and very earth's atmosphere, it is to be cherished, for without oxygen,
little attention is accorded it until too late. the life expectation is reduced to, roughly, three minutes.
Children, like athletes, are generally believed to breathe No gratification of parental pride can possibly be worth the
"naturally" unless they are obviously ill or prone to illness. damages resulting from tensions, but most parents, unfortu-
Many children do retain the natural coordination of the nor- nately, are involved in their own problems and forget that trou-
mal, healthy infant well on into childhood, but far more lose bles come in the small packages, too.
it at an early age. When the natural coordination goes, the H a child survives the rigors of infancy unscathed, he num-
subsequent pattern is almost certain to exert undue stress on bers in the minority, for as early as three and four years the
one or another of the muscles of breathing and effect a weak- signs of tension begin to appear. When he is placed in the
ness. Such a weakness interferes with the efficient movement competitive situation of group activities, tensions mount with
of air in and out the lungs and eventually results in some sort the pressures to equal and excel. As the inner turmoil increases,
of respiratory complication. the pectoral muscles tend to tighten and raise the chest, thus
Again like the athletes, children are especially susceptible putting the respiratory mechanism out of alignment and estab-
to tensions. Tensions wreak havoc on small respiratory mecha- lishing a pattern of destructive accessory breathing. Should the
nisms, inflicting damage which can alter personalities and condition persist, deterioration of the respiratory muscles and
change the course of lives. A major portion of the tensions the attendant complications begin.
originate in the unrelenting competitiveness of contemporary The warning signs of respiratory faults in otherwise healthy
society. Before a newborn infant can adjust to maintaining his children are susceptibility to respiratory infections, the dis-
body in the alien environment of earth, he begins to be urged appearance of the clear, bell-like quality normal to a child's
to do something or other so that his parents can report a first. voice, and some speech problems. The voice and the breathing
Growth and development, totally individualistic processes at are inseparable, and the alteration in the voice is nearly always
an indeterminate pace, are transformed into competitive matched by an alteration in the breathing. Sometimes the

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Dr. Breath Troubles in Small Packages

solution to the problem is as simple as relieving the pressures ad~lts find these sounds highly amusing and encourage their
on the child; sometimes it is considerably more complicated. children to duplicate them. Children, who are quick to imitate
When the most reliable member of my Cherub Choir, a and placate adults, adopt the false voices of comic characters
self-possessed little lady of about five, started in kindergarten, wh.ich have been made popular through recordings and tele-
her voice gradually lost its lovely clear quality, and the child ~lsIOn.The child not only alters his own voice but in produc-
herself began to lose her former amiability. Each week the mg the false sound, alters his breathing pattern. The cost of
changes became more noticeable and I corrected her breath- the adult amusement is the child's voice and respiratory health.
ing faults accordingly. Finally I spoke with her mother and Because children are imitative, shrill unpleasant voices are
learned that because of her vocal ability and enthusiasm she often a reproduction of the unpleasant adult sounds they hear
was being called upon to lead the singing of her class. Know- around them. In making the sounds breathing patterns have
ing the child, I suspected that in her excitement of group to be altered and candidacy for respiratory complaints is estab-
leadership she was singing not only for herself but for all the lished. Adults sometimes think that a low-pitched growl is a
children. At my suggestion she was removed from her demand- manly sound for a little boy to make. Now, a low-pitched
ing position. With the release of that pressure both her voice growl IS not a manly sound nor is it a natural sound for a little
boy to make. One young choir member had been urged by his
and her disposition returned.
parents to fit himself out with an unnatural, deep voice like
Many children develop the dangerous habit of holding the
breath. Under tension they raise the shoulders in taking a his father and become a real rough-and-tumble guy. He tried
to please and every week I watched his chest grow tighter de-
breath and tense the muscles of the upper chest to hold it. Un-
corrected, this habit will destroy any desirable pattern of spite my intermittent efforts. I could succeed in getting him to
relax his taut muscles and use his natural voice in singing, but
breathing. When called upon in choir rehearsal to recite the
words to a song, an unsure child frequently will hold his I was not in a position to persuade his father to give up the
unnatural speaking voice. Unhappily, I saw him develop into a
breath while trying to think. I can take care of the moment by
nervous, irritable child.
telling him calmly just to relax and think, but I can do little
With proper management of the breathing, the immature
about the other tensions in his life.
voice can be guided through the various stages of development
A deplorable destructive force which increasingly affects the
without endangering the sound-producing structures in the
child's voice and, subsequently, his breathing is the totally er-
throat. When the cherubs are brought to the Choir School,
roneous adult concept of a child's voice as being a high·
some at the age of two-and-a-half years, about seventy per cent
pitched squeak or a growling monotone. The natural sound of
of them would be counted as monotones. Unless they have a
the immature voice has a delicate, clear quality which no adult
physical defect of ear or throat, a rare occurrence, they are
can imitate. To the gross adult ear, the higher pitch of the
monotones because their breathing is faulty or because their
young voice may sound shrill and in adult imitations is in-
ear cannot yet distinguish pitch. By the age of six the propor-
terpreted as an unpleasant squeak, often nasal. Some misguided

190 191
 Dr. Breath Troubles in Small Packages
tion of monotones is reduced to five per cent, and by the age ing tensions of growth and whose breathing has made them
of eight they have all learned the proper production of sound constant candidates for respiratory infection often seek refuge
and are singing. With guidance and constant supervision of subconsciously in illness as a temporary relief from pressure.
the breathing, the voices of both the girls and the boys are They have no other escape from the overpowering forces with
brought through the difficult maturing process of adolescence which circumstance compels them to deal. The brief escape,
without interruption of their careers in the choir. Two young however, does not remedy the situation.
girls who had exceptional voices began voice study at the ages The greatest single aid in the breathing problems of young
of eight and twelve. Each matured gracefully, and one went children is to relieve the demanding pressures which cause a
on to do concert work in Europe while the other auditioned build-up of physical tensions likely to distort breathing pat-
for the Metropolitan Opera and engaged in solo work during terns. The constant drive to achievement can do untold harm
an interim of music study. to the respiratory apparatus of the young. Early indications of
Both voice problems and respiratory health problems gen- approaching trouble are changes in voice quality and suscep-
erally are rooted in faulty breathing. Without the necessary tibility to infections. Habits which will precipitate a pattern of
correction of the breathing, the problem will very likely go accessory breathing and weaken the respiratory muscles are
unsolved, as a choir member in his late teens learned from breath-holding and carrying the shoulders high rather than in
experience. He had had a series of minor illnesses which cli- a relaxed, lowered position. If the child's abdomen protrudes
maxed in a diagnosis of chronic bronchitis. No sooner did he on speaking or exhaling in any fashion, the diaphragm is too
recover from one illness than another began, and he lost so weak to support the air pressure and ultimately may give rise
much time from school that his academic standing was jeop- to an assortment of respiratory complications. Because of
ardized. Finally his parents consulted me about his breathing muscular resiliency these symptoms of weakening of the mus-
and its possible effect upon his respiratory condition. When I cles of breathing very often will disappear as the external pres-
examined the young man, I found that his chest had tightened, sures are relieved and the child can shed his tensions.
forcing him into a pattern of accessory breathing. None of the The little people grow to be big people, and as they grow,
medication given him was reaching the source of the infection. their troubles grow along with them. The respiratory ailments
After two weeks of SIMBIC instruction the infection cleared. of childhood can cause injury which carries over into adult life
The correction of the breathing not only solved the respiratory and develops into respiratory disease and disorder of varying de-
problem, it also brought about a release of the tension which grees of seriousness. Emphysema patients usually have long
was a major contributing factor in the complexity. histories of respiratory infection. Many of the athletes had rec-
Although the muscular resiliency of youth is a marvelous, ords of childhood respiratory complaints and many suffered
built-in protective factor, the continual stress of faulty breath- the far-reaching consequences of early illnesses.
ing and respiratory infection in combination with tensions will . Correction of small troubles in the young can prevent much
eventually destroy it. Children who cannot tolerate the unend- of the respiratory difficulty which neglect fosters in later life.

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 18
OUNCES AND POUNDS

During the first half of the intensive training and

development program for the Olympic candidates in the appli-
cation of SIMBIC to their individual needs, my thoughts and
purposes underwent reorientation. In spite of all earnest effort
and good intent the practice and competition conditions at
the South Lake Tahoe High Altitude Study site did not match
those which could be expected in Mexico City. None of the
track meets held in the course of the summer had had any of
the extreme tension and stress which the September finals for
the selection of the Olympic team would have nor which the
October games in Mexico City would have in even greater
abundance. A practice competition and a determining com-
petition are two different things.
Futhermore, Mexico City would have an air pollution fac-
tor absent from Tahoe. Coupled with the pressures of interna-
tional competition for world championships, it could create
breathing complications. I was becoming less and less inter-
ested in championships and more and more concerned with
health and safety. I had observed the athletes enough to know I,
that the champions extended themselves beyond the physical
barriers and relied upon pure will for their victories. They

195
 "hh.h."~ . - = .--- _ ..
Dr. Breath
Ounces and Pounds
could use the extra energy SIMllICprovided, but more than
instruction and supervision would go on through the Septem-
that, they, like all athletes, needed the means of preventing
ber finals until the games ended.
possible respiratory damage in their excessive exertion. I
My approach to the matter was more realistic. I had no
wanted to give them the ounces of prevention to avoid the
reservation about the importance of continuing through the
necessity of pounds of cure long after the victories had become
memones. games, but I knew that the financing of the project extension
from the end of August on would be a major consideration for
Because of the brief time allowed for the muscular develop-
both the Olympic Committee and the Institute. I also knew
ment of breathing coordination, I questioned the ability of
that obtaining the credentials necessary to give me access to
some of the men to withstand the grueling demands of final
the team during their performance in Mexico City would be
performance without supervision. I also had a particular con-
no simple matter. Even so, I addressed myself to the Olympic
cern for a number of the men who had had difficult recoveries
Committee Executive Board and advised as emphatically as I
at the several track meets during the summer and who could could that in the interest of health and safety the SIMllICproj-
never get around to fulfilling their solemn vows to come for
ect be continued on the original terms. Then, according to
breathing instruction. SIMllICwas offered on a strictly volunteer my time-honored custom, I busied myself while waiting.
basis because it requires self-discipline and is of minimum
Staying busy was a rare problem at Tahoe, for someone was
value unless continually applied. I hardly had time to see those always drawn to my trailer door by sheer curiosity or by dire
who wanted it enough to come to be taught. I could not go need. Nothing that materialized within the framework of the
seeking those whose resolution waned with the crisis, nor opening ever surprised me. I did not so much as blink twice
could I stop worrying about the consequences of their folly. the afternoon a small balding man with a bushy beard and
They could have serious trouble without aid from someone eager eyes came to inquire about "some breathing lessons." He
thoroughly familiar with breathing processes and respiratory looked more like a prophet down off the mountain than an
mechanics. Quite possibly that aid might not be available. athlete, but he was in fact a walker from Israel who was work-
When the original plans for the srxmrc instruction project ing out at the track and felt that an improvement in his
were detailed, the work was to be conducted over the six weeks breathing would be advantageous. Since I was obligated to the
of the Medical Testing and Study program. If successful, it U.S. Olympic Committee, I explained to him that in the in-
then would be considered for continuation through the games terest of international harmony I would have to clear with
in Mexico City. The first track meet twelve days after the start Olympic officials. He nodded in understanding and ambled
of the program removed any lingering doubt of the effective- off into the forest silently as he had come. Later, when I was
ness of SIMllICor its value to the athlete. The first progress re- able to work with him, he became so enthusiastic that he
port brought an enthusiastic response from the Olympic Com- wanted to export snrnrc to Israel.
mittee and the Tahoe staff. Everyone directly associated with The Israeli athlete reminded me forcefully that everyone
the preparation for the Mexican games assumed that SIMllIC needs to learn how to manage his breathing. Although srMBlC
196
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 WM9£iOrii« ..... ~ 4.

Dr. Breath Ounces and Pounds

arose from the breathing needs of the chronically ill, its bene- Every function of the body requires oxygen. The act of
fits to the well are manifold, particularly in prophylaxis-the breathing supplies oxygen for all cellular needs and removes
prevention of trouble. Instinct has always prompted me to the gaseous waste products of cellular activity, A constant turn-
avoid complications which can be foreseen. My concern for over of air in the lungs is essential to the maintenance of
the danger potential of the Tahoe finals and the Mexican good health. If oxygen is not supplied in appropriate quan-
games stemmed from this ounce-of-prevention-is-worth-a- tity and carbon dioxide wastes are not removed effectively, the
pound-of-eure attitude, as did my steadily expanding interest body will respond in a variety of seemingly unrelated ways,
in the application of srxrnrc to prophylaxis. from drowsiness and headaches to tension, twinging muscles,
Work with the athletes had added to the Institute files and sneezes. Solely from the standpoint of physical comfort,
quantities of material on the preventive values of snrsrc and breathing is worthy of consideration.
had underscored the relationship between breathing patterns Consequences of faulty breathing can range from unpleasant
and incidence of respiratory infection. Minor respiratory infec- to dangerous. Faulty breathing weakens the muscles of breath-
tions constantly recurring pave the way for later, more serious ing, particularly those of exhale. As the muscles weaken, the
disorders. Whenever the number of such infections can be re- turnover of air in the lungs decreases and residual volume
duced, the likelihood of more complicated conditions develop- increases, thus leaving an accumulation of gaseous waste prod-
ing in the future also is reduced. Prevention of respiratory ucts in the passageways of the lungs. In the "dead" spaces
problems with all their many ramifications is far better than through which air is not circulated, infection settles just as
any attempt to solve them. scum settles on a pond through which no water flows freely.
Breathing by its very nature makes prophylaxis difficult. It Circulation of the blood through the dead spaces tends to slow,
is such an obvious human necessity that it generally is ignored and medication, regardless of quantity or quality, cannot act
until a problem calls attention to it. It requires little conscious effectively upon the infection. In this manner the groundwork
effort and makes no direct demands on the individual for pro- is laid for a cycle of recurrent illnesses which in their own good
vision of a substance to be breathed. On the other hand, eat- time can damage the lungs and create a respiratory cripple.
ing, also an obvious human necessity, is seldom neglected. It srxmrc has been particularly efficient in breaking down the
requires an amount of effort and makes unending demands cycle of illnesses and preventing recurrence. The prophylaxis
on the individual for provision of an assortment of substances study at St. Albans indicated the value of srMBrc in reducing
to be eaten. Not only is it a pleasure, it is a whole complex the incidence of pneumonia. Because of the existing sensitivity
of industries and businesses. Much attention is given to the of the lungs, respiratory patients are constantly in danger of
intake of appropriate quantities of proteins, fats, carbohy- contracting an infection which develops into pneumonia.
drates, vitamins, and minerals. Conversely, oxygen, the matter Lung damage from prior illnesses leaves dead spots within the
of breathing, occasions little notice, yet without the breath- lungs, and conventional medication procedures fail to clear the
ing of oxygen all the food could not be consumed. infection in these spots. All too frequently another pneu-

198 199
 -'. ,.
¥ffi9\£'rifi'i' =wi' O.AO'

Dr. Breath Ounces and Pounds

monia follows. A patient in the St. Albans study had had three age the athlete's respiratory mechanism, they drain his body's
pneumonia illnesses within one year before he began SIMBIC energy and reduce his performance potential. The more quickly
instruction. After he developed his breathing coordination, he they are cleared, the less likely they ale to cause lasting effects.
went for the remainder of my stay at the hospital, two years An athlete's respiratory mechanism is as much a part of his
or so, without another occurrence of pneumonia. Others in the physical equipment for performance as the body structures di-
study who had case histories of repeated infections had no in- rectly employed in performance. His muscles of breathing
fections during that time. sustain the total organism and require proper development for
By effectual movement of air through the lungs SIMBIC maximum efficiency. Every athletic program, whether for Lit-
opens the dead spots, stimulates the blood circulation, and tle Leaguers or world champions, could make an appreciable
enables the medication to act upon the infection. An emphy- contribution to the health and safety of its participants by
sema patient who had been hospitalized for six weeks in an including thorough respiratory instruction. Proper respiratory
attempt to diagnose and treat an infection of steadily increas- management reduces the probability of damage from faulty
ing seriousness carne to me for a long-overdue SIMBICcheckup. breathing under stress and promotes general health through a
We corrected some faults he had developed in his absence, stimulation of the circulatory system. It eliminates many phy-
then he went back to the hospital for additional medication. sical problems before they ever have an opportunity to take
With the opening of the dead spots the medication could take root and flourish.
effect, and after a few days the stubborn infection cleared. Similarly, effective respiratory programs incorporated into
As long as the breathing is correct, SIMBICpupils who have the school curriculum would provide special advantages for
emphysema can clear infections in a matter of days even children and young people. Proper breathing, as the athletes
though they may have histories of extended, serious illnesses. discovered, induces a state of relaxation and prevents the
The athletes at Tahoe were akin to the emphysema patients build-up of corrosive tensions. Pupils and teachers alike could
in that the severe demands upon their respiratory system made do very well with a reduction in classroom tension. Even more
them susceptible to colds and respiratory infections. Tahoe had important is the maintenance of a steady oxygen supply to the
a bouncing thermometer which rose and set with the sun, and body with the accompanying benefits in health and well-being.
the athletes were constantly overheating and cooling their Young people who want to "turn on" and experience fully the
bodies. The chill, dusty mountain air was conducive to colds sensations of the physical being will find that the positive stim-
of all sorts. However, the men in the SIMBrcproject had fewer ulation of a naturally well-oxygenated system sustained by
colds and colds of shorter duration than those outside the proper breathing is far more satisfying than the negative stim-
project. One runner incurred a serious respiratory infection ulation of drugs and chemical products.
when he left Tahoe for a weekend to participate in a track Because human beings live in the atmosphere and must de-
meet.. He asked for an extra SIMBICsession, and his infection rive their very source of life and energy-oxygen-from the
cleared in record time. Infections not only tend to dam- atmosphere, their respiratory system and its employment are

200 201
 Dr. Breath

of supreme importance to them whether or not they choose to

recognize and respect the fact. Proper breathing can avoid or
reduce the consequences of many of the evils flesh is heir
to; improper breathing can and ·does affect the other systems
of the body detrimentally. With the unceasing pollution of the
19
environment, proper breathing becomes the most potent form
of health insurance. In urban areas of concentrated air pollu- HALF A LOAF
tion, knowing how to breathe for maximum efficiency amounts
to possession of a weapon for survival.
Air pollution combined with tensions, which are at the
base of most of the major problems of mechanized, commer-
cialized society, creates a critical need for the ounces of pre- Rom time to time the athletes came to me about
vention, particularly when they are as simple as proper breath- "this friend in L.A.," or Denver, or Kansas City, or some other
ing. The pounds of cure often prove to be too little come too distant point, who "needs a little help with breathing.
late. What'll I tell him?" The question seemed so innocent that
only a stock reply should have been required, but I never
could bring myself to develop an automatic response. I have
always worked with individuals and individual problems.
Knowing the intricacies of breathing and the differences be-
tween people, I hesitate to give general advice. What can be
helpful to one can just as readily be harmful to another.
SIMBIC is concerned with the involuntary muscles of breath-
ing, their tone, and their development. It has nothing to do
with any form of calisthenics designed to force the operation
of these muscles through use of the voluntary muscles or ex-
ternal pressures. Despite the radical nature of the entire con-
cept of breathing coordination, the acceptance of snasrc as a
complete departure from all previous approaches to the act of
breathing seems to be extremely difficult for both the scientist
and the layman. When an attempt is made to simplify the
subject, the response is all too often the automatic assumption
that this is just a new presentation of an old topic, one already

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Dr. Breath Half a Loaf

long since exhausted. The topic is indeed old, but accurate, that the advice was for the well. Anyone with a serious res-
scientific knowledge of it is only at a beginning. Most popular piratory problem or disease should be exceedingly cautious
notions of it amount to folklore. about following general advice intended for the well. Where
Many people who have had singing lessons or who have damage already is present, the possibility of further damage
practiced "belly-breathing" or yoga are firmly convinced that also is present.
they know the major facts of breathing, yet time and again I Acutely aware of the pitfalls of oversimplification, I pro-
have been called upon to redevelop the abused and weakened ceeded to advise. My experience has been that most people
diaphragms of just such people. As the wise man remarked, have a somewhat vague idea of the respiratory mechanism, its
"It isn't what people know that hurts them. It's what they structure, and its functions. This deficit in the departments of
think they know that isn't so." What most people think they anatomy and physiology creates some rather curious notions
know about breathing simply is not so. about the process of breathing. Observation of the external
A very real need for respiratory education exists. All the motions of the body during the act of breathing can be very
friends in L.A. and Denver and Kansas City should be told misleading about what is going on inside. Knowledge is not
enough about the management of breathing to enable them to necessary to the performance of the act, but it does help to
use their respiratory equipment intelligently and avoid the clear away some of the misconceptions.
common distresses of the day. srxrsrc, however, by virtue of First of all, the body has to corne off the flattened textbook
dealing with the singularity of the individual's respiratory pages and be thought of as a kind of cylinder which, in breath-
structure, cannot be reduced to a do-it-yourself formula. Dr. ing, functions all the way around, not just in front, as it would
Nims of West Haven has tried unsuccessfully for more than often seem to. The lungs lie within the encompassing cage of
~ve years to analyze and define SIMBIC in terms which any med- the ribs like two inverted cones with the base toward the
ical man can follow to achieve the desired result of establish- mid-region of the body. They should be filled with air from
ing breathing coordination. Time and research lie between the bottom to the top, just as any container is filled. The
~he knowledge of the existence of breathing coordination and lungs, however, are not just any container. They possess the
Its availability to the public. peculiar property of being able to be filled partially from the
Meanwhile, the benefits of proper breathing habits are so top, and herein is the origin of numberless respiratory pro~-
numerous and the need for knowledge and practice of proper lems. Accessory breathing, as this partial filling from the top IS
breathing is so great that half a loaf would appear to be better called, destroys the natural breathing pattern, alters the POSI-
than none. Whatever advice I could give the athletes to pass tion of the chest, weakens the muscles of breathing, and
on to their friends might possibly be better than their having makes the practitioner a prime candidate for various respiratory
no instruction at all. When I agreed to tell the men "what to infections and disabilities.
~ell 'em," I also warned that they were giving not SIMBIC Proper breathing always fills the lungs from the base at t~le
mstructIon but general advice on breathing. I noted further middle of the body, and the action of breathing occurs pnn-

204 205
 Dr. Breath Half a Loaf

cipally in this middle area. The entire circumference of the tends to force the ribs upward and outward on the exhale and
mid-region should contract and expand with the movement can alter the position of the chest.
of air out and in the lungs. Back motion in breathing gen- Contrary to general belief, the more important phase of
erally is neglected, but it is of vital importance. When the breathing is the exhale, the movement of air from the lungs.
back muscles are inoperative, accessory breathing begins. The If a container is to be refilled, it must first be emptied of its
athletes used the sensation of the back motion to maintain contents. The lungs are containers for the body's supply of
air with life-giving oxygen. Before they can be refilled with a
breathing coordination during performance. When the back
new supply, they must be emptied of their waste-containing
t~nsed, they went into accessory breathing, and their effi-
old supply. The sensation of breathlessness does not indicate,
ciency was reduced immediately.
as is often supposed, the need to fill the lungs. It indicates
Breathing motion at the middle of the body does not mean
instead the need to empty the lungs so that they can be re-
that the diaphragm is moving in and out, as many believe.
filled. Attempts to introduce more air into already overinflated
The motion is due to the emptying and filling of the lungs.
lungs increases the sensation of breathlessness. When air has
In the process of breathing, the diaphragm, which extends
been removed in sufficient quantity on the exhale, the auto-
through the center of the body from back to front separating matic inhale occurs and the body needs for oxygen can be
the chest cavity from the abdominal cavity, moves upward on
satisfied.
the exhale and downward on the inhale like a flexible dome. A natural device for promoting a long, relaxed exhale is the
The upward movement helps to move air out of the lungs; sigh. The aftermath of the sigh is an intake of air. Sighs gen-
the downward movement results from the pressure of the in- erally follow a period during which breathing has become slow
coming air. With the movement of the diaphragm is a corre- and needs to be increased. The long, relaxed exhale, which is
spo~dmg movement in the abdominal region. Diaphragmatic the principle of the sigh, can be cultivated to advantage. Like
motion downward increases the pressure within the abdominal the sigh itself, it should be a product of muscular tone, never
c~vity and causes the abdomen to move outward. Upward rno- of force. Counting silently often helps to prolong the exhale.
tion of the diaphragm decreases that pressure and the ab- Too much cannot be said against the use of any form of
d?men tends to flatten. The abdominal muscle supports the force, muscular or mechanical, to compel the operation of the
diaphragm but never forces it. muscles of breathing. Breathing is a relaxed process. When it
The motion of the abdomen in the breathing process should becomes forced, the desirable pattern is destroyed and undue
not be confused with the form of breathing known as "belly- stress falls upon individual m usc1es. With the destruction of
breathing," which employs the abdominal muscle to force the the original pattern, an altered pattern of accessory breathing
motion of the diaphragm. In the case of a weakened dia- is adopted and, if continued, can weaken the respiratory
phragm such forcing causes further damage and can produce apparatus.
numerous respiratory complications. "Belly-breathing" also When the long, relaxed exhale has been mastered, a person

206 207
 Dr. Breath Half a Loaf
with no respiratory problems can improve the tone of his phragm further and cancel any benefits to be derived from the
muscles of breathing by adding sound to the exhale and count- process.
ing aloud. Anyone with a serious respiratory problem should Breathing is a rhythmical function which requires constant
be guided through the muscular redevelopment process and maintenance to keep the body supplied with oxygen for effi-
would be very wise to confine himself to the long, silent ex- cient operation. Often in periods of concentration or tension
hale. Production of sound places more stress upon the muscles the tendency is to hold or suspend the breath. Such a habit of
than the ill can support. breath-holding can be detrimental to the body and can pro-
The well should begin with a low count of ten and con- duce bizarre results. A doctor with whom I was associated had
tinue a relaxed exhale at the end of the audible count. After reached a point at which he was seriously considering giving
the subsequent inhale the count should be increased by five up operation of his car. He had begun to experience "black-
and the exhale extended as before. With gradual rise, by fives, outs" while driving and had almost incurred several serious
in the count the inhale following will tend to increase and accidents. At one time we had discussed the diminished sup-
each exhale to lengthen. If the lower abdomen begins to tense ply of oxygen to the brain brought about by breath-holding,
or forcing occurs, counting must stop. Performed correctly, and he happened to remember the discussion. Upon observa-
the procedure gives a sensation of total relaxation. The gen- tion he discovered that in the tensions of traffic he held his
eral high count on a single breath is about one hundred and breath. When he maintained his breathing, the blackouts
times to fifteen to twenty seconds. After the muscles have de- ceased.
veloped, the high count may average thirty or forty seconds Students and persons engaged in mental activity are in-
on a single breath. clined to hold or to slow the breath when they concentrate.
Counting should be conducted in a supine position. The The reduced supply of oxyge;' to the brain reflects in slug-
floor will do nicely and will eliminate the need for expensive gishness and sleepiness and in a healthy respiratory mecha-
equipment. The body should remain relaxed throughout the nism will cause a yawn. For peak mental efficiency, attention
procedure, for breathing is a relaxed process and induces should be given to the breathing and a rhythmical pattern
relaxation. Any forcing of the count or tensing of the rib should be maintained.
cage indicates a fault and should be avoided. The inhale Rhythmical breathing is not to be interpreted as "syste-
should always be a spontaneous response to the prolonged, matic breathing"; that is, a certain count for the exhale and a
relaxed exhale at the end of the oral count. The shoulders certain count for the inhale. The only thing to be said for the
should be kept down and the chest relaxed. If the lower practice is that it avoids breath-holding. Such a system of
abdomen protrudes on the count, a weakened diaphragm is breathing destroys natural breathing patterns and sets up
indicated and the count should be suspended. In such event artificially maintained patterns in place. The artificial pat-
a return to silent counting in a prolonged exhale is advisable. terns cannot accommodate the constantly changing needs of
To continue the application of sound would weaken the dia- the body and will produce numerous ill effects. A well-known

208 209
 "£;f"'Co

Dr. Breath

athlete with whom I worked briefly employed systematic

breathing. He had a weakened diaphragm and suffered con-
stantly from abdominal pressure pains and side stitches during
performance. He also had a serious stomach-ulcer condition
caused by the innumerable pressures and tensions of top-level
20
competition. Although he was aware of his physical improve-
ment with SIMBIC, he could not bring himself to abandon his A SWING
former habits and accept SIMBIC discipline. Through the OF THE PENDULUM
season his condition gradually deteriorated, and he eventually
lost his national standing.
Since the diaphragmatic muscle not only participates in
breathing but also regulates the pressure in the thoracic and Tme at Tahoe was a relentless enemy steadily ad-
abdominal cavities, abdominal conditions affect the breathing. vancing. Runners ran against the clock and everyone raced
Any undue pressure in the lower abdomen, such as that caused the calendar. So milch had to be accomplished before the
by overeating or by pregnancy, restricts the breathing. The September finals that no day could be stretched enough to
abdominal muscle was designed to support, not force, but include everything. Each swing of the pendulum reminded
support the diaphragm. When the abdominal muscle weakens me of some task left undone. At one extreme of the arc were
and permits the viscera to sag, an abnormal descent of the the breathing problems of the Olympic candidates; at the
diap.hragm occurs. Unless the condition is corrected, diaphrag- other were those of emphysema patients in the East from
matic weakness will result. whom by now I had been too long absent. As the pendulum
. The abdominal muscle can be strengthened for its support- swung from tic to toe, I knew that I had to duplicate the
mg role through the practice of simple leg-lifting exercises. In action and betake myself from West to East on a hurried
the supine position the legs should be lifted alternately a com- journey to attend some urgent matters.
forta~le number of times then raised together if possible. The My opportunity came when the athletes had to leave Tahoe
exercise should never be carried to the point of strain. Over- for a few days to participate in competitions "down below."
exertion is never wise. I winged my way back to New York and plunged into a sched-
Breathing is a process which will occur of itself, but proper ule marvelously planned to include everything except sleep.
breath~ng requires considerably more attention. Improved Part of my mission had to do with the Tahoe finals. The other
breathmg for health and efficiency in the oxygen-starved state part was devoted to Institute business and to affairs concern-
of modern society is an undertaking well worth intelligent ing the work in emphysema. The tic of the clock was deaf-
pursuit. emng.
All the emphysematous SIMBIC pupils had weathered the

210 211
 .riht ....
-- --- - - --- .. _--- ~

Dr. Breath
A Swing of the Pendulum
summer well and were eager for reports from the mountains. many; the results were the same: breathlessness. The weakened
As I checked them to make certain that they had not fallen muscles were unable to move out untrapped air efficiently and
into breathing faults, a curious phenomenon occurred. I had to open new areas of the lungs for the effective exchange of
the strange feeling that I was viewing the athletes through a gases. Through snrsrc the individual pattern of muscular co-
magnifying glass. Apart from the condition of the Iungs, the ordination could be reestablished and the weakened muscles
difference between the extremes was primarily one of degree. could be redeveloped to move air from and into the lungs at
The small problems of breathing in the athletes were exag- peak efficiency with minimum effort and without the employ-
gerated into major difficulties in the emphysema patient. The ment of any of the artificial devices which have been developed
dyspnea of the athlete's recovery period became a common to aid the breathing. A radical aspect of snrnrc is that rede-
experience of the patient. Both suffered similar apprehensions velopment of the involuntary muscles was not considered to
and dangers, but to the former these were the norm of com- be possible.
petition while to the latter they were a way of life. Breathless- Obviously, snrnrc could not restore the damaged lung tissue,
ness, regardless of the immediate cause, always has the same but with the redevelopment of the weakened muscles and the
fundamental cause. restoration of the proper mechanics of breathing, it made pos-
Prior to SrMBrC,the overinflated condition of the lungs which sible the employment of previously inactive lung areas at the
produced breathlessness in the emphysema patient was under- highest level of efficiency of which the individual was capable.
stood, but the reason for the persistence of the condition was The deterioration of the tissue through the stress of exertion
not. The alveoli, or air cells of the lungs, lost their elasticity was halted and the progress of the disease was arrested. An
because of some form of damage and served as traps to hold advanced patient who had adhered to snrsrc discipline faith-
within the lungs air which normally should have been moved fully was in better physical condition five years after he began
out on the exhale. On the subsequent inhale the trapped air to practice srMBrc than he was at the outset. His respira-
blocked the intake of necessary quantities of new air, and the tory functions were improved and his general health was far
body's requirement for oxygen set off the sensation of breath- superior. When he began, he had been taking oxygen daily
lessness. That was all clear enough. What was not clear was of necessity. He immediately eliminated the oxygen and
the underlying reason for the failure of untrapped air to be never returned to it. He has completely incorporated sncsrc
moved out efficiently on the exhale. The obvious reason for into his pattern of living and constantly attends his mus-
dyspnea, the air trapping in the alveoli due to the cells' loss of cular development.
elasticity, did not explain the condition completely. The dyspnea of the athletes and the dyspnea of the emphy-
The research work in srxmro revealed that the loss of cellu- sema patient differ only in that the athletes. do not have a
lar elasticity was a secondary cause of dyspnea. The primary breakdown of lung tissue. However, the overinflation of the
cause was the breakdown of the mechanics of breathing. Rea- lungs with nnexpelled air is the same and the breakdown of
sons for the weakening of the muscles of breathing were the mechanics of breathing is the same. The photographs of
212
213
 Dr. Breath A Swing of the Pendulum
the emphysema patient which I had tacked to the wall of my serna. For the most part, the emphysematous tend to be
trailer served to remind the athletes of the dangers inherent intense people who pursue their interests immoderately. Their
in poor breathing management. Similarly, the athletes were very nature makes them candidates for the disease. Once they
a symbol of the physical discipline required of the patient in have developed the condition, they have difficulty in modify-
his maintenance of his breathing coordination. ing their activities to live with it comfortably. Having no
Effects of dyspnea on the athlete are principally of the visible signs of disability, they often cannot accept the fact
moment; whereas, the effects on the emphysema patient are that they will not return to a former state of health. When
pervasive, exerting their influence long after the immediate they feel good, they overexert and exhaust themselves. Since
emergency. Because the breathing affects all the functions of they lack physical reserve, they require considerably longer
the body, the nervous system responds to breathlessness by pro- than normal for recovery. They also are inclined to disguise
ducing tensions and causing unstable emotions. In the well the their true state of health and pretend in public to be far
state passes with relative speed; in the diseased it lingers and fitter than they are. The pretense does double disservice. They
lowers the individual's tolerance to situations he might have overextend themselves, and their public activity deceives their
endured atone time. When this tendency is unknown to the private associates, who find the invisible illness hard to believe.
patient's family and associates, he is considered disagreeable Lack of sympathy on the part of associates is the gray ghost
and difficult and is subject to a lack of understanding which constantly haunting the emphysema patient, who never seems
can upset him and lead back into an attack of dyspnea. to be quite able to elicit understanding.
The interrelationship of the breathing and the nervous system According to individual physical state, the person with
makes most of the emphysema patient's responses an exag- emphysema is like an automobile with a given quantity of gas
geration of the normal response. The patient's nerves are in the tank. How the gas is used is of little consequence,
frayed by his constant preoccupation with his breathing and whether in a long trip or in traffic or in leakage. When it is
an incident of minor consequence can bring about dyspnea. gone, it is gone, and no matter how much mileage is left in
I have observed a patient in the simple process of trying to the engine, the car will not move without more gas. The
arrange a luncheon appointment with an acquaintance be- emphysematous has a given quantity of body energy. Whether
come so involved that he was out of breath at the end. An- he uses it in physical activity, mental activity, or nervous
other who conducts important business transactions on the waste does not matter. When it is gone, he will have to stop
telephone can become unduly disturbed by failure to complete and recover. His recovery is slower than normal because the
a call. Tension can result from a minor occurrence as readily disease is constantly draining away a portion of energy. .
as from a major and can just as readily produce dyspnea. No Warning against overexertion should not be taken as advice
buffering emotional reserve is available. to become inactive. Inactivity slows the body processes and
Tensions and pressures can damage the respiratory system can cause highly undesirable states of congestion. In under-
as effectively as infection and disease and result in emphy- taking physical activity the emphysematous should be very

214 215
 Dr. Breath A Swing of the Pendulum

cautious of exercises. Physical exercises may give a passing keep his breathing constantly in mind and should be aware
sense of well-being because they tend to increase the circula- that change in body activity and body position will alter the
tion; however, the extra strain imposed by increased breathing supine pattern of breathing. He must remember that the
demands of exercise upon already weakened muscles of breath- breathing action occurs in the midregion of the body and that
ing offsets the temporary benefit. The patient has to know the back is included in the motion. The body is never made
himself well enough to gear his activity to his available energy. to function by application of muscular force. Thinking the
To aid his breathing, he should keep in mind always that action will cause it to happen through the body's own proc-
his problem is to move air from the lungs. Again, any advice esses. Breathing is always relaxed.
on breathing procedure should be followed with utmost cau- Any patient who decides to undertake the oral count sug-
tion because the breathing mechanism is weakened and is gested for the well should do so in full knowledge that the
liable to further damage. With care the patient can learn addition of voice to the breathing places as much strain upon
to prolong the exhale. In the beginning the air should be the muscles of breathing as physical exertion. He should pro-
expelled from the lungs to a silent count of five with no ceed slowly, observing all the precautions of the silent count.
forcing of any sort. The lips should be separated to allow free The moment the natural voice alters or the abdomen pro-
passage of air. Pursed lips are likely to offer more resistance trudes, he should stop. Protrusion of the abdomen indicates
than the breathing muscles can support. They can also cause the inability of the diaphragm to support the air pressure.
the bronchial tubes to swell and constrict the air passages. Again, the breathing must not be forced by constriction of
The upper chest remains relaxed, with shoulders down, and either the abdomen or upper chest and throat.
the lower abdomen must not protrude on the exhale. The Certain breathing procedures can be helpful to the emphy-
breathing motion comes from the circumference of the mid- sema patient in his daily activities. Possibly the most demand-
region of the body, and care is necessary to avoid tensing the ing task he is called upon to perform is climbing stairs. He
rib cage. This procedure should be followed in as nearly a should keep in mind that he is moving his body against grav-
supine position as the patient can tolerate. If necessary, he ity and that the movement of dead weight is doubly dIfficult.
can elevate head and shoulders with pillows, but the torso Although the breathing procedure would seem to. count:r
should be straight. reason it is the reverse of normal because the slow whale IS
The silent count can be increased gradually by two's or very difficult for the untrained, as is change of diaphragmatic
five's as the patient observes all the attendant conditions of motion. Both tend to induce breath-holdmg, which IS detri-
relaxation and is careful to avoid protrusion of the lower ab- mental under any conditions and particularly so under condi-
domen. If the abdominal muscle is weakened, the leg-lifting tions of exertion. The climb, then, begins with an inhale a.nd
exercise can be undertaken with care not to overexert or strain. continues upward on a long exhale, with the body leamng
As the prolonged exhale is mastered, the inhale will occur slightly forward to take advantage of the momentum. The pa-
spontaneously and may become deeper. The patient should tient should proceed as far as possible comfortably, pause

216 217
 .ri,,£ .... !f-

Dr. Breath

for the automatic inhale, and go forward on the exhale. The

body should always move forward. Hauling of dead weight
from step to step is far more exhausting than continuing in
motion.
For the performance of tasks an exhale when the body bends 21
and an inhale when the body straightens make the chores
easier. An exhale helps in sitting or stooping; an inhale aids THE MASTER SWITCH
rising. The exhale for bending the body eliminates air pres-
sure against which the muscles otherwise would have to work
with an unnecessary expenditure of energy. The most impor-
tant point is to avoid holding the breath. Concentration is on
the motion of the back and the maintenance of breathing.
My return to Tahoe from my flight to the East
Emphysema patients do well to eat moderately. Large quan-
was memorable for the mound of mail awaiting. The past had
tities of food in the stomach increase the pressure in the
caught up with me. From the start, press coverage of activ~ties
abdomen and restrict movement of the diaphragm, thereby
at the Olympic high altitude study site had been plentiful,
making breathing difficult. Food should be taken in small
and srMBIChad received a colorful share. The resulting reader-
quantities with increased frequency. If a patient suffers a loss
correspondence stirred up had accumulated during my brief
of appetite, he can supplement his diet with a nutriment to
absence and stood ready to fill my idle hours. The range of
prevent undue weight loss. Like food, sleep or rest is also more
inquiries was as broad as the mountains themselves. Everyone
beneficial in small quantities than over an extended time.
Self-medication is a practice which often produces undesir- seemed to have a problem in some fashion involving breath-
able results. If a little medication helps, more medication will mg.
not necessarily help more, as some misguided patients seem Emphysema patients, as might be expected, were numer-
to think. Overmedication can cause tensions and nervousness ous, as were aspiring athletes who longed for a formula to gIVe
which increase the breathing problem and effect a physical them what nature had denied. All manner of respiratory suf-
condition worse than that originally requiring medication. ferers sought relief from their distress; people with nervous
As must the athlete, the emphysema patient has to learn to disorders wanted to know whether breathing would help; and
adapt his activities and his physical habits to achieve his prime heart patients who had experienced shortness of breath were
objective. For the athlete, that objective is top performance interested. A group of entertainers who had run out of breath
in competition. For the patient, it is top performance within during a high altitude engagement were concerne~ for their
the restrictions of his disease. next trip to the mountains. The Olympic candidates had
turned breathing into the most popular of the year-round
218
219
 - -- . --.-

Dr. Breath The Master Switch

sports. Naturally, I approved of that. Breathing is a very good efficiently, the remaining air will establish conditions con-
thing to do. ducive to infection and will cause dead spaces into which in-
While the interest in SIMBICpleased me on one hand, fection will settle beyond the reach of medication.
it distressed me on the other. I was pleased that people were Often, emphysema patients who come to me for a checkup
becoming more aware of the importance of breathing habits. will comment that they have not been feeling as good as usual,
I was distressed by the indication of the multiplicity of breath- and in the course of the session a telltale bit of mucus will
ing problems. With every enlargement of my contact with indicate an unsuspected infection. Mild medication and care-
the public I saw more clearly that the failure to recognize and ful attention to breathing will clear the condition in a day or
accept the extreme importance of the act of breathing was a so. Where a more serious infection exists, appropriate medi-
fatal error on the part of mankind. cation and proper breathing management prevent the devel-
The respiratory system with its vital function of breathing opment of a major illness. But, no amount of medication can
is a sort of master switch for the entire body. It turns on the be fully effective unless it is moving into the areas of the
body activities at birth and turns them off at death. It supplies infection. The breathing does the moving.
the body with the oxygen necessary for the maintenance of In addition to emphysema SIMBrchas been effective in the
life. As the supplier of life-giving oxygen, breathing affects the management of asthma, bronchitis, pneumonia, bronchiec-
entire body. When the synergistic pattern of breathing coordi- tasis, and various respiratory infections. Wherever a breathing
nation breaks down, the results are sometimes obvious, as in problem exists, a breakdown in the mechanics of breathing is
the case of respiratory disease and disorder. More often, they sure to exist also. Scar tissue from tuberculosis, pneumonia,
are subtle, disturbing some other system of the body with no and respiratory infections frequently causes labored breathing.
visible indication that respiration could be involved even re- An artist, a brilliant woman and wife of a distinguished
motely. Because breathing is vital, sundry devices have been scientist, had extensive scar tissue from tuberculosis and had
provided to maintain it and to keep the body operative. With sough t relief from breathing difficulties in both this country
the breakdown of breathing coordination, accessory breathing and Europe. She was advised repeatedly that unimpeded
takes over and the individual himself is none the wiser. He movement of air through her lungs was impossible. With
may suffer the consequences the remainder of his life and SIMBICshe experienced unlabored breathing for the first time
never know that the real cause of his trouble is the way he in years. The coordination and development of her muscles
breathes. of breathing made possible the movement of air through the
Quite obviously, a respiratory disease or disorder can be unaffected lung areas, thus enabling her to use to maximum
expected to respond to an increase in breathing efficiency. The efficiency the lung tissue available for exchange of gases.
A somewhat similar condition brought a very gracious lady,
degree of severity of respiratory complaints is determined by
the degree of weakness of the muscles of breathing. If those wife of an Olympic official, to me at Tahoe. She had a
long history of respiratory infections and tuberculosis compli-
muscles are not capable of moving air out and in the lungs

220 221
 Dr. Breath The Master Switch

cated by other conditions. She did not want her busy, active living on borrowed time. Doctors had completely discour-
life disrupted by breathlessness and was ready to undertake aged hope, which was all the man wanted-just a shred of
SIMBIC discipline with the purposefulness of a gold medal hope that the child might survive. He believed implicitly that
contender. She made excellent progress and learned to manage an improvement in breathing would help, and he was right,
her breathing to meet her needs. but breathing could not alter the existing physical condition.
Since breathing is the master switch of the body, the diver- As best I could, I explained that the benefits of SIMBIC
sity of its effects and applications never surprised me. During would be of a general nature and of indeterminate direct
the long, careful years of research, so many indications of value to the child's heart ailment. In conscience, I could not
SIMBIC potential appeared and so many were applied success- permit him to believe that this was the miracle he secretly
fully that I did not doubt the efficacy of breathing coordina- pursued. Nevertheless, he was determined to explore every
tion no matter how remote the possibility might seem. The possibility and urged me to return to Laguna Beach with him
relaxing effect on the nervous system alone relieved a multi- that evening. I could not comply, but I did agree to fly down
'tude of evils. More important, I knew that the restoration of over the weekend to work with the boy. I was not certain to
the muscles of breathing to their proper functioning could in what extent SIMBIC would help, but I knew that it would give
no way inflict damage upon the body. If any question arose, the grandfather the immeasurable satisfaction of having tried.
it was how much, not whether, SIMBlC could be of direct value. Upon my arrival I found a bright-eyed, handsome little boy
The question arose on a bright, crisp afternoon toward the who readily learned the fundamentals of SIMBIC and who gave
end of August when the athletes were preparing to go "down few indications of the gravity of his condition. I instructed
below" again for competitions and I was planning to stay all members of the household so that they might be able to
"upstairs" to sort a backlog of data. I came down from my help the boy attend his breathing and derive maximum
trailer into the communications center to the information that benefit from it. In that time and a subsequent period I spent
a man from Laguna Beach was looking for me. I left a schedule with him, his breathing improved appreciably and affected
of my whereabouts for the remainder of the day and went favorably some of the debilitating complications of the heart
about my business. After a reasonable passage of time he found condition. SIMBIC could not offer him a blank check to draw
me. He had read of the Tahoe SIMBlC project in the Los on life, but it did provide extra credits for the borrowing of
Angeles papers and, on the slender chance that I might be more time. How much time he could continue to borrow was
able to help or advise him, had made the long automobile not predictable, but he escaped the immediate threat to his
trek from Laguna to Tahoe to discuss his problem. life and gave his grandfather the hope sought. .
Thin, earnest, middle-aged, fatigued by his unbroken jour- Chief value of SIMBIC in the management of heart disease
ney, he was in search of nothing more than hope for his is the easy movement of air through the lungs to provide
grandson. The boy, age ten, suffered chronic refractory heart more oxygen for the body and relieve some of the stram
failure due to a severe pulmonary vascular disease and was on the heart. Emphysema patients tend to have a secondary

222 223
 Dr. Breath The Master Switch

heart condition due to the demands made upon the heart by were hardened. He frequently laughed uncontrollably and
the effort of breathing. Notations of the effect of improved for some time he had lacked his usual body coordination.
breathing on the circulatory system were as early as the work When SIMBIC instruction began, his diaphragm went into a
in East Orange and continued through the entire SIMBIC re- spasm and he could not stop laughing. As he began to relax,
search. Particularly at West Haven immediate improvement the laughter ceased but the leg and body muscles quivered
in heart condition appeared after SIMBIC sessions. Sufficient out of control for several minutes. By the end of the session
evidence exists to warrant the theory that a breakdown in the he could breathe in a coordinated pattern.
mechanics of breathing can impose severe enough strain on At the second session he became completely relaxed and
the heart to cause heart failure. the tension disappeared. By the third session a speech defect
Just as breathing affects the heart, the heart can affect the due to weakened respiratory muscles had improved notice-
breathing with its increased oxygen requirements. The same ably and he was recovering more quickly between boxing
is true of the nervous system. All the systems of the body are a rounds. Meanwhile, he came in first in the marathon with
two-way exchange with the repercussions of disorder in one the report that he had no problem. As the breathing devel-
being reflected in the disturbance of the other. The nervous oped, the jerkiness of his moveme.nts vanished and ~; w~nt
system is highly responsive to the breathing, and vice versa. on to win his challenge fights, which he termed the easiest
SIMBIC has caused numerous unusual side effects because of the fighting" he had ever done. What had appeared to be "over-
interrelationship of the systems of the body. Among the ath- training" was actually muscular tension caused by the emo-
letes at Tahoe the sleeplessness resulting from body tensions tional tension of the impending series of competitions. Faulty
was relieved with the improvement in the breathing and the breathing had forged an endless chain of destructive tensions
relaxation accompanying the establishment of breathing co- and fatigue which threatened the young man's health as well
ordination. No one could have been more surprised than they as his athletic achievements. No one even suspected the real
to discover that their manner of breathing helped them sleep. cause of the trouble.
Emphysema patients who had not slept for several nights often Similarly, speakers and singers and persons called upon to
fell asleep during SIMBIC sessions. use the voice a great deal often experience a form of laryn-
In the Boys' Club study prior to the Olympics project a gitis derived from throat fatigue and tensions. The real ~ause
novel response to SIMBIC occurred. A seventeen-year-old boxer of the condition is faulty breathing. When the mechanics of
who had just completed a series of bouts to win the Golden breathing are impaired, the respiratory muscles cannot sup-
Gloves championship faced two challengers. At the time he port the stress of voice production, and throa.t ten.slOnsresult
was considered "overtrained" and his coach was concerned from the efforts to force the voice. Body fatigue Imposes ex-
thi Uncommon demands
because of the impending competition. A sensitive young tra stress upon the musc Ies 0 f b rea mg. .
man disposed to various tensions, he had extreme body tension made on the respiratory system during periods of fatigue can
with chest raised and tensed so that the pectoral muscles very well cause voice difficulties.

224 225
 - --~ --~- ~------

Dr. Breath The Master Switch

Another condition, this one seemingly remote from breath- a practice he had not been able to follow previously, and he
ing, which has made a surprising response to SIMBrcis stomach had his best performance in two years. Still another, a world
ulcers. An emphysema patient who had had ulcers for an ex- champion, was being forced out of competition by severe side
tended time noticed that his condition improved as his breath- stitches and abdominal sensitivity. He had a seriously weak-
ing improved. Finally, the ulcers disappeared altogether and ened diaphragm plus other physical complications. As the
he has not since-a matter of several years-had a recurrence. muscles of breathing developed, the side stitches and the ab-
Other SIMBrcpupils have paralleled the experience. The im- dominal pain ceased, and he began taking the hardest work-
plications are that the relief of tension brought about by outs he had attempted in years. So it went at Tahoe.
breathing coordination served to ease the tension-controlled And so it goes with srMBIC.A whole range of possibilities
factors underlying the ulcer condition. lies waiting to be explored. Breathing certainly cannot cure
Among the rainbow assortment of SIMBrcsurprises at Tahoe any and everything, but breathing coordination has repeatedly
was the correction of chronic sore back problems. One athlete, indicated its value in relieving the difficulties which arise in
a decathlon man and a medical doctor, had had a chronic sore other areas of the body. Conversely, faulty breathing can just
back for four months prior to coming to Tahoe. On maximum as readily inflict injury. Whatever, breathing is a body process
exertion he went into accessory breathing and had difficulty in which will not tolerate neglect.
recovering. When his breathing coordination had been estab-
lished and the muscles began to develop, he was able to take
harder workouts than he had at sea level and for the first
time he had no recovery problem, In running, his weakest
event, he broke his life record. Added to all of that, the sore
back cleared. A coach who had srsonc instruction found that
the relaxation resulting eased his tensions and relieved a back
condition due to bone growth. He reported jubilantly that for -
the first time in thirteen years he had no back pain. With
removal of tension all kinds of things happen.
Another athlete was sent to me because he had incurred
an oxygen debt during workout and had blacked out. Subse-
quently, he developed the dreaded kidney condition which
often results from an oxygen debt. However, the increased ox-
ygen supply available to him through the improvement in
breathing enabled him to recover from the kidney infection
in three days. Later he maintained a daily workout schedule,

226 227
 22
WHERE DANGER LIES

Summer ended abruptly at Tahoe. One bright blue

and gold morning I awoke into crisp, cool air which did not get
appreciably warmer with the advance of the day. Hardy resi-
dents of the high country informed me gleefully that despite
the calendar autumn had come upon us. The sudden advent
of autumn reminded me that September and the finals were
only a matter of days away. The Olympic Executive Com-
mittee still had reached no decision on the extension of the
SIMBIC project through the finals and on into the Mexican

games.
Although the Tahoe staff took my presence for granted and
had complete confidence in their recommendations to the
Executive Committee, I could not share their certainty. I
made a final appeal and waited. This time I did not have to
wait long. The reply came promptly with gratitude for the
program and regrets that, desirable as the continuation of
SIMBIC and my services would be, no more funds were avail-

able for that purpose.

When I told my colleagues and pupils of the decision, their
shocked response might have been gratifying if I myself had
not been quite so concerned over the final competition for

229
 Dr. Breath Where Danger Lies
positions on the Olympic Team. No one could possibly know ideas in the wake of SIMBIC.Breathing had become recognized
what precise effect on breathing problems the tensions and as an essential to top performance.
exertion of the last desperate attempt to make the team would Sins of omission and commission stood revealed in the re-
have. I surely did not, but I knew the competitors well enough maining days before the finals. The atmosphere was super-
to anticipate their reactions. Some caused me considerable charged with tension. Some of the last-minute men came to
worry and I wanted to be at hand in case they had difficulty me wound as tight as toys on Christmas morning and re-
in recovery after the exhausting effort to take the coveted quired the better part of the session to get themselves relaxed.
honors. Whenever I could, I went up to the track to observe the final
Olympic officials, including Head Coach Payton Jordan workouts. Often while I was there, the wind would swoop
and Manager Mike Portanova, assured me that the program down suddenly from over the mountains and kick up swirling
extension had been expected as a matter of course and would clouds of dust in the loose, dry earth surrounding the tra:k.
be a significant contribution if arrangements were possible. I watched the men battle through those unpredictable flumes
The men themselves were requesting SrMBrCsessions in ad- and wondered what the direct effect on breathing efficiency
vance of their scheduled events. I felt strongly that I should might be. . ,
stay to help the athletes and to observe the effect of the com- To know where danger lies demands constant Vigilanceand
bination of circumstances on their breathing, What I could constant evaluation. Breathing problems can stem just as
learn and what I could contribute would warrant an expen- readily from the quality of the air breathed as fro~ the man-
diture of Institute funds. On my trip East I had prepared for ner of breathing. Unless an individual is consCIOUSof his
this eventuality; therefore, the necessary measures could be breathing pattern, substances in the air he breathes ca,n pro-
completed quickly. .
voke an alteration . h
III t e pattern.
U np Ieasant fumes induce
,
Business attended, I went on to more important matters. shallow breathing which easily lapses into accessory breathIng
The approaching competitions strengthened a lot of weak with all the attendant problems. Fresh-scented air, identified
wills, and athletes who had never quite managed to fit SIMBrC as "good clean air" stimulates the desire for deeper inhala-
into their schedules decided that a little extra measure of .
tions : mayor ' may not b e forced , Between the extremes
which ,,
security might be worthwhile. Time was too short for the , I h
is a scale of responses and potentia azar , ds The condition off
muscles of breathing to develop appreciably, but the men . sidering matters 0
the air itself can never be neg Iecte d III con
could be taught enough about the management of their
breathing. had
breathing to tide them over an emergency. I was amused at Earlier in the Tahoe season when most of the mhenh d
this time to learn how much information, as well as misinfor- I competitIOns, t ey a
gone down to Los Angeles for sea Ieve 'h' h I
mation, about breathing had sifted through the athletic strata f arefied air at Ig a-
expected the removal of the factor 0 r .'
of Tahoe. Few had failed to renew old error or to adopt new ith resulting improve-
titude to provide a certain advantage WI
230
231
 ./mI'!:'1flffn' _ II

Dr. Breath Where Danger Lies

ment in performance. They returned to the mountaintop older earth, deep commotions within the planet have spewed forth
and wiser. Their performances had not surpassed those at Ta- deadly fumes and gases, pollens have floated on the air, and
hoe, possibly for many reasons, and the removal of the high decomposition of organic matter has contributed its noxious
altitude air factor had not been the advantage anticipated. share to the surrounding atmosphere. The respiratory system,
All the SIMBle pupils remarked the restricting effect the air which makes possible human existence in the atmosphere, is
pollution had had on their breathing. Some who experienced sensitive to and responsive to all that passes through it. Res-
little difficulty in recovery at altitude found that the concen- piratory problems began when the first form of animal life
trated air pollution of the urban area created recovery prob- breathed and have been increasing with an accumulative in-
lems. Others reported nansea caused by the quality of the air, tensity.
and some came back with infections. At Tahoe they had been For eons the oceans of air enveloping the earth, like the
removed from concentrations of pollutants long enough for oceans of waters upon the earth, have absorbed and subtly
their respiratory system to become sensitized and to respond transformed the waste products of the planet. The operation
with uncommon reaction to the sudden exposure to air has been a smooth one until the acceleration of waste accum-
pollution. ulation by the steady output of civilized soc~ety's artifi~ial
Danger often lies where least expected. The most seri- products. Air pollution is an increasing creation ~f society
ous threat to life in the latter part of the twentieth century which can very well destroy society through destruction of ,t~e
is air pollution with its devastating power to alter breathing breathing mechanism as well as the air breathed. ~e ongm
patterns and render the respiratory system susceptible to func- of the problem is human greed which refuses to disturb an
tional diseases and disorders which can and do result in fatality. economic system geared to the production of comforts and
No statistics are kept on the deaths caused directly and indi- conveniences.
rectly by all the many forms of air pollution. No account is Industrial wastes are contaminating the environment faster
made of the heart attacks provoked by respiratory failure than ways to counteract them can be conceived much less
ultimately derived from some unsuspected air pollutant. No put into effect. Major offender is the powerful petroleum
count could possibly be taken of the nervous and psycho- ,
mdustry, controller of t h elves
I' 0
f b'll'ons
I I,
of people
.
around
logical disorders stimulated by inhaled substances and termi- the earth Not only do the refineries and allied chemical plants
. ili th rod
nated by suicide. Few ever think of the endless stream of pour out pollutants endlessly, the engines uti mng e p .
. ' . t ibute their deadly share.
poisons introduced into the body through the air breathed. ucts in ever-increasing quantItIes con n . II
Breathing problems never stop with the respiratory system However modern economy, spelled with the capital do od
, " h . d t that the likelihoo
alone; they also include the air. sign is so hopelessly allied Wit III us ry ,
, . f thi source IS at present as
Neither air pollution nor respiratory damage is a new topic. of diminishing air pollution rom IS . th
divid I lives cannot tip e
Both have been about for a long, long time. Since the begin- remote as the planet Pluto. I n IVl ua
ning, the winds have been driving dust and sand across the balance of such scales.

232 233
 •

Dr. Breath Where Danger Lies

Perhaps the sacrifice of enough individual lives to industrial victimized by the environmental forces beyond his control. In
and vehicular wastes may eventually arouse concern and effect rural and suburban areas the tendency is to consider air poIlu.
change. Meanwhile, respiratory sufferers like the emphysema tion less of a threat. Crop-dusting and pest-control spraying
1Jatient at West Haven who encountered a diesel engine will are overlooked as air pollution factors. Those deadly particles
have to manage their breathing as best they can. For a man in are breathed into the lungs and lodge there as irritants while
'good health to tangle with a machine is risky business. For the victims go their merry way wondering at their increased
the emphysema patient the incident was a disaster. The pa- susceptibility to respiratory infection.
tient had advanced emphysema but with SIMBIC had learned On the golf course of a resort hotel I have s.t~od and
to manage his life efficiently. On a cold day in December he watched a low-flying plane lay <l blanket of insecticide over
took his car to a garage to have the tires changed, and while the hotel grounds as guests continued unheeding with then
he was there waiting, the motor of a trailer truck in for repairs fun activities. At the first whiff I took shelter indoors, but the
<wasswitched on with the garage doors closed. Before he could others hardly noticed the plane. In the dining room that eve-
'escape, he had inhaled the diesel fumes, which set him to ning coughs accompanied every course and red eyes were part
coughing. By the time he was 'outside the building, he was of the make-up. No one ever knew why a sudden rash of col~s
'Coughing up thick mucus black with diesel exhaust. The cold appeared in high summer. Nor did anyone suspect that a .VI-
air made breathing almost impossible for him, and the cough- cious cycle of respiratory infection and a~errant. breathmg
'ingdestroyed his coordination. He was rushed to the hospital had been set in motion and could continue mdefimtely.
by ambulance and arrived in a nearly fatal state of dyspnea. Even more innocently the public has taken unto its~lf an
For three days he coughed up mucus blackened with the assortment of individually administered air pollutants in the
adhesive oil particles of the diesel engine fumes. His lungs form of aerosol sprays, certain . pam . t s, an d household
. cherni-
were highly sensitized and susceptible to infection, and he cals. Aerosol sprays, introduced on the market in the late
contracted pneumonia. With SIMBIC we were able to manage 1950'S as another step forward to better living, a~e fine pa~'
his breathing with no problems in that area during his long, ticles of matter suspended in a gas and dispersed into the air
debilitating bout with infection. That was the first time in under pressure. They are b rea th em" d . to the lungs and lodge at
eight years he had had a major illness unaccompanied by an there with all the other inhalants to work their wickedness
fr m paints and household
acute breathing problem. Finally, six months after admission the opportune moment. F urnes 0 . h
to the hospital he was discharged. Although he would never chemicals can be excee mg ydi I dangerous to anyone WIt a
be so listed medically, he was a direct victim of vehicular air heart condition or a respiratory disorder., . dl
pollution. Had he been unable to manage his breathing, he An urban housewife whose heart condltI,on su~pose Y was
'Would likely have died. under control set about her spring cleaWhmngl wltlh a. vganhetyer
h Id d ts ne ceamn
Air pollution in cities has come to be accepted as part and of new improved house 0 pro UC • th f es
parcel of urban living. The average city-dweller expects to be poorly ventilated bathroom, she was overcome by e urn

234 235
 •

Where Danger Lies

Dr. Breath
Air pollution is something that happens to the air outside, so
resulting from the contact of cleansers and water and had to
goes the myth.
be hospitalized. The strain of the respiratory reaction further Outside, inside, wherever it is, air pollution is air pollution.
dam.ag~d her heart and she never recovered completely from Men, women, and children, smokers and non-smokers, have
the Incident. She continued in a semi-invalid state for a num- to breathe air. If air pollution continues at its present giddy-
ber of months and finally died of complications of her heart ing pace, respiratory problems can be expected to mount. All
condition. If records were carefully kept and could be care- the products for the artificial needs of a progressive society
fully examined, statistics would be shocking. will not be able to repair damaged lung tissue nor to restore
King of all the self-administered air pollutants is tobacco weakened muscles of breathing. Progress comes at a high price.
smoke. If smokers damaged only themselves, that would be An effective personal measure to counteract exposure to air
matter enough for concern. However, the manners of the pollution is the prolonged exhale, once the safety of uncon-
modern smoker are barbaric, and the barbarism is aided and taminated or relatively uncontaminated air has been reached.
abetted by public institutions. The smoker who pauses to give It helps to move air through the lungs and prevent the
so much as a passing thought to the non-smoker is fast dis- build-up of irritants in the respiratory passa~es. Nothmg can
appearing from the earth. The non-smoker, whatever his substitute for clean air, but effective breathmg habits can b.e
desire or respiratory condition, has become the trapped, un- of great advantage in the maintenance of health in spite of air
willing victim of the smoker. The tars and nicotine may have
filtered through the smoker's lungs, but the expelled smoke pollution.
is unavoidably inhaled by the non-smoker and can and does
irritate the respiratory passages. Should a state of sensitivity
exist, a non-smoker's respiratory system can become so irri-
tated by expelled smoke that respiratory infection is readily
contracted. Such considerations would appear to be ignored
by operators of the public services. The few existing no-
smoking regulations are laxly enforced.
Soaring aloft with absolutely no avenue of escape, the air
traveler is forced to inhale directly the smoke of the passengers
around him, and through the inadequate air conditioning
system he must inhale an admixture of all the smoke of all
the smokers. Woe be unto him if the lot includes a cigar or
pipe smoker. But who cares for his burning eyes and aching
throat and chest? Certainly not the airlines, nor the railroads,
nor the buses, nor restaurateurs, nor anyone else in business.
237
236
 23
THE CRYSTAL BALL

September tipped the tall pines with golden light

beneath blue, wind-swept skies for the 1968 Olympic Team
Trials at South Lake Tahoe. Excitement and expectation
snapped and crackled through the air like a charge of electric-
ity. The time had come. Across the finish tape lay Mexico
City with all its glitter of glory, and this was the opportunity
to get there ahead of the crowd.
South Lake Tahoe swarmed with newsmen carrying tiny
typewriters, radio and television commentators trailing truck-
loads of broadcasting equipment, manufacturers' representa-
tives bestowing all sorts of products which might be remotely
connected with athletic endeavor and later so advertised as
used by the Olympic Team. Observers from other countries
joined the sports enthusiasts from down below to form a cheer-
ing throng of spectatorS. The schedule of events and the con-
ditions surrounding the trials reproduced as nearly as possible
the conditions which might be expected in Mexico City so that
the team candidates could have a foretaste of the real thing.
The easy atmosphere which had enveloped the workouts and
competitions of the summer vanished when the visitors began
to arrive. A certain purpose reflected in the eyes of the

239
 Dr. Breath The Crystal Ball

athletes, and the magic sound of "Mexico" was heard at every the four-hundred-meters. Lee came into the SIMBICprogram
turn. SIMBICpupils were participating in fourteen of the events, late in the season because of a breathing problem which pro-
and my schedule of pre-event sessions hardly left me time to duced a burning sensation in his chest. He devel~ped at a re-
·, te the burning sensatIOn
get up to the track for the trials. No one but the athletes markable pace and was abIe to eIirrnna , d
themselves knew what personal challenge the trials held for when he ran, In the early rounds of the trials he was pitte
, , h t on to the finals to first
them. To judge by body tensions, for many the days of the against close competition, but e wen
trials would mark a turning point; for some the trials would place on the team, d cam
become finals indeed. For all, the pressures were excessive. Despite all the excitement and flurry of ~ewsmen an h :
hi ft his wmnmg race, e re
Each day after my early SIMBICsessions I hurried to the eramen clustering about im a er . b thi had
s that his rea mg
track to be ready to cope with the unpredictable. Psychological membered srsrarc and to Id t h e pres, f spi it meant
S h panslveness 0 spm
tensions generated by the desperate desire to win a place on the influenced his performance. uc ex d I t the education
team created body responses which were manifest immediately II d a great ea 0
a great deal to me persona Yan f th MBICInstitute.
., ' tntparto eSI
in the breathing. Men who had had no problem in the practice P rogram which IS an impor a h ided
hl thorn SIMBlCas ai
competitions of the summer experienced difficulties under the Ironically, the statement of one at e e w to make the public
extreme stress and greater exertion of the team trials. Athletes . ,. f ance can do more
In a wmmng per orm b thi habits than can
who were not in the SIMBICprogram and who had not learned , f proper rea mg
aware of the Importance 0 ti ts who owe their
to manage their breathing efficiently had difficulties far in ex- . . I f physema pa len
scores of testimonia s 0 em thel'r breathing,
cess of those of the SIMBICmen. . ired b Tty to manage
very lives to their acqUire a I I. t he assured me that
Athletes who had breathing coordination sessions prior to Later, when I thanked Lee for his cour esy, m he would do
competitions reported a greater ease of performance than those anything he could do for the SIMBICprogra
who did not. Rick Sloan was a singular example. At the end gladly. . I were stellar and were
of the first day of the decathlon trials he was in fifth place and Performances in the Tahoe tna s d lauded by the press.
had incurred a serious oxygen debt in the four-hundred-meters. . I b the spectators an
cheered uproanous Y Y k ne noticed the agony
Following the race I worked with him for about an hour or With all the glory around the trac no oreexerting themselves
so to bring him round, and that evening he continued to con- t t The men we
in the green recovery en. d bt was inevitable, but the
centrate on his breathing. The second day he made certain to the limit of endurance. Oxygen e able to manage
between each event that his breathing was properly coordi- d instructIon were , I
men who had ha SIMBIC d in comparatIve y
. h h Ip reco vere
nated. In the course of the day he moved spectacularly from their breathing and, Wit e, h d ended for the day, I
fifth place in the competition to second place on the decathlon short time. Often, after the gamkes an athlete out of an oxy-
team. The improvement in his performance he credited to his , . tent wor mg a b
was still In the recovery d . 'tration of oxygen Yen-
ability to manage his breathing. ti the a mlms , .
gen debt and preven mg Had oxygen been admlms-
A high point in the trials for me was Lee Evans' victory in thusiastic ambulance corpsmen.

240 241
 •

Dr. Breath The Crystal Ball

tered to anyone of the men at that point, the consequences to the track and the restricted areas of the competitions in
could have been serious. In oxygen debt the need is to clear Mexico City. Loyally backed by the Olympic personnel and
the lungs of carbon dioxide. Indiscriminate administration of the athletes , who could not believe that I would not be with
oxygen holds the potential of suffocation. Forcing oxygen into them indefinitely, I busied about trying to get credentials,
lungs already overextended with unexpelled air can be of no Meanwhile, the trials continued to knock down old records
advantage, but the point is frequently wasted on the unin- and establish new ones. The performances were truly Olym-
formed who believe oxygen debt simply to mean lack of pian, some almost beyond belief. Mighty deeds were done in
oxygen. those bright September days, The competitions were difficult
For the Olympic Team Trials the staff of the Medical Test- for me because I knew the men and their ambitions, and they
ing and Study Program was replaced by the staff that would could not all win even though I wished they might. To lose is
accompany the team to Mexico. None of the coaches, trainers, sad when winning can mean so much. Because a number of
or doctors had been present at Tahoe at the time the several Olympic candidates had spent the summer workmg out else-
SIMBIClecture-demonstrations were presented, and none was where than Tahoe, new elements of competition appeared at
familiar enough with the mechanics of breathing and manage- the trials, frequently with surprising results. Athletes who had
ment of breathing crises to deal expertly with problem recov- been expected to win easily did not always fulfill the high ex-
eries. This knowledge coupled with an awareness of the air pectations. .,
pollution in Mexico City was not calculated to comfort me. At the outset of the SIMBrcprogram eight events requmng
. . f ' t d over were designated for
I knew further that the ultimate competition for Olympic sustained exertion 0 two rrunu es an
" .' hes I six other events re-
medals would hold tensions and pressures and exertions to inclusion: however III time coac es III
make the Tahoe Trials seem like a little girls' skipping con- quested ;hat men ~ith breathing problems be instructed. Of
c pupils were winners
test. the fourteen events represente d, srMBI ,
h I th ther three The entIre
The course of the summer's work with the Olympic candi- in eleven and placed fourt III eo'
, d d fifty-kilo walk teams
dates had left me with a sense of responsibility for the welfare decathlon elght-hundre -meters, an , d
, 'I Bill Tomey RIck Sloan, an
of the athletes in the SIMBICprogram. At the trials I was called were made up of SIMBICPUPIs: I 0, nd
upon to manage the breathing problems of men who were not Tom Waddell of the decathlon; Tom Farrell, Wade Belli.,a
hi ki f the eight_hundred-meters; and arry
in the program; so, my feeling of responsibility gradually R on K u t sc ins 10 f the fifty-kilo
Young, Goetz Klopfer,k and Dave Romans Y 0
spilled out over the entire team. There was not the remotest
possibility by this time that Olympic funds would be chan- walk, ils Ron Laird and Tom
neled into breathing recovery problems in Mexico City, but In the twenty-kilo walk SIMBICpup , Phil Shi ick
, d ' the long jump 1 mru
there was every chance that the Institute could finance such Dooley placed first and thir ; III I h Bob Price
h d meter steep ec ase
an enterprise as a service project for the U.S. Olympic Com- was fourth; in the three-t ousan - d t . termediate hur-
, h f r hundre -rne er III
mittee if I could obtain the credentials necessary to admit me came in fourth; III t e our-

242 243
 Dr. Breath
The Crystal Ball
dies Boyd Gittins and Ron Whitney were second and third;
decathlon team whereby he could supervise the breathing and
in the four-hundred-meters Lee Evans and Ron Freeman took
the athletes could help one another with their recoveryprob-
first and third; in the one-hundred-ten-meter high hurdles Pat
lems. I urged him especially to avoid the use of oxy~en m o~-
Pomphrey ran fourth; in the pole vault John Pennel placed
second; in the two-hundred-meters John Carlos was first; in ygen debt recovery. I ha d camp Iet e confidence . in
h hiTom. s
knowledge and judgment an d feIt muc h better WIt im m
the fifteen-hundred-meters Marty Liquori and Dave Patrick
were second and fourth; in the triple jump Art Walker placed charge. .' hether my
Back at the old waiting game agam wondermg w d
first; in the five-thousand-meters Lou Scott and Gerry Lind-
.
credentials for MeXICOCity wou . Id come through,
. h ff ct eona
I rna
gren ran third and fourth.
The outcome of the trials pleased me very much because mental note of the great nee d for research into bi tee t' e with
rtion in com ina IOn
the srMBrc winners enthusiastically acknowledged the influ- the respiratory system of extreme exe h t' of exertion
. II f bot at nne
ence of breathing on their performance, and like Lee Evans' such factors as heat and air po u IO~ d th t I had better
statement to the press, such acknowledgment from champions and afterward. My mental note remm~e. ~e th a future of the
goes a long way toward persuading the average citizen that he get out the crystal ball and take a 100 in hOd ebrought to the
. . f the summer a
might do well to look to his breathing. All in all, the summer Institute. The expenences a . d earch As soon
ibili
fore many pOSSII ities or f both service
. an
db' res tten. and the
had been exceptionally rewarding to me. I had had an oppor-
OI plCSha een wn
tunity to perform a greatly needed service for the United as the last report on t h e ym d d fil d new pro)'ects
d d rrelate an eo,
States Olympic Committee and simultaneously to gather a mountain of data sorte an co I tion Coaches and
I ti and eva ua I .
quantity of valuable information for use of the Institute in should be ready for exp ora IOn . f work in athletics
uggestIons or
the future. Moreover, I had come to know and to appreciate athletes had made numerous s b tion had made me
deni geofoServal
many people engaged in an activity with which I had had alone, and my broa enmg ran f h practical projects as
. . f th need or suc
previously only a nodding acquaintance. especially COnsCIOuS a e . C mmittee as well as
In spite of the plus factors of the trials, I still had troubling the service program for the OlymPffict °and implications of
abstract research prolec i to thee ecs
. tss III
minuses to consider. The extreme effort the athletes had ex-
erted to win their places on the Olympic Team had precipi- breathing coordination. I ing organization op-
. . young, eva VI .
tated oxygen debt requiring my aid in the management of The SIMBICInstitute IS a d th t mustering serIOUS
t k n for grante a . .
recovery. I had helped men in the decathlon, in the eight-hun- erating in an area so a e . I d'fIicult task. Otherwise Ill-
dred-meters, and in the five-thousand-meters. Four had severe consideration for it is a wearylllg y I f lishly to matters of
ond very 00
recovery problems which were resolved in relatively short time. telligent people a ften resP . tory problem or ex-
. nter a respua .
I was not happy at the thought of their being unaided in Mex- breathing until they encou . ti S of the Institute ISto
f the objec ive d f
ico City. In case I failed to get credentials for the Mexican perience dyspnea. O ne a t tly enlarging nee or
I · ith the cons an . I
games, I worked out a plan with Dr. Tom Waddell of the concern the pub IC WI bat the effects of au po -
.
proper breathing manag ement to com
2+1
245
 Dr. Breath The Crystal Ball
lution on the respiratory system and on the total efficiency of areas as public schools and athletic programs. Knowledge is
the body functions. No one, whatever his physical condition, limited in regard to the effects of inhalants on the efficiency
can afford any longer to ignore or to take lightly his mode of of mental and physical functions, the influence of fluctuations
breathing. Everyone, even top athletes, can improve the in the rate of breathing, and the inter-effects of the respiratory
efficiency of breathing. system and the other systems of the body. Wherever a breath-
Although the Institute is a tax-exempt, non-profit organiza- ing problem is in evidence, a need for investigation exists. The
tion for research and education in the field of breathing, it has Institute proposes to highlight the needs and to fulfill them m-
access only to limited funds for application to immediate proj- sofar as is possible.
ects. The policy has been to seek funds for current needs, not The problem of what to do has never troubled the Institute.
to accrue against future possibilities. As the Institute grows, The question has always been which project to undertake next.
the policy will adapt to the climate of the time. As I hovered over the crystal ball trying to divert my tho~ghts
The ultimate goal is the establishment of a respiratory cen- from the Olympics by probing into the future, some business
ter for the diagnosis and management of problems of breath- matters arose in Southern California and the Southwest, and'
ing, for development of SIMBICpractitioners, and for SIMBIC the time came to leave Tahoe. Coasting down the other side
instruction on a broader scale than is possible at present. Re- of the Sierra, I wished mightily that my mythical ~rystal ball
search eventually may yield methods of teaching SIMBICon would give me a glimpse of what lay ahea~ in the immediate
other than an individual basis; meanwhile, the sole known way weeks to come. It remained quite unrevealIng.
of establishing breathing coordination is with the aid of a
skilled instructor to make the pupil aware of body responses to
his individualistic pattern of breathing. Before SIMBICcan be-
come available generally, a system of developing practitioners
must be evolved. srMBICinstruction is a complex process which
cannot be undertaken without extensive preparation. The ulti-
mate goal has to be approached as a journey through time. Al-
ways it lies at the center of the crystal ball to challenge the
imagination and the fortitude.
Until the future becomes the present, much research waits
to be done. Little is known of the effect of breathing patterns
in the practice of psychiatry or in the management of nervous
disorders, drug addiction, circulatory disorders, and the like.
The value of proper breathing in prophylaxis is known, but
methods of application need to be evolved, particularly in such

246 247
 24
DR. BREATH
TURNS THE LAST STONE

After the autumnal chill of Tahoe and the unper-

turbable heights of the Sierra, the warmth and bustle of South-
ern California were pleasant contrast. Like a hermit in from
the hills, I had to accustom myself to the abrupt change of
surroundings. Fortunately, my business affairs were uncom-
plicated and permitted the indulgence in a brief holiday to
celebrate the conclusion of the summer's tasks. However, nag-
ging at the back of my mind were the probabilities of Mexico
City: what might happen, what would be done, how breath-
ing problems might be avoided. I did not feel that I had the
answer to all things in the respiratory category, but I knew
that I did have solutions for many problems likely to occur.
During my excursion across the Southwest over a terrain
sharply reminiscent of Mexico, I could not shake off the con-
viction that someone thoroughly familiar with the operation
of the respiratory system and with the numerous complica-
tions of breathing in the crucial period of recovery from ex-
treme exertion should be at hand for the Olympic games.
Those eventful moons ago at Yale when I was smiling at the
emergence of "Dr. Breath," I should never have thought that
the same Dr. Breath, then wholly absorbed in the abstracts of

249
 Dr. Breath
Dr. Breath Turns the Last Stone
breathing, could so involve himself in the realities of sports
competition. commonly large from the outset, other participating coun-
tries were a trifle testy about the matter. Nevertheless, I de-
He had, however, and in the process had charged too
cided to approach the International Committee ~ith the, sug-
many windmills and turned too many stones along the way to
gestion that my services be made available on an international
leave a stone un turned now. Very little action was possible out
basis and that I not be considered a United States represen-
in the middle of the great American desert, but back in New
tative.
York I had a few final resources to try before resigning the
effort. My sense of urgency surprised me, I thought I had come
to terms with that by-product of the intensity of the work at
i By then September had given way to October and the games
were only days away. When I conferred ~th President A~ery
Brundage's staff, the International Committee ,was embroiled
Tahoe, the assumption of personal responsibility for the wel-
in crises threatening the opening of the OlympI~s" My sugges-
fare of the athletes, but still it plagued me.
tion was welcomed, but at t h a t pom. t the acquisttion
" of ere-
My return to New York at the end of September brought
dentials lay with the Mexican Organizing CommIttee., Bemg
me into an inheritance of inquiries from all over the country.
thus advised, I immediately made an appoint~ent WIth the
The finals at Tahoe and the impending Mexican games had
. M'exican C onsu I I'n New York ' Consul Pesquene"Ireceived meI
precipitated a quantity of S1MB1C publicity and had drawn at- .
graciously and listene WIth moun tiIDg enthusiasm whid e '11
d wi
tention to breathing. When athletes supposedly in the finest
explained my proposal: In a gesture of international goo WI
of physical condition attest their need for proper breathing
the S1MB1C Institute would make my services as a resplratoryf
measures, the average citizen at last begins to reckon that he " them in the course 0
consultant available to anyone requmng
might do with a few improvements. The mail was filled with
the games, He felt certain that credentials would present no
every conceivable request and a few I should never have
imagined. Projects suggested by enterprising promoters would problem. , f thing un
Although I knew better than to be certam 0 any, .-
have filled several calendars, In among the oddities were a · h d I did permit myself a moment of optrrmsm just
num ber of serious proposals for cooperative research and accom p IIS e , te my acnvi-
to relieve the suspense which seemed to perrnea, f
enough earnest queries to underscore further the need for Id lete the transactIOn or me,
public education in the field of breathing and the functions of ties. Before the Consul cou comp d dvised direct com-
the respiratory system. he became involved in affairs of state an, a V. of the
. id t P dro Ramirez azquez
One piece of correspondence was of singular import. It munication WIth Presi e~, e itt He gave his com-
. 0 izmg Comml ee.
closed the final door on the hope that I might obtain cre- Mexican Olympic rgan I d ed me of his full
plete endorsement of the proposa an assur
dentials for the Mexican Olympics through the United States
Olympic Committee. At the time the credentials had been al- support. . d ere t ever closer, I was
lotted, there was no category for me, and the United States As October 12, the opemng ate'h Pes to Mexico City.
h I h e and telegrap WIr
quota had been filled long since. As the quota had been un- busy on tete ep on I d My honest intentions were
Finally all the red tape was c eare .
250
251
 - -- - -~. .

Dr. Breath Dr. Breath Turns the Last Stone

defined unmistakably. Dr. Breath had turned the last stone, also for the purpose of diverting my thoughts from Mexico
and as usual, nothing remained to be done but to wait. I was City, but it failed. After a feeble struggle Igave up all pretense
glad there was not much time for that, but even so, the in- of work and took up my station before the television set.
tensity made up for the duration. When the determining tele- The end of every competition involving SIMBIC men found me
gram from Mexico arrived, I realized that, whatever the mes- pacing the floor, coaching, advising, cajoling, imploring, hop-
sage, nothing could disturb my sense of relief. I had done all ing the athletes would avoid the oxygen tanks constantly and
that Icould do. dramatically presented on the television screen. For all my
Couched in graceful, diplomatic terms, President Vazquez's knowledge of SIMBIC, Iwas not certain that my own respiratory
telegram thanked me for the offer and explained that the cre- system could have withstood the tensions and pressures of
dentials list, closed before my application, could not be reop- on-the-scene witness of those monumental events. As a
ened. I read the telegram a second time and tested my would-be spectator, I should likely have been driven to mad-
response. I was still relieved to have a final decision. Now I ness and attempted to battle through the guards to aid the
could lay aside my self-imposed responsibility and go on to the athletes. Again, I congratulated myself on having the good
next thing. sense to remain in New York with adequate mileage between
Long before Ileft Tahoe, Ihad decided not to make the trip myself and circumstances beyond my control.
to Mexico City unless I could be of service to the athletes. I My trackside view of the Olympics on television left me
could not sit in the stadium and watch the games knowing that limp. I ran and jumped for everybody and tried to breathe for
Iwas powerless to give the help needed. Being so near and yet them all. Ihad my moments of supreme elation, though, when
so far was a condition beyond my endurance. I was certain that Bill Toomey placed first in the decathlon and Lee Evans and
the SIMBIC men could manage their breathing efficiently dur- Ron Freeman swept through the four-hundred-meters WIth
ing recovery and, in the unfailing generosity of the athletic first and third. Achievements of the other bronze-medal men-
code, would help others. But generous intent and profes- Tom Farrell in the eight-hundred-meters, John Carlos in the
sional skill are not the same. If I could not go to Mexico to two-hundred-meters, and Larry Young in the fifty-kilo walk-
employ my professional skill, I should have to absent myself accorded me like pleasure. I did not delude myself that
from the scene. In the early days of Tahoe I had tried the SIMBIC makes athletes. Great athletes are compounded of iron
casual bystander role unsuccessfully. I did not propose to put will, courage, and a few other uncommon qualities as well as
myself through that nerve-racking experience again. muscle bone and nerve. They make themselves. I was glad
On Saturday, October 12, 1968, amid much pomp and cir- that SI~BIC could help them do the job and assist in repairs
cumstance, the Olympics began without me-without my after competition.
bodily presence, that is. I had laid out a heavy schedule of When the 1968 Olympics concluded, I came to th~ end of
work for myself to try to catch up on some of the formidable an era. I was a bou t a thousand years older and considerably
.
accumulation during my extended absence. The schedule was wiser than at the outset of my investigation of the breathing

252 253
 Dr. Breath
Dr. Breath Turns the Last Stone
habits and patterns of the physically superior. Dr. Breath had to work with you, to whatever extent you can handle. Thanks
gone forth naively in search of perfection and had come home again for your great help."
from the adventure with a bagful of pieces to be fitted into the Payton Jordan, head coach of the 1968 U.S. Olympic Track
puzzling complex of human breathing. Teaching srMBICis an and Field Team, was cordial in his comments: "Even though
exchange process wherein the instructor can learn much from I did express my 'thanks' verbally to you for your unselfish
the pupil, for each pupil is unique and makes his unique re- contributions to our 1968 'team' effort at the time of the Tahoe
sponse. The athletes, from the Boys' Clubs through the Yale Altitude Training, I want to express in writing my eternal
men on to the Olympians, had taught me more about the gratitude for your personal friendship and your expert breath-
application of SIMBICthan they might have guessed. ing coordination instruction for the athletes. On beh~lf of
Apart from the professional rewards of the Olympic proj- every athlete, our coaching and managerial staff, we .wlsh to
ect, I derived much personal satisfaction from the friendships share with you the fine successes enjoyed at Mexico CIty. You
and acquaintances which grew along the Tahoe trail. I had were instrumental In . creating
. the finest spm . it ever an d more
been thoroughly initiated into the sports world and would con- World and Olympic records than in all past Carnes his,~ory!I
tinue to follow athletic careers as a matter of personal as well extend my best wishes to you for continued fine success:
as professional interest. Sooner or later everyone came to Mad- Among my prized possessions is the Mexican Olympic com-
ison Square Garden, and I would be there to watch the per- memorative coin mounted in a key chain from Mike Porta-
formance and check the breathing for any faults which might nova manager for t h e U ..S 01 ymplc. Track and Field Team.
have developed. Mik~ and I shared some tense moments during the Ta~oe
The wake of the Olympics brought official expressions of trials , and he became an enthusiastic exponent of breathing
gratitude for the SIMBICprogram. Everett D. Barnes, acting
coordination. f h 68
executive director for the United States Olympic Committee, Although the Mexican games marked the end 0 t e 1~
wrote: "The work that has been accomplished and the inter- Olympic. adventures of Dr. Brea th , I somehow
. had the feeling
Th
est you have shown in the program are deeply appreciated. that he was not yet entirely finished WIth the athlet~s. he
Please accept our thanks." usoc President Douglas F. Roby winds of Tahoe had stirred up a lot of ideas along WIth t e
cited SIMBICwith "We wish to thank you for your interest and dust After the records and materials were sorted and the th
we trust that the results of the work you have done will en- port~ written and all the papers fil~d neatly awa~ D~a~~~
courage the United States Olympic Committee to follow a just might be off and running agam. I wondere w g
program as recommended by you in the future." and the Yale men would say to that.
From Dr. Merritt Stiles, who was responsible for intro-
ducing the SIMBICproject to the usoc originally, came the
assurance: "I recommend strongly that our athletes continue

254
255
 A Note About the Author

Carl Stough was born in 1926 in York, Penn-

sylvania, and now lives in New York City.
He is married and has one daughter. His
wife is co-author of this book.