YOGA

for

ASTHMA

Dr R NAGARATHNA M.D. (Gen. Med.),

F.R.C.P. (Edin)

DrHRNAGENDRA M.E,PH.D,

Swami Vivekananda Yoga Prakashana

#19, Eknath Bhavan, Gavipuram Circle,
Kcmpegowda Nagnr, Bangalore - 560 018.
Yoga for Asthma: An introduction bookl:! of Yoga practices
written by Dr R Nagarathna and Dr H R Nagendra Published by
Swami Vivekananda Yoga Prakashana, #19, Eknath Bhavan,
Gavipuram Circle, Bangalore - 560 019 and printed by
Rashtrotthana Mudranalaya, Bangalore -560 003, pp 194 +10,
pb, l/8th Demy.

© Reserved

First Edition : November 1998

Reprint Nov, 2009 1000 copies
Price : Rs. 60/-

PUBLISHED BY :
SWAMI VIVEKANANDA YOGA PRAKASHANA
# 19, Eknath Bhavan, Gavipuram Circle,
Kempegowda Nagar, Bangalore - 560 019
Ph. : (080) 26612669, Telefax : (080) 26608645
E-mail : [email protected], web : www.vyasa.org

ISBN : 978-81-87313-10-6

PRINTED AT
RASHTROTTHANA MUDRANALAYA
Keshava Shilpa. Kempegowdanagar,
Bangalore - 560 019.
Phone :(080) 26612730, 26612732.
 PUBLISHER'S NOTE

This is the second and revised edition of the version "New

Light lor Asthmatics" first published in 1998. It is gratifying
that all copies were sold out. The increasing awareness amongst
both asthmatics and the clinicians has been possible.
Thanks to the beneficiaries who took steps to spread this
message through word of mouth to large number of other
sufferers and also co-operate in research projects, which gave
a scientific stamp to whatever they were experiencing through
yoga. We arc glad that today integrated approach of yoga
therapy is universally recognized by most asthma care givers
as an acceptable component of management without any
apprehensions. The title of the book has also been changed as
"Yoga for Asthma" as yoga is no longer a new method and it
has already established its efficacy and is in use for more than
15 years.
We sincerely thank the authors, printer and artist, for their
co-operation that has resulted in this book.
Finally we thank all the readers of this book.

Publisher
February, 2(KM
Bangalore

in
 PREFACE

Man has stepped into the third millenium. Medical men are
working with many technologists to offer better health care.
World health organisation is engaged in taking stock of global
health status and taking necessary steps to raise the health
standards.
Scientific aptitude that entered medical profession in the begining
th
of 20 century made rapid strides in eradicating epidemics and
pandemics, through invention of antibiotics and vaccines.
Although nutritional deficiencies and infections continue to be
the major problem in the under-developed and developing
countries, the scenario in developed countries is totally different.
Hi-tech medical facilities with fascinating advances in spare part
surgeries, although has made life more comfortable, with a life
expectancy of greater than a hundred years, the expected quality
of life, with harmony and peace seems to be far from reality.
Problems of stress, stress-related ailments, stundent unrest,
breaking up families, are all on an exponential rise. The frustrated
patients are moving towards alternative so-called non-scientific
therapies.
Deep thinkers have raised questions as to why this way? What
went wrong in our health delivery system? Why the mental and
social health problems are on the increase? What should we do
to prevent such problems? Can we raise the basic health level to
greater heights as a preventive programme rather than do fire
fighting after ailments have shown up? What are the markers of
positive health? Is positive health a single state? what are the
measures of positive health at the physical, mental, social and
spiritual levels? What are the tools for achieving states of positive
health?
Health professionals who started by giving relief to their suffering
sick lellow beings, through medicines and surgeries, are now

IV
faced with such newer questions because of the need of the hour.
Mast of the common health and social prohlems cannot be solved
through germ theories, antibiotics or surgeries. The advent of
fascinating diagnostic tools has started pointing to the role of
mind on matter. Biochemical, psycho-neuro-physiological,
immunological researchers are all recognizing the role of mind,
the lifestyle, suppressed emotions, stress etc. in the causation of
many of these challenges of the millenium. Several research
publications on the value of positive thinking, prayer, spiritual
healing, mind-body medicine, yoga, aeupunture. Qigong therapy,
energy medicine are being poured into medical journals in spite
of the resistance from hard-core matter-based pharmaceutical and
surgery-oriented researchers.
Now in the turn of the millenium. health professionals are forced
to accept the paradigm shift in our approach to understanding
human health problems. Mental health is being studied in all its
facets. A large research team is at work in WHO, during this
year of mental health, to find out methods of promoting the
mental, social and spiritual well-being of the human race at large.
Yoga, a science not less than years old has addressed a
normal man to move towards higher slates of harmony and peace
both as an individual and also as a social being. Through years
of introspection, practice and dialogue a huge knowledge base
is available in this soil of spiritual seekers who meditated in the
caves of Himalayas. The fund of knowledge that has been handed
over to us by these keen researchers is gaining recognition by
the health scientists as a valuable tool to raise the basic human
consciousness towards a harmonious lifestyle of contentment
and peaceful living.
S VY AS A with scientific research as its base has used many of
these technii|ues from the yoga lore and demonstrated its value
in promotion of positive health in several areas.
Positive physical health in the form of improved muscle strength.

V
stamina, dexterity, immune stability have been achieved after
the integrated approach of yoga for Positive physical health.
Improved perceptual sharpness, intelligence, memory, emotional
stability that are indicators of positive mental health have been
achieved after yoga pracitces.
Use of yoga in rehabilitation of socially sick persons from remand
homes, prisons etc. has been achieved. The crime rate reduced
in many cities of USA when one percent of the population
practised Transcendental Meditation. Prevention of many of the
stress-related health problems are possible through yoga practices.
Large number of general public, professionals, executives etc,
are drawn towards these PPH programmes not only to prevent
the dreaded diseases like heart attacks and cancers, but also to
promote their own family harmony and peace.
This booklet takes you through a glimpse of the huge knowledge
base from which relevent concepts, and practices have been culled
out to make it practicable for common, working busy person of
today.
We are indebted to Mrs Devi Guha Chowdhri and Mr Chowdhri
for their contribution in compilation of this book. We thank
Dr Shirley Telles for her contribution to the scientific knowledge.
We thank Dr Sudha Rani, Sri Agarwal M, Sri Amrit Ram,
Sri Natesh and many other Yoga Therapists for their help in
preparing and publishing this booklet.

R Nagarathna
H R Nagendra

vi
 CONTENTS
Page No.
1. Introduction 1-4
What is Asthma?
What is Nasal Allergy?
What is Nasal Allergy?
How common is asthma and Nasal allergy?
Why is asthma increasing?
2. Anatomy and Physiology of Respiratory System 5-18
Introduction
Anatomical Features
Mechanics of Breathing
Lung Function Tests
Control of breathing
3. Causes of Asthma & Nasal Allergy 19-34
How does the narrowing of bronchial
airways occur?
What is the cause of Asthma?
What is the role of immune system in asthma?
What is the role of nervous system in asthma?
What triggers asthma attack?
How does stress lead to asthmatic attack?
4. Management of Asthma 35 - 54
What are the preventive measures?
Drug Therapy
5. Health and Disease - A Yogic Prospective 55 - 72
Concept of Health & Yoga
Uuderstanding Yoga
Definition of Yoga
The five Sheaths of Existence
The Science of Illness
6. Breathing Practices
Standing
Hands In and Out Breathing
Hands Stretch Breathing
Ankles Stress Breathing
Sitting
Dog Breathing
Rabbit Breathing
Tiger Breathing
Sasarikasana Breathing
Supine
Straight Leg Raise Breathing
Instant Relaxation Technique (I.R. T.J
Sithillkarana Vyayama (Loosening Yourself)
Forward and Backward bending
Side bending
Pavanamuktasana Kriya
Quick Relaxation Technique (Q.R. T.J
Suryanamaskara

7. Yogasanas
Standing Postures
Ardhakati Cakrasana
Ardha Cakrasana
Pada Hastasana
Sitting Postures
Vajrasana
Vakrasana
Ardha Matsyendrasana
Pascimottanasana

viii
 Prone Postures
Bhujarigasan
Salabhasana
Supine Posture
Sarvangasana
Matsyasana
Halasana
D R T (Deep Relaxation Technique)
8. Pranayama
Surya Anuloma Viloma Pranayama
Candra Anuloma Viloma Pranayama
Nadisuddhi Pranayama
Cooling Pranayama
Bhramari Pranayama
9. Meditation
Nadanusandhana
(A-kara, U-kara, M-kara, A-U-M)
OM-Dhyana (Meditation)
Cyclic Meditation

10. Kriyas
Trataka
Jala Neti
Sutra Neli
Vamana Dhouti
Vastra Dhouli
11. Meditation & the Seineee of Kmoton Culture
12. Yoga - Chair Breathing
13. Research on Yoga for Asthma - a review
References
 INTRODUCTION
How many of us have really noticed our breath? It is an often
taken for granted function of our system and never given any
importance till such time one feels difficulty in breathing. But
have we not noticed always that any change in the mind and
emotions has always reflected in our breath almost instantly? A
th
cricketer in his 99 run has to focus on his breathing as his anxiety
is reflected in his breath. As the question papers are given in the
examination hall, there is a sigh till such time the student has
seen and felt comfortable with the questions. Just before the being
comes into this world the mother needs to work on her breath.
But what happens when this breath is not just as simple as it
sounds? What happens when one has to pull and push and
wheeze and struggle to take one single, simple breath? This is
the problem that goes on & on with asthmatics.
Chronic allergic cold is a more common condition than asthma.
Although much less serious in its outcome, it could lead to marked
discomfort and nuisance to life, as will be seen later. These two
conditions are simply different expressions of the same underlying
defect, namely, the hyper-reactivity of the inner lining of the
lower and upper portions of the respiratory tract. Considering
the marked similarity in their causation and their response to yogic
treatment, we have included both these conditions here.

What is Asthma?
The word "Asthma" is of Greek derivation and it means panting
or gasping. Not all difficulty in breathing is asthma. The prefix
bronchial refers to the fact thai the basic problem is in the bronchi,
Yoga for JAstftma

the lower air conduits within the lungs. With the growing
knowledge about asthma, this condition is clearly defined and
differentiated from other illnesses with breathlessness. Some
common features of asthma are -
1. Episodes of breathlessness which
changes in severity spontaneously
or with treatment,
2. Wheeze (whistling noise) while
breathing out and demonstrable
variation in obstruction to air
flow through the airways of the
lungs.
Bronchial asthma is characterized by recurrent attacks of difficulty
in exhalation due to wide-spread reversible narrowing of airways
in the lungs, which varies in severity over a short period of time
either spontaneously or as a result of treatment. Remarkable
hyper-reactivity of the air passages and excessive response by
narrowing to various kinds of stimuli, is characteristic of asthma.
The condition is not due to any known specific infection. This is
a disease characterized by airway inflammation and bronchial
hyper responsiveness.

So asthma is not one disease: it covers a multitude of different

patterns. Like the word 'cancer' it tells you roughly what sort of
condition we are dealing with, what ballpark we are in. Under
that general heading you will find a range of severities, a range
of triggering factors and a range of outcomes. It logically follows
that what is good for one asthmatic person may be unsuitable
for another.

Asthma is a very individual condition and management needs to

be personal because of the variety of factors that underlie each
individual's asthma.
 Yoga for Jistfima

What is Nasal Allergy?

Hay fever and allergic rhinitis are the other names for nasal allergy
(NA). The three cardinal symptoms of this condition are sneezing,
running nose (rhinorrhoea) and blocked or stuffy nose. This may
occur seasonally as in Hay fever or perennially almost all year
round. There may also be itching of nose, ears, eyes, throat and
post-nasal discharge. At times, the inner lining (mucous
membrane) of the paranasal sinuses may get involved in this
allergic inflammation leading to pain and discomfort in the
forehead and cheeks. Occasionally this may form the base for
acute or chronic infection leading to sinusitis. Although not a
fatal condition, it could lead to much discomfort, loss of interest
at work and psychological depression.
Exposure to cold wind, sunlight, dust and fumes, etc. may
precipitate the onset of the symptoms. Exactly like in bronchial
asthma hyper-reactivity of the inner lining of the nose is the cause
of this problem.

How common is asthma and Nasal allergy?

Prevalence of asthma varies considerably within countries and
greatly between countries. More common in developed countries
than developing countries, reasons for which are ill defined.
Nearly 5-10% of population have asthma. In India it is about
6% varying from 2-17% in different sections of the society. It
can start at any age varying from 2-17% in different sections of
the society. It can start at any age but in majority it starts before
the age of 10 yrs. Twice as common amongest boys than girls;
male, female ratio is equal in adults.
It is almost unheard of in Eskimos and black Africans living in
rural areas, whereas in the Western Caroline Islands nearly 50
percent of the inhabitants have asthma, with three quarters of
children being affected.
Yoga for ^Asthma.

Between these extremes are the westernized populations such as

people in the UK and other European countries, Australia and
New Zealand, which all have roughly the same percent of asthma.
Interestingly, those parts of the world with less asthma are those
that are less encouraging to the survival of the house dust mite.

Why is asthma increasing?

It is possible that some of the increase is due to doctors now
using the word 'asthma' whereas before they would have used
'wheezy bronchitis', but this cannot explain the greater part of
the rise. Exposure to allergens in the houses, viral infections,
aspects of the indoor environment such as central heating, air
pollution, the stress of modern living - even the treatments used
for asthma itself - have all been blamed for the increase. How
ever, evidence for any of these individually being responsible is
limited. In fact, it is highly likely that the rise is due to a
combination of these factors although allergies are likely to be
the more important cause.

Reminiscences of a (Partcipant

jisthmaisan inheritance tome from my dear father-who sufferedfrom this disease

for considerable period. It was also harassing me from my 20th year, for nearly
seven years. In 'November 1983; I joined Yoga classes at Vivekananda %endra;
Mftat a transformation Yoga has brought in me First, I got rid of this pestilence.
Second this cure has in turn made me more optimistic in life. Now feeling of welH-
being and cheer is ever-prevalent as compared to the constant despair earlier.
Having been cured offisthma naturally, I-want to pass on this happy news to
others who are also suffering from this ailment. Constant practice of Yoga all its
aspects as taught by 1'xve^ananda %endra can help and I want everyone to take
advantage of this simple but very effective remedy. I offer my share by taking yoga
classes organised by %endra.

Smt-tyteera (Bfiojraj
J\ge 30 years
 )ooa tor tithma

ANATOMY AND PHYSIOLOGY OF

RESPIRATORY SYSTEM
Introduction
It is by means of breathing that even eel] in the body receives
its supply of oxygen, and at the same time gets nd of the products
of oxidation. Oxygera, combining with the carbon and hydrogen
of the tissues, enable* the metabolic process of each individual
cell to proceed, with the result that work is affected and waste
products in the form of carbon-dioxide (CO.,) and water (H,0)
are eliminated. Respiration is a two-fold process whereby the
interchange of gases takes place in the tissues called internal
respiration* and in the lungs known as 'external respiration'. Air
is drawn into the lungs during inspiraloin and expelled from
the lungs during expiration. The air enters through the respiratory
passages which are enumerated and briefly described below.
•

Anatomical Features
NOSE: The nose is
divided into two nostrils NASAL CAVITY
by a nasal septum. The
division is normally
unequal. Both the
septum and the side
walls of the nose are i.
made up of cartilages in
their lower parts and by
thin flat bones in 1 heir
upper parts. Three strips
Optming ui tafi f ,u*riu<iiuii>
of bones pro]eel from
Ihe bony side wall of the nose
Middle „
called Turbinate bones to S u e
nasal concha P . . n o r

Ethmoid air cell

form the Nasal Conchae.
The external opening of the
nose (anterior nares) opens
Inrerior nasal concha
into the Vestibule of the nose.
The inner lining of vestibule Nasal septum |
Maxillary sinus
continues with the skin of the
anterior nares. This contains nterior ethmoidal artery

a number of coarse hairs Posterior

ethomidal artery
which project downwards. - Posterior
septal artery
The nasal cavities are lined
with highly vascular mucous
membrane that continues with Mucous membrane

that of the throat and with that

of the para-nasal sinuses. This
lining consists of a single layer of cells containing small delicate
hair like projections (cilia). There are a large number of mucous
secreting cells scattered along the nasal mucosa that secrete a
thin transparent fluid to keep the surface moist and sticky.
The filaments of the olfactory nerve arise from small receptors
scattered in the mucous membrane of the nasal cavity in its upper
part. These are the points that pick up the sense of smell. Apart
from these special sensory nerve endings there are touch and
pain sensitive nerve endings distributed in the nasal lining
that help in the protective reflex of sneezing apart from being an
organ to sense the smell.

Functions of Nose
The nose acts like a room air conditioner with 3 major functions
of cleaning, temperature control and humidity control, apart from
being an organ to sense the smell.
1. Filtering the inhaled air: The downward projecting hairs,
the crevices of the conchae and the sticky mucus on the wide
 Yoga for Asthma

mucous membrane surface renders the air tree of big and

small pollutants.
2. Warming of the air : Air as it
passes up the irregular nasal
passage (enough time is provided
for temperature control due to the
length of the passage) gets
warmed up to body temperature
by exchange of heat across the
wide mucosal surface area.
3. Humidifying : The evaporation of the moisture from the
extensive surface of the nasal mucosa humidifies the inhaled
air.
4 Sense ofsmvJJ: This is perceived by end organs in the nasal
lining and the electrical activity is passed on through the
olfactory nerves.

Sneezing Reflex
This is a protective reflex lo expel and thus prevent irritating
substances in the air from reaching the lungs.
A reflex arc consists of sensory receptors that receive the
information, the afferent nerve (upstream nerve) that carries the
information to the centre, the efferent path (downstream nerve)

Snwtr

A MUSCLE REFLEX ARC SNEEZING REFLEX ARC

7
•Yoga for JAstdma

that carries the information from the centre to the effector organ
that carries out the effect.
Here the receptor is the touch sensitive nerve endings (sense
organ) distributed in the nasal lining that sends an array of
electrical impulses along the sensory nerve (the afferent).
Whenever the inhaled air contains strong irritants, the information
is carried to the sneezing centre, a group of nerve cells, in the
brain stem. From here the message is sent along the motor nerves
(the efferent) to all the chest muscles (effector organ) to contract
forcibly, to cause a big inhalation followed by a forcible co-
ordinated contraction of all respiratory muscles, to blast out the
irritant from the nose and mouth by a burst of exhalation.
Thus we find that sneezing is an important and necessary
protective reflex. The sneezing becomes a problem in persons
with nasal allergy whenever this reflex is overdone due to
hypersensitivity of the nasal lining, triggering off the loop even
for very small non-dangerous irritations.

Pharynx
This is a common muscular tube (throat) that lies behind the
nose and the mouth. The pharynx is guarded by tonsils at the
sides, and adenoids at the top. Tonsils and adenoids are
collections of white blood cells (lymphatic tissue) which act as
defence army-guards by fighting away any dangerous germs
that may contaminate the inhaled air. These white blood cells in
fact surround the bacteria to digest them away and themselves
die in the process, to be replenished soon. The muscles of
pharynx are chiefly useful in swallowing. The pharynx opens
into the Larynx (the voice box) in front and the Oesophagus
(the food tube) behind.

Larynx

Larynx is composed of pieces of cartilages to maintain its shape

and the patency. Attached on top is a small piece of cartilage

8
 Yoga for Asthma

called Epiglottis that closes the Larynx like a lid during

swallowing so that the food glides over it into the food canal
(Oesophagus) and not into the wind pipe (trachea).

The Vocal Cords are thin flaps that project from the side wall of
the larynx. The movement of these flaps are controlled by highly
efficient groups of delicate laryngeal muscles. The vibration of
these cords due to the air passing through the glottis causes voice
production.
Trachea
The Trachea (wind pipe) about 10 cms long extends from the
larynx to divide into right and left bronchi. There are incomplete
rings of cartilages in the wall to maintain the patency under
varying intra-thoracic pressure conditions occurring during
breathing. The trachea divides into right and left bronchi which
enter the corresponding lungs.

Lungs
The lungs, two in number, are the principal organs of respiration.
They till the chest cavity, one on each side separated in the middle
m
by the heart, its
blood vessels and Trachea
(windpipe)
other structures. The Left lung

lungs are cone

shaped with the apex
Right lung Bronchus
above and the base [major airway)
resting on the floor
Bronchiol
of the chest cavity (minor airway)

on the diaphragm.
They are divided
into lobes by fissures; the right has three and the left has two
lobes.
Bronchi
The right and left
bronchi are formed Close-up of
Bronchiole
by the bifurcation of Muscle--'
Mucous
gland

the trachea. The right Wall of bronchiole

bronchus is shorter Internal Wall
Muscle
of Bronchiole
and divides into three
branches to enter
three lobes of the right lung and the left is longer and divides
into two branches to enter the two lobes of the left lung. These
further divide and redivide into a number of bronchi like the
branches of a tree to ramify into smaller bronchi and finally end
as bronchioles that enter the air sacs called alveoli.
The larger bronchi have incomplete rings of cartilage in their
wall and they disappear in smaller bronchi. The inner lining of
the bronchus (mucous membrane) has ciliated (hairy) layer of
cells, the movement of the cilia being upwards to remove the
finer pollutants that would have escaped the nose. The inner
lining also contains mucus secreting cells that secrete thin mucus
that provides the lubricating layer of moisture and also helps to
humidify the air. The most important in the bronchus is the thin
circular layer of smooth muscles that run all the way along the
10
 Toga for JAsthma

bronchial tree. The contraction of this thin circular bronchial

muscle leads to narrowing and its relaxation to dilatation of the
air passages. The calibre of the bronchus varies with several
factors and this is controlled by a highly complex neuro-chemical
mechanism described later.

Alveoli
Alveolus is lined by a single layer of flat cells. It is here that the
blood comes into almost direct contact with the air, being
separated only by exceedingly thin permeable membrane
consisting of two layers of flat cells. Oxygen diffuses from the
inhaled air in the air sac to the blood moving very slowly in the

Capillary

capillaries and carbon-dioxide moves from the blood to the air

sac due to the differences in partial pressure of the two gases.
Carbon-dioxide moves more readily than oxygen. Pulmonary
artery and veins carry de-oxygenated and oxygenated blood from
and to the heart respectively. Bronchial arteries supply
nourishment to the lungs.The compositions of inhaled and
exhaled air are given below:
Inspiration Air Exhaled Air
Nitrogen 79% 79%
Oxygen 20% 16%
Carbon-dioxide 0.04% 4.04%
Miscellaneous 0.96% 0.96%

11
Yoga for Asthma

Pleura
liach lung is
surrounded by a
double layer of
membrane called
Pleura. The inner
layer of Pleura Visceral
closely surrounds membrai
Parietal |
the lung and the membrai
outer layer covers
the interior of the
chest wall. Between
the Pleural layers
there is a thin layer of lubricating fluid lo prevent friction.

Mechanics of Breathing
Respiration involves two processes. The inspiration (Puraka)
which is active and exhalation (Recaka) which under normal
conditions is a passive phenomenon.
The inspiration takes place by the expansion of the thoracic cage
and the lungs passively expand to fill up this increased space
when the air is drawn into the air passages. Three sets of muscles
are involved in inspiration:
i. Diaphragm is a dome-shaped
sheet of muscle in the floor of
the chest. Contraction of the
diaphragm enlarges the chest
cavity vertically from above
downwards.
ii. Abdominal muscles also
assist during forced
| when breathing out
respiration Expiration takes
Position o f diaphragm
place as the chest wall falls when breathing in

back during relaxation of

 Yoga for J\stftma

these muscles when the intra-thoracic volume decreases and

the air is forced out of the lungs through the air passages.
iii. Intercostal muscles are two layered of oblique strips of
muscles in between the ribs. Contraction of this muscle
causes elevation of the ribs to expand the chest in the
forward and outward direction.

THORACIC BREATHING

Clavicle
(collarbone)

iv. Claviculai Muscles are neck muscles attached to the clavicle

below and the jaw bone above. Contraction of these muscles
along with shoulder girdle muscles help to pull up the sternum
and clavicle to expand the chest in upward direction. These
muscles are used only in deep forced breathing.

Lung function tests

The lung volumes are measured by an instrument called
Spirometer. The person blows through its mouth piece into the
instrument. This air rotates a drum and a needle attached to
it, marks the volume on a paper. Alternatively, the air expands
the bellows which make the needle attached to it mark the same
on a graph, which is digitized to show the loop of breathing on
the computer screen.
Yoga for Jistfima

Total Lung Capacity(T.L.C.) is from 4.5 to 5 litres of air. Tidal

air is the amount of air that is breathed out in one breath at rest
and this is about 0.5 litre.

NOSMAL
GOTO

RESIDUAL
VOLUME
Flow-volume loop: Tone in wronris is 4
TC axis and volume in litem on "V axis
Spirometry showing h a * volomes and capacities

Vital Capacity (V\C.) is the volume of air that can be breathed

out after a full deep inspiration. In normal healthy adult it is 4-5
litres.
Residual Volume (R. V) is the volume of air that remains in the
lungs after complete exhalation.
Forced Vital Capacity (F.V.C.) is measured by blowing forcibly
and completely after a maximum deep inspiration.
Slow Vital Capacity (SVC) is recorded as the person blows
slowly and completely after a deep inspiration. In normal healthy
persons FVC and SVC are same. In asthmatics, FVC is less
than SVC.
Forced Expiratory Volume in first second(FEV ) is noted by {

marking off the volume that is exhaled in the first second on the
FVC curve. Normally F E V / F V C is more than 80% in normal
persons. This ratio is reduced in asthmatics due to narrowing of
air passages and improves completely after a bronchodilator.
Peak Flow Rate (PFR) is measured by using a small portable
(mini PFR meter) instrument. Here the person blows into the
 Toga for Jlstfima

mouth-piece forcibly in a single blast

after a deep inspiration. Several
studies have shown that PFR
correlates with FEVj /FVC ratio and
hence is a good and easy indicator of
the level of broncho-constriction.

How to use a Peak flow meter?

1. Stand up, if possible.
2. Check cursor is on Zero.
3. Take a deep breath in, place peak-flow meter in the mouth
(hold horizontally) and close lips.
4. Blow suddenly and hard.
5. Note number indicated by cursor.
6. Return cursor to zero.
7. Repeat twice to obtain three readings.
8. Write down the best of the three readings.
Reversibility test for Asthma
Sometimes these breathing tests are performed before and after
inhalation of a bronchodilator drug, which opens the airways. If
the readings increase by 15 per cent or more after inhaling the
drug, the airway narrowing is said to be reversible and confirms
a diagnosis of asthma. Even asthmatic patients do not always
show reversibility on every occasion tested, but it is nevertheless
a very useful diagnostic test in patients in whom asthma is
suspected.

Control of breathing
Normal rate of respiration is slightly quicker in women than in
men. Normal rates per minute are given below:
i. In newborn babies 40 permin
ii. At one year 30 permin
•— ID
 iii. 2-5 years 24 permin
iv. In adults 10-20 per min

The rate and depth of respiration varies with the oxygen demands
of the body. They increase with exercise and emotion and
decrease during rest.
The respiration is regulated and controlled by two principal
factors:
(a) Nervous Control: The
respiratory centre is a
group of nerve cells
situated in the medulla
oblongata (lower part
of the brain stem). This
maintains the basic reflex
rhythm of respiration
through nerves that pass
up and down the spinal
cord to the muscles of

(b) ChemicalControhThe respiratory centre can be influenced

by certain chemical changes in the blood. Excess carbon-
dioxide (excess acidity) and reduced oxygen in the blood
stimulates this centre to cause an increased rate and depth of
breathing and vice versa.
The rhythmic discharges of this lower centre for respiration in
the medulla is under control of influences from higher centres.
One such higher control is exerted by the hypothalamus,the seat
of autonomic nervous system. Nervous connections exist
between these two centres. Excitatory impulses with any
emotional upsurge pass down from the hypothalamus to
increase the rate and depth of breathing.
 Yoga for Jistfima

A second set of nervous connections exist between the frontal

cortex and the medullary centre because of which the respiration
can be easily altered voluntarily. This is the highest level of
nervous control.
Thus we find that there is
a hierarchy in the nervous
control systems working
in harmony without
disturbing the basic
involuntary rhythm at rest.
The higher controls are to
help alter the rate and
depth of breathing to meet
the oxygen demands of
the body.
Respiration is a function in the body which has both involuntary
and voluntary nervous controls. Respiratory system forms the
threshold between totally involuntary functions like the functions
of heart, intestines, etc., and voluntary functions such as those of
skeletal muscles (e.g. limb movements).
(%£mintscences of (Partcipants
l.ylsthma and I -were constant companions for about five years. It was not of
my own making. I didnot want it but it wouldnot leaveme and enjoyed harassing
me. OnCy those who sufferfromJLsthma foow what it means. 'Every problem must
have a soCution somewhere, sometime, but the probkm itself was tofind it. I was
lucky that Ifound it at Vivekananda %endra through their Yoga Therapy, jlfter
undergoing Yoga training, which I continue to practice even now regularly, I have
been able to get ridofthe medicines. Once ortwice a year, I may get wheezing which
I manage with simple breathingj>ractices if not yoga chair breathing. I wish I had
known and practiced Yoga earlier instead of suffering for a Cong period. 'What I
learnt was not merely a physical relaxation but also a method of calming the mind
too, in that, this method changes our outlookjtself Vnknown fear and doubts
have gone and I can nowface problems surely I do strongly recommend to allmy
sisters to take to Yoga to get over theirproblems. Simple but sure-fire remedy is this.
I have experienced it. You can also. 'Why not try?
'Miss. C- Sunita
Age -16years
 CAUSE OF ASTHMA AND
NASAL ALLERGY
How does the narrowing of bronchial airways occur?
The airway narrowing in asthma occurs due to inflammation of
the inner lining, resulting in:
1. Swelling of the the inner lining of the bronchus which gets
engorged, swollen, contributing partly to the reduction in the
airway narrowing.

gland from gland increases

NORMAL AIRWAY
AIRWAY DURING ASTHMA ATTACK

2. Secretions are poured out from the swollen mucosa into the
bronchi, further decreasing the effective lumen. Characteri-
stically the secretion in asthma is sticky and is expectorated
with great difficulty towards the end of an attack.
3. Broncho-constriction or contraction of the bronchia] muscles,
lessening the calibre of the bronchus. Tightening of circular
strip of muscle that surrounds the bronchus is irritated to cause
this narrowing.
'Yoga for Asthma

What are the changes in the nose that cause the symptoms
in Nasal allergy?
As we have seen, nasal allergy is only a younger sister of
bronchial asthma, the causative factor in both cases being almost
the same, the changes observed being very similar.
1. The irritation of the nerve endings within the nose leads to
continuous bouts of sneezing which is one of the symptoms
(This sneezing reflex corresponds to the broncho-spasm and
cough).
2. Swelling of the inner lining of the nose contributes to the
nasal stiffiness. This swelling leads to distressful feeling of
blocking as the nasal air passage is already very irregular.
Sometimes chronic irritation and swelling can lead to
longterm thickening and hypertrophy of the mucosa causing
fleshy masses to project into the nasal cavity called nasal
polyps.
3. The secretion of large quantities of watery mucus from the
mucous membrane of the nose leads to the rhinorrhoea.
Similar changes of excessive secretion and swelling of the inner
lining occurs in the lining of the paranasal sinuses leading to
symptoms of allergic senusitis.

What is the cause of Asthma?

Unfortunately, medical researchers do not know exactly what
causes asthma. It is entirely possible that no single cause will
ever be found. Inflammation causes mucus to build up in the
airway, cutting down on the space available to move air.
Inflammation also stimulates the muscles around these tubes to
contract (broncho-construction), narrowing the tubes and further
cutting down the airflow. Although inflammation is the root
cause of all asthma, the trigger for this inflammation is different
lor different people. Understanding how inflammation causes
asthma brings us one step closer to controlling this disease.
 Yoga for jZsthma

A lot of things are able to provoke asthma inflammation. These

vary from person to person. The most common ones are:
a. Allergens^organic
Food Product* Pat DiniUr

substances that cause

allergic reactions): house
dustmites, pollens (grass,
trees.), molds, pet dander, Hou

and cockroaches.
b. Tobacco : Non-specific
irritants and pollutants in
the air, strong fumes or
odors like household
sprays, paints, gasoline,
perfumes etc.,
Is Asthma a hereditary disease?
It has been observed that
persons with asthma
have a family history of
hay fever, asthma or skin
allergy. One inherits only
a tendency of hyper-
reactivity and not a specific
allergic disease. One is
born with a tendency to
react hypersensitively and manifests the condition earlier and
more severely than normal persons if exposed to one or more ol
the triggering factors. Some recent studies in the large population
has shown an increased tendency of airway responsiveness to
broncho-constrictive substances in asthmatics compared to
normals. This shows lhal asthmatic subjects represent the most
sensitive extreme of the population and are not a separate sick
population as such.
Genetics
The probability of having asthma increases if one parent has got
asthma and even higher if both parents have it. But genetic aspects
of asthma are very complex, and it does not depend on one only
gene like other well-known diseases (celiac disease). Asthma is
a poligenic disorder, that means, a number of genes are related
with asthma and every gene explains different faces of the
disease. It explains how in a family with twins, one has asthma
and another does not. As a whole we know that genes decide
the age of starting of asthma, degree of inflammation of airways,
severity of symptoms, response to medicines and the relationship
between asthma and allergies.
Thus genes carry the tendency and the environment (external
and internal) makes asthma manifest.
What is the role of immune system in asthma?
Inflammation is an important part of the body's response to injury
or infection. Basically, inflammation is the immune system's call
to action. Signals sent by the immune system recruit an army of
cells to fight off invaders, such as bacteria or viruses. They also
start the healing process when there are signs of tissue damage.
For example, when you scrape a knee on a dirty sidewalk,
bacteria cling to the wounded tissue. "Scout" cells sense these
foreigners and send chemical signals that attract other cells to
this spot. These new arrivals release substances that attract some
more cells that help clean the wound and draw more body fluid
to it. This is why the area becomes swollen.
Inflammation is an essential part of the functioning of a normal
lung. Tiny areas of inflammation occur thousands of times a day
in order to combat the viruses, bacteria and pollutants to which
we are exposed. These hostile factors when inhaled into the lungs
stick to the surface of the airways. The body uses the
inflammatory response of immunoglobulins to break down and
remove them. Normally, none of this activity produces any
22
 Toga for Asthma

obvious symptoms. However, asthmatics hyper-react to some

factors, aggravating inflammation throughout the small and
medium airways. It is thought that asthmatics, over-produce
unique antibodies (immunoglobulin (IgE)) in response to these
factors. Thus in people with asthma, the lungs and airways
overreact to foreign substances in the air, such as cat hair, mold
or pollution. Sometimes even clean, cold air can constrict the
airways, especially in people with exercise-induced asthma. Thus
in people with asthma, the lungs and airways overreact to foreign
substances.
You inhale something for the first time, say pollen for example.
Your body's immune system decides that the pollen (called an
allergen) is a danger to your safety and creates a specific IgE
antibody to the pollen. These antibodies are attached to a part of

IgE

the immune system called the must cells. Which are found in the
inner lining of airways and skin. When you inhale the pollen
next time, these IgE antibodies attach onto the allergen and trigger
the mast cells to release a host of chemicals called inflammatory
mediators.
•Yoga for Jistfima

These substances irritate the sensitive linings of the airways, just

as continuous scratching of an insect bite would aggravate your
skin rash. As a result, blood vessels near the allergen widen.
This increases blood flow bringing as many white blood cells
and inflammatory mediators to the area as possible. The walls of
the blood vessels become leaky, allowing white blood cells and
the inflammatory mediators to leave the blood and engulf the
allergen. The inflammation caused by these chemicals keep
restricting the airways, thus prolonging the asthma attack. Thus
asthma-associated inflammation occurs as a seven-step process:

1) Sensitization
Sensitization occurs as a result of presentation of an antigen to a
T-lymphocyte. At this point, no one knows for sure which cell
or cells are involved in antigen presentation. When an antigen
(for eg., pollen) processed and delivered to a T-lymphocyte, it
responds by changing itself from a naive lymphocyte to an
allergic type of cell (T-Helper 2, or T-H2). These cells now
release a series of chemicals called cytokines. The cytokines find
their way to B-lymphocytes, which in turn produce the specific
immunoglobulin IgE. The IgE then attaches to mast cells, thereby
completing the sensitization or antigen presentation phase, the
first step in the inflammatory cascade.

2) Stimulation
Genetically predisposed
individuals exposed at an
early age to indoor aero-
allergens, occupational
antigens and respiratory
viral infections become
sensitized to certain
allergens. In sensitized
individuals, many factors

24
 Yoga for Jistkma

(stimulus) may trigger off inflammation. Large number of factors

may stimulate an exacerbation of the disease, including allergens
and environmental agents, through triggering of mast cells.
The issue of whether all cases of asthma require a specific stimulus
remains unresolved and controversial. However, recent studies
have provided evidence that most, if not all, asthma does have
an allergic basis that may revolve around IgE.

3) Cell signaling
Stimulation activates a complex communication network.
Signaling cells issue biological commands that lead to recruitment
of inflammatory cells into the airways.

4) Migration
During the triggering and signaling processes, substances are
produced that chemically attract migration of white blood cells
(leukocytes) into the airways. At various times after exposure to
allergen, migration may involve different types of white blood
cells called eosinophils, neutrophils, lymphocytes and monocytes.
The migration begins within two hours and may continue for up
to 48 hours.
5) Activation of inflammatory cells
Following migration into the airways, inflammatory cells
(eosinophils) require activation to produce the narrowing of
airways that cause symptoms of asthma. Activation probably
occurs after the cells' exposure to cytokines and other potential
activators found in inflamed lungs. Potential activating substances
include interleukin-1 (IL,), interleukin-5(IL,.), tumor necrosis
factor-alpha(TNFA) and granulocyte macrophage-colony
stimulating factor (GM-CSF).
6) Tissue stimulation and/or damage
Evidence continues to accumulate to suggest that the
inflammatory processes of asthma in the bronchial wall take place
rFi
Yoga for jlsthma

at different levels, i.e., of the epithelium, basement membrane,

smooth muscles and nerves.
7) Resolution
There may be abnormal or incomplete repair mechanisms after
the inflammation has stopped. This may lead to chronic persistent
inflammation in asthma leading to repeated attacks.
More research is needed to confirm the lack of resolution in the
inflammatory process and to identify associated underlying
mechanisms. Better understanding of the resolution process could
help explain the differences among mild, moderate and severe
asthma and lead to the development of more effective therapies.

What is the role of nervous system in asthma?

The normal calibre of the bronchus is maintained by a balanced
functioning of sympathetic & parasympathetic parts of the
Autonomic Nervous System (ANS). Both these systems function
reflexly. The parasympathetic reflex loop consists of the afferent
nerve endings (upstream) which terminate under the inner lining
of the bronchus, the upstream information reaches the brain stem
vagal centre and the efferent (downstream) passes down the vagal
centre to end in the bronchus. Whenever the vagal afferent nerve
endings are stimulated the reflex arc is excited and bronchospasm
occurs by the release of acetylcholine in the efferent nerve
endings. This in turn results in excessive formation of cyclic
Gaunine Mono-Phosphate (cGMP) that can cause irritation of
bronchial smooth muscle.
The sympathetic nerve (relaxing nerves) supply to the bronchus
consists of impulses travelling from the hypothalamus to end in
adrenal medulla to release a chemical called epinephrine.
Epinephrine is carried in the blood stream to the bronchus where
it activates the sympathetic receptors which in turn stimulate the
bronchial cells to promote formation of cyclic Adenosin

26
 Yoga for Asthma

RT LT

CAUSE OF ASTHMA - Autonomic Imbalance

Monophosphate(cAMP). This substance relaxes the bronchial

smooth muscles and opens up the air passages.
Thus, the calibre of the bronchus is determined by a very delicate
balance in the amounts of cyclic AMP and cyclic GMP. The
fundamental event in asthma appears to be the preponderance of
cGMP over cAMP.
This imbalance can come about by:
1. Excessive stimulation of the afferent (upstream) vagal
receptors on the surface of the airway smooth muscle,
triggering the arc reflex of bronchospasm.
Eg: Irritation by air pollutants, infection, strong odors or the
histamine (the chemical released from mast cells during an
allergic reaction) can act on the vagal receptors to increase
cGMP.
•Yoga for Jistftma

2. Direct excitation of the

PSYCHE
vagal centre within the
brain. Emotional
tension is the chief
factor that can excite
SYMPATHETIC
the vagus centrally. (CAMP)
PARASYMPATHETIC
(CGMP)
3. Sympathetic
hyporeactivity also IMBALANCE
contributes to the
imbalance. cAMP-cGMP imbalance signals the abnormality
to the ANS centres in the hypothalamus. These hypothalamic
centres fail to send the necessary compensatory impulses to
cope up with the asthmatic stress, thus there is insufficient
secretion of epinephrine and Cortisol in the blood resulting in
lesser sympathetic (p ) stimulation and insufficient c AMP to
2

balance for the rising cGMP levels in the bronchus. Thus the
inefficiency of the compensatory central mechanism tends
to prolong the bronchospasm.

What triggers asthma attack?

Allergens, fumes, dust and odours, cold air and viruses, emotions
and stress, climate and pollution. Any one of these substances
can trigger or worsen asthmatic attacks, because the hyperirritable
sensory nerves and the immune system respond to even low
concentration of these which would not affect normal persons.

Allergies
(a) Pollen: is the best recognized trigger but animals, particularly
cats and horses, are also potent causes of attacks. Chronic
exposure may result in more persistent symptoms. The
importance of animals in the house may be missed as the
patient claims to be able to stroke the cat without 'getting an
attack' not realizing that long-term exposure is causing
chronic symptoms.
 'Yoga for ^Asthma

b. House Dust : The most

important factor in precipitating
asthma, however, particularly in
children, is exposure to the house
dustmite. House dustmite is a
little insect, smaller than a pin
point that lives in carpets,
mattresses and furry toys. There can be as many as two
million in each mattress! There are good theoretical reasons
to believe that ducted or warm air central heating may cause
a problem, especially in those patients with allergy to house
dustmite.
When a susceptible individual is exposed to a protein in the faecal
pellet of the house dustmite over a period of time, the body's
white cells become sensitive to this 'foreign substance'. As the
protein is inhaled, a reaction to it occurs in the lining of the
bronchial tubes, resulting in inflammation of the airways. Hence
controlling the house dust mite is very important in some patients,
but the measures could be expensive.
c. Fumes and Odours: Cigarette
smoke is a potent trigger for many
patients, as are dusty environments,
where the dust acts as an irritant.
Odours, such as scent or after-
shave, can be a trigger for certain
individuals but this is not an allergy. Presumably, it is an
irritant reaction to the chemicals involved, and the best
treatment is avoidance where possible, although this may
have important consequences.

2. Infection
Asthma and allergic rhinitis are not infectious as they are not
caused by any bacteria or virus. Viral infections (not bacterial)
 'Yoga for Jistfima

of the respiratory tract (e.g.,flu) commonly evoke acute flare up

of asthma. The mechanism appears to be that the firing threshold
of the vagal nerve endings in the mucosa are reduced and hence
broncho-constriction occurs. Increased broncho-constriction
response has been noticed even in normal subjects during viral
respiratory infections like flu.
Antibiotics are only effective in treating bacterial infections which
are very rare in asthma; As viruses are completely unaffected by
antibiotics, there is no place for them in the management of
asthma. Yet antibiotics are commonly prescribed for episodes
of worsening asthma.

3. Physical exertion
Like infections, physical exertion
can also trigger off broncho-
spasm. In some children this may <
1
be the only provocative factor
and could be very troublesome.
The mechanism has not been
completely worked out.
However, the development of
airway obstruction and its
severity are quantitatively related
to the degree of airway cooling and drying that occurs during
the increased ventilation on exertion. Running in an open cool
atmosphere induces bronchospasm to a greater extent than spot
jogging or swimming in an indoor warm pool. Both vagal reflex
and mast cell mediator release seem to occur in response to airway
drying.

4. Climate and Pollution

Many patients with asthma know that their condition is affected
by the weather, but there is no uniform pattern. Some prefer
cold to warm weather; others prefer hot, dry atmospheres. You,
 •Yoga for Asthma

the patient, know best and will usually adjust your behaviour
and treatment accordingly.
There is no direct evidence that exposure to air pollution at current
levels will turn a non-asthmatic person into an asthmatic.

5. Occupational asthma
Repeated exposure to certain environmental substances can lead
to asthma through all the three mechanisms:
a. Antibody formation - IgE
mediated,mast cell mediator
release. Eg. Animal handlers,
bee keepers and bakers.
b. Chemical release - in cotton
workers, the cotton track
contains a histamin releasing
substance.
c. Inflammation-inflammatory bronchitis can occur in persons
with pre-existant hyper-responsiveness when exposed to
irritant gases involved in industries like Hydrochloric acid.
Sulphur-dioxide, Hydrogen Sulphide, Plastic fumes, etc.

6. Psychological Factors
Laughing and crying
Both laughing and crying are symptoms of emotional stress.
"Hansi men KhasI" (fat 3r TIRHT) is an old proverb started from
asthmatic patient. When an asthma patient laughs it can aggravate
asthma. Not only laughing but also crying can also trigger asthma.
Some children use it as a protective method. When confronted
with an angry parent or teacher the child cries and induces asthma,
which generates sympathy and extra favour. Usually crying and
laughing aggravate asthma in children when it is not controlled
properly. Over-protective parents are the greatest danger to
healthy development of a chronically ill child.

31
•Yoga for Jistfima

7. Emotions and Stress

Children often become more wheezy at birthday parties, where
the combination of excitement and exertion makes asthma more
obvious. Asthma was for years regard as a neurotic condition,
but it is now clear that emotional factors act only as triggers, not
initiators of asthma. Excitement, grief and stress can all trigger
an asthma attack.

Anxiety & Depression

Not only emotional stress exacerbates asthma but in many patients
an asthmatic attack induces emotional stress in the form of
anxiety and depression. Despite taking drugs when an asthmatic
patient gets recurrence of episodes of asthma it causes anxiety,
depression and frustration both to him and the other family
members. In this state of mental trauma many a times he may
decide, to stop the treatment. This deteriorates the condition
further. Hence the problem of asthma should not become a central
focus of the family. A regular treatment should be given without
undue expression of emotions. Abundant objective data now
exists to demonstrate that psychological factors can interact with
asthmatic diathesis to worsen or ameliorate the disease process.
Persons with asthma or nasal allergy tend to be characterized by
a relatively prominent emotional element like dependence, anger
or fear and consistently report their inability to express their
feelings. Repressed anger in particular is associated with asthma.
Asthmatics are psychologically very sensitive and meticulous.
This leads to psychological hypersensitivity with deep rooted
conflicts and emotional suppressions. Such long standing
tensions (psycho-) can percolate into the physical level to disturb
the bodily functions (somatic) which in turn can lead to actual
tissue damage as occurs in many psychosomatic illnesses.

How does stress lead to asthmatic attack?

If you want to lift an object from the ground your thought-energy
 •Yoga for Asthma

will be carried through

nerves to muscles.
Muscles will contract as
per message from the
nerves and lift the object.
Muscles of the limbs are
under your control but
there are large number of
muscles in the body such
as those in your windpipe
and heart that are not under voluntary control and are termed as
involuntary muscles. Muscles of windpipe are controlled by a
nerve called Vagus (para-sympathetic). Emotional stress activates
Vagus nerve in the brain which in turn causes contraction of the
muscles of windpipe leading to narrowing of windpipe.
Some investigations have demonstrated that suggestions can
decrease or increase the effect of broncho-constrictor substances.
Emotional state,through the mediation of adrenal gland can
indirectly affect the allergen-antibody reaction.
When a person is tense, the pattern of his breathing changes and
he takes faster and deeper breath called hyperventilation.
Hyperventilation is a known trigger for aggravating asthma. This
is similar to exercise-induced asthma.
What are the indications that psychological factors
are playing a role in asthma?
a. Aggravation of asthma in absence of exposure to any allergic
factor or throat infection. Such a situation indicates the
possibility of an emotional factor. Most of the times the patient
is not aware of this emotional stress.
b. If your symptoms improve when you are away from home,
it indicates that emotional stress is of home-origin.
c. If your symptoms improve when you are away from the
office it indicates that the emotional stress is in the office.
33
 r
rem' _fa Asthma

d. Over-sensing the asthma symptoms: despite improvement in

asthma, some persons continue to suffer discx>mfort. High
anxiety, extreme awareness of slightest symptoms with
depression and wish to die are some of the feelings expressed
by such asthmatic.
e. Under-sensing the symptoms of asthma is also not safe. Many
a times patient has severe airflow obstruction-as measured
by peak flow meter but the patient does not feel it and the
attack may reach a dangerous state.

Qtfmimscences of a <Partcipant
1
Km *- S Sreeldkshmt is a young girloften years. She was suffermgfrom Asthmafor
nearly two years and~was always Bstfess due to weariness on account ofwheezing
and blocking ofnose. On a suggestionfrom an acquaintance she was admittedtoa
three weeks yoga therapy camp organisedBy I nekananda Kjmdm, Regular -Practice
of what she learnt vt the camp helpedher immensely. She is now very active, cheerfuC
anduashxtfyasagvlof her age should fe-Qto^yMngamd
which made her healthier, she now goes about humming bhajan/songs and takes
interest w extra-curricularactivities reading good books besides what is prescribed
for her class. She has a lot to thankjl'tvek&nandd Kfndra as Asthmatic attackjs
now a thing of the past andlifts its ugly form rarely.

^Parents of
Kun S- Sreeldkshmt
 Yoga for Asthma

MANAGEMENT OF ASTHMA
Asthma is a chronic inflammation of the airways. Although the
disease remains episodic and seasonal with reversible airway
narrowing with symptom free periods lasting several months.
We now realize that many asthmatics have chronic airway
obstruction which cannot be completely reversed. This
irreversible loss of airway caliber is secondary to structural
changes in the airways called airway remodeling. Thickening
of the airway wall by scar like tissue just under the inner lining
of the bronchus (subepithelial fibrosis) is the cornerstone of
remodeling. Goblet cell hyperplasia, submucosal gland
hypertrophy and increased vascular permeability, are other
changes that are all initiated by chronic airway inflammation
involving more than fifty inflammatory mediator chemicals. What
we have come to realize is that these changes occur early, within
the first few years of diagnos of asthma. Any plan for long-term
management of asthma should therefore be aimed at managing
the underlying airway modeling and not just manage the
symptoms.

What are the preventive measures?

Although a diagnosis of asthma may seem to lead inevitably to
the use of drugs to control the condition, there are several ways
in which you and your family can help reduce symptoms,
a) House dust: Cleaning of house dustmite is very important
to prevent asthma it may be very expensive. Sprays to kill
the mites are ineffective on their own in controlling asthma.
Carpets and loose fittings should be removed. Cuddly toys
should be put in the deep freeze for 12 hours a week to kill
the mites.
m
 Yoaa for 3jtfima
v

b) Pets: Getting rid of domestic pets is a contentious issue.

Where there is undoubted allergy to cats, dogs or rabbits, a
balance has to be struck between control of asthma using
inhalers and the grief that can be caused by banishing the
pet!
c) Bedroom temperature: Some prefer the cooler night air,
other people will find it causes them to wheeze more,
particularly if they have to get up at night for some other
reason.
d) Food allergies: A small proportion of patients with asthma,
particularly children, undoubtedly have food sensitivities.
True food allergy is not particularly common but is
undoubtedly more common than many doctors believe. Skin
tests can be very misleading and should not be relied upon to
diagnose or exclude food allergy. A clear history of, for
example, wheezing within minutes of eating a peanut, is easy
to recognize, and the best treatment is avoidance. On the other
hand, sensitivity to dairy-products or wheat is more difficult
to recognise because the effects are more chronic and not so
dramatic.

Drug therapy
The whole aim of managing asthma is to put you, the patient, in
control of your asthma rather than have the asthma being in
control of you. It is very important to avoid certain drugs that
cause asthma or make it worse. Aspirin, beta-blockers, which
are used in treatment of hypertension, anxiety & palptation are
some examples. Even if you have been taking these medications
for some time without problems, if you develop wheezy
breathlessness, stop taking these tablets.
Drugs for asthma are divided into two categories: relievers and
preventers. The reliever medicines work quickly and control the
symptoms and attack of asthma. The preventive medicines
prevent the onset of symptoms by controlling inflammation.

36
Drugs for asthma are administered m injection, tablet, syrup or
aerosol. Aerosol through inhaler devices is the fwelerred mode
of administration. With aerosols, the dose and the side effects of
the drug are much less, and therapeutic effect» better. Devices
used for inhaled medications arc the metered dose inhaler iMUl).
dry powder inhaler (DPI) and nebulizer
The following guidelines by mt>dern medical experts, employ a
graded method of controlling asthma symptom* using the
minimum amount of medication.
Step I
Most asmtnatics Frt into this level. You are advised to use rhe
relief inhakrs as required If your use t>f the relief inhaler stays at
less than one puff a day on average, no farther drug treatment
need be considered.
Step2
If you are u^ing mure than i w puff a day of relief inhaler on an
average, you need a preventive inhaler.
Step 3
If your symptoms persist, go on to higher doses of inhaled
preventive treatment or consider adding another drug.

Step 4
If you are still having problems the use of even higher doses of
inhaled preventive treatment, oral steroid use and nebulisers and
other treatment options will be considered.

What drugs are available as releivers?

Beta-2 agonists, theophylline and Ipratropium are included in

this category.
Sympathomimetic Drugs {Beta-2agonists)
Beta -2 agonists are also available as inhaled preparations. Inhaled
preparations are better because the inhaled drug even in a small
dose causes equal or better bronchodilatation and the action is

How Drugs act on Blocked Airways

PREVENTERS RELIEVERS
Acting on Inflamed lining Acting on Contracted Muscle

much quicker. Salbutamol and terbutaline are short-acting,

whereas salmeterol and formeterol are long-acting beta-2
agonists. Short-acting medicines are very good reliever
medicines for treatment of an attack of asthma and for pretreating
the symptoms associated with exercise. However, regular long-
term usage has recently been associated with diminished control
 Yoga for Jistfima

of asthma. Therefore, it is recommended that use of short-acing

beta-2 agonist should be kept to a minimum. Long acting inhaled
beta-2 agonists are used to enhance long-term control of asthma
symptoms, including those of nocturnal asthma symptoms.
Short and long-acting beta-agonists can be used as reliever
medications or as adjuncts for long-term control, but neither has
any anti-inflammatory activity; should not be considered as
primary therapy.

Theophylline
There are two types of formulations of theophylline: short-acting
and the sustained-release. Sustained-release theophylline has
more uniform absorption and longer half-life. It inhibits both early
and late asthma reactions after an allergen is inhaled. It has some
anti-inflammatory effects as well.
Theophylline can have adverse reactions. Nausea and vomiting
are early common adverse effects. Other rare effects include
tachycardia, arrhythmia, diuresis-seizures.

Anti-Muscarinic Drugs
In the history of treatment of asthma, Datura (Vcjmis mentioned
as the first inhaled medicine and the hukka (|^JT) as the first
inhaler device. Both were discovered in India. Ipratropium
bromide and oxitropium are the therapeutic agents of this class.
These agents are used as additional drugs in patients with severe
persistent asthma. These can also be used as an alternative to
beta-agonists, as first line therapy in chronic bronchitis, and in
patients of asthma who do not respond to beta-agonist or when
beta-agonist cannot be used particularly in the late onset asthmatic
patients. They counter the hyper-reactive para-sympathetic nerves
in bronchus.
Dry mouth, blurred vision, glaucoma and urinary retention are
the side effects with these drugs. However, these side effects are
very uncommon with inhaled anti-muscarinic compounds.
m
 Yoga for Asthma

Preventive therapy : Anti-inflammatory drugs

Controlling inflammation has become a central objective of
asthma therapy. Better control of inflammation is essential for
better control of the disease and may open the door to alteration
of the disease course. Control of inflammation can occur at
several levels. In allergy-driven asthma, environmental measures
are. very important, as they eliminate disease "triggers."
Pharmacologically, inflammation control has been accomplished
primarily by use of corticosteroids. Inhaled or oral steroids have
been shown to decrease populations of inflammatory cells and
cytokines in the airways of asthmatics. Improvement in
inflammation is associated with improvement in pulmonary
symptoms. The effect likely relates to an interruption in the
inflammatory cascade.
There are three main types of preventor drugs : inhaled steroids,
Cromoglycate(Intal) and Nedocromil (Tilade).

Inhaled steroids
The word 'steroid' conjures up
disturbing pictures in many
people's minds, and there is much
misinformation circulating about
these very effective drugs.
These steroids are not the anabolic
steroids used by body builders and
illegally by some athletes.
The inhaled version used as preventive treatment is the same
sort of drug as tablet steroids used for acute attacks of asthma
and, for example, in some patients with arthritis.
The dose of the inhaled drug is extremely small compared with
that contained in steroid tablets. For instance, two puffs twice a
day of a 'Becotide-100* inhaler delivers 400 micrograms of drugs.
In acute asthma, six 5 milligram tablets of steroid will be given
ran \
 'Yoga for Jtstftma

per day equal to 30, 000 micrograms of drug i.e., 75 times the
dose delivered with 9 puffs/ day.
The side effects of inhaled steroids are few compared with those
of oral steroids but, most importantly, are very much less than
the dangers of undertreated asthma.
Five percent of patients on inhaled-steroids will complain of a
sore or dry mouth (sometimes this is due to thrush) and huskiness
of voice; such as teachers or telephone operators.
At higher doses (1500 micrograms per day or more), particularly
in older patients, side effects, may be more disturbing and can
be minimized by mouth-washing after each dose and by use of
large volume spacer devices which act as 'reservoirs' and
markedly reduce the amount of drug deposited in the mouth.

Chromoglycate
Sodium cromoglycate has been available for as long as inhaled
steroids. It is a very good form of prevention in the milder forms
of childhood asthma, particularly in controlling exercise - induced
symptoms. It needs to be used three or four times a day, a
disadvantage when compared with inhaled steroids, but it can
be used simply before exercise to prevent exercise-induced
symptoms and has virtually no side effects.

Nedocromil (Tilade)
Nedocromil sodium has a preventive strength similar to that of
low-dose inhaled steroids and comes as a mint-flavored dry
powder aerosol.

Leukotrienc blockers (Singulair, Aecolate)

The leukotriene blockers (Singulair, Aecolate) are a completely
new form of asthma treatment. They are essentially preventive
drugs but do have slight broncho-dilator effects. So far, these
drugs seem to have relatively few side effects, reassuring for a
tablet medication.
Yoga for Jisthma

Management of Asthma in Emergencies

When an acute attack of asthma occurs there are two mainstays
of emergency treatment available: big doses of reliever drug
(often via a nebuliser) and big doses of an anti-inflammatory
drug (injected or oral steroids). Some patients will be able to
self-start emergency treatment with a nebuliser and/ or a course
of tablet steroids, but for most patients who have not had a
severe attack before, they should contact their GP as quickly as
possible or attend the local casualty department. Delay can be
very dangerous and it is better to be safe than sorry.
Complementary Therapies
There is considerable interest in the role of alternative or
complementary therapies for the treatment of asthma. This is
due to worries about the side effects of conventional medical
treatment and a belief that 'natural substances' are better for
asthma than drugs.
Although virtually all of the available standard asthma treatments
(drugs) have been proven in properly controlled trials of
efficacy, very few complementary approaches have been
scientifically asessed. This is why many doctors pour scorn on
such forms of treatment. Yet complementary practitioners often
quote anecdotal stories of benefit. Consistent successes over
many years show that these treatments also do work carefully.
This has resulted in a polarization of belief between those who
feel that conventional medicine is the only suitable treatment
and those who regard conventional treatment as verging on the
poisonous!

Psychological Methods
1. Psychotherapy
In this method, you become aware of the psychological conflicts
through discussions with the psychiatrist. The supressed
emotions in the psyche that were disturbing the autonomic
 Yoga for Jistfima

balance to cause asthma or nasal allergy are brought to the surface

which can now be handled through knowledge and self-analysis.
Fear, nervousness and anxiety
• Try to search a factor constantly bothering you.
• Introspect, analyse pros and cons and discuss it with your
doctor.
• Drugs for emotional stress: There are large number of drugs
available for anxiety disorders but the problem is that these
drugs lead to depression of respiration. Hence they may prove
fatal if taken at the time of severe asthma. Though, in stable
asthma lower dose of sleeping pills does not pose an increased
risk. The basic rule is to avoid anxiolytic drugs if problem is
solved with psychotherapy and reasoning. If necessary, these
can be taken for short periods and in minimal dose.
Laughing
• Laughing aggravates asthma, but it does not mean that you
should not laugh. You should but in asthmatic style. Take a
deep breath and laugh till half of breath comes out. Avoid
spasmodic laugh causing complete emptying of lungs.
• If you are going to a party with your friends and expect lot of
fun and laugh, it is advisable to take an extra dose of inhaler
before going to party.
Emotional swings, elation and depression
• An asthmatic patient should control emotional swings and
must continue medicines regularly despite these swings.
• Parents of an asthmatic child should make introspection to
assess their interference or over-protection in the life of the
child.:
Stress-induced asthma in children
• Parents should observe a child and try to find out whether
the child is using asthma to get extra favour and sympathy.

43
 In case of doubt, try to measure asthma in morning and
evening by a peak flow meter. Normal range reading will
indicate psychological problem.
Oversensing & undersensing Asthma.
• Both under-sensing & over-sertsing the problem of asthma
are wrong. The solution lies in regular measurement of asthma
.with the help of peak flow meter. You should learn to correlate
symptoms with peak flow measurements.
• You should realise that if peak flow is low but you do not
feel any symptoms, it means asthma is progressing.
• If you are over-sensing the problem of asthma, peak flow
measurement would be near normal. If reading is near your
personal best, you should assure yourself that it is not the
disease but the psychological factor and instead of taking
drugs you should use onlyyoga techniques of chair breathing.

2. Behaviour therapy
This is based on the principle of learning. This is a process of
deconditioning of conditioned reflexes. The sneezing and
bronchospasm are reflexes responding to various types of irritants
and the body has somehow learnt (conditioned) to over-use these
inflammatory responses and autonomic reflexes. The
psychologist tries to teach you deconditioning by working from
the mind level through reward-punishment technique to stop the
hyper-responsiveness of this broncho-constriction loop.

3. Hypnotherapy
Some patients get great benefits from hypnosis; it helps to cope
with acute attacks or worsening of asthma. Hypnosis is a
technique in which the hypnotist, through suggestions, pushes
the psyche into a dream-like state. In this state of mind the
subject's body and mind simply respond to the suggestions
without any resistance. There are two stages of hypnosis. In stage
I, the subject can only experience the suggestions at his mind
:
 Yoga for Jist/ima

level whereas in stage II hypnosis, the person can bring about

changes at body level. For e.g., a piece of cold iron rod can
produce severe pain and a bleb when suggested that it is a red
hot piece of iron. Hypno-anaesthesia is widely used in dentistry.
The subject simply benumbs his own gums under hypnosis and
tooth extraction is carried out.
Under a hypnotic state, a single suggestion to relax the bronchus
is sufficient to relieve an attack of asthma or nasal allergy. An
asthmatic who learns the technique of auto-hypnosis can often
overcome his episodes without resorting to drugs. Hypnotic
psychotherapy also contributes to remove the internal conflicts.
Hypnotherapy works purely through tapping one's o wn mental
po wer to correct the disturbances at the body le vel.
Stabilising the vital energy
1. Homoeopathy: By using minute quantities of potentised
drugs, the disturbances in the vital energy flow is corrected.
Through this method, the symptoms move from centre to
the periphery before it finally disappears. Thus an asthmatic
might develop worsening of his nasal symptoms or the skin
manifestation before it finally disappears. There are several
examples of asthmatics who have been helped to a great extent
by this method.
2. Ayurveda: According to ayurveda asthma is a peripheral
manifestation of a deeper imbalance. The vata, pitta and kapha
are the three aspects of the vital energy that carry on the
functions of the body. A balance of all these three, maintains
normal health. Whenever there is over-functioning of any of
these three (excess of kapha in case of asthma and nasal
allergy), ill health results. By various herbal preparations,
food habits and lifestyle modifications, you try to set right
this vital imbalance.
3. Acupuncture.The disturbances in the flow of vital energy
'Qi' or 'Chi' that has caused the disease is set right by

45
 Yoga for Jksthma

samulating appropriate points ^ ^ ^ ^ ^ ^ ^ ^ ^ ^

along the specific meridians j^^^^^^^^B
(called Yin & Yang) in which ^^^^p^^^l
the flow is disturbed. This is
done by using sharp needles
stuck at the right points at
various depths from the
surface of the skin to reach
these points along the
channel. There is no doubt
that acurxincture has found more acceptance in medacM circks
than have other forms of complementary therapies,
particularly with regard to pain relief. It is also oaae of ibe
lew alternative approaches that has been property tesied in
clinical tests in asthma. Minor benefits h a w been sbowss in
mild asthma, but acupuncture has not been shown t© iNe of
help in patients with more severe asthma.
4. M^s*eto-t&er*pr: It is nowadays becoming evades* ihai
magnetic fields can create disturhances in vital eraeigy ftsftnoce..
In an experiment, rats with their head facing north and body
axis along the North-South line showed greater lesSfcssaess
than those oriented in other dnvctiora. OcmivSIIeJ
feiki treatments on asthmatics h a w sK>wn h e a e S i ^ dBFects.

Yoga Therapy
The definition of Yoga and
the principles of Yoga
therapy are discussed in the
next chapter Yo$aitarapv
techniques correct the
problem from the most
fundamental level The
oomvt*ons aiv sought
the innermost law* of owj
, Yoga for Asthma

existance (Anandamaya Kosa or the soul or the will the master

of the system). A total correction of the bodily disturbances is
brought about by correcting the disturbances at the emotional,
psychological and the vital energy levels. The integrated
approach uses several techniques with an unique aim of reaching
a state of total silence or calmness of mind or deep relaxation
and rest.
It is not an exaggeration to say that yoga combines the effects
of all the methods mentioned earlier. Let us now see how this is
achieved.

a. Psychological level
1. Yoga is a method to turn
the mind inwards and
achieve deep awareness
of functions of internal
organs. Internal awareness
helps to solve one's own
internal psychological and
emotional conflicts as we
saw in psychotherapy.

2. The internal awareness helps to change the learnt conditioning

and helps to change the pattern of psychological and
physiological responses as in behaviour therapy.
3. Yoga is a technique of
unfolding the potential PERFECT
HEALTH
divinity within, so that the
dormant capabilities are snoHA srwm

opened up consciously. Just NORMAL

HEALTH /y
like in hypnotherapy, every //"*£MJ\ Soul o TotcntiM/fy Vniot

man can tap his dormant SICKNESS < / / <7fc QotlU to mnaftsl t*r
T>wmty with a "
capacities or altering his
own physiology under the

47
Yoga for Asthma

effect of a simple suggestion. Through yoga one does this

consciously with self-mastery over such states of
consciousness. This is achieved through the total cessation
of internal dialogue of the mind. It is known that yogis in
such states of deep inner poise can, not only alter their
physiology but can master the laws of nature (external too)
as in Siddhis.
b. Vital energy (Prana) level.
Prana is the life energy that
gives life to each and every
cell of the body. It is said
that imbalances, blockages
in the flow of prana in the
prana channels (Nadls)
cause diseases. The cause Pranayama is the skill to
of the disturbed flow is slowdown the breath
believed to be excessive
speed.
Yoga provides several techniques of getting mastery over this
life energy (Prana). Pranayama corrects the disturbances in the
flow of these energies that make all organs function efficiently.
An attempt for correcting the disturbances in vital energy flow,
we saw, has been tried in Homoeopathy and Ayurveda by drugs
and non-pharmacologically by acupuncturists and magneto-
therapists. Yoga corrects the alterations in the Prana flow by
slo wing do wn the Prana activity gently and cautiously through
conscious, slow, rhythmic breathing. Once slowed down, the
disturbances are set right automatically.
c. Body level
1. Pranic disturbance during acute attack: At the physical level,
yogasanas, enhance local relaxation and improves tolerance.
There are several examples of asthmatics practising yoga,
who learn to relax their bronchus during an attack of asthma
48
. Toga for JJsthma

without resorting to drugs. The

deep relaxation reduces the
element of panic during an attack
so that one can direct their mind
inwards to relax their bronchus.
The relaxation of the voluntary
muscles slowly extends to the
in voluntary muscles too. We may
compare this action of yoga at the periphery to reliever
inhalers containing sympathomimetics.

2. Internal Bio-feedback: Further, the internal awareness of

the state of the bronchus
provides a feedback to
learn the art of relaxing
one's own bronchus by
auto-suggestions like in
the case of bio-feedback
SAMATVAM Y O G A U C H Y A T E
where one masters the
involuntary functions of b a l a n c e it y o g a

the body.

3. cGMP - cAMP imbalance. We have seen that the bronchial

hyper-responsiveness is manifestation of the imbalance due
to the excess of cGMP over cAMP in bronchial wall. This
imbalance is due to over-activity of the parasympathetic
nerves that supply the bronchial muscles.

Can yoga correct this chemical imbalance ?

Yogic deep relaxation and rest decrease the overall activity
of the nervous system leading to remarkable reduction in
discharge frequency and the trigger threshold. This can be
very easilly recognised by practitioners of yoga at their
emotional level. After the practice of yoga one feels so calm
inside that the same situations which enraged him earlier

49
Yoga for Jistfima

would no longer trigger his anger. The duration and force of

the anger or anxiety or any emotional reaction go on reducing
with yoga practice. As one stabilizes this with regular
practices over a few array of fears, huge impulses from the
emotional cortex to the Hypothalamus die down. The over
reactive pathways get retrained to function normally and
trigger threshold of parasympathetic nerves go on reducing.
This effect on the nervous system is the one that can reduce
the excitement of the para-sympathetic centre so that intrinsic
tube of asthma comes under control.
Thus, Yoga by definition is a technic to acheive balance
(Samatvam yoga). This balance that is experienced at the
psychological level percolates into the physiology as
homoeostasis and corrects imbalance at the Autonomic
Nervous System level.
4. Yoga has a stabilising effect on the immune system of the
body. It is known that yoga can increase tolerance to
infection by increasing the overall health and also the local
resistance to infections in the respiratory passage. It was
observed that the frequency of upper respiratory infections
during one year reduced significantly after regular practice
of Transcendental Meditation. In infection-induced asthma,
the frequency of asthma reduces remarkably once the
infection frequency reduces. This has been observed by many
of our young patients with infection-triggered asthma.
5. Desensitization: Kriyas may help in developing tolerance to
external agents, similar to desensitization therapy for allergens.
For example, in a practice called jalaneti one washes the nose
with luke-warm saline water and in Sutraneti a thread or a
rubber catheter is introduced into the nose. Here the water
and the rubber tube being irritants off the nose, the hyper-
responsive nasal mucosa would trigger off a whole chain of
events including excessive sneezing, rhinorrhoea (water
 Yoga for Asthma

running from the nose) and nasal blocking. But under the
background of deep relaxation and use of will-power, the
person learns to tolerate these irritants without any of these
reactions. In other words, these kriyas have taught how to
tolerate the irritants entering the nose without reacting
violently. Similarly the excitability of the nerve endings in
the bronchial wall to various irritants causing asthma also
can be reduced by another kriya called Dhouti.
This yogic desensitization or stamina building (Titiksa)
brought about by graded exposure to non-specific irritants
in the background of deep relaxation is comparable to
immuno-therapy in which increasing doses for specific
allergen are presented in the form of injections so that the
system gets desensitized to that substance.
10. Differentyogasanas help to correct thepostural abnormalities
and improve the respiratory stamina. They may also help in
drainage of secretion. The breathing exercises especially the
chair breathing technique trains diaphragmatic breathing,
which is a big help during attacks.
 Yoga for Asthma

A. D R U G S F O R A S T H M A

Drugs Level of action Side effects

I. Relievers
1. Salbutamol- Short acting reliever • Mild effect on heart
Terbutaline Selective activation of (32

bronchial sympathtic • Gastritis

nerve endings

2. Salmeterol long acting reliever Habituation and

Formeterol P sympathetic agonist
2 ineffectiveness
after long-term use.

3. Ipratropium blocks, parasympathetic - Dry mouth.blurred

Oxytropium nerve endings vision, glaucoma,
urinary retention
4. Theophylline Bronchial muscle Sleeplessness
group relaxation Gastritis
5. Antihistamines Neutralises histamin in Drowsiness
bronchial & nasal lining Tolerance

II. Preventers
1. Cromoglycate Prevents Antigen- Almost nil
antibody union
2a. Steroids • Anti inflammatory effect Long-term usage
inhalers Stabilises mast cell wall growth retardation,
Beclamethasone • Primes sympathetic oral fungal infection,
Budesonide nerve endings hoarseness of voice,
Fluticasone • Softening of muscle loss of taste, cataract
2c. Oral or injected Life-saving muscle weakness
corticosteroids mode of action same as hypertension
Long-term use inhaled steroids diabetes
prohibited. osteoporosis
Leukotriene blocks minor side effects.
inhibitors inflammation following
Zafirlucast exercise, aspirin, allergens
Zi teuton
( Singulair, Aecolate)
 Yoga for Asthma

B. COMPLEMENTARY THERAPIES
Therapy Level of Action
I. Psychological methods

1. Psychotherapy Awareness of the psychological

conflicts and suppressions
2. Behaviour therapy Reflex learning. Reverse the
leamt-habit of sneezing and
wheezing
3. Hypnotherapy Utilise dormant powers of mind
in an altered state of
consciousness

II. Vital energy balance

1. Homoeopathy Corrects the disturbances in

the internal milieu

2. Ayurveda Corrects the excess or

deficiency of Tridosas,
Vata.Pitta & Kapha.

3. Acupuncture Flow of Qi (Vital energy)

along body meridians,
Yin & Yang balance.

4. Magnetotherapy Corrects vital energy distur-

bances by altering the
magnetic field effects.

C. YOGA THERAPY
The integrated approach of yoga therapy provides self corrective
t e c h n i q u e s to h a n d l e the p r o b l e m s at all levels physical, vital
energy, m i n d , e m o t i o n s , intellect and spiritual.

Practices Level of Action Comparison Kosa

Reliever
Bronchial muscle Broncho- Annaniaya (AK)
1. Chair breathing
relaxation dilator to A nandamaya
drugs (AnK)
 Yoga for Jistfima

2. Sithillkarana Stamina buikuiig Physio- (AK) to (AnK)

Vyayania & therapy
breathing practices
3. Krivas
r
Master> over hyper- Immuno- (AK) to (AnK)
reactive reflexes. therapy

4. Asanas Drainage of secre- Physio- (AK) to (AnK)

tions; Improves Therapy
general health;
Normalises the body
weight; Increases work
tolerance

5. Pranayania Set right • Ayurveda Pranamaya(PK)

imbalance of Prana • Homoeo- (AnK)
(vital energy) pathy
• Magneto-
Therapy
6. DRT relax the Bio-feedback (AK) to (AnK)
savasana involuntary therapy
muscles through
relaxing voluntary
muscle

7. Dhyana • Stabilisation of (MK) to (AnK)

(Meditation) nervous system
and emotions.
• Reduced metabolism
Parasympathetic
and sympathetic balance
8. Devotional • Emotional stability emotional (MK) to (AnK)
session • Reduced emotional catharsis
hyper-reactivity.
• Reduced hypothalamic
discharges, and central
vagal stimulations
9. Lectures, • Self-confidence Psycho- (Vijnanamaya
counseling • Awareness of one's therapy Kosa) to (AnK)
on yoga vedanta psychological conflicts.
philosophy Stress management
Happiness analysis
10. Karma yoga Working in relaxation Laughter AnK
Non-reactivity prevents build up therapy
to situation or suppression of
emotions
 Yoga for JZstfima

1 f 9 t L

HEALTH AND DISEASE - A YOGIC

PROSPECTIVE
Concept of Health and Yoga
According to the World Health Organisation (WHO) the state
of Health is defined as a state of complete physical, mental and
social well-being and not merely an absence of disease or
T
infirmity. W HO also suggests a fourth dimension spiritual well
being. It is clear from this definition that health and ill-health are
not two discrete entities as commonly understood but health
should be conceived as a continuous function indicating the state
of well-being.
In the diagram, the 3rd quadrant 'the region of ill-health'
represents what normally we designate as 'Sickness'. Below this,
man acts instinctively and is akin to animal man. Coming to the
first quadrant, the region of 'Normal Man' the state of normal
health is indicated. As he moves along the line further up, he
becomes healthier featured by the dormant faculties expressing
more vividly in man. This is shown as the region of Super Man,
the next region after the
human spectrum. In this
state, the limitations of
normal man namely the
strong urges of thirst,
hunger, fear and sex are
reduced greatly and are
fully under control. In the
concept of Sri Aurobindo,
the new faculties of deeper
Yoga for Jistfima

perceptions of the world beyond the five senses emerge in this

phase of superhuman existence. Further growth leads man to
unfold even deeper layers of consciousness and widen the
spectrum of his knowledge to move towards divinity or perfection.
In this march towards perfection, Yoga is a systematic conscious
process for accelerating the growth of a human being from his
animal level and ultimately to divinity. It is a systematic
methodology for an all round personality development-physical,
mental, intellectual, emotional and spiritual components-of man.
Thus, Yoga in its general methodology for the growth of man to
divine heights includes techniques useful for therapeutic
applications in making man healthier.
Before we proceed to understand the generation and implication
of illnesses, we need to understand yogic concept of human
body.

Understanding Yoga
The term Yoga has its verbal root as "3*1 (Yuj) in Sanskrita. Yuj
means joining. ^ T c l 3#T ^fr %T : (Yu jyate anena iti yogah)
Yoga is that which joins. What are the entities that are joined?
In the traditional terminology it is joining of ^CUCHI (Jivatma)
with H<HICHI (Paramatma), the individual self with the SELF. //
is an expansion of the narrow, constricted egoistic personality
to an-allpervasive, eternal and blissful state of REALITY.
Patanjala Yoga is one among the six systems of Indian
philosophy known as Sat darsanas. One of the great Rsis (Seer),
Patanjali, compiled the essential features and principles of Yoga
(which were earlier interspersed in Yoga Upanisats) in the form
of 'Sutras' (aphorisms) and made a vital contribution in the field
of Yoga, nearly 4000 years ago (as dated by some famous western
historians). According to Patanjali, Yoga is a conscious process
of gaining mastery over the mind. We will see the details later.
The scope of Yoga as portrayed in Bhagavadglta and Upanisats

56
 'Yoga for Jistfima

is far more comprehensive. As Swami Vivekananda puts it "It

is a means of compressing one's evolution into a single life or a
few months or even a few hours of ones bodily existence". In
general, there is a growth
process, due to interactions BASIC INSTINCTS

with nature in all creation.

But it may take thousands
and millions of years for
this natural growth; that is
Ahara nidra bhaya maithunam ca
the long, instinctive way in samanyametat pashubhirnaranam
animals. Man, endowed Budhlrthl Tesam adhikovlshesah
with discrimination power, Budhirvihinah pashubhlh samanah

conscious thinking faculty

ff^(Buddhi) and well-developed voluntary controls aspires to
accelerate his growth. YOGA is that systematic conscious
process which can compress theprocess of man'sgrowth greatly.
Sn Aurobindo emphasizes an all-round personality development
at the physical, mental, intellectual, emotional and spiritual levels.
He means by Yoga a methodical effort to wards self-perfection
by the de velopment of the potentialities latent in the individual.
It is a process by which the limitations and imperfections can be
washed a way resulting in a Super-human race.
Thus, Yoga is a systematic process for accelerating the gro wth,
of a man in his entirety. With this growth, man learns to live at
higher states of consciousness. Key to this all-round personality
development and growth is the culturing of mind.
We will now see how different texts on Yoga, define yoga.

Definition of Yoga
As mentioned earlier, Fatanjali defines in his second aphorism,
%I: fai^m" ftTta: Yogah Citta Vrtti Nirodhah. (Yoga Sutras: 1.2)
Yoga is a process of gaining control over the mind. By so
controlling the mind we reach our original state: ?T^T
57
^cR^HH, 'Tada drastuh YOGA
svarupe a v a s t h a n a m ' IS THE SKILL TO CALM
DOWN THE MIND
(Yoga Sutras 1.3), then
the Seer establishes
himself in his causal state.
This is the technique of
TOGAH
'mind control' prescribed
by Patanjali.

Control involves two aspects - a power to concentrate on any

desired subject or object and a capacity to remain quiet when
required. All of us have been developing the first aspect namely
concentration. Rarely, the second capacity of man to remain calm
and silent has been harnessed. Yoga mainly emphasizes, this
second aspect. In Yoga-Vasistha one of the best texts on Yoga,
the essence of Yoga is beautifully portrayed thus: *H: H ^ I H - I I H N :
%T'$rqfasfclvT 'Manah Prasamanopayah Yoga ityabhidhiyate' -
Yoga is called a skilful trick to calm down the mind. It is an
3tM:(Upayah) a skilful subtleprocess and not a brutal, mechanical
gross effort to stop the thoughts in the mind.
An unskilled layman trying to repair a radio is almost sure to
spoil it, while an experienced and skilful person knows exactly
on what to lay hands and to rectify the malfunctioning. He
operates at the right place. Knowledge is the key. Similarly, in
the control of mind, a novice tries hard and gets disgusted when
he finds himself more 'messed up'. Yoga gives him the necessary
techniques to operate at the right place at the right time to gain
complete mastery. This skill is the trick of alio wing the mind to
calm down and not to use brutal force to stop it.
One of our asthma patients would sit up in the middle of the
night with an episode of asthma and shift her mind to a state of
total inner quietitude through chanting on OM and thus succeded
in stoping all her medicines to remain free from asthma after 6
months of regular practice.
58
 Yoga for Asthma

In action, Yoga is a special skill which makes the mind reach

its subtler state: ^ ^ ^ K r l ^ ' Y o g a h Karmasu Kausalam'
(Gita 2.50), Yoga is dexterity in action. The dexterity is in
maintaining relaxation and awareness in action. Relaxed action
is the process. Efficiency in action is an outcome. Thus, Yoga
is a skilful science of gaining mastery over the mind. Yoga is
normally and traditionally conjectured and popularly known as
a process or a technique to reach the ultimate state of perfection.
However, yoga is even defined as the states of higher powers
and potentialities and as the ultimate state of Silence. Further
yoga is also described as the power of all creative endeavours
and creation itself.
The subtle state of mind featured by 'Steadiness' is referred to as
Yoga. Yoga is a state of great steadiness at emotional level;
balance of concentration and detachment at mental level and
homeo-stasis at body level. It integrates the personality by
bringing body-mind coordination in a well-balanced way.

Thus, Yoga is
i. a process for elevating oneself through calming of mind,
ii. also the very states of higher, subtler layers of mind (and)
iii. conceived as a creative power in man and that of the Reality
itself.
3. The Five Sheaths of Existance
In the tradition of Yoga and Upanisats there are five aspects
of existence of man. The first and the grossest - the physical
frame which we are all so familiar is called Annamaya kosa.
The second subtler sheath is the Pranamaya kosa featured by the
predominance of Prana, the life principle. Through the invisible
channels called NADlS in this sheath How the PRANA.
The next sheaths in the order of subtlety are :
i. Manomaya Kosa, ii. Vijnanamaya Kosa and
iii. Ananadamaya Kosa.
'Yoga for Asthma

THE FIVE SHEATHS (KOSAS) OF OUR EXISTENCE

A schematic diagram shown in indicates Anandamaya Kosa as

the outer most and the subtlest. As the sheaths become subtler,
the freedom of operation in the living beings increases, the
bondage decreases and the bliss associated with it also increases.
While in Manomaya Kosa the creative power predominates, in
Vijiianamaya Kosa it is the power to discern and discriminate.
Bliss is embodied in Anandamaya Kosa, the highest stage of
evolution in the manifested existence. It is the subtlest among
the five sheaths of existence. In his journey towards the Ultimate,
Man crosses these sheaths of existence one by one. Through
analysis called 'Pafica Kosa Viveka' (Knowing through
experience, one's five sheaths of existence) and the associated
practices called 'Tapas', man transforms himself by gradually
getting relieved from the bondages and constrictions of each
sheath. This is one of the methods of reaching the ultimate
goal enumerated and described in the Upanisats.

4. The Science of liinesses

In Anandamaya Kosa, a man is the healthiest with a perfect
harmony and balance of all his faculties. At Vijiianamaya Kosa
there are movements, but are channelised in the right direction.
As such, it is in the Manomaya level where imbalances start, say
the Yoga texts. Likes and dislikes have come to play at this
 Yoga for Jistfima

level. These imbalances amplify themselves resulting in mental

illnesses called 'Adhis'. At this stage there are no symptoms at
the physical level. Prompted by the perpetual growth of desires,
these mental diseases,
Ajnana(3TfR) concealed in YOGIC CONCEPT OF DISEASES
us, begin to manifest
themselves externally.
Gradually they percolate
ADHIJA ANADHIJA "\
to the physical frame. Stress bom Psychosomatic Non Stress bom
Preponderance of Ajnana Somatopsychic Infection
Hysterical Injury
(ignorance about one's neurosis Toilns

real state of bliss) leads one

to perform wrong actions
as the eating of unwholesome food, living in unhealthy dwellings,
doing things at untimely hours, injuries inflicted, association
with the wicked, evil thoughts, etc. These breed physical diseases
called Vyadhis or the secondary diseases.
The Adhis (primary diseases) are two-fold-Samanya (ordinary
and Sara (the essential). The former includes the diseases
incidental to the Body while the latter the rebirth to which men
are subject. The Samanya are normally produced during the
interactions with the world. These may be termed as
Psychosomatic Ailments. When dealt with suitable techniques
and congenial atmosphere, Adhis of this ordinary type will
, vanish. Along with it are destroyed the physical ailments, Vyadhis
caused by these Adhis (AdhijabVyadhayah). The subtler Adhis
of the essential type, Sara, which cause the birth of the physical
body can be destroyed only by the Realization of the causal states
of mind and a corresponding ability to live in Vijnanamya and
Anandamaya Kosas. In that case, man transcends the cycles of
birth and death.
This concept of Vyadhis caused by Adhis is summarised
schematically in Figure 3. The figure also depicts the second
class of ailments Anadhijah Vyadhayah-those not or iginated

61
Yoga for Asthma

REMEDIES
SnBTTOAL
:far
Thr cyclejoi J
Self
Birth ADeatftaf
The Physical Body

SAMANYA MENTAL
1—| Odiaaty
Coagealal

Ptychoa
kcaalqac
•Hmcals o a o d aaoag
l wilh the w « U
PHY S E A L
ANADHOAH

Iafedioas A
Adhi Coaiagioax Di*
Goatf aclioa*

A Schematic D i a g r a m o f A i l m e n t s

by mind. These would probably include the infectious and

contageous diseases. Through conventional medicines (the
chemotherapy of modern medicine can come under this
heading).

5. The Psychosomatic Illness

Among the two types of Adhis, the Samanya (ordinary) type
corresponds to the modern psychosomatic ailments.
The yoga texts say:
When the mind is agitated during our interactions with the world
at large, the physical body also follows in its wake. These
agitations cause violent fluctuations in the flow of Prana in the
Nadis. The Prana flows in wrong paths flying from one to other
without rhythm and harmony. The Nadis can no more, in this
condition, maintain stability and steadiness, but quiver. Due to
these disturbances in the Prana and unsteadiness in the Nadis,
the food does not get properly digested. There arises Kujirnatvam
(wrong digestion), Ajirnatvam (non-digestion) and Atijirnatvam
(over-digestion). When this improperly digested food settles
down in the body amidst such commotion, it results in ailments
of the psychosomatic type. This process of Adhi becoming
62
 Yoga for Asthma

Vyadhi is shown schematically Contained in this process of

generation of psychosomatic ailments as the method for treating
such ailments.

6. The Integrated Approach

Disturbances in the Manomaya Kosa percolates into the physical
sheath (Annamaya KoSa) through the Pranamaya Kosa. Hence,
in the treatment of these Adhija vyadhis it becomes mandatory
to work at all the levels of existence to bring about quick results.
The integrated approach, thus, consists in not only dealing the
physical aspect of the problem, but use techniques to operate on
all layers of our existence. The large number of Yogic practices
available in the texts of Yoga and Upanisats are adopted to
balance and harmonise the disturbances at each of the Kosas
and tackle this set of complex psychosomatic ailments.

(a) Annamaya Kosa Practices : The Physical body

Kriyas, loosening movements and Yogasanas are used to operate
at the Annamaya Kosa level, to remove the physical symptoms
of the ailments.
(i) Kriyas are Yogic processes described in Hatha Yoga to
cleanse the inner organs of our body.
c '
Kriyas
• Activate and revitalise the organs
• Tone up the functions of organs
• Desensitize, the hyperactive reflex loops
• Promotes deep internal awareness.
I . '
Among the major Kriyas enumerated in the text of Yoga
simplified versions of a lew Kriyas like catheter Neti, Jala Neti,
Kapalabhati, Agnisara, Vaman Dhouti (Kunjala Kriya) etc., are
used extensively.
Yoga for Jistfima

(ii) Loosening exercises : Very simple yogic physical

movements to mobilise and activate particularly affected
parts of the body are used. Some easy physical exercises
are adopted to fulfill the needs of the particular ailments to :

Physical
• Loosening the joints
• Stretch and relax the muscles
• Improve the strength & stamina

(iii) Yogasanas: Yogasanas are physical postures often imitating

the natural positions of the animals, meant to tranquil the mind.

Asanas
• Physical revitalization.
• Deep relaxation and mental calmness.

(b) Pranamaya Kosa; The Sheath of Prana

Prana is the basic life principle. Pranayama is a process for

gaining control over Prana. Illnesses have characteristic prana

DHARANA
(Focmlng)

Aijuna and the bird's eye

4
DHYANA
(Defocuilng)
Lens

abnormalities. Through practice of proper breathing, Kriyas and

Pranayama, these imbalances the Pranayama Kosa can be
corrected. Suitable types of Pranayama and breathing help to
remove the random agitations in Pranic Hows in the Pranamaya
Kola. Thu*. the ailments arc handled at this Franamaya Kosu
level.
(C) Munnmaya Koto : Mind Body
A direct operation on this level is made possible by the laM three
limbs OF As|anga Yoga OF Patanjali Dharuna. Dhy&mi and
Samadhi. The culturing ol mind is accomplished by focussing
OF the mind (l)harana) initially, followed by relaxed dwelling ol
the mind a single thought (l)hyumi) lor longer and longer
durations leading ultimately to SUPERCOIIHlousncss (Sammllu).
A progressive habituation
allows the mind LO remain I I

are numerous, interesting '**TT

and noteworthy. lis
application to (real many
psychosomatic ailments has become popular,
To handle and gain control over the basic cause lor mental
agitations, we use the Yoga techniques that control oui emotions.
A devotional session containing Prayers, (hunts, Mhiijaii*,
Nflmavalis, Dhuns, Ntntrfl* etc., help to build u congenial
atmosphere to evoke, recognize, attenuate and dissipate the
emotions. Thus, control over emotions is obtained through the
path of divine love. The emotional imbalances and upsurges urr
eliminated by such control,

(I)) VUfiflniHiiHyH Kofoi: Knowledge body

A basic understanding is the key to operate from Vijniuiumayu
Ko<u. tlpauisads are the treasury ol such knowledge which is
the redeemer ol all miseries and obsession. It is the lack o| that

{1}
inner J nana which is responsible for many wrony habits.
'Yoga for Jistfima

agitations, etc. The Happiness Analysis - Ananda Mimamsa -

of the Taittlriya Upanisat handles the most fundamental problem
relevent to all living creatures. It helps the person to change his
attitude of greed and deep attachment to material possessions
and enjoyments. The realisation that happiness is within and
'each one of us' in our causal state is 'Ananda' embodied,
remo ves all doubts, clears the mind and stabilizes the body. As a
result, man's outlook in life changes. Knowledge burns the
strong attachments, obsessions, likes and dislikes which are the
basic reasons for the agitations of mind. The Sara type of Adhis
can only be removed by this knowledge (Atma-Jnana or Self-
Realisation).
The approach of Yoga therapy has deep roots in Upanisats and
texts on Yoga. The basic set of yogic practices (see index) used
in the treatment of respiratory ailments has been developed on
the foundations of the integrated approach of yoga therapy
described above. They can be used for prevention, treatment as
well as rehabilitation of bronchial asthmatics. A set of such
practices is listed below.
The following is an extract from Laghu Yoga Vasistha (in
Samskrta) which describes the genesis of illnesses and suggests
the remedy for the same.

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Rama Uvaca

Kimvinasah kimutpadah sariresminmunlsvara,

Adhyayo vyadhayascaivayathavatkathayasu me. (1)
Dehaduhkham vidurvayadhimadhyakhyam vasanamayam,
Maurkhyamulahi te vidyatattvajnanapariksaye. (2)
Atattvajnanavasatastvinndriyakramanam vina,
Hrdi tanavamutsrjyaragadvesesvanaratam. (3)
Idam praptamidam neti jadyatsughanamohadah,
Adhayah sampravartante varsasu mihika yatha. (4)

68
 Yoga for Jistdma

Bhrisam sphurantisvicchasu maurkhye ca ghanatam gate,

Durantabhyavaharena durdesakramanena ca. (5)
Duhkalavyavaharena duhkriyasphuranena ca,
Durjanasaiigadosena durbhavoddbhavanena ca. (6)
Kslnatvadvatipurnatvannadlnarnrandhrasan^
Prane vidhuratam yate kaye ca vikallkrta. (7)
Dauh sthityakarananaddosadvyadhirdehatpravartate,
Nadyah pravmnidaghyabhyarmvalcaraviparyayah. (8)
Praktani caihiki vapi subha vapyasubha gatigh,
Yaivadhikasaiva tatha tasminyojayati krama. (9)
Adhayo vyadhayaScaivam jay ante bhutapancake,
Katham srnu vinasyanti raghavanam kulodvaha. (10)
Dvividho hi vyadhirastiha samanyah sara eva ca,
Vy avaharasca samanyah saro janmani yah smrtah. (11)
Praptenabhimatenaiva nasyanti vyavaharikah,
Adhiksaye cadhibhavah ksayante vyadhayopyalam. (12)
Atmajnanam vina saro nadhirnasyati Raghava,
Yatha rayvavabodhena vina sarpo na nasyati. (13)
Anadhija vyadhayastu dravamaritrasubhakramaih,
Cikitsakadi sastroktaihrnasyanti tvam ca vetsi tat. (14)

Rama Uvaca

Adhih katham bhavedvyadhih katham ca sa vinasyati,

Iti me bhagavanbruhi prassapadaya gira. (15)
Anaveksyapuromargamamargamanudhavati,
Prakrtam margamutsrjya sararto harino tatha. (17)
Sahksobhatsamyamutsrjya vahanti pranavayavah,
Asme vahati prane nadyo yanti visansthititam. (18)
Asamyaksansthite bhupe tatha varnasramakramah,
Kujirnatvamajlrnatvamatijirnatvameva va. (19)
69
 Dosayaiva prayatyannam nadlpranaviparyay at,
yanyannani virodhenatisthantyantah sanrake. (20)
Tanyeva vyadhitam yanti parinamasvabhavatah,
E vamadhervedvyadhinasacca nasyati. (21)
Yatha virakam kurvanti harltakyah svabhavatah,
Bhavanavasatah karya tatha yaralavadayah. (22)
Suddhaya punyaya sadho kriyaya sadhusevaya,
Manah prayati nairmalyam nikaseneva kancanam. (23)
Anando vardhate dehe suddhe cetasi Raghava,
Purnendavudhite samyananairmalyarn bhuvaneyatha. (24)
Sattvasuddhau vahantyete kramena pranavayavah,
Jarayanti tathannani vyadhistena vinasyati. (25)
Adhi vyadhyaoriti proktau nasatpathi kramau tvayi.

The following is the translation of Samskrt text taken from Yoga-

Vasistha:
Rama interposed and said: Please enlighten me as to the origin
and destruction of mental and bodily diseases. In answer to this
Vasistha continued: The pains that afflict the body are called
the secondary diseases, whilst the Vasanas that affect the mind
are termed mental or primary diseases. We have reached our
present state through the absence of the transcendental Jnana,
want of mastery over our sense organs and the perpetual growth
of desire and egoism in the mind. And our delusion becomes
intensified in us by forgetting the degradation of our state through
such causes. With the growth of such delusion, the mental disease
also conceals in us like the snows of winter. When the intense
desires of a person begin to manifest themselves externally and
the Ajfiana in him preponderates, he performs fearful Karmas
and these in their turn breed bodily diseases. The body is further
subject to diseases through such actions as the eating of
unwholesome food, living in unhealthy countries, doing things

70
 Yoga for JAsthma

at unseasonable hours, injuries inflicted, association with th.e

wicked, longing after improper things, evil desires, bad thoughts,
the distention and contraction of the orifices of the Nadis in the
joints, etc. and the interrupted flow of the beneficial Pranas
throughout the body-these cause the body to wither. These
flourish in the form of diseases in the body, waxing and waning
like the floods in a river during the different seasons. The body
attracts effects to itself according to the nature of its countless
affinities, good or bad, whether in previous births or in the present
one. Thus we see diseases, primary and secondary, arise through
the five fold Bhutas (elements).
Now listen. Oh Rama, to the manner in which the two forms of
disease, primary and secondary, are destroyed in two ways. The
wise say that primary disease has two sub-divisions: samanya
(ordinary) and sara (essential). The former includes the diseases
incidental to the body, while the latter the rebirth to which men
are subject. If the diseases which afflict this body return to their
primal state then they are destroyed. Their primary causes being
(bad) thoughts, if these thoughts destroyed, all bodily diseases
will vanish. But the disease of rebirth, coming under the head
of sara, will never go except through Atma-Jnana. Is it possible
to suppose that the misapprehension of a serpent in a rope can
be removed except through the discovery of the real rope? But
those grievous diseases of the body which do not arise through
the original cause can be extirpated by mantras, medicine and
the many means used by men well versed in medical lore. I
need not expatiate upon this subject any further here.
Here Rama asked Vasistha how mental diseases arise and how
they are destroyed. Vasistha proceeded: When the manas is
agitated, then this body also follows in its wake. And when the
body is agitated, then there is no proper perception of the things
that are in one's way and Prana flies from its even path on to a
bad road, staggering like an animal wounded by an arrow.

71
 Yoga for Jistfima

Through such agitation, Prana, instead of pervading the whole

body steadily and equally, vibrates everywhere at an unequal
rate. Therefore the Nadis do not maintain a steady position, but
quiver. Then, to the body which is the receptacle of food digested
partially or completely, the Nadis are simply death, because of
the fluctuation of the Pranas. The food which settles down in
this body amidst such commotion is transformed into incurable
diseases. Thus through the primary cause (of the mind) the
disease of body is generated. If this primary cause be annihilated
at its root then all diseases will be destroyed. Now hear of the
path by which diseases may be removed by the uttering of
Mantras. Like base gold n4uch, when placed in the crucible is
transformed through alchemical processes into pure gold, the
mind is rendered unfailingly pure through true, virtuous and pure
actions and by serving the wise. In the mind purified thus there
is unalloyed bliss. Is not the whole world exhilarated with joy
when the soft and delicious moon begins to shed its silvery light?
If the mind becomes purified with true Sattvagua, then Prana-
Vayu will begin to circulate freely throughout the body, the food
taken will be digested properly and hence no diseases will arise.
I have thus described to you the path by which the two kinds of
diseases can be destroyed.
 Yoga for Asthma

BREATHING PRACTICES
Introduction
Hereditary tendencies and family influences coupled with home
atmosphere play a vital role in the personality development of
all of us. Of particular value are the formative years of childhood
days. Deficiencies and subnormal tendencies deep within
manifest in pranic imbalances featured by wrong breathing
rhythms, speeds and haphazardness, manifesting as asthma.
Corrections of breathing patterns is one of the most effective
ways by which many of these problems in children as well as in
the grown ups can be solved. Also good breathing habits harness
the energies for systematic development of the physique and the
psyche.
Respiratory system is a bridge between the conscious and the
sub-conscious, voluntary and the involuntary or, in general, the
body and mind. The system is both voluntary.as well as
involuntary. Using the voluntary control we change the
involuntary functions.
The objectives of the breathing practices :
1. Training for full utilisation of all lobes of the lungs.
2. Normalise breathing rate.
3. Make the breathing uniform, continuous and rhythmic.
The practices include i) certain Yogic cleansing practices as
well as, ii) sectional breathing and, iii) full yogic breathing.
The principles involved in regularising the breathing are :
i. Ability to increase and decrease the breathing rate.

73
 Yoga for Jistfima

ii. Developing awareness of breathing through the movements

of different parts of the body.
iii. Slow down exhalation longer than inhalation.

Special tips for beginners

i. First emhasize the movement of hands, legs, abdominal or
' thoracic muscles as needed in each exercise. Correct the
movements.
ii. Use 'in' and 'out' instructions of the mind (or that of teacher)
for inhalation & exhalation. Emphasize on full breathing each
time.
iii. Synchronise breathing with the corresponding movements.
Check and correct.
iv. Initially the movements will be faster to cope with the higher;
breathing rate. As progress is made, the movements will get
slower. Feel the movement of air filling and emptying
the lungs. Develop an awareness of breathing.
v. Close the eyes and repeat a few rounds retaining the
awareness.

Sithilikarana Vyayama Benefits

1. Reduces the fat, specially from abdominal region which is
very important in diabetes mellitus.
2. Helps in reduction of body weight in over-weight diabetes
and maintaining the body weight in over-weight diabetes and
maintaining the body weight in under-weight diabetes.
3. Increases the strength, stamina and tones up the body.
4. Most important, it creates better gradient to transport glucose
from the blood to the cells, using the available insulin
effectively without demanding extra insulin.
 'Yoga for JZstfima

A. Sthiti (initial) and Sithila (relaxation) postures

{for all breathing practices, Sithillkarana Vyayamas
and Yogasanas)

Initial Standing Posture: Tadasana

• Stand erect with feet close together, knees
together.
• Hands along the thighs with fingers stretched
out.
• The legs, trunk and the head aligned in a
straight line.
• Close the eyes.

w
Standing Relaxation Posture:
Sithila Tadasana
• Stand erect with legs about six to twelve
inches apart, hands hanging freely by the
side of the body with the shoulders
collapsed.
• M a k e sure that the body is completely
relaxed.
47 % • Gently close the eyes

Initial Sitting Posture: Dandasana

• Sil wjlh both legs stretched
and heels together.
• Plate the palms on the floor
by the side of the buttocks
• Make the spine, neck and
head erect.
• ( lose the eves
'Yoga for JAsthma

Sitting Relaxation Posture: Sithila Dandasana

• Sit with legs stretched apart and relaxed.
• Slightly incline the trunk backwards, supporting the body by
placing the hands behiiivi.

• Fingers point backwards.

• Let the head hang freely behind or rest on either of the
shoulders.

• Gently close the eyes.

Initial Prone Posture

• Lie down on the abdomen with legs together, toes pointing
outward and the soles of the feet facing up.

• Chin or Forehead touching the ground.

• Stretch the hands straight above the head, biceps touching
the ears and palms resting on the ground.
• Close the eyes.
 Yoga for Jistfima

Prone Relaxation Posture: Makarasana

• Lie down on the abdomen with the feet wide apart, heels
facing each other.
• Bend both the hands and place the right palm on the left
shoulder and the left palm on the right shoulder.

• Rest the. chin at the point where the forearms cross each
other.
• Gently close the eyes.

Initial Supine Posture

• Lie down on the back with legs together.

• Stretch the hands straight above the head, biceps touching

the ears and the palms facing the ceiling.
• Close the eyes.

Supine Relaxation Posture - Savasana

• Lie supine on the ground with hands and feet apart.
• Slightly stretch the body and allow the whole body to relax
completely with eyes gently closed.
Yoga for Asthma

• • If your back hurts, bend the knees.

• Become aware of different parts of the body starting from
toes to head. Feel the spread of relaxation in all parts of the
body progressively.
• With regular long practice, the relaxation will become
deeper, natural and spontaneous. Then the whole body is
relaxed to the extent that one forgets the body. The mind
experiences alertful rest.

Benefits of Savasana
a. Deep rest to all part of body reduces oxygen requirement.
Hence the tissues are trained to remain healthy even when
the chronic airway narrowing does not supply enough oxygen
due to air trapping (emphysema) or collapse of air sacs
(atelectaik)
b. Deep rest to nervous system and immune system helps in
restoring normalcy.
c. Reduction of speed at the mind level (Manomaya Kosa), speed
and constriction at prana level (Pranamaya Kosa) helps in
better mastery over uncontrolled speeded up nervous or
immune responses (Annamaya Kosa).
 Yoga Jar Anhma

B. BREATHING PRACTICES

Standing Postures
1. Hands In and Out Breathing
Sthiti: Tadasana
PRACTICE
• Stretch out your arms in front, in level with your shoulders
and bring the palms together.
• Inhaling spread your amis sideways in horizontal plane.
• While exhaling bring the arms forward
with palms touching each other.
• Repeat 5 times, making your arm
movements, continuous and
synchronising with the breath flowing
in and out rhythmically.
• Relax in Tadasana. Feel the changes
in the breath and the body, especially
the arms, shoulders and the back of
the neck
 Yoga for jAstfima

2. Hands Stretch Breathing

Sthiti: Tadasana
PRACTICE
• Stand erect with feet together (heels
together and toes 4 to 6 inches apart)
relaxed by the side of the body.
• Gently bring your hands in front of the
chest.
• Interlock the fingers and place the palms
on the chest.
• Collapse and relax your shoulders.
• Close your eyes.

PRACTICE

Stage 1: (Horizontal)
• While inhaling, stretch the arms
straight out in front of your body so
that the arms are at shoulder level.
• At the same time twist the hands so
that the palms face outwards.
• Fully stretch the arms, but do not
strain.
• Now, while exhaling reverse the
process and bring the palms back on
to the chest.
• Collapse the shoulders again.
• This is one round, repeat 5 times.
 Yoga for Asthma

Stage II: (At 135°)

• Repeal the same movements now

stretching the arms above the forehead at
an angle of 135°.
• Repeat 5 times.

Stage III: (Vertical)

• Again repeat the same
movements, this time
stretching the arms
vertically above the head.
• While moving up and
down the palms close to the nose tip.
• Repeat 5 times.

Benefits
1
Helps in opening the lower, middle and upper
zones of the chest for better mastery.
2 Deep internal linear a w a r e n e s s and
concentration on balancing the body helps
in bringing about prana balance.
3 Awareness of the touch of air as it Hows in and out.
4 Awareness of expansion and contraction of airways in these
three sections.
5. Trains the chest wall muscles for rhythmic breathing.
6. Balances the prana in the chest.
7. Improves concentration and calms down the mind.

Note
/// stage III while the :irms nun c up ami down in the same plane ol the
body the hands H •//// c n>ssedlinptrx needtt> move \ ery close f<> flu• tip
ot the nose.
( \ tllupse the shoulders ;il the hepinninp :iml end ol eneh cycle
Maintain perfect awareness o/'fhe breathing.

Kl
 Yoga for JAsthma

• Exhalation should be longer than inhalation.

• If required, it can be practised sitting in a chair too. Properly
synchronize the breathing with hand movements.

3. Ankle Stretch Breathing

Sthiti: Tadasana
PRACTICE
• Open the eyes and fix your gaze on a point
on the wall ahead. Place the palms on front
of your thighs.
• While inhaling, raise your
;
> Jh hands and stretch the
ankles. Feel yourself
growing taller and firm.
• As you exhale, bring your
hands and heels down.
• Repeat 5 times keeping the movement of
hands and ankles, continuous breathing in
synchronization. Feel the stretch from your
ankles up to finger tips as you reach upwards.
• Relax in standing position, hands by the side
of the thighs. Observe your breath and enjoy
the stability for a few seconds.

Benefits
a. This practice helps in breath awareness.
b. Awareness of exapansion and constriction of
airways in mid zone of the lungs.
C. Strengthens the clavicular muscles.

d. Vertical stretch followed by relaxation improves the prana

balance the Candra and surya nadis.
e. Improves capacity to focus (dharna).
f. Relax the body, balance the prana, calms down the mind.
 Yoga for Asthma

Sitting Postures

4. Dog Breathing
Sthiti: Vajrasana
PRACTICE
• Place the palms of the hands on the
ground beside the knees.
• Make the spine slightly concave and
fix the gaze straight ahead.
• T h e m o u t h is o p e n e d wide, the
t o n g u e is pushed out to its
maximum. Practise rapid, forceful
inhalation and exhalation,
e x p a n d i n g and c o n t r a c t i n g the
abdomen vigorously.
• Repeat the practice for 30 seconds.
• Relax in Sasarikasana.

Benefits
a. Full diaphragm contraction empties locked up air in the alveoli
of the lower lobes.
b. Rapid exhalation cleanses the lower & middle portion of lungs
by expelling carbon-dioxide trapped in the alveoli.
c. Awareness of airway in lower and middle zone helps in
relaxing the bronchi.
d. Opens up prana blocks and Calms down the mind.

Note
• " Since tins dynamic nature of practice is a form of hyperventilation,
epileptics and high b/ood pressure patients should avoid it.
 Yoga for AsI lima

5. Rabbit Breathing
Sthiti: Vajrasana
PRACTICE
• Keeping the knees together, bend forward and rest the
forearms on the floor, keeping the elbows by the side of the
knees and palms flat on the ground.
• Maintain the head at a distance of one hand length from the
ground to chin. Open your mouth partially. Protrude the
tongue partially. Touch the lower lip resting on the lower set
of teeth.
• Gaze at a point about 2 feet on the ground in front of you.
• Pant quickly like a rabbit, using only the upper part of the
chest. Feel the air moving beautifully in and out of the lungs.
Feel the expansion and contraction of the chest muscles.
Continue for 20 to 40 breaths.
• Close your mouth and
relax in Sasankasana.
Stretch your hands
forward with the
forehead resting on
the ground. Feel the
relaxation of chest
and thorax. Allow
your breath to return
to normal.

Benefits
a. One gets train in effortless rapid breathing that is necessary
during acute episode of asthma.
b. Very good practice to develop awareness of the airways that
is necessary for voluntary control.
c Mastery over diaphragmatic breathing by voluntarily,
increasing the speed of diaphragmatic movement.
d. Opens up the prana blocks in the upper chest region.
e. A quick way to calm down the disturbed mind.
 Yoga for Jistfima

Note
• Breathe rapidly through the mouth only, using the thoracic muscles.
• Make sure that the abdomen presses on your thighs, preventing any
abdominal movement.
• Do not drop your head on to the floor.

6. Tiger Breathing
Sthiti: Vajrasana
PRACTICE
• C o m e to Vajrasana.
• Lean forward and place
the h a n d s flat on the floor
in line with the s h o u l d e r s
with fingers pointing
forward. A r m s , thighs and
heels should be about one
s h o u l d e r w i d t h apart. T h e
arms and thighs are
p e r p e n d i c u l a r to the floor.
• W h i l e inhaling raise the
h e a d a n d l o o k at t h e
ceiling.
• At the s a m e time, d e p r e s s
the spine making it
concave.
• W h i l e exhaling, arch the
spine upwards and bend
the head d o w n w a r d bringing the chin towards the chest.
• T h i s constitutes o n e round of tiger breathing.
• Repeat 5 rounds.

Note
• Before starting the practice ensure that you are comfortable while
standing on "all-fours" (i.e.. two hands and two knees).
• Co-ordinate the movements with breathing.

85
 Yoga for Asthma

• Keep the eyes closed and practise with awareness.

• Do not bend the arms or move the thighs forwards and backwards.

Benefits
a. Awareness and mastery over all three sections of the chest
wall (lower, middle & upper).
b Empties the lungs by actively squeezing out the air from all
• parts of the lungs; allows better aeration during the stretch.
c. Expansion and contraction of chest wall leads to harmonious
functioning of muscles of respiration.
d. Awareness of expansion of airways in all zones of chest
during head-up portion.
c. Complete emptying of all the air sacs and airways in the next
position.
d. Feedback of airway status as you listen to the mild whistling
sound from small and big airways.
d. Calms down the mind.

7. Sasarikasana Breathing
Sthiti: Vajrasana
PRACTICE
• Take the hands behind the back, make a fist of the right hand
and hold the right wrist with the left hand.
Relax the shoulders.
 'Yoga for Asthma

• While inhaling bend backwards from the waist opening up

the chest.
• While exhaling slowly bend forward from the waist bringing
the forehead on to the ground in front of the knees. Collapse
the shoulders.
• While inhaling slowly come up to the vertical position and
then slightly lean backwards.
• This forms one round.
• Continue ten rounds slowly.

Note
• Keep the shoulders collapsed.
• You can separate the knees as per your comfort to a void unnecessary
pressure on the abdomen and chest.
• Synchronize breathing with movement.
• Keep your eyes closed and maintain breath a wareness.

Benefits
a Same as tiger breathing further passive compression .
b . Expels air trapped in lower zone of lungs.
c. Trains in diaphragmatic breathing.
d. Releases prana blocks,
d. Calms down the mind.

8. Straight Leg Raise Breathing

Stage I: Alternate legs
Sthiti: Supine Posture
PRACTICE
• While inhaling slowly raise the right leg without bending the
knee, as far as comfortable (up to 90°, if possible).
• While exhaling return the leg to the floor as slowly as possible.
• Repeat the practice with the left leg.
 'Yoga for Jlstftma

• This is one round.

• Perform 10 times.

Note
• If you need, you can keep the arms by the side of your body with the
palms facing the floor at any con venientposition or at shoulder level.
• Do not bend the knee throughout the practice.
• Do not disturb the leg lying straight on the ground in order to be able
to raise the other leg further.

9. Instant Relaxation Technique(IRT)

Sthiti: Savasana
PRACTICE
• Bring your legs together; join the heels and toes together
and place the palms by the side of the thighs.
• Keep the face relaxed with a smile all through the
practice.
 Toga for Asthma

• Start tightening from the toes.

• Tighten the ankle joints, and calf muscles.
• Pull up the kneecaps.
• Tighten the thigh muscles.
• Compress and squeeze the buttocks.
• Breathe out and suck the abdomen in.
• Make fists and tighten the arms.
• Inhale and expand the chest.
• Tighten the shoulders, neck muscles and compress the
face.
• Tighten the whole body from the toes to the head.
• Tighten tighten lighten'
• Release and let go the whole body instantaneously.
• Legs and arms go apart with the open palms facing the
roof.
• Collapse the whole body.
• Enjoy the instant relaxation.
 Yoga for Jistfima

C. LOOSENING PRACTICES
(SithilTkarana vyayama)

INTRODUCTION
A flexible and strong spine is believed to be mandatory for a
healthy growth. Right from childhood if we can train our muscles
holding the vertebral joints properly, a strong foundation is built
to acquire a body with good stamina.
Positive health and not mere absence of abnormalities or diseases
is the goal set by the World Health Organisation. The series of
Sithilikarana Vyayama given here are meant to achieve this goal
of a good physique by proper training of the muscles of the
spine. They not only help in performing the asanas better by
loosening the joints but they also help in building up stamina
and tolerance.
Sithilikarana Vyayama as the name indicates is loosening
exercises performed normally with speed and repetitions. These
dynamic practices are akin to conventional P.T. exercises except
that most of these practices involve flexing of the spine.
The Principles of Sithilikarana Vyayama are to :
i. loosen the various joints in the body, and
ii. flex the spine, by repeatedly stretching and relaxing the
different muscles.
The Objectives are to
a. remove lethargy and tardiness in the body,
b. develop the stamina of the body and
c. discipline the body-mind complex.
Special tips for beginners
1. Practice the exercises stepwise.
2. Count the steps slowly and perform the same with attention.
3. Check the performance of each step before increasing the
speed.
4. Learn to synchronise each step in a group.
 Toga for Asthma

5. Increase the n u m b e r of r e p e t i t i o n s d e p e n d i n g on your

capacity.

1. Forward and Backward Bending

Sthiti: Tadasana
PRACTICE
• Stretch the arms straight above the
head with the palms facing forward.
• Inhale and bend b a c k w a r d s with
arms stretched above the head.
• W h i l e e x h a l i n g bend forward as
much as possible.

While inhaling come up and bend

b a c k w a r d s and go on rapidly to
forward bending with exhalation.
Repeat 20 limes with increasing
speed.
Gradually slow down and ultimately
stop the practice.

Not
Start slowly and gradually increase the
speed u ittun your limits

• You may also practise this while standing with legs apart when the
arms will he moving between the legs.
• While bending forward do not let the hands touch the ground; suing
them in the air backwards.
• Always bend from the lower waist
• Make the movements free, easy and flowing.

Benefits
a. Increased flexibility of spine gives the generalized feeling
of well-being.
m
Yoga for Asthma

b. Vigorous exhalation empties trapped air. Trains in exercise

tolerance prevents or cures exercise, induced asthma.
c. Exercise tolerance.
d. Expels phlegm from all air passages
e. Expels carbon-dioxide from air trapped sacs.
f. Opens up collapsed air sacs due to active inhalation with
vigorous backward bending.
g." Builds physical stamina.
h. Allows free flow of prana in nadis.
i. Calms down the mind.

2. Side Bending
Sthiti: Tadasana
PRACTICE
• Keep the legs about one metre
apart.
• Raise the hands sideways parallel
to the ground while inhaling.
• Bend to the right till the right
hand touches the right heel while
exhaling. Bend in the same plane.
• Look at the palm of the left hand
directing forwards.
• Come up with inhalation.
• Repeat 4 or 5 times to the right and left side alternate.
• Relax in Tadasana.

Benefits
a. Exercise tolerance.
b. Opens up airways in middle lobes of lungs.
c. Expels carbon-dioxide and phlegm.
d. Free flow of prana in Ida and Pirigala nadis
e. Calms down the mind.
 Toga for Asthma

f. Strengthens the muscles of mid zone of chest and the mid

back. This prevents exhaustion during labored breathing
during an attack or during exercise .
g. Empties the air sacs in mid and upper zone.
h. Promotes better air movement (ventilation) in the air sacs
in middle lobe.

3. Pavanamuktasana Kriya
Stage I: Leg Rotation
Sthiti: Supine Posture
PRACTICE
• While inhaling raise the right leg up to 45° position, without
bending the knee. Keep the left leg firm on the ground.
• At 45° exhale and again while inhaling raise the leg further
up to 90° position.
• Now while exhaling, bend the right leg at the knee and pull
the right knee towards the chest with the hands (fingers
interlocked) and lift the head simultaneously and place the
chin on the right knee. Normal breathing.
• Maintain and lift the left leg and rotate five rounds clockwise
and five rounds anti-clockwise without bending the knee
with normal breathing.

• Then lower the left leg to the ground.

• N o w while inhaling release the hands, bring the head back
on to the ground and straighten the right leg.
• While exhaling lower the right leg to 45° position.

r«n
 •Yoga for Asthma

• Here inhale and while exhaling again lower the right leg
further down to the ground. Relax for a while.
• Repeat the same practice on the left side.

Note
• While rotating the leg, try to draw as big a circle as possible in the air.
• Maintain the compression around the abdomen to ha ve the best results.
•. Here, the leg is raised to 9CP position with two inhalations and similarly
lowered on to the ground with two exhalations.

• Do not bend the leg at the knee, which is being rotated.

Benefits
a. Improve digestion.
b. Releases abdominal gas dexterous which in turn can cause
great discomfort in an asthmatic.
c. Pavana muktasana releases all the gases accumulated in the
32 feet long small and large intestines, thus improving the
digestion.
d. Better appetite and assimilation through better blood flow to
digestive system.
e. Prevents constipation.
f. Shifts prana blocks from udana and mukhaprana (that causes
asthma and nasal allergy) by activating samana.
Stage II: Rocking and Rolling

Sthiti: Supine Posture

• Inhale and raise both legs to 45° position

• Exhale here and while inhaling again, raise the legs further
up to 90° position.
• While exhaling fold both the knees and pull them towards
the chest with the hands interlocked around the knees and
place the chin on the knees.
• Normal breathing.
 •Yoga JOT Asthma
PRACTICE
a. Rucking
• Rock the body forwards and backwards 5 to 10 rounds.
• While rocking forward, try to stand on the feet and while
rocking backward, feel the nice massage to the spine.

• Relax for a while in the same position and go on lor rolling

b. Rolling
• Roll the entire body to the right until the right elbow touches
the ground
• Then roll to the left until the left elbow touches the ground
• Repeat this rolling alternately to the right and left 5 rounds.
• Stop the movement.

• Inhaling, release the hands, bring the head on to the ground

and straighten both the legs lo *)(>"

• While exhaling, l o w e r lln. legs s l o w l y (o 45" position

• Inhale here and while exhaling again lower the legs further
down till the legs are on the ground.
• Relax in Savasana.
 Yoga for jAsthma

Bcnifits of Loosening practices

a. Rocking and Rolling in the final posture also helps in im-
proving back muscle stamina and that contributes to improve
the posture and exercise capacity.
b. Increases the oxygen concentration in the blood.
Normalization and slowing down of breath done with total
awareness gives the deep rest to the body and calms down
the mind.

4. Quick Relaxation Technique (QRT)

Sthiti: Savasana
PRACTIC87E
Phase I
• Feel the abdominal movements.Observe the movements of
abdominal muscles going up and down as you breathe in
and out normally. Observe 5 cycles.
Phase II
• Synchronize the abdominal movements with deep
breathing. The abdomen bulges up with inhalation and
sinks down with exhalation. Observe 5 cycles.
Phase III
• As you inhale deeply and slowly, energize the body and
feel the lightness. As you exhale completely collapse all the
muscles, release the tension and enjoy the relaxation.
Observe 5 cycles.

Chant 'AAA' in a low pitch while exhaling. Feel the

vibrations in the lower parts of the body.
Slowly come up from either the right or the left side of the
body.
 'Yoga for Asthma

HARMONISE AND RELAX

SORYANAMASKARA 4j4-WW>K: (Salutations to Sun)

Suryanamaskar combines Yogasanas and Pranayama. It comes
inbetween Sithilikarana Vyayama and Yogasanas. It brings about
the general flexibility of the body preparing it for Asanas and
Pranayama. This is usually done both at sunrise and sunset, facing
the Sun, after chanting the following verse:

1I f ? T 3 m I
Hiranmayena Patrena Satyasyapihitam Mukham
Tat tvam Ptisan Apavrnu Satya Dharmaya Drstaye

Meaning: Like a lid to a vessel, O Sun, your golden orb covers

the entrance to Truth. Kindly open thy entrance, to lead me to
truth.

There are mainly two modes of performing Suryanamaskara. In

one, there are 12 steps or counts and in the other only 10 in each
r o u n d . Each stage of S u r y a n a m a s k a r a is a c c o m p a n i e d by
regulation of breath. Each round of Suryanamaskara is done after
the utterance of 'Omkara' with the appropriate 'Bija mantra',
along with the corresponding name of Sun God in the following
sequence:

1. & *p IH*N TO: Aum Hram Mitraya Namah

2. 3> I ^ T ^ T O : Aum Hrim Ravaye Namah

Aum Hrum Suryaya Nainah

4. &|:*[H%TO: Aum Hraim Bhanave Namah

5. Aum Hroum Khagaya Namah

6. 3bf:^TO Aum Hrah Pusne Namah

7. 3> j^RjW'.*faTO Aum Hram Hiranyagarbhaya Namah

 'Yoga for JistBma

8. J) ^ H i l ^ T O Aum Hrlm Mancaye Namah

Aum Hrum Adityaya Namah
10. $> t * t f ^ ^ T : Aum Hraim Savitre Namah
11. & e ^ S R f f a ^ T : Aum Hroum Arkaya Namah
12. & f: *1K4KN ^ t t ; Aum Hrah Bhaskaraya Namah

5. Suryanamaskara
Sthiti: Tadasana
PRACTICE
Stand erect with legs together. Bring the
palms together to namaskara mudra.

Step J

Take the hands above

the head while
inhaling and bend
the trunk backwards.
Sthiti

Step J

Step 2

• Bend the body forward while

exhaling. Touch the forehead to the
knees.
• Keep the palms on the floor on either
side of the feet.
 Step 3
In this step breath in and kick
the right leg back.
Push the buttock forward and
downward so that the left leg
is perpendicular to the ground.
Step 3 Look up.

Step 4
• In this step, exhale and
take the left leg also back,
resting only on palms and
toes. K e e p the body
straight from head to toes
inclined to the ground at
about 30°.

• Take care to keep the neck in line with the back.

Step 5
• While inhaling,
bend the legs at the
knees and rest them
on the floor with
buttocks resting on Step 5
the heels without
altering the position of the palms and toes.
• Exhale as you rest the forehead on the floor.
• Then relax in normal breathing.

Step 6
• While exhaling without
shifting the positions of
hands and toes, glide the
body forward and hold
the breath (Bahya
Step 6
kurnbhaka) and rest the
9)
'Yoga for Asthma

forehead, chest, hands, knees and toes on the ground. Raise

the pelvis off the ground.
Note that eight points of the body are in contact with the
ground - hence the name sastariga namaskara (Salutation
with eight parts).

Step 7
• Inhale, raise the head and
trunk making the spine
concave upwards without
lifting the position of the
hands and feet.
Arch the back as far as you can
Step 7 until the elbows are straight.
Keep the knees off the ground.
Step 8
• While exhaling, raise the
buttocks, push the head
down until the heels touch
the ground without
shifting the position of
hands and feet.

Step 9
Same as step 5.

Inhale and bring the right leg

in between the two hands.
Arch the back concave
upwards as in step 3 until the
right leg is perpendicular to
the ground.
 Yoga for Asthma

Step 11
Exhale and bring the left foot forward next
to the right foot and reach down with your
upper body to touch the forehead to the
knees as in step 2.

Step 11
Step 12
• While inhaling, come up to sthiti.
• This c o m p l e t e s one round of Surya
Namaskara. Repeat 3 rounds.

Note
(In 10-stages- Suryanamaskara the S" and 9" stages
are omitted).
The prolonged pronunciation of 'Omkara' followed
Step 12
by the Bija aksara, 'Ha' and the sounds 'R' M which
come in every Mantra influences and stimulates the nerve centers in the
brain corresponding to the respiratory, circulatory and digestive systems,
make them more active, efficient and healthy.

Benefits
Combines the practices at all the three Kosas. Annamaya Kosa
where the imbalances are manifest. Body movements, 12 different
complimentary postures to strengthen, master, and relax the
muscles in all part of the body, opens up the chest. Trains in
rhythmic contraction and relaxation of respiratory muscles. Helps
in awareness of involuntary muscles of bronchus.

Pranamaya Ko$a
Breathing combined with each posture helps in balancing the
prana; releasing prana blocks in all branches of nadis; Awareness
of prana in different parts of body prepares for betler mastery
and slowing down.

101
Mammmya Ka<*
Devotion and surrender to the Lord Sun prepares the mind lor
e m o t i o n culture and s l o w i n g d o w n o f the s p e e d e d up l o o p of
emotions, which is u c o m m o n feature o f asthmatics. Asthmatics
are k n o w n lo he e m o t i o n a l l y h y p e r s e n s i t i v e w i t h m o b i l i t y to
express their emotions.

Through these practices one learns to settle d o w n in the silence

of the Ananudumaya ko,<a,

Exercise is one of the w e l l - k n o w n trigger*! for asthma. Both in

children and adults. This could be the only trigger in s o m e children
(Exercise Induced-Asthma (LI A)). The reason for HI A has been
worked out.

Alter a long search for various physical, chemical factors during

exercise that may cause asthma, it is n o w clear that the airway
drying due to rapid breathing during strenuous physical exercise
is responsible for triggering the parasympathetic nerve e n d i n g s
in bronchi. Hence y o g i c l o o s e n i n g e x e r c i s e s w h i c h are in the
Ion 11 of strenuous p h y s i c a l m u s c u l a r a c t i v i t i e s are useful in
retraining the airways to tolerate the dryness that g o e s with the
p a n t i n g m o u t h b r e a t h i n g after a n y e x e r c i s e . T h e Y o g i c
sTtithilikarana v y a y a m a w h i c h is c a r r i e d o u t u n d e r c l o s e
supervision is characterized by s y s t e m a t i c graded s t i m u l a t i o n
immediately followed by deep rest and relaxation, If you d e v e l o p
a mild wheeze during the practice, stand still listen to the whistling
internal noice cSt use the sound as an internal feedback to send
messages o f relaxation and e x p a n s i o n t o t h o s e a i r w a y s w h e r e
the w h e e z e is arising. Thus loosening exercises performed with
jerks, and stiffness arc useful in desensitization o f an asthmatic
It) exercise.

Exercise also helps in opening up the praua blocks in nasal allergy,

Eur example persons with blocked nose can open up nostril within
two minutes by spot jogging as it activates the sympathetic nerves
system,
 YOGASANAS
a. The two schools of Yogasanas
Yogasanas are specialised postures of the body often imitating
many of the animal postures. Large number of Asanas exist. The
same asana is often named differently and performed in various
modes by different schools in our country and abroad All these
are permutations and combinations of the two basic types of
Asanas.

Type 1: Dynamic type of Asanas of the Hatha yoga

Type 2: Relaxing type of Asanas performed on the principles
laid down by Patanjali in his Yoga aphorisms.
The first school utilises speed, repetitions, mainlaincnce with
strength (Isometric) and often jerks in the mode of performance.
The second, Patanjali system, emphasizes on mental equipoise
through relaxation, and effortlessness. Maintenance for longer
duration with ease is the key factor in this second school. The
objective of the first school is predominantly to shatter the laxity,
lethargy and Tamas in general. By repetitions and quick actions
it develops the strength of the muscles and the stamina of the
organs and systems in the body. These aid the growth process.
It is this system that we have chosen in the formative and
developmental phases of students. Relaxation, slow breathing
and calming the mind which form the triplet of Yoga featured in
the Patanjali Yoga lore is adopted in the later years of man (above
say 18 years) where the normal growth of the physical frame
would be almost complete. It is here thai energy channelisation,
and conservation processes are harnessed and the overshoots
and imbalance of the bodily functions arc controlled. The real
contribution of Yoga to modem world is found at this level. It is
this system that we have described in this chapter.
Yoga for Jistfima

(i) Dynamic Asana

As the name implies, the characteristics of this system of
Yogasanas are energising movements with speed and repetition.
While the physical exercises (Non-yogic) are effective on
muscular, circulatory and respiratory systems, the Yogic exercises
have an effect on the nervous and glandular systems as well.
The Dynamic Yogasanas stimulate the nervous and glandular
systems resulting in evocation of energy. This energy combats
laziness by shattering Tamas and gives rise to Rajas (activity).
This particular system is recommended for children as well as
people who are lethargic. The Suryanamaskara and Sithilikarana
Vyayama can be included in this system of dynamic Yogasanas
as it is a combination of different asanas, and involves speed.

(ii) Relaxing Asana

The aim of this system is to develop an inner awareness and
unfold the higher levels of consciousness. Movement without
jerks and effortless maintenance characterise this system. This
results in strength and forbearance-titiksa. There is also a
proportionate growth of the body. The control of food and other
Yamas and niyamas are common to both systems. While the
non-yogic exercises and dynamic Yogasanas affect expenditure
of energy and perspiration, the Yogasanas based on Patanjali's
aphorisms result in deep relaxation and energy conservation,
resulting in freshness. This is basically a nerve culture as it calms
down the nerves.
The features of yogasanas are summarised below :
i. Evoking the dormant potentiality in man is the goal.
ii. To raise man from his animal nature to normalcy and raise
him further up the steps to achieve the goal of total freedom.
iii. Flexibility of spine is aimed at.
iv. Emphasis on positive health and overall personality
development is given.
v. Mental equipoise, Pranic balance and physical stamina are
the outcome.
 Yoga for Asthma

b. Physical Exercises and Yogic Practices

From time immemorial man is trying to be free from disease and
make his body handsome; make it strong and ultimately make
it immortal. The search for the fulfilment of these desires brought
about the development of physical culture where various types
o / e x e r c i s e s are employed. Exercises can be broadly classified
into two types (i) passive, and (ii) active. Under passive type, we
have massage and manipulation of muscles by others, where the
beneficiary is passive. Whereas in the active type, we have
exercises emphasizing on different characteristics, which are
enumerated below.

Strength : Body b u i l d i n g and weight lifting utilizing the

implements like bar-bells, dumb-bells and also vigorous exercises
like pull-ups and push-ups etc.The practices may involve moving
the joints (isotonics) or tighten, the muscles without changing
the joint position (Isometrics).
Speed : Sports, athletics, etc.
Dexterity : Aerobatics, gymnastics, archery, fencing, boxing,
etc.
Endurance : walking, hiking, swimming, etc.
The common features of all these non-yogic type of exercises
are that they involve speed, jerks and repetition. They are energy
expending processes, resulting in strengthering of the muscular
and circulatory system. Any of these practices can be used for
m a i n t a i n i n g good physical health or as a sport. The attitude of
competition, showmanship and materialistic gain often develops
arrogance, tensions, etc., Physiotherapy predominantly adopts
these physical exercises and movements to treat several ailments
connected with muscles, joints, nerves and other systems.

c. Stages in Yogasana
Most people are of the opinion that Yogasanas are meant for
keeping the body fit and healthy. In other words they limit the
asanas lo physical exercises. It is just like going to a millionaire
and asking for a rupee!
Tio? •
'Yoga for Jlstfima

'Asanas' form one 'ariga' or limb of Patanjali's eight-limbed

Yoga. This means that he has introduced it with a specific purpose
of utilizing the physical body, which is visible and gross, to
develop an inner awareness and thus reach higher consciousness.
Yogasanas help us to develop forbearance because of
maintenance. While maintaining, we go through three stages
which are Sthira, Cira and Sukha.
Initially, the posture is shaky. A beginner cannot reach the final
posture immediately. After gradual practice he reaches and
achieves steadiness and this stage is called 'Sthira'. In this stage,
however he is not able to maintain it for the prescribed length of
time due to the effort involved. When he withdraws the effort by
relaxation (Prayatna-Saithilya) as per the suggestion of Patanjali
in the first half of his Aphorisms (2.47), He reaches the stage
' Cira' in which he is able to maintain it for the prescribed length
of time. The mind control begins here. In 'Sthira' the mind gets
concentrated on the process of maiantaining the final posture.
As the posture becomes effortless and natural, the mind according
to its nature starts wandering. To avoid this Patanjali gives us a
method in the next half of the same sutra (2.47) "Ananta-
Samapatti" or contemplation on the infinite. Here the word
'Ananta' can be interpreted as the chosen deity, or the chosen
sound (Mantra) or just expansiveness. When this is done the mind
calms down and as it stays in silence it starts experiencing the
bliss and this stage is called as 'Sukha'. Patanjali defines the
nature of Asana in the previous Sutra (2-46) viz: Sthira-Sukham
Asanam': Posture should be steady and comfortable. The Sukha
stage is comparable to Dhyana. If the posture is 'Sukha' for an
appreciably long time (subjectively varient) the person enters
'Asana Siddhi' which is the super-conscious state or 'Samadhi'.
This is given by the subsequent sutra (2.48)'tato
dvandvanabhighatah': From that (mastery of the posture) no
assaults from the pairs of opposites. This is how we derive
infinitely more than just the physical benefits.

106
 Yoga for Jistfima

D. An Ideal Healthy Body

All attempts of Kamsa to kill Krsna had failed. He hits upon a
brilliant plan of which he is sure of success. He hosts a carnival
of fun and games to which he invites all people including Krsna
as well as Balarama. The obstacles are cleverly spaced from the
main gate onwards. A rogue elephant attacks Krsna and he kills
it. Finally, the court wrestler Canura challenges Krsna and the
wrestling bout is very beautifully described in Srimad Bhagavat.
Canura is described as 'a man-mountain' with very heavy body
having rippling muscles exhibiting strength in every way. The
gestures, facial expressions are also given. He is said to be tense,
stiff, straining every muscle with an angry face. Contrary to it
Krsna's body is described as, well proportioned with a balanced
growth, agility, capable of great speed in movements, having
good reflexes and highly flexible. Komala (petal soft) but stone
hard when situation arises and naturally relaxed during action
due to lack of strain. His psychology is also very congenial; his
face is always smiling as if he is ready for a sport; very keen
observation due to tranquility of mind and clarity of thought. He
keenly observes the 'man-mountain' and notes that he has a slight
limp on the right leg probably due to an injury in a past fight.
When the fight begins, Krsna fights effortlessly and wins by using
the strength of Canura on himself.

This gives us the characteristics of an ideal body:

1. Balanced and harmonious growth,
2. Great speed in movement due to agility,
3. Highly flexible,
4. Komala but stone hard when the need arises,
5. Relaxation in action and hence conservation of energy, and
6. Tranquility of mind and clarity of thought, i.e., harmony
of body and mind.
These characteristics can be achieved with the persistent and
regular practice of Yogasanas.
These effects of Yogasanas described in yoga texts indicate that
Yogasanas not only work on the Annamaya Kosa, but operate in
tune with bringing stability and harmony in other Kosas also.
'Yoga for jZsthma

PRACTICE OF YOGASANAS AND RELAXATION

Standing Postures

1. Ardhakati Cakrasana
Sthiti: Tadasana
TECHNIQUE
While inhaling, slowly raise the
right arm side ways up.
At the horizontal level turn the
palm upwards.
Continue to raise the arm with
deep inhalation vertically until the
biceps touches the right ear, palm
facing the left side.
Stretch the right arm upwards.
While exhaling bend the trunk
slowly to the left.
The left palm slides down along
the left thigh as far as possible.
Do not bend the right elbow or
the knees.
Maintain for about a minute with normal breathing.
Slowly while coming back to vertical position inhale and
stretch the right arm up. Feel the pull along a straight line
from the waist upto the fingers.
Bring the right arm down as you exhale to Sthiti position.
Come back to Tadasana Sthiti.
Repeat on the left side, by bending towards the right side.
Note
• Bend laterally. Do not bend cither forwards or backwards.
 'Yoga for Jistfima

Benefits
1. Reduces fat in waist region, stimulates sides of the body.
2. Opens up the airways in the mid zone of the lungs.
3. Annamaya Kosa: Relaxation in final posture helps in aware-
ness and sensitization of the bronchial caliber to prepare for
better internal sensory feedbacks.
4. Pranamaya Kosa: Balances prana in Ida and Pihgala nadis.
5. Manomaya Kosa: slows down and expands the mind.

2. Ardha Cakrasana
Sthiti: Tadasana
TECHNIQUE
• Support the back at the waist by
the p a l m s , fingers p o i n t i n g
forwards.
• Inhale and bend backwards from
the l u m b a r r e g i o n . D r o p the
head backwards, stretching the
muscles of the neck.
• M a i n t a i n for a m i n u t e with
normal breathing.
• Return to Sthiti.
• Relax in Tadasana.

Benefits
Makes the spine flexible, stimulates the spinal nerves, promotes
circulation of blood into head. Strengthens the neck muscles.
Expands chest and shoulders. Improves breathing. Calms down

the mind.

Limitations
Persons with problems of vertigo have to avoid this posture.
'Yoga for Jistfima

3. Pada Hastasana
Sthiti: Tadasana
TECHNIQUE
Stand erect with legs together.
Inhale slowly and raise the arms
sideways.
At this horizontal level, turn the
palms upwards.
Continue to inhale and move the
arms upwards until the biceps
touches the ears. Turn the palms
forward.
Stretch up the body from the waist.
Keeping the lower back concave,
exhale and bend forward until the trunk is parallel to the
ground. Stretch out the shoulders at horizontal plane and
inhale.
Exhale while going down further until the entire palm rests
on the ground and chin touches the knees.
Maintain in this final posture for about 2-3 minutes without
bending the knees.
Inhale, come up slowly to the vertical position and stretch
the arms above the head.
Exhale, drop down the arms, turn the palms downwards at
the horizontal position.
Continue to exhale and return to Sthiti.
Relax in Tadasana.
Note
Never bend the knees.
Keep (he neck up until (he forward bending at the hip and the waist
is completed and then drop the neck freely down to touch the chin
to knees.
 Yoga for JAslhma

Benefits
M a k e s the Spine flexible, S t r e n g t h e n s the t h i g h s . Helps
preventing constipation and menstrual problems. Improves
digestion. Enhances blood flow to the head region, Empties the
lower air sacs of trapped air, Opens up clogged small airways,
Shifts prana blocks. Calms down mind.

Limitations
People with severe degree of hypertension, cevical spondylosis,
and disc prolapse to avoid this posture.

Sitting Postures
4. Vajrasana
Sthiti: Dandasana
TECHNIQUE
• Fold the right leg and bring the
right heel under the right buttock.
• Sitting on the right heel, fold the
left leg and bring the left heel under
the left buttock.
• Sit erect c o m f o r t a b l y with the
buttocks resting on both the heels
and palms resting on the thighs.

Note
• In the final posture the soles of the feet face upwards, heels are kept
together and the entire weight of the body is felt on the back of the
feet.

Benefits
• A Meditative posture as we can sit comfortably for a long
lime with erect spine.
• Sitting relaxed with spine erect is a prerequisite for a
balanced both nostril breathing an indicator of Susumna

III
 Yoga for Jistfima

nadi functioning. Opening the susumna nadis is one the

major aims of yoga practices. Since this indicates a state of
perfect health free from asthma or any other illness. Hence
this posture prepares you for subtler practices of
pranayama and mediation to move towards normalization
of hyperactive (speeded up excited erratic) immune and
autonomic nervous system.

5. Vakrasana
Sthiti: Dandasana
TECHNIQUE
• Bend the right leg at
the knee and place it
beside the left knee.
• Straighten and twist
the waist towards the
right as you exhale.
Bring the left arm
around the right knee
and catch the right big
toe.
• Take the right arm back and keep the palm on the ground
in such a way that the trunk is kept erect with a proper
twist.
• After maintaining for about a minute with normal breathing
return to sthiti and relax for a while in Sithila Dandasana.
• Repeat the same on the other side.
Benefits
Lateral twist gives flexibility to the spine, tones up the spinal
nerves. Prepares the spaine for Matsyendrasana. Helps to cure
constipation and dyspepsia. Improves lung capacity.
Limitations
People who have recently undergone abdominal surgery may
avoid.
6. Ardha Matsyendrasana
Sthiti: Dandasana
TECHNIQUE
• Bend the right leg at the
knees by drawing it along
the ground.
• Place the sole of the right
foot against the inner side
of the left thigh.
• Keep the right heel about 4
to 5 inches away from the
perineum.
• Bend the left knee and place the left foot on the outer
side of the right thigh near the right knee.
• D o not sit on the heels.
• Inhale, raise the right arm up vertically and stretch up the
shoulder.
• Exhale, twist the waist to the left and bring the right arm
over onto the outer side of the left knee. The left knee acts
as a fulcrum for getting maximum twist of the spine. Catch
the left big toe with the right hand. The right triceps rests
on the outer side of the left knee.
• Now take the left hand behind the back and try to touch the
right thigh.
• Look back over the left shoulder keeping the trunk erect.
• Maintain for about a minute with normal breathing.
• Come back to Sthiti.
• Relax for a while in Sithila Dandasana.
• Repeat the same, on the other side.

Benefits and Limitations

This is an improvement over the degree of spinal twist of

{Tin—
 Yoga for Jistfima _

vakrasana and hence the same benefits are enhanced. Merging

in a feeling of expansion (Ananta Samapatthi) is the key to open
up the bronchial airways.

7. Pascimottanasana
Sthiti: Dandasana
* •

TECHNIQUE
• Inhale, raise both the arms sideways at shoulder level parallel
to the ground.
• Turn the palms facing upwards.
• Continue to inhale and
raise the arms further
up vertically biceps
touching the ears and
stretch the trunk from
the coccyx region.
Now turn the palm
forwards.
• Exhale, bend the trunk forwards from the lower back.
Stretchy the arms, hands parallel to the ground.
• Exhale completely, form hooks of index fingers and catch
hold of the big toes. Bend the back further forward from the
lumbar-sacral region so that the trunk is stretched along the
thighs and the face rests on the knee. Bend the hands at the
elbow and relax the abdomen muscles.
• Maintain the position for about a minute with normal
breathing.
• Return to sthiti reversing the steps and the breathing
• Relax in Sithila Dandasana.
Note
• Do nor alio w the knees to bend.
 Yoga for JAsthma

Benefits
Gives flexibility to the back bone. Stimulates the spinal nerves
and back muscles. Improves digestion, Energises the whole
body. Removes constipation.
Limitations
People with heart ailments, back problems and spondylosis
should avoid this posture.

8. Bhujangasana
Sthiti: Prone Posture
TECHNIQUE
• Bend the arms at the elbows and place the palms beside the
lower chest at the level of the last rib exerting least
pressure on the palms.
• Keep the elbows close to each other and let them not
spread out.

• Inhale and come up.

• Arch the dorsal spine and neck backwards as far as you
can.
• Keep the body below the navel in touch with the ground.
• Maintain the final position with normal breathing for one
minute with least pressure on the palms.
• While exhaling come back to sthiti position.
• Relax in Makarasana.
Benefits
Brings flexibility to the dorsal spine. Strengthens the spinal
muscles. Reduces the abdominal fat. Useful in management of
bronchial problems and back problems.

Limitations
Those who have undergone the abdominal surgery may avoid
this Asana for 2 months. Proceed cautiously in cervical
spondylosis.

9. Salabhasana
Sthiti: Prone Posture
TECHNIQUE
• Make fists of your palms with the thumbs tucked in and
place them under the thighs, with back of the hands towards
the ground.
• While inhaling raise both the legs up as far as comfortable
without bending the knees.

• Maintain this position for about one minute with normal

breathing.
• Come back to Sthiti position while exhaling.
• Relax in Makarasana.
Note
• Pull up the knee caps and squeeze the buttocks to improve the
posture.
 'Yoga for Asthma

Benefits
a. The forward stooping of an asthmatic is due to lack of strength
in the spinal muscles. Hence the practice of Bhujahga, Salabha
and Dhanurasanas help in strengthening the spinal muscles
which in turn corrects their posture.
b. Bhujarigasana for the u p p e r dorsal and neck m u s c l e s ,
salabhasana for the lower dorsal and lumbar muscles and
dhanurasana for the entire spine.
c. Salabhasana also helps in releasing the phlegm from the air-
ways in the lower zone of the lungs.
d. Balances the prana. Tones up the kidneys and hip muscles.
Reduces fat on thighs and buttocks

Limitations
Cardiac patients and diabetics may avoid this posture.
Proceed cautiously in low back pain.

Supine Posture
10. Sarvarigasana
Sthiti: Supine Posture
TECHNIQUE
• Inhale, raise the legs together slowly
and gracefully (without bending the
knees) till it forms about 45° to the
ground.
• Continue to inhale and raise the legs
further to 90° position. Bring the
arms down and place them next to
the buttocks.
• Exhale, raise the buttocks and the
trunk, taking support of the arms and
e l b o w s , without lifting the head.
Rest the e l b o w s on the ground
firmly and support the back with
both palms.
• 177
 'Yoga for JZsthtna

• While retaining the legs parallel to the ground, straighten the

trunk by pushing it with the hands untill the chin is well set
in the suprasternal hollow.
• Inhale and raise the legs vertically keeping the body erect
and come to the final shoulder stand position.
• Maintain effortlessly with normal breathing for about 2-3
minutes. Carefully avoid all jerks.
• Slowly come back to Sthiti and relax in Savasana.

Benefits
a. Cleans the airways in lower zone
b. Balances the prana, Calms down the mind
c. Improves posture by reducing dorsal kyphosis
Limitations
People with Cervical spondylosis, low back pain and
hypertension should not do this pasture.

1 1 . Matsyasana
Sthiti: Supine Posture
TECHNIQUE
• Take the right leg and place it on the left thigh.
• Place the left leg on the right thigh as in Padmasana.
• Place the palms on either side of the head with fingers
pointing towards the shoulders.
• Inhale, take the weight on the palms and lift the head and
the back off the ground.
 Yoga for Asthma

• Bring the center of the crown of the head to the ground by

bending the dorsal and cervical spine backwards.
• E x h a l e and r e m o v e the h a n d s after the weight is well
b a l a n c e d on the head and catch hold of the big toes
hooking the index fingers around them.
• Press the elbows on the ground to bear the weight of the
upper half of the body.
• M a i n t a i n this p o s i t i o n for one m i n u t e with normal
breathing.
• As you exhale come back slowly step by step to supine
sthiti.

• Relax in Savasana.

Benefits
a. C o m p l e m e n t a r y to S a r v a h g a s a n a , good for diabetes,
asthmatics and other respiratory problems.

b. Complementary to Sarvahgasana helps in improving the

posture and reducing the dorsal kyphosis. This happens when
m a i n t a i n e d for 1/3 the duration of s a r v a h g a s a n a with
complete effortlessness, ease relaxation.

c. Attention is focused (dharana) on mid dorsal section of the

spine, where the strong stimulation due to stretch and pain is
felt. While maintaining give auto-suggestions of defocusing
from the point of pain (Ananata Samapatti) as suggested by
Patanjali. Releases the prana blocks and clears the airway
narrowing.

Limitations
Those who have recently undergone any abdominal or thoracic-
surgery and cervical spondylosis should avoid this posture for
3 months.
12. Halasana
Sthiti: Supine Posture
PRACTICE
• Inhale, raise the legs together slowly and gracefully
(without bending the knees) till it forms about 45° to the
ground.
• • Continue to inhale and raise the legs further to 90° position
and simultaneously bring the arms down placing them next
to the buttocks.

• Exhale, raise the buttocks and the trunk without lifting the
head. Support the back by the palms. Rest the elbows on
the ground firmly to get better support to the back.
• Maintaining the legs parallel to the ground, straighten the
trunk by pushing it up with the hands till the chin is well
set in the suprasternal hollow. Inhale in this position.
• Exhale, bring down the toes further to touch the ground.
Release both hands and rest the arms straight on the
ground parallel to each other with palms facing the
ground.
• Maintain this position for one minute with normal
breathing.
• Inhale, come back slowly step by step to rest the trunk on
the floor.
• Now exhale and bring down the legs to the ground.
• Relax in Savasana.
 Yoga for Jistfima

Note
• Make sure that you have achieved perfect balance before you
release the hands supporting the trunk.

Benefits
Stretches and stimulates the back muscles, spinal joints and
lumbar nerves. Enhances blood flow to the neck, activating the
thyroid and keeps spine flexible.
Limitations
People with any problem with the spine, hypertensives and
those with the cardiac problems must avoid this asana.

13. Deep Relaxation Technique (DRT)

Sthiti: Savasana
PRACTICE
• Gently move your whole body, make yourself comfortable
and relax completely.

Phase-I
• Bring your awareness to the tip of the toes, gently move your
toes and relax. Sensitize the soles of your feet; loosen the
ankle joints; relax the calf muscles; gently pull up the knee
caps release and relax; relax your thigh muscles, buttock
muscles; loosen the hip joints, relax the pelvic region and
the waist region. Totally relax your lower part of the body.
R..e..l..a..x.... Chant A-kara and feel the vibration in your
lower parts of the body.
Phase-II
• Gcnlly bring your awareness to the abdominal region and
observe the abdominal movement for a while, relax your
abdominal muscles and relax the chest muscles. Gently bring
your awareness to your lower back, relax your lower back,
loosen all the vertebral joints one by one. Relax the muscles
and nerves around the back bones. Relax your middle back,
shoulder blades and upper back muscles, totally relax. Shift
your awareness to the lip of the fingers, gently move them a
little and sensitize. Relax your fingers one by one. Relax your
palms, loosen the wrist joints, relax the forearms, loosen the
elbow joints, relax the hind arms-triceps, biceps and relax
your shoulders. Shift your awareness to your neck, slowly
turn your head to the right and left, again bring back to the
center. Relax the muscles and nerves of the neck. Relax your
middle pari of the body, totally relax. R..c..l..a..x.... Chant
U-kara and feel the vibration in the middle part of your body.
Phase-///
• Gently bring your awareness to your head region. Relax your
chin, lower jaw and upper jaw, lower and upper gums, lower
and upper teeth and relax your tongue. Relax your palates-
hard and soft, relax your throat, and vocal chords. Gently shift
your awareness to your lips, relax your lower and upper lips.
Shift your awareness to your nose, observe your nostrils, and
feel the warm air touching the walls of the nostrils as you
exhale and feel the cool air touching the walls of the nostrils
as you inhale. Observe for a few seconds and relax your
nostrils. Relax your cheek muscles, feel the heaviness of the
cheeks and have a beautiful smile on your checks. Relax your
eye balls muscles, feci the heaviness of eye balls, relax your
eye lids, eye brows and in between the eye brows. Relax
your forehead, temple muscles, ears, the sides of the head,
back of the head and crown of the head. Relax your head
region, totally relax. R..e..l..a..x.... and chant M-kara feel the
vibration in your head region.
 'Yoga for Jistfima

Phase-IV
• Observe your whole body from toes to head and relax, chant
an AUM in a single breath. Feel the resonance throughout
the body.
Phase-V
• Slowly come out of the body consciousness and visualize
your body lying on the ground completely collapsed.
Phase- VI
• Imagine the vast beautiful blue sky. The limitless blue sky.
E x p a n d your awareness as vast as the blue sky. Merge
yourself into the blue sky. You are becoming the blue sky.
You are the blue sky. Enjoy the infinite bliss. E..N..J..O..Y..
the blissful state of silence and all pervasive awareness.
Phase-VII
• Slowly come back lo body consciousness. Inhale deeply.
Chant an "AUM-kara". Feel the resonance throughout the
body. The soothing and massaging effect from toes to head.
Phase-VIII
• Gently move your whole body a little. Feel the lightness,
alertness and movement of energy throughout the body.
Slowly bring your legs together and the hands by the side of
the body. Turn over to the left or the right side and come up
when you are ready.
(Reminiscences of a (partcipant
lam anyoungman who -was suffering from fillergic (BronchialJAsthmafor over 13
years. I hadto take drugs regularly to keep it under controlwhich was only temporary.
(During summer season, the attacks kept me wheezing aft night and I was 'ever in
despair if my life was thus to Be altthrough.

^.chance reading of a newspaper article regarding 'Yoga Therapy Camp conductedby

Vxvekgnanda %endra caught my attention andl attendeda Yoga Therapy camp and
was much Benefitted (By regularpractice of what Ilearnt in the camp, 1 was able to
cure myself of this adment andl rarely use bronchodilaiors now.

IntheCamp we were explained in great detailallabout this dread-disease which

made it lookjess invincible. 'We were then taught Yogasanas, Yogic Kfiyis and
(pranayama (breath control and regulation). Though these appeared difficult at
first, became easier soon. We also learnt about the eight steps (JAstanga Yoga) leading
to self-realisation. (Raja Yoga, Jhana Yoga and(Bhakti Yoga were also explained In
fact, the camp was inaugurated by a devotee ofISXCON (InternationalSocietyfor
TQishna Consciousness) with an empahsis on (BhaktiYoga.

(Bhakji Yoga helps one to identify himself with his 9Aaker and %p.rma Yoga to
perform his duties .dispassionately, as an instrument in His hands. 'What doubt is
there about the success of anything that is done with such celestial guidance? Our
attempts to follow these Yoga ways ndus ofour obsession about our own seemingly
hard-to-solve problems and they allvanish like mist before the rising Sun. The path
of(Bhakti has done immense good to me.

There is no person who is born without problems. Some manage their affairs as well
as they can in the circumstances they are placed and some do not.forwant of ability
or guidance. ^Ability they can discover within themselves and guidance is what is
required. Vivekananda Kendra provides this guidance through its highly dedicated
personnel It is upto us to avail of their help. JZs one of those who has benefitted
with their help I invite all readers also to do so. Iam gra tefulto (Dr.K (RjNagarathna
forgiving me an opportunity to express myself.

r
(B.S. Chana ru
26years
 •Yoga for Asthma

PRAlSlAYAMA
Sectional Breathing
This is a preparatory breathing practice lor doing Pranayama.
It chiefly corrects the breathing pattern and increases the vital
capacity of the lungs. It has 3 sections:
(a) Abdominal Breathing or Diaphragmatic Breathing (Adhama)
Sit erect in Vajrasana. Exhale. Inhale completely, slowly and
continuously. This is called Puraka. The abdomen is made to
bulge continuously with the air entering especially into the lower
sections of the lungs. Before exhaling stop the breath (Antarya
Kumbhaka) for a second. While exhaling (Recaka) the abdomen
is drawn inwards continuously and slowly. Before the breath is
reversed, slop the breath (Bahya Kumbhaka) for a second and
inhale. Repeal the breathing cycle. There should be no jerks in
the whole, process. It should be smooth, continuous and relaxing.
The diaphragm separating the thorax from the abdomen descends
during inhalation with the bulging of the abdomen. This increases
Ihe air-flow inlo the lower sections of the lungs. The rhythmic
m o v e m e n t of the d i a p h r a g m massages the contents of the
abdomen gently, and helps the organs to function normally. It
promotes the general circulation also.
(b) Thoracic (chest) breathing or intercostal breathing
(Madhyama)
In this sectional breathing performed while sitting erect in
Vajrasana, inhalation and exhalation are performed by expanding
and contracting the chest only. Air flows through both nostrils
slowly and continuously. I he abdomen is controlled to avoid its
bulging The middle lobes are opened up fully by this type of
breathing.

125
(c) Upper lobar breathing or clavicular breathing (Adya)
Sit erect in Vajrasana. Raise the collar bones while inhaling. Keep
the abdominal muscles contracted. The air is forced into the
uppermost regions of the lungs thus ventilating the upper lobes.
The sparingly used upper lobes of the lungs will be properly
aerated by this breathing.
These three sectionalised breathings are also called 'Adhama
'Madhyama' and 'Adya'. In complete Yogic breathing technique
the above three sections will be combined. During inhalation,
the Adhama, Madhyama and Adya occur sequentially and during
exhalation the same sequence namely abdominal, chest and
clavicular breathinc occur. The whole process should be relaxing
and comfortable, without any tension in the face.
Four Mudras are generally associated with these sectional
breathing. They are Cin Mudra for Adhama, Cinmaya Mudra for
Madhyarm, Adi Mudra. for Adya and Brahma Mudra for complete
Yogic breathing.

PRANA AND PRANAYAMA

The basic vitality which is key to life, is what we term Prana.
Prana is the basic life principle. We believe that everything in
creation has Prana. Growth of Prana from a lower strata to higher
strata is the process that characterises life. In man, this process
is being accelerated by the conscious discrimination faculty and
is called 'Pranayama', regulation of Prana. 'While the goal of
life is to manifest the divirnty in us', the process of manifestation,
a scientific method is Pranayama" or in general 'Yoga'.
The normal misconceptions about Prana arise due to partial
understanding. Some say that Prana is the air entering in and
going out of the lungs, others feel that it is the energy that which
governs breath; some say that it is nothing but nerve impulses
etc. But as we have seen, Prana is the basic life principle. In its
dormant form, it exists in the mineral world. In the vegetable
kingdom, we can observe that the primary facets of Prana. Start
manifesting in the vegetable kingdom. As Prana manifests more
and more in the animal and human spectra, newer faculties
126
 'Yoga for Jistfima

emerge. The structure of the body is also suitably transformed

giving scope for the fuller manifestations of the higher emerging
faculties such as the mobile limbs and the senses in the animal
world and the complex anatomy of the human body. In different
parts of the body, different aspects of Prana work with proper
co-ordination and organisation between them. In the human
system our seers have recognised five major facets of Prana
carrying on five major functions.
There are five different manifestations of Prana also is called
Mukhya Prana (the chief Prana) to distinguish it from its five
manifestations. They are Prana, Apana, Samana, Vyana and
Udana. They are described in Prasna Upanisat as follows:

W£F& ^J: y<sHlfa+paJT Wi:

II II

Payupasthe apanam caksuh srotrc inukha nasikabhyam

pranah svayam pratisthate madhye tu samanah'.

'The Apana controls the organs of excretion and procreation; in

the eye and the ear as well as in the mouth and the nose dwells
the Prana himself; and in the middle is the Samana'.
The manifestation of chief Prana in the lower regions of the
abdomen is termed as Apana. Prana acts in the upper regions-
face, nose etc., which essentially corresponds to the force which
activates breathing. That which keeps the balance between the
upper and lower forces (Prana and Apana) is called Samana.
Vyana is defined as:

".reWHslHHlil U^HlPui *\<A«t\\§ 11

1 1 ^ 3 3.^11
Yoga for .'Asthma , .

llfdi. hycsa atnui; Atraitadckaiatam nadinam tasam fata

tatamekaikasya dva saptati dva saptatih,
Pratitakhananadlsahasrani bhavantyasu Vyanatcarati.

In the heart dwells Atman. There are (in the heart) a hundred
branches in each one of the Nadis, and each of these branch
Nadis again has seventy two thousand Nadis. In all these the
Vyana moves'. Vyana is that aspect of chief Prana that flows
through each and every Nadi. It coordinates the functions of
different aspects of Prana.

3 ^ % o f 3^R: 3^ TCfcT I

II W\Z M

Athaikayordhvani (h/ana/i punyena punyam lokam nay ati

papena papain. Ubabhyamcva manusya lokam'

And then, through one of them (Susumna). the Udana carries

(the soul) to the virtuous world by virtuous deeds, to the sinful
world by the sinful acts, and by both to the world of men'. And
Udana is the one that flows upwards in a subtle passage called
Susumna. Normally this is not known to ordinary people.

Pranayama is the science of regulating and gaining control over

this Mukhya Prana allowing its fuller manifestations to emerge.
But in particular wc use regulation of breath to gain control over
Prana. Hence, we need to understand the difference between
normal breathing (which is normally flowing randomly through
one or both the nostrils), Kriya (like Kapalabhali), Yogic full
breathing and Pranayama.

Normally there arc three components of breathing i.e., Inhalation.

Exhalation and Stoppage of breath. They are termed Puraka,
Recaka and Kumbhaka respectively. In Kumbhaka the stoppage
of breath can occur in 3 ways: after inhalation (Antar Kumbhaka),
after exhalation (Sunya or Bahya Kumbhaka) and an automatic

128
 'Yoga for jAslhma

suspension of breath (Kevala Kumbhaka). This last variety, Kevala

Kumbhaka is the aim of all Pranayamas. In this stage there is no
force inside urging us to breathe in or out. A natural suspension
of breath is accomplished. This may be induced for a short time
by a p r e c e e d i n g Kriya like K a p a l a b h a t i . Due to hyper-
oxygenation, wc get a glimpse of what Kevala Kumbhaka is
like. Recognition is half the solution, but it should not end there.
We must learn to induce this stage of automatic cessation of breath
without the preceeding Kriya. Thus, the real Kevala Kumbhaka
is the goal of all breathing techniques we are getting acquainted
with. There arc various effects of this Kevala Kumbhaka namely,
deep relaxation, lowered metabolic rate, sense of blissfulness,
expansivencss and single thought, essentially the same effects
as in Dhyana.

(See our book Pranayama for more details).

Schools in Pranayama
In the first school of p r a n a y a m a forceful kumbhaka is a
mandatory part. The ratio of Puraka, Antarya Kumbhaka, Recaka
and Bahya Kumbhaka will be initially 4 : 4 : 4 : 2 (the numbers
in the ratio could be taken as s e c o n d s ) . Gradually as one
p r o g r e s s e s , the K u m b h a k a portion is increased 4:12:8 :8;
4:16:8:12; 4:32:8:16; etc. As the duration of Kumbhaka is
increased more and more, some portion of the Kumbhaka will
be Kevala Kumbhaka. Continued practice leads one to attain
Kevala Kumbhaka for a longer duration.
While in the second school, emphasizing the slowness of recaka
and puraka, no forceful stoppage of breath (Kumbhaka) is used.
Instead, the time taken for each inhalation and exhalation is made
to increase gradually. Associated with it will be the deep
relaxation. As one progresses, one finds that an automatic
cessation of breath results. At the change over regions from
Recaka to Puraka and Puraka to Recaka, a slowness takes place
resulting in Kevala Kumbhaka.

129
 Yoga for }\sthma

In the first school, there is the danger of premature energy

evocation, Kundalini shooting up without proper overall purifi-
cation of the system in those who start doing for long durations.
It may result in a disaster; neurotics and lunatics may be the
outcome. One should work with precaution. The major point,
many such wrecks miss, is the use of Bandhas with Kumbhaka-
the Jalandhara, Uddiyana and Mula Bandhas. If this precaution
is taken and a disciplined life is followed, one could use this
school with no danger.
We have chosen the second, the safe path. Relaxation resulting
from slowing down of breath is the key. Both schools have the
same aim, but the second involves lesser violent changes. It is
smooth. Hence you can notice, that in all the Pranayamas, we
are not using Kumbhaka at all. But we would allow the automatic
suspension of breath whenever it occurs. In fact, we should
welcome it. Glimpses of Kevala Kumbhaka should be instilled
in each and every Pranayama. That is the key. After prolonged
v
practice of this method we proceed to introduce Kumbhaka' in
the Pranayama in the follow-up camps.

1. Surya Anuloma Viloma Pranayama

Sthiti: Vajrasana
PRACTICE
• Adopt Nasika mudra with your right
hand.
• Close the left nostril with the little and
ring fingers of Nasika Mudra.
• Inhale and exhale slowly through the
right nostril (Surya Nadi) only.
• Keep the left nostril closed all the time
during the practice.
• One cycle of inhalation and exhalation
forms one round.
• Practice nine rounds.
 'Yoga for }\slhma

Note
• Time taken for exhalation should he longer than inhalation.
• Depression patients may practice this Pranayama 27 rounds before
breakfast, lunch, dinner and before sleep (4 times a day).

2. Candra Anuloma Viloma Pranayama

Sthiti: Vajrasana
PRACTICE
• Adopt N a s i k a Mudra with your right
hand.
• Close the right nostril with the tip of
the thumb.
• Inhale and exhale slowly through the
left nostril (Candra Nadi) only.
• K e e p the right nostril closed all the
time during the practice.
• One c y c l e o f inhalation and exhalation forms one round.
• Practice nine rounds.

Note
• Time taken for exhalation should be longer lh:w inhalation.
• Anxiety patients may practice this Pranayama 27 rounds before
breakfast, lunch, dinner and before sleep (4 times a day).

Benefits
Physical
These Pranayamas help in clearing of the nasal passages. Willi
regular and long practice, flow of breath through each of the
nostrils becomes smooth and slow.

Therapeutic
It is Very useful lor nasal allergy and Deviated Nasal Spectrum
( D N S ) . S u r y a n u l o i n a - V i l o m a helps in reducing the obesity
e f f e c t i v e l y and ( a n d r a n u loma V i l o m a helps in increasing
weight.
Yoga for JAstftma

For specific significant improvement, the recommended

schedule is to have twenty-seven rounds of this Pranayama
four times a day (before breakfast, lunch, dinner and before
going to bed). Systematic practice right or left nostril
pranayamas have benefited large number of obese and under
weight persons respectively to achieve normal weight.

Spiritual :
Cleaning of Surya and Candra Nadis is the first step to bring
the balance between the two Nadis. They aid in unbfolding of
the inner layers of consciousness.

Limitations

For Suryanuloma-Viloma Pranayama, people suffering from hi-

blood pressure, any heart disease and underweight problem
should a avoid this practice.
For CandranuJoma- Viloma Pranayama, people suffering from
obesity and any type of allergic should avoid it.

3. NadTsuddhi Pranayama
Sthiti: Vajrasana
PRACTICE
• Sit in any meditative posture.
• Adopt Nasika Mudra.
• Close the right nostril with the right
thumb and exhale completely
through the (left) nostril. Then inhale
deeply through the same left nostril.
• Close the left nostril with your ring
and little finger of the Nasika Mudra,
release the right nostril. Now exhale
slowly and completely through the
right nostril.
• Inhale deeply through the same
(right) nostril. Then close the right nostril and exhale
 Yoga for Jistfima

through the left nostril. This is one round of Nadisuddhi

pranayama.
• Repeat nine rounds.
Note
• This practice helps to maintain balance between Nadis.
• If you feel headache, hea viness of the head, giddiness, uneasiness etc.

Benefits
Physical
It promotes balance between the two nostrils apart from cleansing
the nasal tract. It increases the vitality. Metabolic rate decreases
as in case of all other Pranayama prctices. It increases the digestive
fire and appetite.
Therapeutic
It lowers the levels of stress and anxiety by harmonising the
pranas. It is beneficial in respiratory disorders such as Bronchial
asthma, Nasal allergy, Bronchitis etc.
Spiritual
It induces tranquility, clarity of thought and concentration. It
clears pranic blockages and balances Ida and Pingala
Nadis,causing Shusumna nadi to flow which leads to deep states
of meditation and spiritual awakening. It helps to maintain
Brahmacharya which is a pre-requisite for spiritual progress.

Limitations
No Limitations.
•Yoga for Jistfima

4. Cooling Pranayama

a. Sitall Pranayama
Sthiti: Vajrasana
PRACTICE
• Place the palms resting on the
. thighs.
• Stretchthe tongue forward
partly out of the mouth and

\
fold it so as to resemble the
beak of a crow.
• Slowly suck in the air through the beak and feel the jet of
cool air passing down the throat into the lungs.
• Slowly exhale through the nostrils, feeling the movement of
warm air all the way up from the lungs through the throat
and the nasal passages.
• This completes one round of Sitali Pranayama.
• Repeat nine rounds.

b. Sitkari Pranayama
Sthiti: Vajrasana

PRACTICE
• Place the palms resting on the
thighs.
• Fold the tip of the tongue
inwards horizontally. The
folded tongue slightly comes
out between the two rows of
teeth and provides a narrow
opening on both sides.
• Slowly suck the air in through the two sides of the tongue.
Feel the cool stream of air diffusing throughout the mouth
and throat into the lungs.
 Yoga for Asthma

• Exhale slowly through both nostrils. Feel the warmth of the

exhaled air.
• This completes one round of Shkari.
• Repeat nine rounds.

c. Sadanta Pranayama
Sthiti: Vajrasana

PRACTICE
• Place the palms resting on the
thighs.
• Let the upper set of teeth
touch the lower set of teeth.
• Keep the tip of the tongue just
behind the teeth.
• Inhale through the crevices of
the teeth and feel the cool air
moving slowly and continuously into the mouth and
passing down the throat into the lungs.
• The warm air is exhaled out slowly through both t h e
nostrils. Feel the warmth of exhaled air.
• This completes one round of Sadanta.
• Repeat nine rounds.
Benefits
Physical :
They induce muscular relaxation and an over-all cooling effect.
They soothen the eyes, cars and purify the blood. They quench
the thirst, appease hunger and generate a feeling of satisfaction.
The taste buds and the mouth are sensitised.

Therapeutic :
Allergies due to cold can be effectively overcome by prolonged
practice. They help in reducing tensions and stresses and induce

1 ^
1 .>.'
'Yoga for Jistfima

mental tranquility. Sitkari and Sadanta keep the teeth and gums
healthy. They help reduce blood pressure and acidity in stomach.
They cure chronic dyspepsia (indigestion), various chronic skin
diseases, and releases even very subtle tensions.

Spiritual
Expansion of awareness - a facet of spiritual growth - takes place
as you move from sitali (linear awareness) to sitkari (surface
aware-ness) and then to sadanta (3-D awareness).

Limitations
People with Low Blood Pressure should avoid. People suffering
from cold, sore throat, bronchitis etc. should avoid. Practitioners
with sensitive teeth, missing teeth or dentures should avoid sitkari
and sadanta. Instead they can practise sitali. Generally, avoid in
winter or in cool climates.

5. Bhramarl Pranayama

Preparatary Practice of M-kara and N-kara:

• In order to chant M-kara, you can chant any word ending
with 'M' such as 'Om', 'Mum', 'Swim', etc. but stretch the
'M' part only. This will result in 'M-kara' chanting.
• Chant 'MM' a few times and observe that your lips are
closed, rows of teeth are separated and the tongue is just
behind the lower set of teeth.
(N-kara)
• In order to chant N-kara, you can chant any word ending
with 'N' such as ' 'King', 'Ring', 'Sing' etc and streth the
'N' part only .This results in the 'N-kara' chanting.
• Chant 'NN' a few times and note that your lips are
separated during this chanting.
• While practicing Bhramarl, wc need to use this sound of
'N-kara' and not 'M-kara' whereas while practicing
nadanusandhana we use the 'M-kara'.
 'Yoga for Jistfima

Note:
• In the beginning, 5 to 10 rounds of Bhramari is sufficient. Slowly
increase to 10 to 15 minutes.
• It can be practised at any time to relieve mental tension.

Benefits
Physical :
Creates a soothing effect on the nervous system. Cultures the
voice and increases the melody.
1. Centering the awareness is an important step in harmonious,
rhythmic free flow of prana that cures illnesses. Perfect health
is indicated by the prana flowing in the central channel
sushumna recognizable as equal flow of air in both nostrils.
2. Bhramari pranayama helps in starting from focusing the mind
on the point of voice production in threat, you need to feel
the vibration differing from this central point (the seal of
visudha charka) to the upper respiratory pathways' including
the phoenix nasal passage. Paranasal sinuses eustachian tubes.
The perception of these vibrations spread in three dimensional
spherical ways to reverberate the entire skull region. This gives
the necessary soothing internal massage.
a. To release the phlegm in upper aiways and also
b. To reduce the basic inflammation and open up the blocks.
3. Bhramari pranayam is very useful to calm down the mind
and thus stress reduction.
Yoga for Jistfima

Fields of Application of Yoga at

VYASA
1. Yoga for all General public and Masses (Rural)
2. Yoga for unraveling the Hidden potentials of
human beings
3. Yoga in Education
4. Medical Applications
5. Yoga for Corporate Sector: SMET, HOLSYM
6. Yoga for the Handicapped: MR, Blind, Schiz
7. Yoga for the socially deprived: Orphans,
( Addicts Remand home inmates, Prisoners
8. Other Applications of Yoga: Sports, Music,
Dance, Law, Quantum Physics and Technology

What is Prashanti Kutiram?

The abode of peace (Prashanti Kutiram) is the name
of a spacious campus 20 miles from Bangalore. This
is the Head Quarters of VYASA.
^ 1
 Yoga for jAsthma

MEDITATION
a. Naddnusandhana
(A-kara, U-kara, M-kara, A-U-M)
1. A - Kara chanting
Sthiti: Vajrasana
PRACTICE
• Sit in any meditative posture and adopt
cin-mudra.
• Feel completely relaxed and close your
eyes.
• Inhale slowly and completely.
• While exhaling chant 'AAA' in a low pitch.
• Feel the sound resonance in the abdomen and the lower
parts of the body.
• Repeat nine times.

2. U - Kara chanting
Sthiti: Vajrasana
PRACTICE
• Sit in any meditative posture.
• Adopt Cinmaya Mudra.
• Inhale slowly and completely.
• While exhaling chant *UUU* in a low
pitch.
• Feel the sound resonance in the chest
and the middle part of the body.
• Repeal nine times.
119
3. M - Kara chanting
Sthiti: Vajrasana
PRACTICE
• Sit in any meditative posture.
• Adopt Adi Mudra.
• Inhale slowly and completely.
• . while exhaling chant 'MMM' in a
low pitch.
• Feel the sound resonance in the entire
head region.
• Repeat nine times.

4. A-U-M Chanting

Sthiti: Vajrasana
PRACTICE
• Sit in any meditative posture
• Adopt Brahma Mudra.
• Inhale slowly and completely fill the
lungs.
• While exhaling chant 'A-U-M ' in a
low pitch.
• Feel the sound resonance throughout
the body.
• Repeat nine times.
Note
• Different sounds like A, U, M & A UM are produced loudly so that
they generate a fine resonance all over the body. (Resonance will
occur only when the frequency of the generated sound matches with
the natural frequency of the body).
• These resonant sounds act as stimulations and the post-resonance
silence deepens the awareness and releases even very subtle tensions.
• Therefore, while producing different sounds (A, U,M,&A UM) try to
adjust the pitch in such a way that a fine resonance is achieved.
b. OM- Ohyana (Meditation)
Sthiti: Any Meditative Pasture
PRACTICE
• Sit in any comfortable meditative posture feeling complete!)
relaxed.
Phase I
• Close your eyes and start chanting
OM mentally. Allow the mind to
repeat OM continuously without
any break. If there are destractions.
chant OM faster, not giving a
chance for distractions.
• After a while the chanting slows
down. Consciously slow it down
further. If the mind jumps to
distractions, increase the speed of
japa o f OM kara. Thus, by
increasing and decreasing the
speed of chanting, allow the japa to settle down to a slow-
pace with an unbroken stream of effortless flow of OM
japa in your mind.
Phase II
• Make the chanting softer and softer, gentler and gentler,
and more and more effortless. As you progress on the path
of meditation, you will reach the second phase of japa in
which you start feeling the vibrations of the japa in some
part of the body and l a t e r throughout the body ( t h r e e
dimensional - 3D awareness).
Phase III
• A s y o u s l o w d o w n t h e j a p a o f OM, observe t h e gap
b e t w e e n t w o O M s . A s \ o u s l o w d o w n further, t h e gap
goes on becoming wider and wider to diffuse into silence.
'Yoga for Jistfima

Phase IV
• The experience of inner silence helps to expand from the
three dimensional awareness of the body to all pervasive
awareness(beyond the limits of the body). The bed of
silence becomes deeper and more expansive. Visualise and
feel anocean of silence with gentle soft waves of OM on it.
Now merge into complete silence and reach the stage of
. Ajapa(no repetition). This silence is the source of Creativity,
Power, Knowledge and Bliss. Remain in this state for a
while.
Phase V
• From this deep ocean of silence in the heart region, let one
OM emerge as an audible sound which diffuses into the
entire body and the space all around. Enjoy the beautiful
vibrations.
• Blink the eyes slowly, gently open the eyes and come out
of meditation.
Note

• Try to touch this state of deep rest and inner silence several times
in the day whenever you have some free time.

c. Cyclic Meditation
Step I: STARTING PRAYER
• Lie on your back. Relax and collapse the whole body on the
ground; legs apart; hands apart; palms facing the roof; smiling
face; let go all parts of the body. As you repeat the prayer
feel the resonance throughout the body.

Laye Sambodhayet Cittam Viksiptam Samayet Punah

Sakasayam Vijanlyat Samapraptam Na Calayet
 Yoga for Jistfima

Meaning: In the state of oblivion awaken the mind: when agi-

tated pacify it; in between the mind. If the mind has reached the
state of perfect equilibrium, then do not disturb it again.

Step II(a) : Instant Relaxation Technique (IRT)

• Bring your legs together;
join the heels, toes together,
and palms by the side of the
t h i g h s . K e e p y o u r face
smiling till the end. Gently bring your awareness to the tip of
the toes. Stretch the toes, tighten the ankle joints, and tighten
the calf muscles. Pull up the kneecaps. Tighten the thigh
muscles. Compress and squeeze the buttocks. Exhale and
suck in the abdomen. Make the fists of the palms and tighten
the arms. Inhale and expand the chest. Tighten the shoulders,
neck muscles and compress the face. Tighten the whole body
from the toes to the head. Tighten tighten tighten Release
and relax. Legs go apart; arms go apart, palms facing the
roof. Assume the most comfortable position; let the whole
body sink down. Let all the groups of muscles beautifully
relax. Collapse the whole body. Enjoy the relaxation.

Step 11(b) : Linear Awareness

• Now slowly raise the left hand above the head J
along the ground. Slowly turn over to the left side.
Place the head on the left biceps; the right leg on
the left leg; right palm on the right thigh. Let the
whole body relax. Feel entire weight of the body
coming down to the ground along the left side of
the trunk. Fine linear awareness. Slowly start
coming up to Tadasana. Let all the movements
slow down. Let the breathing be deep, slow, and continuous.
Eyes are kept closed. Carefully feel the changes in your body
as you standup and reach the vertical position. Feel the How
of blood down the heart. Feel the heartbeat and the pulse.
Chant Bhramari to generate 3D awareness. NNN' Feel the
whole body resonating. Feel the fine massaging effect.

143
Step II (c): Centring
• Now slowly lean forward. Feel the weight of the entire body
on the toes. Pointed awareness. Slowly lean backwards. Feel
the weight on the heels. Surface awareness. Come to the
center. Lean to the right. The weight of the entire body is on
the right edge of the right foot. Linear awareness. Lean to
the left. Come to the center. Fine surface awareness. Now
• the whole body is centered, the weight of the body is equally
distributed throughout the soles of the feet. Collapse the
shoulders, arms hanging freely down. Smiling face. Feel all
the changes taking place throughout the body.

Step III: Standing Asanas

Ardha Khati Cakrasana
• Now we pass on to the first set of stimulation and relaxation.
• Ardha Kati Cakrasana - the half wheel posture.
• Slowly start raising the right arm sideways up,
to raise the arm slowly and continuously to
horizontal position, enjoy the movement. As
the right arm reaches 90° position twist the
palms at the wrist. Concentrate on pointed
awareness at the wrist and glide the right arm
up to 135° position. Beautiful pointed
awareness on the deltoid muscles of the right
arm. As the right arm reaches up the vertical
position feel the nice stimulation in the
shoulder muscles. The right biceps touching the right car,
feel the beautiful surface awareness. Feel the blood gushing
down the arm. Smiling face. Stretch the right arm from the
tip of the fingers of the right palm. The entire right portion of
the body gets stretched, but not the face. Keep the face always
smiling and relaxed. Slowly start bending down to the left.
Left palm sliding down along the left thigh. Fine movement
of surface awareness. Enjoy the fine stretch of the waist
muscles on the right side and compression on the left side.
Observe all the changes taking place in your body. Slowly
 Yoga for Jistfima

start coming back to vertical position. Feel the blood flowing

down and spread of nerve impulses throughout the body.
Again stretch and pull up the right arm. Feel the entire right
portion of the body stretched from the toes to the tip of the
fingers. Slowly start bringing the right arm down to 135°
gliding down smoothly. Feel the pointed awareness at the
shoulder as you reach horizontal position and at the wrist as
you slowly turn the palm downwards. Further, bring down
the right arm to 45°. Feel the tingling sensation at the tips of
the fingers. Continuously glide down the hand by the side of
the thigh and hang it freely. Have a glance of the whole body
again from toes to head. Entire right portion of the body is
beautifully charged with nerve impulses and energized.

• Now let us perform A K C from the left side. Slowly start

raising the left arm sideways upwards to 45° . Glide smoothly
u p w a r d s to horizontal position, palm twisted upwards.
Beautiful pointed awareness at the wrist. Left ami beautifully
moving up to 135° . Then to vertical position. Left biceps
touching the left ear. Now stretch up the left arm from the tip
of the left fingers. Entire left portion of the body gets stretched
up but not the face; face smiling and relaxed. Slowly start
bending to the right. Right palm sliding down the right thigh.
Movement of surface awareness, beautiful stretch of the left
waist muscles. Enjoy the changes going on. Feel the heart
beat and the nerve impulses spreading throughout the body.
Slowly start coming up to the vertical position. Feel the nerve
impulses from the tips of the fingers of the left palm. Pull up
the left palm. Entire left portion of the body gets stretched
up. Slowly bring the left arm down to 135°, then further down
to horizontal position. Twist the wrist downwards and enjoy
the pointed awareness. Glide your arm down further to 45°
Continuously drop down the hand by the side of the thigh
and hang it freely. Collapse the shoulders. Have a glance of
the whole body again from toes to head. Entire left portion
of the body is charged with nerve impulses, energized and
light. Enjoy the sense of well being. Both the sides of the
body are now equally energized.

145
 'Yoga for Jistfima

Step IV. Quick Relaxation T e c h n i q u e (QRT)

• Now slowly sit down and then
lie down to Savasana from the
right side. Let all the movements
be slow and continuous. The
entire right arm stretched, head on the right biceps, left leg
on the right leg, left palm on the left thigh, the weight getting
transferred to the ground from the right side, beautiful sharp
linear awareness. Slowly turn over, the muscles of the back
collapsing on the ground, bring down the right arm along
the ground. Legs apart, arms apart, palms facing the roof.
Assume the most comfortable position.
Phase I -Observing the abdominal movements.
• Bring your awareness to the movements of the abdominal
muscles moving up and down as you breathe in and out.
Recognize the haphazardness and jerky movement of the
abdominal muscles. Do not manipulate the breathing, let it
be natural, simply observe the abdominal movement. Count
five rounds mentally, one inhalation and one exhalation
forming one round.
Phase II -Associate with breathing.
• Synchronize the abdominal movements with the breathing.
While inhaling the abdomen bulging up and while exhaling
the abdomen sinking down. Inhale' deeply and exhale'
completely. Continue up to five rounds.
Phase III - Breathing with feeling.
• As you inhale, the abdominal muscles are coming up.Feel
the whole body getting energized and feel the lightness. As
you exhale, feel the whole body collapsing and sinking down
nicely. Release all the stresses and tensions completely. Inhale
deeply and exhale completely. Continue up to five rounds.
• Bring your legs together and hands by the side of the body.
Come up straight with the support of the elbows to the sitting
legs stretched relaxation position (Sthiti) - Dandasana. Let
all the movements be slow and continuous without jerks.
 Yoga for Asthma

Legs apart. Take support of the palms behind the back. Relax
the neck muscles, the head hanging freely down backwards
or resting on either of the shoulders. Feel the changes
throughout the body.

Step V: Sitting Asanas

• Now we pass on to the next set of stimulation and relaxation.
Vajrasana, Sasankasana and Ardha- ustrasana/Ustrasana
combination.

Vajrasana
• Slowly fold the right leg backward and then
the left leg, sitting on the heels, coming to the
Vajrasana position. Palms on the thighs and
keep the spine erect. Enjoy the effect of
harmonizing, the beautiful balance. Recognize
all the changes in the body.
Sasankasana
• Now slowly start taking the arms behind. Hold the right wrist
with the left palm. Start feeling the
pulse at the right wrist, feel the heart
beat. Now slowly start bending down
forward for Sasankasana. The ^^^^
abdominal and chest muscles ^^^B
pressing on the thigh, beautiful
surface awareness. Now collapse the forehead on the ground.
Fine surface awareness. Collapse the shoulders. Observe all
the changes going on, the increased flow of blood into the
head and feel the heaviness in the head region. Inhale and
chant M-kara, MMM... Feel the resonance throughout the
head, 3D awareness. Slowly come up to Vajrasana. Carefully
follow all the changes in the head region. Feel the lightness
in the head. Feel the heart beat, fine 3d awareness throughout
the body. Slowly release the arms, place them on the thighs
near the knees.
 Yoga for Jistfima

Ustrasana
• Slowly rise up to stand on the knees for
Ardha-ustrasana, . Standing on the knees,
observe all the changes in the head region.
Slowly slide the palms up along the thighs,
fingers together and support the waist with
the palms, fingers pointing forwards.
Slowly start bending backwards from the
waist. Relax the neck muscles; head hanging freely down.
Beautiful stretching of the abdominal and thoracic muscles.
This is Ardha-ustrasana. Those who can, go further down to
Ustrasana by placing both the palms on the soles of the feet.
Have a beautiful smile on the face. Inhale and chant AAA;
Slowly return by releasing the arms and placing them on the
waist. Feel the avalanche of nerve impulses throughout the
body. Feel the heartbeat. Slowly come back to Vajrasana
and place the palms on the thighs. Feel all the changes and
let the changes continue; fine 3-dimensional awareness
throughout the body. Unfold the right leg and the left leg.
Assume the leg stretched position. Head hanging freely
backward or resting on either of the shoulders.
Step Vii : Deep Relaxation Technique (DRT)
• Slowly slide down to
Savasana with the support of
the elbows. Legs apart, hands
apart, palms facing the roof.
Let the whole body collapse
on the ground. Let us make ourselves comfortable and relax
completely. We will now go for DRT: continue as in page
no. 55
 Yoga for Asthma

10

KRIYAS - CLEANSING TECHNIQUES

Introduction
Kriyas are cleansing practices. In that sense, we all practise Kriyas
daily. Bathing, washing the face, brushing the teeth, all are Knyas.
But yoga Kriyas refer to special yoga techniques meant to cleanse
the inner organs, developed by the yogis. Among several Kriyas
available in the yogic lore six major Kriyas called Sat Kriyas are
quite comprehensive.
They are
i. Trataka for eyesight.
ii. Neti for upper nasal trackt (from throat to nostrils).
iii. Kapalabhati for lower respiratory trackt (from nostrils to
lungs).
iv. Dhouti for upper gastro intestinal tract (GIT) upto stomach.
v. Nauli for abdominal viscera (Agnisara is the preparatory
phase for Nauli).
vi. Basti for lower gastro intestinal tract (GIT) the colon and
rectum. (Sankha praksalana is for the entire GIT).

Yoga Kriyas
. . ,
• Cleanse the inner tracts.
• Remove Tardiness of organs.
• Develop an inner awareness.
• Desensitization.
• Stamina building.
Sneezing, running nose and blocking of nose are natural
mechanisms to prevent and throw out any unwanted dangerous
substances that may enter the nose. Nasal allergy or hay fever is
1
 Yoga for Jistfima

a condition where in this protective response has turned into a

disease because of the over reactivity of the air passages. In yoga
therapy which is a self corrective technique, you are using your
will power to reverse this hyper-reactivity. This is the process of
voluntary desensitization by systematic repeated intermittent
exposure to a non-specific provocative substance-the saline water,
on the background of deep rest to the nerves and the immune
system, in the nasal lining. On the first day when you try to
practice Neti Kriya you will find it very disturbing with much
discomfort. As the water or the rubber tube touches the inner
lining of the nose, with a strong will power you go on to do the
practice ignoring the up going sensations of irritation.
Psychological acceptance of the irritating provocation followed
by very deep rest is the trick to develop mastery over the reflex.
As you go on repeating the kriya day after day, you will notice
that it is becoming easier and easier. After a few attempts the
water or the rubber tubing passes through the nostril without
any irritation and you start enjoying the process. What has
happened is that your voluntary nervous system (using your will
power) has now learnt to control the involuntary reflex response
to irritation. This is mastery. You have not lost the capacity to
sneez but learnt to overcome the uncontrolled exaggerated reflex
responses. It is important to do all these practices after you have
learnt the technique of relaxation. Hence understand and learn
the practice.

It you have severe nasal allergy learn how to relax during and
after the practices of breathing techniques, asanas and meditation
before you go on to try Kriyas. Do not practice neti kriya in the
first week of starting the yoga lesson as you may not have learnt
the technique of relaxation which is an essential component of
neti kriya.
Can all asthmatics perform Neti ?
If you have had ear surgery or surgery for sinusitis, it is better to
avoid Jalaneti but you can perform catheter neti (Danda Neti).
150
 Yoga for Asthma

When surgery is done the passage from the nose to the sinuses
may have been widened and water may enter the sinuses and
get locked in there to cause problems. But the catheter cannot
enter the sinus and hence may not cause any problem.

What is the role of Dugdha Neti and Ghrita Neti?

Dugdha neti is, neti performed by using half strength milk with
salt, in the same way as Jalaneti. This may be more useful than
Jala neti, in persons with specific allergies to inhaled proteins.
If you have prominent nasal polyps do not perform cathter neti;
it may bleed when touched by the catheter. If you have any other
associated major illness like heart disease, hypertension, take
advice by a trained yoga therapist before you try neti.
For persons who have dryness of the nose due to chronic damage
to the inner lining with bleeding (with or without loss of smell)
ghrita neti performed with ghee immediately after jalaneti is a
useful practice.
What is the role of Dhouti in asthma?
Vamanadhouti performed after drinking hike warm saline water
in a very useful tool for its immediate effect of relieving acute
attacks of asthma. It is a common experience in children that
whenever they have an acute attack of asthma with wheezing
and cough, they go on coughing to end up with vomiting that
brings out all the phlegm and the wheezing stops. This is the
nature's mechanism of activating the upward force of udana by
the upward surge of prana during vomiting. This natural
phenomenon is used during the voluntary training of vamana
dhouti; to help you comeout of an attack without resorting to
inhalers. Thus Vamanadhouti stimulates udana force that not only
cleanses the stomach of the acid and mucus but also stimulates
the cough reflex thus cleansing the air passages (small and big)
of all the clogged up phlegm. When carried out repeatedly over
a period of a few months it can help you develop mastery over

151
not only the voluntary cough reflex but also the wheezing
(bronchospasm) reflex.
The reflexes in this region such as sneezing, wheezing, coughing
and vomiting are all controlled by ANS Vamana dhouti
voluntarily activates the autonomic nervous system this reflex
voluntary stimulation of these involuntary stimulation of these
involuntary function where followed by voluntary deep relaxation
helps in developing mastery over these reflexes similar to the
principle of biofeedback. The concept in biofeedback is to
develop mastery over an autonomic function by giving a
voluntary sensory input of the functional status of the target organ.
For eg., in biofeedback training to relax, you are attached to a
small electrode from the ECG which is connected to the
equipment that records and displays colored light to indicate the
heart rate. By constantly looking at this light, you are asked to
move the light from red zone to green zone for which you have
to relax and calm down your mind. As soon as you get tensed
the light shifts to red zone and when you relax it shifts to green
light with this visual voluntary input soon you can learn to relax
and be calm. This you have learnt to develop voluntary control
over the involuntary function of increasing or decreasing the
heart rate which is a function of ANS.

In yoga this type of training in mastery over all internal functions

is aimed at not by using an external gadget but by deep internal
awareness. The inner eye or the inner observation is sharpened
by regular practice of awareness of the subtle visceral or organ
sensations. This is done by exciting the target organ through a
cautious controlled provocation of basic protective reflexes such
as sneezing (Neti), vomiting (Dhouti) or blinking (Trataka). The
ancient rishis also realized that the integral part of this mastery
over these basic reflexes includes a conscious deep rest.
Therefore mastery means ability to activate or stop the reflexes
when required. Yogic loosening exercise and asanas performed
with intense.
 'Yoga for Asthma

CLEANSING BREATHS
1. Anunasika Breathing
(Cleansing by inhalation and exhalation)
Sthiti: Any Meditative Posture
• Exhale completely. Inhale through both
nostrils and hold the breath for a few
seconds.
• Blast out the air through both nostrils in
short b u r s t s , until the lungs are
completely empty. Repeat 5 times.
• Now close the right nostril using the
thumb of the right hand. Inhale, hold for
a few seconds and blast out through
left nostril in short bursts of air. Repeat
several times.
• Next, close the left nostril using the ring and the little lingers
of right hand in nasika mudra. Repeat the above process
several times through right nostril.
• Repeat the complete process several times using both nostrils.
This type of breathing clears the respiratory passages and
purifies the sinuses in the skull.

2. Mukha Dhouti
(Cleansing through a single blast
breath).
Sthiti: Tadasana
PRACTICE
• Spread the l e g s apart by about
2 feet.
• Lean forward and place the hands
on the knees.
• Inhale deeply and expel the air
forcibly as in a jet through the
m o u t h , c o n t i n u o u s l y . This is
— 15T
foga for Asthma

effected by contracting the diaphragm as prolonged

exhalation. Repeat several times.
Benefits
a Forceful exhalation expels the air trapped in alveoli during
airway narrowing.
b. Helps in expelling carbon-dioxide and have better
.oxygenation of blood.
c. Leads to faster recovery after a dynamic muscle work.
d. Expels secretion trapped in airway.

3. Mukha Bhastrika
(Cleansing through hyperventilation)
• Kneel down, with the heels together and sit erect.
• Inhale fully.
• While exhaling in a series of expulsions of the breath through
the mouth, (keeping the lips puckered as if you are going to
whistle) bend forward and rest the head on the ground in
front of the knees. The expulsions are done with the help of
the abdominal muscles.
• Inhale, come up slowly.
• Repeat several times.
• The purpose of Mukha Bhastrika is to reduce the level of
carbon di-oxide present in the body. Also a cleansing practice.

4. Viparltakarani Kriya
(Cleansing in inverted posture)
Sthiti: Supine Posture
PRACTICE

• Raise the legs to 90°, keeping the knees straight.

• Raise the buttocks and the trunk off the ground by supporting
the body with the hands at the waist to transfer the weight to
the arms and elbows. Keep the elbows as close to each other
as possible.
 Yoga for Asthma

• Slowly move into the final position

of Viparitakarani by raising both legs
to vertical position and maintaining
the trunk at an angle of 45° to the
ground.
• In the final position the weight of the
body rests on the shoulders, neck and
the elbows, the trunk is at 45° angle
to the floor, the legs are straight and
perpendicular to the floor. Note that
the chin should not press against the
chest.
• Close the eyes and feel comfortable.
• Now practice Kapalabhati at a rate of about 40/minute.
• Now slowly in a rolling motion, pull the buttocks inwards.
• Then contract the anal sphincter muscles and pull the anus
inwards and upwards.
• Hold it as long as possible with normal breathing.
• Release the bandha and then retrace the steps to come down
to the supine sthiti and rest in Savasana for a while.

Benefits
It stimulates and tones the uro-genital and excretory systems.
Intestinal peristalsis is also stimulated, relieving constipation.

MAJOR KRIYAS
Among the six processes which purify the system mentioned
earlier: Kapalabhati, Neti, Dhouti, Nauli, Trataka and Basti we
will briefly describe the first five only.

TRATAKA
A. Preparations
i) Get candles, candlestand and match box.
ii) Wash your eyes with cool and clean water (with eye cup if
available) before starting the practice for good result.

155
Yoga for Jistfima ^

iii) When you practice in a group, sit around the candle stand,
making a circle at sufficient distance from the candle stand
(1.5 to 2 meters). The maximum number of participants in a
group around could be about ten. Keep the candle at the
same level as the eyes.
iv) Arrange a few chairs for those who are not able to sit on the
ground.

Instructions
• Sit in any comfortable meditative posture, if necessary you
may sit in a chair.
• Remove your glasses and wrist watches.
• Keep your spine, neck and head in a line. Collapse your
shoulders.
• Close the eyes and adopt Namaskara mudra.
• Maintain a smile on your face through out the practice. Calm
down your mind. Observe your body & breath.
• Begin the session by chanting the verse from the Upanisats
praying for the welfare of the teacher and the student.

Starting Prayer

chicj/cj^l

& YTlfcT: YJlf^f: VJlfcT: 11

Om sahanavavatu, Sahanou bhunaktu,
Saha viryam karavavahai ,
Tejasvinavadhitamastu, ma vidvisavahai
Om Santih, Santih, Santih.
May he protect us both (i.e., the teacher and the student). May
he nourish us both. May we both work together with great energy.
May our study be enlightening and fruitful. May we not hate
each other. Om Peace, Peace, Peace.
 Yoga for Jistfima

• Gently take your hands behind the back, catch the right wrist
with left palm, make a loose fist with the right hand and feel
the pulse of right hand using your fingers of left hand.
• As you exhale, gently bend forwards to touch the ground
and surrender to the All Mighty.
• Come back as you inhale.

Jyoti Trataka (in three stages)

Step I: Effortless Gazing or Focusing at flame
• Let us start Stage-I of Jyoti Trataka i.e., "Effortless gazing or
Focusing".
• Gently open your eyes with a few blinks and look at the floor.
Do not look at the flame directly.
• Slowly shift your vision to the base of the candle stand, then
move to top of the stand, then to the candle and then slowly
look at flame of the candle. Now, start gazing at the whole
flame without any effort. Do not blink your eyes. There may
be a few irritating sensations, but use your will power and
gaze in a relaxed way. If tears appear, allow it to flow freely.
This is a sign of good practice. Let the tears wash out the
impurities from the eyes. Learn lo ignore the irritation and
watering from the eyes.
• Gaze at the flame about 30 seconds.
 •Yoga for jistfima

• Slowly close your eyes, rub your palms against each other
for a few seconds, form a cup of your palms and cover your
eyeballs.
• Give press and release palming.
• After completing five rounds, gently drop your hands down.
• Feel the cool sensation around the eyeballs. Relax for a few
. seconds. Do not open your eyes immediately.

Step II: Intensive focussing at the tip of the wick of the flame

• Pass on to Stage-II of Jyoti Trataka i.e., "Intensive focussing"

(Dharana) .
• Gently open your eyes with a few blinks and look at the floor.
Do not look at the flame directly.
• Slowly shift your vision to the base of the candle stand, then
move to top of the stand, then to the candle and then slowly
look at the flame of the candle. Now, start gazing at the whole
flame without any effort.

• Slowly gaze at the tip of the wick of candle, the small black
cord. Focus your attention at one point. This is a practice of
focussing and concentration. Keep on gazing, use your will
power. Let the tears come out and try not to blink your eyes.
By practice the gaze becomes steady, making the mind one
pointed.
• Gaze at the flame for about 30 seconds.
 Yoga for Jistfima

• Slowly close your eyes, rub your palms against each other
for a few seconds then form a cup of your palms and cover
your eyeballs.
• Give constant pressure palming. Press constantly around the
eyeballs with your palms and inhale deeply and exhale
completely continue four more rounds count mentally. Do
not touch the eyeballs with your palms directly. Relax your
eye muscles completely.
• After completing five rounds, gently drop your hands down.
• Feel the cool sensation around the eyeballs. Relax for a few
seconds. Do not open your eyes immediately.
Note for Stage-I & II
• Continuously gaze at the flame, no blinking or winking, smooth and
effortless gazing.
• Use your will power and ignore watering or irritation in the eyes.
Gradually increase the duration of gazing upto 60 seconds over a few
weeks of practice.

Step III: De-focussing

• Let us proceed to Stage-Ill of Jyoti Trataka i.e., "De
focussing".
• Gently open your eyes with a few blinks and look at the floor.
Do not look at the flame directly.
• Slowly shift your vision to the base of the candle stand then
move to the top of the stand, then to the candle and then
slowly look at the flame of the candle. First fix your attention
at the flame, then gradually widen your vision. Slowly de-
focus your attention from the flame and have a de-focused
gaze on the flame. With expansive awareness, collect all the
details of the flame such as colour of the flame, shape of the
flame, and aura around the flame. Then observe the aura
expanding more and more and see the small light particles
around the flame. Recognize the subtle change of acheived
by de-focussing.
• After one minute of de-focussing, gaze or focus on the flame.
Slowly close your eyes and retain the image in your mind.
Visualize the flame between your eyebrows and collect all
the details with your eyes closed. When the image disappears
go for palming.
• This time we combine palming with breathing and Bhramari.
First apply constant pressure around your eyes, then inhale
and chant Bhramari Mm....; feel the vibrations of Bhramari
through out the body; repeat the same. Inhale - chant Mm....
as you exhale, inhale Mm...., inhale Mm.... and the last round
inhale Mm....; feel the sound resonance in the entire head
region specially round the eye region.
Step IV: Silence
• Feel the silence and relax for a while. After sufficient
relaxation, gently drop your hands down. Sit quiet for some
time and feel the deep comforting effect of the practice. Be
aware of the changes taking place inside you. Recognise that
the mind has become completely calm, your concentration,
will-power and sharpness of eyesight have improved.
• Gently bring your hands behind the back, catch hold of the
right wrist with your left palm, make a loose fist with the
right hand and feel the pulse of the right hand.
• As you exhale, gently bend down towards the floor and
surrender to the All Mighty.
 Yoga for Jistfima

• Come back as you inhale.

• Gently give a feather massage around the eye muscles with
three fingers (index, middle and ring fingers).
Tips for Practitioners
• This is to be practiced in the dark preferably in the evening.
• Remove glasses, wristwatches, and belts and make yourself
comfortable in the posture.
• Sit with your head, neck and spine upright. Always open the
eyes with a few blinks.
• During eye exercises you must not move your head and must
carry on eyeball movement only.
• During Jyoti Trataka, when you open the eyes, don't look at
the flame right away. Start looking at the floor and then slowly
bring your gaze onto the flame.
• During palming don't let the palms touch or press the eyeballs.
(Palms & not the fingers cover the eyes).
• During palming do very slow & deep breathing with
awareness.
• Palms are placed in such a way that there is complete darkness
to the eyes.
• The facial muscles, eyebrows and eyelids should remain
totally relaxed with a beautiful smile on the face.
• Trataka should be performed after asanas and pranayamas.
• Trataka must be practiced on a steady flame.
• The practitioner should always avoid undue strain to the eyes.
Benefits
Therapeutic
Errors of refraction get corrected. It balances the nervous system,
relieving nervous tension, anxiety, depression and insomnia.

Spiritual
It helps to develop intense concentration and improves memory.

161
It helps to develop a strong will-power. It is an excellent
preparation for meditation.

Limitations
Epileptics should avoid gazing of flickering candle flames . They
can, however, choose a totally steady object to gaze on. If you
are a sensitive person it may aggravate your insomnia as it makes
you very alert. Hence do not practice Trataka before going to
bed.

NETI
a. Jala Neti (Cleaning the nasal passage)
Sthiti: Tadasana
PRACTICE
Add about half a teaspoon of salt
to a neti pot full of sterile lukewarm
water.
Stand with the legs apart.
Hold the neti pot in your right hand.
Insert the nozzle of the Neti pot into
the right nostril.
Keep the mouth open and breathe
freely through the mouth.
Tilt the head first slightly
backwards, then forwards and sidewards to the left so that
the water from the pot enters the right nostril and comes out
through the left by gravity. Allow the flow till the pot is
empty.
Repeat the same on the left side.
To clear the nasal passages of the remaining water, blow out
the water by active exhalation through alternate nostrils as
in Kapalabhati.
 Yoga for Asthma

Benefits
It helps to clear nasal passages. Cleans cold, hypersensitivity,
headache, sinusitis and bronchitis.
Limitations
Neti should be avoided if you have had a recent ear infection or
nasal septum operation. Also avoid neti for a few days after a
bleeding nose.

a. Sutra Neti or Rubber Catheter Neti

Sthiti: Tadasana
PRACTICE
• Insert the blunt end of a thin soft
rubber catheter horizontally into
the right nostril.
• Gently push it along the floor
of the nose until the tip is felt in
the back of the throat.
• Insert the right index and the
middle finger through the
mouth and catch the tip of the
catheter at the back of the
throat.
• Pull it out through the mouth and gently massage the nasal
passage by catching the two ends of the tube.
• Remove the catheter through the nose.
• Repeat on the left side.
Note
Yoga for Asthma

Benefits
Clears the nose and pharynx. Will power increased. Desensitizes
to dust, pollution etc. in nasal allergy patients.

Limitations
Same as jalaneti, other severe plus, back pain, hypertension,
cardiac problems. Avoid during later part of pregnancy.

DHAUTI
a. Vamana Dhauti

Sthiti: Tadasana

PRACTICE
• Drink about one and a half
liters of lukewarm saline water
(about 1% saline) as quickly as
you can until you feel like
vomiting it out.
• Churn the stomach by twisling
exercises.
• Stand with feet apart at shoulder
width and bend the trunk
v
forward forming an angle of
about 80 degrees to the ground.
• Now with the help of the middle
three fingers of the right hand, tickle the back of the throat to
vomit out (vaman) all the water.
• Repeat the process of tickling the throat until no more water
comes out which may mean that all water has been vomited.
• With continued practice one can stimulate the vomiting
sensation and vomit out the water without using the fingers
at the throat.
• Relax completely in DRT for about 15 to 20 minutes.
• Have a bland breakfast after about half an hour.
 'Yoga for Jistfima

Note

• This is to be done early in the morning on an empty stomach.

• A bland breakfast could preferably consist of Indian kichadi. (rice and
lentil-dhal, cooked with or without salt), along with a tea spoon ful of
pure ghee. A void coffee or tea for breakfast.
• With long practice one can learn to vomit all the water as if it is a
continuous jet. This is called Gajakarani.

Benefits
Vaman dhoti or kunjal kriya removes hyper acidity, good for
flatulence and dyspepsia (indigestion), cleanses the stomach of
all its contents, promotes proper functioning of the stomach and
prevents hyper acidity. Dhouti Kriya is extremely useful for gas
trouble, high acidity in stomach and for curing Asthma also. Useful
for asthma and bronchitis to clear the air passages through reflex
stimultaion fo udana Prana.
Limitations
Avoid-in case of severe abdominal pain, abdominal surgery,
tonsillitis, hypertension, ischaemic heart diseases and during
menstruation.

b. Vastra Dhauti
Preparation
1. Use white thin & soft cotton cloth without any stiches of 5-6
cms. width and about 7 to 10 meters long.
2. Place it in a bouel of water on the table in front of you and
stand comfotably in tadasana.

Sthiti: Tadasana
PRACTICE
• Catch on end of the cloth with both hands and start swallowing
slowly with deep awareness and ease. Drink sips of water
along with the cloth if it does not move on smoothly.
• Make sure that about 20 - 25cms of the cloth is left out towards
the end.
[1651 —
Yoga for Asthma

• After completing wait for a few

seconds, churn the abdomen by
movement or agnisara twisting.
• Lean forward and start pulling out
the cloth slowly with ease and
relaxation.
• If the cloth is not coming out
easily, wait, take a deep breath and
relax, drink a few sips of water and
then continue.

NOTE
• Do the practice under supervision of a guide.
• Ne ver pull hea vily on the cloth as the food tube(oesophagus) may go
into a spasm and make the procedure very strenuous.
 MEDITATION AND THE SCIENCE OF
EMOTION CULTURE
MEDITATION AND SILENCE
M o d e m research has now thrown light on the Yogic processes
especially meditation. Experiments on T.M. (Transcendental
Meditation) have shown that meditation can induce greater rest
as can be seen in the following chart.
It is shown that meditation for 20 minutes can give much more
rest than 6 hours of sound sleep.
Meditation is a Yogic process of providing deep rest to the system
by allowing the mind to calm down to its basal states. Features of
meditation are
1. Mind dwells on a single thought of choice
2. Deep relaxation of all parts of the body
3. Reduced metabolic rate by slowing of breath
4. Freshness, lightness and a feeling of expansion at mental
level.
5. Calmness, peace" and serene bliss.
6. Continuous awareness.
T h e benefits are m a n y . Improved concentration, memory,
emotional equipoise and higher creativity, are observed.
A. Simple Process of meditation
1. Ask the meditators to sit in Padmasana or any comportable
posture with spine erect.
2. Let them close the eyes and relax the whole body.
3. Let them perform 5 rounds of Bhramari.
4. Let them sit silent now and repeat Bhramari in the mind
and feel the vibrations.
I/V7
10/
Yoga for jAstftma

5. Let them learn to enjoy the state and ask them to enjoy the
silence.
Tips to Teachers
1. Make them interested in meditation by telling the benefits
of meditation.
2. Ask them to feel vibrations in Bhrgmari all over the body.
Use palms on face, throat, thorax, abdomen thighs and soles
to allow the vibrations to spread.
3. Teach them to feel the breath - cool air entering through
the nostrils and warm air coming out.
4. Mental 'm' repeated - you can give them counts of the
sound, if necessary.
5. Ask them to narrate their experiences.
6. Use post meditation phase to harness the memory and
creativity developed in them.
7. Develop a fine atmosphere of silence and serenity during
meditation.
Some Teaching Tips
1. Opening up the blocked nostrils:
Often it is experienced that one of the nostrils is blocked.
This may be due to cold or deviated septum or Pranic
imbalances. Following techniques often help them.
a. For opening the right nostril
i. Lie down on the left side.
ii. Support the left arm pit with a stick.
iii. Cross the right, thigh on the left while sitting on a chair or
lying down supine, and vice versa for the left.
b. Often jogging releases the nasal blocks.
c. Use neti or kapalabhati, if necessary.
2. Use least pressure on the nostrils. Ultimate aim is to use no
fingers but to move the breath at will.
 Yoga for Jistfima

3. Let abdominal breathing be predominantly adopted.

4. Steps of introduction are same as Yogasanas.
5. Can be oractised anytime of the day.

THE SCIENCE OF EMOTION CULTURE

1. Harnessing the "Right Brain"
Brain researchers have found that the right lobe of the brain
is the seat of emotions, creativity, etc. which we have been
calling as the "heart". The "head" representing the intellect has
its abode in the left lobe of the brain. Modem science has helped
to develop the left brain but the right is grossly neglected. This
lopsided growth is at the base of most of the modern aliments
and i n c r e a s i n g unrest and decreasing quality of life. Thus,
harnessing the right brain has become very necessary.
Bhakti yoga or the Yoga of devotion aims to fill this need. This
science of emotion culture develops the right brain, purifies
the emotions and elevates man to experience ecstatic bliss of
Divinity.
Bhakti Lahari audio cassettes of sVYASA consist of Prayers,
Slokas, Namavalis, Bhajans, Chants, etc. These devotional songs
harness the emotional personality through the science of emotion
culture by invoking, amplifying and diffusing the emotions.
Through release of emotional suppressions you can acheive better
health, harmonious growth of head and heart, and great bliss.

2. Physiology of Emotions
In thinking, changes are confined predominently to the skull
region. When any thought persists, it intensifies, triggering the
centres of emotions in the right brain and limbic cortex. This
discharges nerve impulses that activate the sympathetic nervous
system and also releases hormones that are transmitted through
the blood stream. This in turn sets off a series of chain reactions
resulting in wide spread physiological changes.
The emotions are thus felt all over the body such as tears in the
eyes, choking in the throat, rushing of blood to the face, goose-
flesh, etc. At their termination the nervous system slowly returns

169
Yoga for Asthma

to normal. The changes due to emotions or feelings are more

intense and lasting compared to mere thinking.
3. Kama, Prema and Bhakti
Love is one of the most powerful emotions manifest in all beings.
At its grossest level it projects itself as lust. This Kama is insatiable
and energy-sapping. Its effect is like a tempest after sunset.
Selfishness reigns supreme in this. But Prema (pure love) is
elevating. Its gentle spring always remains fresh. Featured by
Tyaga (sacrifice), the lover finds his happiness in that of his
beloved. "Tat Sukha Sukhitvam" is the formula, says Narada.
Much greater is the bliss of Prema compared to the joy of Kama.
Bhakti is Prema (love) with total surrender. With the "Saranagati"
of himself and his ego at the feet of the Lord, man merges himself
into his Lord culminating in saksatkara. In this state, the Bhakta
experiences an ecstatic bliss.
4. Sing with Bhava
Songs in devotional sessions are aimed to tune the heart-strings
towards a self-elevating Bhakti bhava.
Come, join the group, sing aloud. This is the way to purify your
emotions and grow towards perfection or Divinity.
In training the right brain, it is the Bhava (attitude) that matters
more than mere words. That is why hymns, whatever be the
language, have universal appeal. There is a heavenly rhythm, a
harmony and a melody in every sound and sigh. If these are
fine-tuned with Prema and Bhakti, one reaches the heights of
happiness-the zenith of ecstasy.
Sing loudly with the group; sway with the sound. Let your heart
melt, let tears roll down your cheeks freely; let go all your feelings
without inhibitions. You feel light in the head. Your emotional
suppressions diminish, diffuse and vanish like clouds before
sunshine. You come out of the session with a lightness of heart
and the gloom of unknown sorrow changes into a bright gleam
of joy. The world appears a better place. Serve others too with
this elixir of happiness by emotion culture.
• fT5o|
CORRECTING THE WRONG NOTIONS
a. Lectures
The IAYT, as mentioned earlier, works at all levels i.e.
Annamaya koSa, Pranamaya ko$a, Manomaya ko$a, Vijnanamaya
ko£a and Anandamaya koSa levels. We saw in the previous
section as to how mind and emotions are dealt with to vanquish
the Adhi.
At Vijnanamaya Ko.<a level, the wisdom predominates and
analysis to understand the subtleties of the laws of human
existence is used. Series of 12 lectures on Integrated Approach
of Yoga Therapy unravel the concept of health according to WHO
definition and its relation to yoga; concept of body and disease
according to modern medical world and yoga & spiritual lore;
the root cause in the Manomaya ko.<a as Adhi which leads to all
moderen diseases called Vyadhi; various yoga methods work at
all the 5 levels i.e., Annamaya ko.<a, Pranamaya ko£a. Manomaya
koSa, Vijnanamaya koSa and Anandamaya kosa levels; unseen
imbalances at the mind level, emotions and prana level can be
set right to prevent diseases, promote normal and positive health
and remove the symptoms of the diseases; at Vijnanamaya kosa
level the lectures will correct our notions about stress, misery
and happiness as postulated and described in Yoga and Spiritual
lore; the lectures related to Anandamaya Ko£a are meant to
delineate the methods used to bring Ananda (bliss) into our day
to day lives by the process of Karma Yoga.
Thus, the scries of lectures open up new vision among the
participants towards a life of fulfilment and bliss.
The details can be found in the following books brought out by
Swami Vivekananda Yoga Prak.ishana (Publications wing of
sVYASA)

1. Yoga and Health.

2. Yoga, its basis and applications.
3. The science of emotion culture.
4. The secret of action.
5. The science and art of pranayama.
171
Yoga for Asthma

b. Yoga Counselling
Having given the overall vision about Yoga, Health and IAYT
for promotion of positive health through the lectures and
interactions through questions and answers, yoga counselling is
used to concretise this wisdom presented through lectures to solve
the probelems of the individuals.
Specially trained yoga counsellors diagnose the basic problems
of participants at psychological level which may later percolate
into the prana & body level to cause diseases. One or more of
the following 8 dimensions are found during the interaction and
discussion on a one to one basis;
a) Hereditary Tendencies
b) Congenital problems & their repurcussions on the psychology
c) Over sensitivity
d) Excessive rush & speed of mind
e) Perfectionist attitude in life
f) Calamities & trauma encountered by the persons
g) Psychological conflicts between
i) One ethical norm and other
ii) One duty & other duty
iii) duty & ethics
h) Questioning the very basis of
i) ethics & morality
ii) duties
iii) injunctions & disciplines in life
iv) the purpose of this life.
Having identified one or more of these problems, the councellor
will suggest solutions to the problems and will substantiate &
convince the usefulness of those solutions through anecdotes,
illustrations, scientific data (if necessary) etc.
The participant will understand & decide to try out the suggested
methods to change themselves by those specific yoga methods.
The persons are asked to keep a diary to check for themselves

172
 Yoga for Jistfima

about their progress or otherwise, they are followed up on a day

to day basis so that they will be able to learn as to how they can
apply the principles effectively.
BRINGING BLISS INTO DAILY ACTIVITIES
Karmayoga techniques are used to bring the bliss and happiness
of Anandamaya Kosa into all activities of their daily life
The general nature of us is that either
a) we want to escape work or
b) we get lost in work, often getting obsessed with work
and turn workaholics leading to large tensions and stresses
c) we maintain moderation in our work habits, think of helping
others or involve in national constructive works or
humanitarian services etc.
Initially we alternate phases of relaxtion, slowing, calming and
silencing with work. Gradually we start learning the art of work-
ing in relaxation. As we leam the science of deeper relaxation
through dynamic relaxation process as cyclic meditation, we learn
the art of working in blissful awareness. The inner cleansing starts
and the deep seated stresses, blocks, knots, obsessions, phobias,
etc will all come out from the subconsciousness level paving
way for manifestation of the divinity within us.
Hardly do we realise the importance of silence at the mental level,
slowing of breath at Prana level and relaxation of groups of
muscels at the body level, and much less the experience of bliss,
when we start understanding the role of each of the above and
start using them regularly the happiness in our life starts
blossoming. This is what we call as promotion of positive health.
The positive health can now be called blissful health.
And that is the way of Anandamaya Kosa
Let us all, not only use IAYT to prevent ailments to maintain
normal health but also promote our positive health through regular
practices of yoga mentioned in the earlier chapters of this book.
 Integrated Approach of Yoga Therapy

Kosa Practices
1. Annamaya Kosa : Loosening, Asanas,
Kriyas, Diet.
2. Pranamaya Kosa : Kriyas, Breathing,
Pranayama.
3. Manomaya Kosa : Dhyana, Bhakti,
Devotional songs.
4. Vijnanmaya Kosa : Jnana, Lecture &
yogic counselling.
5. Anandamaya Kosa : Working in blissful
awareness.
 YOGA - CHAIR - BREATHING
Asthmatics find their periods of severe airway obstructions most
difficult to manage and invariably have to mebulization, resort
to injectable steroids and Bronchodilators. For such cases an eight
step yoga procedure has been developed based on the knowledge
base called Yoga-chair-breathing. We describe the procedure.
Bronchial asthmatics invariably know as to when they get
episodes of airway obstructions. They are asked to resort to the
Yoga-Chair-Breathing technique when the 'attack' starts. They
are asked to pull a nearby chair and start the following procedure
without resorting to drugs.

EIGHT STEP PROCEDURE

1.1.R.T (i.e.,Relaxation using a chair a s support)
• Sit on the floor with legs W 1
stretched under the chair. Pull
the chair towards the chest and
hold onto it with your arms.
• Start I.R.T. Stretch and tighten
the entire body from toes to the
head.
• Start tightening from the toes, ankle joints, calf muscles.
• Pull up the kneecaps.
• Tighten the thigh muscles
• Compress and squeeze the buttocks.
• Breathe out and suck the abdomen inside.
• Form the fists and tighten the anus.
'Yoga for Jistfima

• Inhale and expand the chest.

• Tighten and shoulders, neck muscles, compress the face,
• Tighten the whole body from the toes to the head
• Tighten tighten tighten
• Release and relax. Collapse the whole body. Legs go apart.
• Relax the whole body at once, and rest the head and the arm
on the seat of the chair as in Makarasana or simply relax the
arms forward and head resting on the chair.

2. Neck Muscle relaxation with chair support

• Neck movements (5 times)

Slowly move the head forward adn backward relaxing the
posterior neck muscles. You can either hold onto the edge of
the chair or simply relax the arms forward with the head
resting on the chair.

• Neck movements with breathing (5 times)

Inhale as deeply and slowly as possible while moving the
head backward and exhale while moving it forward-repeat 5
times.
• Neck movements with 'A-kara' (5 times)
Chant 'A-kara' in a low tone while bending the neck forward.
 Yoga for Jistfima

3. Neck movements in Vajrasana

(Sitting on heels without chair support):
• Neck movements only (5 times)
Move the head forward and backward in a relaxed way.

Neck movements with breathing (5 times)

Inhale while moving the head backward and exhale while
moving it forward
Neck movements with 'U-kara' (5 times)
Chant 'U-kara' in a low voice while bending the head
forward.

Sasankasana
Sasankasana movements only (5 times)
Bend forward and backward from the
waist region while sitting in vajrasana
and holding the right wrist with the left
behind the back.
Sasankasana movement with breathing
(5 times)
Synchronize your breathing with the
forward and backward movements <>l
the neck. While inhaling bend backward
and while exhaling bend forward
Yoga for Asthma

Sasankasana movements
with M-kara (5 times)
Chant M-kar in a low voice
while bending forward to
Sasankasana.

5. Tadasana (Standing Posture)

• Stand in this posture for about a
minute.

6. Neck Movements in Tadasana

• Neck movements only (5 times)
Move the head forward and
backward slowly.
• Neck movement with
breathing (5 times)
Synchronize your breathing
with neck movement.
• Neck movement with
M-kara (5 times)
Chant M-kar in a low voice
while bending the head
forward.
7. Ardha Cakrasana - Pada-Hastasana
• Movements only (5 times)
From Tadasana move to Ardhacakrasana slowly and then
shift to Padahastasana allowing the hands to hang loosely
down. This is one cycle. Repeat five times slowly and
continuously.
• Return to Tadasana.
• Movements with breathing
(5 times)
Synchronize the movements
with the breathing. While
inhaling go to move to
Ardhacakrasana and while
exhaling move to
Padahastasana.
• Repeat the cycle five times.
• Movement with M-Kara (5 times)
Chant M-Kara in a low voice while bending forward to
Padahastasana.

8. Quick Relaxation Technique (QRT)

Phase I
• Feel the abdominal movements.Observe the movements of
abdominal muscles going up and down as you breathe in
and out normally. Observe 5 cycles.
Yoga for Asthma

Phase II
• Synchronize the abdominal movements with deep
brealhing.The abdomen bulges up with inhalation and sinks
down with exhalation. Observe 5 cycles.
Phase III
• As you inhale deeply and slowly, energize the body and
' feel the lightness. As you exhale completely collapse all the
muscles, release the tension and enjoy the relaxation.
Observe 5 cycles.
• Chant 'AAA' in a low pitch while exhaling. Feel the
vibrations in the lower parts of the body.
• Slowly come up from either the right or the left side of the
body.

Note
• Initially this Yoga Chair Breathing technique takes about 30
to 35 minutes. With practice the time required will about
20 minutes.
• During an attack of wheez this technique can be used
instead of Bronchodilators. With this technique one can
learn to overcome the bronchospasm effectively.

180
 Yoga for Asthma

13

R E S E A R C H O N Y O G A F O R A S T H M A -

A R E V I E W

Are there studies to show that psychological stresses can

trigger asthma?

Negative emotions, worry, anxiety, sadness, anger and depression

l>
can all worsen the asthma in known asthmatics. Milled and his
friends (1994) wanted to study how emotions may trigger
asthma? They recorded the functions of the autonomic nervous
system by a test called heart rate variability and showed that
emotions worsened the existing imbalances of the sympathetic
and parasympathetic nervous system. It is known that asthmatics
have para-sympathetic hyper-reactivity and sympathetic hypo-
reactivity and they showed that this imbalance is worsened by
the negative emotions. They also showed that happiness can
relieve airway obstruction.
I had a lady asthmatic who lived in Bangalore. She came to me
and said 'Dr. I have a peculiar type of asthma. Many of my
asthmatic friends say that their asthma gets worse in winter or
rainy season or with dust or smoke. But I have no such triggers.
I just realized something unusual. My attacks show up generally
in the first week of the month and I did not know why. Each
time my attack becomes so severe that I need hospitalization,
IV iluids,a course of steroids etc.. and I will be back to work
only after two or three days. Once, when I had the attack I went
to my mother's house which is just across the road and my attack
vanished. When this happened on more than one occasion, 1
analyzed the situation and realized that my attack was triggered
by my anger followed by frustration. The reason for the anger is

1X1
Yoga for Jistfima

that when my husband gets his salary, we have arguments about

how the amount has to be spent. I am always the loser. He has
to have his last word . Heat builds up; I get irritated and end up
screaming and the frustration ends up with an attack of asthma.
Do you think my analysis is right? Are there people who have
this type of triggers? What does medical science say about this?
I want to know whether yoga can help me not to get lost in this
type of my emotional surges and end up with an attack'.
(2)
Reietveld et al studied four groups of children ;Gp (a) viewing
an emotional film of 10 mm, gp(b) performing standard physical
exercise, gp (c) combination of a+b and gp (d) combination of
b+a. Group (c) where exercise was proceeded by the emotional
film had the worst airway narrowing and breathlessness than
only the exercise group who also had breathlessness. It is well
known that either excessive panic (or insensitivity to the distress)
0
can be very risky during the attack (lehrer ' 1998).

Is there scientific proof for the efficacy of yoga and relaxation

therapies in asthma? .
(4)
Alexander and his friends (1972) showed that systematic
(5)
relaxation improves airway caliber. Wilson (1975) showed the
(6)(6a)
efficacy of physiotherapy in asthma. Goyeche (1980-1982)
reviewed the existing literature and explained that the integrated
set of yoga practices that include yoga postures, correction of
breathing pattern and muscle relaxation, help asthmatics by
releasing suppressed emotions, reducing anxiety, and also by
expectoration of mucus and developing self-conscious
awareness.

We have consistently observed the beneficial effects of yoga in

asthmatics through the integrated approach of yoga therapy.
When we started our work in 1977 -78 in Kanyakumari with a
ten bed facility we started understanding and developing suitable
yoga modules for asthma based on the scriptures and improvised
them based on the results of our observations on these residential
11821 •
 Toga for Jistfima

patients. This gave us the pilot data and the confidence to go on

to design well controlled studies for long term follow up. Then
we shifted to Bangalore to carry on recruiting large number of
subjects through non-residential yoga therapy camps. Patients
would come to the center daily after their working hours and
learn the techniques.In our very first yoga therapy camp in 1979
(125 mild, moderate and severe asthmatics) we noticed very
encouraging results. Severe asthmatics who were on 8 to 10
tablets per day (including steroids), some requiring several doses
of inhalers per day, some requiring hospitalization almost once
a week, could learn these techniques and greatly benefit within
two weeks. As we knew
that asthma can be affected
* by positive emotions, we
were not ready to conclude
anything by this temporary
excitement of two weeks .
We made more rigorous
—
" design with matched
controlled studies and
followed them up systematically for 54 months. The results were
now acceptable. Now there was enough convincing evidence
that the set of IAYT (described in this book) could be accepted
as beneficial to patients with asthma. There was reduction in
medication by 80 %(non yoga group had increased by 10%).The
severity and the frequency of attacks had reduced. Their airway
caliber (as measured by peak flow meter) had improved
significantly. When this work was published in the British Medical
(7)
journal in 1985 it created a ^
great sensation; readers digest, . _-H SEVERITY, j!
the BBC, many new papers &
popular magazines flashed this
news around. Further in 1986 a
follow up of 576 asthmatics was
published in Journal of Asthma
. 1183 k -
Yoga for Jistfima

(8)
from USA . Our cross cultural studies in USA amongst mild
asthmatic students of Colorado state university was published
t9)
by Dr Vedandatan in 1998 which showed significant relaxation,
positive attitude and tendency for lesser usage of inhalers.

Group No. of Initial Time

Episodes PFR (1/min) taken (min)
1 78 112.6 *** 29.8
PI 21 92.5* 92.5
NC 10 96.0 * 41.0
D 1 68.0 38.0
Pooled 110 106.8 32.1
NS - Not Significant, I- Improvement, PI- Partially Improved,
NC- No. Change, D- Deteriorated, ***p< 0.001. * p< 0.05.

(l0)
Another interesting study that was published in 1991 was the
efficacy of yoga chair breathing in relieving 70% of episodes of
asthma within a mean time of 30minutes without resorting to
inhalers.
0 n
Apart from our work, others like Dr Singh and his friends
(1990) from Punjab also showed the beneficial effects of yogic
breathing. 18 subjects with mild asthma had improved much
better than the control group after 2 weeks of practice of yoga
pranayama. They used a breathing device that simulates yogic
pranayama with an inhalation, exhalation ratio of 1:2. and
compared it with breathing through a placebo device. They also
showed the beneficial effects of yogic vomiting in asthma.
The next question we need to address is- can yoga reduce the
basic hyper-reactivity of the air passage? This question was taken
02
up by Manocha ' (2003) who tried to give a challenge to the
airways by asking asthmatics to inhale methacholine in very
minute measured doses through a nebulizer before and after yoga
practices. Methacholine is a chemical challenge to the air passage
as it is known to provoke the airway narrowing in asthmatics at
 Yoga for Asthma

much lesser concentrations than normal persons. Manocha

showed that after yoga practices there was significantly higher
concentration that these asthmatics could tolerate. A similar
(13)
observation was made by our team (Sudharani-2001) by using
exercise(spot jogging) as a challenge instead of methacholine
nebulization. The exercise lability of the air passages had reduced
significantly after yoga after two weeks of intensive residential
training. Future work should be able to answer - how does yoga
help in asthma? And what are the mechanisms of action?
Looking at the changes
in the immune system,
we could demonstrate a
significant reduction in
the white blood cells
called eosinophils in the
blood. There are the
soldiers recruited by teh
body whenever there is
an allergic response.
All these studies go to show that even the scientists of modern
medical field are accepting that mind management is an important
component in treating asthmatics. Although there are wonder
drugs available today and just two puffs of inhalers a day could
keep most asthmatics happy to manage their lives without much
problems, scientists continue to search for newer insights and
techniques. In this context yoga provides a totally different
paradigm of understanding the problem of asthma; provides
techniques to tackle the problem by a different approach. These
evidences open up the doors to our understanding of the inner
freedom that exists in man to master the response patterns at the
physical level by manipulating the mind and vice versa.
Yoga for flsthma

References
1. Miller, B.D., Wood, B.L., Influence of specific state on autonomic
reactivity and pulmonary: Function in asthmatic children: JAM Acad
child Adolesc Psychiatry: 36(5) 669-77. (1994).

2. Rietveld, S., Prins, P.J.,: The relationship between negative emotions

and acute subjective and objective symptoms of childhood asthma:
Psychol med 28 (2): 407-15 : (1998)

3. Lehrer, P.M.,: Emotionally triggered asthma: a review of research

literature and some hypothesis for self-regulation therapy: APPI
psychophysiol biofeedback 23(1): 13-41 (1998).

4. Alexander, B., Systematic relaxation and flow rates in asthmatic

children: Relationship to emotional precipitants and anxiety: Journal
of psychosomatic research, vol 16, 405-410, (1972).

5. Wilson, A.F., Honsberger, R., Chiu J T and Novey, H.S.: Transcendental

(5)
meditation and asthma: Respiration 32 (1) : 74-80 (1975).

6. Goyeche, J.R., Ago, Y., Ikemi, Y., Asthma: The yoga perspective. Part
I. The somatopsychic imbalance in asthma: towards a holistic therapy.
J. Asthma Res 17 (3): 111-21 (1980)

6a. Goyeche, J R., et al: Asthma - the yoga perspective. Part II. Yoga therapy
in the treatment of asthma. J. Asthma 1 9 ( 3 ) : 189 - 2 0 1 , 1982.

7. R. Nagarathna, H.R. Nagendra : Yoga for Bronchial Asthma : A

Controlled Study. British Medical Journal Vol. 2 9 1 , 19 October 1985
1 0 7 7 - 1 0 7 9 . Vivekananda Kendra Yoga Research Foundation,
Bangalore, India.

8. R. Nagarathna, H.R. Nagendra : An Integrated Approach of Yoga

Therapy for Bronchial Asthma: A 3 -54-Month Prospective Study.
Journal of Asthma, 23(3), 129-137 (1986). Vivekananda Kendra Yoga
Research Foundation, Bangalore, India.

9. P. K. Vedanthan,M.D., * LakshmayyaN. Kesavalu, B.V.Sc,KrishnaC.

Murthy, M.D.,* Kirby Duvall, M.D.,* Mary J. Hall, R.N.M.A,* Sheila
Baker, M.S.,* and S. Nagarathna, M.D.S : Clinical Study of Yoga
Techniques In University Students With Asthma: A Control Study.
Allergy and Asthma Proc. January -February 1998; Vol. 19, No. 1 : 3-9
Vivekananda Kendra Yoga Research Foundation, Bangalore, India.

10. Singh V. Effect of respiratory exercises in asthma: The Pink City .Lung
exerciser. J Asthma 24:365-369, 1987.
 W for Jistfima

11. Nagarathna R., Nagcndra H R a n d Seethalakshmi R . Yaga - Chair

Breathing for Acute Episodes of Bronchial Asthma. Vivekananda
Kendra Yoga Research Foundation, Bangalore, India.
12. Manocha R, marks GB, Kenchington P, et al. Sahaja Yoga in the
management of moderate to severe asthma: a randomized controlled
trial. Thorax 57 (2). 110-5, 2002.
13. Sudharani, R Nagarathna, H R Nagendra, Psychophysiological changes
after yoga practices in Bronchial Asthma. 2001

187
•Yoga for Asthma

Integrated Yoga Module for

ASTHMA
Steps Pg.No. Practice Rounds Duration
1 > Breathing Practices
79 Hands In and Out breathing 5 1 min
80 Hands stretch breathing 5 1 min
82 Ankle stretch breathing 5 1 min
83 Dog Breathing 1 min
84 Rabbit Breathing 1 min
85 Tiger Breathing 1 min
86 Sasankasana Breathing 1 min
87 Straight Leg raise Breathing 1 min
2 > 88 Instant Relaxation technique (IRT) 2 min
3 > Loosening Exercises
91 Forward and Backward Bending 50 1 min
92 Side Bending 10 1 min
93 Pavanamuktasana Kriya 5 1 min
4> 96 Quick Relaxation Technique (QRT) 4 min
5 > Yogasana
Standing
108 Ardhakati Cakrasana 1 min
109 Ardha Cakrasana 1 min
110 Padahastasana 1 min
Slitting
111 Vajrasana 1 min
112 Vakrasana 1 min
113 Ardha Matsyendrasana 1 min
114 Pascimottanasana 1 min
 Prone
115 Bhujaftgasana
116 Salabhasana
Supine
117 Sarvahgasana
118 Matsyasana
120 Halasana
6 > 122 Deep relaxation technique(D.R.T)
7 > Pranayama
130 Surya Anuloma Viloma Pranayama
131 Candra Anuloma Viloma Pranayama
132 Nadi Suddhi Pranayama
133 Sitali/ Sitkari/ Sadanta Pranayama
136 Bhramari Pranayama
8 > Meditation
139 Nadanusandhana
141 OM-Dhyana (Meditation) /
142 Cyclic Meditation

> Vamanadhouti + DRT - once a week

> Laghu Sankapraksa}ana+ DRT- Daily

18*)
'Yoga for Jistfima

I N D E X

Hands In and Out Breathing

Pg no.79, 5 rds, l m i n

1
Hands Stretch Breathing
Pg no. 80, 5 rds, 2 Vi min

Ankle stretch breathing

Pg no.82, 5 rds, V^rnin

Dog Breathing
pg no. 8 3 , 5 x 3 rds 1 min

Rabbit Breathing
pg no. 8 4 , 5 x 3 rds 1 min

Tiger Breathing
pg no. 85, 5 rds, J min

Sasankasana Breathing
pg no. 86, 5 rds, 1 min

Straightleg raising
Pg no.87, 5 rds, 1 min

< Forward & Backward bending

pg no. 9 1 , 5 rds, 1 min

Side bending
Pg no.92, 5 rds, lmin
 Pavanamuktasana
pg no. 93, 5 rds. 1 min

<3 Ardhakati Cakrasana

Pg n o 108, l + lrds,2 min

Ardhakati Cakrasana
_ Pg no 109+ 1 mm

<3 Pada Hastasana

Pg n o 110, 1 +lrds. 2 min

Vajrasana
Pg no 111, 1 min

<H Vakrasana t
4k
Pg nol 12, 1 + lrds, 1 min

Ardha Matsyendrasana
Pg no 1 13, 1 + lrds, 1 min

Pascimottanasana
pg no. 114, 5 rds, 1 min

Bhujangasana
Pg no 115, 1 min

Salabhasana 1
Pg no 116. : nun

Sarvahgasana
Pg no 117. 1 min

Matsyasana
Pg no 1 18. /-2
l
nun

Halasana
Pg no 120. 1 min

D e e p Relaxation T e c h n i q u e
Pg ni) 122. 1
; min

191
Yoga for jAsthma

Surya Anuloma Viloma

Pranayama Pg no 130,1 nun
Candra Anuloma Viloma
Pranayama Pg no 131, 5 rds, 3 nun

Nadisuddhi Pranayama
Pg no 132, 1 min

Bhramari Pranayama
Pg no 134, 5 rds, 3 min

Sitali, Sitkari, Pranayama

Pg no 134,135, 1 min
Sadanta Pranayama
Pg no 135, 1 min

Nadanusandhana
Pg no 139, 13 min

Viparitakarani Kriya
Pg no 154, 1 nun

<4 Om Meditation
Pg no 141. 13 min

Jalaneti
Pg no 161, 13 min

Sutraneti
Pg no 162, 13 min

Vamanadhouti r>
Pg no 163, 13 min

<3
Vastradhouti
Pg no 165. 13 min

Pascimottanasana
k>
Pg no 165, 13 min

192
r Breathing
 Standard International Transliteration Code
(used to transliterate Sanskrit words in the text)
—
3T — a 5 da
•
3TT — a dha
• •

i
? — — na
i •
•
— zz
i ta
3 — u zz tha
35 0 zz da
W — r zz
•
«r dha
— e zz na
ai
— pa
3ft 0
— pha
au,ou
7 =
ba
—
m
3T: zz bha
h — ma
=
ka
— — ya
kha
—
T ra
ga
—
— la
gha
— va
ha
—
—
ST sa
ca
*T zz sa
cha •
sa
ja —
ha
jha ST — ksa
—
na — tra
3 ta zz jna
— tha
 YOGA FOR ASTHMA
This boohjs one of the series on "IntegratedApproach of Yoga Therapy
for modern aiCments" published by Swami Vivekananda Yoga
(prakashana. The authors of this book^ are both scientists who have
carried out systematic research and developed these integrated yoga
therapy modules in tune with both the traditionalyoga texts and the
modern medical understanding of the ailments. (Research by these
authors since 1980 has validated the efficacy of these techniques
through scientific observations publishedin Indeed Medical Journals.

VYfiSA has wide experience in healing asthmatics throughyoga. Over a

million asthmatics have been treated round the globe with consistent
results. Long term (54 months) follow up data published in (British
Medical Journal and Journalof Asthma showed 80% reduction in need
for medication with improved lung function and quality of life. Yoga
trains asthmatics to overcome the hyper-reactivity of the nasal and air
passages through the regularpractice of asana, pranayama, meditation,
andcleansing techniques apart from changes of life style.

The first part of this book^gives the understanding of what, how and
why of asthma based on the latest knowledge in modern medicine. The
second part deals with the theoretical background of yoga therapy
followed by the description of the practices.

The listfor one hour daily practices and thatfor chair breathing during
acute episodes are given in Integrated Yoga Module for asthma.

D r R N a g a r a t h n a , MBBS, MD, FRCP (Edin),

Chief Yoga therapy consultant,
Dean, Division of Yoga and Life Sciences,
Vivekananda Yoga Mahavidyapeetham of
Swami Vivekananda Yoga Anusandhana Samsthana