Part - I

YOGA IN HEALTH AND DISEASE

Nagarathna R, Nagendra H R, Shirley Telles

Vivekananda Kendra Yoga Research Foundation, Bangalore, India

The modern medical system has replaced almost all the traditional systems of medicine in
different parts of this globe because of its rational basis. It has proved itself most effective in
saving man from the fatal hands of contagious and infectious diseases. However, rapidly
increasing incidence of stress related ailments is posing a great challenge to the modern
medical system. It is here that Yoga appears to make a vital contribution to the modern
medical system. To date, large number of publications are available studying various aspects
of yoga in health and disease.

YOGIC CONCEPT OF ILLNESSES

The root cause of Stress induced ailments is the amplified likes and dislikes at the manomaya
kosa which results in distressful emotional surges called 'Aadhi'. The life style gets disturbed
because of long standing uncontrolled surges of stressful reactions like intense desire,
(Kama), anger (Krodha), fear (Bhaya), jealousy (Matsarya), etc. These agitations cause violent
fluctuations in the flow of prana in the 'naadis' which are said to be the channels distributed all
over the body through their branching system. Each and every cell in the body, requires the
right quota of its pranic energy to carry on its biochemical processes in an efficient way. The
example is that of uninterrupted power supply necessary for every electrical gadget in right
quantities. Just as these equipments would fail if there is any irregularity in the power supply,
human organ systems fail to function if they do not get the right quantum of prana. Thus the
disturbances in the Manomaya kosa percolate into physical body (Annamaya Kosa) through
disturbed prana flows. Hence the management of these stress induced ailments should correct
imbalances at all these levels. Yoga techniques are offered to correct the imbalances through
a set of yoga practices which we have termed as Integrated approach of yoga therapy (IAYT).
These are practised to correct the problem at various levels:

Annamaya Kosa: Physical Kriyas (Traditional voluntary internal cleansing techniques),

Yogasanas (body postures) and Shavasana (Relaxation posture).

Pranamaya Kosa: Five types of systematic regulated slow deep breathing practices with or
without breath holding, called Pranayama.

Manomaya Kosa: Meditation (Dharana and Dhyana) and devotional session (Bhakti yoga).

Vijnanamaya Kosa: Understanding the nature of ones problems in the light of Indian thinking
through self analysis (Jnana yoga).

Anandamaya Kosa: Practice joy under all circumstances (Karma yoga). Try to touch the inner
core of one's self in solitude and establish in the experience that Ananda is the basic fabric of
this universe including the self.
YOGA IN STRESS RELATED DISEASES

Negative emotions and psychosocial pathology are found to be related to severe asthma
(Friedman, 1984; Carswell, 1985; Carson and Schauer, 1992). Self-rated hostility and depression
(Schmaling et al. 1997) and higher degree of frustrating situations in their life (Berezin et al. 1997)
were found to be associated with decreased pulmonary function, blood immunoglobulin levels
and clinical state of the disease.

Goyeche (1982) published his work on the integrated yoga approach to asthma with beneficial
results. Singh et al (1990) studied 18 subjects with mild bronchial asthma after Two weeks of
practice of yogic Pranayama by the use of a breathing device called pink city lung exerciser
(PCL). Vedanthan et al (1998) studied the effect of yoga practices on 17 students in the age
group of 19-52 years in an university set up. Daily symptom score, medication score, AM and PM
PEFR, weekly questionnaires and lung functions were measured. The subjects in yoga group
reported significant degree of relaxation, positive attitude and tendency for lesser usage of
inhalers. We followed up 53 pairs of bronchial asthmatics in a controlled study and also 570
asthmatics in a prospective study for 3 to 54 months. There was 80% reduction in meditation &
symptom scores with improved lung function in yoga group and not in control group (38). Further,
regular practitioner stood to gain the best (41) .

Yoga in Anxiety Neurosis

Norton & Johnson (1983), DeLuca & Holborn (1984), Tarrier & Main (1986) have demonstrated
the comparative efficacy of different types of muscle relaxation therapies (taped instructions or
applied relaxations) in different types of anxiety of both cognitive and somatic type such as snake
phobia, nail biting, hair pulling, panic attacks as well as general anxiety. Tyrer et al (1988) in their
randomized control study on 210 subjects demonstrated that self help group fared better than the
diazepam group and consumed less psychotropic drugs. Crisan (1988) observed reduction in
scores on Max Hamilton's a anxiety scale, general health questionnaire, heart rate, urinary level
of VMA and a rise in galvanic skin resistance in 19 patients with generalized anxiety neurosis
after 8 weeks of Pranayama practice.

Yoga in diabetes

In both IDDM and NIDDM physiologically demanding stressful situations like infection, pregnancy
etc. are known to increase the demand for insulin. Similarly emotional stresses also contribute to
the irregular control of diabetes. Jobson et al (1991) in a well planned controlled study showed
that although there was demonstrable physiological rest (reduced muscle activity and skin
resistance) the progressive relaxation training and biofeedback given once a week did not help in
improving diabetic control in 20 patients with type II diabetes.

Monro et al (1992) carried out a controlled trial on 21 subjects with NIDDM. Fasting blood glucose
and glyco-sylated hemoglobin reduced significantly (p<0.05) in the group of 11 who practiced the
integrated program of yoga as compared to a matched control group of 10 who did not practice
yoga. Several other studies (Sahay et al 1986, Jain et al 1993) have shown the beneficial effects
of yoga in NIDDM through reduction in hyperglycemia and the need for oral hypoglycemic agents.
Rice et al (1992) observed increased peripheral blood circulation in lower extremities as
measured through toe temperature and blood volume pulse in 40 diabetes in the age range of 17
to 73 years after biofeedback assisted relaxation training.

Yoga in Hypertension

Datey & his co-workers (1969) showed the beneficial effect of shavasana in mild hyper-tensives
who were not taking medication. Patel (1973,75) has shown the beneficial effects of shavasana in
hypertension in her year long follow-up control study. In an open study comprising 23 hyper-
tensive patients Sachdeva et al (1994) observed reduction in systolic blood pressure and diastolic
blood pressure.

Yoga in Coronary Heart Disease

Greenwood et al (1996) reviewed the literature and showed that both social support and life
stresses influence the incidence and mortality of coronary heart disease, the latter more so than
the former. The emotion support had the largest effect. Orth Gomer et al (1997) analyzed the
heart rate variability from a halter record during transient myocardial ischeamia and observed
suppression of the efferent vagal activity and suggested that this vagal blockage may be a fore-
runner to onset of ischaemia.

The work of Ornish et al has become a major land mark on this path of preventive cardiology.
Gould, Ornish and coworkers (1995) studied the changes in myocardial perfusion by positron
emission tomography (PET) after 5 years of intense risk factor modification. The experimental
group of 20 followed a program of very low fat vegetarian diet, mild to moderate exercise, stress
management and group support. Although there was a significant degree of improvement
observed in the percent diameter stenosis on coronary angiography in the experimental group as
compared to control group, greater degree of changes were observed in ventricular perfusion and
the measurement of area of LV with less than 60% activity in PET.

Yoga in Rheumatoid Arthritis

Stress could be a major triggering or aggravating factor for the autoimmune inflammation in
rheumatoid arthritis has been understood. Haslock (1994) reported the beneficial effect on grip
strength and Stanford health assessment questionnaire disability index in 10 severe rheumatoid
arthritis subjects, as compared to 10 matched controls who participated in a program of IAYT.
Role of yoga in mechanical back pain, carpel tunnel syndrome, cervical spondylitis, fibro-myalgia
and chronic pain have been studied by many workers.