On Chikits-Krama: Some Notes and Observations from a Course by Srivatsa Ramaswami [1], including Application to Bronchial Asthma David

Hurwitz Overview The Raja-Yogis understood the physiology of the body and the psychology of the m ind. The innovations of yogic breathing exercises, exercise to the internal orga ns through mudrs and bandhas, and positional advantage of inversions were their c ontributions to keeping the whole body healthy. They also studied the causes of mental ailments and developed attitudinal, dietary, and psychological parameters for leading a healthful life. This approach came to be known as chikits-krama or therapeutic methodology. It is highly relevant during midlife. General Principles Because chikits is not mentioned in any of the Yoga texts, there are as many proc edures (for dealing with ailments) as there are Yoga teachers. For T. Krishnamacharya, chikits-krama included individual application of all avai lable Yoga tools (i.e., yama, niyama, sana, prnyma, dhyna, kriy, chant, etc.). In addi tion, it included whatever was good for the health and well-being of the student or patient. Chikits-krama was thus broader than just the treatment of ailments. The practice of Yoga necessarily involves the practice of all its angas (limbs). The practice of one anga in isolation does not constitute Yoga practice. Some o f the essential elements necessary to realize the benefits of Yoga are: shauca o r cleanliness, not just of the body, but of all the senses; samtosha, contentmen t; svdhyya, the study of scriptures; and shvara-pranidhna, devotion to the Lord, i.e ., the transcendental Self.[2] Regarding the doshas, in the most general terms the problems associated with eac h are: Vta-dosha = circulatory ailments in all nds (channels). Vta-dosha includes problems of prna and ratka (blood) samchra (flow; see below). Ailments include joint pain/a rthritis, nervous system disorders/paralysis, etc. The yogic tool for vta-dosha i s sana. That is, movement is helpful for circulatory problems. Kapha-dosha = phlegm = respiratory problems. For kapha-dosha or respiratory ailm ents, the yogic tool is prnyma. Pitta-dosha = digestive disorders. Mudrs and bandhas constitute the yogic tools f or digestive disorder. This is an oversimplification, but it conveys the general idea. Samchra means "flow or movement." Sam + chra = complete movement. Prna samchra refer s to the proper flow of prna, or life force. According to Hatha-Yoga, if the nds, w hich are the conduits of prna, are filled with impurities, the prna samchra is affe cted. Several cleaning methods, such as nd-shodhana prnyma, facilitate the proper sam chra of prna. Prnyma is the greatest tapas (method of purification) Krishnamacharya used to say t hat prnyma blows away the dirt from the nds, thereby improving the prna samchra. Practice of yogsana that includes use of breathing with the various vinysas[3] and prati-kriys (counterposes) ensures that one's circulation and respiration are im proved.

With the help of prnyma, it is possible to dilate the bronchial tubes in an asthmat ic, reduce blood pressure or increase it, and reduce the heart rate. Brain-based neurological disorders such as epilepsy, as well as skin allergies and other co nditions, also respond to prna control. The ancient yogis had a different physiological and anatomical understanding of the body than modern allopathic medicine. They viewed the body in terms of the nds , the cakras, and the koshas, or internal organs (editor's note: the term kosha is used here in its literal sense, i.e., as "sack or container"). They believed illness was caused by the koshas, i.e., the vital internal organs, and the muscl es being displaced from their original positions. Yogic practice aims to return them to their original positions. The rishis (seers) believed this could be acco mplished through the practice of inverted postures. Shrshsana (headstand) and sarv angsana (shoulder stand) are the most important of these.

Note: Krishnamacharya, Ramaswami's teacher, emphasized correction of the displac ement of the organs or koshas. Krishnamacharya also discussed the alignment of t he cakras, but taught that the cakras should be dealt with separately, with the nds. The ancient yogis believed that sana with prnyma and mudr could realign the cakra and return them to their proper place. In his lectures at Loyola, Ramaswami did not address this particular topic. His approach in the class was focused on the organs/koshas. The ancient yogis felt that mla-bandha (root lock) and uddyna-bandha (upward lock) were of great importance in massaging and exercising the internal organs. In fac t, Yoga is the only system that aims to exercise every part of the body, both in ternal and external. Patanjali's Yoga-Stra, I.30, states that the symptoms of vikshipta, or mental dis turbances, are: vydhi (physical ailments), styna (stubbornness, inertia), samshaya (doubt), pramda (exaggeration, overstating things), lasya (laziness, vacillation) , avirati (lack of dispassion, inability to look at things objectively), bhrantidarshana (misunderstanding, mistaking one thing for another), alabdha-bhmikatva ( inability to reach a certain level), and anavasthitattva (slipping back). Any one of these symptoms affects the mind's ability to focus. The solution, acc ording to Patanjali, is ekatattva-bhysa (practice on one principle, YS I.32), or meditation. Note, however, that if the mind is able to focus, these symptoms do not appear. That is to say, if we read YS I.30 in the reverse order, then meditation or trai ning the mind to focus is a way of treating the mental ailments listed. These we re the psychological disorders understood by the ancients and summarized by Pata njali. As to vydhi (physical ailments), we are not saying that meditation will result in a cure for physical ailmentsYoga's purpose is not to make the gross physical bod y immortalbut meditation may remove the mental disturbances caused by vydhi. For those who believe in the divine, faith may help in the healing of certain ai lments. And, the sun is the greatest manifestation... "Arogyam bhskart icchetta." If you desire health, obtain it from the sun. For thos e who believe in the divine, faith may help in the healing of certain ailments, and the sun is the greatest manifestation of the divine in our solar system. We thus introduce mantra and samantraka srya-namaskara. The srya-namaskara mantras wi th the vinysas are given in Ramaswami's book Yoga for the Three Stages of Life.[4 ] Other Srya (sun god) mantras that are popular include the aruna chapter in the Ya

jur-Veda, a one-hour chant. Another work on Srya is known as ditya-hridayam, a ten -minute prayer from the Rmyana that is very popular among the general Indian popul ation. Because it is not a Vedic chant, everyone can chant it. The gyatr-mantra is another important Vedic mantra on Srya that is commonly practiced. And thus it i s said, "arogyam bhkart icchetta"; if you desire health, pray to Srya, the sun god. An Application: Bronchial Asthma (the most common respiratory ailment) Note 1: Patients must be treated when they are not having an attack. Note 2: Perhaps the most important factor is that in Yoga there is extensive par ticipation by the patients, which builds confidence, as opposed to drugs, which build dependence. 1. The first step is to strengthen the system, the breathing apparatus. We want to strengthen and stretch the thoracic muscles. For this we can begin with the a rm movements of the tdsana (mountain pose) sequence[5] up through twisting. These movements can be done while standing, sitting, or even lying down, and should be done just to the extent possible. They can even be done without regulated breat hing, if breathing is difficult. The beauty of these vinysa-krama movements is that they stretch and strengthen bo th the interior musculature as well as the exterior. That is, the intercostal mu scles get a good workout. 2. Next, introduce breathing. Because asthmatics retain phlegm, begin by slowly introducing kapla-bhti. Kapla-bhti helps to open the bronchial tubes and discharge p hlegm, reducing irritation to the bronchial tubes. Kapla-bhti can be done seated in a chair, if necessary. It is not necessary to hav e the patient sit in a Yogic posture. The number of repetitions will need to be determined on an individual basis. Note: If someone has a cold or a nostril is blocked, do nd-shodhana or alternate n ostril kapla-bhti. For example, inhale through the right nostril, and exhale throu gh the left nostril. Care must be exercised, however, in the case of sinusitis t o avoid propelling phlegm into the sinus cavities. 3. Next, introduce ujjay prnyma. The importance of ujjay is that it simulates asthmat ic breathing, causing the sympathetic nervous system to open the bronchial tubes . Ujjay breathing hence strengthens the sympathetic nervous system. In addition, the patient gains confidence from being able to breathe in this simulated circum stance, and thus during an attack there is less panic. In effect, ujjay breathing trains the system not to panic when an attack comes. 4. After some time, we may begin sarvangsana, the panacea. The neck must be suppl e for this, however, so we may begin with any form of viparta-karan, even placing the feet against a wall or on a chair and then raising the hips off the floor. Y ou can help support the patient's back with your knee or by holding the legs up. The main requirement is that the hips should be up. Because of the release of p hlegm, patients may need to come down after ten or fifteen seconds or less to sp it. The importance of sarvangsana is that it enhances ujjay breathing. The jlandhara-ba ndha (throat lock) is more natural in this position, and so the ujjay is more pro nounced. The bronchial tubes open, and this removes phlegm. The upside-down posi tion helps the phlegm flow down to clear the chest. 5. The abdomen may be heavy or stiff, hindering breathing. Some forward bending could help, even seated in a chair.

6. The use of sound through singing and chanting is helpful, as they help the pa tient gain control over exhalation and to exhale completely. (Exhaling is the gr eatest problem for asthmatics.) 7. Asthmatics should avoid kapha (phlegm) producing foods, as well as cold items and any foods that cool the system. Note: The above practices should be used as adjunct therapy. Medication should n ot be altered or reduced until there is clearly detectable improvement and both the patient and his or her doctor gain confidence. If patients have reduced or e liminated medications and subsequently have an attack, they should immediately r esume the needed usage. Remember, the techniques are not important; the patient is important. Endnotes [1]. From a course given by Srivatsa Ramaswami at Loyola Marymount University, L os Angeles, California, October 2004. [2]. T. Krishnamacharya. Yoga Cikitsa. Darsanam, November 1995, 4(3). [3]. The vinysa-krama method is detailed in Srivatsa Ramaswami, The Complete Book of Vinyasa Yoga. New York: Marlowe & Co., 2005. [4]. Srivatsa Ramaswami. Yoga for the Three Stages of Life. Rochester, Vt.: Inne r Traditions, 2001, pp. 124-125. [5]. The Complete Books of Vinyasa Yoga, op. cit. David Hurwitz 2005 About Srivatsa Ramaswami: Srivatsa Ramaswami studied Yoga for over 30 years with T. Krishnamacharya and taught Yoga for over 20 years at Kalashetra in Chennai, India, where he resides. He has lectured widely at universities, taught therapeu tic Yoga at hospitals, and has created over 40 cassettes of Vedic chanting. He i s the author of Yoga for the Three Stages of Life and The Complete Book of Vinya sa Yoga. About David Hurwitz: David Hurwitz lives and teaches in Los Angeles. He has been studying the Yoga of Krishnamacharya since 1990, first with A.G. Mohan of Madra s, India, and next with Gary Kraftsow. For the past few years he has been studyi ng with Srivatsa Ramaswami and assisting him with writing. They have recently co mpleted work on a new book, Questions and Answers on Yoga. Contact: yogidave@sbc global.net.