An article on yoga therapy

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Hi folks,

I just translated this article from Russian, but it was a tough one, and I need your help and editorship:)) Please, read it (hopefully, you know the subject very well) and let me know if some parts of it are unintelligible or sound funny. Thank you in advance… and enjoy!

[B]Working out an individual practice program according to the principles of Indo-Tibetan medicine.[/B]
By Sergey Agapkin.

Sergey Agapkin is a doctor, specializing in medical gymnastics, physiotherapy and traditional rehabilitation therapies. He is an author of various articles and researches on the neighboring fields of Aurveda, Yoga and Medical Tantra (Tibetan medicine).

First of all, there should be a certain clarification. This article deals with working out an individual program of exercises for beginners that should balance their main bodily systems and eliminate diseases. In Yoga Sutras by Patanjali ill health is the first obstacle on one’s way of yoga which should be overcome. Vyasa’s commentary on Yoga Sutras states that “An illness is an imbalance of humors (dosha), bodily secretions (dhatu) and organs”. It’s a pity Patanjali does not give any practical advice on combating diseases. But, luckily, we can find such advice in aurvedic teachings. Aurveda like yoga is based on the philosophical system of Sankhya, which clearly illustrates Vyasa’s definition of illness. As a matter of fact, a very similar definition is used by Indo-Tibetan medicine, but it is not purely theoretical there. It actually gives a guiding principle for their diagnostic algorithms and multi-compound recipes of their herbal remedies. These algorithms are supposed to diagnose your “heat - cold” syndromes and to find out if your bodily controlling systems (doshas) as well as your organs and tissues are in good order. After having received this information, they select herbs that bring optimal effects in these tree directions. For instance, a remedy called “rnam-rgyal-mkhris”, which has been used by Tibetan medicine to treat acute hepatitis, consists of hips, myrobalan and momordica’s seeds. Hips are used for curing many “heat” diseases, myrobalan berries are helpful for balancing doshas, and momordica affects the hepatobiliary system directly. Due to this complex action, affecting simultaneously various aspects of the pathologic process, such a simple remedy, consisting of only tree components, can bring deep therapeutic effects.

It is obvious, that using the above said algorithm to choose the appropriate exercises for one’s individual yoga practice can significantly raise its effectiveness, in general, and therapeutic value, in particular, which is especially important for beginners’ classes. Everybody knows that for most people who start practicing hatha yoga, the main and, sometimes, the only objective is to improve their health. Our algorithm consists of three stages, and each of them is divided into diagnosing and correction parts as below:

1. а) Find your ratio between the “heat” and “cold” elements as they are present in your body.
   б) Choose your exercises and your practice regimen that should balance the “heat” and “cold” elements.
2. а) Find your tri-dosha ratio.
   б) Choose your methods of balancing the doshas, such as asanas and kriya practices.
3. а) Diagnose your ill organs or systems. If there aren’t any, find the “places of less resistance” (lat. locus minoris resistentia) in your body, because under unfavorable circumstances they will, most probably, become niduses of disease, “places of major reactivity” (lat. locus majoris reactivae).
   б) Choose your methods of curing your ill organs and improving your vulnerabilities.

Further down, all these stages will be explained to you in detail, one by one, in a much simplified and easy to understand manner. I should note that some yoga teachers, whether they are aware of it or not, do use a similar algorithm. Certainly, an experienced teacher does not have to perform highly complex diagnostic procedures. He trusts his intuition and experience. A single glance or a short conversation can be sufficient to lay out an accurate exercise program which is optimal for this particular person facing such problems at the moment. However, not everybody gets the opportunity to learn from great teachers. As for various workshops and intensive courses, they are mainly designed for the people who are already very profound and confident on their way. As for the others, they have to do the exercises that they find in books or invent themselves. It, certainly, helps them to get their brains in gear, but may not altogether be very healthy. One of my teachers used to say that “There are two types of people: some will learn from somebody else’s mistakes, and the others, from their own. The latter are more likely to become Masters, the former are more likely to survive”. I have to admit that time proves it. I should note, though, that recently published books elucidate on the rules of combining exercises, but, mostly, from a technical point of view. Here we will dwell on the therapeutic aspects.

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So, let?s take a closer look at our algorithm.

1. Find your ratio between the ?heat? and ?cold? elements as they are present in your body, and choose your methods of balancing them.

The majority of our contemporary researchers into Indo-Tibetan medicine, namely, L.L. Hundanov, L.L. Hundanova, T.V. Batomunkueva, identify the ?heat? and ?cold? terms with the ergo- and trophotropic systems of our organism. The hypothesis about their existence was formed in 1925 by W. R. Hess, a Swiss physiologist. Later on his theory was enriched by one of his disciples, M. Monier. Our ergo- and trophotropic systems are mainly the same as the sympathetic and parasympathetic divisions of a vegetative nervous system. These systems are antagonistic, for the most part, and their fluctuations preserve our homeostasis, a dynamic balance that should maintain our internal environment in a stable state. Various internal and external factors bring about ergo- and trophotropic reactions which, ideally, should be compensated by their antagonists, and as they lessen, they usually come to a relatively balanced state. In most cases such states are relative, since a prefect balance between the sympathetic and parasympathetic systems is quite rare, and usually one of them is more or less dominating. It reminds me of balance scales, where one arm is the sympathetic system and the other, the parasympathetic one. It happens often though, that these arms are not equal. The bigger this difference is, the easier you loose your balance. In case you are off your balance significantly, and there is no ongoing compensation to it, you will face troublesome symptoms or functional disorders (so called dystonias result from alterations of arousal in either one of the systems).

It should be mentioned that you can?t really say one of these systems is ?good? while the other one is ?bad?. The sympathetic system is just as good as the parasympathetic one. If your sympathetic system dominates, you are more likely to have hypertension, arteriosclerosis and ischemic heart disease. But, the people, who suffer from gastric and duodenal ulcers, in most cases (more than 90 %) have a dominating parasympathetic system. The same is true for bronchial asthma?s patients.

In Indo-Tibetan medicine they traditionally use methods of visual examination and diagnosing by pulse to recognize ergo- and trophotropic states. Our contemporary medicine organizes such external evidence in the specific tables (Dr. Vein?s tests), and it tells a heart rhythm?s variability by measuring the pulse. In ancient times there even has been an analogue for our modern method of measuring the galvanic skin response. It was a handshake by which you could tell if the skin was watery and therefore electroconductive. It could also help you to realize which division, the sympathetic or parasympathetic, of the patient?s higher nervous system dominates. Nowadays you can diagnose very precisely ergo- and trophotropic activities by means of Lusher?s test which is often used in psychology.

Generally, the people with a dominating sympathetic system have dry reddish skin and mydriatic pupils. Their pulse and breathing are rapid, and they are more likely to suffer from hypertension. Such people demonstrate their intolerance to both coffee and cold weather.

Parasympathetic dominant people, on the contrary, have pale and watery skin; their sweat is excessive, and they have miotic pupils. Their pulse, breathing rate, blood pressure and temperature is normal or a little low. They are heavy coffee drinkers and can even get addicted to it. They are intolerant of hot weather.

These symptoms become more obvious as the imbalance worsens.

Kerdo vegetative index has been used quite frequently and for a long time now. It defines a quantitative ratio between your sympathetic and parasympathetic systems. It can be calculated by the following formula:
VI(Vegetative Index)=(1 - Dyastolic Blood Pressure/Pulse)*100

A positive index tells that your sympathetic system is active, and a negative one means that your parasympathetic system dominates. The closer the index is to zero, the more balanced your state is.

In Bhagavad-Gita there is a saying: ?balance is called yoga?. Perfectly in unison with it are the following phrases from a most interesting and informative monograph by E.I. Sokolov called Emotions and Atherosclerosis: ?Balance reactions of these two systems maintain an optimal homeostasis. The close interrelation and synchronization between the ergo- and trophotropic systems allow a healthy person to adapt well to various conditions, such as environmental, social, provisioning conditions etc.? Reaching this state is necessary if you want to practice pranayamas, and it is, basically, a criterion which shows you are ready. Patanjali says that ?because of it (your asana practice - S.A.), dual polarities stop influencing you?. It is most important, in this respect, to choose a correct practice regimen.

A static practice that requires holding each pose for a long while, is good for sympathetic dominant, ?heat? people, especially, if it starts from shavasana or a similar exercise (horizontal body positions strengthen the parasympathetic system). Alternatively, they can start by performing three sets of paschimotanasana, each lasting for three minutes, like V.S. Boyko does. The same effect can be reached if they relax from 5 to 10 minutes in shashankasana. Bending forward is very helpful also, and so is Chandra Bedhana breathing technique (breathing through the left nostril).

Parasympathetic dominant people should better start their practice with any variant of Syria Namaskar, Sukshma Vyayama (Dhirendra Brahmachari?s school) or with Pavanmuktasana series (Bihar school). Back bends are most helpful for them, and so is Surya Bedhana (breathing through the right nostril). A short clarification: such practices as Surya or Chandra Bedhana as well as Anuloma-Viloma pranayama should be referred to as kriyas, to be more accurate.

In fact, there are already some compensatory methods that balance ergo- and trophotropic ?left-overs? during your yoga practice. For example, in Ashtanga Vinyasa yoga tradition (Pattabhi Jois? school) its dynamic style is compensated by Udjai pranayama.

That means that there is really no big difference between static and dynamic yoga styles, they are just meant for different types of people.

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2. Find the ratio between your doshas and choose your methods of balancing them.

In Indo-Tibetan medicine doshas form one of the key principle. Vata, Pita, Kapha - Gas, Bile, Mucus - these are the three basic elements that build up the entire Universe and a human body. These doshas define your Prakriti, a body?s constitution type. Knowing your type allows you to change your lifestyle, diet and individual practice in order to achieve a perfect balance. There are quite a few ways to find out what your prevailing doshas are. They can be diagnosed by pulse, urine or external evidence; you can also take functional tests? (measuring adrenalin, insulin etc.). The latter method was created by L.L. Hundanov, L.L. Hundanova and T.V. Batomunkueva. A very reliable method of determining your dominant doshas is to complete a simple quiz. It has been first used as an aurvedic diagnostic tool by Dr. Chopra. Later on such questionnaires have become a commonplace, and now you can find them in most books on Aurveda and Tibetan medicine. It is quite easy to find such books and to complete a simple test. However, it would be better if you answer several questionnaires of that sort and compare their results. Pure doshas are quite rare. Usually, you will come across various combinations of two doshas, or you can calculate a certain ratio where all three of them are present in different proportions. As soon as you know that, you can start choosing methods of balancing your doshas in order to achieve an ideal 1:1:1 ratio that Tibetan medicine calls a Buddha state.

A very effective method of balancing your doshas is by karma or kriya yoga practices. Usually, yogis speak of six karmas (Shatkarma), although in Aurveda they have just five (Panchkarma). There are tree of them that affect your doshas the most, namely, Basti (cleanses the colon), Vamana (cleanses the stomach) and Shankh Prakshalana treatment (cleanses the whole digestive tract). Vamana dhauti lessens kapha, Basti lessens vata, and Shankh Prakshalana lessens pita. There are detailed descriptions of these procedures in various books on Aurveda and Tibetan medicine. Kriya practices in yoga have the same significance as Panchkarma procedures in Aurveda, although the latter have a better therapeutic potential because they use herbs, oils and additional procedures. For instance, in yoga practice there is a 40-day course of Vamana, but in Aurveda it does not last longer than eight days. It is very important to choose kriyas in accordance with your constitution. A most famous contemporary yogi, T. Krishnamacharya, writes that ?Practicing kriyas if you don?t know your individual dosha can bring more harm than good. Each person has a dominant dosha, and kriyas should only be considered if they are in accordance with your individual constitution.? It is important to select proper asanas that can help you to balance your doshas. There is a concept of five elements (Pancha Tattva) that is very helpful in this respect. In Indo-Tibetan medicine they believe that Vata is produced by unification of Vaju (Air) and Akasha (Ether); Pita originates from Agni (Fire) and Apo (Water); Kapha, from Apo (Water) and Prithvi (Earth). At the same time the yogic chakra concept states that the Earth?s tattva is located in the Muladhara chakra; the Water?s tattva, in Svadhisthana chakra; The Fire?s tattva, in Manipura chakra; The Air?s tattva, in Anahata chakra; The Ether?s tattva, in Vishuddha chakra.

The Muladhara chakra is physically positioned in the tail bone and perineum area; Svadhisthana is located in the lumbosacral region; Manipura, in the thoracolumbar area; Anahata, in the thoracal region; Vishuddha, in the cervical area. Beside the specific parts of a spinal column bearing the above names, the chakras are also connected with the bodily areas which are innervated by the appropriate parts of the spinal cord. By selecting the asanas that affect these areas you can make a specific tattva stronger or weaker, and as a result of it your doshas should get balanced. For instance, if your Vata:Pita:Kapha ratio is 33:33:33, and you have one hour for your daily practice; then you should perform exercises for each dosha during 20 minutes. If the ratio is 60:30:10; then you do some anti-Kapha exercises for 34 minutes, and work with your Pita and Vata doshas for 22 and 4 minutes respectively. Hence, most of the time you concentrate on performing the asanas that affect your perineum (Muladhara), lumbosacral (Svadhistana) and thoracolumbar joint (Manipura) regions. Most standing asanas, from tadasana to hanumanasana, are good for working with your Muladhara chakra. In this respect you can also use balance asanas, from vrikshasana to utthita-parsva-sahita, or sitting asanas, such as vajrasana, bhadrasana, siddhasana, padmasana, garudasana and gomukhasana. The Svadhistana?s asanas, which affect the lumbosacral area, are the following: such back bends as shalabhasana series, ardha-bhujangasana etc.; forward bends: kurmasana and yoganidrasana; twisted poses: parivrita-trikonasana, meru-vakrasana, marichyasana and bharadvajasana series. The Manipura?s asanas, which affect the thoracolumbar joint region, are as follows: such back bends as bhujangasana series, ganda-bherundasana, vrishchikasana, rajakapotasana; forward bends: halasana, karna-pidasana, pindasana; twisted poses: ardha- and paripurna-matsjendrasana, pasasana. Mayurasana is especially good for your Manipura chakra. The Anahata?s asanas, which affect the thoracal region, are as follows: such back-bends as purna-bhujangasana, urdhva- and ardha-mukha svanasana, dhanurasana series, ustrasana, chakrasana, natrajasana, gherandasana; it is quite complicated to do your forward bends in this particular area, still there are a few of them, such as salamba and niralamba sarvangasana, garudasana (the arms position); for your twisted poses you can do some variants of marichyasana, matsjendrasana and pasasana. The Vishuddha?s asanas, which affect the cervical area, are as follows: such back bands as matsyasana, kapotasana, viparita-dandasana; forward bends: sarvangasana, shashankasana, pindasana; twisted poses: most of the above mentioned twisted asanas will do.

This list is neither perfect nor complete. Most asanas are left out here, yet they are of no lesser significance. Many asanas affect several chakras simultaneously. In fact, there are a few asanas that affect all of them (some variants of chakrasana and pindasana).

Practicing a number of asanas you gradually exceed your body?s limitations, but after a while these asanas loose their therapeutic value for you. To neutralize this effect you have to practice their more advanced variants.

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3. Diagnose your ill organs and choose methods of curing them and reducing your vulnerability.

Traditional medicine lists eleven main organs as follows: small intestine, cholecyst, liver, stomach, spleen (pancreas), kidneys, pericardium, lungs, heart, bladder, large intestine. In Chinese medicine there is also a ?tree heaters? term which is interpreted by V. Lad as ?tridosha balance?. By all means, this list does not include all the organs that are known by western medicine. However, it has been used successfully for diagnosing and treating numerous diseases for centuries.

In this case the methods of diagnosing include pulse diagnostics, visual examination, inspection of your body?s natural excrements and discharge. Our contemporary medicine added some important methods, such as thermopuncture diagnosing (by Nakatani, Voll etc.). Our modern procedures, including Ultrasound, MRI, X-ray etc., can also be very helpful if they are properly and adequately used.

As soon as we know which organs are underperforming or may fail, we choose proper asanas that will cure and pre-empt problems. As we affect some specific areas of our body by means of asanas, we do, in fact, by various regulation mechanisms affect our organs. A pretty simple mechanism can be used to change the local hemodynamics. For example, you will have a compensatory effect of the increased blood flow after some flexion or extension exercises.

Derma-visceral and motor-visceral reflexes are of high importance since they allow you to affect directly your organs? functions. As a matter of fact, our organs, muscles and zones of Zaharin-Ged (special areas on the skin) have sensitive nerves which are interrelated in the spinal cord?s region (granthis). Дело в том, что чувствительные нервы внутренних органов, участков кожи (зоны Захарьина-Геда) и мышц пересекаются на уровне сегментов спинного мозга (грантхи). And vice versa: if you exercise some specific muscles and stimulate certain areas on your skin, it will have a wholesome effect on your organs.

Such asanas as bhadrasana, gomukhasana, garudasana, shalabhasana, kurmasana and marichyasana are especially good for your urogenital system. Halasana and matsjendrasana are good for your liver and cholecyst; series of bhujangasana, especially tiryak-bhujangasana, dhanurasana and shalabhasana, for kidneys; mayurasana, pasasana and series of matsjendrasana, for your stomach and pancreas. If you have any lung problems, you should do back bends in your thorax area, such as matsyasana, bhujangasana and ardha-mukha-svanasana. You can cure your heart and pericardium by doing series of salamba- and niralamba-sarvangasana.

Conclusion.

Hence, this algorithm gives you an opportunity to elaborate your individual program by selecting the appropriate practice regimen that balances your ergo- and trophotropic systems, and doshas, as well as improves the health of your organs. As soon as you enter a balanced state you are ready to advance and pursue further self-perfection on your way of yoga. In Indo-Tibetan medicine they also use diet, herbal therapy, regimen, massages and hydrotherapeutic procedures to reach this healthy state. Combining these methods with your yoga practice can significantly increase its usefulness.