(On the Treatment of High Blood Pressure and Heart Disease)

High Blood Pressure is one of the most prevalent complaints of the present day, and whilst not being a disease in itself it can be productive of many. Apart from somewhat alleviating the condition drug therapy is not the answer and it can make confusion worse confounded in the long run.

Both hypertension and hypotension are circulatory disorders, and as the breathing or respiratory centre in the brain is quite close to the circulatory centre it should now occasion no surprise for readers to learn that breathing has an enormous influence upon the circulation and hence upon the regulation of the blood pressure.

Now the vast majority of folk do not breathe fully. This vital function is reduced to something quite inadequate for the needs of their bodies and minds, through bad postural, dietetic and occupational habits. Added to these are the inevitable cigar­ettes. Most smokers inhale, so it stands to reason that the amount of smoke inhaled displaces that amount of life-giving air from the lungs, as well as poisoning the respiratory system. And adults are very shallow breathers as it is.

No food, no matter how dietetically sound it may be, can be properly digested without an adequate supply of oxygen. Is there any wonder then that there is so much digestive trouble and sub­sequent disease? The Torah (Gen. 2:7, 6:17, 7:15, 22, etc.) speaks of the Breath of Life; and quite apart from inhaling oxygen from the atmosphere the Yogi of India ages ago maintained that a cosmic Life-force is also taken into the organism at each breath, and this force is termed "Prana." It is a Sanskrit word meaning "absolute energy." Paracelsus had the same conception in his "vital fluid," and later Reichenbach called it "Odyle" or "Odic Force as a universal property of all matter in variable and unequal distribution." Still later there was Dr. Richardson, F.R.S., with his "Nervous Ether"; also Brunler with his "Biocosmic Energy," and there is to-day the X-Force of L. E. Eeman, further "discover­ed" and scientifically demonstrated by Dr. Wilhelm Reich under the name of "Orgone," which means "biological energy" surround­ing and permeating everything. The Kahunas of Hawaii Islands gave the word "Mana" to this all pervading energy, which they used in the performing of miracles.

Since Yogi has been mentioned above it may well be stated here that the complicated exercises given in books on Yoga breath­ing are quite unnecessary for the purpose set out in this article on "Respiratory Therapy." In any case they should never be under­taken without a proper physical examination and instruction at the hands of a competent Practitioner.

Now to come back to our "muttons" as the French say: Of the ultimate cause of hypertension we know nothing definite. Various causes are mentioned. Of course, constitutional factors play an important role. Formerly one believed that the chief cause of hypertension lay in the capillaries being spasmodically contracted in an extensive area of the body, remaining in this state of contraction and thereby producing the increase in blood pres­sure in the whole circulation. Nowadays one believes that it is a matter of hypersensitivity of the constrictor centre in the brain, and this hypersensitivity is occasioned in the majority of cases by reduced breathing, a "chronic under-aerification." The normal stimuli of life, which are not registered by non-sensitive persons suffice with sensitive people to maintain the constrictor centre in abnormal sensitivity.

The diaphragm is the most important breathing muscle and separates the chest from the abdominal cavity. On inhalation the diaphragm descends, flattens itself out and thus increases the size of the chest cavity. The most powerful movement of the dia­phragm takes place in the supine position, stronger than when standing or sitting. For all that, many persons are unable to breathe so well in the supine position and to satisfy their air hunger, because the pressure conditions in the thoracic and ab­dominal cavities are different on lying than on standing or sitting. Furthermore, on lying, the viscera press the diaphragm upwards more towards the head so that the lungs must contract more strongly. This is the real reason why with many heart sufferers the supine position is impossible. They suffer from orthopnea, i.e., they can breathe only in the erect position. Their air-need increases on lying, for only on sitting or standing can the dia­phragm descend into the abdominal cavity, because the organs (vis­cera) no longer press against it.

The less flexible the thorax becomes with age due to shallow breathing over a lengthy period, the firmer it remains in the posi­tion of inhalation, and is no longer able to return to the position of rest; all the less also is the quantity of air that is exchanged on respiration. Therefore, people should be taught to prolong EXHALATION and to pay specific attention to this. To super­impose yet deeper inhalation movements upon the already fixed and firmly held inhalation position is incorrect, because such efforts, which are in part erroneous and spasmodic, deepen the breathing only by a trifle on inhalation.

What is of importance is first to restore the flexibility of the thorax by prolonging the exhalation, and by the energetic move­ment of the diaphragm to relax the lungs better. The air exchange is thus promoted better than solely by the attempt to inhale forc­ibly. By such an attempt only the lung tissue which is permanently distended, becomes still more burdened, an excessive demand being put upon its elastic power. Hence it is quite wrong when some Physical Training Instructors cultivate only the inhalation, and decline to use the exercises by which the thorax is contracted and thus made smaller.

The activating cause of hypertension has been discovered in shallow, ineffective breathing. The outstanding symptom, viz., the considerable rise in the blood pressure, has been brought back to normal by correct systematic breathing exercises. And this is confirmed over and over again in one's practice. Also the sub­jective symptoms of this complaint are removed, such as the feeling of shortness of breath, sleeplessness, irritability, pressure in the head and on the chest, headache, palpitation giddiness, apathy to work, memory weakness. After three to six weeks of the breath­ing cure patients have become completely well without any other medicament, and have remained so as long as they continue to do the breathing exercises.

In order to remain healthy and capable everyone must eat and drink daily of sufficient quantity and quality. Hardly anybody will omit a meal, but there are always numerous individuals who just will not see that they must carry on with their breathing exer­cises day by day. Only those who indulge in sport regularly or sing daily need no extra breathing exercises. Among a hundred or so of professional singers examined in Munich not a single one of them suffered from high blood pressure. That speaks volumes in favour of correct, full breathing.

There is no doubt that the success of the cold water cure and of clay pack cures rests upon a strong stimulation, speeding up and deepening the breathing. But why not intelligently use the breath­ing apparatus that is part and parcel of the human organism and is thus constantly with us?

The first breath drawn in at birth fills the lungs with air—an amount of air which never disappears from the lungs. It is the so-called minimum air, that causes a lung, once it has breathed, to float upon water. To this air-quantity in the lung is joined another lot during growth and respiration that cannot be breathed away and disappears only then from the lung when the thoracic cavity is opened or the lung is removed from the thorax. It is the so-called "collapse air." Collapse air and the minimum air to­gether form the residual air, which, as already stated, cannot be removed from the lung by breathing.

It has already been mentioned that the BREATHING centre influences the circulatory centre, both of which are close together in a part of the brain, and when the latter is not functioning as it should owing to the breathing centre not doing its job properly circulatory disturbances occur which later give rise to all kinds of disease processes. The condition can be corrected by properly regulated respiration, which must be carried out as follows:

Inhale slowly through the nose at the same time slightly pro­truding the lower abdomen which is then slowly retracted so that the ribs are lifted outwards and upwards towards the chest so as to fill the lungs completely with air, but without strain. At the completion of inhalation the breath is to be held for a second or two. Then—and this is another very important point to note, viz., the air is to be EXHALED through the mouth on the sustained note of OO. The lips must form the roundest possible O and the air must be exhaled slowly to the UTMOST limit, but again without STRAIN. This process is to be repeated for 10 minutes three times a day at first, working up to not more than 15 minutes at each practice a day, when the exercise may be done four times daily, the last one, it is suggested, being performed whilst lying in bed just before settling down for the night's rest; at other times in lying or sitting position; later in the standing position.

This respiratory exercise must be carried out every day with the greatest regularity, preferably immediately after a meal, as it will greatly aid digestion and bowel movements. The keynote to the success of this therapy, as it is indeed to anything else worth while, is PERSISTENCE, i.e., unflagging and regular application. To relieve the possible monotony of the sustained OO-ing sound, the OO-ing can take the form of a scale or tune.

If there be any blood pressure of a pathological nature present, then respiratory therapy will normalise it in a comparatively short time—and plenty of evidence can be adduced to support this claim —whilst a wonderful sense of well-being will be the lot of those who practice this respiratory technique: not only will the whole nervous system be revitalised, but the whole organism. Digestion will be improved as no food can be adequately digested without a full supply of oxygen, and this can be had only from the air we breathe. This fact warrants the repetition I have given it, and I also repeat here that one should be just as disinclined to miss one's daily practice of full breathing as one would miss a meal; but whilst feeding can well be dispensed with when ill to the patient's ultimate advantage, full breathing can but hasten the cure in those patients who are not too ill to practice it. In fevers Nature her­self sees to it that the respiration is accelerated in order to supply the system with more oxygen to serve the increased needs of the organism as a whole.

So much has been written about diet that I am certainly not going to dwell on this subject here. I just wish to make a point or two: Many thousands of people take much meat and animal protein with their meals and yet only a very small percentage get gout. But whoever has a disposition to gout can be saved from it if he carefully avoids all purines which bring about attacks of gout. Whoever feeds himself very modestly, taking no meat, and reduc­ing the intake of protein and animal fat sufficiently, will not get gout in spite of the disposition to it. Similarly, with high blood pressure, whoever lives a corrective careful way of life will be pro­tected from this complaint, even when he has the predisposition to it, for he will have excluded the various irritants and toxins without which, even when the predisposition is present, the com­plaint cannot develop—providing, of course, that the intake of oxygen is sufficient to deal with the food consumed, and this means habitual good, full, rhythmic breathing. Inheritance and the ap­pearance of a disease on the one hand, cure and disappearance of it on the other, stand only apparently in contradiction, for a good Practitioner can, in spite of heredity, achieve success in the cure and maintenance of health of the one so threatened.

In order to explain the curative effect of deep breathing upon persons who are threatened with blood pressure, we must bear in mind that deep breathing on the whole can produce its effect in three different areas, viz., in the purely mechanical-physiological sphere by the change of the manifold conditions of pressure in the respiratory movement; in the chemical sphere that takes place in internal breathing, i.e., the giving up of the oxygen to the tissues and the taking in of carbonic acid gas—and finally in the purely nervous sphere.

A few words now on the efficacy of respiratory therapy in the cure of heart disease which was discovered by a Dr. Tirala of Vienna.

In recent years he has been most successful in opening up a new region of activity for respiratory therapy. It is not only with hypertensives that a large, flabby, dilated heart often occurs that causes the patient also a number of subjective complaints.

Palpitations, shortness of breath, a weak feeling, reduced efficiency, quick fatigue are symptoms that such a heart is con­siderably handicapped in its adaptability, as it is with changes in the heart musculature (myocardium) as with myocarditis and myo-degeneration; further in all cases, which are due to so-called relative valvular faults; finally in all disorders which are due to poor, indifferent circulation of the heart muscle. All these hearts are treated with numerous medicaments, which, of course, are only so long "effective" as they are taken.

In the respiratory therapy as described herein not only have we a remedy in our hands to reduce these hearts, but to make them efficient once more. Whilst being misled by a mechanical con­ception, we have learnt that a really dilated heart can never again return to normal size. Dr. Tirala has been successful in a large number of cases, in proving, by careful X-Ray photographs, that the dilated heart could be made considerably smaller with the help of systematic breathing exercises. Naturally, the reduction depends on the reparative ability and regenerative power of the musculature. This one is unable to determine exactly in advance; only in the course of the cure will it become evident to what extent such a dilated heart can be made smaller. There have been re­ductions in the transverse diameter observed by Dr. Tirala of a few millimeters up to 4.5 cm.

The examination is conducted in the following manner: At the beginning of the cure an X-Ray photograph of the patient's heart is taken and the picture of the heart on the plate or film exactly measured. At the end of the cure, a second photograph is made, which is taken at the same hour of the day and precisely under the same conditions. The patient is directed with particular care to allow the exposure to be made in exactly the same position and with the same short depth of inhalation in front of the appara­tus. One nearly always succeeds in attaining the same breathing position, which one can see from the position of the ribs and of the diaphragm very clearly in the pictures. Certainly, after treat­ment, the position of the heart on the diaphragm is mostly differ­ent; usually it does not lie flaccid any more; but the tone of the heart can be clearly seen from the outline. For enhancing the accuracy, cinematograph X-Ray pictures have been taken during the last 10 years, from which one can measure gross alterations of the heart with meticulous exactitude.

In none of the modern books on heart-therapy has Dr. Tirala been able to find even a hint about the therapeutic effect of breath­ing upon the heart. This latter is an important advance in the domain of heart therapy; for it is not only a matter of the heart "becoming smaller" as evidenced by X-Ray pictures and by palpa­tion, but also of an appreciable increase in efficiency due to a genuine increase in the tone of the heart muscle itself. The exhal­ation-time which, in part, is a function of heart power, becomes considerably prolonged in the course of a few weeks with all pati­ents. Patients who come with an exhalation time of 5 to 10 sec­onds, at times even only 1 to 2 seconds, learn not only to exhale correctly, but they acquire also the ability to exhale much longer, up to 30 and 40 seconds. This increase in the expiratory time goes together with a genuine toning up of the heart muscle.

Patients who complained of head pressure and giddiness and who were unable to walk any longer without having to stand at every 10 steps in order to take in a breath, report, not influenced by any suggestive questions, that they can walk again, that they are more efficient, that they have pleasure in going for walks and to wander about; in a word, that they feel themselves in possession of their powers. The feeling of strength, however, really depends upon the health and efficiency of the heart. Simultaneously with the reduction of the size of the heart and its increase in efficiency the subjective feeling of well-being is enhanced.

But a note of warning here. Heart sufferers must not under­take respiratory therapy without expert guidance and supervision to begin with. Some patients may need a course of treatment to make good their biochemical deficiencies before they commence this therapy.

Dr. Tirala has had some amazing results, too, with his res­piratory therapy in the treatment of other ailments, including sugar diabetes, dispensing with insulin injections in some cases, but let no diabetic sufferer act foolishly in this respect otherwise he may find that he has thrown out his means of survival.

Enough has now been said, surely, to convince the reader of the tremendous value of full, rhythmical breathing and of its wide scope in the treatment and cure of many hitherto intractible diseases.

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