Physiology of Breathing Process As Per Ayurveda

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
The balance between inspiration (air in) and expiration (air out) is an indicator for ‘optimum health’.

Breathing phenomenon

Breathing Phenomenon according to Ayurveda
Though Ayurvedic treatises have spoken about air, breathing etc, the first comprehensive explanation of breathing mechanism seems to be explained by Acharya Sharangadhara. 

नाभिस्थः प्राण पवनः स्पृष्ट्वा हृत् कमल अन्तरम्।
कण्ठाद् बहिः विनिर्याति पातुं विष्णु पदामृतम्॥
पीत्वा च अम्बर पीयूषं पुनः आयाति वेगतः।
प्रीणयन् देहम् अखिलं जीवं च जठत अनलम्॥(शा.पू.५/४४-४५)

Translation of SHarangadharas verse of ‘breathing phenomenon’
According to Sharangadhara, the breathing phenomenon takes place in the below mentioned steps –

• The Prana vayu located in the Nabhi (navel), travels to Hrit Kamalantaram (region of heart).
• From there it travels to the Kanta (throat).
• From the kanta, the prana vayu comes out to the environment.
• In the external environment, the Prana Vayu takes (collects) the Vishnu padamrita or ambara piyusha.
• Taking the Ambara Peeyusha with it, the Vayu once again gains entry into the body.
• After entering into the body it nourishes all the dhatus (tissues) and also kindles the jataranala (digestive fire located in the stomach or belly).

The true translation of the verse given by Sharangadhara looks weird in relation to its explanation to the ‘breathing phenomenon’.

We need to dig into the deeper meaning of the shloka (verse) to understand what it actually means!! Before doing that we shall discuss about the terms mentioned in the shloka.

Understanding the terms related to the breathing phenomenon as explained by Sharangadhara

Nabhi –
Nabhi generally explains the ‘umbilicus’ or navel region. Here we get a doubt why and how Nabhi is concerned with breathing phenomenon. Here are some clarifications.

Nabhi is said to be the site or point of origin of siras (veins or blood vessels) but in modern day anatomy we see that the blood vessels start and end in the heart. We have many instances wherein Nabhi (navel) and Hridaya (heart) are used as synonyms. Thus, in this instance we shall consider Nabhi as heart and not navel. Hence the controversy of breathing getting started from Nabhi is cleared.
Therefore in the Sharangadharas explanation of ‘breathing phenomenon, ‘Nabhi=Hridaya’.

Prana Pavana (Prana Vayu)
Prana Vayu is one among the 5 types of Vayus. Its location is said to be Murdha or head. But it also travels in the Ura (chest, region of heart and lungs) and kanta (throat).

But the Prana Vayu in this instance is said to travel from Nabhi upwards. Thus it cannot be the same Prana Vayu explained in Ayurvedic treatises as ‘one among the 5 types of Vayu’.

Here we need to consider Prana Vayu as ‘the air going out’ during the phenomenon of breathing i.e. Carbon dioxide or the exit gas (We breathe in oxygen and throw out carbon dioxide).

अपानं अधो वृत्तौ प्राणम् ऊर्ध्वं वृत्तिं पूरकेण…।(श्रीधराचार्य, भगवद् गीत ४-२९)

We have lot of references explaining Prana Vayu having Urdhwa Vritti (moving upwards) and Apana Vayu having Adho Vritti (moves downwards). Ayurveda too has the same opinion about Apana Vayu. Among them this reference taken from Sridharacharyas commentary on Bhagavad Gita is an important one.

Hrit Kamalantaram –
Hrit or Hridaya is a word used to describe Heart. It also describes the chest contents related to the heart i.e. Phuphusa or lungs. Hridaya is said to be in the shape of ‘kamala mukula’ inverted bud of lotus. (Kamala=Lotus). This is also because, the heart expands and contracts like the bud of the lotus open in the day and closes towards evening. Similarly we can also see that the lungs also expand and contract with each act of breathing.

In this instance Hrit Kamalantaram should be taken in terms of lungs.
Taking Nabhi as Hridaya or heart, the explanation of Sharangadhara can be understood as –

‘The Prana pavana or carbon dioxide located in the Nabhi (right ventricle of the heart, deoxygenated blood) touches or enters the Hrit Kamalantaram i.e. the kamalas or the lotus present in the proximity of the heart i.e. lungs’ 

Thus the first line of the verse of Sharangadhara’s verse explains ‘the pumping of deoxygenated or carbon-dioxide rich blood from the right ventricles into the lungs (for purification) through the Pulmonary arteries’.

Kanthat Bahir viniryati –
The Prana Vayu (carbon dioxide) after entering the lungs or hrit kamalantara makes an exit from the kanta or throat.

उभय अत्रो उरसो नाड्यौ वात वहे अपस्तम्भौ नाम्॥(सु.शा.४/३१)
Sushruta tells that there are 2 Marmas (vital areas or organs), 2 in numbers, located 1 on each side of the uras or chest; they carry the vata or air. They are named as Apastambha Marmas. These points out to the explanation of right and left bronchus which help in permitting the air (oxygen) into the lungs and the same channels carry the carbon dioxide out of the lungs. This also, when blended with Sharangadharas explanation shows that the carbon dioxide is pushed from hrit kamala (lungs) into the apasthambas i.e. tracheas, which carry the impure air towards the throat for expelling it.

Patum Vishnu Padamritam –
Here Vishnu Padamritam (akasha, sky) means the external environment. The Prana Vayu exits through the kanta (throat) and comes out into the external environment.

Peetva cha Ambara Peeyusham –
Ambara Peeyusha means the nectar of sky i.e. fresh air or oxygen which is nothing short of ‘nectar of life’. The Prana Vayu (carbon dioxide) on coming out through the throat into the external environment (Vishnu padamritam), takes up the ambara peeyusha.

Actually the impure air or Prana Vayu which makes an exit from the body doesn’t take the form of Ambara Peeyusha or oxygen. The explanation is to tell that the air which we breathe in and out is the same, but when it comes out it takes the form of prana vayu (carbon dioxide) and when it goes in, it goes in the form of ambara peeyusha (oxygen).

This is to explain ‘When the impure air goes out, the pure air is ready to take its place and enter the body’. This also explains beautifully the vicious cycle of input of pure air and output of contaminated air, continuously and rhythmically throughout the life.

To put it in simple words – When the air comes out it will be impure and is called prana vayu. When the air goes in it is pure and will be called as ambara peeyusha.

प्राणो हि आभ्यन्तरो नृणां बाह्य प्राण गुणान्वितः॥(सु.सू.१७/१३)
The Prana Vayu in the interior (prana vayu here means oxygen in the body) takes the form of the Prana Vayu present in the exterior (oxygen in the environment) and nourishes the body made up of 5 basic elements of nature (Pancha Mahabhutas).

Punaraayati vegataha –
The air adorned with ambara peeyusha or pure air rushes into the body very quickly in great force. This statement shows that the body, at all times is in grave need of ambara peeyusha or oxygen to run all its activities. Vegataha or ‘with force’ indicates the quickness with which the oxygen needs to be supplied to the body.

Preenayan Deham Akhilam, Jeevam cha Jatharanalam –
The Ambara peeyusha coming into the body is put into circulation along with rasa-rakta (nutritive portion of food and blood) from the hridaya and nourishes the entire deha (body), supports life and life activities and kindles jatara anala (digestive fire)

Now after understanding the terms in detail, let me put the explanation of Sharangadhara explaining ‘mechanism of breathing’ as follows –

‘The Prana Vayu (Carbon dioxide) located in the Nabhi (right ventricle of the heart), is pumped into the hrit kamala (lungs) through pulmonary arteries. From the lungs, the prana vayu given up by the deoxygenated blood, comes out to the atmosphere (Vishnu padamrita), through the kanta (trachea), to allow fresh air or oxygen (ambara peeyusha) to enter the body through the air passages, lungs and blood to nourish the tissues, to stimulate the digestive system and to maintain the life’.

What happens after the Ambara Peeyusha enters the body?
The ambara Peeyusha or shuddha Vayu (clean and sterile air or oxygen) after entering through the nasa (nostrils), gains entry into the Hrit Kamala or phuphusa (lungs). Here they get admixed with the blood which has given away the prana vayu (as explained above) and goes back to the Hridaya or Nabhi. Hridaya is the root of dhamanees which carry the rasa (nutrients) to all parts of the body. Rasa and ambara peeyusha (nutrition and oxygen) travel through the same routes, same siras and dhamanees. Even the modern science has the same concept of circulation of nutrition and oxygen through the heart and its vessels.

Below said are the references explaining the circulation of oxygen, nutrients and oxygenated blood from the heart.

हृदो रसो निःसरति तस्माद् एव च सर्वशः।
सिराभिः हृदयं च एति तस्मात् तत् प्रभवाः सिराः॥(भेल संहिता सू.२१) 

According to Bhela – ‘The Siras take their origin from Hridaya. Through these siras the hridaya circulates the rasa (nutritive juices) throughout the body’. Here Bhela has said that Hridaya is the root of Siras. Elsewhere we can find the references telling that ‘Nabhi is the root of siras’. Thus by cross references, Nabhi becomes synonymous with Hridaya.

सिरा धमन्यो नाभिस्था सर्वां व्याप्य स्थिताः तनुम्।
पुष्यन्ति च अनिशं वायोः संयोगात् सर्व धातुभिः॥(शा.पू.५/४३,४४)

The Siras (veins) and Dhamanis (arteries) are located embedded in the nabhi (nabhi=hriday=heart in this instance). Starting from the nabhi, these vessels lay scattered in the whole body. They carry Vayu (air) and nourish all the tissues (dhatus) throughout the day and night.

धमन्यो रस वाहिन्यो धमन्ति पवनं तनौ॥(शा.पू.५/३५)
The Rasa Vahini dhamanees (channels carrying the nutritive juices i.e. arteries) pulsate and push the pavana (air or oxygen) to all parts of the body.

शोणित कफ प्रसादजं हृदयं यद् आश्रया हि धमन्यः प्राणवहाः॥(सु.शा.४/३१)
Sushruta also tells that Hridaya or heart is formed from the prasada bhaga (essence of) kapha and shonita (blood). It gives origin to the pranavaha dhamanees (the arteries which carry the prana or oxygen).

Just Before Finishing
Sharangadhara is the first among the ancient Ayurvedic seers to write a comprehensive version of breathing phenomenon. All the older acharyas including Charaka, Sushruta etc too have explained the related terms in a scattered form.

Sharangadhara’s explanation when analyzed in the way we have done in this article, seems to be correlating with the modern day explanation of breathing and gas exchange. The Prana Vayu and Nabhi mentioned by Sharangadhara do not carry the same meaning as the same terms used in Ayurveda (or contemporary Ayurveda texts), including their functions. But the meanings Sharangadhara has given to the Prana Vayu and Nabhi in his explanation in the verse seems to be influenced by some other contemporary works or parallel references which he might have blended with Ayurveda to make things look more scientific. The meaning they carry is in lines with meanings given in Bhagavad Gita, Darshana Shastra, Shankaracharya etc.

Thus Sharangadhara and his work look to be influenced not only by Ayurveda but also other contemporary works.
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