VITAL FACULTY: RESPIRATION
The Source of Pneuma
The Vital Faculty is the first and most important faculty to the life and health of the organism. And the Vital Faculty and its functioning all starts with pneuma, which the lungs and the respiratory tract extract from the air we breathe.
The Lungs and Respiratory System
All the vital functions run on pneuma, and the lungs and respiratory tract are the original source of pneuma in the body. Pneuma and its Vital Force make possible the combustion of the other two vital principles: the Innate Heat and Thymos.
The lungs and respiratory tract are the seat, or home, of the Air element and its
pneuma in the organism. The essence of the Air element is exchange and contact. Through the lungs and respiratory tract, we are in constant contact with the ambient air through gas exchange and the constant flow of pneuma into the body.
Since they must be in constant contact with the outer environment, the lungs and respiratory tract are quite sensitive and vulnerable to a whole host of climactic factors and exogenous pathogenic influences. These include variations in air temperature, moisture or pressure; particulate matter; and microbes. Like the Air element, the lungs and respiratory tract have a Mutable nature, because they're always having to adapt to environmental changes and influences.
The whole lungs and respiratory tract can be seen as one big inverted tree, with its roots in the ambient air and its terminal branches in the alveoli of the lungs. The alveoli, being the basic functional units of respiration and gas exchange in the organism, are like the leaves. The rooting of the tree in the ambient air shows how dependent we are on the air we breathe for our very survival.
For the purposes of anatomical study, we can divide the respiratory tree into various parts, but actually, they are one contiguous whole. Greek Medicine divides the respiratory tract into upper and lower parts, with the lungs, starting with the bronchii, as the lower respiratory tract and the various auxiliary organs and passageways as the upper respiratory tract.
The lungs are a noble organ of the Vital Faculty, whereas the respiratory tract consists of the various attendant vessels of the lungs, which are both afferent (taking fresh air in) and efferent (exhaling stale air out). Since the lungs and upper respiratory tract are one contiguous whole, conditions of humor and temperament in the lungs will also affect the upper respiratory tract, and vice versa.
The lungs are two pinkish, spongy organs, located on either side of the heart, that fill the bulk of the thoracic cavity. They are honeycombed with numerous bronchioles and alveoli. This resilient sponginess gives them the ability to exhale air when compressed and suck air back in when allowed to re-expand.
In Greek Medicine, the lungs function as a bellows, pumping fresh air, or pneuma, to the heart, which combusts and infuses the pneuma into the blood as the Vital Force and Innate Heat, to power cellular metabolim. The lungs and heart work closely together, with the lungs as the bellows that fans and stokes the heart - furnace.
In addition to feeding and replenishing the vital principles generated in the heart, the lungs also serve to fan the heart to cool it down somewhat, and keep it from overheating. In exhalation, the lungs also act as the exhaust valve that sucks impure, sooty vapors and stale air out from the heart, which is like the engine of a car.
Because the lungs and heart work so closely together, their vital functions are intimately connected. The rhythmic puffing of the lungs as a bellows is reflected in the rhythmic pulsating of the heart as it contracts and expands in systole and diastole. This rhythmic pulsation of alternating contraction and expansion is even considered to be an inherent functional characteristic of pneuma itself. Even the peripheral arteries, which carry fresh pneuma-infused blood to the extremities, pulsate due to the pneuma they contain.
In temperament, the lungs are only very slightly cold, but are moderately to quite wet. The lungs require a considerable amount of moisture to function, since the air they breathe exerts a considerable drying effect. Not only must gas exchange in the alveoli take place in an aqueous medium, but the delicate respiratory passages need adequate moisture to keep them from getting red, dry, irritated or inflamed. Excessive dryness can damage the lungs, and the whole respiratory tract.
This inherent wetness gives the lungs a Phlegmatic temperament, which also makes them vulnerable to accumulations of excess phlegm. And so, the lungs are one of the main accumulation sites for excess phlegm.
Since the lungs are almost neutral in their inherent temperature, they are equally vulnerable to injury by excessive cold as well as by excessive heat. Excess cold will greatly and quickly increase phlegm congestion, and also tighten and constrict the lungs, inducing spasmodic coughing. Excess heat, often in the form of a fever, will overly dry out the lungs, leaving the respiratory passages red, irritated and inflamed and making their phlegm secretions too thick, sticky and hard to expectorate.
A slight residue of the Choleric humor is present in the pulmonary mucous secretions, where it acts as a surfactant to keep these secretions from getting too sticky. This surfactant, plus the constant circulation of Vital Force and pneuma in the lungs through respiration keeps the delicate respiratory passageways open, and keeps them from collapsing or sticking together. In the blood going to the lungs, Choleric residues enable the blood to penetrate into the fine capillaries to reach the alveoli and get oxygenated.
The lungs, being inherently moist in temperament, eliminate not only stale gases, but superfluous moisture as well. And so, the lungs are one of the main organs for eliminating excess moisture from the body; the others are the skin, which sweats, and the kidneys, which pass urine. This common function of eliminating superfluous fluids and moisture gives the lungs, skin and kidneys strong reflex relationships with each other.
Besides superfluous moisture, the lungs can also exhale vaporous residues from other morbid or superfluous humors from the body. The sweet-smelling breath of diabetics is well-known. Foul vapors from superfluous or morbid humors can also contribute to bad breath.
Avicenna believed that the lungs had very little inherent moisture of their own, but rather that they retained the moist vapors of the various humors circulating through them. In Greek Medicine, the lungs also receive a lot of phlegm that drains down into them from the head and brain.
The lungs have several protective mechanisms to cleanse themselves of harmful or superfluous secretions, irritants and phlegm. Microscopic hairs, or cillia line the respiratory passages, helping us to expectorate phlegm and sweep out debris.
However, coughing is the most important of these protective cleansing mechanisms. Whenever there is an obstruction or irritation of the lungs' respiratory passages, their natural reflex reaction will be to relieve or expel it through coughing.
Occasional or moderate coughing is only natural, and should not be suppressed. But habitual, frequent or excessive coughing indicates some kind of respiratory imbalance or pathology, or the abnormal accumulation of phlegm and/or irritants. If excessive coughing becomes chronic or prolonged, it can exhaust the lungs, and irritate and inflame the delicate respiratory passages.
At this point, therapeutic intervention becomes necessary, to remove the root cause of the coughing problem. Phlegm and irritants are removed with expectorants and expectoration. Bronchiodilators are used to open up constricted respiratory passages. Respiratory tonics and restoratives are given to deepen and strengthen the respiratory function in deficient or consumptive coughing. If the coughing is due to excessive smoking, quitting is advised.
The lungs are enclosed in the pleura, which bathes them in an internal sea of pleural fluid. The pleura keep the lungs from overheating, and also protect them from excessive wear and tear against the ribcage during the respiratory process.
Reflex Relationships of the Lungs to Other Organs
The lungs, being so central and important to the life, health and functioning of the entire organism, have important reflex relationships with many other organs. Because the lungs are the source and origin of pneuma in the body, which the heart combusts into the Vital Force, which the liver converts into the Natural Force and the brain converts into the Psychic Force, the lungs and respiratory function have a profound impact on the functioning of all the body's faculties and organ systems.
Deep, full breathing vitalizes the brain and improves the functioning and perceptive abilities of the mind and spirit. This fact is well-known by yogis and spiritual adepts, who practice special breathing exercises to deepen their meditation.
Proper respiration and an adequate supply of pure, fresh air is also important to optimal stomach and digestive functioning. This is also a well-known fact.
The most important reflex relationship of the lungs is with the heart. Greek Medicine recognizes the intimate relationship between our breathing patterns and our heartbeat and circulatory rhythms. When we exercise, our heart rate increases in response to the oxygen/pneuma debt incurred by the muscles and tissues; the lungs must also breathe more heavily. Both our heartbeat and breathing patterns are strongly influenced by our prevailing mental and emotional states.
The lungs are the apex of an internal organ pyramid encompassing the whole torso. The lungs sit on top of the diaphragm, which is the large respiratory muscle that expands and contracts the thoracic cavity in inhalation and exhalation, respectively. Right underneath the diaphragm sit two important digestive organs, the stomach and the liver, whose condition and functioning strongly impact the lungs and their respiratory function. In addition, the diaphragm and lower ribs, or hypochondriac region, is also the accumulation site for a lot of aggravated choler, melancholy and psychosomatic stress and tension, all of which can impede or inhibit optimal respiratory function.
The stomach is connected to the lungs via the gastropulmonary reflex. Through this reflex, emesis, or therapeutic vomiting, can be used to clear the lungs of excess phlegm. Many expectorants also cleanse phlegm from the lungs by mildly stimulating this reflex.. By this same reflex, a lot of excess phlegm generated due to faulty or incomplete digestion in the stomach finds its way into the lungs. A stomach that's overly full can also inhibit proper breathing.
Similarly, if the liver is excessively clogged or congested, the respiratory function will also be inhibited or impeded. If there is stagnant melancholy or vital energy in the liver, the chest will be stuffy, respiration will be impeded, there will be tightness and constriction under the lower ribs, and much sighing.
Sitting right underneath the stomach as the foundation of the torso's internal organ pyramid lie the intestines, especially the colon, or large intestine. If the colon is stuffed, clogged or congested by chronic constipation and the normal downwards discharge of its waste products blocked, the free descent of the lungs and diaphragm in respiration will also be inhibited or impeded. The lungs and colon also have a close reflex relationship due to their similarities of function. Both organs absorb vital substances into the body while discharging harmful wastes; in this sense, the lungs and colon are mirror images of each other.
Also sitting under the diaphragm at its back side, and therefore affecting the lungs and respiratory function, are the kidneys and adrenal glands. If the kidneys and adrenals are weak or devitalized, the lungs will be unable to inhale deeply, fully and completely. Many forms of chronic asthma, consumptive coughing or respiratory weakness involve weak kidneys and adrenals. The kidneys and lungs both play important roles in regulating body fluid metabolism.
The lungs and the skin also share a close reflex relationship. Both are in constant contact with the ambient air and external environment. Both organs also breathe, or have a respiratory function. And both the lungs and skin, as well as the kidneys, play important roles in regulating the fluid balance of the organism.
The lungs and skin, both in intimate contact with the outside world, are symbiotically linked together in the surface complex; what affects the one will also affect the other. When exogenous pathogenic factors invade the surface of the organism, the pores of the skin will close as a protective response. With the closed skin pores unable to release their excess moisture via sweating or subtle transpiration, the excess fluids back up into the lungs and congest them as phlegm, provoking coughs, sneezing and an upper respiratory tract infection.
The Upper Respiratory Tract
The upper respiratory tract consists of the various subsidiary organs and passageways that channel air into and out of the lungs. These passageways also condition and filter the incoming air, and give it sufficient warmth and moisture to facilitate gas exchange in the alveoli, and to keep the lungs from drying out.
The upper respiratory tract also includes the larynx, which is the organ of vocalization and speech. The vocal function is dependent on a steady, well-regulated outflow of breath from the lungs.
The brain is Phlegmatic in temperament, like the lungs. The brain and head are accumulation sites for excess phlegm, from where it drips down into the throat, pharynx and bronchii in post nasal drip. Phlegm congestion in the lungs and respiratory tract is often connected with phlegm congestion in the head, making it stuffy, sluggish and groggy, clouding the mind and thinking.
Now, let's look at the upper respiratory organs one by one:
Nose: The nose is the external entrance to the respiratory tract, and is the first organ to condition the incoming air. Because the nasal passages warm, moisten and filter impurities out of the air, breathing is best done through the nose.
Because the nose is the upper end of the respiratory tract and the lungs its bottom end, the nose has a strong reflex relationship with the lungs. You can often tell the condition of the lungs by looking at the nose. If the nose is congested with phlegm, so will be the lungs; if it is red, swollen or inflamed, so will be the lungs.
The nose also reflects the condition of the heart and the blood vessels and capillaries that serve it. A swollen, bloodshot nose shows excessively dilated blood vessels due either to alcoholism or circulatory system disease. The nose is also an outlet for releasing excess phlegm congestion in the head and sinuses.
The nose is also where the brain and Psychic Faculty connect with the respiratory tract and Vital Faculty. The sense of smell, being our most primitive sense, is very instinctual, and strongly affects the mind and subconscious. The nose is thus the gateway to the brain and mind.
Sinuses: The sinuses are closely connected with the nose, and have an important reflex relationship with the stomach. Choleric irritability, inflammation and congestion of the gastric mucosa is often linked with chronic or allergic sinus congestion and inflammation. The sinuses support the nose in helping the respiratory tract condition and adjust to changes of temperature, pressure or moisture in the ambient air.
Throat and Pharynx: The throat is very warm in temperament, since it's constantly being heated by the hot exhalation, or outbreath. This makes it very susceptible to colds and chills, which produce hoarseness and a scratchy sore throat. The throat and pharynx are also vulnerable to catarrh and mucus congestion caused by post nasal drip and phlegm and moisture descending from the head and sinuses.
The throat is where the upper respiratory and the upper digestive tract converge. As the top end of the digestive tract, the throat has a reflex relationship with the colon; congestion and toxicity in the colon, or bottom end of the digestive tract, is often associated with a sore throat, or congestion and toxicity at its top end.
Ears and Eustachian Tubes: The ears are a sense organ of the Psychic Faculty, but the eustachian tubes connect them with the throat and upper respiratory tract. The function of the eustachian tubes is to facilitate swallowing and to use swallowing to equalize pressure within the ears and auditory aparatus. Upper respiratory tract infections can sometimes spread through the eustachian tubes to the ear, especially in children.
Larynx: The larynx, the organ of voice and speech, is an efferent, expressive organ of the Psychic Faculty. Nevertheless, they're located at the top end of the trachea in the respiratory tract, right underneath the epiglottis, and function on exhaled air from the lungs. Like the throat, the pharynx is also quite warm in temperament, and easily injured by cold and chills. They're also vulnerable to fatigue, irritation and inflammation from screaming, yelling, or other forms of vocal straining; if this stress becomes chronic, nodes can form on the vocal cords. Imbalances of humor and temperament affecting the throat and pharynx will also affect the larynx.
Trachea: The trachea, or windpipe, branches off from the esophagus right above the larynx. The epiglottis is the flap that closes off the trachea when we swallow food and drink. When the epiglottis dysfunctions, food goes down the wrong way, and the lungs, as a protective reflex, cough up the offending foreign matter.
Bronchii: The bronchii are where the trachea splits into two branches, each of which goes to either lung. The lower respiratory passages in each lung branch out from the bronchii like a tree.
The Psychosomatic Aspect of Respiration
Breath, or pneuma, is energy; breath is Life. Your breathing patterns, or how you use and relate to your breath, shows how you relate to Life and its Vital Force.
Many people have quite constricted or shallow breathing. Psychosomatically, they have some blockages or inhibitions about filling themselves too full of Life.
Full, proper, deep breathing is diaphragmatic or abdominal breathing. But many people hold a lot of psychosomatic stress and tension in their diaphragm, making it unable to descend deeply or fully enough to permit complete abdominal breathing.
Cramped or constricted breathing can also come from feelings of being smothered, overwhelmed or crowded out of one's psychic space. Respiration needs space within which to function; the phrase "breathing room" is very apt indeed. Sometimes, even serious respiratory conditions like asthma can come from a feeling of being smothered.
Respiration is rather unique as a physiological function because, although it's usually automatic, or autonomic, it holds the distinction of being able to be brought under a considerable degree of conscious control. Our mental and emotional states usually exert a great degree of influence on our breathing patterns, which is usually unconscious and automatic, or mostly so. But through self cultivation and awareness, we can learn to bring our breathing patterns under our conscious control and consciously regulate our mental and emotional states through our breathing.
If you feel afraid, anxious or nervous, for example, your breathing tends to get rapid and shallow. By consciously breathing more deeply and slowly, we can do a lot to mitigate or reduce that fear or anxiety.
In The Traditional Healer's Handbook, Hakim G. M. Chishti gives various traditional correspondences in Greek/Unani Medicine between breathing patterns and the emotional states that generate them:
Anger makes the respiration sudden and forced, and favors exhalation over inhalation.
Joy and Delight are associated with gentle and gradual breathing rhythms, and also favor exhalation over inhalation.
Fear and Terror, like anger, make the respiration sudden and forced, but unlike anger, favors inhalation over exhalation.
Gloom and Depression, like joy, make the breathing gentle and gradual, but unlike joy, favor inhalation over exhalation.
The first step in controlling your mind is learning to control your breathing. Yogis and spiritual adepts have known and practiced this for centuries.