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Saturday, August 6, 2011

Qigong and Physiology: The Science of Healing

The Science of Healing
Article by Roger Jahnke, OMD

Much of what is described in traditional medical systems as the "balance" of forces, such as yin and yang in the Chinese system, can be associated with the dualistic components of the nervous system. In the central nervous system yin is rest and yang is action. Balance is the state between rest and action called dynamic equilibrium. This is the state that training in Tai ji and Qigong seeks to refine. In the autonomic nervous system yin may be associated with the parasympathetic and yang may be associated with the sympathetic. The balance of yin and yang is associated with homeostasis.

Because the western world view has generally had a difficult time understanding and accepting the concepts of Qi (chi), prana or vital force from the Asian systems, there has been a strong trend toward explaining the effects of yoga, qigong, acupuncture, etc through the mechanisms of the nervous system.(25,54,55) While these practices do have a definite effect upon neurological function, with consequent effects on body systems, the neurological mechanism may actually be an intermediary for a more refined and less quantifiable system of subtle energies. However, a great deal of research has been done that reveals the neurological mechanisms that may be activated in Qigong and Yoga and it is appropriate to explore them here.

There are a number of mechanisms associated with the brain, nervous system and other related systems that Qigong and Yoga/Pranayama practice enhance including:
  1. Initiation of the "relaxation response" (RR), para-sympathetic aspect of the autonomic nervous system or resting aspect of the basic rest activity cycle (BRAC).
  2. Shift of the neurotransmitter profile.
  3. Dilation of blood capallaries initiating increased microcirculation in the periphery, brain and organs.
  4. Supports the brain/neurological aspects of immune function.
  5. Balance right/left brain hemisphere dominance.
  6. Induction of alpha, and sometimes theta wave forms in EEG.
  7. Affecting neuroreflex mechanisms through the stimulation of acupuncture response points.
  8. Generating an affect on the function of the hypothalamus, pituitary, pineal, third ventricle complex within the brain.

1. Initiation of the relaxation response
When the predominance of autonomic nervous system activity is sympathetic the human system is working, expending energy and breaking down tissue. This is associated with the action phase of metabolism, and referred to as catabolic. This is associated, in its extreme, with the "fight or flight response" with increased heart rate, breath rate and blood pressure. It is also called the stress state and has been associated with adrenal exhaustion and collapse (56). 

This state, when overactive and not balanced to homeostasis by ample parasympathetic activity, contributes to the production of positively charged hydrogen ions. As mentioned in an earlier section on free radicals these hydrogen ions bind with oxygen. This can cause a net oxygen deficit and a general acidic pH in the internal environment. Biological stress is conducive to the proliferation of a number of diseases or syndromes including hypertension, pain, depression, immune deficiency and inflammation.(57)

The opposite aspect of autonomic activity, parasympathetic, is a phase of rest and tissue regeneration. It is associated with the conservative phase of metabolism, anabolic. In its extreme this state is associated with the "relaxation response" (RR)(57), characterized by decreased heart and breath rate and a lowering of blood pressure. This is also associated with the resting phase of the basic resting activity cycle (BRAC).(58) Conscious deactivation of the sympathetic function with the activation of certain parasympathetic features of autonomic activity can neutralize the negative effects of "fight or flight" overactivity. The primary steps to initiate this state are deep, slow breathing coupled with the intention to relax.(57) These are the identical initiating steps for the practice of Qigong and Yoga. The literature alludes liberally to traditional Asian health maintenance practices as the historic source of techniques for generating the relaxation response(RR) and the typical biofeedback response(3).

With the addition of gentle movement and stretching, extra oxygen is demanded from the blood, which may help to reduce the presence of hydrogen ions and initiate a swing toward a more anabolic level of activity. This may help to produce a less acidic internal environment and a net greater availability of free oxygen with increased energy productivity and tissue regeneration.

Controlled, deep, slow breathing accompanied with the intention to relax initiates the RR and the resting phase of the BRAC, which are para-sympathetic/anabolic/alkaline responses, generally recognized as healing and regenerative. Increased oxygen to hydrogen ion ratio is also recognized as conducive to healing and regeneration.

2. Neurotransmitter profile
Much of the new science of psychoneuroimmunology is founded upon findings in the area of neuro-hormones, neuropeptides or neuro-transmitters. It has already been mentioned that neurotransmitter receptor sites have been found on lymphocytes. A particular profile of neurotransmitters is present in a person who is experiencing pain, anxiety or depression. (59) In contrast joy, comfort or celebration produce unique neurotransmitter profiles as well. (60) 

In hypertension, pain and inflamation, which which have been associated with the hyperactivity of the sympathetic aspect of the autonomic nervous system, a number of specific neurotransmitters are present in the blood. In patients suffering from pain increased norepinephrine, reduced cholinesterase and depressed beta endorphine were found to be typical.(59)

When methods are employed that regulate the sympathetic function through the hypothalamus a neurotransmitter profile characterized by decreased norepinephrine, elevated cholinesterase and elevated beta endorphine emerge.(59) The neurotransmitter profile present in the parasympathetic and usually more anabolic (alkaline) environment is recognized as able to reduce pain and depression(59), reduce cravings for addictive substances(61) and promote healing. Chinese research has quantified neurotransmitter activity specific to Qigong exercise. It was found that the Qigong effect is associated with specific shifts in the monoamine neurotransmitter content of the blood.(62) 5HT and 5HE generally tend to be decreased by Qigong practice. Noradrenaline and dopamine tend to increase. The aspects of Qigong and Yoga that quiet the mind and relax the body induce a neurotransmitter profile that is conducive to healing.

3. Increased microcirculation
A classic body response in Qigong and Yoga is the elevation of skin temperature. In the fight or flight state, hyper-sympathetic, the arterioles in the skin, muscles and certain organs constrict. During the systematic deactivation of sympathetic function, typical in Qigong and Yoga/Pranayama, vasodilation occurs with the accompanying warmth of the surface of the skin. This is one of the primary goals in biofeedback training and was found as a typical response when the skin temperature of meditators was evaluated in research.(3) A number of studies from China explore the microcirculatory mechanism very thoroughly and conclude that this mechanism is a major reason for the continued successful application of such an ancient health maintenance method. (63,64,65,66,67,68)

In traditional chinese medicine it is said "the blood is the sister of the Qi". (28,29) Because Qi and blood are in a direct relationship the inhibition of the circulation of one tends to inhibit the circulation of the other. In addition, the theory suggests that when the blood is optimally circulating in a part of the body that the Qi or vitality is circulating there as well. If the Qi is a bio-electrical, electromagnetic or subtle energy aspect of the human being, the presence of increased blood circulation and its accompanying heat may also signify the presence of increased electromagnetic or other subtle energy potential. This may be a key to explain how Qigong practitioners and mental healers are able to support the healing process in a person from a distance through "Qi emission" or "external conductance of the Qi".

4. Brain/neurological aspects of immune function
In the classic tradition of Western science it has been thought that the immune system was an autonomus self regulating system, operating on its own. A tremendous amount of reseaearch has demonstrated that this view was incorrect. Mental emotional states have been found to effect resistance to disease and infection.(60) Immune organs including the thymus gland, spleen, lymph nodes and bone marrow have been found to be invested with nerve endings.(60) Lymphocytes and macrophages have been shown to have receptors for neurochemicals, including catacholamines, prostagandins, serotonin and endorphin.(60) There is a definate relationship between brain and nervous system function and immune capability.

In the practice of Qigong and Yoga, as has been discussed, the hypothalamus regulates the autonomic nervous system function toward a lessening of the sympathetic activity, which is associated with the stress response.(3,57) A number of studies have demonstrated that the hypothalamus has an influence over immune function.(60) Meditation, progressive relaxation, deep breathing and slow relaxed movement all tend to move the practitioner out of the sympathetic state and induce the relaxation response. Research on the effect of relaxation and visualization sheds some light on the effect that the Qigong and Yoga states may have on immune function. Groups of elders who recieved relaxation training had significant increases in the activity of "natural killer cells" while control groups did not. Chinese research has corroberated the positive effect of Qigong practice on the status of the immune system. (65,69,70,71,72)

5. Brain Hemisphere Dominance
Thousands of years ago the oriental practitioners of self-care disciplines intuitively developed an awareness of an alternating cycle of the predominance of body activity from the right side of the body to the left side. One particular Qi Gong practice, Tai ji, is founded on a constant, flowing of the limbs in circular motions, alternating from right to left. The side of the body that bears the weight is planted, stable, and associated with the Yin. The side that is free to move and kick is active and associated with the Yang. Constant alternation of right and left side activity are thought to balance the forces of yin and yang in the body. Focusing on the right and left sides alternatively activates, and reputedly balances, the right and left motor centers in the brain.

The channels or circuits that conduct the human resonating energy field, according to yogic medicine, are called nadis. Ida nadi and Pingala nadi associate with right and left brain activities.(72,73) In addition this association effects right and left nasal passage activity as well as the physiology of the right and left body. These channels alternate in their predominant activity over a 2-3 hour cycle causing the dominant nostril to be clear and the non-dominant nostril to swell and become congested.(73) This phenomena was not noted in the Western world until 1889 when the German physician R. Kayser recorded his observation of the "nasal cycle". (74) Much of the research on this phenomenon up through the 1980's was motivated by the quest to develop pharmaceuticals for nasal congestion. (72) 

It has been demonstrated that the nasal cycle is coupled with the alternating lateralization of cerebral hemispheric activity. (73) It was found with research subjects, that when a shift occurred in either nasal dominance or brain hemisphere dominance there was an associated shift, within moments, in the other as well. The right nasal cavity, associated with pingala nadi tends to be more open and the left more congested when the left hemisphere of the brain is more active. This is associated with the active phase of the BRAC and increased general sympathetic tone.(72) In contrast the right brain hemisphere is more active when the left nostril is open and dominant and the individual is in the resting phase of the BRAC or the para-sympathetic mode.

A number of different physiological states have been found to be associated with the dominance of one or the other nostril.
  • deep sleep is initiated more quickly with left nostril dominance.
  • appetite and digestive ability are enhanced during right nostril dominance.
  • sexual intercourse is most satisfying when the man is dominant in the right nostril and the woman in the left.
  • left nostril, right brain dominance is more conducive to recieving new ideas, while right nostril, left brain dominance is an advantage during discourse.
  • it is possible to alter the pattern of "thought waves" by consciously alternating nasal dominance by exercising the congested nostril by forced nostril breathing.(75)
A specific Qi Gong and Yoga breath technique which has been practiced for centuries is the right and left singular nostril breathing. Dr. Shannahoff-Khalsa of the Salk Institute has done extensive research with this technique, originally prompted by his work with the Kundalini Yoga tradition. The studdies done by he and his associates has shown that forcing the breath through the constricted nostril can increase the EEG amplitude of the contralateral hemisphere of the brain.(76) It has been demonstrated that certain psychopathologies are brain hemisphere specific.(77,78) It may be possible, therefore, that the use of single nostril breathing may be applicable as therapy in cases where lateralized dysfunction has been found.

It was discovered that there is a direct correlation between nasal dominance, brain dominance and the lateralized biochemical activity in the peripheral body parts. Recent studies of the nasal cycle comparing plasma catecholamine levels in the venous circulation of the right and left arms found that levels of norepinephrine alternated with the rhythm of sympathetic dominance of the nostrils.(79) 

6. Induction of alpha/theta brain wave activity
The intention to relax and deepening of the breath are the classic initiating actions that trigger the relaxation response(RR). Research with practitioners of Yoga(3) and Qigong(4) has shown that during practice brain wave frequency tends toward the alpha range and in certain cases theta frequency brain activity is achieved. Alpha level brain function is a result of relaxation and is conducive to healing. The slowing of heart rate, reduction of blood pressure and elevation of skin temperature are common physiological features of the alpha state. Theta is a deeper trance like state that has been found in research with individuals with extraordinary capabilities to be associated with paranormal skills like sitting on beds of nails and immediate wound healing without bleeding.(3)

In Qigong and Yoga it is a goal to bring the lowest frequency of brain wave activity to the practice. In the quiescent Qigong, where there is no movement, deep states of consciousness with low frequency brain waves are more easily attained than in the dynamic (moving) Qigong. Similarly, in Yoga, there are methods involving movement and methods that primarily involve stillness. The pure meditation state lends more easily to the theta range of brain activity.

EEG studies from China have concentrated on the quiescent state, meditation with no movement (80,81,82). However, it is very likely that the dynamic or moving methods are most effective if the alpha or theta state can be simaltaneously achieved. In both Qigong and Yoga it is a primary focus to "allow the body and energy to sink and relax" and to "relax into the posture".

7. Neuroreflex Stimulation
Pressing points, holding reflex areas or thumping and stroking "energy pathways" are all aspects of health maintenance systems of ancient cultures. The ususal explanation for the mechanism of these effects involves what were originally called Head's zones named for Dr. Head who originally researched the relationship between sensory areas on the surface of the body to organ function.(83) In a similar and more current approach to a like idea, dermatomal zones are the segments on the surface of the body that are innervated by sensory neurons from specific segments of the spine which also have links to the autonomic ganglia. For example, the dorsal aspect of the foot is innervated from the 5th lumbar spinal nerves and the central area of both the dorsal and palmar aspect of the hand are innervated by the 7th cervical spinal nerves. The spinal nerves from the 2nd thoracic to the 1st lumbar innervate the dermatomes directly adjacent to their areas of the spine on the front, back and lateral aspects of the chest, abdomen and pelvis.(24)

A stimulus at the dermatome is carried to the the spinal segment where it has the oportunity to effect, through a reflex arc, neurons from the autonomic ganglia.(84) Surface stimulus may effect organ function through this neuroreflex mechanism. This mechanism has been cited as a rational for how acupuncture works. (54)

In Qigong especially, and to a certain extent in Yoga, there are numerous techniques for massaging, thumping and stroking the surface areas of the body. When twisting to loosen the spine and warm up to do Qi Gong the practitioner hits the hands against the lumbar space in the back and the lower ribs in the front. This is done to stimulate the function of the kidneys, liver and spleen. It is likely that one mechanism through which this may occur is the neuroreflex mechanism.

Certain methods of Qigong practice focus totally on techniques of self applied massage or stimulation of channels and reflexes. One method called Mei Yin Jian Shen Gong is comprised primarily of self massage gestures. In another method the hands stroke near the acupuncture channels: up the inside of the legs, out the inside of the arms, along the outside of the arms and on to the head and finally down the lateral side of the torso and legs to the lateral aspect of the feet. In the western model this would be referred to as reflex stimulation. However, in the oriental energy model this method is referred to as a form of "Qi" circulation.

8. Interface of Neuro-endocrine Structures of the Brain
In both Qi Gong and Pranayama a primary goal is to circulate the "energy" to the crown of the head. In Qigong this is referred to as the "point of one hundred gatherings" (Bai hui, GV or Du 20). In Yoga/Pranayama this point is the target of the kundalini energy and is known as the Crown Chakra or "thousand petaled lotus". This area has had recognition in the christian tradition through the halos of angels. In the Jewish tradition this same area is where the men wear the yalmuka.

Science has corroberated the significance of this region with its identification and investigation of several anatomical structures thought to be the primary hierarchy of neurological and endocrine function. These include the pituitary gland, pineal gland, hypothalamus and third ventricle of the cerebrospinal fluid system. In the ancient traditions it is suggested that these structures function as antenae-like conductors for the electrical, magnetic and subtle energy bio-fields. It may be premature to agree with this theory but it is very clear from the current literature that the hypothalamus and the pituitary are structures that participate in the subtle endocrine modulation of many physiological and emotional processes.(3,60)

Earlier we explored the research that links cerebrospinal fluid (CSF), the lymph and immunity. The CSF has the richest mixture of neurochemicals in the whole body. It interacts directly with the hypothalamus whose lateral walls and floor comprise the third ventricle, an important resevior for CSF. Research has found over 60 neuropeptides or neurotransmitters. Candace Pert and her team at the National Institutes of Mental Health demonstrated that there are 40 times more neurotransmitter receptor cites in the hypothalamus than in any other location of the brain or nervous system. (85, 86)

Neurotransmitter activity has been found to be in a direct relationship with pain and depression (59) and to have a specific relationship to immune function (51,87). Focusing one's attention on a physiological outcome has been shown to have a potential effect on physiological function.(88) Therefore, it is a strong possibility that the intention to circulate the Qi or Prana to the "crown" has the potential to effect the levels of neurotransmitter and endocrine activity, not only in this section of the brain, but throughout the entire body. In work with voluntary control of biological function it has been found that deminishing or quelling sympathetic function is accomplished by regulating the activity of the hypothalamus.(3) When practitioners of Qigong circulate the Qi in the Ren and Du vessels, "circulate the light in the microcosmic orbit"(89), or when Yoga/Pranayama practitioners bring Prana up along the spinal in the Kundalini channel, the focus of the method is to achieve peace, or in more scientific terms, reduce sympathetic activity and slow brain wave frequency toward the theta range. The anatomical structure which is the target is the the anatomical hypothalamus, which is the sympathetic control center.