This aphorism is first recorded in Chapter 6 of the Zhuangzi, which states: "The sage’s breath of ancient times came from deep inside. The sage breathes with his heels, while the commoners breathe with their throats."1 It indicates that deep breathing is beneficial to the intelligence.
Breathing is the most important activity of humans, as well as all other creatures and plants. And it is of the most obvious symbol of life. All ancient cultures were aware of this principle. Hippocrates (c. 460-377 BC), the father of Western medicine, described it by stating:
"Bodies of men and animals generally are nourished by three kinds of nourishment and the names thereof are solid food, drink, and wind. Wind in the body is called breath, outside it is called air. It is the most powerful of all and it is worthwhile examining its power...... A man can be deprived of food or drink for two or three days and live, but if the wind passages of the body be cut off, he will die in the brief part of a day, showing that the greatest need of a body is air. Moreover all other activities are intermittent, for life is full of change, but breathing is continuous for all mortal creatures, inspiration and expiration being alternate."2
It is recorded in the Hebrew Old Testament that Elijah restored to life the son of the widow of Zarephath by performing artificial respiration3. And even animals realize the importance of breath, killing their prey by strangulation or crushing their windpipes.
As breathing is indispensable to all creatures, so it is natural to realize that the substance that we inhale, although invisible, is very important. Integral to the ancient Chinese worldview was the recognition of the importance of an invisible material, called qi, to life in the universe. Beginning students of TCM are often confused by this seemingly abstract concept. Actually, the Chinese character for qi (气) is quite concrete, originally picturing clouds in the sky. In the early Western Zhou Dynasty (c. 11th century BC-771 BC), the meaning of the term was extended to include the act of breathing, and the substance that is inhaled and exhaled.
Although the ancient Chinese did not know the composition of what is inhaled and exhaled, they understood that the substance that is inhaled is beneficial to life and the substance that is exhaled is harmful to life. They developed a system of breathing exercises called tuna to maintain health and cure disease4. Tu (吐) means exhaling and na (纳) means inhaling. It is Zhuangzi (c. 369-286) who first defined tuna as exhaling the old and inhaling the new. Two main kinds of tuna were practiced prior to the Qin Dynasty (221-207 BC). The first was called shiqi (食气), or eating qi; its purpose is to inhale qi of the highest quality5. The second was called zhongxi, or heel breathing; its purpose is to maximize the inhalation of beneficial, or clear, qi, and exhale harmful, or turbid, qi as completely as possible.
Inscriptions on a jade article describing the process of abdominal breathing, c. 380 BC.
Heel breathing means to inhale deeply and evenly, as if inhaling to the heels. It is much deeper than abdominal breathing, which is the generally accepted type of deep breathing6. Deep breathing inhales more oxygen, massages the internal organs, calms the mind, and therefore is beneficial to both the health and intelligence. By contraries, rapid, shallow, chest breathing results in less oxygen transfer to the blood and subsequent poor delivery of nutrients to the tissues7.
The good news is that similar to learning to play an instrument or riding a bike, one can train the body to improve its breathing technique. Heel breathing seems difficult, as it needs imagination and meditation, while abdominal breathing is more practical. With regular practice you will breathe from the abdomen most of the time, even while asleep. The steps are as follows:
1. Place one hand on your chest and the other on your abdomen. When you take a deep breath in, the hand on the abdomen should rise higher than the one on the chest. This insures that the diaphragm is pulling air into the bases of the lungs.
2. After exhaling through the mouth, take a slow deep breath in through your nose imagining that you are sucking in all the air in the room and hold it for a count of 7 (or as long as you are able, not exceeding 7).
3. Slowly exhale through your mouth for a count of 8. As all the air is released with relaxation, gently contract your abdominal muscles to completely evacuate the remaining air from the lungs. It is important to remember that we deepen respirations not by inhaling more air but through completely exhaling it.
4. Repeat the cycle four more times for a total of 5 deep breaths and try to breathe at a rate of one breath every 10 seconds (or 6 breaths per minute). At this rate our heart rate variability increases which has a positive effect on cardiac health8.
In general, exhalation should be twice as long as inhalation. The use of the hands on the chest and abdomen are only needed to help you train your breathing. Once you feel comfortable with your ability to breathe into the abdomen, they are no longer needed.
Notes and references:
1. Zhuangzi: Brief Annotations of Zhuangzi (Zhuangzi Qianzhu庄子浅注), ed. Cao Chuji. Beijing: China Book Company, 1982. 6:88.
2. Hippocrates, Vol. II, Breaths, p. 3. Quoted in William F. Petersen, Hippocratic Wisdom, Springfield: Charles C Thomas, 1946, p. 17.
3. Bible, 1 Kings xvii:17-23. Quoted in Douglas Guthrie, A History of Medicine, p. 30.
4. The popular Chinese practice of qigong is closely related to tuna. Qigong is quite recent, gaining widespread popularity only after the liberation of China in 1949. Gong means exercise, and qigong refers to a series of exercises which utilize qi to maintain health and treat disease. Although there are manymodern types of qigong, qigong can best be translated as "breathing exercises," as this is the earliest type of qigong.
5. Ma Jixing, Study and Annotation of Ancient Medical Relics of Mawangdui (Mawangdui Guyishu Kaoshi马王堆古医书考释). Changsha: Hunan Science and Technology Press, 1992, p. 829 .
6. Abdominal breathing is also known as diaphragmatic breathing. The diaphragm is a large muscle located between the chest and the abdomen. When it contracts it is forced downward causing the abdomen to expand. This causes a negative pressure within the chest forcing air into the lungs. The negative pressure also pulls blood into the chest improving the venous return to the heart. This leads to improved stamina in both disease and athletic activity. Like blood, the flow of lymph, which is rich in immune cells, is also improved. By expanding the lung's air pockets and improving the flow of blood and lymph, abdominal breathing also helps prevent infection of the lung and other tissues. But most of all it is an excellent tool to stimulate the relaxation response that results in less tension and an overall sense of well being.
7. You can see if you are a chest breather by placing your right hand on your chest and your left hand on your abdomen. As you breathe, see which hand rises more. If your right hand rises more, you are a chest breather. If your left hand rises more, you are an abdomen breather.
8. https://www.amsa.org/healingthehealer/breathing.cfm
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