The Wave One Breath Makes Through the Whole Body

The Wave One Breath Makes Through the Whole Body

We are taught that breathing is the taking in of oxygen. That is not wrong. But I do not think breathing does only that. One breath, while taking oxygen in, makes a wave of pressure through the whole trunk. And that wave does work of its own.

The Heart Pushes; It Does Not Draw Well

We commonly take the circulation of blood to be the heart's work alone. That is half right.

The heart pushes blood out powerfully. But the force with which it draws blood back after its circuit is weaker than one might think. Blood from places lower than the heart and far from it, the legs above all, has to climb against gravity, and the heart cannot pull all of that up.

So what carries that blood up? This is where breathing comes in.

Breathing Becomes a Suction Pump

When you breathe in, the pressure inside the chest falls. Things are drawn toward lower pressure. So with every in-breath the chest draws venous blood up from below. This action of breathing pulling blood upward is called the respiratory pump, and the flow of that blood returning to the heart after its circuit is called venous return. If the heart is the pushing pump, breathing is the drawing pump. Both must work in turn for blood to complete its round.

There is something with no pump of its own at all: lymph. Lymph is the route that gathers and carries away fluid pooled between tissues, and it has no pump like the heart. So lymph flows mainly carried by breathing and by the body's movement. The wave of pressure made by breathing pushes the pooled fluid along.

So one breath does not only take in oxygen. It draws venous blood upward and pushes lymph along at the same time. Every shallow breath is in fact giving the circulation of the whole body a small hand.

When Breathing Is Shallow the Wave Ends at the Chest

The trouble comes when breathing becomes shallow.

If the breath is shallow and only heaves at the upper chest, this wave of pressure cannot travel down to the abdomen and pelvis; it ends at the chest. Below, where the wave does not reach, venous blood and lymph pool a little at a time. Then the legs feel heavy and swell easily, the head is not clear, digestion is slow, and sleep does not refresh. Each of these is trivial on its own; what they share is "not circulating well, pooling a little."

The Heart Is Normal, the Lungs Are Normal, and the Body Is Heavy

This wave is not a state at rest; it is movement. A cardiac test looks at the shape of the heart and the force of its beat; a lung test looks at the shape and capacity of the lungs. Neither looks at whether the wave of pressure made by breathing is reaching the whole body. So the seemingly contradictory situation arises in which the heart and lungs are both normal and the body keeps swelling and feeling heavy.

Up to here this is the well-known account of breathing assisting venous and lymphatic circulation. I add one thing to it: seeing breathing as a large flow that regulates pressure throughout the body. That is a view I have refined over a long time in the consulting room.

Sending the Wave Down Again

So with such a person, rather than forcing circulation, I look first at getting the wave of the breath to reach the abdomen and pelvis. There are times when one deep, slow breath sends that wave downward before any medicine does. However, if one leg suddenly swells and hurts, or breath comes short abruptly, that is an urgent matter different from this story and you must be seen first.

The breath we take more than twenty thousand times a day. Each one, while taking in oxygen, makes a small wave through the whole body and pushes blood and fluid upward.

If the body keeps swelling and feeling heavy while heart and lungs are normal, what that report points to is not the heart or the lungs but a wave that did not reach the bottom.