When Seemingly Unrelated Symptoms Come Together

People like this come to my consultation room.

Their legs swell, their head feels heavy, digestion is poor, sleep is shallow, and their shoulders are always knotted. Each symptom got a different medicine from a different hospital. A diuretic, a painkiller, a digestive, a sleep aid, a muscle relaxant. There are five medicines, but the body is one.

And none of them touches the root.

I Look First at the Breathing

To these patients I say this: "Let me watch how you breathe for a moment."

Most are startled. Why look at breathing, they ask, when the legs are swelling.

And most are like this: only the chest heaves, while the belly barely moves. The breath is short, and the muscles of the neck and shoulders lift along with it.

Why Is This a Problem

The real work of breathing is not only to draw in oxygen. Breathing creates a wave of pressure inside the torso.

When you breathe in, the diaphragm descends. The pressure inside the chest falls and the pressure inside the belly rises. As this wave repeats some twenty thousand times a day, it pushes along the body's various flows.

The heart pushes blood out, but its power to draw returning blood back in is weak. When the pressure inside the chest falls, venous blood is sucked up into the heart.

With lymph the situation is a little different. There is no central pump like the heart, but the larger lymph vessels contract and pulse on their own. To this, the arteries running alongside squeeze as they beat, the muscles squeeze as they move, and the pressure of fluid pooled between the tissues pushes it along. Breathing is one of those several forces, and its share is especially large in the final stretch coming into the chest.

But shallow breathing where only the chest heaves cannot make this wave.

Then What Happens

When the wave does not rise, these things happen together.

The legs swell — the veins and lymph cannot be drawn upward. They pool below.

The head feels heavy — venous blood descending from the head also drains well when the pressure inside the chest falls. Without the wave, it stagnates up top. The nasal lining swelling easily is for the same reason.

Digestion falters — the intestines are pushed along when the pressure inside the belly rises and falls. When the diaphragm does not move, the intestines move less.

Sleep is shallow — with each breath in and out, the heart rate minutely speeds up and slows down. Breathing is not a switch that turns the autonomic nervous system on and off. It is, though, one of the few handles we can consciously take hold of. Short, hurried breathing keeps the tension-side switch turned on.

The shoulders knot — when the diaphragm does not work, the body recruits the muscles of the neck and shoulders to lift the chest. Muscles recruited twenty thousand times a day cannot help but knot.

Five places are resting on the same condition.

But "Just Breathe Deeply" Is Not Enough

When I explain this far, many ask: "So should I just work hard at deep breathing?"

It helps. But often that alone is not enough. There is a reason the diaphragm cannot descend.

It may not be that the diaphragm fails to move because the breath is shallow, but that the breath is shallow because the diaphragm cannot descend.

• Is the pressure inside the belly high, pressing from above?
• Has the fascia around the diaphragm been stiff for a long time?
• Is pooled fluid pushing up from below?
• Has posture collapsed so that the ribs cannot move?

No matter how large a breath you take from above while leaving what pushes up from below in place, the diaphragm cannot descend all the way to where it belongs.

That Is Why There Is an Order to Treatment

I set the order this way.

1. Lower the pressure inside the belly — drain what has pooled, soften what has stiffened
2. Release the stiffness around the diaphragm — not by forcibly bending, but by gradually changing its quality
3. Then teach the breathing anew — because now there is room for the diaphragm to descend
4. Herbal medicine bridges the gaps — it drains what has pooled and creates conditions in which things will not stiffen. It works in the hours after leaving the treatment room

When the order is kept, I see cases where the five grow lighter together. There are times when this is better than working on each one separately.

Twenty thousand times a day

Breathing is involved throughout venous return, lymphatic flow, and autonomic regulation. But breathing is not the only doorway into these symptoms. It is one among the conditions that bear on several places at once, and it is closer to something I look at first because it is one we can consciously take hold of.

And not all swelling and headache can be explained this way. It may be a problem of the heart, the kidneys, or the thyroid, and there are signs that must be confirmed by testing. When I see such signs, I recommend testing first.

But if you feel that you are taking five medicines and yet not one of them touches the root, it is worth checking, at least once, the possibility that those five began in one place.

We breathe twenty thousand times a day. That is how much work it does.

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Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)