Introducing yog to medical students by Prof Madanmohan

Dr. MADANMOHAN, MD, PGDY, FIAY
Director-Professor & Head, Department of Physiology
&
Programme Director, ACYTER
Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER),
Puducherry - 605 006, India
Email : drmadanmohan123@rediffmail.com, drmadanmohan123@gmail.com
INTRODUCINGYOGTOMEDICALSTUDENTS:
THEJIPMEREXPERIENCE
Aug - Sep 2008

INDEX
1. Acknowledgements 01
2. Yog: a precious gem of Vedic thought 03
3. Yog and modern medicine: need for integration 05
4. Introducing yog to medical students: the JIPMER experience 07
5. List of lecture topics 08
6. List of yog therapy modules 08
7. Daily practice schedule for yog class 09
8. Programme evaluation and students’ feedback 33
9. Conclusion and suggestions 43
Introducing Yog to Medical Students : The JIPMER Experience

ACKNOWLEDGEMENTS
My long cherished desire to introduce the science of yog to medical students was waiting for an opportunity
and funds and I am grateful to Shrimati Anita Das, former Secretary AYUSH, Ministry of Health & Family
Welfare, Government of India whose keen interest to promote yog made this possible. It was the dynamism
and youthful enthusiasm of Dr. Ishwar V Basavaraddi, Director, Morarji Desai National Institute of Yoga,
New Delhi, that motivated me to take up the challenge at a very short notice. Encouragement, guidance and
support of Professor KSVK Subba Rao, Director, JIPMER, made the execution of the programme a smooth
affair. I am grateful to Professor KS Reddy, Dean JIPMER for his quiet encouragement. I thank
Professor Ashok Kumar Das, Medical Superintendent, JIPMER and Professor S Badrinath, Project Co-
ordinator, JIPMER for their support.
Conducting yog practice sessions for the whole batch of medical students (n=100) was a unique experience
and in this I was ably assisted by Shri R Murugesan, Dr. Navasakthi, Shrimati Meena Ramanathan and
Shri G Dayanidy. I am especially grateful to student participants (JIPMER batch of 2008), who inspite of
their tight teaching schedule participated whole-heartedly in the programme.
I had to execute this project at a short notice and in addition to my routine official duties. I am grateful to my
colleagues Professor GK Pal, Professor P Vijayalakshmi, Professor GS Gaur and Dr. Pravati Pal for their
understanding and support.
Dr. Ananda Balayogi Bhavanani, Programme Co-ordinator, ACYTER and Dr. D Amudharaj, PG student
played a crucial role in analyzing the data and preparing the report. A special appreciation to Dr. Manasi
Bhattacharjee and Dr. Susanta Kumar Padhy for administering and analyzing the psychological questionnaires.
I am grateful to my students Dr. Basanta Manjari Naik, Dr. M Rajajeya Kumar, Dr. S Senthil Kumar and
Dr. D Thenmozhi for assisting me in conducting the programme. I thank Shri M Mathivathanan and
Shri S Mourthy whose type-setting at a commendable speed made it possible to prepare this booklet in a
record time along with J. Selvakumaran of Sri Sarguru Printographs of Villupuram. Finally, I wish to express
my indebtedness to Swami Ramdevji of PatanjaliYog Peeth, Haridwar, whose life and magnificent work has
motivated me to dedicate my life for the cause of yog. He recently exhorted me to promote scientific research
in yog.
Introducing Yog to Medical Students : The JIPMER Experience 1

YOG: A PRECIOUS GEM OF VEDIC THOUGHT
The scientific – spiritual discipline of yog is the most precious gem of our cultural heritage and Vedic thought.
Rigved, the first book of humankind has described meditation by which wise and worthy persons establish
their intellect in the Divine (Rigved, 5:81:1). Yajurved (11:14) exhorts us to practice yog to enhance mental
and physical strength. In the 700 verses of Bhagavadgita (3000 BC) the term yog comes 105 times and Lord
Krishn is hailed asYogeshwar or lord of yog. Mahrishi Patanjali (~ 200 BC) codified the now popular ashtang
yog and his Yog Darshan is one of the six schools of Indian philosophy. Modern research has established its
scientific basis and yog is now a global phenomenon.
The term “yog” and the English word “yoke” are derived from Samskrit root “yuj” which means union. Yog
is a psycho-somatic-spiritual discipline for achieving union and harmony between our mind, body and soul
and the ultimate union of our individual consciousness with the Universal Consciousness.This can be achieved
by systematic and disciplined practice of ashtang (eight-limbed) yog described by Patanjali. The first 2 limbs
of ashtang yog are yam and niyam which are ethical codes and personal discipline for the development of our
moral, spiritual and social aspects. 3rd
and 4th
limbs are asan and pranayam which help in our physical
development and improvement of physiological functions. 5th
and 6th
limbs are pratyahar and dharana for
controlling our senses and making our mind one-pointed, calm and alert. The final two limbs of dhyan and
samadhi result in inner peace, ecstasy, higher levels of consciousness and the ultimate union of our individual
consciousness with the Universal Consciousness, resulting in God realization. The result is unfoldment of a
unique spiritual personality that is a blessing for the whole humanity. It is clear that the holy science of yog is
ideal for our physical, mental, moral-spiritual and social development. By disciplined yog sadhana, we can
develop our total personality in an integrated and holistic manner.
Scientific research has shown that yogic techniques produce consistent and beneficial physiological changes.
A few weeks of disciplined yog practice can lead to improvement in many physiological and psychological
functions. Practice of asan and pranayam results in an overall improvement in cardio-respiratory functions
and physical fitness which improves one’s tolerance to stressors. Meditation makes the mind calm and one-

pointed. Meditative power (dhyan shakti), will power (ichha shakti) and discriminative power (vivek shakti) are
three great powers that can be developed by disciplined yog sadhana.Yog aims at the development of all the three
aspectsofourbeing,i.e.thephysicalbody,themindandthenon-materialspiritandayogiisaperfectlydeveloped
andbalancedperson.Awelldevelopedbody-mindcomplexactsasavehicleforspiritualdevelopmentandultimate
spiritulaisationofourphysicalandmentalaspectsalso.HumanbodyisthehighestandthebestcreationofGodand
an instrument for performing noble deeds (Sharir madyam khalu dharm sadhanam). Through this body we can
practiceyogandreachhighestphysical,mentalandspiritualdevelopment.ThatiswhyVedicRishishavecalledthis
body as devapuri, ayodhya and temple of the Divine (Deho devalayah). By yog sadhana, we can keep it fit and
cleanandseektheDivinewithin.Thatistheultimategoalofyog.
4 Introducing Yog to Medical Students : The JIPMER Experience

YOG AND MODERN MEDICINE: NEED FOR INTEGRATION
Good health and freedom from disease is the greatest achievement, a blessing indeed and should be the goal
of modern medicine as well as yog. Modern medicine as well as yog have scientific basis and universal
outlook. Hence, they are complementary and bound to come together. It is gratifying that science has started
studying the effects of yogic techniques while yog has started using modern technology and scientific methods.
Modern medicine is based on observation and rational analysis and is objective in its essence. On the other
hand, the soul of yog is subjective experiences, intuitive wisdom and creative illumination.
Modern medicine has made tremendous progress in recent years. State of the art diagnostic methods, powerful
drugs and awesome surgical techniques available to us now were unthinkable a few decades ago. However,
it needs to be emphasized that allopathy does not have all the answers. Its primary concern is our physical
body and it is basically disease oriented. Its services are expensive and beyond the reach of common man.
Yesterday’s “wonder drugs” are being replaced by today’s more powerful and “safer” drugs and this process
continues. One wonders what will happen tomorrow, to the wonder drugs of today! When I was a medical
student (1960s), penicillin and streptomycin were commonly used “wonder drugs”. They are now a history.
Drugs have many harmful side effects.Allopathy is far from effective in stress-based, chronic degenerative,
old age and lifestyle disorders which are the bane of modern society.
On the other hand, yog is holistic because it has promotive, preventive as well as curative potential. It is
holistic because it acts on our body, mind as well as soul. It is holistic because it is not only philosophy, but
science as well as art. A distinctive feature of yog therapy is that it is not only free from the negative side
effects of drugs, but has “positive” beneficial side benefits in terms of improvement of psychosomatic health.
In the early and uncomplicated stages of diseases like hypertension and type II diabetes, yog can be used as
an effective alternative to drugs. In the later stages of these conditions, yog can be used as an effective
lifestyle adjunct to medical treatment to reduce drug dosage and improve quality of life of the patient. It
needs to be emphasized that yog is most effective for prevention as well as management of all–pervading
stress and stress disorders.

Inspiteofitstremendouspotential,yoghasitsownlimitations.Itisnomatchtoallopathyinthemanagementofacute
infections and medical and surgical emergencies. It also needs to be emphasized that yog is discipline (Atha
yoganushasanam,YogDarshan,1:1)andwithoutdisciplineandcommitment,complianceisabigquestionmark.
It is clear that yog and modern medicine are natural allies and their coming together is inevitable and long
overdue. Full cooperation and ultimate merger of the two systems will give us a more effective and holistic
health science that will be a boon to humanity. Popularisation of yog will give a big boost to public health.As
a result, there will be a great relief to our under-staffed, fund-starved and over-burdened public health delivery
system. To achieve this beautiful goal, we need a group of committed intellectuals who are scientists by
training, yogis by heart and action-oriented karmayogis. Without such a holistic vision and action, we will not
be able to achieve health for all even by 3000 AD, “Health for all by 2000 AD” has already remained a pipe
dream.

INTRODUCING YOG TO MEDICAL STUDENTS:
THE JIPMER EXPERIENCE
Yog is the best means for managing the stress of our daily life. Medical students have to face overloaded
curriculum and frequent examinations after a sudden change in the study environment. Regular practice of
yog will improve their psychosomatic health and enable them to face the situation.
The holistic science of yog has a great future as it has the potential to prevent as well as manage a number of
stress-induced chronic diseases that defy allopathic medicine.Aholistic physician who himself practises yog
will be able to render better medicare and will be a boon to the society.
I have given yog training to many batches of medical students, school children, police personnel and hospital
patients with the aim of determining the effectiveness of yog as a health-promoting and therapeutic intervention.
The results have been gratifying and many papers have been published in indexed journals. It was my heart’s
desire to introduce yog to medical students as a branch of physiology and contemporary medicine. The
opportunity came with financial support from Morarji Desai National Institute ofYoga, New Delhi. With the
aim of motivating 30 students to join the initial programme, I took introductory lecture for the batch of 2008.
However, after the introductory lecture, many students wanted to join and I enlisted the entire batch (n=100)
for the programme. The objectives of the programme were:
1. To promote awareness among medical students about the effectiveness of yog as an inexpensive
means for achieving holistic health.
2. To impart knowledge, skill & attitude about the theoretical & practical aspects of yogic science.
3. To motivate medical students to take up further studies, therapy & research in yog.
4. To introduce yog in medical curriculum as a branch of physiology & contemporary medicine.

LECTURE TOPICS
1. Introductory lecture
2. What is yog?
3. Healthy lifestyle: a yogic perspective
4. Effect of yog training on physiological functions
5. Dhyan and its psychophysiological correlates
6. Pranayam and its physiological benefits
7. Stress and its management: a yogic perspective
8. Spiritual health and healing: a yogic perspective
9. Diet for health and healing: a yogic perspective
10. Therapeutic potential of yog
11. Benefits of yog practices
12. Traditional basis of yog
YOG THERAPY MODULES
1. Anxiety
2. Hypertension
3. Diabetes mellitus
4. BronchialAsthma
5. Obesity
6. Arthritis
7. GI disorders
8. Menstrual disorders
I designed a 60 hour programme that included i) lectures (12 h), ii) lecture-demonstrations (3 h) iii) practice
sessions (36 h) iv) students seminar on yog therapy modules (6 h) and v) pre-test, post-test, administration
of questionnaires to students and programme evaluation by the students (3 h). The list of lecture topics and
yog therapy modules is given below and the schedule for practice sessions follows.

DAILY PRACTICE SCHEDULE FOR YOG CLASS
Prayer
AUM chant
Asans:
1. Pavanmuktasan
2. Navasan
3. Naukasan
4. Makarasan
5. Bhujangasan
6. Shalabhasan
7. Dhanurasan
8. Yog mudra
9. Ardh-matsyendrasan
10. Pashchimottanasan
11. Talasan
12. Trikonasan
13. Hast-utthanasan &
padahastasan
14. Ardhahalasan
15. Viparitakarani
16. Sarvangasan
17. Matsyasan
18. Vrikshasan
19. Shavasan
Pranayams:
1. Bhastrika
2. Kapalabhati
3. Nadi shuddhi
4. Savitri
5. Pranav (AUM)
Meditation
Suryanamaskar

INTRODUCTION
The scientific-spiritual discipline of yog is the best means to achieve holistic health. Patanjali says:
“Ath yog anushasanam” (Yog Darshan, 1:1). Let us start disciplined practice of yog.
The place should be quiet, solitary with minimum distractions, free of insects and well ventilated. Greenery,
river bank or sea shore is an added advantage. Clothing should be minimum, decent, loose and comfortable.
If weather is cold, use appropriate clothing / blanket. Take off your shoes, belt, watch and glasses. A
four-folded blanket or 0.5 cm thick carpet covered by a clean cotton sheet should be spread on an even and
hard floor. Do NOT practice (even shavasan) on a soft bed and springy mattress. Listen to your body and
practice asans with full awareness, slowly, gracefully with steady, uniform movement and without straining.
According to Patanjali, asan should be firm but comfortable (Sthir sukham asanam, Yog Darshan, 2:46).
Going into the posture, maintaining it and coming back to starting position should take ~ 6 s each, i.e., ~ 18
s for an asan. In the beginning, you should hold the posture for a few seconds and increase the duration as
you progress. Breathing and movement should be in syn, slow, uniform, graceful and performed with full
awareness (dhyan poorvak). Keep eyes open when you have to maintain balance, as in standing postures.
Relax in mini-shavasan between the postures.
PAWANAMUKTASAN
(wind – releasing posture)
This asan relaxes, improves flexibility, massages abdominal
viscera and gives relief from excess wind in the gut.
1. Lie supine and relax.
2. Breathe in.
3. While exhaling, fold your legs and thighs so that the
legs are folded against the thighs and knees are brought
toward the chest. Simultaneously, raise your head and
shoulders to bring your nose between the knees. Fold
your arms and embrace the folded legs just below the
knees.
4. Maintain this position for 6 s while holding the breath
out in shunyak.
5. Inhaling, come back to position 1. Relax.
Good for flexibility of back, menstrual disorders, gas trouble, indigestion, constipation, and impotency.
Avoid in hypertension and bad back.

NAVASAN
(boat posture)
1. Lie supine and relax. Exhale.
2. While inhaling slowly raise your arms, head, shoulders,
trunk and legs simultaneously to ~ 45º. Fingers & toes
should be at the same level and eyes focused at the big
toe. The body is balanced on buttocks.
3. Maintain in kumbhak for 6 s.
4. Exhaling, return back to starting position 1. Relax.
Strengthens abdominal muscles
and is good for healthy back.
NAUKASAN
(prone boat posture)
It is the reverse of navasan and is done in the prone
position. Strengthens anti- gravity muscles and
improves posture and strength of back.
MAKARASAN
(crocodile posture)
1. Lie prone and spread your legs comfortably apart.
2. Grasp the shoulders by the opposite hands. The folded
elbows should lie one above the other and forehead
should rest on the crossed arms.
3. Practice adham pranayam
This is a relaxing asan and can be practiced between difficult asans.

BHUJANGASAN
(cobra posture)
1. Lie prone, hands beneath the shoulders and relax.
Exhale.
2. Inhaling, raise your head, shoulders, chest and abdomen
over a period of 6 s. Arch the back as much as you can.
3. Hold for 6 s
4. Slowly exhale and return to starting position 1. Relax
Good for back. Improves posture. Develops chest muscles and improves vital capacity. Gives gentle
massage to abdominal viscera and improves bowel function.
Avoid in hernia, pregnancy, hypertension, peptic ulcer.
SHALABHASAN
(locust posture)
1. Lie prone with feet together. Relax
2. Clench your fingers and keep the fists under the thighs.
3. Inhale and raise both legs as high as you can. Do not
bend the knees nor raise your head. Press clenched
fists, against the floor.
4. Hold for 6 s
5. Exhaling, slowly lower your legs and come back to
starting position 1. Relax.
It tones arms, lower back, lower abdomen, buttocks and lower limbs and massages abdominal viscera.
Improves digestion. Good for diabetes. This asan appears simple but is strenuous and difficult for
elderly and obese. Avoid jerks and undue strain.
Avoid in hypertension, heart problems, hernia and pregnancy.

DHANURASAN
(bow posture)
1. Lie prone with your feet a little apart. Relax.
2. Bend the legs at knees and grasp the ankles. Exhale.
3. Inhaling, simultaneously pull up the legs, thighs and hips
as you raise your head, shoulders and chest.
4. Balance your body on the navel, arch the spine as much
as comfortable and look up.
5. Maintain for 6 s
6. Slowly exhale and come back to starting position 1.
Relax.
Dhanurasan gives good exercise to muscles of arms, legs as well as trunk and improves flexibility of
many joints. It strengthens chest. Sedentary persons get maximum benefit in minimum time. Beneficial
in dyspepsia, constipation, rigid joints and diabetes.
Being strenuous, avoid in pregnancy, hypertension, hernia, back problems and until full recovery from
abdominal operation.
MATSYASAN
(fish posture)
1. Sit in padmasan and relax.
2. Slowly and carefully bend backwards with support of
arms and elbows.
3. Lift the chest up, making an arch between buttocks and
top of head. Hold big toes and rest elbows on the floor.
4. Close eyes and breathe (madhyam) as deeply and slowly
as comfortable. Maintain the posture for 6 s.
5. Slowly and carefully return to starting position 1. Relax.
Matsyasan tones abdominal muscles & expands chest. Improves vital capacity. Avoid in pregnancy,
heart disease, peptic ulcer, hernia and bad back.

TALASAN
(palm-tree posture)
1. Stand with your feet together (or a little apart) & toes
turned outward. Keep eyes open and look straight.
2. Exhale fully. Start inhaling as you slowly raise your
arms and heels.
3. You should be standing on your toes, palms facing each
other and arms touching the ears.
4. Stretch your whole body, arms, head and neck,
shoulders, body, legs and feet. Hold for 6 s.
5. Exhaling, slowly return back to starting position 1.
Relax.
Talasan vertically stretches to whole body, especially the spine and improves posture and balance.
Body becomes well built and well-proportioned. Vital capacity improves.
TRIKONASAN
(triangle posture)
1. Stand straight, feet ~2 feet apart. Exhale.
2. Inhaling, simultaneously raise both arms to shoulder
level.
3. Stretch the arms and bend to left side as you breathe
out. Left hand should touch the left foot and right hand
should be vertically up. Look at your right palm as you
maintain the position. Do not bend the knees or elbows.
4. Inhaling, come back to position 2.
5. Repeat on opposite side. Relax.
This asan is strainless and gives a good lateral stretch
to the spine. It is good for back and hip joints.

HAST-UTTHAN AND PADAHAST ASANS
(raised arms & hands-to-feet posture)
1. Stand straight and relax. Exhale.
2. Inhaling, raise both arms above the head. Keep eyes
open throughout. Bend backwards your arms, head
and upper trunk as you inhale.
3. Slowly exhale and bend forward. Let your fingers touch
the toes and forehead the knees. Do not bend the knees.
Hold the position as you relax the back.
4. Breathing in, come back to the starting position 1.
Relax.
Combined together, these 2 asans complement each other and give a good flexibility to the spine.
Good for dyspepsia and constipation. Inverting the trunk stimulates cardiovascular reflexes and
improves vitality.
Avoid in hypertension, hernia and bad back.
ARDHAHALASAN
(half–plough posture)
2. Inhaling, press the palms against the floor and slowly
raise your legs through 30º, 60º and finally to 90º. By
the time the legs are perpendicular, inhalation should
be complete.
3. Fix your gaze on the big toes and maintain the position
for 6 s. Do not move head, body or arms.
4. Exhaling, press the palms down and slowly bring down
the legs. Relax.
This is a simple asan that gives the benefits of inverted posture.

VIPARITAKARANI
(invertedposture)
2. Inhaling, press your elbows down and slowly raise both
the legs & the trunk. Do not bend at the knees. Support
the slanted trunk and buttocks on the palms. Breathe
normally. Keep legs straight.
3. Return slowly to the starting position. Relax.
This inverted posture improves health, strength and vitality and is preparatory practice for sarvangasan.
Contra indications: spondilytis, hypertension, heart ailments, eye problems. Avoid in menstruation
and pregnancy.
SARVANGASAN
(shoulder stand)
1. Lie supine and relax.
2. Do viparitakarani
3. Raise the body further so that the hips, trunk and the
legs are vertical in a straight line. Press the chin against
the suprasternal notch (jalandhar bandh). Entire weight
of the body rests on head, neck and shoulders and hands
are used for balancing.
4. Return slowly to the starting position. Relax.

YOG MUDRA
(symbolofyog)
1. Sit in padmasan. Close the eyes and relax
2. Take your arms to the back and grasp your right wrist
by left hand.
3. Inhale deeply (mahat yog pranayam). Slowly exhale
and bend your head and trunk and rest your forehead
on the floor. Relax and breathe normally. Hold for 6 s.
Avoid strain.
4. Inhaling, slowly return back to starting position 1.
Yog mudra stretches the back and massages abdominal organs.
Avoid in heart problems and bad back.
PASHCHIMOTTAN ASAN
(back stretch posture)
1. Sit with your legs stretched (dandasan). Relax.
2. Take a deep mahat yog breath. Start exhalaing and
bending forward from the waist and grasp the toes which
should be stretched towards you. Rest forehead on the
knees. You may draw in the abdomen (uddiyan bandh)
and hold breath out (shunyak) in this position. Hold for
6 s.
3. Breathing in, slowly come back to the starting
position 1. Relax.
This asan gives a good stretch from heels to the top of head. Uddiyan bandh performed in this asan
massages the abdominal viscera.
The asan is beneficial in dyspepsia, constipation and diabetes.

ARDH-MATSYENDRASAN
(halfspinaltwist)
1. Sit with both legs stretched in front (dandasan) and relax.
2. Bend left leg, keeping left knee on the floor in front of you and the left heel by the side of right hip.
3. Bend right leg, knees up and the heel by the left side of left knee.
4. Pass left arm over right side of right knee and grasp the
right foot.
5. Take your right arm behind the back and grasp left
buttock.
6. Breathe in. Breathing out, turn your whole body – head,
shoulders and trunk to right and bring the chin over the
right shoulder. Hold for 6 s.
7. Breathing in, come back to position 5. Relax.
Repeat on opposite side.
VRIKSHASAN
(tree posture)
1. Stand straight and relax.
2. Place the left sole over the medial side of right thigh,
heel close to perineum and left knee to the left side.
3. Join the 2 palms on the middle of the chest in namaskar
mudra. This is Dhruvasan.
4. Now raise the joined palms above the head and stretch.
Eyes should be kept open to keep balance.
5. Slowly return to starting position 1. Relax.

SHAVASAN
(yognidra)
Shavasan is very effective for prevention as well as management of stress and stress-induced disorders like
hypertension, coronary artery disease and insomnia. Swatmaram (Hath Pradipika, 1:32) says “Shavasanam
shranti haram chittavishranti karakam” i.e. shavasan wards off fatigue and gives mental rest.
1. Starting position: Lie down supine with feet comfortably apart, toes slightly everted, arms ~ 30º
from the body, palms up and fingers slightly curled. The whole body should be straight and
symmetrical. Slightly bend your elbows so that the arms rest well on the floor. You may like to
bend the knees a little and a rolled up towel will serve the purpose. In the beginning (beginning
only) of the practice, you may use a thin pillow under your head. Make final adjustments so that
you feel most comfortable. Gently close your eyes and drop your chin a little so that the teeth are
slightly parted and lips gently touching each other.
2. Be still and take a few slow, deep breaths concentrating on the breathing. Savitri pranayam (2 or
3 tal) is a good idea.
3. Make a resolve (sankalp). Will power and sankalp are the very basis of great achievements.
Sankalp should be noble and great. Make your own resolve and do not change it lightly. It may be
something like this: “By the Divine Grace and my disciplined yog practice, I will be blessed with
holistic health. I will become a noble human being and a great professional. So be it – tathaastu”.
4. Body awareness: Starting from the feet and working up to the top of your head, mentally “see”
each part of the body, consciously relax it and “let go”. Muscles should be relaxed consciously
and effortlessly. If any part of the body/muscle group is taut, relax it thoroughly. The process of
contraction– relaxation (spand–nishpand) can be used during shavasan. Starting with your feet,
be aware of your both feet, breathe in and visualize pran going to the feet, contract them feeling

the tension, let go of the tension and feel that your feet are relaxed. Similarly, relax all parts of your body as you go
up,mentally“seeing”eachpartandrelaxingit.Attheend,ifthereisanyresidualtensioninanypartof
yourbody,releaseitconsciouslyandfeeltherelaxation. Afterrelaxingeachpart,onceagainrelaxthe
whole body by visualizing a wave of relaxation sweeping up from feet to the head, i.e., “trigger the
relaxationresponse”. Feelthatyouarerelaxedandletgo. Youshouldneitherrushthroughtheprocess,
nor be too slow.About 5 min is fine.
5. After relaxing the body, watch your breath without altering it. Just watch it as it enters your nose
and feel its cold touch. When it leaves out, feel its warm touch at the nostrils. Do it for ~ 2 min.
Breathing rate and heart rate will decrease spontaneously and you will feel calm, relaxed and
recharged.
The whole process of shavasan may take about 10 min.
To come out of shavasan, do not hurry/jump up. Gently roll to one side and slowly sit up while the eyes are
still closed. Maintain this state of psychosomatic relaxation for some time before you resume your daily
activities.
You can practice shavasan whenever you feel tired or tense.

PRANAYAM: A VEDIC AND PHYSIOLOGICAL PERSPECTIVE
Yog (and the English word yoke derived from it) means union and harmony. Vedic philosophy emphasizes
one-ness, unity and universality. Vedic concepts of i) one omnipresent God as the universal divine being
(Ekam sadvipra bahudha vadanti. Rigved, 1: 164: 46; Ishavasyam idam sarvam. Yajurved, 40: 1), ii) world
man (Vishwa manusho. Rigved, 8: 45: 42), iii) world as one family (Vasudhaiv kutumbakam) and iv) the
ultimate goal of yog being the union of our individual soul with the one Universal Soul can be the basis of
unity of humanity and the modern concept of global village. From the yogic and spiritual point of view, the
Vedic concept of pran, the omnipresent and universal divine force is very important. Ken Upanishad (1: 2)
describes the supreme God as “Pranasya pranah”, i.e. the very source of pran, the giver of life to pran. In our
body, pran manifests as life energy or ki (as in reiki or qigong) and in Samskrit, living beings are called as
prani. Pran improves the quality of vegetation and herbs and thereby the quality of our life (Atharva Ved, 11:
4: 6). This whole world vibrates with pran (Kath Upanishad, 6: 2). Our nerve currents, bio-rhythms and the
very life are expressions of pran.
From the Vedic point of view, the goal of pranayam is conscious unification with the universal vital life force
or pran. Breathing is the most tangible expression of pran and pranayam is the ingenious technique for
recharging our batteries and enhancing vitality by drawing pran from the omnipresent and inexhaustible
universal source of pran. Pranayam means control and expansion of pran. Since life, breathing and mind are
closely interrelated and act on each other, pranayam has significant influence on our psychosomatic health.
According to Patanjali (Yog Darshan, 2: 52-53), pranayam removes the covering of inner light and our mind
gains the power of concentration. According to manusmriti (6: 71), pranayam purifies the senses and mind
even as fire removes the impurities of metals. Thus, the breathing techniques of pranayam are psychosomatic
techniques that purify, balance and energize the practioner.
Fromthephysiologicalpointofview,pranayamisofgreatsignificance.Deepandcompleteyogbreathing(mahat
yogpranayam) i)strengthensthediaphragmandintercostalmuscles,ii)massagesabdominalviscera, iii)stretches
allpartsofthoraxandlungsand iv)improvesvenousreturn.Breathingmeditativelywithfullconcentrationimproves

mind-body coordination. During slow, deep and rhythmic breathing, there is a conscious alteration of activity of
medullaryneuronsandadefinitepatternofproprioceptiveinputsfromthoraxandabdomen.Thismaymodulatethe
activity of central neuronal circuits. We have found that slow, rhythmic pranayam produces deep psychosomatic
relaxation(Madanmohanetal.TheYogaReview,1983,3:25-34).Inananotherstudy,wehavefoundthatbellows
typeofpranayamproducesimmediateandsignificantreductioninauditoryandvisualreactiontimesindicatingan
improvedsensorimotorperformanceandenhancedprocessingabilityofthecentralnervoussystem(Bhavananiet
al. Ind J Physiol Pharmacol, 2003, 47: 297-300). In a study on patients with premature ventricular complexes
(PVC)andepisodesofpalpitations,wehavefoundthatpranayamproducesanimmediatereliefofpalpitationsand
PVC (Ravindra et al. International J Cardiology, 2006, 108: 124-125).
Understanding its physiological and therapeutic potential, let us start disciplined and dedicated practice of
pranayam.

PRACTICE SESSIONS ON PRANAYAM
1. Practice separately adham (lower / abdominal), madhyam (mid-chest) & adya (upper chest / clavicular)
breathing. During adya, raise your shoulders to enhance expansion of upper lobes. Join these 3 in
one complete yog breath, the mahat yog pranayam. Breathe slowly, uniformly and as deeply as
comfortable ( about 80% of your capacity). Practice in a relaxed manner and with full awareness.
2. Pranav pranayam:After a deep inspiration, chantAUM with awareness of vibratory sound. Visualize
that you are breathing in pran during purak. Chant (low pitch) visualizing pran vibrating in lower,
middle and upper parts of your body with A, U & M sounds respectively.
3. Savitri pranayam: Slow, deep & rhythmic breathing with a ratio of 2: 1: 2: 1 between purak
(inspiration), kumbhak (held-in ), rechak (expiration) & shunyak (held-out) respectively.
Go upto 6: 3: 6: 3. (i.e. 3 tal). Breathe slowly, uniformly and with meditative awareness. Whenever
you are tired, you can breathe submaximally in supine position and enjoy deep relaxation.
4. Nadi shuddhi: Start purak through left nostril, then rechak through right nostril, purak through right
nostril & rechak through left nostril. This completes 1 cycle. With practice, you can incorporate
kumbhak & latter on shunyak.
5. Kapalabhati: Forceful & sharp rechak with contraction of middle & lower abdomen. Keep chest &
shoulders immobile. Rechak is important & active while purak is relatively passive. Start with 1/s &
10/round. Go upto 2/s & 20/round. Practice according to your capacity. In yogic tradition, kapalabhati
is one of the shat (six) kriyas.
6. Bhastrika: Bellows-type breathing with emphasis on thoracic (not abdominal) activity. After 10
bellows, inspire deeply, relax & enjoy in silence for as long as comfortable. This is 1 round. Practice
3 or more rounds according to your capacity.
7. Sheetali: Purak through partially protruded & folded tongue. Be aware of hissing sound & cooling
effect on the tongue. Kumbhak as long as comfortable. Rechak slowly through both nostrils. It is a
cooling pranayam.
8. Chandra anulom: Purak & rechak through left nostril while right nostril is kept closed. In
surya anulom, purak and rechak are through right nostril while the left nostril is kept closed.
9. Chandra bhedan: Purak through left & rechak through right nostril. Reverse in surya bhedan.

MEDITATION
Concentration is focusing our mind on an object. When the concentration becomes continuous and deep and
the goal is higher spiritual ideal, it becomes meditation (Yog Darshan, 3:1, 2). Meditation helps us to realize
and enhance our real personality and live a purposeful and fulfilling life and this makes us happier.Yogeshwar
Krishn describes the result of meditation as peace, bliss and oneness with the Divine (Bhagavadgita, 6:15,28).
Mediation is very effective in prevention as well as management of stress and stress disorders. Meditation
makes the mind one-pointed and evolves human consciousness. We will learn two preliminary methods
leading to meditation. Slow, rhythmic breathing helps in calming and focusing the mind. Watching the breath
as described in step 5 of shavasan also helps in meditation.
1. Nadanusandhan:
i) Sit in vajrasan or any meditative posture.
ii) Inhale slowly and deeply, filling lower, middle and upper lungs (mahat yog pranayam).
iii) Exhale and chant AUM, experiencing sound vibrations in lower, middle and upper parts of your
body as you chant Aaaa….., Uuuuu….., and Mmmm…….. respectively.
Repeat 6 to 9 times.
2. AUM meditation:
i) Sit comfortably in a meditative posture.
ii) Mentally repeat (japam) AUM continuously and without a break.
iii) If there are distractions, repeat AUM faster and then consciously slow down.
iv) As you progress, make the japam more gentle, soft and effortless.
MUDRA
Mudra means a gesture or seal and is related to acupressure points and energy channels. Mudras are used in
yog and Bharat Natyam to express devotional, aesthetic and emotional attitudes. Mudras deepen our awareness,
perception and concentration. There are many mudras. You have already learned vipareetakarani and yog
mudras which are body mudras. Today, we will learn hand mudras.
1. Chin mudra: Fold the index fingers so that they touch the inside root of the thumbs. Alternatively,
you may touch the tips of thumbs and index fingers so that they form a circle. Keep other fingers
straight and a little apart. Rest the hands on the knees, palms facing upward.
2. Jnan or dhyan mudra: As chin mudra except that the palms face downwards.
3. Bairav mudra: Palms facing up, keep your right hand over the left hand and place both hands on the
lap. In Bhairavi mudra, left hand is placed over the right hand.
4. Namaskar mudra: Join the palms of both hands together in front of the chest in the traditional Indian
way of greeting.

BANDH
Bandh means bind, lock, tighten and hold. They are used along with pranayam to awaken psychic faculties.
1. Jalandhar bandh:
i) Sit in a meditative asan
ii) Breathe in
iii) Contract throat muscles and press chin tightly against the suprasternal notch. Hunch your shoulders
a little up and forward. Hold as long as comfortable and then release slowly.
• Massages thyroid and activates vishuddhi chakra. Conditions circulatory and respiratory reflexes.
• Avoid in hypertension, cervical spondylosis and vertigo.
2. Uddiyan bandh:
ii) Inhale deeply and then exhale fully
iii) Lean forward and pull abdominal wall in and up towards the spine
iv) Hold till comfortable and then release slowly.
Beneficial in: dyspepsia, constipation, laziness, tension, diabetes.
Avoid in: pregnancy, abdominal problems, hypertension, heart problems, and increased
intraocular pressure.
3. Mool bandh:
ii) Tighten the anal sphincter and raise perineal region. Breathe normally.
iii) Hold till comfortable.
It increases energy level.
4. Maha bandh or bandh trayam:
i) Sit in a meditative asan. Close your eyes and relax.
ii) Breathe in and then breathe out.
iii) Do jalandhar, uddiyan and mool bandh in that order.
iv) Hold as long as comfortable.
v) Release mool, uddiyan and jalandhar bandh, in that order.
Improves general health and vitality, calms the mind.
Avoid in high or low blood pressure, heart problems, abdominal problems, pregnancy.

SHAT KARM
Shat karm includes following 6 purification practices:
1. Kapalabhati: You have already learned this breathing technique.
2. Tratak: Gazing at one point to develop concentration power.
3. Basti: Washing and toning of lower intestine. Enema is a common practice. Naturopathy centers use
large quantities of water (alternate hot and cold water) to wash whole of the colon.
4. Dhauti: In vaman dhauti (kunjal kriya) water is drunk and vomited out to clean the stomach. In
shankhaprakshalan, whole GIT is washed by drinking salt water. In agnisar kriya, digestive fire is
activated by rapid movement of abdominal wall after exhaling fully.
5. Nauli or lauliki: Churning of abdomen by the recti muscles. It massages the whole abdominal area.
Avoid in pregnancy, abdominal problems, hypertension and heart disease.
6. Neti: Cleaning the nasal passages.
• Jalaneti with warm normal saline.
• Sutraneti with cotton thread or rubber catheter.

SURYANAMASKAR
Suryanamaskar is a flowing series of 12 yog postures done with concentrated awareness. Each stage
is accompanied by regulation of breath. The 12 steps of suryanamaskar are as follows:
1. Stand erect with palms together. Inhaling, take the hands above the head and bend the trunk
backwards.
2. Exhaling, bend the body and touch the knees by the forehead. Keep the palms on the floor on
either side of the legs.
3. In this stage, kick the right leg back, take the left knee forward, look up and inhale. Touch the
thigh with the heel.
4. Take the left leg also back, resting only on palms and toes; keep the body straight from head to
toes and inclined to the ground at about 30 degree. Exhale completely.
5. Bend at the knees and rest the knees on the floor without altering the positions of the palms and
toes. Rest the forehead on the ground. Inhale while moving backwards and then exhale completely.
6. Without moving the hands and toes, come forward on the chest and rest the forehead, chest,
hands, knees and legs all the eight parts will be touching the ground. The buttocks will be raised
up. Stay in ‘breath-out’condition (bahyakumbhaka).
7. Inhaling, raise the head and trunk making the spine concave upwards without changing the
position of the hands and feet. Keep the knees off the ground.
8. Exhale and raise the buttocks, push the head down and arch your back fully with the heels
touching the ground and palms on the floor.
9. Same as 5th step. Inhale and exhale.
10. Inhale and bring the right leg in between the two hands and in line with them. Arch the back
concave upwards as in step 3.
11. Exhale and bring the left foot forward next to the right foot and touch the knees with forehead
as in 2.
12. Inhaling, come up, stand erect with hands along the body and relax.

PROGRAMME EVALUATION & STUDENTS’ FEED BACK
The preliminary task of priming medical undergraduates in yog was welcomed with unexpected enthusiasm
& co-operation by the students. The following are the statements of the students’ feedback and programme
evaluation. There was an appreciable improvement in the students’ knowledge base regarding the ancient
science of yog, the increase being 30% (Fig.1).
In the absence of physical disease or infirmity the level of well being is largely and essentially determined by
the psychological state. Standard, appropriate and time tested questionnaires currently employed in clinical
practice were chosen to study the psychological well being of the participants. There was an observable
increase of the same, reflecting realistic values, though the improvement was not extraordinary (Fig. 2).
Figure 3 gives specific improvements in different aspects of psychological well being.Therewasacommendable
improvement in the number of students reporting a positive well being at the end of the programme (Fig. 4).
Maintenance of dynamic homeostasis is not possible without reliable feed back systems. Constant commitment
and continuous refinement with the help of feedback systems results in strong, efficient and fruitful programmes.
Keeping this in mind, we give a lot of importance to student feedback to improve the reach of this programme
to the target population.
Figures 5 to 23 reflect the student feedback & evaluation responses for various aspects of the training
programme. Every question (Fig. 5, 6, 7, 8, 9) had a due choice of extreme poority for two reasons. One is to
look out for any inconvenience or problems which are hidden, and second reason is to reflect the genuineness
in the conduct of the questionnaire. Mixed responses were received from students regarding the
recommendation of yog in UG medical curriculum (Fig.9). The underlying reason is hectic schedule and
loaded curriculum in a medical school (Fig. 22). Frequent internal assessments and other examinations render
students to be not sure of recommending yog in medical curriculum.Although a majority of students recommend
yog in medical curriculum to help them withstand this hectic curriculum, a word of caution from students is
not to impose lengthy and frequent theory classes of yog which could be taxing on the time available for their
academics.

Clarity, realism of objectives and presentation of relevant topics to fulfill the objectives of the course were almost
fullyachieved(Fig.10,11,12,14).Studentsweresatisfiedwiththemannerthecoursewasconducted,i.e.encouraging
active participation, opportunity for critical questions etc. (Fig 16, 17). This again re-emphasizes the importance
given to student feedback & comments. Facilitatory & hindering factors (Fig. 21, 22) were analysed and the same
willbegivendueconsiderationinthenextsessionasactionofrefinement.
Finally students’ suggestion to improve the course were analysed. Figures 21, 22, 23 were given as open type
questions and every single response is carefully analysed, categorized and presented for the use of future
planning and improvement of the course.
We had made it amply clear to the students that the feedback must be absolutely honest and realistic. Keeping
this in mind, I kept away from administering & analyzing the feedback and the work was done by my juniors.

CONCLUSION AND SUGGESTIONS
The programme had an overwhelming response with excellent co-operation from the medical undergraduates.
In light of the keen interest shown by the organizers and encouraging student feedback, the following are the
suggestions:
1. There should be a regular and compulsory training schedule for yog in the medical curriculum. It may
be included as a part of physiology and contemporary medicine. Complementary health systems are
already being taught in many standard modern medical schools in different parts of the world.
2. The optimal time in an undergraduate medical programme where yog can be incorporated is during
the first year i.e. the first semester and during the final year part-I i.e. VI / VII semester. The former
will help them in combating and adapting to the totally new and extremely stressful first year
undergraduate medical curriculum. The latter will help in better understanding of the science of yog
and its possible applications in clinical practice. This will also enable them to shape themselves as
holistic physicians and help them in their personal development as well to become more efficient
physicians.
3. The present programme was constrained by lack of space with correct ambience and comfort, which
is very essential for the yog training. It is suggested that there should be a space fully furnished,
having the right ambience and comfort that will facilitate the teaching and practice of yog. The space
should be exclusively devoted to the yog training programme.
4. From the students’ standpoint, practice sessions with integrated theory and morning practice sessions
and training schedule within the college hours are among the major recommendations. Students also
wanted a facility to continue yog practice on a regular basis even after the completion of the introductory
programme.

Introducing yog to medical students by Prof Madanmohan

Introducing yog to medical students by Prof Madanmohan

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