Poorna shankhaprakshalana (PSP) is a hatha yoga practice involving the graded consumption of a large amount of salted lukewarm water along with the performance of a large number of rounds of selected asanas. The practice has, amongst its various effects, a cleansing effect on the gastrointestinal (GI) tract. A concern was felt about the safety of the practice for people with high blood pressure (BP), poor myocardial contractility and diminished kidney function. Hence, Yoga Research Foundation designed a research project to study the dynamics of ingested salted water in the body over a period of 48 hours. This study was carried out, in the first stage, on 38 normal subjects (BYB students) and 12 diabetics (a total of 50 subjects), using normal (0.9%) salt solution, and in the second stage, on 14 diabetics, using a half-strength (0.45%) salt solution. Stage 1 examined the hydrodynamics of PSP, while Stage 2 compared the efficacy of normal salt solution with half-strength salt solution. The project lasted from November 2000 to May 2003.
The aim of this research was to study:
Everyone in the ashram who performed PSP during the period of the study was selected as a subject. Subjects of both genders were included. Thirty-eight subjects were BYB students. All were young or middle-aged adults without major health problems (one person had high BP). Twelve subjects were participants in an Intensive Diabetes Management Course. They were middle-aged or aged adults with NIDDM (non-insulin dependent diabetes mellitus) and 3 also had high BP. These 50 subjects used normal (0.9%) salt solution for the practice of PSP.
In the second stage of the study, 12 diabetics from these 50 subjects comprised group A, which used normal salt solution. Fourteen participants from an Intensive Diabetes Management Course, including 8 participants from a follow-up Intensive Diabetes Management Course, comprised group B, which used half-strength (0.45%) salt solution for the practice of PSP. They were middle-aged or aged adults with NIDDM. Three subjects in group A and 4 in group B also had high BP. The 8 subjects from the follow-up course had also been group A subjects in the previous year.
The technique of PSP followed in this study was as recommended by Swami Satyananda Saraswati in Asana Pranayama Mudra Bandha, published by Yoga Publications Trust, Munger, Bihar, India. The only difference between the two groups was in the strength of the salt solution used. Group A used a 0.9% salt solution and group B used a 0.45% salt solution. The following parameters were recorded for 48 hours:
The readings of these parameters were taken at the following time intervals:
The food intake was not weighed and the water loss from the lungs and the skin could not be measured. The time and the consistency of GI tract output were noted down. The GI tract output was calculated from the weight gain and urine + kunjal output.
See Diagram 1 and Tables 1-4 (overleaf) for details of results. The results of the first stage of the study (Table 1) help us understand the hydrodynamics of PSP. The results of the second stage of the study compare the efficacy of normal salt solution with half-strength salt solution.
Stage 1: Stage 1 of the study shows that PSP is very effective in cleansing the GI tract. About 66% of the water intake stayed within the GI tract and was eventually evacuated through the rectum. At the end of the 45-minute rest period, the kunjal output was 15% and urine 8%, and only 11% of the water intake was still within the CVS (cardiovascular system). The total absorption of water into the body systems was about 19% (11% retention + 8% urine output). It was fully cleared before 12 hours.
Stage 2: The results given in Diagram 1 show very clearly that for group A, the practice of PSP was more effective in cleansing the GI tract. About 63% of the water intake stayed within the system and was eventually evacuated through the rectum. The time taken to achieve this was short - by the end of the 45 minute rest period after PSP. The amount of water intake required was about 4600 ml or a little over 15 glasses, with a range of 3600-4800 ml or 12-16 glasses. The amount of output through kunjal was about 22% of the total intake at that time (the difference between the readings of urine + kunjal output in % of total intake, at 'post' and 'post kunjal' time intervals). Hence about 15% of the water intake was absorbed into the circulatory system and eventually excreted through the kidneys. It seems that this route of water disposal is slow. At the end of the 45 minute rest period only 4% of the output was excreted through the urine (total 15%). The remaining 11% was slowly excreted until the time interval of 'after 12 hours'. This means that the water distribution becomes stabilized at the time interval of 'after 45 minutes rest' and the water balance is regained before the time interval of 'after 12 hours'.
However, for group B, the practice of PSP was less effective in cleansing the GI tract. About 35% of the water intake stayed within the system and was eventually evacuated through the rectum. The time taken to achieve this was the same as group A - by the end of the 45 minute rest period after PSP. By this time the remaining water had been absorbed into the circulatory system. The amount of water intake required was about 5200 ml or over 17 glasses, with a range of 4800-6000 ml or 16-20 glasses. The amount of output through kunjal was about 15% of the total intake at that time (the difference between the readings of urine + kunjal output in % of total intake, at 'post' and 'post kunjal' time intervals). Hence, about 50% of the water intake was absorbed into the circulatory system and eventually excreted through the kidneys. It seems that this route of water disposal is slow. At the end of the 45 minute rest period only 13.5% of output was excreted through the urine. After 6 hours, a further 19%, and after 12 hours, a further 15.5% of output was excreted through the urine (a total of 48% of the expected 50%). This means that the water distribution becomes stabilized at the time interval of 'after 45 minutes rest' and the water balance is regained after the time interval of 'after 12 hours'. Group B took longer than group A to regain water balance. Moreover, in spite of greater water intake on day 1 and the same intake on days 2 and 3, group B showed more weight loss than group A on day 2 and day 3. This means that there was dehydration due to the kidneys overshooting their target of restoring water balance.
The effects on the circulatory system also point in the same direction.
In group A, there was a uniform rise in pulse rate throughout the practice due to the effects of physical exertion. During the rest period the pulse rate settled down somewhat and stayed that high throughout the day, probably due to water retention leading to increased blood volume. The systolic and diastolic BP showed the following changes:
In group B, two peaks were noted in the pulse rate; the first in the beginning of the practice and the second after 6 hours. These increases in the pulse rate were lower than in group A and the fall in the pulse rate during the rest period as well as on days 2 and 3 was more pronounced. This could not be explained.
The systolic and diastolic BP showed the following changes:
The swara pattern was quite interesting. In stage 1 subjects showed an initial rise in pingala activity, but as the practice progressed ida activity started to dominate. Motility in the GI tract (a function of the parasympathetic system) leads to ida dominance or vice versa. Subjects were quiet and restful. After the rest time pingala and ida were balanced.
In group A, very little change in the swara pattern was noted. In group B, there was an initial rise in ida activity followed by pronounced pingala dominance as the practice progressed and also during the rest period. Spasm of the GI tract sphincters (a function of the sympathetic system) leads to pingala dominance or vice versa. Some of the subjects were uncomfortable and mildly restless. Later in the day balance between pingala and ida was achieved.
Description | Water Intake | U+K Output | WI gain | Digestive Output | Dig Output/water in % | U+K/water in % | WI gain/water in % |
---|---|---|---|---|---|---|---|
pre | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
6 glasses | 1800 | 81.2 | 1402 | 316.8 | 17.6 | 4.511 | 77.889 |
Post | 4826 | 355.2 | 1224 | 3246.8 | 67.277 | 7.360 | 25.363 |
Post kunjal | 6352 | 1490.6 | 1138 | 3723.4 | 58.618 | 23.467 | 17.916 |
After 45 mins. | 6352 | 1513.7 | 736 | 4102.3 | 65.583 | 23.830 | 11.587 |
After 6 hrs. | 6352 | 1767.2 | 914 | 3670.8 | 57.79 | 27.021 | 14.389 |
After 12 hrs. | 7020 | 2507.7 | 1030 | 3482.3 | 49.605 | 35.722 | 14.672 |
Day 2, 6am | 7884 | 3650.5 | -118 | 4351.5 | 55.194 | 46.303 | -1.497 |
Day 3, 6am | 9938.4 | 6080.4 | -108.44 | 3958.44 | 39.83 | 61.261 | -1.091 |
Table 1 shows the mean values of total water intake,
total measured output, gain in body weight and possible output through
the digestive tract at the different time intervals during and after
the practice of PSP during the first stage of the study (N=50).
Note: The shaded areas are of special interest.
Group A (N=12) | Group B (N=14) | |||||||
---|---|---|---|---|---|---|---|---|
Description | Water In | U+K Out | WI gain | Dig Out | Water in | U+K Out | WI Gain | Dig Out |
pre | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
6 glasses | 1783.333 | 1800 | 6.25 | 10.417 | 1800 | 80.357 | 1842.857 | -123.214 |
Post | 1616.667 | 4600 | 154.167 | 2829.166 | 5185.714 | 469.643 | 3000 | 1716.071 |
Post kunjal | 1850 | 6700 | 1707.917 | 3142.083 | 6557.143 | 1583.929 | 2871.429 | 2101.786 |
After 45 mins. | 750 | 6700 | 1710 | 4240 | 6557.143 | 1878.571 | 2385.714 | 2292.857 |
After 6 hrs. | 1050 | 6700 | 1895.533 | 3754.167 | 6557.143 | 3264.286 | 1414.286 | 1878.571 |
After 12 hrs. | 1500 | 7583.333 | 2622.917 | 3460.416 | 6835.714 | 4453.571 | 571.429 | 1810.714 |
Day 2, 6 a.m. | -116.667 | 8437.5 | 4429.167 | 4125 | 8200 | 5755.357 | -528.571 | 2973.214 |
Day 3, 6 a.m. | -101.833 | 10954.17 | 7937.5 | 3118.503 | 11010.71 | 5669.643 | -671.429 | 3012.5 |
Table 2 shows the mean values of total water intake,
total measured output, gain in body weight and possible output through
the digestive tract at the different time intervals during and after
the practice of PSP in both group A and group B.
Note: The shaded areas are of special interest.
Group A (N=12) | Group B (N=14) | |||||
---|---|---|---|---|---|---|
Description | Dig Output/water in % | U+K/water in % | WI gain/water in % | Dig Output/water in % | U+K/Water in % | WI gain/water in % |
pre | 0 | 0 | 0 | 0 | 0 | 0 |
6 glasses | 0.579 | 0.347 | 99.074 | -6.845 | 4.464 | 102.381 |
Post | 61.504 | 3.351 | 35.145 | 33.092 | 9.056 | 57.851 |
Post kunjal | 46.897 | 25.491 | 27.612 | 35.053 | 24.156 | 43.791 |
After 45 mins. | 63.284 | 25.522 | 11.194 | 34.967 | 28.649 | 36.383 |
After 6 hrs. | 56.032 | 28.296 | 15.672 | 28.649 | 49.782 | 21.569 |
After 12 hrs. | 45.632 | 34.588 | 19.780 | 26.489 | 65.152 | 8.359 |
Day 2, 6 a.m. | 48.889 | 57.494 | -1.383 | 36.259 | 70.187 | -6.446 |
Day 3, 6 a.m. | 28.469 | 72.461 | -0.93 | 27.36 | 78.738 | -6.098 |
Table 3 shows the mean values of water output through the digestive tract, kunjal & urine and water retention (gain in body weight) in terms of % of total water intake at the different time intervals during and after the practice of PSP in both group A and group B.
Note: The shaded areas are of special interest.
Group A (N=12) | Group B (N=14) | |||||||
---|---|---|---|---|---|---|---|---|
Description | Pulse diff. | SBP diff. | DBP diff. | Swara | Pulse diff. | SBP diff. | DBP diff. | Swara |
pre | 0 | 0 | 0 | R5L681 | 0 | 0 | 0 | R4 L82 |
6 glasses | 17.333 | 12.5 | 4.417 | R5L582 | 6.071 | 9.643 | 2.786 | R3 LT1 80 |
Post | 20.5 | 2.167 | 4.25 | R4L682 | 2.071 | 6.214 | 3.643 | R5 L7 82 |
Post kunjal | 24 | 7.417 | 5.333 | R4L583 | 3.429 | 8 | 6.786 | R10 L3 81 |
After 45 mins. | 6.667 | -2 | -0.583 | R5L483 | -6.214 | -5.143 | -5.071 | R10 L4 80 |
After 6 hrs. | 10.167 | -1.417 | -0.75 | R5L384 | 9.143 | -10.286 | -6.714 | R6 L8 80 |
After 12 hrs. | 9.5 | 4.167 | 3.167 | R4L781 | 5.429 | -3.786 | -3286 | R7 L4 B3 |
Day 2, 6 a.m. | -0.667 | 3.417 | 3.583 | R3L782 | -5.142 | 0.571 | -1.929 | R7 L5 B2 |
Day 3, 6 a.m. | 2.667 | -6.25 | -0.917 | R4L484 | -1.071 | 0.071 | -1.857 | R4 L8 B2 |
Table 4 shows the mean values of the change in pulse
rate and systolic as well as diastolic BP, reflecting cardiovascular
system (CVS) effects, and the status of the swara, reflecting autonomic
nervous system (ANS) effects at the different time intervals during
and after the practice of PSP in both group A and group B.
Note: The shaded areas are of special interest.
Only 15% of the water is absorbed into the circulatory system in PSP performed with normal salt solution, but 50% of the water is absorbed when half-strength salt solution is used. The greater the quantity of water absorbed, the longer the kidneys take to excrete it - about 12 hours or more. For people with jeopardized kidney, heart or vascular functions, this may not be advisable. One may think that by reducing the salt content the safety of the practice will increase. In fact, by reducing the salt content the practice becomes unsafe. Hence, it is advisable to observe the contra-indications diligently and to avoid modifying the practice of PSP. While the results in Stage 2 are from people with NIDDM, it is expected that similar results would be seen in people in good health.