Buteyko

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Consult a Buteyko teacher and medical/health practitioner before proceeding with any exercises or treatments.

About the Author: Paul J. Ameisen, MBBS, ND, DipAc, FACNEM, has been a Medical Practitioner for 21 years. His first appointment was as Resident at St Vincents Hospital, Sydney. He has since practised at Liverpool Hospital, Sydney; Framingham Union Hospital in Boston, USA; Baragwanath Hospital, South Africa; and Mudgee District Hospital, NSW, Australia. He has a Diploma of Naturopathy, a Diploma of Acupuncture from Medicina Alternativa, and is a Fellow of the Australian College of Nutritional and Environmental Medicine.

Dr Ameisen is currently in private practice. He is the author of Every Breath You Take (Lansdowne Publishing, Sydney, 1997, ISBN 1-86302-567-7).

Russian physician Professor Buteyko developed this simple, drug-free treatment for asthma and other diseases after he noticed that over-breathing disturbs the metabolism and makes the body more prone to illness.

I have been a medical practitioner for twenty-three years, with both city and country practices and overseas postings, and in that time I have treated thousands of asthma patients. Like every conscientious medical doctor, I have kept up to date with the latest research and with advances in techniques and medication in order to help my patients to the best of my ability. This has been especially important to me, as I take a keen interest in respiratory diseases. In addition, much of my work has been in Australia, where a major respiratory disease has a strong hold. Australia and New Zealand have more asthma sufferers per capita than any other countries in the world. More than one million people (some estimate nearly two million) have asthma in Australia; that is, 25% of children, 15% of teenagers and 10% of adults. In New Zealand, 700,000 people, or 20% of the population, have asthma. In 1995, one New Zealand child in five had asthma; for Maori children, the figure was one in three.

Asthma is on the increase in the industrialised countries of the world. In the USA, 16 million people suffer from it, as do three million in the United Kingdom. Boys have asthma more commonly than girls, and about one child in four has asthma at some stage of development. About half the children with mild asthma will improve and "grow out of" the condition through their teenage years. The others have to continue with a disease that can interfere with their pleasure in life, their education, their sporting interests, their well-being and even their relationships with family and friends. Adult or "late onset" asthma also occurs, more frequently in women than in men. These unlucky people not only suffer acute discomfort, disruption of every aspect of their lives and often sheer misery from their condition, but they may also be facing a threat to their life. Not only is asthma itself on the increase, but so are deaths from asthma attacks. It is a frightening fact that in Australia in 1996, for instance, asthma attacks caused more than 800 deaths.

Medicine in the 20th century has not coped well with asthma. The number and availability of drugs to treat the disease have been sharply increasing since the beginning of the century, but so has the incidence of asthma. The Asthma Foundation of Australia reported that the incidence of asthma in children in Australia doubled between 1982 and 1992. As a doctor, I could not help wishing that there were another way of helping a child control his or her asthma, instead of having to fall back on an increase in the drugs I prescribed.

Then, in the early 1990s, I first became aware of the work and methods of a certain Professor Konstantin Pavlovich Buteyko, a diagnostic respiratory physician whose techniques, developed in the 1950s, were considered a breakthrough in Russia and still are, after decades of research and treatment of asthma patients. It was two of my patients who told me about it - a mother and daughter who had attended a clinic in Sydney and had both derived extraordinary benefit from the simple breathing technique that they were taught by the Buteyko practitioner.

I became interested, and I observed the technique over a long period. Doctors are always cautious about any new research or treatments they observe, and I was no exception. But there is nothing more convincing to a scientific mind than genuine, sustained and verifiable results, and I eventually became convinced, from the objective evidence, that I was looking at a dramatically effective treatment for asthma. I began referring patients to the clinic and became supervising medical officer, so this enabled me to monitor and help my patients and others even more effectively. Consequently I have also been able to make a study of the 8,000 patients treated so far in Australia, and when invited I have spoken on radio and television about the far-reaching, beneficial effects of this natural, benign method. My book, Every Breath You Take, was the result of six years of research into the method and the results it has achieved for asthma sufferers. The results are astonishing and suggest a direct link between our breathing patterns and our level of health.

THE THEORY BEHIND THE BUTEYKO METHOD
The Buteyko theory is that the basic cause of asthma is habitual, hidden over-breathing (literally, taking in too much air when breathing). The treatment is based on bringing the breathing to normal levels and thus eradicating over-breathing (hyperventilation) and reversing the need for the body's defence mechanisms. These defence mechanisms, according to the theory, include spasm of the airways, mucus production (in the chest, nose, throat and ears), and inflammation (swelling) of the bronchial walls.

The Buteyko method's message is that when asthma sufferers learn to alter the volume of air they habitually inhale, their asthma attacks can be significantly reduced and the use of asthma drugs and apparatus can be reduced or entirely eliminated. It is possible that the economies of the industrialised countries worldwide could save billions of dollars spent annually on asthma drug subsidies and hospitalisation, if their health administrators took notice of the advances in asthma treatment pioneered by Professor Buteyko.

The method is on record as having benefited 100,000 patients in Russia, and it is officially recognised by the Russian Government. Professor Buteyko's experimentation and his documented clinical trials on patients in Russia indicate that the great majority of asthma sufferers over four years old can be significantly relieved by the method (younger children may find it more difficult to learn), and any individual on asthma drug treatment can reduce that drug intake by 90% or more in the majority of cases. Outside Russia, the first Buteyko clinical trials on asthma sufferers were completed in 1995 in Australia by Associate Professor Charles Mitchell of the Queensland University Medical School, Dr Simon Bowler of the Mater Hospital and Ms Tess Graham of the Buteyko Group. The results of the first half of the trial, which were presented to a conference of the Thoracic Society in Hobart on 30 March 1995, supported the findings of Professor Buteyko, and a press release at the time made the general findings public.

The Buteyko method is taught in all capital cities and many country areas of Australia, as well as in New Zealand, Europe and the United States [see contact details at the end of this article].

With more than 10,000 people having learnt the method in Australia as at mid-1999, the success rate continues to be very high. Asthma sufferers attending the clinics have found that, after learning and practising the method, they can reduce their use of relievers and preventers to varying significant degrees. It is impossible to overestimate the importance of the Buteyko method for asthma sufferers and their families. I believe it is the great medical breakthrough of the 20th century, and I am proud to be author of the first-ever book on this subject outside Russia. The book was the result of my own investigation of the theory and practice of the method, and relied on my close experience with the clinics and the patients who have benefited from the method. That experience is ongoing and growing. I have the sanction of Professor Buteyko and of the Buteyko clinics to reveal the method, its scientific bases, and its results.

NORMAL BREATHING 3 to 5 litres per minute, healthy level of 6.5% carbon dioxide in air sacs.

HIDDEN OVER-BREATHING 5 to 10 litres per minute, results in very gradual sickness not easily noticed, and illness develops over many years.

OVER-BREATHING 10 to 20 litres per minute is known as an "attack", where the adult asthma sufferer, or a person with a condition, hyperventilates rapidly.

SEVERE OVER-BREATHING 20 to 30 litres per minute. At this maximum level, the person suffers a sudden anxiety attack.

THE IMPORTANCE OF CARBON DIOXIDE
You may have thought that in a discussion about the lungs we would talk about oxygen first and foremost. But the first thing I want to bring up here is how important carbon dioxide is in the body. In fact, we know that each human cell needs a specific concentration of carbon dioxide - about 7% - to sustain normal life.

When human life first began on the planet, the composition of the atmosphere was different from what it is today, for there was more than 20% of carbon dioxide in the air that living beings breathed. But the percentage has fallen greatly, and now our air contains only 0.03% of carbon dioxide. Our bodies have had to compensate gradually for this, and they have done so by creating an internal air environment in the small air sacs inside the lungs. With the action of normal, healthy breathing, these air sacs, or alveoli, contain around 6.5% of carbon dioxide. So, as we breathe in and out normally, that 6.5% of carbon dioxide exists inside the lungs, in balance with the oxygen that we also need to stay alive.

An important factor that seriously affects that level of necessary carbon dioxide in the lungs is over-breathing, also known as hyperventilation. If we breathe in too great a volume of air for our body's needs, we breathe off carbon dioxide too rapidly and the lungs are unable to maintain the right level in the air sacs. When carbon dioxide is low due to over-breathing, this causes a chemical reaction that makes it hard for oxygen to be released from the bloodstream into the tissues of the body. The tissues of the body then become starved of oxygen, despite the blood being rich in oxygen. Tissues starved of oxygen cannot be healthy: they become irritable; and smooth muscles react by going into spasm. Smooth muscle is found around our air tubes and around blood vessels, arteries and veins, and forms part of the wall of the intestines. Oxygen starvation of vital organs (such as the brain) excites the breathing centre in the brain, thereby creating a state of breathing stimulation. This increases the breathing even further, creating a "shortness of breath" sensation in the already deep-breathing person, which further deepens the breath and creates a vicious circle because even more carbon dioxide is breathed off.

THE RESULTS OF OVER-BREATHING
Professor Buteyko came up with the theory that a majority of the human population actually over-breathes, some more severely than others. Because people are unaware of this factor, he called it hidden hyperventilation - long-term over-breathing not clearly visible to the individual. He noticed that the result of obvious over-breathing has the equivalent effect of an acute and serious anxiety attack: shaking hands, anxiety, chest pain, air hunger, finger tingles and spasm (tetany), cramps and racing pulse. He went on to find that the effect of less serious over-breathing, which is not noticed immediately, has equally dire consequences for a person's health over time.

The amount of air we breathe is measured in litres. Table 1 shows the effects of normal breathing and over-breathing. In general, the person's system becomes ill through over-breathing, and is then more prone to viral illness and allergies. The shift in the rate of body activity disturbs the normal flow of chemical reactions in the body and results in further illness.

If over-breathing disturbs our basic total metabolism, as the Professor believes, we can start to understand how it might cause a diverse set of symptoms: bronchospasm (spasming of the air tubes), heart blood- vessel spasm and increased blood pressure. These symptoms are recognised and help us define certain diseases: asthma, angina and hypertension. Professor Buteyko concluded that if breathing is not corrected, this in turn leads to further deterioration of asthma, sclerosis (hardening) of blood vessels and lungs, myocardial infarction (heart attack) and strokes. In fact, he claims over-breathing to be directly linked to at least 150 diseases. The Buteyko theory states that these diseases are the body's defence mechanism against the excessive loss of carbon dioxide through over-breathing.

It is important to remember that the human organism tries at all times to keep carbon dioxide at the normal, beneficial level in the lungs. Buteyko theory explains that when we over-breathe; the body adopts a defence mechanism to retain carbon dioxide.

1. Spasm of the airways and air sacs. These close up to make openings narrower in an effort to keep the carbon dioxide in the lungs.
2. Mucus and phlegm development. This is another way for the body to narrow the airways in an attempt to trap the carbon dioxide.
3. Swelling of the mucus lining and the bronchial tubes. This is a further way for the body to narrow the airways. Asthma sufferers will instantly recognise the above symptoms. There is another that is not obvious to those who over-breathe
4. Increased production of cholesterol in the liver. This causes a thickening of the cell walls of the blood vessels, which in turn prevents transfer of carbon dioxide from the blood vessels back to the small air sacs in the lungs.

Professor Buteyko concluded that to avoid making the body ill through over-breathing, and also to avoid the uncomfortable and unpleasant effects of the defence mechanism at work, the solution was to educate the over-breathers so that they could learn to breathe in a shallower way, so that their lungs could return to normality - that is, with the carbon dioxide level at around 6.5 per cent. To achieve this re-education, it was important for people to see what factors were making them over-breathe in the first place.

TRIGGERS THAT MAY CAUSE OVER-BREATHING
According to Professor Buteyko's research, the majority of people over-breathes or hyperventilates. Some people seem to over-breathe more than others, so they may be more susceptible to certain external factors.

There are a number of triggers that seem to make this situation a special problem for those who have a tendency towards asthma:

1. The belief that deep breathing is helpful and improves health. This is received wisdom in the Western world, though not in Eastern cultures, where shallow breathing is practised for bodily and mental health. We breathe in more air when we exercise, it is true, but it does not follow that regular deep breathing is beneficial. In fact, try to make the barbecue fire catch by breathing in deeply and blowing out hard, and you will rapidly become faint. Observe top athletes and swimmers: these super-fit people have the slowest pulse and shallowest breathing in the population. A fit, healthy body breathes slowly and more shallowly. Swimming is the best sport for asthma sufferers because swimmers hold their breath while exercising; they practise the Buteyko method without realising it.

2. Stress from both positive and negative emotions. Both excitement and depression cause stress, and research shows that people under stress over-breathe.

3. Over-eating. When we eat too much, the system has to work harder to process the food, and this can cause over-breathing. To avoid this, one should not over-eat. It is also a fact that animal protein makes the body work harder. Many asthma sufferers will have noticed that red meat and cheese (animal protein), for example, sharply increase hyperventilation. To avoid over-breathing caused by the food we eat, it is better to eat more plant products than animal products. You should also eat raw food more than cooked food, as raw food causes less over-breathing.

4. Lack of regular exercise. Physical activity, on the other hand, encourages the release of carbon dioxide from the body cells, increasing its level in the lungs. In vigorous exercise (except for swimming), of course, we breathe deeply, which results in a short-term drop in the carbon dioxide level, but the long-term result of fitness is a higher level of carbon dioxide in the lungs and better nourishment of all the cells in the body.

5. Prolonged, excessive sleep. Professor Buteyko's research demonstrates that lying down for a long time, especially on the back, while asleep or while bed-ridden, causes severe over-breathing. Techniques to avoid over-breathing in horizontal positions are described later. Patients should sleep only 6 to 7 hours if possible, on the left side, and breathe through the nose with the mouth firmly shut.

6. Hot and stuffy environments. We over-breathe when our body detects that the air we are breathing does not contain what we need. On the other hand, mild or cold temperatures all assist shallow breathing - a conclusion reached after 10 years of research and measurement. We soon realise this when we sit in a sauna: sweating may detoxify the body, but it also creates extra work, causing hyperventilation. When we move from a cooler climate to a hot one, a similar reaction can occur.

7. Bronchodilators. These are standard medication for asthmatics. Bronchodilators give quick relief at first, but Professor Buteyko argues that they in fact cause further over-breathing because they are designed to open the air passages and keep them open maximally for 4 to 12 hours, allowing the sufferer to continue what he or she thinks of as "normal" breathing. Based on Professor Buteyko's research, a person who suffers from asthma is an over-breather, so after 2 to 12 hours the low carbon dioxide level means that their airways will go into spasm again, and the bronchodilator will be needed once more. This is a vicious circle.

8. Excessive sexual activity. The hyperventilation in sexual activity is obvious - and normal. It is only when this activity becomes excessive because of a sex addiction that hyperventilation becomes a problem, because it lowers the level of carbon dioxide in the lungs.

9. Smoking and pollution. When we walk into a smoke-filled room we may cough; this is because we are entering a situation that is allergic and toxic. We also get the signal, "not enough air", so we over-breathe. Some people, asthmatics included, react more sensitively to such situations than others and have the same reaction to pollution: over-breathing.

10. Alcohol and recreational drugs. These put a stress on the body due to their toxicity and over stimulation, and Professor Buteyko's studies give evidence that they lead to over-breathing.

THE PHYSIOLOGY OF BREATHING
We all know that breathing plays a vital role in the human organism. Nutrition is of major importance to us, yet we can survive without food for weeks and without water for days. But if the average individual is without air for three to five minutes, he or she cannot survive. We normally breathe 20,000 to 30,000 times every 24 hours.

The optimal level of carbon dioxide (CO2) in the alveoli, or small air sacs in the lungs, is around 6.5%. If for any reason (such as over-breathing) it falls below this, there is a gradual alkaline reaction, called respiratory alkalosis, in the lungs. At the extreme, if the carbon dioxide level falls to below 3%, shifting the pH (the acidity level) to 8 (more alkaline), the organism dies. When the carbon dioxide level is lowered, the gradual alkaline reaction in the lungs carries through to the blood, and total blood CO2 will also be low. The kidneys further try to "buffer" or correct this imbalance. This partially makes up for the CO2 deficiency, but it sets up a course of events that changes for the worse the rate and efficiency of activity of all the vitamin and enzyme systems in the body - and it is these systems that run our energy and vitality.

While air is held in the lungs, the molecules it contains pass through the walls of the alveoli and into the blood, to be carried around the system to nourish the body tissues. Oxygen is carried in the blood by means of a haemoglobin (Hb) molecule (which is part of a red cell). When the carbon dioxide level is low due to over-breathing, the oxygen is held tighter than normal to the Hb molecule, due to a chemical bond, and cannot readily separate itself from the haemoglobin. Not enough oxygen is getting into the tissues, so they become starved of oxygen. This oxygen starvation of the tissues is called hypoxia.

� Smooth muscle, found around bronchi and bronchioles or air tubes, around blood vessels, arteries and veins, and as part of the wall of the intestines. You can guess that smooth muscle is of importance in asthma.

� Cardiac muscle, i.e., specialised muscle cells, each cell able to contract by itself.

As stated before, tissues starved of oxygen cannot be healthy - they become irritable; and the way smooth muscle reacts in distress is to contract or spasm. Thus, we start to understand that if carbon dioxide is not at its proper or normal level (6.5%) in the air sacs and falls too low through over-breathing, the oxygen becomes more bound to the haemoglobin molecule and is less able to separate and feed the tissues.

Now, children in the Western world are generally taught that the deeper they breathe, the more oxygen they get "inside". Most adults believe this, as well as in the efficacy of all sorts of "deep breathing" exercises. It is true that we take in more oxygen when we breathe deeply, but how much oxygen is then available from the blood to the tissues? This availability is governed by something known as the Verigo-Bohr effect, where lowered levels of CO2 strengthen the bond between haemoglobin and oxygen, thus lowering the oxygenation of the tissues. The stated purpose of the Buteyko method is to reverse the Verigo-Bohr effect.

To summarise, oxygen enters the lungs, goes into the blood and is trapped by the haemoglobin molecule. How easily it is released to feed the body cells depends on the level of carbon dioxide. The oxygen is properly released when carbon dioxide is at a high level in the lungs. If it is low, the tissues suffer oxygen starvation. Oxygen starvation affects all the vital organs, and it has a particular effect in one of them, the brain: it excites the breathing centre located there, setting off a state of breathing stimulation. This increases the breathing even further, creating a "shortness of breath" sensation in the already over-breathing person, which further deepens the breath. So then there is a further progressive decrease (breathing off) of carbon dioxide from the lungs.

The way to reverse this process is to breathe more shallowly, to trap more carbon dioxide in the lungs and return its level to normal. If the carbon dioxide rises again to normal levels, oxygen is more readily released from the haemoglobin molecules and can then nourish the tissues and cells. It is interesting to note that few medical experts in the Western world have taken very much account of the idea of shallow breathing. Eastern ideologies, on the other hand, have proposed for centuries that there is value in stopping over-breathing, and have made breath control part of a wide range of exercises for the body and mind, examples being the practice of meditation, yoga (pranayama breathing), Tai Chi, Chi Gong, and Judd-Shi from Tibet.

THE AIM OF THE BUTEYKO METHOD
Over-breathing, then, is an increase in the function of the lungs above what is normal. It is also called hyperventilation. The significance of Buteyko's discoveries hinges on the diagnosis of what he termed hidden hyperventilation. This is long-term over-breathing that we are basically not aware of. A series of regulated breathing exercises is used to teach the person who over-breathes to breathe a normal volume of air for the rest of his or her life. It can be done - thousands of relieved patients have proved it - and the technique is so simple that a child can follow the method and even have fun while learning.

THE BUTEYKO BREATHING EXERCISES
The Buteyko course consists of five to ten sessions of tuition, varying from one to two hours each. Usually five to seven sessions of one hour are enough for the patient to witness improvement and have confidence in the technique. However, the most severe cases, such as those who need regular hospital admittance, may require up to nine months of practice to achieve the desired level of health.

In the Buteyko technique, patients are taught to normalise their breathing. They are asked to:

2. Tape the mouth up while sleeping, unless there is some severe nasal condition. Adults can easily adapt to this, but it often frightens parents initially. However, I have seen no child come to any harm over seven years of recommending the practice. Partial taping can be practised until children and parents become more confident. A very light, easily removable micropore tape is used.

3. Sleep on the left side and avoid sleeping on the back. Sleeping on the back causes the most hyperventilation. Professor Buteyko's research has shown that sleeping on the left side causes least hyperventilation.

The Control Pause
The control pause is described as the time it takes someone to breathe out normally, then hold his or her breath in the out position until the very first signs of discomfort occur. That measurement is recorded, and then the person continues to breathe through the nose in a shallow pattern. Most people can achieve 10 to 20 seconds, at rest. Some cannot achieve even one second, while others can do 40 seconds plus, quite naturally. The idea is to succeed in holding the breath in the out position for up to 50 to 60 seconds, until first difficulty is reached, to achieve the desired improvement. This is the measure of success. If a person has a control pause of 15 seconds, he or she is breathing a volume of air per minute that is enough for four people. A control pause of 30 seconds indicates the person is breathing for two people. A control pause of 60 seconds means breathing is under control and he or she is breathing for one person.

The Maximum Pause
The maximum pause is the time it takes a person to breathe out normally, hold his or her breath in the out position and, through specially taught exercises and distractions, prolong this pause to the maximum time. With exercise, repetition and perseverance, some people surprise themselves with times of up to two minutes and even longer.

Patients are asked to come to classes for education and encouragement in these breathing exercises and to discuss problems and incidentals such as coincidental viruses, personal problems and so on. Often, family members are invited to attend, free of charge, to encourage the patients further.

Between the classes, patients are urged to follow the four rules set out above (only nasal breathing, sleeping on left side, etc.), and to follow a rigid regime of breathing exercises. Twice daily exercises for 20 minutes are required.

Some people with mild illness stop their exercises after some two months and find their breathing has changed to a shallower pattern, where they take in less air or take smaller breaths. They can then stop their exercises altogether, as they no longer hyperventilate.

So, in order to prolong the maximum pause, firstly the patient, under supervision, breathes out to the maximum, holds the nose and firmly closes the mouth while seated upright. Then, he/she holds the breath in expiration (that is, with "empty" lungs) until he/she feels uncomfortable.

The person then continues in expiration while utilising one or more distractions:

1. Body gyrations. These involve moving the torso about while holding the nose - flinging the body from side to side, bringing the head towards the knees, rocking from side to side, and rocking forwards and backwards.

2. Mobile exercises. Finally, the sitting gyrations don't distract the person enough and he/she stands up while holding the nose and begins to walk around the room in circles. He/she may walk outside the room, keeping on the move until he/she can really no longer hold the breath. In our clinic, this is often called "the Groucho Marx walk".

3. Nose-breathing. The person then tries to prevent over-breathing by breathing strictly through the nose. He/she sits down again and deliberately tries to achieve a shallow breathing equilibrium. After a rest of two to three minutes of shallow nose breathing, another control pause is carried out.

4. Fun & Games. Children usually make a game of the exercises. When they start to have difficulty holding the breath, and really want to breathe in while they are sitting down and holding the nose, they pace out steps around the room and count up the number of steps in their heads. Some do squats; some jump up and down on the spot. Afterwards, they compare their results with others. Both children and adults can be fiercely competitive over their achievements!

Adult asthma sufferers are usually accustomed to using peak- flow meters. But rather than using the meters (which can be used if desired, however), Buteyko practitioners prefer to use a single instrument: the stopwatch. Success is measured as each person's increase in control pause is accurately timed.

Maximum pause can be stretched to surprising lengths, but it is the control pause that is the final measure of success. If the feeling of first difficulty does not arise until 40 to 60 seconds have passed, a patient can feel confident that his/her respiratory problems are improving rapidly, that the hyperventilation is being corrected and that the oxygen and carbon dioxide ratio has been normalised. However, if the person feels an attack coming on, he/she can do one maximum pause, then three minutes' shallow breathing, then one more maximum pause. If no relief is felt, the patient can take one puff of the bronchodilator and, if necessary, one puff five minutes later.

A typical session of Buteyko breathing exercises

� Mild cases of asthma tend to be episodic, and may be triggered by types of exercise or by viral infections. Once the Buteyko method has been learned and practised correctly, mild cases tend to need only episodic treatment with bronchodilators and episodic breathing exercises.

� Moderate cases are those who suffer from frequent asthma or mild continuous asthma, and those who make regular use of a bronchodilator with usually a steroid preventive inhaler. The exercise requirements for these people are 2 to 4 times per day for 20 minutes.

� Severe cases are usually on medication of two different types of bronchodilator inhalers plus steroid inhaler, with or without oral steroids and with or without other agents like methotrexate. They tend to need frequent hospital visits. The breathing exercise requirements for people who suffer serious attacks, with protracted stays in hospital, are 3 to 5 times per day for 20 to 30 minutes initially, later easing to two sessions. To achieve best results, these sufferers may need 3 to 12 months of practice.

A Final Note of Caution
The purpose of this article is to familiarise the reader with the Buteyko theory and method, not to serve as an instruction manual. The Buteyko method should not be learned without expert supervision. Consult a Buteyko teacher and medical/health practitioner before proceeding with any exercises or treatments. About the Author: Paul J. Ameisen, MBBS, ND, DipAc, FACNEM, has been a Medical Practitioner for 21 years. His first appointment was as Resident at St Vincents Hospital, Sydney. He has since practised at Liverpool Hospital, Sydney; Framingham Union Hospital in Boston, USA; Baragwanath Hospital, South Africa; and Mudgee District Hospital, NSW, Australia. He has a Diploma of Naturopathy, a Diploma of Acupuncture from Medicina Alternativa, and is a Fellow of the Australian College of Nutritional and Environmental Medicine. Dr Ameisen is currently in private practice. He is the author of Every Breath You Take (Lansdowne Publishing, Sydney, 1997, ISBN 1-86302-567-7).

The Buteyko Method of Therapeutic Breathing for Allergies ME/Chronic fatigue Asthma Migraine Depression Panic attacks Eczema Rhinitis Emphysema Sinusitis Gulf war syndrome Sleep Apnoea Hyperactivity Sleeping disorders High blood pressure Snoring

"Modern medicine has slipped to the levels of blind empiricism. This appears to have happened because attempts to find the causes of diseases such as asthma, stenocardia, hypertension, etc., have been fruitless therefore an important principle of medicine is being trampled on. The very principle upon which the Buteyko philosophy is based: "Having not found the reason of the disease, the physician has no right to treat the patient. Only having discovered the reason for the disease is it possible to guarantee recovery." Modern medicine, as it stands at the moment, has either stopped looking for the causes of asthma, stenocardia, hypertension, etc., or it has false impressions of their reasons. That is why these diseases continue to remain incurable. Through understanding "trigger factors" we can only hope to treat the problem symptomatically. Only through the understanding of the cause of the disease, can we hope to cure. The aim of the Buteyko method is to correct the patient's breathing pattern, that is recondition the breathing pattern to internationally recommended levels. Through this process the shortfall of carbon dioxide is rectified. The Buteyko process is completely safe and drug free." - Professor K.P. Buteyko

The Buteyko technique represents a development of the hyperventilation syndrome theory. This theory is based on the contemporary understanding of the immense biological role of carbon dioxide gas in the human organism. The human metabolism developed in the ancient geological eras when carbon dioxide in the air and water measured in tens of percent. It is probably due to this factor that a definite concentration of carbon dioxide gas (approximately 7%) must be an absolutely essential condition of each human cell in order for it to sustain all the normal pathways of the biochemical processes.

The problem faced by the evolving human organism has been the depletion of carbon dioxide in our atmosphere from the tens of percent of ancient eras to the current level (1982) of 0.03% [1996 of 0.035%]. Human evolution has dealt with this dilemma by creating an autonomous internal air environment within the alveolar spaces of the lungs. These alveoli contain around 6.5% of carbon dioxide, quite a contrast to the surrounding air. The gaseous mix in the womb is also an interesting indicator of the ideal human environment. Here there exists between 7 to 8% of carbon dioxide. Professor Buteyko was asked to speak on this subject at the World Congress of Bio chemistry that took place in Moscow in 1972.

Carbon dioxide is, through the conversion into carbonic acid, the most important buffer system in the body's regulation of its acid-base balance (acid-alkali balance). A low level of carbon dioxide may lead to alkalosis. If the level of carbon dioxide lowers to below 3% shifting the pH to 8 then the whole organism dies.

A low level of carbon dioxide causes a displacement of the oxyhemoglobin dissociation curve, thereby not allowing correct oxygenation of the tissues and vital organs. (Bohr effect)

Carbon dioxide is a smooth muscle vessel dilator. Therefore a shortfall of carbon dioxide causes spasming of the brain tissue and, bronchus tissue etc., etc.

Hyperventilation causes a progressive loss of carbon dioxide. The higher the breathing, the lower the carbon dioxide level.

Carbon dioxide is the catalyst to the body's metabolic processes, playing a vital role in biosynthesis of amino acids and their amides, lipids, carbohydrates, etc. This is explained in more detail in "The Biochemical Basis of K.P. Buteyko's Theory of the Disease of Deep Respiration".

Through an understanding of current physiology we should begin to see links between carbon dioxide and oxygenation of the body, carbon dioxide and disease. It is clear that a deepening of the breathing does not mean an increase in oxygen uptake. On the contrary it means a decrease in oxygenation, which leads to hypoxia, imbalance in the acid-alkali balance, and cell spasming.

The fifth point of physiological understanding explains the destructively poisonous influence that hyperventilation has on the organism. It shows us clearly (in conjunction with the other points) that over-breathing leads to imbalance in the body and general deterioration of health.

The term "hyperventilation" should be clearly defined. It is not reserved only for the most extreme and visible cases. Hyperventilation simply means "an increase in the function of the lungs above the normal recommended amount". The significance of Buteyko's discoveries hinge on the diagnosis of what Buteyko termed "hidden hyperventilation", that is long term over-breathing that is not clearly visible in the patient.

If a patient hyperventilating 30 Lt/min can receive disastrous physical repercussions in the very short term, then it should be understood that over-breathing 5-10 Lt/min would have equally dire consequences over the long term. The average asthmatic over-breathes between 3-5 times the recommended amounts, sometimes more.

The detrimental influence of the deep breathing on the organism is a direct result of the creation of a carbon dioxide deficit. This has been proven by many experiments, starting with the work of the well-known physiologist, Dr. D. Henderson, in 1909. In his experiments, animals were mechanically induced to deep breath and died as a result.

Through its conversion into carbonic acid, carbon dioxide is the most vital player in the maintaining of the body's acid-base balance. Lowering carbon dioxide in the lungs by deep breathing shifts the body's pH towards alkalinity, which changes the rate of activity of all body ferments and vitamins. An alkaline system is more 'susceptible to virus' and allergies. The shift in the rate of metabolic regulator activity disturbs the normal flow of metabolic processes and leads to the death of the cell. As mentioned before, if the level of carbon dioxide is lowered below 3%, shifting pH to 8, the whole organism dies.

Symptoms of various combined disturbances in the organism of a deep-breathing person are exceptionally diverse. The traditional methods of disease analysis have resulted in the various symptoms of over-breathing: (bronchospasms, heart muscle spasms, increased or decreased arterial pressures, fainting spells with convulsions) being called separate illnesses: bronchial asthma, stenocardia, hypertension, allergies, etc. The latter named all lead to complications, sclerosis of the lungs and vessels, myocardial infarcts, and strokes.

The theory of the disease of deep breathing has previously been presented in a lecture: "On Discovery of the Deep Breathing Being the Principal Reason for Allergies, Sclerosis, Psychosis, Tuberculosis, Precancerous Conditions and Other Symptoms of Disease".

In that lecture Professor Buteyko mentioned that his discovery is not only represented in the method of treatment of diseases, but in the exposure of their causes. Professor Buteyko believes that modern medicine has slipped to the levels of blind empiricism. This appears to have happened because attempts to find the causes of diseases such as asthma, stenocardia, hypertension, etc., have been fruitless therefore an important principle of medicine is being trampled on. The very principle upon which the Buteyko philosophy is based: "Having not found the reason of the disease, the physician has no right to treat the patient. Only having discovered the reason for the disease is it possible to guarantee recovery."

Modern medicine, as it stands at the moment, has either stopped looking for the causes of asthma, stenocardia, hypertension, etc., or it has false impressions of their reasons. That is why these diseases continue to remain incurable. Through understanding "trigger factors" we can only hope to treat the problem symptomatically. Only through the understanding of the cause of the disease, can we hope to cure.

It has eventuated, through Professor Buteyko's research, that deep breathing is directly linked to at least 150 diseases. Buteyko has conducted an immense synthesis of diseases and has found that diseases such as asthma, hypertension, stenocardia, myocardial infarcts, strokes, haemorrhoids, eczema, amongst others, are all symptoms of imbalance created by deep breathing. In cases where Buteyko's patients had these diseases, they have all been cured, as was proven in the Leningrad and Moscow approbations. The Buteyko theory cites that these diseases are the body's defence mechanisms against the excessive loss of carbon dioxide through over-ventilation.

The lowering of carbon dioxide in the nerve cells heightens the threshold of their excitability, alerting all branches of the nervous system and rendering it extraordinarily sensitive to outside stimuli. This leads to irritability, sleeplessness, stress problems, unfounded anxiety fears, allergic reactions, etc. Concurrent with this, the breathing centre in the brain is further stimulated thereby causing a further loss of carbon dioxide. In this way another vicious cycle has commenced.

Having touched directly on the physiological problems of hyperventilation, and the resulting "blowing off" of too much carbon dioxide, an obvious question arises: What is the cause of deep breathing itself? What is hyperventilation a consequence of? There are several factors known to induce deepening of the breath. The most important factor, in Buteyko's opinion, is the propaganda of the usefulness of deep breathing.

The contemporary man starts to be taught to breathe deeply even before he is born, when his mother is sent for sessions of deep breathing exercises during her pregnancy. Often the newly born is encouraged to increase his breathing by having his little arms raised and lowered. And so it follows on, in kindergartens, schools, armies, sport, etc. Deep breathing is encouraged without any scientific basis.

There are other factors as well - overeating, especially of animal protein (fish, chicken, eggs, milk and naturally meat) sharply increases breathing. It should be noted that animal products increase breathing more than plant products: cooked foods more than raw.

Another factor deepening the breath is a state of limited mobility, lack of physical work or activity, idleness. Physical activity encourages the release of carbon dioxide from the cells. Increasing its levels in the body. The breath is deepened by hydrodynamics, by bed rest regimes, by prolonged horizontal positions (especially lying on the back), prolonged sleep.

Recommendations for longer periods of sleep and even sleep therapy have never cured anybody. Most attacks of epilepsy, asthma, myocardial infarction, strokes, paralysis, etc. occur towards the end of sleep, around 5 a.m. Further factors deepening the breath are the various emotions either positive or negative, stress, heat, and stuffy environments. And the other way around, calmness, temperance cold temperatures, all assist the shallow breathing.

The aim of the Buteyko method is to correct the patient's breathing pattern, that is recondition the breathing pattern to internationally recommended levels. Through this process the shortfall of carbon dioxide is rectified. The Buteyko process is completely safe and drug free.

In contrast to the dangers of low carbon dioxide, if the breathing is decreased to below normal and the level of carbon dioxide is above normal by 0.5 to 1.0%, there are no negative symptoms manifested. On the contrary, those afflicted with the heavy consequences of deep breathing e.g., bronchial asthma, stenocardia, hypertension, develop symptoms of super-endurance with higher than normal levels of carbon dioxide. The Buteyko clinics have been regularly observing this for the second decade now. It is evident that decreasing of the depth of breathing does not result in any kind of undesirable occurrences.

What is the normal or correct amount of air we should be breathing? This varies from person to person, although on average 3-4 litres per minute.

While the Buteyko method introduced into the west has been getting excellent results, it does not entirely accord with Professor Buteyko’s recommended practice. During two weeks he spent in New Zealand in December 2000, he demonstrated the Buteyko technique, as it should be practiced.

Firstly, it needs to be understood that breathing too much is a bad habit that leaves you with a debilitating shortage of carbon dioxide and bicarbonate. It usually results from long term, undischarged stress. Any stress makes you breathe more. If this is sustained over a long time period it becomes a habit. The physiology behind this habituation process is well understood. Buteyko therapy aims at reversing this, by habituating to less breathing. You do this by developing and sustaining a feeling of a slight shortage of air over a long time period. This gradually restores your carbon dioxide and bicarbonate levels back to normal.

While it is possible to stifle an asthma attack with a long and uncomfortable breath hold know as a maximum pause (MP), this procedure does not reverse your asthma and does not retrain the respiratory centre to pace your breathing correctly. Professor Buteyko is emphatic that the maximum pause has no therapeutic value in restoring healthy breathing, which is the aim of his therapy. It is also dangerous for people with various disorders such as hypertension, heart disease, epilepsy, kidney disease and diabetes. It can also destabilize your breathing, making it worse.

Unfortunately the maximum pause has been introduced into a westernised version of the Buteyko technique, much to the annoyance of the Professor.

An understanding of the physiology behind the Buteyko method leaves no doubt that the maximum pause cannot improve your breathing.

Professor Buteyko is firmly opposed to the DIY/self-help approach. The Buteyko technique relies 100% on patient compliance for effectiveness. Learning it from a script is like learning Yoga or martial arts from a book. Most people will experience changes in their bodies as their CO2 levels rise. These changes vary from one individual to another. Buteyko practitioners’ help you deal with these changes, keep you motivated and ensure that you do the breathing exercises correctly. Support for your Buteyko practitioner enables him to continue his work of bringing the technique to other sufferers. Nevertheless, very few people around the world have access to a Buteyko practitioner. So here are some basics to help get you started.

Do not make any changes to medication. Steroids must be taken as prescribed. Because of carbon dioxide shortage asthmatics often don’t make enough Cortisol (natural steroid) and must have supplements. Steroids are not just anti-inflammatory but the body needs them and without the right amount it can be almost impossible to get breathing back to normal. Your doctor will be able to review your need for steroids when you stop having asthma symptoms.

Bronchodilators must be taken only when needed. As you progress, discuss with your doctor the possibility of weaning yourself off long acting bronchodilators and replacing them with short acting ones. That will give you more control over using them when needed. You should find that within days you will be able to overcome asthma attacks with reduced breathing and won’t need the bronchodilators. Nevertheless, you must always carry them with you for emergencies.

Always breathe through your nose. If your nose is blocked perform the following exercise: After breathing normally (do not make any exaggerated breathing manoeuvre), hold your breath for as long as is comfortable, and then gradually resume very gentle breathing. It may help to pinch your nose, nod your head a few times or do some other form of exercise. In stubborn cases or when the blockage is due to a cold, you may have to try a few more times.

To avoid breathing through your mouth in your sleep, you might like to experiment with a little light medical paper tape to keep your mouth closed. Professor Buteyko does not recommend mouth taping at night, but most people find it extremely valuable. If you do, protect your lips with suitable cream, use a low tack tape (some are quite aggressive), and make sure you fold a tab or handle at each end for rapid and easy removal. Do not go to sleep with tape on your mouth if this causes any form of anxiety.

Make sure you’re comfortable before starting the exercises. Remove unnecessary clothing since the improved blood carbon dioxide will dilate blood vessels in the skin, thereby warming you up.

To get your posture right stand with your back to a wall, heels, shoulders head and bottom touching the wall. Now drop your shoulders. Keep this upper body posture when sitting.

While maintaining your posture, relax all the muscles in your chest, neck, shoulders, arms, tummy and particularly the diaphragm. It’s a good idea to tense them up a bit first before relaxing them so that you can properly identify them and make sure they are all relaxed.

Take off your shirt and stand in front of a full-length mirror. Watch your chest and tummy for breathing movement. Make sure that your chest does not move at all, and only the upper part of the tummy moves, between navel and breastbone. The second thing to check for is that the tummy moves out with each in breath and not the other way around. Many people get this wrong. Your out-breath must be free, relaxed and unforced.

Your aim is to develop a feeling of slight hunger for air, sustain this over a period and do this frequently. In fact, this should become a habit so that you do it all the time until you have achieved your health goal.

Try to feel your breathing and become aware of your breathing pattern. Now try to maintain this pattern while taking in just a little less air on each breath so that you develop a slight hunger for air. Initially try to sustain this for two minutes, then five and then ten.

If you follow all the steps correctly, then you should feel really calm, and even a little sleepy. If you already practice relaxation techniques, yoga etc, you can combine them with reduced breathing.

Hyper ventilators breathe more than normal in order to achieve lower than normal blood carbon dioxide levels. It follows that if you have to breathe more than normal, then you will also not be able to hold your breath as long as you should. Professor Buteyko has cunningly used this principle to measure your blood carbon dioxide by testing how long you can hold your breath.

You start the pause somewhere in your normal breathing cycle. This is how you start the pause: Look up with your eyes and at the same time pinch your nose and start a stop watch. Just before it starts to get uncomfortable, stop the stopwatch and resume normal breathing. You should be able to resume normal breathing without any effort and without taking deeper or more frequent breaths.

Do not worry about which phase of the respiratory cycle you happen to be in before starting the pause. A pause is just an interruption of normal breathing.

The time in seconds is called a Control Pause (CP). Asthmatics typically have a CP of 5 - 15 seconds. (But not everyone with such a low CP has asthma.) Your aim is to achieve a CP greater than 40 seconds, although for perfect health Professor Buteyko recommends a CP of at least 60 seconds.

When at rest, correctly seated, comfortable and relaxed and after breathing normally for at least five minutes you are ready to do a set.

First measure your pulse and then do a CP. Record the results on a table. Then do reduced breathing for ten minutes. Breathe normally for three minutes, then take your pulse again and take another CP. If you’ve done your reduced breathing correctly your pulse should go down and your CP should go up. Sometimes the pulse remains the same. If it goes up you’re not doing it correctly.

After three days you should be able to do around 8 to 10 sets a day. You can then start integrating reduced breathing into your daily life. Ideally you should aim at doing reduced breathing all day.

That takes care of the exercises. Here are a few helpful hints to help your recovery.

Don’t eat unless you are hungry. Only eat until you have had enough. Eating increases breathing, eating excessively increases breathing excessively.

Don’t dress too warmly. Be careful not to overdress children. If you are worried about them being cold, check their ears, nose, hands and feet. If these are warm, they’re OK.

Make sure you get plenty of vigorous exercise. But don’t exercise to the point where you have to open your mouth to breathe.

If any of these recommendations make you dizzy, sick, anxious or give you palpitations, stop immediately. If possible see a Buteyko practitioner.

The Health Secretary, Stephen Dorrell, has announced a five-year, 5 million (UK pound) research programme to identify the cause of asthma. "There is no cure for asthma," says a spokesman for the National Asthma Campaign. "One thing is certain: the outlook for asthma research has never looked so good."

Yes, asthma research is doing well - it has a rosy future. But, sadly, asthmatics do not. Once, asthma scarcely existed; now treating it is a lucrative with more and more sufferers dependent on expensive drugs.

When it was announced recently that Third World countries had fewer asthmatics than developed countries, the irony was missed by experts who said that it was modern life was too clean. Other specialists say asthma is caused by pollution. The truth is western doctors haven't got a clue/

In Soviet Russia, which was spared the grip of the pharmaceutical lobby, Professor Konstantin Buteyko devised a system of breathing exercises that combat asthma and hay fever effectively.

The basis of Buteyko is that we need carbon dioxide in our lungs to process oxygen into the bloodstream. This is a physiological fact, not mumbo-jumbo. Carbon dioxide is known to be connected with the function of the nervous system. When asthmatics become tight chested, their bodies are trying to tell them to slow down, to take less oxygen and more CO2.

Now they are treated with bronchodilators that have the reverse effect, opening up the airways to allow more oxygen in and expelling CO2. Because these inhalers are addictive, they become ever more insidious.

For the pharmaceutical industry, Buteyko's method is bad news. It requires no drugs at all. GPs are happy to hear about it but they will not recommend it. And there is little incentive in the pharmaceutical industry to cure the disease.

Konstantin Pavlovich Buteyko was born on the 27th January 1923, into the small farming community of Ivanitsa (about 150km from Kiev). Inheriting his fathers enthusiasm for machines, Konstantin was enrolled into the Kiev Polytechnic Institute until his studies were interrupted by World War II when Buteyko joined his country's armed forces. After his experiences during the War, Buteyko felt compelled to study what he called "the most complicated piece of machinery of all" - the human organism.

In 1946, he enrolled into the First Medical Institute in Moscow. During his third year he started working in the clinical therapy group under the departmental head, academician Evgeniy Mikhailovitch Tareiev.

During this third year at the Institute, Buteyko was given a practical assignment which involved monitoring diseased patients breathing. He spent hundreds of hours sitting by patient's bedsides, recording their breathing patterns prior to death. He noticed a considerable and uniformed deepening in patients breathing with the approaching of death. By recording these increases, Buteyko found that he was soon able to form a prognoses on how many days or hours were left before the patient's death occurred. This event determined the area of Buteyko's future interest.

In 1952, having graduated from the Institute with Honours, Buteyko continued his experiments independently along similar lines. He asked healthy subjects to breath deeply for a period of time, and found that they became dizzy and nauseous, developed asphyxiating symptoms such as wheeziness and coughing, and eventually fainted. This (he had been told) was due to oxygen over-saturation of the brain.

During the second month of this independent work it occurred to Buteyko that certain diseases may develop as a result of deep breathing. He himself had suffered form hypertension for some time, and had often pondered its causes. By measuring his carbon dioxide levels, Buteyko discovered that his body's carbon dioxide level was lower than recommended. It was known that over breathing lowered carbon dioxide levels in the body. He theorised that if his low levels were caused by over-breathing, then by correcting his breathing he may be able to cure his disorder.

He immediately began experimenting on himself. Soon he had trained himself to breathe in a more shallow fashion. He found that by reducing his breathing, some symptoms such as headache and rapid heart beat also reduced. When he increased the depth of his breathing, the symptoms returned. Buteyko concluded that he had discovered the reason for his disease. He immediately set out to devise a program by which a patient's breathing could be quickly and effectively measured and then, if need be, reconditioned. He had shortly healed himself completely.

Buteyko checked and rechecked his theory on patients. He measured the breathing patterns of sufferers of asthma, angina and other diseases, discovering, without surprise, that they too were hyperventilating. Once again by correcting these patients' breathing to an acceptable level Buteyko was able to normalise their carbon dioxide shortfall and their attacks stopped immediately. When they were asked to return to their previous breathing patterns, their attacks resumed. It was clear, that Buteyko had stumbled across a very important discovery, a global discovery, and that current medical thinking was upside down.

Through further research, Buteyko was able to lay down the theoretical foundation for this idea - hyperventilation causes a depletion of carbon dioxide; low levels of carbon dioxide in the organism cause blood vessels to spasm and also cause oxygen starvation of the tissues. This results in a whole range of "defence mechanisms" that have been previously misunderstood and labelled as diseases. It was not difficult to surmise that vessel spasming occurring in hypertension could occur also with other types of diseases, for example: stenocardia (angina pectoris) with the resultant myocardial infarction (heart attack): end arteritis (inflammation of the innermost coat of an artery, usually occurring in legs) or ulcerative stomach disease. Scientific data associated with the physiological role of carbon dioxide is discussed in more detail in the "Buteyko Theoretical Manual".

Buteyko worked very intensively at the Central and Lenin Medical Libraries researching his theory. Was it really possible that for the entire existence of the medical science such a simple thought had never occurred to anyone else? He learnt very quickly that the answer to this question was yes. For centuries, the majority of the human race had taught their children to breath deeply, and no-one, even for a moment, tried to reduce breathing. During his research, Buteyko was lucky to learn of a few experiments supporting the viability of his thinking. (See- Bohr, Holden, Priestly, Henderson, De Kosta). This then led to Buteyko sharing his thoughts with his teachers, but he found no support from any of them.

He knew well, through his studies, that many medical discoveries had initially been dismissed and suppressed officially only to become accepted practice years later. He recalled the story of sepsis in 1846. A doctor friend of Zemelweise had cut his finger while performing an autopsy on a woman who had perished of sepsis (or "puerperal fever" as it was then known). Three days later, the doctor also contracted the "puerperal fever". Zemelweise concluded that "something" had been passed from the corpse and into the doctors cut, via the blood. At the time microbes were not yet known of, they were discovered by Pastor 20 years later.

With the desire to confirm his supposition, Zemelweise began washing his hands prior to operations, disinfecting them with a chloride of lime solution. He suggested his assistants also follow this routine. In those times, about one third of all new mothers and surgical patients died of sepsis. A three month experiment confirmed Zemelweise's hypothesis, and he lost no patients thereafter. He informed the society of surgeons and suggested they follow his example. He was declared to be mentally disturbed.

Similar destiny befell Professor Lister, an Englishman, who ten years later also called for disinfection of hands prior to operations. Only after this discovery had reached the ears of the public, and hordes of patients' relatives started to turn up at the operations demanding to know if the surgeons had washed their hands before operating, did this procedure become accepted by the surgeons. This happened half a century after the initial discovery by Zemelweise.

Historical knowledge of this nature made it clear to Buteyko that voicing his convictions was not likely to bring any positive results at that stage. He knew he must organise an experimental laboratory . He had to gather evidence, develop it, and only then, announce the fundamentals of his ideas.

Later that year Buteyko became a clinical therapy intern under Academic Tareiev again. Here he was given his chance to establish a functional diagnostics laboratory, This project failed due to lack of funds, personnel and equipment. An attempt to establish the laboratory under the auspices of the Ministry of Health in Moscow was also unsuccessful - the necessary equipment was made available, but not the scientific personnel. In 1958 Buteyko was invited by Professor Meshalkin to join the Institute of Experimental Biology and Medicine at the Siberian Branch of the USSR Academy of Science (where Meshalkin was the director). Once again he set about the task of establishing a laboratory of functional diagnostics. This project was completed in 1960.

In 1958 - 1959 Buteyko conducted clinical studies on nearly 200 people, both healthy and sick. When the first data, various measurements, associations, deductions, correlations, regulations, etc., were obtained, all of these confirmed the correctness of Buteyko's discovery. On 11th January 1960, he presented his work to the Scientific Forum at the Institute and tried to explain the concepts of his thinking. He told those present of the experiments, which showed the objective linear relationship between the depth of breathing, the content of carbon dioxide in the body and vessel spasm and degrees of illness.

Buteyko's colleagues were stunned. Surgeons took the studies as some dirty trick, because Buteyko offered to treat such diseases as asthma, hypertension, angina, without a knife. Invasive surgery never cured these diseases anyway, everybody knew that, and mortality was high. But the Buteyko method gave a quick, almost 100% recovery. Quite naturally, Buteyko had expected the surgeons to be delighted but unfortunately their reaction was quite the opposite.

Nevertheless, he did received temporary approval from Professor Meshalkin who chaired the Forum. He said he understood the perspective and wanted the research continued.

Over the next ten years of the laboratory's existence, Buteyko and his team were able to obtain extensive information on the basic functions of the human organism - whether healthy or diseased. The laboratory was equipped at the highest level. There was a compendium of over forty various instruments capable of registering almost all basic functions of the human organism, and producing approximately 100,000 pieces of data per hour. Analysis of this information was done on computers, mathematically deriving physiological measurements and the various conformities of the body's processes.

Two hundred medical specialists were trained in the laboratory, most of whom, by the way, had suffered from one condition or another and successfully treated themselves with the method. Soon they were all treating other patients utilising Buteyko method. Official statistics showed that as at 1 January 1967 more than 1000 patients suffering from asthma, hypertension or angina had been successfully treated and had totally recovered from their illnesses.

Despite this, Meshalkin categorically refused Buteyko's request for a trial to be conducted at the Institute's clinic. Shortly thereafter Meshalkin mysteriously implemented brutal repression, up to the forcible confiscation of the laboratory equipment. There were to be no publications, and strong reprimands were made for any public appearances or speeches on the subject. This attitude was exhibited not only by Professor Meshalkin but by all of his student-surgeons. In 1963 Professor Meshalkin had also subjected a few new ideas which challenged current opinions of surgery, to a similar treatment. As a result of these unseemly management practices, the Institute was disbanded and closed.

This disbandment may have saved Buteyko's laboratory. He was able to keep one third of all the instruments, personnel and the original laboratory premises. From 1963 to 1968 the laboratory was attached to the Institute of Cytology and Genetics of the Siberian Branch of the USSR Academy of Science. Professor Meshalkin's clinic was reassigned into the system of the Russian Ministry of Health. Buteyko's repeated requests to accredit his method had not met any support whatsoever.

Only in January 1968, after representations made by the local and foreign press in defence of his discoveries was the trial carried out in Leningrad, at the Institute of Pulmonology under Academician Uglov. Shortly before this, a visit was paid to Buteyko's clinic by the Minister of Health, Academician Petrovsky. The Minister informed Buteyko that if he successfully treated at least 80% of the patients given to him, Petrovsky would make recommendations for an immediate entrenchment of the method into standard medical practices. He promised also to make available a 50 bed clinic for the continuation of Buteyko's clinical work. The Minister had one condition - that the patients used in the trial were the most serious and difficult cases, not otherwise treatable by conventional methods of medicine.

Of the 46 patients who underwent Buteyko's treatment 44 (95%) were officially recognised as cured. Only 2 from the 46 had a smaller positive effect. Some of the patients had up to twenty different conditions each. One of the female patients had been recommended to undergo a mastectomy, as she was diagnosed to have a malignant tumour in the initial stages. She had refused the operation. She was included on the list of patients because of her asthma. She recovered not only from her asthma but from the rest of her complaints, including the tumour.

It should be added that the two patients not included in the success rate were also relieved of their diseases after further treatment and had informed the Minister responsible. Consequently, in effect, Buteyko could describe the results of his method as having had a 100% success rate.

The official conclusions of the trial, which was monitored by the health ministry, were sent to the Health Minister, academician Petrovsky. These conclusions were never seen by either Buteyko or the Siberian Branch of the Academy of Science. The Minister later, in a phone call to the chairman of the Siberian Branch, academician Lavrentiev, advised that the trial had failed, with only two out of the 46 patients having been cured. This unexplained falsification served as a foundation for closing the Buteyko laboratory. On 14 August 1968, all of the scientists were dismissed without any offers of alternative employment, and all of the equipment was confiscated or pilfered.

However, even against such great odds, the method survived. The originally trained team of medical practitioners continued to treat patients. Although not one official medical establishment in Moscow was using the method, it was being used in Harkov, Chernigov, Kahovka, Leningrad, Krasnoyarsk, Khabarovsk, Sverdlovsk, etc. Success after success forced the government to once again look into the method. The second official trial was conducted at the First Moscow Institute of Paediatric Diseases in April 1980 at the direction of the Government Committee for Science and Technology of the Soviet Ministry of USSR. The study confirmed the findings of the earlier trial, conducted in Leningrad: 100% success rate. This time the results were officially recognised.