Hatha yoga. Its teachers and serious students are convinced of its power to build strength and confidence, to improve flexibility and balance, and to foster spiritual peace and contentment. And beyond its attributes as preventive medicine, many of us also believe in the power of yoga to heal, to aid in recovering from everything from low back strain to carpal tunnel syndrome and to help cope with chronic problems like arthritis, multiple sclerosis and infection with the human immunodeficiency virus (HIV).
But despite the recent boom in yoga’s popularity, most scientists and physicians have been slow to embrace this discipline. To many of them perhaps, it seems like a mystical pursuit, a quasi-religion with little basis in the modern world of science. In a medical profession now itself dominated by a near religious reverence for the randomized, controlled study, knowledge acquired through thousands of years of direct observation, introspection, and trial and error may seem quaint.
But as the West has slowly opened in the past decades to Eastern, experientially based fields like acupuncture—as part of a greater acceptance of alternative medicine in general—yoga has begun to stake its claim. Concepts like prana or chi, however, are not warmly received by skeptical scientists. To win them over you need to provide the kind of evidence they buy. Studies. Preferably published in peer-review journals. And you need to propose mechanisms of action that conform with science as they understand it.
A significant breakthrough was provided by Dr. Dean Ornish, a California-based cardiologist who interrupted his college years to study with Sri Swami Satchidananda. His work, published in 1990 in the prestigious British medical journal the Lancet, showed that a program that combines hatha yoga with dietary changes, exercise, and group therapy can actually reverse blockages in the heart’s main arteries—which doctors used to think wasn’t possible.
In 1998, research led by Marian Garfinkel of the Medical College of Pennsylvania and published in the Journal of the American Medical Association found that Iyengar yoga could effectively reduce the symptoms of carpal tunnel syndrome, a malady of near epidemic proportions in this computer age. Of note, Garfinkel’s study lasted only eight weeks, and yet the intervention proved efficacious. Serious yoga practitioners realize of course that although some benefit may be noticed after even a single class, yoga’s most profound effects accrue over years—even decades—not weeks. Yoga is indeed powerful medicine but it is slow medicine.
More studies will be needed to convince the medical establishment, but that research could also be slow in coming. Funding is a perennial problem. Unlike the situation with, say, pharmaceuticals, there is no private industry to bankroll the scientific investigation of hatha yoga. Given the incredible cost of long-range studies—which are more likely to demonstrate effectiveness—I suspect that we’re unlikely to see any time soon the kind of overwhelming proof that skeptical scientists want. This presents a philosophical question: When you have an intervention which appears safe and effective—and when its side effects are almost entirely positive—should one wait for proof before trying it? This value judgment lies at the heart of the recent debate over many traditional healing methods.
Ironically, though, even within the world of alternative medicine yoga seems under-appreciated. Two years ago, I attended a four-day conference on alternative medicine sponsored by Harvard Medical School. A wide range of topics from herbs to prayer to homeopathy were covered in detail. Yet in the dozens of presentations I attended, yoga was mentioned just once: In a slide that accompanied the lecture on cardiovascular disease, yoga was one of several modalities listed under “Other Stress Reduction Techniques.” Yoga is certainly a stress reduction device but to reduce it to just that misses so much.
Given the situation, how welcome then is David Coulter’s Anatomy of Hatha Yoga. David combines the perspectives of a dedicated yogi with that of a former anatomy professor and research associate at two major American medical schools. He has set himself the ambitious goal of combining the modern scientific understanding of anatomy and physiology with the ancient practice of hatha yoga.
The result of an obvious labor of love, the book explains hatha yoga in demystified, scientific terms while at the same time honoring its traditions. It should go a long way to helping yoga achieve the scientific recognition it deserves. Useful as both a textbook and as a reference, Anatomy of Hatha Yoga is a book that all serious yoga teachers and practitioners will want on their shelves. It will also be welcomed by sympathetic physicians—and there are more of us all the time—as well as physical therapists and other health professionals. Speaking as a doctor who had already studied anatomy in detail (though forgotten more than I’d care to admit) and as a dedicated student of yoga, I can happily report that this book heightened my understanding of both hatha yoga and anatomy and—as a nice bonus—improved my personal practice.
I realize, however, that to those who lack scientific training Anatomy of Hatha Yoga may seem daunting. Some sections use terminology and concepts that may be challenging on first reading. If you feel intimidated, my suggestion is to adopt the mentality many employ when reading the ancient and sometimes difficult texts of the yoga tradition. Read with an open heart and if you get frustrated, try another part or come back to it another day. As with yoga itself, diligent students will be rewarded with an ever-greater understanding.
Timothy McCall, MD
Boston, Massachusetts
January, 2001
Dr. Timothy McCall is a board-certified specialist in internal medicine and the author of Examining Your Doctor: A Patient’s Guide to Avoiding Harmful Medical Care. His work has appeared in more than a dozen major publications including the New England Journal of Medicine, the Nation and the Los Angeles Times. He can be found on the web at www.drmccall.com