ANGIONEUROTIC OEDEMA

This condition is  characterized by an acute allergic reaction leading to rapidly progressive swelling (slightly itchy) of lips, eyelids, tongue ,hands, genitals and other parts of the body following the exposure to substances to which the person is allergic. This type of allergic reaction may be triggered by many things such as drugs(penicillin and related family of antibiotics, antiepileptic drugs, aspirin, some sleeping tablets, etc), insect bites, items of food (milk, egg, dhals, potatoes, fish etc), food additives (coloring agents and preservatives),infections and infestations(round worm, amoebiasis, viruses such as hep B,EB,etc).Emotions can also trigger this type of response with Angioneurotic oedema (AE).

 There are some big cells called Mast cells which are filled with a chemical substance called histamine spread out here and there under the skin in all parts of the body which are like our emergency defense squad. As soon as the immune system senses that the body is exposed to a foreign substance that is not safe, these mast cells are triggered and they release a chemical called Histamine which cause swelling even in normal persons. For example when you are bitten by a bee the swelling that occurs locally is this mast cell response. The swelling of the skin is the nature’s protective mechanism of diluting the toxin by releasing a large quantity of water into the skin for emergency management. In persons who have an altered over-reactive response (called allergy) it can happen in all parts of the body for any small trigger as mentioned above. The fact to note here is that this type of mast cell response can also be triggered off by our own nervous system even when there is no outside agent and can lead to emotion or stress induced AE.

The immediate treatment for one episode of AE is simple. Administration of a single injection of steroid or intake of antihistamine tablets (if it is not a severe reaction) is sufficient to tide over the emergency situation. But prevention of recurrence is the challenge. The only way seems to be avoidance of all known triggers listed by observations by the patient (as mentioned above).
 What is the role of YOGA?

According to yoga AE is also an Adhija Vyadhi.The over reactive skin response is a manifestation of the over sensitive mind of the person. These over sensitive emotional responses which have become a habit of excessive of anxiety or anger or fear or frustration (at manomaya kosha level) has percolated into the body (annamaya kosha)resulting in a chain reaction at the immune system level to show up as these mast cell responses all over the body. The whole pathway of how emotions can rupture the mast cells is now traceable. Emotions act on the nervous system to start off electrical signals from the nerve cells in the emotional part of the brain (called limbic cortex).These are passed on through nerves which are the wirings that conduct electricity to reach the site of damage. Several chemicals are released from the nerve endings when this electrical signal reaches them. These chemicals called cytokines dissolve the wall of the mast cells. Mast cells release Histamine. This acts on the blood capillary wall and makes it more permeable to  water. Water oozes out of the capillaries resulting in the swelling. Steroids act quickly by making the mast cell wall tough so that they do not respond to the cytokines and hence it can prevent or relieve the immediate effect. This is like cutting the branches of an unwanted tree. Yoga tries to correct the problem at the root cause by teaching techniques of correcting the habit of the over sensitive emotional response pattern of the individual.

Integrated approach of yoga therapy for prevention of AE includes kriyas which constitute a very important component of the set of practices recommended. Kapalabhati at the rate of about 60 per minute practiced with gaps of one minute to experience the deep rest that follows each round is useful. Over months of practice you may increase it gradually to 120 per minute for two minute with increasing gaps of silence following the practice. The mechanism of action of Kapalabhati has to be understood by the concepts of IAYT culled out from many yogic texts which says that the healer within is the wakeful alertful silent state of mind (the mind that dwells in anandamaya kosha).Hence the internal quiet state of mind that is experienced as soon as you stop the rapid breathing of Kapalabhati is the healer. Therefore the instruction for a good and effective practice of Kapalabhati is ‘Go on touching that inner silence of the mind during and immediately following the practice. With regular practice  go on increasing the duration of the silence that follows and sit in the inner blissful awareness as long as possible. Repeat the strokes of fast breathing as soon as the mind starts wandering’. Other practices of IAYT that are essential for management of AE is the same as those for promotion of positive health.

ARDHAKATI CAKRASANA
Sthiti: Tadasana
practice
l     While inhaling, slowly raise the right arm side ways up.
l     At the horizontal level turn the palm upwards.
l     Continue to raise the arm with deep inhalation vertically until the biceps touches the right ear, palm facing the left side.
l     Stretch the right arm upwards.
l     While exhaling bend the trunk slowly to the left.
l     The left palm slides down along the left thigh as far as possible.
l     Do not bend the right elbow or the knees.
l     Maintain for about a minute with normal breathing.
l     Slowly, while coming back to vertical position, inhale and stretch the right arm up. Feel the pull along a straight line from the waist upto the fingers.
l     Bring the right arm down as you exhale to Sthiti position.
l     Come back to Tadasana Sthiti.
l     Repeat on the left side, by bending towards the right side.
Note