All Washed Up

A Technique for Inner Cleansing.
By Michael Grady

Here in the West we are very conscientious about cleaning the exterior surfaces of our body—skin, hair, and nails—and even some of the more accessible interior surfaces, like the teeth, mouth, and ear canal. Yogis go much further. They do not confine their hygiene to easily accessible surfaces. In their quest for saucha (purity) they have discovered diverse ways of cleansing the body’s interior. This inner cleansing often begins with the digestive tract. There are a variety of ways of cleaning it, some of them quite startling to the Western mind.

One of the simplest and safest is the upper wash. This, as the name implies, involves washing the upper portion of the digestive tract—the oral cavity, esophagus, and stomach. Essentially, this practice involves swallowing a quantity of saline and immediately bringing it up again. It is also known as gaja karani (“the action of the elephant”), a reference to the habit elephants have of drawing water up through the trunk and then regurgitating it. At first this practice may strike Westerners as extreme. In the first place, we associate vomiting with illness, and in the second the idea of cleaning the stomach is alien to us. Why does the stomach need cleaning?

To answer this, let’s begin by looking at the digestive and respiratory systems. Both are open channels to the world outside the body. The respiratory system transports air from outside the body to the lungs, and the digestive system transports food through the stomach and intestines. Both tracts need protection from contaminants, friction, and dehydration—protection that is provided by mucus. In the respiratory system mucus traps bacteria, pollen, and dust, and helps protect the delicate lung tissue from drying out. It collects in the back of the throat during sleep, and is swallowed and sent to the stomach. In proper proportion, mucus protects the stomach from its own digestive acids and effectively lubricates the entire gastro-intestinal tract. In excess, it contributes to sluggish digestion and poor appetite. These conditions tend to create listlessness, which is the antithesis of the clarity required to practice yoga. Prolonged congestion may also be accompanied by restlessness and anxiety, which is again in opposition to the effect yoga practitioners are seeking. The upper wash can enhance breathing and reduce congestion due to hay fever and allergies, or from eating an excess of “mucus-producing” foods like milk, yogurt, cheese, or ice cream.

The upper wash expels a sizable quantity of mucus from the body quickly, and it can be useful whether you are prone to congestion or just want to alleviate cold symptoms. The upper wash not only rinses excess mucus from the upper digestive tract, it also draws mucus from the nose and bronchi. It may dry out your nose and perhaps prevent a cold from really taking hold. Doing it in the morning may save you the inconvenience of wiping your runny nose all day. Or, when the nasal wash is not sufficient to open your nasal passages for alternate nostril breathing and meditation, the upper wash may do the trick.

The Ayurvedic View
Ayurveda, an ancient Indian system of medicine, uses the five-element theory to explain the conditions which result in disease or health. This same theory is also useful in describing the benefits of the upper wash. (The elements referred to here are not atomic elements that differentiate forms of matter but rather forces that regulate states of matter and energy.) These elements are metaphorically referred to as earth, water, fire, air, and ether. For example, earth represents a stabilizing, solidifying force, while water represents that which is fluid and movable. When these five elements are in balance the organism is healthy, while an imbalance results in disease or the beginning of disease.

Earth and water elements in combination are known as kapha. An imbalance of kapha often manifests as excess mucus and may result in a cold, cough, or other respiratory problems. (Kapha is actually the origin of the word “cough.”) Ayurveda teaches that the “home” of kapha is the stomach and lungs. The upper wash throws out excess mucus, relieving the body of its heavy influence. Once the imbalance is reduced, the body is more able to heal itself—the fire element (pitta), being less dampened by kapha, empowers the immune system to burn up excess mucus, killing bacterial or viral invaders. The upper wash, however, does more than simply alleviate congestion. Ayurvedic physicians recognize that the upper wash increases the fire element, and this is why they prescribe it for a variety of conditions in which more fire is needed. Such conditions include asthma, diseases of the spleen, indigestion, and some skin disorders. A strengthened fire element not only improves these conditions, it also makes the mind clearer and sharper. That is why the upper wash leaves many people with a clearer mind and a clearer sense of vision.

Can Vomiting Be Pleasant?
For most people the biggest hurdle in the way of practicing the upper wash is the negative association with vomiting. Chances are you have never thrown up except when you were feeling ill, and the experience has always been accompanied by the foul taste of undigested food and stomach acid. Expelling salt water long after your last meal has left the stomach is quite a different experience.

To begin, choose a morning when you’re not rushed. You’ll need about an hour for the practice, including time to rest afterwards. Find a place where you can spend twenty to thirty minutes without interruption: a bathroom or a sink in a private place will do. So will a secluded spot outdoors, except in inclement weather. It’s helpful to have empty bowels, as the pressure of the water retained in the stomach, along with the inevitable passage of some of it into the small intestine, can trigger a bowel movement. Mix two quarts of lukewarm water in a pitcher with one tablespoon of salt to make it palatable and to help draw mucus out of the tissues. Use a rounded tablespoon if you are using kosher or other coarse-grained salt. If the water is too warm it will pass more quickly into the intestines, where it is beyond the range of the upper wash. During regurgitation there is an automatic contraction of the ab-domen, which propels the water out of the stomach. The cleansing process is accentuated by intensifying the natural abdominal contraction. So, before drinking the salt water, you can prepare the abdomen with any variation of agni sara or uddiyana bandha (stomach lift).

Because the force of vomiting temporarily elevates blood pressure, the upper wash should not be done by anyone with high blood pressure or heart disease. It should also be avoided by people with stomach ulcers, hyperacidity, or hiatal hernia, and by women during pregnancy, menstruation, or lactation.

Ready, Set, Go
Now you are ready to begin drinking. Squat down with your pitcher of water in hand. (If you have bad knees, or if for some reason you can’t squat comfortably, sit on a stool or step.) Pressing the thighs against the lower abdomen compresses the intestines and helps prevent the water from leaving the stomach. Compose yourself, and take a few slow, deep breaths. Resolve that you are going to quickly drink two quarts of water without pausing, except to catch your breath. If you drink slowly the water will pass into the intestines. Normally we don’t think about breathing when we’re eating or drinking, but you will become conscious of breathing while drinking such a large volume in a short time.

Both air and water follow the same route into the throat before the air enters the trachea (windpipe) and water passes into the esophagus. The epiglottis, a saddle-shaped plate of cartilage, sits at the level of the Adam’s apple and shuts like a lid over the windpipe when we swallow, to prevent water from entering the lungs. While drinking rapidly, air and water must queue up like two teams passing through a common turnstile. Only one person (or in this case one gulp of water or air) can enter at a time. A friend of mine likes to regulate his breathing and drinking in this pattern: inhale, swallow, inhale, swallow, inhale, swallow, exhale, swallow, exhale, swallow, exhale, swallow. His breaths are shallow and frequent. Another option might be: exhale, inhale, swallow, swallow, swallow, exhale, inhale, swallow, swallow, swallow. Here the breath is deeper. Either way, resist the inclination to hold your breath, which will leave you gasping for air. Staying conscious of your breath will keep you calm and centered. Drink until the water is gone. If your stomach feels uncomfortably full, that’s OK—you are going to throw it up soon. Drinking until you feel too full will make it easier to throw the water up.

The stomach is contracted if it has been twelve hours or more since the last meal—uncomfortable fullness means the stomach is stretching, and mucus will be released from the folds of the stomach lining. My first instructor encouraged me to try to drink three quarts of water. I was very uncomfortable, but those first gags came easily. After drinking all of the water, some experienced practitioners like to stand up and pump and twist the abdomen a few times, creating more turbulence in the stomach to intensify the cleansing. Most beginners, however, will have little interest in doing anything but relieving the fullness. Too much exercise at this time, or waiting too long, will cause the water to move down into the intestines. So when you have finished drinking, stand up and bend forward at the waist. Support the weight of your torso by placing one hand above the knee and leaning on it. Carefully insert the index and middle fingers of the other hand (with nails trimmed) into the mouth and follow the tongue to where it descends into the throat. (If you go a little further you will reach the epiglottis.) Touching this sensitive area will trigger a gag reflex—a shivering sensation that results in an abdominal contraction that forcefully projects the contents of the stomach upward and out of the body. You can induce a stronger abdominal contraction by pressing your abdomen with the other hand. Don’t suppress the gag reflex. Keep your throat relaxed and your chin extended. Regurgitation is a powerful force. Surrender to it, and you will expel the bulk of the water in a few gushes.

With practice, you may be able to do the upper wash without using your fingers—simply bend over and contract your abdomen while keeping your throat and mouth open. It can be difficult to empty the last bit of water from the stomach. Don’t give up too soon. Often the last bit is the most frothy with liquefied mucus. If a sour or bitter taste comes into your mouth, you know you’ve reached the end of the wash. The bitterness is bile drawn up from the small intestines into the stomach through the force of vomiting. An acid taste probably means that you ate too late or too much during your evening meal, and your stomach hasn’t returned to a less acidic resting condition. When you finish the wash, rest for twenty or thirty minutes. If you regurgitated most of the water, you can eat breakfast after resting. If you weren’t able to throw up the water, or threw up very little, you will probably need a longer rest before you feel like doing anything. The bloated feeling in the stomach will gradually subside as the salt water passes into the intestines. And as the water works its way out over the next hour or two, expect to urinate frequently and/or have a loose stool.

A Tool for Health
Though it may have taken a bit of encouragement for you to attempt the upper wash, consider doing it again soon. Repeat the practice on three consecutive mornings, or on every other morning for a week, and then once a week for the rest of the month. This will help you to become more comfortable with the practice. Do it while you have momentum. Thereafter, repeat the practice once a month or as needed to relieve congestion. The upper wash is particularly beneficial during the change of seasons or during the cold season when others around you are getting sick. Try it when you feel that first increase in congestion. If you catch cold anyway, but don’t have a sore throat or more serious symptoms, a daily upper wash may alleviate much of the mucus discharge and speed your recovery.

By practicing the upper wash regularly you will develop an appreciation for how it feels to have clean upper digestive and respiratory tracts. The upper wash introduces a new feeling of well-being—an alternative to feeling sluggish and congested. You may begin to accept this cleaner, more vibrant condition as normal—as the way you should feel. Then you will understand why, for many yogis, the upper wash is an integral part of their practice.

Michael Grady has been teaching yoga breathing practices for over 25 years.