explanation about hygiene auxiliaries which should be maintained during a therapeutic fast for better health with reason.

1. Hygiene auxiliaries
What do you understand by hygiene auxiliaries ??

2. What is hygiene ??
 Origin – (Greek) “Hygieons” which means healthful
 Aka – hygia refers to goddess of health
 Hygiene is a series of practices performed to
preserve health.
 Although WHO defines hygiene as conditions &
practices that helps to maintain health & prevent the
spread of disease.
 Now – hygiene =art of living

3. Auxiliaries
 Refers to offering or providing
 Giving help or support to (health) hygiene

4. Hygiene auxiliaries of fasting
 Supporting vital elements of fast to avoid complications &
to gain maximum benefits.
 It includes :
 Air & breathing
 Enema
 Bathing
 Clothing
 Water drinking
 Exercise
 Mental influence/ hygiene
 **Rest
 **Preparation

5. Air & Breathing
Why air or breathing in fasting ?
 Fasting is a process of rejuvenation, restoration & elimination &
Respiration being a vital means of elimination is included in HA of
fasting.
Benefits :
 Increases circulation which further helps in better repair, healing &
elimination = better immune functioning
 Increases oxygen supply = better vital organ functioning esp. brain =
better concentration, energy levels, memory. Also increases serotonin =
elevates mood = reduces stress
 Better O2 supply = decreased load on heart = lowers blood pressure &
heart rate
Features of place
 Green, calm, quiet, safe, clean, ventilated, sunlight present
Practice to be performed
 Deep breathing practices, brisk walk

6. Relation of health with breathing !
 Physical – For functioning of body
 Physiological & neurobiological – breathing
affects parasympathetic nervous system (vagus
nerve) resulting in calm, sharp, focus mind. Reduced
BP, HR
 Psychological – diverting attention from thoughts,
calms mind
 Spiritually/ traditionally – concept of prana /Qi /life
force etc.

7. Enema
 Liquid injected into the rectum for therapeutic or diagnostic
purpose. But here only therapeutic.
 During fasting eliminative channels esp. intestine should
take part in eliminative procedure. Enema is the measure
which supports intestine for better elimination usually during
the process of fasting, due to lack of bulk of solid food the
bowel movement becomes sluggish which produces mild or
severe constipation in order to assist intestine enema is
given to get rid off the toxins.
 It is observed that even if no fecal matter comes out after
enema specially in long term fasting it is recommended to
take it on the daily basis.

8. Physiology of enema
 volume of the liquid in enema causing rapid expansion of
the intestinal tract (in conjunction with, in the case of
certain solutions) irritation of the intestinal mucosa which
stimulates peristalsis and lubricates the stool to
encourage a bowel movement.
 Doses – everyday in the morning during the period of fast
(if required)
 Volume of dose – 900ml – 1Lit.
 Contraindication of enema: AKI, hemorrhoids

9. Bathing
 Washing or cleansing of body with water for hygiene
purpose. Though effects varies depending on:
temperature, duration, type(immersion > shower), type
of water.
 Bathing helps in eliminating metabolic waste products,
sediments over skin (as a result of perspiration)
 Bathing with lukewarm water (f/b cold shower) is
advised daily is advised during the fast.
 Though sun bath is highly recommended during fast.

10. Effects of bathing on body
 Psychological effects – improving symptoms of stress,
anxiety & depression, aids mental well-being
 Physiological effects – quality sleep, reduces
inflammation, ease muscle spasm, heart health, easy
breathing, smoothens nervous system, stimulates GI
functioning, improves overall body circulation, balances
hormones, hydrates skin, hair, eyes, regulates
homeostasis
 Cold showers – improves immunity, increases alertness,
enhanced muscle recovery, stimulates weight loss, skin &
hair health
 Hot showers – secretion of GH, detoxification, reduces
anxiety, acts as natural decongestant , feeling of well
being, increasing ROM & reduced pain in
musculoskeletal & rheumatological disorders.

11. Clothing
 During fast – hygienic cotton clothes perspiration
clothes loose as well as white clothes. The clothing
during fasting should be comfortable loose &
hygienic. The dress material should be as natural
(e.g. - cotton)
 In winter, warm clothing to maintain proper body heat
is required, it is advisable to change clothes every
day or at the end of the day.
 In rainy season – clothing should be free from
dampness, sunlight dried or heated.

12. Physiological & Physical effects
 Higher breathability – degree to which a fabric permits
air and moisture to pass through it as heat and moisture
can accumulate in the microenvironment inside the poor
breathable fabric.
 Evaporative property of fabric – affects level of heat and
favourable moisture transfer can lessen the thermal
sensation of wetness
 Perception of discomfort ratings are associated with
increases in skin temperature and sweat rates which is
affected by type of clothing used.
 Subjective perception of clothing – thermal comfort,
physical protection, sense of well being
 poor heat transferring clothing material causes
discomfort with increased subjective feeling of warmth &
sweating which may influence ones performance it has
been found that it can influence mental performance,
cognitive performance.

13. Cont.
 comfort properties of a fabric depend on its ability to
transmit water and vapor from the body to prevent
accumulation of liquid on the skin.
 As thermal energy generated by the body will be
transmitted, and vapor moisture will be diffused, resulting
in a comfortable condition in breathable fabric.
 The value of breathability is calculated by measuring the
quantity of moisture vapor through a fabric during a
specified time period and reported as the moisture vapor
transmission rate (MVTR)
 Higher values indicate better removal of vapor and
moisture, and prevention of the accumulation of gas and
vapor
 Although this property of fabric varies due to temperature
& humidity example – wool resist air/moisture
permeation.

14. Water drinking
 Water is a vital source for maintaining various life
processes inside the body.
When to drink - at interval of 1 – 1.5 hour, irregular water
drinking is prohibited during the fast.
Amount - water intake should be 2-3 lit. in winters, 3-6 lit.
in summer. Adequate amount of water which can be
physically circulate throughout the body & works as
buffers collecting metabolic end products, supports the
insensible perspiration (induced amount should be 200-
300 ml at the gap of 1 hour).
Quality of water- water should not be very hard or soft,
naturally existing water of the region is preferred.

15. Temperature of water - `should resonate the body
temperature of the being. Never drink too hot/ too cold
water to prevent imbalance of heat regulation of the
body.
 Physiological importance of water
 Flushing out waste perspiration, urination, defecation
 Maintaining body temperature
 Aids in functioning of brain
 Protection of tissue, spinal cord, joints
 Hydrates body = enhances physical performance
 Aids digestion, nutrient absorption & prevents
constipation & so on

16. Exercise
 Activity requiring physical effort, carried out to sustain or
improve health and fitness.
 It is usually prohibited in the duration of fast also there is
rules of exercise according to the duration of fasting
(short/long/intermittent).
 In short term fasting one should apply proper rest & no
exercise to be done but in long term fasting few exercises
(yoga, pranayama, walking) is very much required to help
the process of elimination.
 Effects !!

17. Skeletal and Hematological changes
 Stimulates sympathetic nervous system and will induce
an integrated response from the body, also regulating
homeostasis for increased physical demand of the body
– physical, metabolic, respiratory, cardiovascular.
 circulatory system control the transport of oxygen and
carbon dioxide, as well as help to buffer the pH level of
active tissues. This action is accomplished by increasing
cardiac output (increased heart rate and stroke volume)
and modulating microvascular circulation.
 Blood flow is preferentially shunted away from the
gastrointestinal (GI) and renal systems and toward active
muscles through selective constriction and dilation of
capillary beds. This increased skeletal muscle blood flow
provides oxygen while facilitating the removal of carbon
dioxide. The increased metabolic activity increases
carbon dioxide concentrations and shifts the pH to the
left, which further facilities erythrocytes (RBC) to extract
carbon dioxide (CO2) and release oxygen (O2)

18.  On a mechanical level, RBCs that have been in
circulation for a long time tend to be less compliant than
younger RBCs, meaning that during exercise, older
RBCs can be haemolyzed intravascularly when passing
through capillaries in contracted muscles. This activity
leads to an average decrease in RBC age since the
younger RBCs have more favourable rheological [physic
– deals with deformation & flow of matter]properties.
Younger RBCs also have increased oxygen release
compared to older RBCs.
 Exercise increases erythropoietin (EPO) levels, which
cause an increase in RBC production. Both of these
factors improve the oxygen supply during exercise. Over
time, vascularization in muscles also improves, further
improving gas exchange and metabolic capacity.

19. Respiratory system
 The respiratory system works in junction with the cardiovascular system. The
pulmonary circuit receives almost all of the cardiac output.
 increased cardiac output, perfusion increases in the apex of each lung,
increasing the available surface area for gas exchange (decreased alveolar
dead space- vol. of air which does not participate in gaseous exchange –
conducting zone).
 With more alveolar surface area available for gas exchange, and increased
alveolar ventilation due to increased frequency and volume of respiration,
blood gas and pH balance can be maintained.
 CO2 is one of the metabolic products of muscular activity. CO2 is carried
away from peripheral active tissues in various forms. The majority is
transported in the form of bicarbonate, but a portion also travels as dissolved
CO2 in plasma and as carbaminohemoglobin on RBCs.
 CO2 readily dissolves into the cytosol of erythrocytes, where it is acted upon
by carbonic anhydrase to form carbonic acid. Carbonic acid then
spontaneously will dissociate into a hydrogen ion and bicarbonate.
 After being transported to the lungs, a high oxygen environment (Haldane
effect), this reaction is catalyzed in the opposite direction to reverse itself
and produce CO2, which is exhaled and removed from the body.
 carbon dioxide eliminated per unit of time is sustained by the effect of the
decreased alveolar dead space and increased tidal volume in one resp.
cycle vol. of air moves in & out 400ml – F & 500ml - M , as mentioned
before.

20. Endocrine
 Plasma levels of cortisol, epinephrine,
norepinephrine, and dopamine increase with
maximal exercise and return to rest. The increase in
levels is consistent with the increase in the
sympathetic nervous system activation of the body.
 Growth hormone is released by the pituitary gland to
enhance bone and tissue growth.
 Insulin sensitivity increases after long-term exercise.
 Testosterone levels also increase, leading to
enhanced growth, libido, and mood.

21. Function
 Cognition: Studies have shown exercising subjects
to have higher concentration scores than non-
exercising subjects.
 Flexibility and mobility
 Cardiovascular health
 Improved glyceamic control and insulin sensitivity
 Mood elevation
 Lower risks of cancer
 Increased bone mineral density

22. Adaptations
 Musculoskeletal system
 Increased muscle capillary perfusion
 Increased strength due to muscle hypertrophy
 Increased endurance due to increased muscular
mitochondrial content
 Increased bone density
 Cardiovascular
 Improved contractility
 Increased blood vessel diameter
 Increased capillary density
 Improved vasodilation
 Decreased average blood pressure at rest or submaximal
activity due to the increased efficiency

23.  understanding and applying exercise
physiology can help to reduce time to
diagnosis, improve outcomes, and
ultimately improve patients’ quality of
life.

24. Mental influence
 Prevention of oneself from all types of negative
thoughts & negative behavior, fear, arrogance,
anger, extreme competition is very must
recommended during fast.
 As said in Charak samhita : fasting is not a physical
action but is a mental entity.
 Also as per Yoga vasistha – all the physical disorder
results due to mental impairment.
 Importance of mental health !!

25. Rest
 Under considered yet most important factor of
fasting. The basic principle of fast is to provide rest
to activate the process of elimination.
 During rest vital energy gets diverted towards
elimination. Therefore, suggested that one should
adopt rest for body during therapeutic fasting
 Official work, mental; overworking should be
suspended & one should be encouraged towards
reading spiritual /health related books.

26. QUESTIONS????