Alicia Meuret, director of the Anxiety and Depression
Research Center at Southern Methodist University in Dallas. In 2014,
Meuret and a team of researchers gathered 120 randomly selected asthma
suf ferers, measured their pulmonary lung functions, lung size, and blood
gases, and then gave them a handheld capnometer , which tracked the carbon
dioxide in their exhaled breath. Over four weeks, the asthmatics would carry the device around and
practice breathing less to keep their carbon dioxide levels at a healthy level
of 5.5 percent. If the levels dipped, the patients would breathe less until the
carbon dioxide levels rose back. A month later , 80 percent of the asthmatics
had raised their resting carbon dioxide level and experienced significantly
fewer asthma attacks, better lung function, and a widening of their airways. They all breathed better . The symptoms of their asthma were either gone or
markedly decreased. “When people hyperventilate, there is something very strange
happening,” Meuret wrote. “In essence they are taking in too much air . But
the sensation that they get is shortness of breath, choking, air hunger , as if
they’re not getting enough air . It’ s almost like a biological system error .”
W illing the body to breathe less air appeared to correct that system error . •       •       •
By the end of his career , and the end of his life in 2003 at the age of 80,
Buteyko would become a bit of a mystic. He barely slept and claimed that
his techniques could not only heal illnesses but promote intuition and other
forms of extrasensory perception. He was convinced that heart disease,
hemorrhoids, gout, cancer , and more than 100 other diseases were all
caused by carbon dioxide deficiency brought on by overbreathing. He even
considered asthma attacks less a problem, less a “system malfunction,” andmore a compensatory action. That airway constriction, wheezing, and
shortness of breath was the body’ s natural reflex to breathe less and more
slowly . For these reasons and others, Buteyko and his methods have been
lar gely dismissed by today’ s medical community as pseudoscience. Nonetheless, a few dozen researchers over the past few decades have
attempted to gain some kind of real scientific validation on the restorative
ef fects of breathing less. One study at the Mater Hospital in Brisbane,
Australia, found that when asthmatic adults followed Buteyko’ s methods
and decreased their air intake by a third, symptoms of breathlessness
reduced by 70 percent and the need for reliever medication decreased by
around 90 percent. A half-dozen other clinical trials showed similar results. Meanwhile, the Papworth Method, a breathing-less technique developed in
an English hospital in the 1960s, was also shown to cut asthma symptoms
by a third. *
Still, nobody seems to know exactly why  breathing less has been so
ef fective in treating asthma and other respiratory conditions. Nobody knows
exactly how it works. There are several theories. “It is a deficiency in the body that causes symptoms,” said Dr . Ira
Packman, an internist and former medical expert for the Pennsylvania
Insurance Department who overcame his own debilitating asthma by
breathing less. “Replace the deficient element,” he told me, “and the patient
gets better .”
Packman explained that overbreathing can have other , deeper ef fects on
the body beyond just lung function and constricted airways. When we
breathe too much, we expel too much carbon dioxide, and our blood pH
rises to become more alkaline; when we breathe slower and hold in more
carbon dioxide, pH lowers and blood becomes more acidic. Almost all
cellular functions in the body take place at a blood pH of 7.4, our sweet spot
between alkaline and acid. When we stray from that, the body will do whatever it can to get us back
there. The kidneys, for instance, will respond to overbreathing by
“buf fering,” *  a process in which an alkaline compound called bicarbonate
is released into the urine. W ith less bicarbonate in the blood, the pH lowers
back to normal, even if we continue to huf f and puf f. It’ s as if nothing ever
happened.The problem with buf fering is that it’ s meant as a temporary fix, not a
permanent solution. W eeks, months, or years of overbreathing, and this
constant kidney (renal) buf fering will deplete the body of essential
minerals. This occurs because as bicarbonate leaves the body , it takes
magnesium, phosphorus, potassium, and more with it. W ithout healthy
stores of these minerals, nothing works right: nerves malfunction, smooth
muscles spasm, and cells can’ t ef ficiently create ener gy . Breathing becomes
even more dif ficult. This is one reason why asthmatics and other people
with chronic respiratory problems are prescribed supplements like
magnesium to stave of f further attacks. Constant buf fering also weakens the bones, which try to compensate by
dissolving their mineral stores back into the bloodstream. (Y es, it’ s possible
to overbreathe yourself into osteoporosis and increased risk of bone
fractures.) This unending grind of imbalances and compensations, of
deficiencies and strain, will eventually break the body down. Packman was quick to point out that not all respiratory illness suf ferers
and other sick people have a carbon dioxide deficiency problem. Those
with emphysema, for instance, may have dangerously high levels of carbon
dioxide because they’ve got too much stale air trapped inside. Others may
test with completely normal blood gas and pH levels. But such nitpicking,
he said, missed the lar ger point. All these people have a br eathing pr oblem. They’re stressed, they’re
inflamed, they’re congested, and they struggle to get air in and out of their
lungs. And it’ s these breathing problems that slow , paced, less techniques
are so ef fective at fixing. •       •       •
Over several months leading up to the Stanford experiment, I visited with
several Buteyko teachers and other low-breathing devotees. They told me
the same story , of how they’d been plagued by some chronic respiratory
illness that no drug or sur gery or medical therapy could fix. Of how they all
“cured” themselves with nothing more than breathing less. The techniques
they used varied, but all circled around the same premise: to extend the
length of time between inhalations and exhalations. The less one breathes,
the more one absorbs the warming touch of respiratory ef ficiency—and the
further a body can go.This shouldn’ t come as much of a surprise. Nature functions in orders of
magnitude. Mammals with the lowest resting heart rates live the longest. And it’ s no coincidence that these are consistently the same mammals that
breathe the slowest. The only way to retain a slow resting heart rate is with
slow breaths. This is as true for baboons and bison as it is for blue whales
and us. “ The yogi’ s life is not measured by the number of his days, but the
number of his breaths,” wrote B. K. S. Iyengar , an Indian yoga teacher who
had spent years in bed as a sickly child until he learned yoga and breathed
himself back to health. He died in 2014, at age 95. I’d hear this repeated over and over again by Olsson during our early
Skype chats and again throughout the Stanford experiment. I’d read about it
in Stough’ s research. Buteyko and the Catholics, Buddhists, Hindus, and
9/11 survivors were aware of it as well. By various means, in various ways,
in various eras of human history , all these pulmonauts discovered the same
thing. They discovered that the optimum amount of air we should take in at
rest per minute is 5.5 liters. The optimum breathing rate is about 5.5 breaths
per minute. That’ s 5.5-second inhales and 5.5-second exhales. This is the
perfect breath. Asthmatics, emphysemics, Olympians, and almost anyone, anywhere,
can benefit from breathing this way for even a few minutes a day , much
longer if possible: to inhale and exhale in a way that feeds our bodies just
the right amount of air , at just the right time, to perform at peak capacity . T o just keep breathing, less .Seven
CHEW
It’ s the nineteenth day of the Stanford experiment, and Olsson and I are,
once again, sitting side by side at the dining room table at the center of our
home lab. The place is of ficially a sty . W e’ve just stopped caring. Because
now we’re just a few hours away from it all being over . I’m sitting with the same thermometer and nitric oxide sensor in my
mouth, and the same blood pressure cuf f around my biceps. Olsson’ s got the
same face mask around his head, the same EKG sensor on his ear . He’ s
wearing the same slippers as well. W e’ve done this drill 60 times in the past three weeks. It all would have
been unbearable had it not been for the mounting ener gy , mental clarity , and
overall well-being we’ve felt, such vast and sudden improvements
experienced the minute we stopped mouthbreathing. Last night, Olsson snored for three minutes while I clocked in at six, a
4,000 percent decrease from ten days ago. Our sleep apnea, which
disappeared the first night of nasal breathing, has remained nonexistent. My
blood pressure this morning was 20 points lower than its highest point at the
beginning of the experiment; on average I’ve dropped 10 points. My carbon
dioxide levels consistently rose and were finally nudging toward the “super
endurance” mark shared by Buteyko’ s healthiest subjects. Olsson, again,
showed similar improvements. W e did it all by breathing through our noses,
slowly and less with full exhales. “I’m done,” declares Olsson, with the same smirk on his face. He walks
down the hallway one last time and goes back across the street. And one
last time, I’m left alone in the clutter , where I eat the same dinner I had ten
days ago.The last supper: a bowl of pasta, leftover spinach, a few soggy croutons. I take a seat at the kitchen table in front of the same unread pile of the
Sunday New Y ork T imes , pour a little olive oil and salt into the bowl, and
take a bite. A few mashes in my mouth and it’ s gone. •       •       •
As random as it might seem, this mundane act—that few seconds of soft
chewing—was the catalyst for writing this book. It’ s what inspired me to
turn the casual hobby of investigating what happened to me in that
V ictorian room a decade ago into a full-time quest to discover the lost art
and science of breathing. At the beginning of this book, I began to fill in why humans have such a
hard time breathing, how all that tenderizing and cooking of food
eventually led to airway obstruction. But the changes that occurred in our
heads and airways so many years ago were only a small part of how we got
to here. There is a much deeper history to our origins, which is weirder and
wilder than anything I had anticipated when I first began. And so, here, at the end of the Stanford experiment, it seems only
appropriate to start over again, picking up where we left of f, at the dawn of
human civilization. •       •       •
T welve thousand years ago, humans in Southwest Asia and the Fertile
Crescent in the Eastern Mediterranean stopped gathering wild roots and
vegetables and hunting game, as they had for hundreds of thousands of
years. They started growing their food. These were the first farming
cultures, and in these primitive communities, humans suf fered from the first
widespread instances of crooked teeth and deformed mouths. It wasn’ t terrible at first. While one farming culture was plagued by
facial and mouth deformities, another hundreds of miles away seemed not
to suf fer at all. Crooked teeth and all the breathing problems that come with
them seemed totally random. Then, about 300 years ago, these maladies went viral. Suddenly , all at
once, much of the world’ s population began to suf fer . Their mouths shrank,
faces grew flatter , and sinuses plugged.The morphological changes to the human head that had occurred up to
this point—that lowering of the larynx that clogged our throats, the
expansion of our brains that lengthened our faces—all these were negligible
compared to this sudden shift. Our ancestors adapted to those gradual
changes just fine. But the changes triggered by the rapid industrialization of farmed foods
were severely damaging. W ithin just a few generations of eating this stuf f,
modern humans became the worst breathers in Homo  history , the worst
breathers in the animal kingdom. I had a hard time comprehending this when I first came across it years
back. Why hadn’ t I been told about it in school? Why didn’ t so many of the
sleep doctors or dentists or pulmonologists I interviewed know this story? Because this research, I discovered, wasn’ t happening in the halls of
medicine. It was happening in ancient burial sites. The anthropologists
working at these sites told me that if I wanted to really understand how such
a sudden and dramatic change could happen to us, and why , I needed to
leave the labs and get into the field. I needed to see some of the Patient
Zeros of the modern obstructed human, the turning point when our farm-fed
faces fell apart on a mass scale. I needed to get my hands on some skulls:
old ones, and lots of them. I hadn’ t been introduced to Marianna Evans yet, so I didn’ t know the
Morton Collection existed. I called some friends instead. One of them told
me that my best chance of stumbling upon a lar ge trove of centuries-old
specimens was to fly to Paris and wait beside a set of trash cans along Rue
Bonaparte. My guides would be waiting there on T uesday night at seven
p.m.
—
“This way ,” the leader said. The rusting steel door behind us moaned and
squealed and the sliver of streetlight grew thinner until there was no more
light at all, only fading echoes. One of the guides I was following lit up her
high-powered headlamp, the two others cinched their backpacks, and went
down the first stone steps of a spiral staircase that led into pure blackness. The dead were downstairs. Six million of them, spread out in a labyrinth
of halls, stalls, cathedrals, ossuaries, black rivers, and billionaire playrooms. There was the skull of Charles Perrault, the author of “Sleeping Beauty”
and “Cinderella.” A little deeper were the femurs of Antoine Lavoisier , thefather of modern chemistry , and the ribs of Jean-Paul Marat, the
assassinated French Revolution leader and the subject of Jacques-Louis
David’ s most morose painting. All these skulls, all these bones and millions
of others, some dating back a thousand years, had been lying there, silently
collecting dust underneath the Garden of Luxembour g in the heart of the
Left Bank. Leading the expedition was a woman in her early 30s with a purple-red
mane that draped over a faded camouflage jacket. She was followed by
another woman in a red pantsuit and a third in a fluorescent blue coat. They
wore knee-high mud boots and overstuf fed kitbags and looked like cast
members from the all-female Ghostbusters  reboot. I didn’ t know their real
names and was told not to ask. These guides, I would learn, prefer to be
anonymous. At the foot of the staircase was a tunnel made of rough limestone walls. As we pushed deeper , the walls grew a little tighter , eventually forming a
hexagonal shape—narrow at the feet, wide at the shoulders, and narrow
again at the top. The tunnel had been built this way for ef ficiency , to allow
ancient limestone miners to walk single file in as little space as possible. But the curious result was that the hallways were the shape of a cof fin. Fitting, perhaps, because we’d just entered one of the lar gest graveyards on
Earth. For a thousand years, Parisians had buried their dead at the center of the
city , mostly in a plot of land that became known as Holy Innocents’
Cemetery . After hundreds of years of use, Holy Innocents’ became
overcrowded, and the dead were stacked in warehouses on top of one
another . Those warehouses became overcrowded too, until the walls
collapsed and spilled decomposing bodies into city streets. W ith nowhere to
put the dead, Parisian authorities instructed limestone miners to dump them
into wagons and wheel them into Paris’ s quarries. As new limestone
quarries were dug out to build the Arc de T riomphe, the Louvre, and other
great buildings, more bodies went under ground. By the turn of the twentieth
century , there were more than 170 miles of quarry tunnels filled with
millions of skeletons. The City of Paris of fered a sanctioned tour of the quarries, called the
Paris Catacombs, but that only covered a small portion. I’d come here to
look inside the other 99 percent, where there were no tourists, descriptive
plaques, ropes, lights, or rules. Where nothing was of f-limits.A group called “cataphiles” have been exploring the nether regions of
this place since entering the quarries became illegal in 1955. They’ve found
their way down through storm drains, manholes, and secret doorways along
Rue Bonaparte. Some cataphiles had built private clubhouses within the
limestone walls; others hosted weekly subterranean dance clubs. There was
a rumor that a French billionaire chiseled out his own lavish apartment
down there and hosted private parties, where guests do who-knows-what. Cataphiles made new discoveries all the time. My guide, the woman with red-purple hair whom I’ll call Red, had spent
15 years mapping these dirty tunnels. She was fascinated with the stories
and history of the place. She told me earlier that she discovered a new
ossuary an hour ’ s hike from here in the crawl space of a cave. It was filled
with a few thousand victims of a cholera epidemic that ravaged Paris in
1832. This was the time in W estern history when small mouths, crooked
teeth, and obstructed airways became the norm throughout much of
industrial Europe. These were the skulls I was looking for . W e passed through halls, over puddles of stagnant water , and crawled
face-to-butt like a human centipede through a kind of oversize rodent hole,
until we reached a stack of wine bottles, cigarette pack wrappers, and
dented beer cans. The walls were layered in decades of graf fiti: the initials
of two lovers, cartoon dicks, an obligatory 666 . A few feet in front of us
was a stack of what looked like kindling. It wasn’ t kindling, not wood at all. It was a heap of femurs, humeri,
sternums, ribs, and fibulas. Bones, all human. This was the path to the
secret ossuary . •       •       •
By around 1500, the farming that had begun in Southwest Asia and the
Fertile Crescent ten thousand years earlier took over the world. The human
population grew to a half billion, 100 times what it had been at the dawn of
agriculture. Life, at least for city dwellers, was miserable: streams of human
waste gushed down city streets. Air was tainted by coal smoke and nearby
rivers and lakes ran with blood, fat, hair , and acids from manufacturing
runof f. Infections, disease, and plague were a constant menace. In these societies, for the first time in history , humans could spend their
entire lives eating nothing but processed food—nothing fresh, nothing raw ,nothing natural. Millions did. Over the next few centuries, food would
become more and more refined. Advances in milling removed the germ and
bran from rice, leaving only the starchy white seed. Roller mills (and, later ,
steam mills) ripped the germ and bran from wheat, leaving only a soft,
white flour . Meats, fruits, and vegetables were canned and bottled. All these
methods extended the shelf life of foods and made them more accessible to
the public. But they also made foods mushy and soft. Sugar , which was
once a prized commodity of the wealthy , became increasingly common and
cheap. This new , highly processed diet lacked fiber and the full spectrum of
minerals, vitamins, amino acids, and other nutrients. As a result, urban
populations would grow sicker and smaller . In the 1730s, before the onset
of industrialization, the average Briton stood about five-seven. W ithin a
century , population shrank two inches, to less than five-five. The human face began rapidly deteriorating, too. Mouths shrank and
facial bones grew stunted. Dental disease became rampant, and the
incidence of crooked teeth and jaws increased tenfold in the Industrial Age. Our mouths got so bad, so overcrowded, that it became common to have
teeth removed altogether . The sideways grin of the Dickensian street urchin was not the af fliction
of only a few sad, impoverished orphans—the upper classes suf fered, too. “The better the school, the worse the teeth,” a V ictorian dentist observed. Breathing problems skyrocketed. •       •       •
Back in the quarries, Red led me through the narrow opening of the ossuary ,
across rocks and bones and broken bottles. She told me how the cholera
epidemic of the early 1800s killed close to 20,000 people. The authorities
had nowhere to put the dead, so they dug a big hole in Montparnasse
Cemetery and buried them with quicklime to disintegrate the flesh. The
ossuary was located at the bottom of that hole. About ten more minutes of crawling and we reached it, a room
surrounded by piles of bones and skulls. I had expected this place to have a
horror -show creepiness, but it never materialized. Instead, entering there,
surrounded by remnants of all these ancient lives, there was only a long andheavy stillness, like the sound of a rock dropped in a well after the echoes
fade away . Red and the cataphiles placed candles on the skulls and pulled cans of
beer and groceries from their packs. I turned and wormed myself deeper
into the chasm, pulling my body along the floor until it felt like my chest
might be stuck between two huge boulders. At one point, I considered that
if any of us might suddenly get trapped in here, if we were to break a leg,
panic, or lose our way , there was a good chance we’d never make it back
out. Our skulls would join the millions of others lining these walls,
becoming candle holders for cataphiles in some future world. Onward and inward, another wiggle and another yank, and I was in the
thick of it—hundreds of more skulls in all directions. These people had
been city dwellers, and they’d very likely relied on the same highly
processed industrial foods. T o my eye, their skulls all appeared lopsided,
too short, their arches V -shaped, and stunted in some way . I stayed for a
while bathing in them, inspecting them, feeling them, comparing them. Admittedly , I was very much a novice at inspecting skeletons, and
perhaps some of the jaws and other pieces were mismatched. Nonetheless,
there was such a clear dif ference in the shape and symmetry of these
specimens compared to the dozens of hunter -gatherers and other ancient
indigenous populations I’d seen in books and websites before coming here. These were the Patient Zeros of the modern Industrial human mouth. “V oulez-vous manger quelque chose?”  Red said, her words echoing of f
the bare walls. I shimmied back beneath the crawl space and joined the
group. They were smoking, sharing swigs of arak from a flask, and passing
around snacks in the flickering glow of candlelight. Red pulled of f a chunk
of soft white bread and a slice of plastic-wrapped cheese and handed it to
me. Beneath the stare of all those age-old eyeholes, I took a bite and
mashed it in my crooked mouth a couple of times. •       •       •
Researchers have suspected that industrialized food was shrinking our
mouths and destroying our breathing for as long as we’ve been eating this
way . In the 1800s, several scientists hypothesized that these problems were
linked to deficiencies of vitamin D; without it, bones in the face, airways,
and body couldn’ t develop. Others thought the lack of vitamin C was theculprit. In the 1930s, W eston Price, the founder of the National Dental
Association research institute, decided it wasn’ t one specific vitamin or
another , but all of them. Price set out to prove his theory . But unlike his
predecessors, he wasn’ t interested in the causes of our shrinking mouths and
deforming faces. He was interested in finding a cure. “ Since we have known for a long time that savages have excellent teeth
and that civilized men have terrible teeth, it seems to me that we have been
extraordinarily stupid in concentrating all of our attention upon the task of
finding out why all our teeth are so poor , without ever bothering to learn
why the savage’ s teeth are good,” wrote Earnest Hooton, a Harvard
anthropologist who supported Dr . Price’ s work. Over a decade starting in the 1930s, Price compared the teeth, airways,
and general health of populations around the world. He examined
indigenous communities whose members were still eating traditional foods,
comparing them to other members in the same community , sometimes the
same family , who had adopted a modern industrialized diet. He traveled to a
dozen countries, often in the company of his nephew , a National
Geographic  researcher and explorer , and compiled more than 15,000 print
photographs, 4,000 slides, thousands of dental records, saliva and food
samples, films, and a library of detailed notes. The same story played out no matter where he went. Societies that
replaced their traditional diet with modern, processed foods suf fered up to
ten times more cavities, severely crooked teeth, obstructed airways, and
overall poorer health. The modern diets were the same: white flour , white
rice, jams, sweetened juices, canned vegetables, and processed meats. The
traditional diets were all dif ferent. In Alaska, Price found communities who ate seal meat, fish, lichen, and
not much else. Deep inside Melanesian islands he found tribes whose meals
consisted of pumpkins, pawpaws, coconut crabs, and sometimes long pigs
(humans). He flew to Africa to study the nomadic Maasai, who subsisted
mostly on cow’ s blood, some milk, a few plants, and a bite of steak. Then
he traveled to Central Canada and studied indigenous tribes who suf fered
through winters when the temperature, according to Price’ s notes, could
reach 70 degrees below zero and whose only food was wild animals. Some cultures ate nothing but meat, while others were mostly
vegetarian. Some relied primarily on homemade cheese; others consumed
no dairy at all. Their teeth were almost always perfect; their mouths wereexceptionally wide, nasal apertures broad. They suf fered few , if any ,
cavities and little dental disease. Respiratory diseases such as asthma or
even tuberculosis, Price reported, were practically nonexistent. While the foods in these diets varied, they all contained the same high
amounts of vitamins and minerals: from one and a half to 50 times that of
modern diets. All of them. Price became convinced that the cause of our
shrinking mouths and obstructed airways was deficiencies not of just D or
C but all  essential vitamins. V itamins and minerals, he discovered, work in
symbiosis; one needs the others to be ef fective. This explained why
supplements could be useless unless they’re in the presence of other
supplements. W e needed all these nutrients to develop strong bones
throughout the body , especially in the mouth and face. In 1939, Price published Nutrition and Physical Degeneration , a 500-
page doorstop of data collected during his travels. It was “a masterpiece of
research,” according to the Canadian Medical Association Journal . Earnest
Hooton called it one of the “epochal pieces of research.” But others hated it,
and vehemently disagreed with Price’ s conclusions. It wasn’ t Price’ s facts and figures, or even his dietary advice that made
them bristle. Most of what he’d discovered about the modern diet had
already been verified by nutritionists years earlier . But some complained
that Price overreached, that his observations were too anecdotal and his
sample sizes too small. None of it mattered. By the 1940s, the idea of spending hours a day
preparing meals of fish eyes and moose glands, raw roots and cow blood,
coconut crabs and pig kidneys, seemed outdated and quaint. It was also way
too much work. Many people moved to cities to get away from those foods
and the grimy lifestyle that came with them. Price, it turned out, was also only half right. Y es, vitamin deficiencies
might explain why so many people eating industrialized foods were sick;
they might explain why so many were getting cavities and why their bones
were growing thin and weak. But they couldn’ t fully explain the sudden and
extreme shrinking of the mouth and blocking of airways that swept through
modern societies. Even if our ancestors consumed a full spectrum of
vitamins and minerals every day , their mouths would still grow too small,
teeth would come in crooked, and airways would become obstructed. What
was true for our ancestors was also true for us. The problem had less to do
with what we were eating than how we ate it.Chewing. It was the constant stress of chewing that was lacking from our diets—
not vitamin A, B, C, or D. Ninety-five percent of the modern, processed
diet was soft. Even what’ s considered healthy food today—smoothies, nut
butters, oatmeal, avocados, whole wheat bread, vegetable soups. It’ s all
soft. Our ancient ancestors chewed for hours a day , every day . And because
they chewed so much, their mouths, teeth, throats, and faces grew to be
wide and strong and pronounced. Food in industrialized societies was so
processed that it hardly required any chewing at all. This is why so many of those skulls I’d examined in the Paris ossuary
had narrow faces and crooked teeth. It’ s one of the reasons so many of us
snore today , why our noses are stuf fed, our airways clogged. Why we need
sprays, pills, or sur gical drilling just to get a breath of fresh air . •       •       •
The cataphiles gathered their packs and bottles and cigarette butts from the
ossuary , and I followed them back through the crawl spaces, across the fetid
streams, up stone staircases, and out the secret door onto Rue Bonaparte. They scurried me past the police station and onto the Métro, where a trail of
human bone dust followed me like breadcrumbs from V ictor Hugo station
back to a friend’ s apartment. I left Paris mildly haunted. Not by the piles of bones in those
under ground warrens, but by the comprehensiveness of our folly . What
looked like human progress—all that milling, mass distribution, and
preservation of food—had horrible consequences. Breathing slow , less, and exhaling deeply , I realized, none of it would
really matter unless we were able to get those breaths through our noses,
down our throats, and into the lungs. But our caved-in faces and too-small
mouths had become obstacles to that clear path. I spent a few days feeling sorry for humanity and then quickly set of f in
search of solutions. There had to be procedures, manipulations, or exercises
that could reverse the past few centuries of damage from soft and mushy
industrialized food. There had to be something that could help me with my
own obstructed airways, and the wheezing, respiratory problems, and
congestion I’d often experienced.I started by visiting modern medical of fices, meeting with specialists
who looked at the top of the nose and worked down from there. Dr. Nayak, the Stanford nose surgeon, told me during our earliest
meeting that most of the nasal unblocking work he does involves turning “a
one-lane highway into a two-lane highway .” If a sink is plugged, we find a
way to clear it safely and rapidly . Sometimes we’ll use Drano for a minor
clog; if that doesn’ t work, we’ll call in a plumber . The nose tends to work in
the same way . Sprays, rinses, and aller gy medications can help quickly clear
minor congestion, but for more serious chronic obstruction, we’ll need a
sur geon to plumb the path. I heard this analogy a lot. Should I, or anyone else, develop a chronic mild nasal obstruction at any
point in the future, Nayak first recommended a “Drano” approach in the
form of a saline nasal rinse, sometimes with a low-dose steroid spray , a
treatment that costs next to nothing and can be self-administered. He has
also prescribed a topical rinse spiked with higher -dose steroids for patients
on the path to reconstructive nasal sur gery and found that 5 to 10 percent of
patients no longer felt the need for further treatment. Should obstruction become more stubborn sinus infections, Nayak
might of fer a patient a balloon. In this procedure, he inserts a small balloon
into the sinuses and carefully inflates it. Balloon sinuplasty , as it’ s
commonly called, creates more space for mucus and infection to pass out,
and air and mucus to pass in. In one unpublished case-control study , Nayak
found that, of the 28 selected sinusitis patients who received the procedure,
23 needed no other treatment. Sometimes the nostrils are the problem, not the sinuses. Nostrils that are
too small or that collapse too easily during an inhale can inhibit the free
flow of air and contribute to breathing problems. This condition is so
common that researchers have an of ficial name for it, “nasal valve
collapse,” and an of ficial measurement, called the Cottle’ s maneuver . It
involves placing an index finger on the side of one or both nostrils and
gently pulling each cheek outward, lightly spreading the nostrils open. If
doing this improves the ease of nasal inhales, there’ s a chance that the
nostrils are too small or thin. Many people with this condition receiveminimally invasive sur gery , or use adhesive strips called Breathe Right or
nasal dilator cones. If these simpler approaches fail, the drills come out. About three-
quarters of modern humans have a deviated septum clearly visible to the
naked eye, which means the bone and cartilage that separate the right and
left airways of the nose are of f center . Along with that, 50 percent of us
have chronically inflamed turbinates; the erectile tissue lining our sinuses is
too puf fed up for us to breathe comfortably through our noses. Both problems can lead to chronic breathing dif ficulties and an
increased risk of infections. Sur gery is highly ef fective in straightening or
reducing these structures, but Nayak warned that it needs to be done
carefully and conservatively . The nose, after all, is a wondrous, ornate
or gan whose structures work as a tightly controlled system. The vast majority of nasal sur geries are successful, Nayak told me. Patients wake up, take the splints out and bandages of f. No more
congestion. No more sinus headaches. No more mouthbreathing. They are
on their way to a new life, breathing better than they ever did before. But not all of them. If sur geons drill out or remove too much tissue,
especially the turbinates, the nose can’ t ef fectively filter , humidify , clean, or
even sense inhaled air . For this small and unfortunate group of patients,
each breath comes in too quickly , a hideous condition called empty nose
syndrome. I interviewed several empty nose suf ferers, seeking to understand their
condition. I talked for months with Peter , a laser technician who worked in
the aeronautics industry in Seattle. He’d scheduled a sur gery , hoping to
clear up some minor obstruction, and, against his permission, had 75
percent of his turbinates removed over two procedures. W ithin days of the
first, he felt a sense of suf focation. He couldn’ t sleep. The sur geons
convinced Peter they hadn’ t removed enough, so they went back in. The
second sur gery made things much worse. Y ears later , each breath Peter took
shot a bolt of pain to his brain, as if it had been delivered from an air pump. Doctors told Peter nothing was wrong; they prescribed antidepressants and
suggested regular exercise. At one point he contemplated suicide. I traveled to Latvia to meet for two days with the then-president of the
Empty Nose Syndrome Association. Her name was Alla and she was in her
early 30s. Eight years ago, after completing two master ’ s degrees, Alla was
pursuing a corporate career and spent her of f hours singing and dancing.She was physically fit and had never suf fered from a serious illness. During
a checkup, a doctor found a small cyst in her sinus and suggested Alla have
it removed in a routine procedure. The sur geon dug through her nose,
removing lar ge portions of her sinuses and turbinates while also for getting
to remove the cyst. The ef fects were dramatic. “It feels like I’m constantly
drowning in air ,” Alla told me. She was forced to quit her career and give
up most of her physical activity . “Every day a struggle, every breath,” she
said. Hundreds of people with empty nose syndrome told me overlapping
stories: they complained about sleepless nights, panic attacks, anxiety , loss
of appetite, and chronic depression. The more they breathed, the more out
of breath they felt. Their doctors, families, and friends couldn’ t understand. Having access to more air , more quickly , could only be an advantage, they
said. But we know now that the opposite is more often true. Five percent of Nayak’ s patients in the past six years—nearly 200
people from 25 states and 7 countries—have come to Stanford to
understand if and how empty nose syndrome is af fecting them, and what
procedures might help them breathe normally again. If they pass a rigorous
screening test, Nayak will go into their noses and add back  the soft tissues
and cartilage that had been taken out. One estimate says that up to 20 percent of patients who got their lower
(inferior) turbinates removed were at risk of eventually suf fering some
degree of empty nose syndrome, although Nayak believes these numbers
are grossly overinflated. The number of patients complaining of breathing
dif ficulties after more minor procedures is certainly far lower , but even if
they represented 1 percent of 1 percent, the empty nose stories spooked me
enough to explore other options before I ever went under the knife to fix my
obstructed breathing. So I dug a little deeper , a little lower , into the mouth. •       •       •
Sleep apnea and snoring, asthma and ADHD, are all linked to obstruction in
the mouth. There are no professionals who spend more time looking in the
mouth than dentists. I talked to a half-dozen who specialize in procedures to
remove obstacles. Here’ s what they told me to look for .If you go to a mirror , open your mouth, and look at the back of the
throat, you’ll see a fleshy tassel that hangs bat-like from the soft tissues. That’ s the uvula. In mouths least susceptible to airway obstruction, the
uvula will appear high and clearly visible from top to bottom. The deeper
the uvula appears to hang in the throat, the higher the risk of airway
obstruction. In mouths that are most susceptible, the uvula may not be
visible at all. This measurement system is called the Friedman tongue
position scale, and it’ s used to quickly estimate breathing ability . Next is the tongue. If the tongue overlaps the molars, or has
“scalloping” teeth indentations on its sides, it’ s too lar ge and will be more
apt to clog the throat when you lie down to sleep. Farther down is the neck. Thicker necks cramp airways. Men with neck
circumferences of more than 17 inches, and women with necks lar ger than
16 inches, have a significantly increased risk of airway obstruction. The
more weight you gain, the higher your risk of suf fering from snoring and
sleep apnea, although body mass index is only one of many factors. W eight
lifters frequently deal with sleep apnea and chronic breathing problems;
instead of layers of fat, they have muscles crowding the airways. Plenty of
rail-thin distance runners and even infants suf fer , too . That’ s because the blockage doesn’ t start with the neck, uvula, or
tongue. It starts with the mouth, and mouth size is indiscriminate. Ninety
percent of the obstruction in the airway occurs around the tongue, soft
palate, and tissues around the mouth. The smaller the mouth is, the more the
tongue, uvula, and other tissues can obstruct airflow . There are various ways to improve matters for airway obstructions. Dr . Michael Gelb is a renowned New Y ork dentist who specializes in treating
snoring, sleep apnea, anxiety , and other breathing-related problems. “I see
her , this same patient, every day ,” he told me when I visited his Madison
A venue clinic in New Y ork. Many of Gelb’ s patients, he said, don’ t fit the
traditional mold. They are mid-30s, fit, successful. No health issues
growing up, but in the last couple of years they’d experienced fatigue,
bowel issues, headaches. Their ears hurt when they bite down. Their
primary care doctors misdiagnose them and prescribe antidepressants, but
the drugs don’ t work. So they try a continuous positive airway pressure
mask, or CP AP , which forces bursts of air past the obstructed airways into
the lungs.CP APs are a lifesaver for those suf fering from moderate to severe sleep
apnea, and the devices have helped millions of people finally get a good
night’ s rest. But Gelb told me his patients have a hard time wearing them. Further , many don’ t have medically diagnosed sleep apnea; the data from
sleep studies shows they’re breathing during sleep just fine. Y et these
people keep getting more tired, for getful, and sick. These people may not
register a sleep apnea problem, Gelb told me, but they all had a serious
breathing problem. “By the time I get them, I’m dealing with the walking
dead,” he said. Gelb and his colleagues sometimes remove tonsils and adenoids. This
can be especially ef fective for children: 50 percent of kids with ADHD
were shown to no longer have symptoms after having their adenoids and
tonsils removed. But these ef fects can also be fleeting. Y ears after having
tonsils removed, children can develop obstructions in the airways and all
the problems that come with it. This is because neither adenoid/tonsil
removal nor CP AP nor other procedures provide a satisfying long-term
solution, because none deals with the core issue: a mouth that is too small
for the face. Gelb also of fers treatments to correct head and neck posture, using
various gizmos to force the jaw away from the airways. Most work. He
showed me a gallery of patients who looked practically reborn after
treatment. But I wasn’ t the walking dead—not yet, at least. The obstruction
in my airways was much milder . For me and the majority of the population, the best medicine, Gelb said,
is preventative. It involves reversing the entropy in our airways so that we
can avoid sleep apnea, anxiety , and all the chronic respiratory problems as
we grow older . It involves expanding the too-small mouth. •       •       •
The earliest orthodontics devices weren’ t intended to straighten teeth, but to
widen the mouth and open airways. In the mid-1800s, a host of children
were born with cleft palates and narrow V -shaped arches. Their mouths
were so small that they had trouble eating, speaking, and breathing. Norman
Kingsley , a dentist and sculptor , wanted to help them, so in 1859 he built a
device that forced the jaw forward, creating room at the back of the mouthto open the throat. It worked well enough. By the 1900s, a French sur geon
named Pierre Robin was designing his own contraption. Robin called it the “monobloc,” and it consisted of a plastic retainer
with a dowel screw that forced the upper palate to grow outward. W ithin
just a few weeks, his patients’ mouths grew lar ger and their breathing was
significantly improved. The monobloc kicked of f a wave of other mouth-expanding devices that
would be used for another benefit: straightening crooked teeth. T eeth will
grow in naturally straight if they have enough room. Expanding devices
returned the mouth to the width it was intended to be, of fering a lar ger
“playing field” for teeth. Expansion would remain a standard practice for
the next 20 years, and would continue to be used throughout Europe for
decades after that. But the process of expanding a mouth took expertise and maintenance;
results varied depending on the skill of the dentist. It didn’ t help that these
devices were miserable and awkward to wear . For those patients with
overbites, the most common problem in the mouth, few dentists could
figure out how to move the bottom jaw forward, so they instead began
working on ways to move the top of the mouth back. By the 1940s, it became standard practice for dentists to extract teeth
then crane back the remaining top teeth with headgear , braces, and other
orthodontic devices. Fewer teeth were easier to handle and of fered more
consistent results. By the 1950s, tooth extractions—two, four , even six at a
time—and retractive orthodontics were routine in the United States. There was a glaring problem with this approach: removing teeth and
pushing remaining teeth backward only made a too-small mouth smaller . A
smaller mouth might be easy for dentists to manage, but it also of fered less
room to breathe. A few months, or years, after their mouths were compressed with braces
and headgear , some patients would complain about breathing dif ficulties
like snoring, sleep apnea, hay fever , and asthma that they’d never had
before. When they bit down, they noticed a clicking sound at the back of
their jaws, along the temporomandibular joint. Some began to look
dif ferent, their faces growing longer , flatter , and less defined. These patients might have represented only a small percentage. But
enough showed the same breathing problems, chewing problems, and
downward facial growth that, in the late 1950s, a former biplane pilot,semiprofessional Formula 1 driver , and British facial sur geon and dentist
named Dr . John Mew took notice. Mew began measuring the faces and mouths of young patients who’d
gotten extractions, and compared them with patients who’d gotten
expansion treatment. Brothers and sisters measured against their siblings,
even sets of identical twins. Over and over again, the children who’d had
teeth removed and had under gone retractive orthodontics suf fered from the
same stunted mouth and facial growth. As they grew up, and the rest of
their bodies and heads grew lar ger , their mouths were forced to stay the
same size. This mismatch created a problem at the center of the face: eyes
would droop, cheeks would puf f up, and chins would recess. The more teeth
these patients had extracted, the longer they wore braces and other devices,
the more obstruction seemed to develop in their airways. Mew called the
pattern “sadly a common sequel to fixed orthodontic treatment.”
In a strange twist, he found that the devices invented to fix crooked teeth
caused by too-small mouths were making mouths smaller and breathing
worse. Mew wasn’ t alone. Several other dentists had come to the same
conclusion, publishing scientific papers on the subject. Mew would conduct
his own studies, taking hundreds of measurements and before-and-after
photos of his patients. He even conducted biochemical analysis of the cell
structure of the lips. All of which, he claimed, clearly proved how the
combination of extractions and retractive orthodontics hindered forward
facial growth and breathing. He’d serve as president of the Southern
Counties Branch of the British Dental Association and would use his
influence to petition administrators to run a full investigation. Nobody did anything; nobody really cared. Instead, Mew would become
one of the most divisive men in British dentistry , ridiculed as a “ quack,”
“scammer ,” and “snake oil salesman.” He was sued repeatedly to stop from
practicing expansion and would eventually lose his license. As Mew
approached the tenth decade of his life, it appeared he was going to follow
the same trajectory as Stough, Price, and so many other pulmonauts: to die
in obscurity , buried along with his research. But something curious has happened in the last few years. Hundreds of
leading orthodontists and dentists have come out in support of Mew’ s
position, saying that, yes, traditional orthodontics were making breathing
worse in half their patients. The strongest endorsement came in April 2018,when Stanford University Press published a 216-page monograph by famed
evolutionary biologist Paul R. Ehrlich and Dr . Sandra Kahn, an
orthodontist, detailing hundreds of scientific references that supported
Mew’ s research. In a short time, Mew’ s outlier theories started entering the
mainstream. “In ten years, nobody will be using traditional orthodontics,” Gelb told
me. “W e’ll look back at what we’ve done and be horrified.” This is what
Mew had been saying for the past half century . The rebellion within
orthodontics eventually led to the formation of a professional or ganization
called the Academy of Orofacial Myofunctional Therapy . This group, I’d learned, is much more interested in fixing the problem of
undersize mouths than blaming those who contributed to it. There are too
many variables, and too many guilty parties, they ar gued. As with so many
fixes I’d come across, Mew and the others discovered that the tools they
needed to remove airway obstruction, to restore the function in that too-
small mouth, were created long ago by observant scientists whose research
was accepted as the standard—and then, for one reason or another ,
for gotten. •       •       •
I visited John Mew two weeks after my expedition into the Paris quarries. I
arrived at an empty train station in East Sussex and an hour later was in the
passenger seat of a Renault minivan. Mew was at the wheel, driving twice
the speed limit down a country road canopied in trees in the posh suburb of
Broad Oak, about 90 minutes east of London. “I’ve come under incredible resistance the whole way ,” he told me,
scraping the passenger -side door against an over grown thicket as we
whizzed down a one-way street. “But the science is clear , the facts are clear ,
the evidence is everywhere. There’ s really no way they can keep stopping
it.”
It was a Sunday afternoon, and Mew’ s only plans were to meet with me
and have his children over for tea, but he’d dressed in a three-piece
houndstooth suit with a white shirt and a rep tie from his preparatory
school, which he attended 75 years ago. W e veered onto a gravel driveway
and over a small bridge, then parked in the shadow of a stone turret. I had
heard that Mew lived in a “castle,” and was expecting something castle-esque, with painted concrete and vinyl siding. But every detail of this place
appeared strikingly real, from the moss-covered roof to the blackwater
moat. Mew killed the motor , grabbed his cane, and led me through dark
hallways to a kitchen of black wood cabinets and copper pots. For several hours we sat beside a roaring hearth, where I heard about
how Mew built this castle, doing much of the work himself over the course
of a decade when he was in his late 70s. I also heard about Mew’ s various
devices to expand mouths. His most renowned invention was the Biobloc, a modified version of
Pierre Robin’ s monobloc. Mew used it on hundreds of his own patients;
hundreds of orthodontists still use it today . A 2006 peer -reviewed study of
50 children showed that the Biobloc expanded airways by up to 30 percent
over the course of six months. I came here because I’d become interested in expanding my own too-
small mouth and opening my too-small airways. But Mew told me his
device works best for children age 5 to 9, whose bones and faces were still
developing and easily moldable. For me, that was several lifetimes ago. Mew’ s son, Mike, who is also a dentist, joined the conversation. Mike
was tanned, tall, and lanky , with piercing brown eyes, dressed in fashion
jeans and a tight-fitting sweater . He explained that the first step to
improving airway obstruction wasn’ t orthodontics but instead involved
maintaining correct “oral posture.” Anyone could do this, and it was free. It just meant holding the lips together , teeth lightly touching, with your
tongue on the roof of the mouth. Hold the head up perpendicular to the
body and don’ t kink the neck. When sitting or standing, the spine should
form a J -shape—perfectly straight until it reaches the small of the back,
where it naturally curves outward. While maintaining this posture, we
should always breathe slowly through the nose into the abdomen. Our bodies and airways are designed to work best in this posture, both
Mews agreed. Look at any Greek statue, or a drawing by Leonardo, or an
ancient portrait. Everyone shared this J -shape. But if we look around public
spaces today , it’ s obvious that most people have shoulders hunched
forward, neck extended outward, and an S -shaped spine. “A bunch of
village idiots, that’ s what we’ve become,” shouted Mike. He then assumed
this “idiot” position, inhaled a few short, puf fy , open-mouth breaths, and
looked around dumbly . “It’ s bloody killing us!”Many of us adopted this S -posture not because of laziness but because
our tongues don’ t fit properly in our too-small mouths. Having nowhere
else to go, the tongue falls back into the throat, creating a mild suf focation. At night, we choke and cough, attempting to push air in and out of this
obstructed airway . This, of course, is sleep apnea, and a quarter of
Americans suf fer from it. By day , we unconsciously attempt to open our obstructed airways by
sloping our shoulders, craning our necks forward, and tilting our heads up. “Think of someone who is unconscious and about to receive CPR,” Mike
said. The first thing a medic does is tilt the head back to open the throat. W e’ve adopted this CPR posture all the time. Our bodies hate this position. The weight of the sloping head stresses
the back muscles, leading to back pain; the kink in our necks adds pressure
to the brain stem, triggering headaches and other neurological problems; the
tilted angle of our faces stretches the skin down from the eyes, thins the
upper lip, pulls flesh down on the nasal bone. Because “the village idiot
stare” doesn’ t sound scientific, Mike calls this posture “ cranial dystrophy .”
He claims it af fects about 50 percent of the modern population, including
Mark Zuckerber g, the founder of Facebook. In January 2018, Mike uploaded a Y ouT ube video warning Zuckerber g
that he was going to die ten years early if he didn’ t correct his cranial
dystrophy posture. The message was viewed more than 9,000 times before
it was deleted. Along with maintaining the correct oral posture, Mike recommended a
series of tongue-thrusting exercises, which he says can train us out of the
“death pose” and make breathing easier . The tongue is a powerful muscle. If its force is directed at the teeth, it can throw them out of alignment; if it’ s
directed at the roof of the mouth, Mike believed it might help expand the
upper palate of the mouth and open up the airways. The exercise, which Mike’ s hordes of social media fans call “mewing,”
has been popularly adopted as “ a new health craze.” After a few months,
mewers have claimed their mouths expanded, jaws became more defined,
sleep apnea symptoms lessened, and breathing became easier . Mike’ s own
instructional video on mewing has been viewed a million times. It’ s dif ficult to convey mewing without seeing it, but the gist is to push
the back of the tongue against the back roof of the mouth and move the rest
of the tongue forward, like a wave, until the tip hits just behind the frontteeth. I tried it a few times. It felt awkward, like I was holding back vomit. Mike demonstrated it for me. It looked like he was holding back vomit. It was then—mewing in unison with another grown man in a homemade
castle, clumps of human bone dust still caked in the eyelets of my boots—
that I realized the quest to discover the lost art of breathing was going to be
a bit of a shit show . But I kept at it, mewing all the way back out through the arched
hallways and into a moonless night, thinking how much more I’d enjoy the
practice if I understood why it worked. •       •       •
Which is how I found myself at a final stop, on a dental examination chair a
few blocks south of Grand Central T erminal. Dr . Theodore Belfor was
hunched over me, wearing a short-sleeve shirt, gray slacks, and wingtips,
his shaved head gleaming under the examination lights. He was cleaning a
dental impression mold in the sink and explaining how human evolution is
no longer based on the survival of the fittest, an echo of what I’d hear from
Marianna Evans. He was also describing how my mouth was a total mess
because of it. Belfor was another dentist with big ideas about how humans lost the
ability to breathe. And like the Mews and Gelb, he had big ideas on how to
fix it. “Hold still,” he said in a thick Bronx accent as he reached his big hands
into my mouth. “Narrow arch, crowding, recessed mandible—you’ve got it
all. V ery typical.”
In the 1960s, after graduating from New Y ork University College of
Dentistry , Belfor was sent to V ietnam to work as the sole dentist and mouth
sur geon for 4,000 soldiers in the 196th Light Infantry . He had no oversight
and was able to improvise, invent, and devise novel solutions to what were
often disastrous problems. “I really learned how to put faces back together ,”
he said, chuckling. He returned to New Y ork and was of fered a job working on performing
artists. These singers, actors, and models needed straight teeth but couldn’ t
be seen with braces. A colleague introduced him to an old monobloc-like
device. After a few months of using it, opera singers began hitting higher
notes and chronic snorers slept peacefully for the first time in years.Everyone had straighter teeth and reported breathing better . Some in their
50s and 60s noticed the bones in their mouths and faces growing wider and
more pronounced the longer they wore the devices. The results stunned Belfor . He’d been taught, like everyone else, that
bone mass (just as with lung size) only decreases after the age of 30. W omen will suf fer much more bone loss than men, especially after
menopause. By the time a woman reaches 60, she’ll have lost more than a
third of her bone mass. If she lives to 80, she’ll have as much bone as she
had when she was 15. Eating well and getting exercise can help to stave of f
the deterioration, but nothing can stop it. It’ s most apparent in our faces. Sagging skin, baggy and hollow eyes,
and sallow cheeks all result from bone disappearing and flesh having
nowhere to go but down. As bone degrades deeper in the skull, soft tissues
at the back of the throat have less to hang on to, so they can droop too,
which can lead to airway obstruction. This bone loss partly explains why
snoring and sleep apnea often grow worse the older we get. After decades of experimentation and collecting case studies, of seeing
his patients’ mouths and faces grow younger the older they got, Belfor
decided that the conventional science of bone loss was, in his words, “total
bullshit.”
—
“Clamp your teeth,” he told me. I did and felt stress in my jaw that extended
all the way back to my skull. What I was feeling was the power of the
masseter , the chewing muscle located below the ears. It’ s the strongest
muscle in the body relative to its weight, exerting up to 200 pounds of
pressure on the back teeth. Belfor then had me run my hands along my skull until I felt the web of
cracks and ridges, called sutures. Sutures spread apart throughout our lives. This spreading allows the skull bone to flex and expand to double its size
from infancy to adulthood. Inside these sutures, the body creates stem cells,
amorphous blanks that shift form and become tissues and bones depending
on what our bodies need. Stem cells, which are used throughout the body ,
are also the mortar that binds the sutures together and that grows new bone
in the mouth and face. Unlike other bones in the body , the bone that makes up the center of the
face, called the maxilla, is made of a membrane bone that’ s highly plastic.The maxilla can remodel and grow more dense into our 70s, and likely
longer . “Y ou, me, whoever—we can grow bone at any age,” Belfor told me. All we need are stem cells. And the way we produce and signal stem cells
to build more maxilla bone in the face is by engaging the masseter—by
clamping down on the back molars over and over . Chewing. The more we gnaw , the more stem cells release, the more
bone density and growth we’ll trigger , the younger we’ll look and the better
we’ll breathe. It starts at infancy . The chewing and sucking stress required for
breastfeeding exercises the masseter and other facial muscles and stimulates
more stem cell growth, stronger bones, and more pronounced airways. Until
a few hundred years ago, mothers would breastfeed infants up to two to
four years of age, and sometimes to adolescence. The more time infants
spent chewing and sucking, the more developed their faces and airways
would become, and the better they’d breathe later in life. Dozens of studies
in the past two decades have supported this claim. They’ve shown lower
incidence of crooked teeth and snoring and sleep apnea in infants who were
breastfed longer over those who were bottle-fed. “Now scoot down and put your head back,” Belfor said, pointing the
dental impression tray toward my open mouth. The mold he was about to
take would be used to fit me with a Homeoblock, an expanding device
Belfor invented in the 1990s. It’ s a pink acrylic thing wrapped in gleaming
metal wires that looks no dif ferent from any other retainer . Except the
Homeoblock wasn’ t designed to straighten teeth. Like the first functional
orthodontic devices created by Norman Kingsley and Pierre Robin, its
purpose is to expand the mouth and make breathing easier . Along the way ,
it stimulates the stress of chewing whenever the wearer chomps down, so
they won’ t have to spend three to four hours gnawing on bones and bark
like our ancient relatives. Belfor ’ s patients—who included Richard Gere’ s body double, a middle-
aged housewife from Phoenix, a 79-year -old New Y ork socialite, and
hundreds of others—shared profound results. Belfor showed me their
before-and-after CA T scans when I first got to his of fice. They had
obstructed throats in the shots before; more-open airways and loads of new
bone six months later . It was as if these patients were the dental equivalent
to Dorian Gray . “Now open your mouth wider and say aaahhhhhhh ,” Belfor said.•       •       •
The chew-airway connection, like so much else breath-related, was old
news. As I dug through a century of scientific papers on the subject over
several months, I felt like I was trapped in a respiratory research Groundhog
Day . Dif ferent scientists, dif ferent decades; the same conclusions, the same
collective amnesia. James Sim W allace, a renowned Scottish doctor and dentist, published
several books about the deleterious ef fects of soft foods on our mouths and
breathing. “ An early soft diet prevents the development of the muscle fibers
of the tongue,” he wrote more than a century ago, “resulting in a weaker
tongue which [cannot] drive the primary dentition out into a spaced
relationship with fully developed arches which will lead to more crowding
of the permanent teeth.”
W allace’ s contemporaries began taking measurements of patients’
mouths and comparing them to skulls that dated to before the Industrial
Revolution. The palates of the ancient skulls measured an average of 2.37
inches. By the late nineteenth century , mouths had shrunk to 2.16 inches. No one was disputing these observations. “That the human jaw is gradually
becoming smaller is a fact which is universally recognized,” W allace noted. That didn’ t stop this research from being ignored for the next hundred
years. By 1974, though, a shaggy-haired 26-year -old anthropologist at the
Smithsonian National Museum of Natural History picked up the baton. His
name was Robert Corruccini, and he’d write or contribute to 250 research
papers and a dozen books on the topic. Corruccini traveled the world and
examined thousands of mouths and diets, from Pima Native Americans to
urban populations of Chinese immigrants, rural Kentuckians to Australian
Aboriginals. He even conducted animal studies, feeding a group of pigs a
diet of hard-pelleted chow and others the identical chow softened with
water . The same food, the same vitamins; only the texture had changed. People, pigs, whatever . Whenever they switched from harder foods to
soft foods, faces would narrow , teeth would crowd, jaws would fall out of
alignment. Breathing problems would often follow . Fifty percent of the modern human population would show this
“malocclusion” within the first generation of switching to soft andprocessed foods; by the second generation, 70 percent; by the third, 85
percent. By the fourth, well, look around. That’ s us, now . Some 90 percent of us
have some form of malocclusion. Corruccini presented his groundbreaking data to dental conferences
around the United States, calling crooked teeth a “disease of civilization.”
There was a lot of interest at first. “A really polite reception,” he said. “But
nothing really changed.”
T oday , the of ficial website of the U.S. National Institutes of Health
attributes the causes of crooked teeth and other deformations of the airway
“most often to heredity .” Other causes include thumb-sucking, injury , or
“tumors of the mouth and jaw .”
There is no mention of chewing; no mention of food at all. •       •       •
Belfor collected his own library of data over two decades. He had case
studies and charts and graphs showing how his patients were regrowing
bones and opening their airways.
_OceanofPDF.com_Breath_-_James_Nestor.txt
Summarize the following text section accurately and concisely. Maintain specific details and numerical information, and use anti-repetition mechanisms:

        Alicia Meuret, director of the Anxiety and Depression
Research Center at Southern Methodist University in Dallas. In 2014,
Meuret and a team of researchers gathered 120 randomly selected asthma
suf ferers, measured their pulmonary lung functions, lung size, and blood
gases, and then gave them a handheld capnometer, which tracked the carbon
dioxide in their exhaled breath. Over four weeks, the asthmatics would carry the device around and
practice breathing less to keep their carbon dioxide levels at a healthy level
of 5. 5 percent. If the levels dipped, the patients would breathe less until the
carbon dioxide levels rose back. A month later, 80 percent of the asthmatics
had raised their resting carbon dioxide level and experienced significantly
fewer asthma attacks, better lung function, and a widening of their airways. They all breathed better. The symptoms of their asthma were either gone or
markedly decreased. “When people hyperventilate, there is something very strange
happening,” Meuret wrote. “In essence they are taking in too much air. But
the sensation that they get is shortness of breath, choking, air hunger, as if
they’re not getting enough air. It’ s almost like a biological system error. ”
W illing the body to breathe less air appeared to correct that system error. •       •       •
By the end of his career, and the end of his life in 2003 at the age of 80,
Buteyko would become a bit of a mystic. He barely slept and claimed that
his techniques could not only heal illnesses but promote intuition and other
forms of extrasensory perception. He was convinced that heart disease,
hemorrhoids, gout, cancer, and more than 100 other diseases were all
caused by carbon dioxide deficiency brought on by overbreathing. He even
considered asthma attacks less a problem, less a “system malfunction,” andmore a compensatory action. That airway constriction, wheezing, and
shortness of breath was the body’ s natural reflex to breathe less and more
slowly. For these reasons and others, Buteyko and his methods have been
lar gely dismissed by today’ s medical community as pseudoscience. Nonetheless, a few dozen researchers over the past few decades have
attempted to gain some kind of real scientific validation on the restorative
ef fects of breathing less. One study at the Mater Hospital in Brisbane,
Australia, found that when asthmatic adults followed Buteyko’ s methods
and decreased their air intake by a third, symptoms of breathlessness
reduced by 70 percent and the need for reliever medication decreased by
around 90 percent. A half-dozen other clinical trials showed similar results. Meanwhile, the Papworth Method, a breathing-less technique developed in
an English hospital in the 1960s, was also shown to cut asthma symptoms
by a third. *
Still, nobody seems to know exactly why  breathing less has been so
ef fective in treating asthma and other respiratory conditions. Nobody knows
exactly how it works. There are several theories. “It is a deficiency in the body that causes symptoms,” said Dr. Ira
Packman, an internist and former medical expert for the Pennsylvania
Insurance Department who overcame his own debilitating asthma by
breathing less. “Replace the deficient element,” he told me, “and the patient
gets better. ”
Packman explained that overbreathing can have other, deeper ef fects on
the body beyond just lung function and constricted airways. When we
breathe too much, we expel too much carbon dioxide, and our blood pH
rises to become more alkaline; when we breathe slower and hold in more
carbon dioxide, pH lowers and blood becomes more acidic. Almost all
cellular functions in the body take place at a blood pH of 7. 4, our sweet spot
between alkaline and acid. When we stray from that, the body will do whatever it can to get us back
there. The kidneys, for instance, will respond to overbreathing by
“buf fering,” *  a process in which an alkaline compound called bicarbonate
is released into the urine. W ith less bicarbonate in the blood, the pH lowers
back to normal, even if we continue to huf f and puf f. It’ s as if nothing ever
happened. The problem with buf fering is that it’ s meant as a temporary fix, not a
permanent solution. W eeks, months, or years of overbreathing, and this
constant kidney (renal) buf fering will deplete the body of essential
minerals. This occurs because as bicarbonate leaves the body, it takes
magnesium, phosphorus, potassium, and more with it. W ithout healthy
stores of these minerals, nothing works right: nerves malfunction, smooth
muscles spasm, and cells can’ t ef ficiently create ener gy. Breathing becomes
even more dif ficult. This is one reason why asthmatics and other people
with chronic respiratory problems are prescribed supplements like
magnesium to stave of f further attacks. Constant buf fering also weakens the bones, which try to compensate by
dissolving their mineral stores back into the bloodstream. (Y es, it’ s possible
to overbreathe yourself into osteoporosis and increased risk of bone
fractures. ) This unending grind of imbalances and compensations, of
deficiencies and strain, will eventually break the body down. Packman was quick to point out that not all respiratory illness suf ferers
and other sick people have a carbon dioxide deficiency problem. Those
with emphysema, for instance, may have dangerously high levels of carbon
dioxide because they’ve got too much stale air trapped inside. Others may
test with completely normal blood gas and pH levels. But such nitpicking,
he said, missed the lar ger point. All these people have a br eathing pr oblem. They’re stressed, they’re
inflamed, they’re congested, and they struggle to get air in and out of their
lungs. And it’ s these breathing problems that slow, paced, less techniques
are so ef fective at fixing. •       •       •
Over several months leading up to the Stanford experiment, I visited with
several Buteyko teachers and other low-breathing devotees. They told me
the same story, of how they’d been plagued by some chronic respiratory
illness that no drug or sur gery or medical therapy could fix. Of how they all
“cured” themselves with nothing more than breathing less. The techniques
they used varied, but all circled around the same premise: to extend the
length of time between inhalations and exhalations. The less one breathes,
the more one absorbs the warming touch of respiratory ef ficiency—and the
further a body can go. This shouldn’ t come as much of a surprise. Nature functions in orders of
magnitude. Mammals with the lowest resting heart rates live the longest. And it’ s no coincidence that these are consistently the same mammals that
breathe the slowest. The only way to retain a slow resting heart rate is with
slow breaths. This is as true for baboons and bison as it is for blue whales
and us. “ The yogi’ s life is not measured by the number of his days, but the
number of his breaths,” wrote B. K. S. Iyengar, an Indian yoga teacher who
had spent years in bed as a sickly child until he learned yoga and breathed
himself back to health. He died in 2014, at age 95. I’d hear this repeated over and over again by Olsson during our early
Skype chats and again throughout the Stanford experiment. I’d read about it
in Stough’ s research. Buteyko and the Catholics, Buddhists, Hindus, and
9/11 survivors were aware of it as well. By various means, in various ways,
in various eras of human history, all these pulmonauts discovered the same
thing. They discovered that the optimum amount of air we should take in at
rest per minute is 5. 5 liters. The optimum breathing rate is about 5. 5 breaths
per minute. That’ s 5. 5-second inhales and 5. 5-second exhales. This is the
perfect breath. Asthmatics, emphysemics, Olympians, and almost anyone, anywhere,
can benefit from breathing this way for even a few minutes a day, much
longer if possible: to inhale and exhale in a way that feeds our bodies just
the right amount of air, at just the right time, to perform at peak capacity. T o just keep breathing, less. Seven
CHEW
It’ s the nineteenth day of the Stanford experiment, and Olsson and I are,
once again, sitting side by side at the dining room table at the center of our
home lab. The place is of ficially a sty. W e’ve just stopped caring. Because
now we’re just a few hours away from it all being over. I’m sitting with the same thermometer and nitric oxide sensor in my
mouth, and the same blood pressure cuf f around my biceps. Olsson’ s got the
same face mask around his head, the same EKG sensor on his ear. He’ s
wearing the same slippers as well. W e’ve done this drill 60 times in the past three weeks. It all would have
been unbearable had it not been for the mounting ener gy, mental clarity, and
overall well-being we’ve felt, such vast and sudden improvements
experienced the minute we stopped mouthbreathing. Last night, Olsson snored for three minutes while I clocked in at six, a
4,000 percent decrease from ten days ago. Our sleep apnea, which
disappeared the first night of nasal breathing, has remained nonexistent. My
blood pressure this morning was 20 points lower than its highest point at the
beginning of the experiment; on average I’ve dropped 10 points. My carbon
dioxide levels consistently rose and were finally nudging toward the “super
endurance” mark shared by Buteyko’ s healthiest subjects. Olsson, again,
showed similar improvements. W e did it all by breathing through our noses,
slowly and less with full exhales. “I’m done,” declares Olsson, with the same smirk on his face. He walks
down the hallway one last time and goes back across the street. And one
last time, I’m left alone in the clutter, where I eat the same dinner I had ten
days ago. The last supper: a bowl of pasta, leftover spinach, a few soggy croutons. I take a seat at the kitchen table in front of the same unread pile of the
Sunday New Y ork T imes, pour a little olive oil and salt into the bowl, and
take a bite. A few mashes in my mouth and it’ s gone. •       •       •
As random as it might seem, this mundane act—that few seconds of soft
chewing—was the catalyst for writing this book. It’ s what inspired me to
turn the casual hobby of investigating what happened to me in that
V ictorian room a decade ago into a full-time quest to discover the lost art
and science of breathing. At the beginning of this book, I began to fill in why humans have such a
hard time breathing, how all that tenderizing and cooking of food
eventually led to airway obstruction. But the changes that occurred in our
heads and airways so many years ago were only a small part of how we got
to here. There is a much deeper history to our origins, which is weirder and
wilder than anything I had anticipated when I first began. And so, here, at the end of the Stanford experiment, it seems only
appropriate to start over again, picking up where we left of f, at the dawn of
human civilization. •       •       •
T welve thousand years ago, humans in Southwest Asia and the Fertile
Crescent in the Eastern Mediterranean stopped gathering wild roots and
vegetables and hunting game, as they had for hundreds of thousands of
years. They started growing their food. These were the first farming
cultures, and in these primitive communities, humans suf fered from the first
widespread instances of crooked teeth and deformed mouths. It wasn’ t terrible at first. While one farming culture was plagued by
facial and mouth deformities, another hundreds of miles away seemed not
to suf fer at all. Crooked teeth and all the breathing problems that come with
them seemed totally random. Then, about 300 years ago, these maladies went viral. Suddenly, all at
once, much of the world’ s population began to suf fer. Their mouths shrank,
faces grew flatter, and sinuses plugged. The morphological changes to the human head that had occurred up to
this point—that lowering of the larynx that clogged our throats, the
expansion of our brains that lengthened our faces—all these were negligible
compared to this sudden shift. Our ancestors adapted to those gradual
changes just fine. But the changes triggered by the rapid industrialization of farmed foods
were severely damaging. W ithin just a few generations of eating this stuf f,
modern humans became the worst breathers in Homo  history, the worst
breathers in the animal kingdom. I had a hard time comprehending this when I first came across it years
back. Why hadn’ t I been told about it in school. Why didn’ t so many of the
sleep doctors or dentists or pulmonologists I interviewed know this story. Because this research, I discovered, wasn’ t happening in the halls of
medicine. It was happening in ancient burial sites. The anthropologists
working at these sites told me that if I wanted to really understand how such
a sudden and dramatic change could happen to us, and why, I needed to
leave the labs and get into the field. I needed to see some of the Patient
Zeros of the modern obstructed human, the turning point when our farm-fed
faces fell apart on a mass scale. I needed to get my hands on some skulls:
old ones, and lots of them. I hadn’ t been introduced to Marianna Evans yet, so I didn’ t know the
Morton Collection existed. I called some friends instead. One of them told
me that my best chance of stumbling upon a lar ge trove of centuries-old
specimens was to fly to Paris and wait beside a set of trash cans along Rue
Bonaparte. My guides would be waiting there on T uesday night at seven
p. m. —
“This way,” the leader said. The rusting steel door behind us moaned and
squealed and the sliver of streetlight grew thinner until there was no more
light at all, only fading echoes. One of the guides I was following lit up her
high-powered headlamp, the two others cinched their backpacks, and went
down the first stone steps of a spiral staircase that led into pure blackness. The dead were downstairs. Six million of them, spread out in a labyrinth
of halls, stalls, cathedrals, ossuaries, black rivers, and billionaire playrooms. There was the skull of Charles Perrault, the author of “Sleeping Beauty”
and “Cinderella. ” A little deeper were the femurs of Antoine Lavoisier, thefather of modern chemistry, and the ribs of Jean-Paul Marat, the
assassinated French Revolution leader and the subject of Jacques-Louis
David’ s most morose painting. All these skulls, all these bones and millions
of others, some dating back a thousand years, had been lying there, silently
collecting dust underneath the Garden of Luxembour g in the heart of the
Left Bank. Leading the expedition was a woman in her early 30s with a purple-red
mane that draped over a faded camouflage jacket. She was followed by
another woman in a red pantsuit and a third in a fluorescent blue coat. They
wore knee-high mud boots and overstuf fed kitbags and looked like cast
members from the all-female Ghostbusters  reboot. I didn’ t know their real
names and was told not to ask. These guides, I would learn, prefer to be
anonymous. At the foot of the staircase was a tunnel made of rough limestone walls. As we pushed deeper, the walls grew a little tighter, eventually forming a
hexagonal shape—narrow at the feet, wide at the shoulders, and narrow
again at the top. The tunnel had been built this way for ef ficiency, to allow
ancient limestone miners to walk single file in as little space as possible. But the curious result was that the hallways were the shape of a cof fin. Fitting, perhaps, because we’d just entered one of the lar gest graveyards on
Earth. For a thousand years, Parisians had buried their dead at the center of the
city, mostly in a plot of land that became known as Holy Innocents’
Cemetery. After hundreds of years of use, Holy Innocents’ became
overcrowded, and the dead were stacked in warehouses on top of one
another. Those warehouses became overcrowded too, until the walls
collapsed and spilled decomposing bodies into city streets. W ith nowhere to
put the dead, Parisian authorities instructed limestone miners to dump them
into wagons and wheel them into Paris’ s quarries. As new limestone
quarries were dug out to build the Arc de T riomphe, the Louvre, and other
great buildings, more bodies went under ground. By the turn of the twentieth
century, there were more than 170 miles of quarry tunnels filled with
millions of skeletons. The City of Paris of fered a sanctioned tour of the quarries, called the
Paris Catacombs, but that only covered a small portion. I’d come here to
look inside the other 99 percent, where there were no tourists, descriptive
plaques, ropes, lights, or rules. Where nothing was of f-limits. A group called “cataphiles” have been exploring the nether regions of
this place since entering the quarries became illegal in 1955. They’ve found
their way down through storm drains, manholes, and secret doorways along
Rue Bonaparte. Some cataphiles had built private clubhouses within the
limestone walls; others hosted weekly subterranean dance clubs. There was
a rumor that a French billionaire chiseled out his own lavish apartment
down there and hosted private parties, where guests do who-knows-what. Cataphiles made new discoveries all the time. My guide, the woman with red-purple hair whom I’ll call Red, had spent
15 years mapping these dirty tunnels. She was fascinated with the stories
and history of the place. She told me earlier that she discovered a new
ossuary an hour ’ s hike from here in the crawl space of a cave. It was filled
with a few thousand victims of a cholera epidemic that ravaged Paris in
1832. This was the time in W estern history when small mouths, crooked
teeth, and obstructed airways became the norm throughout much of
industrial Europe. These were the skulls I was looking for. W e passed through halls, over puddles of stagnant water, and crawled
face-to-butt like a human centipede through a kind of oversize rodent hole,
until we reached a stack of wine bottles, cigarette pack wrappers, and
dented beer cans. The walls were layered in decades of graf fiti: the initials
of two lovers, cartoon dicks, an obligatory 666. A few feet in front of us
was a stack of what looked like kindling. It wasn’ t kindling, not wood at all. It was a heap of femurs, humeri,
sternums, ribs, and fibulas. Bones, all human. This was the path to the
secret ossuary. •       •       •
By around 1500, the farming that had begun in Southwest Asia and the
Fertile Crescent ten thousand years earlier took over the world. The human
population grew to a half billion, 100 times what it had been at the dawn of
agriculture. Life, at least for city dwellers, was miserable: streams of human
waste gushed down city streets. Air was tainted by coal smoke and nearby
rivers and lakes ran with blood, fat, hair, and acids from manufacturing
runof f. Infections, disease, and plague were a constant menace. In these societies, for the first time in history, humans could spend their
entire lives eating nothing but processed food—nothing fresh, nothing raw,nothing natural. Millions did. Over the next few centuries, food would
become more and more refined. Advances in milling removed the germ and
bran from rice, leaving only the starchy white seed. Roller mills (and, later,
steam mills) ripped the germ and bran from wheat, leaving only a soft,
white flour. Meats, fruits, and vegetables were canned and bottled. All these
methods extended the shelf life of foods and made them more accessible to
the public. But they also made foods mushy and soft. Sugar, which was
once a prized commodity of the wealthy, became increasingly common and
cheap. This new, highly processed diet lacked fiber and the full spectrum of
minerals, vitamins, amino acids, and other nutrients. As a result, urban
populations would grow sicker and smaller. In the 1730s, before the onset
of industrialization, the average Briton stood about five-seven. W ithin a
century, population shrank two inches, to less than five-five. The human face began rapidly deteriorating, too. Mouths shrank and
facial bones grew stunted. Dental disease became rampant, and the
incidence of crooked teeth and jaws increased tenfold in the Industrial Age. Our mouths got so bad, so overcrowded, that it became common to have
teeth removed altogether. The sideways grin of the Dickensian street urchin was not the af fliction
of only a few sad, impoverished orphans—the upper classes suf fered, too. “The better the school, the worse the teeth,” a V ictorian dentist observed. Breathing problems skyrocketed. •       •       •
Back in the quarries, Red led me through the narrow opening of the ossuary,
across rocks and bones and broken bottles. She told me how the cholera
epidemic of the early 1800s killed close to 20,000 people. The authorities
had nowhere to put the dead, so they dug a big hole in Montparnasse
Cemetery and buried them with quicklime to disintegrate the flesh. The
ossuary was located at the bottom of that hole. About ten more minutes of crawling and we reached it, a room
surrounded by piles of bones and skulls. I had expected this place to have a
horror -show creepiness, but it never materialized. Instead, entering there,
surrounded by remnants of all these ancient lives, there was only a long andheavy stillness, like the sound of a rock dropped in a well after the echoes
fade away. Red and the cataphiles placed candles on the skulls and pulled cans of
beer and groceries from their packs. I turned and wormed myself deeper
into the chasm, pulling my body along the floor until it felt like my chest
might be stuck between two huge boulders. At one point, I considered that
if any of us might suddenly get trapped in here, if we were to break a leg,
panic, or lose our way, there was a good chance we’d never make it back
out. Our skulls would join the millions of others lining these walls,
becoming candle holders for cataphiles in some future world. Onward and inward, another wiggle and another yank, and I was in the
thick of it—hundreds of more skulls in all directions. These people had
been city dwellers, and they’d very likely relied on the same highly
processed industrial foods. T o my eye, their skulls all appeared lopsided,
too short, their arches V -shaped, and stunted in some way. I stayed for a
while bathing in them, inspecting them, feeling them, comparing them. Admittedly, I was very much a novice at inspecting skeletons, and
perhaps some of the jaws and other pieces were mismatched. Nonetheless,
there was such a clear dif ference in the shape and symmetry of these
specimens compared to the dozens of hunter -gatherers and other ancient
indigenous populations I’d seen in books and websites before coming here. These were the Patient Zeros of the modern Industrial human mouth. “V oulez-vous manger quelque chose. ”  Red said, her words echoing of f
the bare walls. I shimmied back beneath the crawl space and joined the
group. They were smoking, sharing swigs of arak from a flask, and passing
around snacks in the flickering glow of candlelight. Red pulled of f a chunk
of soft white bread and a slice of plastic-wrapped cheese and handed it to
me. Beneath the stare of all those age-old eyeholes, I took a bite and
mashed it in my crooked mouth a couple of times. •       •       •
Researchers have suspected that industrialized food was shrinking our
mouths and destroying our breathing for as long as we’ve been eating this
way. In the 1800s, several scientists hypothesized that these problems were
linked to deficiencies of vitamin D; without it, bones in the face, airways,
and body couldn’ t develop. Others thought the lack of vitamin C was theculprit. In the 1930s, W eston Price, the founder of the National Dental
Association research institute, decided it wasn’ t one specific vitamin or
another, but all of them. Price set out to prove his theory. But unlike his
predecessors, he wasn’ t interested in the causes of our shrinking mouths and
deforming faces. He was interested in finding a cure. “ Since we have known for a long time that savages have excellent teeth
and that civilized men have terrible teeth, it seems to me that we have been
extraordinarily stupid in concentrating all of our attention upon the task of
finding out why all our teeth are so poor, without ever bothering to learn
why the savage’ s teeth are good,” wrote Earnest Hooton, a Harvard
anthropologist who supported Dr. Price’ s work. Over a decade starting in the 1930s, Price compared the teeth, airways,
and general health of populations around the world. He examined
indigenous communities whose members were still eating traditional foods,
comparing them to other members in the same community, sometimes the
same family, who had adopted a modern industrialized diet. He traveled to a
dozen countries, often in the company of his nephew, a National
Geographic  researcher and explorer, and compiled more than 15,000 print
photographs, 4,000 slides, thousands of dental records, saliva and food
samples, films, and a library of detailed notes. The same story played out no matter where he went. Societies that
replaced their traditional diet with modern, processed foods suf fered up to
ten times more cavities, severely crooked teeth, obstructed airways, and
overall poorer health. The modern diets were the same: white flour, white
rice, jams, sweetened juices, canned vegetables, and processed meats. The
traditional diets were all dif ferent. In Alaska, Price found communities who ate seal meat, fish, lichen, and
not much else. Deep inside Melanesian islands he found tribes whose meals
consisted of pumpkins, pawpaws, coconut crabs, and sometimes long pigs
(humans). He flew to Africa to study the nomadic Maasai, who subsisted
mostly on cow’ s blood, some milk, a few plants, and a bite of steak. Then
he traveled to Central Canada and studied indigenous tribes who suf fered
through winters when the temperature, according to Price’ s notes, could
reach 70 degrees below zero and whose only food was wild animals. Some cultures ate nothing but meat, while others were mostly
vegetarian. Some relied primarily on homemade cheese; others consumed
no dairy at all. Their teeth were almost always perfect; their mouths wereexceptionally wide, nasal apertures broad. They suf fered few, if any,
cavities and little dental disease. Respiratory diseases such as asthma or
even tuberculosis, Price reported, were practically nonexistent. While the foods in these diets varied, they all contained the same high
amounts of vitamins and minerals: from one and a half to 50 times that of
modern diets. All of them. Price became convinced that the cause of our
shrinking mouths and obstructed airways was deficiencies not of just D or
C but all  essential vitamins. V itamins and minerals, he discovered, work in
symbiosis; one needs the others to be ef fective. This explained why
supplements could be useless unless they’re in the presence of other
supplements. W e needed all these nutrients to develop strong bones
throughout the body, especially in the mouth and face. In 1939, Price published Nutrition and Physical Degeneration, a 500-
page doorstop of data collected during his travels. It was “a masterpiece of
research,” according to the Canadian Medical Association Journal. Earnest
Hooton called it one of the “epochal pieces of research. ” But others hated it,
and vehemently disagreed with Price’ s conclusions. It wasn’ t Price’ s facts and figures, or even his dietary advice that made
them bristle. Most of what he’d discovered about the modern diet had
already been verified by nutritionists years earlier. But some complained
that Price overreached, that his observations were too anecdotal and his
sample sizes too small. None of it mattered. By the 1940s, the idea of spending hours a day
preparing meals of fish eyes and moose glands, raw roots and cow blood,
coconut crabs and pig kidneys, seemed outdated and quaint. It was also way
too much work. Many people moved to cities to get away from those foods
and the grimy lifestyle that came with them. Price, it turned out, was also only half right. Y es, vitamin deficiencies
might explain why so many people eating industrialized foods were sick;
they might explain why so many were getting cavities and why their bones
were growing thin and weak. But they couldn’ t fully explain the sudden and
extreme shrinking of the mouth and blocking of airways that swept through
modern societies. Even if our ancestors consumed a full spectrum of
vitamins and minerals every day, their mouths would still grow too small,
teeth would come in crooked, and airways would become obstructed. What
was true for our ancestors was also true for us. The problem had less to do
with what we were eating than how we ate it. Chewing. It was the constant stress of chewing that was lacking from our diets—
not vitamin A, B, C, or D. Ninety-five percent of the modern, processed
diet was soft. Even what’ s considered healthy food today—smoothies, nut
butters, oatmeal, avocados, whole wheat bread, vegetable soups. It’ s all
soft. Our ancient ancestors chewed for hours a day, every day. And because
they chewed so much, their mouths, teeth, throats, and faces grew to be
wide and strong and pronounced. Food in industrialized societies was so
processed that it hardly required any chewing at all. This is why so many of those skulls I’d examined in the Paris ossuary
had narrow faces and crooked teeth. It’ s one of the reasons so many of us
snore today, why our noses are stuf fed, our airways clogged. Why we need
sprays, pills, or sur gical drilling just to get a breath of fresh air. •       •       •
The cataphiles gathered their packs and bottles and cigarette butts from the
ossuary, and I followed them back through the crawl spaces, across the fetid
streams, up stone staircases, and out the secret door onto Rue Bonaparte. They scurried me past the police station and onto the Métro, where a trail of
human bone dust followed me like breadcrumbs from V ictor Hugo station
back to a friend’ s apartment. I left Paris mildly haunted. Not by the piles of bones in those
under ground warrens, but by the comprehensiveness of our folly. What
looked like human progress—all that milling, mass distribution, and
preservation of food—had horrible consequences. Breathing slow, less, and exhaling deeply, I realized, none of it would
really matter unless we were able to get those breaths through our noses,
down our throats, and into the lungs. But our caved-in faces and too-small
mouths had become obstacles to that clear path. I spent a few days feeling sorry for humanity and then quickly set of f in
search of solutions. There had to be procedures, manipulations, or exercises
that could reverse the past few centuries of damage from soft and mushy
industrialized food. There had to be something that could help me with my
own obstructed airways, and the wheezing, respiratory problems, and
congestion I’d often experienced. I started by visiting modern medical of fices, meeting with specialists
who looked at the top of the nose and worked down from there. Dr. Nayak, the Stanford nose surgeon, told me during our earliest
meeting that most of the nasal unblocking work he does involves turning “a
one-lane highway into a two-lane highway. ” If a sink is plugged, we find a
way to clear it safely and rapidly. Sometimes we’ll use Drano for a minor
clog; if that doesn’ t work, we’ll call in a plumber. The nose tends to work in
the same way. Sprays, rinses, and aller gy medications can help quickly clear
minor congestion, but for more serious chronic obstruction, we’ll need a
sur geon to plumb the path. I heard this analogy a lot. Should I, or anyone else, develop a chronic mild nasal obstruction at any
point in the future, Nayak first recommended a “Drano” approach in the
form of a saline nasal rinse, sometimes with a low-dose steroid spray, a
treatment that costs next to nothing and can be self-administered. He has
also prescribed a topical rinse spiked with higher -dose steroids for patients
on the path to reconstructive nasal sur gery and found that 5 to 10 percent of
patients no longer felt the need for further treatment. Should obstruction become more stubborn sinus infections, Nayak
might of fer a patient a balloon. In this procedure, he inserts a small balloon
into the sinuses and carefully inflates it. Balloon sinuplasty, as it’ s
commonly called, creates more space for mucus and infection to pass out,
and air and mucus to pass in. In one unpublished case-control study, Nayak
found that, of the 28 selected sinusitis patients who received the procedure,
23 needed no other treatment. Sometimes the nostrils are the problem, not the sinuses. Nostrils that are
too small or that collapse too easily during an inhale can inhibit the free
flow of air and contribute to breathing problems. This condition is so
common that researchers have an of ficial name for it, “nasal valve
collapse,” and an of ficial measurement, called the Cottle’ s maneuver. It
involves placing an index finger on the side of one or both nostrils and
gently pulling each cheek outward, lightly spreading the nostrils open. If
doing this improves the ease of nasal inhales, there’ s a chance that the
nostrils are too small or thin. Many people with this condition receiveminimally invasive sur gery, or use adhesive strips called Breathe Right or
nasal dilator cones. If these simpler approaches fail, the drills come out. About three-
quarters of modern humans have a deviated septum clearly visible to the
naked eye, which means the bone and cartilage that separate the right and
left airways of the nose are of f center. Along with that, 50 percent of us
have chronically inflamed turbinates; the erectile tissue lining our sinuses is
too puf fed up for us to breathe comfortably through our noses. Both problems can lead to chronic breathing dif ficulties and an
increased risk of infections. Sur gery is highly ef fective in straightening or
reducing these structures, but Nayak warned that it needs to be done
carefully and conservatively. The nose, after all, is a wondrous, ornate
or gan whose structures work as a tightly controlled system. The vast majority of nasal sur geries are successful, Nayak told me. Patients wake up, take the splints out and bandages of f. No more
congestion. No more sinus headaches. No more mouthbreathing. They are
on their way to a new life, breathing better than they ever did before. But not all of them. If sur geons drill out or remove too much tissue,
especially the turbinates, the nose can’ t ef fectively filter, humidify, clean, or
even sense inhaled air. For this small and unfortunate group of patients,
each breath comes in too quickly, a hideous condition called empty nose
syndrome. I interviewed several empty nose suf ferers, seeking to understand their
condition. I talked for months with Peter, a laser technician who worked in
the aeronautics industry in Seattle. He’d scheduled a sur gery, hoping to
clear up some minor obstruction, and, against his permission, had 75
percent of his turbinates removed over two procedures. W ithin days of the
first, he felt a sense of suf focation. He couldn’ t sleep. The sur geons
convinced Peter they hadn’ t removed enough, so they went back in. The
second sur gery made things much worse. Y ears later, each breath Peter took
shot a bolt of pain to his brain, as if it had been delivered from an air pump. Doctors told Peter nothing was wrong; they prescribed antidepressants and
suggested regular exercise. At one point he contemplated suicide. I traveled to Latvia to meet for two days with the then-president of the
Empty Nose Syndrome Association. Her name was Alla and she was in her
early 30s. Eight years ago, after completing two master ’ s degrees, Alla was
pursuing a corporate career and spent her of f hours singing and dancing. She was physically fit and had never suf fered from a serious illness. During
a checkup, a doctor found a small cyst in her sinus and suggested Alla have
it removed in a routine procedure. The sur geon dug through her nose,
removing lar ge portions of her sinuses and turbinates while also for getting
to remove the cyst. The ef fects were dramatic. “It feels like I’m constantly
drowning in air,” Alla told me. She was forced to quit her career and give
up most of her physical activity. “Every day a struggle, every breath,” she
said. Hundreds of people with empty nose syndrome told me overlapping
stories: they complained about sleepless nights, panic attacks, anxiety, loss
of appetite, and chronic depression. The more they breathed, the more out
of breath they felt. Their doctors, families, and friends couldn’ t understand. Having access to more air, more quickly, could only be an advantage, they
said. But we know now that the opposite is more often true. Five percent of Nayak’ s patients in the past six years—nearly 200
people from 25 states and 7 countries—have come to Stanford to
understand if and how empty nose syndrome is af fecting them, and what
procedures might help them breathe normally again. If they pass a rigorous
screening test, Nayak will go into their noses and add back  the soft tissues
and cartilage that had been taken out. One estimate says that up to 20 percent of patients who got their lower
(inferior) turbinates removed were at risk of eventually suf fering some
degree of empty nose syndrome, although Nayak believes these numbers
are grossly overinflated. The number of patients complaining of breathing
dif ficulties after more minor procedures is certainly far lower, but even if
they represented 1 percent of 1 percent, the empty nose stories spooked me
enough to explore other options before I ever went under the knife to fix my
obstructed breathing. So I dug a little deeper, a little lower, into the mouth. •       •       •
Sleep apnea and snoring, asthma and ADHD, are all linked to obstruction in
the mouth. There are no professionals who spend more time looking in the
mouth than dentists. I talked to a half-dozen who specialize in procedures to
remove obstacles. Here’ s what they told me to look for. If you go to a mirror, open your mouth, and look at the back of the
throat, you’ll see a fleshy tassel that hangs bat-like from the soft tissues. That’ s the uvula. In mouths least susceptible to airway obstruction, the
uvula will appear high and clearly visible from top to bottom. The deeper
the uvula appears to hang in the throat, the higher the risk of airway
obstruction. In mouths that are most susceptible, the uvula may not be
visible at all. This measurement system is called the Friedman tongue
position scale, and it’ s used to quickly estimate breathing ability. Next is the tongue. If the tongue overlaps the molars, or has
“scalloping” teeth indentations on its sides, it’ s too lar ge and will be more
apt to clog the throat when you lie down to sleep. Farther down is the neck. Thicker necks cramp airways. Men with neck
circumferences of more than 17 inches, and women with necks lar ger than
16 inches, have a significantly increased risk of airway obstruction. The
more weight you gain, the higher your risk of suf fering from snoring and
sleep apnea, although body mass index is only one of many factors. W eight
lifters frequently deal with sleep apnea and chronic breathing problems;
instead of layers of fat, they have muscles crowding the airways. Plenty of
rail-thin distance runners and even infants suf fer, too. That’ s because the blockage doesn’ t start with the neck, uvula, or
tongue. It starts with the mouth, and mouth size is indiscriminate. Ninety
percent of the obstruction in the airway occurs around the tongue, soft
palate, and tissues around the mouth. The smaller the mouth is, the more the
tongue, uvula, and other tissues can obstruct airflow. There are various ways to improve matters for airway obstructions.
To get the patients to breathe less and maintain a healthy carbon dioxide level.
What was the goal of Alicia Meuret and her team in their 2014 study on asthma patients?
Dr. Packman believed that overbreathing can have effects on the body beyond just lung function and constricted airways.
What was Dr. Ira Packman's theory on the cause of respiratory problems?
The study showed that children who were breastfed and chewed their food had fewer dental problems and better breathing.
What was the result of the study conducted by Dr. Weston Price?
Dr. Nayak warned that nasal valve collapse can lead to chronic respiratory problems and sleep apnea.
What was the main concern of Dr. Nayak about the nasal valve collapse condition?
Dr. Belfor's device was designed to expand the mouth and make breathing easier by stimulating the stress of chewing.
What was the main goal of Dr. Belfor's device, the Homeoblock?