I have often lamented the lack of peer‐reviewed literature on neural therapy in the English language. However this deficiency should not prevent us from reading what has been published and so I have included in this newsletter a few abstracts from papers published in the last year. The first is actually a translation from a German language article (better an abstract than nothing!) The second is from a veterinary journal. (I know one veterinarian who is quite skilled in neural therapy and I have enjoyed learning from him.)
Research and therefore writing about neural therapy for the peer reviewed literature is not easy. The current fashion of "evidence based" practice encourages the most superficial understanding of pathophysiology, and therefore the most superficial treatments. For example, it would be easy to show that injection of a steroid suspension into a subacromial bursa will suppress an inflammatory process.
But it would be another matter to explore the factors that produced the inflammation in the first place. In my experience, subacromial bursitis is "the tip of the iceberg" of disturbed mechanics of the shoulder. And disturbed shoulder mechanics is often a reflection of disturbed mechanics elsewhere ‐ e.g. neck, cranium, chest wall or pelvis.
Similarly, subacromial bursitis can also be caused by interference fields, often located in areas far removed from the shoulder. Sometimes neurological, anatomical, or energetic connections can be found that explain the relationships. Sometimes the relationship is a mystery ‐ at least to me!
A certain amount of humility about what can and cannot be known is a necessary virtue in the practice of medicine. Evidence from the scientific literature can be a marvelous tool ‐ to open our eyes to possibilities and to learn from the experience of others. But to (again) quote Speransky: "Science is analysis; diagnosis is synthesis". Diagnosis (except of acute injuries) is a process in which a complex work of art is created from the patient's history, physical examination, and other evidence. Each individual is unique in myriad ways.
This is especially true in the practice of neural therapy. The goal is to find the loci (or "interference fields") that are disturbing regulation of the body's physiological processes. "Resetting" these controls by neural therapy can often restore the patient's function to normal health. But the location of interference fields is so different and their effects on the physiology so disparate that it is impossible to assemble subjects for trials that would satisfy the rules of scientific "evidence".
One exception to these generalizations is "segmental therapy", the practice of treating the skin overlying a symptomatic tissue or the referral zone of an organ, with subcutaneous injections of procaine. Here it is possible to obtain satisfactory results with less diagnostic precision than is required to identify interference fields in (e.g.) scars or teeth.
An example of this comes from a paper published in 2006 (in Spanish) by one of our readership, Dr. Carlos Chiriboga MD of Ecuador treating a series of 64 patients with chronic neck pain.
For those of you planning to attend the "Mid-winter Neural Therapy Retreat" (More news about this in coming months) in February 2010 near Ottawa, Canada, Dr Chiriboga will be present.
And here are the neural therapy papers, as promised above:
Development and implementation of a 'curriculum complementary and alternative medicine' at the Heidelberg Medical School]. [German] Joos S. Eicher C. Musselmann B. Kadmon M. Forschende Komplementarmedizin (2006). 15(5):251-60, 2008 Oct.
BACKGROUND: The 9th revision of the Medical Training Regulations for Physicians (AAppO) in October 2003 included the new compulsory interdisciplinary subject 'Rehabilitation, Physical Medicine and Complementary and Alternative Medicine (CAM)' (QB 12). The present article describes the development of a 'CAM curriculum' for undergraduate education, its implementation in the QB 12 at the Heidelberg Medical School and its evaluation. METHODS: According to the 6-step approach by Kern, the following aspects are presented: requirements, experiences/interests of students, learning targets, development of practical training courses and lectures, implementation, and evaluation. Experiences/interests of students were assessed by a self-developed questionnaire. Practical training courses and lectures were evaluated by school marks (1 through 6) and by a modified version of the HILVE-I. RESULTS: A selection of CAM methods to be included in the curriculum was made by the participating lecturers based on the criteria 'evidence' and 'prevalence in health care'. Learning targets were defined in terms of knowledge, skills and attitudes. On this basis, practical training courses/lectures comprising classical naturopathy, acupuncture/ traditional Chinese medicine and neural therapy were developed and integrated in the QB 12. Regular evaluations of the practical training courses/lectures constantly reveal good results. 69% of the 219 students questioned indicated to be interested in CAM, 27% already had gained experience with CAM themselves. DISCUSSION: The well-evaluated CAM courses/lectures indicate a successful development and implementation of the 'CAM curriculum' in the QB 12 at the Heidelberg Medical School. Thus, the requirements of the AAppO are met. Moreover, implementation of CAM in undergraduate education allows for the importance CAM has in every-day care of patients in Germany. 2008 S. Karger AG, Basel
Clinical efficacy of neural therapy for the treatment of atopic dermatitis in dogs. Bravo‐Monsalvo A. Vazquez‐Chagoyan JC. Gutierrez L. Sumano H. Acta Veterinaria Hungarica. 56(4):459‐69, 2008 Dec.
The aim of this trial was to assess the clinical efficacy of neural therapy (NT) when treating canine atopic dermatitis. Eighteen dogs (no control group), with at least a 12‐month history of having nonseasonal atopic dermatitis, were included. No medication with either glucocorticoids or cyclosporin was allowed during the trial. One set of NT was given by injecting an intravenous dose of 0.1 mg/kg of a 0.7% procaine solution, followed by 10 to 25 intradermal injections of the same solution in a volume of 0.1‐0.3 mL per site. Dogs were given 6‐13 sets of NT during the therapy. The dermatological condition of each patient was evaluated before and after the treatment using two scales: the pruritus visual analogue scale (PVAS) and the canine atopic dermatitis extent and severity index (CADESI). The reduction of pruritus was statistically significant using a Wilcoxon matched-pairs signed-ranks test (P < 0.001). No adverse side effects were observed. NT seems to be an effective alternative to control signs related to canine atopic dermatitis.
Patient satisfaction of primary care for musculoskeletal diseases: a comparison between Neural Therapy and conventional medicine. Mermod J. Fischer L. Staub L. Busato A. BMC Complementary & Alternative Medicine. 8:33, 2008.
BACKGROUND: The main objective of this study was to assess and compare patient satisfaction with Neural Therapy (NT) and conventional medicine (COM) in primary care for musculoskeletal diseases. METHODS: A cross-sectional study in primary care for musculoskeletal disorders covering 77 conventional primary care providers and 18 physicians certified in NT with 241 and 164 patients respectively. Patients and physicians documented consultations and patients completed questionnaires at a one‐month follow‐up. Physicians documented duration and severity of symptoms, diagnosis, and procedures. The main outcomes in the evaluation of patients were: fulfillment of expectations, perceived treatment effects, and patient satisfaction. RESULTS: The most frequent diagnoses belonged to the group of dorsopathies (39% in COM, 46% in NT). We found significant differences between NT and COM with regard to patient evaluations. NT patients documented better fulfilment of treatment expectations and higher overall treatment satisfaction. More patients in NT reported positive side effects and less frequent negative effects than patients in COM. Also, significant differences between NT and COM patients were seen in the quality of the patient-physician interaction (relation and communication, medical care, information and support, continuity and cooperation, facilities availability, and accessibility), where NT patients showed higher satisfaction. Differences were also found with regard to the physicians' management of disease, with fewer work incapacity attestations issued and longer consultation times in NT. CONCLUSION: Our findings show a significantly higher treatment and care‐related patient satisfaction with primary care for musculoskeletal diseases provided by physicians practising Neural Therapy.
To the editor:
I had an amazing case this week that I thought you would be interested in.
A patient was sent to me from a general practitioner in Nov 2008. She had tried dealing with this on a nutritional medicine approach to no avail.
A 62 year old man with severe rheumatoid arthritis, psoriasis and heart palpitations. In his own words he could barely walk from the bedroom to the bathroom. His oral health was really poor.
We removed some teeth, thoroughly curetting all sockets, irrigated with procaine and did extensive perio in our hygiene department. I removed some old amalgams and decay and made him new upper and lower dentures. He had no other medical treatment during this time treatment.
Saw him yesterday. No signs of symptoms of arthritis, psoriasis or heart palpitations. In fact he is heading over to Perth in Western Australia, over 3000 miles away, with his bike and intends to cycle across Australia!!!
Needless to say he was pleased.
Ron Ehrlich B.D.S.
To the editor:
Thanks so much for you valuable tips.
I had a patient come to the office this week with a terrible pain in his neck radiating around his jaw on both sides and up to his temple on one side. He was on Oxycontin from the ER. He had lost 7 pounds, and had no appetite. His brain CT was normal, but some spondylolisthesis showed in his neck Xray.
I looked it up in the text book you recommended, and proceeded to do only four injections on him, two in his neck area over the vertebrae and one in either angle of his jaw.
That night he went home, was able to eat, no longer needed pain meds, and now is not sure he needs to go for temple artery biopsy for arteritis. It was amazing and what was even better is that I had two medical students with me, who also saw for themselves how neural therapy works.
Without your guidance this would not have been possible. This is a wonderful tool to have in our 'doctor bags.' I guess he just had a severe sympathetic response from his neck degenerative arthritis. He returned the next day for another injection, but was still much better.
Jennifer Armstrong MD
Ottawa, Ontario, Canada.
Robert F. Kidd, MD, CM