The Gerson Institute of Ayurvedic Medicine

Scott Gerson, M.D., Ph.D. (Ayurveda) Medical Director, Jupiter Medical Center Dept. of Integrative Medicine Division of Education and Research

 

 

 

 

 

Lake Mary Clinic, Gerson Ayurvedic Spa, and Panchakarma Facility: at 635 Primera Blvd. Lake Mary, Florida 32746

Jupiter Medical Center at The Calcagnini Center for Mindfulness
1210 S. Old Dixie Highway, Jupiter, Florida 33458, Suite M-117.2

 

 

 

 Telephone: (561) 263-MIND (6463); option 2 (407) 549-2800

Cutting Edge Information

Multiple Sclerosis

What is Multiple Sclerosis (MS)?

Multiple sclerosis (MS) is a chronic usually slowly progressive disease of the central nervous system. It is characterized by areas of demyelination of axons of the brain and spinal cord. The term multiple sclerosis refers to the multiple scars (or scleroses) on the myelin sheaths which cover the axons. It is a highly variable condition that can be relatively mild or quite disabling with loss of the ability to walk, write, or even speak.

What causes Multiple Sclerosis?

The cause is unknown. There are many possible causes of MS, including the following:autoimmune disorders (most likely etiology)viruses (retrovirus, herpes virus?)environmental factors (MS more common in temperate zones than in the tropics)genetic factors (HLA allotype and familial incidence associations exist)

What are the symptoms of Multiple Sclerosis?

The symptoms of MS are unpredictable. They may be mild or severe, of long duration or short. They may appear in various combinations, depending on the area of the nervous system affected. The following are the most common symptoms of MS. Individuals may experience symptoms differently. Symptoms may include:

Common initial symptoms of MS:

  • blurred or double vision
  • red-green color distortion
  • pain and loss of vision due to optic neuritis, an inflammation of the optic nerve
  • difficulty walking
  • paresthesia - abnormal sensation, or pain, such as numbness, prickling, or "pins and needles."

Other possible symptoms of MS:

  • muscle weakness in the extremities
  • difficulty with coordination and balance (impaired walking or standing may occur)
  • spasticity - the involuntary increased tone of muscles leading to stiffness and spasms.
  • fatigue (usually triggered by physical activity and subsides with rest;
  • sensory abnormalities (numbness, tingling, pin prick sensation)
  • speech impediments
  • tremor
  • dizziness
  • visual or hearing impairment
  • difficulty concentrating
  • attention deficit
  • decline in memory

How is Multiple Sclerosis diagnosed?

Modern Medicine has no single definitive test to diagnose multiple sclerosis and the diagnosis is made by deduction from various clinical and laboratory evidence. The MRI (magnetic resonance imaging) is the most sensitive test and can reveal plaques in the CNS which are highly suggestive for MS. Oligoclonal bands found in the CSF indicate IgG synthesis inside the blood brain barrier and is also highly suggestive. Sometimes sensory evoked potentials demonstrate a slowing of nerve conduction due to demyelination and is helpful in clarifying the diagnosis. The evaluation for MS covers mental functions, emotional functions, language, movement and coordination, vision, balance, and functions of the five senses.

Evaluation procedures for MS:

The following may be used when evaluating for multiple sclerosis:

  • Magnetic Resonance Imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; to detect the presence of plaques or scarring caused by MS.
  • Evoked Potentials - procedures that record the brain's electrical response to visual, auditory, and sensory stimuli; to show if there is a slowing of messages in the various parts of the brain.
  • Cerebral Spinal Fluid analysis - a procedure used to evaluate the fluid withdrawn from the spinal column to check for cellular and chemical abnormalities associated with MS.
  • Routine blood tests - to rule out other causes for various neurological symptoms

Conventional Treatment

Conventional medical treatment for MS includes only the prescription of various pharmaceutical drugs at this time. Intravenous corticosteroids are the main form of therapy. Immunotherapy with interferon-ß, intravenous IgG, glatiramer acetate; baclofen for spasticity; narcotics for pain; immunosupression using methotrexate, axathiaprine, cyclophosphamide, or cladribine have all been tried but their significant toxicities and ineffectiveness has led to their disuse. Ayurvedic Treatment of MS:

Ayurvedic treatments for MS, as for all diseases, varies depending upon the range, expression, severity, and progression of the condition (rogapariksha) and the innate constitutional qualities of each individual (rogipariksha). Ayurvedic care should include measures to:

  • restore and maintain the activities of daily living
  • help the patient achieve maximum independence
  • promote healthy family involvement
  • empower the patient to make the appropriate decisions relating to his/her care
  • educate the patient regarding the use of assistive devices (i.e., canes, braces, walkers)
  • establish an appropriate exercise program that promotes muscle strength, endurance, and control
  • reestablish fine and gross motor skills
  • manage bowel or bladder incontinence
  • provide cognitive retraining through meditation and other mind/body exercises

Specific treatment for MS will be determined by your Ayurvedic physician based on:-your Ayurvedic constitution, age, diet, overall health, and medical history -severity of the disease -your tolerance for specific protocols, procedures, or herbal therapies -your preferences and lifestyle

It is a perennial wisdom pervading the human intellect that health must arise from a state of harmony within the organism as well as with the environment. Disease, conversely, results when disharmony and imbalance are sustained by a variety of internal and/or external factors. We must always remember that the genius of Ayurveda is not found in its many herbal remedies or diagnostic brilliance but rather in the basic understanding that health can be created and maintained through simple and natural means which include hygiene, appropriate diet, physical exercise, and a tranquil, peaceful mental state. In addition, Ayurveda recognizes the Paramatman (the One Supreme Self; the Life Force) which pervades all of nature. This Life Force manifests itself as three fundamental psychobiologic energies which we call "doshas". Health depends on maintaining a unique balance of these energies which promotes wellbeing. Thus long ago human thought evolved a medical framework which recognized the individualistic mindbody continuum and acknowledged the existence of the Spirit. This holistic belief system endowed its adherents with a great capacity for selfhealing and resistance to disease. The most distinguishing characteristic of this framework was that mind and body, matter and spirit, soma and psyche were not separate entitiestheir separateness is a mistake of our sensorybased interpretation of reality, an illusion, maya.

Ayurvedic treatments for the conditions associated with MS may include the following:

panchakarma physical therapies

Vasti Karma (therapeutic enemata) is universally regarded as the most important panchakarma procedure, and this is especially so for MS. The reason for this is that Vasti Karma results in the removal of excess Vata dosha from the entire body. The term "Vasti" indicates the procedure by which medicines are introduced into the pakvashaya (colon) via the guda-marga (anus). In modern terms, this would appear to be similar to enema therapy or colonic therapy. But these modern procedures are nothing more than bowel cleansing or nutritive therapies; the scope of Ayurvedic Vasti Karma is far more significant and hence cannot be remotely compared with contemporary enemata.

Although useful in a wide variety of clinical circumstances, Vasti Karma is most of all a specific treatment for Vata disorders (AH Su 1/25). The vital importance of Vata dosha to proper function of the mind and body is already well-established. Vata is the moving force which governs the formation, interaction, spread and elimination of all biological substances and waste products. It is the force which propels the other doshas out of their normal seats and channels out into the peripheral tissues. Being the principal treatment for this most influential of biological energies, Vasti karma is a procedure of paramount importance. In fact, the ancient vaidyas considered Vasti to be half of the treatment for any disease and sometimes the entire treatment (CS Si 1/40-41). Other panchakarma procedures used in some circumstances include: shirobasti (head cap), shirodhara (continuous pouring of oil on the forehead), and lepa (application of herbalized muds).

marma point therapies

There exist in human beings three subtle energy organs which serve to link the gross physical body to the higher states of consciousness: the seven (7) chakras, the fourteen (14) nadis, and the hundred and seven (107) marmas.

The chakras are the wheel-like energy centers located along the spine. The nadis are the subtle conduits or channels which emerge from the chakras to reach various points n the physical body. They are not physical in nature but can be perceived by sensitive individuals as energy flows through them.

The marmas are “vulnerable regions” or “sensitive regions” that emerge from the nadis and distribute and regulate Prana from the chakras and nadis. They can be perceived in the physical body as sensitive points or regions. Marma points represent the physical manifestation of energies which originate in the chakras and nadis.

One of the main purposes of Ayurvedic massage is to promote proper flow through the various marma regions. This flow can be disrupted by various factors including a disruption of the doshas. In addition to massage, marma point therapy is a distinct form of treatment used to treat a variety of disorders.

The following chart gives the most commonly used Marma Points for treating Multiple Sclerosis.

Head and Neck Adhipati, Vidhuram, Adhipati

Arms and Hands Apastambha, Kakshadhara, Talhridayam

Torso Guda, Neela, Apastambha

Legs and Feet Lohitaksa, Indrabasti, Ani

Back and Hips Paarshva Sandhi, Kukundara, Katikaruna

herbal medication

There are many herbal medicines currently in use for the treatment of MS related symptoms. Specific herbal and mineral preparations are carefully gathered and prepared which improve both nervous and muscular function according to Ayurvedic tradition. These botanicals came to range from simple spices used as food supplements to sophisticated herbal/mineral preparations requiring much time and specialized knowledge. Examples of plants/preparations used include: ashwagandha (Withania somnifera), bala (Sida cordifolia), and trailokya rasa chintamani, among others.

self massage training

The Ayurvedic technique of abhyanga self massage is unique in that it addresses both daily rhythms and seasonal rhythms. It is not only an important aspect of one’s daily rituals which nourishes the skin and underlying tissues, improves circulation, improves flexibility, stimulates immunity, and prevents stiffness, but it also is a stabilizing and coherent influence on the nervous energies of the MS patient.

The specific abhyanga technique differs from the standard one and balances all three doshas with particular attention to the Vata dosha. It helps regulate the appetite, strengthens the entire body, nourishes the musculature, returns luster to the skin (often diminished in MS), and truly promotes well-being.

dietary modification

Our health largely depends on how well we nourish ourselves. We derive nourishment by extracting energies encoded in food substances and transforming them into our own biological energies.

Vata-regulating Sattvic foods are absolutely required for all MS patients. These are foods abundant in prana, another word for “life force”. The ancient criteria for foods to be considered sattvic were quite simple: foods were to be grown on good soil, far removed from waste sites, protected from animals, have an attractive and normal appearance, and be harvested at the correct time.

Today we must add these modern criteria: Sattvic foods should be grown without pesticides, herbicides, chemical fertilizers, hormones, enzymes, irradiation, genetic manipulation, or anything unnatural. Foods should be whole foods and be as unrefined as possible. Minor processes are permissible if they do not deplete foods of their prana.

individualized yoga training

Ayurvedic treatments act as a conduit between the universe and the individual to restore the balance of the Tridosha. The Tridosha (Vata, Pitta, and Kapha) are the biological forces which regulate the physical and mental activities of humankind. In fact, this trinity of forces in Man reflects the universal cosmic forces of Creation, Preservation, and Destruction which operate simultaneously and eternally throughout the creation.Ayurveda does not view individual asanas in isolation as specific postures which decrease or increase Vata, Pitta, or Kapha. Rather it looks upon them holistically as a sequence of postures which together promote the flow of energies which will assist in balancing the doshas, open the nadis, encourage excretion of wastes, assimilation of nutrients, and optimize the tissues and mind.

A slow, non-vigorous asana practice which is closely coordinated with the breathing is the best. The practice should be evenly balanced on the left and right sides as well as the front and back. Sudden and abrupt changes of positions should be avoided.The evolution of a Vata excess in MS is that is normally first accumulates in the locus of Apana Vata which is in the colon. From there it spreads through the srotas (channels) to the muscle of the back, the bones of the spine, the heart, and the nervous system including the brain.

Vata types will benefit greatly from the gentle, soothing massaging actions on the muscles, tendons, ligaments, and bones created by most of the asanas but particularly forward bends (i.e. Ardha Baddha Padma Paschimottasana) and twists (i.e. Ardha Matsyendrasana, Trikonasana). Also, the gentler forms of inverted and backbending asanas will effectively release excess sympathetic nervous energy and promote harmony with parasympathetic energy throughout the physiology.

meditative practices

The full dynamic potential of the human being cannot evolve unless the mind of an individual becomes completely integrated. The three aspects of the human mind—intellect, emotion, and will—are generally disproportionately developed in a given person. Observing your friends and family it is easy to recognize people who are dominated by an intellectual approach to life, by their emotional responses to life, or by their seemingly self-centered and forceful will. In order for a person to evolve to his or her fullest potential, including healing from disease, it is essential that these three mental aspects be brought into harmony and balance.

Meditation is a way to achieve this integration and balance. The human mind is an arena of conflicting urges and emotions which thwart the cultivation of any real, sustained health, peace and happiness. The ancient Hindus, who were concerned with contemplation and penetration of the ultimate secrets of life, discovered the utility of the regular and persistent practice of meditation. Mantras are given to each individual in an initiation ceremony according to special astrological calculations as well as consideration of the individual’s mental energies, family life, activities, and other factors.

customized exercise program

Apart from the regular practice of Yoga asanas, treadmill, stationary bike, and other gentle aerobic types of exercise have been shown to be effective in the treatment of multiple sclerosis. If properly individualized exercise can help improve autonomic control of heart rate and arterial blood pressure, cardiorespiratory fitness, skeletal muscle function, and symptom instability under thermal stress.