Understanding Multiple Sclerosis

by John G. Connor, M.Ac., LAc.,  edited by Barbara Connor, M.Ac., L.Ac.

TABLE  OF  CONTENTS
Introduction
What is Multiple Sclerosis?
What causes Multiple Sclerosis?
Chinese Medical view of Multiple Sclerosis
Acupuncture, Craniosacral Therapy, Botanicals and Nutrients in treating MS symptoms
Recommended foods
Swank’s Dietary Protocol
Foods to Avoid
Botanical and Nutritional Support
Herbal and Nutritional Supplement Safety Issues
Lifestyle Recommendations
References

INTRODUCTION
In our treatment of multiple sclerosis (MS) Barbara and I use a combination of acupuncture, craniosacral therapy, botanicals, nutrients, dietary and lifestyle recommendations.  None of the treatment modalities we employ can cure MS but we believe our treatments can help with symptom management and with some of the side effects of the conventional drugs used for MS.  

People with MS are widely using complementary and alternative medicine (CAM) treatments. Internationally, study results indicate that the prevalence of CAM use among people with MS ranges from 41% in Spain to 70% in Canada and 82% in Australia. The reasons for CAM use vary from treatment of concrete symptoms to bodily exploration and development of coping strategies, and CAM treatments are most often used in combination with conventional treatment. (Skovgaard et al 2012)

Over the last few decades medications, such as Betaseron, Avonex and Copaxone, have been developed that favorably alter the disease process in MS.  In recent years the scenario of therapies for MS has widened with the advent of new drugs. The majority of people with MS are probably using one of these medications under the supervision of a physician with expertise in treating MS.  We realize that MS is a very complicated disease and we sincerely hope the following article helps clarify the role that integrative treatments can play in helping people with multiple sclerosis to have a better quality of life. 

The increasing number of first-line and second-line treatment options, together with the variable course of the disease and patient lifestyles and expectations, makes the therapeutic decision a real challenge. There is no single best treatment strategy, but therapy has to be tailored to the patient. This is a time-consuming task, rich in complexity, and influenced by the attitude towards risk on the parts of both the patient and the clinical team. (Lugaresi et al 2013) It is now established that anti-inflammatory and immunomodulatory treatment is beneficial in the early relapsing stage of MS, but these treatments are ineffective in secondary progressive and particularly in primary progressive MS. (Losy J 2013)
 
WHAT  IS  MULTIPLE  SCLEROSIS?
Multiple sclerosis is a disease of the central nervous system (CNS), including the brain, the optic nerve and the spinal cord.  It affects various parts of the nervous system by destroying the myelin sheaths that cover the nerves and leaving scar tissue called plaques, ultimately resulting in destruction of the nerves.  This process is known as sclerosis.  Because the sclerotic lesions can heal, this disease goes through characteristic phases of remission and relapse.

Multiple sclerosis is a neurodegenerative disease characterized by chronic inflammation accompanied by demyelination of neurons in brain. MS is characterized by symptoms like mood disorder, fatigue, vision changes, muscle weakness, and motor changes. Chemokines like IL-17, chemokine (C-C motif) ligand 17 (CCL17), and CCL20 are suggested as major mediators in MS neuroinflammation and pathology. (Bhullar & Rupsainghe 2013)

Multiple sclerosis is an autoimmune disease characterized by recurrent episodes of demyelination and axonal lesion mediated by CD4+ T cells with a proinflammatory T helper (Th)1 and Th17 phenotypes, macrophages, and soluble inflammatory mediators. The overactive pro-inflammatory Th1 cells and clonal expansion of B cells initiate an inflammatory cascade with several cellular and molecular immune components participating in MS pathogenic mechanisms. (Mirshafiey & Kianiaslani 2013)

MS involves autoimmune inflammatory attack against the myelin insulation of neurons.  Thymus derived (T) cells sensitized against myelin self-antigens secrete tumor necrosis factor, cytokines, prostaglandins and other inflammatory mediators that strip away the myelin and sometimes destroy the axons.

 Symptoms vary from person to person.  They usually begin with fatigue followed by visual problems (double vision and blind spots), numbness and tingling, speech disturbances, dizziness, bowel and bladder disorders, weakness, lack of coordination (difficulty walking, foot dragging), paralysis, loss of balance and emotional instability.

Multiple sclerosis (MS) has traditionally been considered an autoimmune inflammatory disorder leading to demyelination and clinical debilitation as evidenced by our current standard anti-inflammatory and immunosuppressive treatment regimens. While these approaches do control the frequency of clinical relapses, they do not prevent the progressive functional decline that plagues many people with MS. Many avenues of research indicate that a neurodegenerative process may also play a significant role in MS from the early stages of disease, and one of the current hypotheses identifies mitochondrial dysfunction as a key contributing mechanism. We have hypothesized that pathological permeability transition pore (PTP) opening mediated by reactive oxygen species (ROS) and calcium dysregulation is central to mitochondrial dysfunction and neurodegeneration in MS. (Su et al 2013)

According to Dr. Andrew Weil although many of us associate MS with eventual paralysis, the course of MS is extremely individual, ranging from periodic, mild flare-ups in some people to severe progression of symptoms in others.  In fact more than 75% of people with MS will never need to use a wheelchair.

WHAT  CAUSES  MULTIPLE  SCLEROSIS?
The cause of MS is still unknown, although it is widely believed to be an autoimmune disease in which white blood cells attack the myelin-producing cells in the CNS as if they were a foreign substance.  T-cells reactive to the major constituents of myelin, such as myelin basic protein (MBP) and proteolipid protein, migrate from the peripheral circulation, across the blood-brain barrier, and into the brain.  There they proceed to attack myelin-ensheathed axons and myelin-producing cells, initiating an inflammatory cascade that eventuates in the white matter lesion or plaque of MS. 

Myelin-reactive T-cells in the peripheral circulation may become activated by microbes. Structural similarities between the foreign antigens on the microbes, and the self-antigens of myelin may lead to inadvertent auto-sensitization of the T-cell against self.  Cytokines, which are small peptide substances that act as cell-to-cell messengers to regulate immune cell activity, may also play a role.  Cytokine production can set the immune system into one of two major modes: T-helper types 1 (Th1) or 2 (Th2).  Th1 activation features mainly cell-mediated cytotoxicity, and inflammatory and hypersensitivity reactions.  In MS the Th1 pattern dominates.  Therapeutics are being pursued that down-regulate Th1 cytokines, with the goal of systemically turning off the autoimmunity of MS.

Some experts suggest that an as-yet-unidentified virus may be involved.  Heredity may also be a factor.  Another theory is that it is caused by food intolerances or allergies, especially allergies to dairy products and to gluten.  It has been seen to follow malnutrition, emotional stress, and infections.

The cerebrospinal fluid (CSF) of most MS patients contains an elevated level of antibodies, which is characteristic of an infectious process. One hypothesis states that this is in fact due to an unrecognized infectious agent that causes MS.  Epidemiological studies suggest MS is initiated by a primary encounter with an environmental agent during childhood or early adulthood.  Viruses are obvious candidates for the infectious agents in MS because several cause demyelination in humans and animals.  The demyelination of MS may result from direct viral damage to brain cells, or from viral infection leading to the formation of antibodies, which then attack the myelin.

Some studies suggest that oxidative stress may be one of the sources, or a consequence of the disease, from loss of oxidant/antioxidant balance. Clarification of the mechanisms involved in oxidative stress, in different forms of multiple sclerosis, could result in improvements in the monitoring and prognosis of the disease, with subsequent increases in a patient’s quality of life. (Ferreira et al 2013)

Chemokine Receptors in MS:

According to an article published by R&D Systems entitled “Chemokine Receptors and Multiple Sclerosis Pathogenesis” (Fall 2003) – as a result of the myelin reactive T cells crossing the blood brain barrier into the CNS an inflammation cascade is initiated with release of inflammatory mediators that damage or destroy oligodendrocyte-formed myelin sheaths and underlying axons. Several lines of evidence suggest that chemokines, small secreted proteins important for regulating leukocyte trafficking, play a role in directing or maintaining T cells in regions where myelin destruction takes place.

The article goes on to say that several studies show that T cells isolated from the blood and CSF of MS patients exhibit increased levels of chemokine receptors including CCR5 and CXCR3.  In addition, some studies show that elevated levels of CCR2, CCR5, CXCR3 on cells in blood and CSF are associated with relapse in individual patients, while treatment of MS with IFN-β results in down regulation of CXCR3 and CCR5.  Chemokines undoubtedly play critical roles in directing lymphocytes to regions of inflammation.  Further studies will be needed to determine whether chemokines and their receptors might represent effective targets for future MS therapies.

 According to an article by Parris M. Kidd, PhD, on multiple sclerosis published in Alternative Medicine Review (2001) agents that can trigger MS exacerbations include viral infections, emotional stress, pregnancy, heat exposure, allergic reactions to foods and irritation or provocation by environmental agents.  The major etiological factors best supported by the available evidence are inherited susceptibility, microbial infections and environmental toxin exposure.  Diet has been less studied but undoubtedly makes important contributions.

Some of the factors that may contribute to the causation, exacerbation or progression of MS as outlined in Dr. Kidd’s article are as follows:

Viruses Linked to MS:
Human Herpesvirus Type 6 (HHV-6)
Chlamydia
Mycoplasmas
Varicella zoster
Retroviruses
Nidoviruses

Toxins and other Environmental Factors which may be Linked to MS
Solvents and pesticides
 X-rays
Exposure to cats, dogs and caged birds
Mercury

Dietary Factors Contributing to the Worsening of MS:
High animal fat diet
Diets high in gluten and milk (T-lymphocytes reactive with milk proteins are very common in persons with MS, and small proteins from milk have been found to be molecular mimics of self-antigens in myelin.)
Allergies to tobacco, house dust, etc.
Sulfite food additives

CHINESE  MEDICAL  VIEW  OF  MULTIPLE  SCLEROSIS
In Chinese Medicine MS is considered a type of Atrophy or Flaccidity (Wei) Syndrome.  Demyelination – a loss of fatty substance surrounding the nerve fibers – corresponds to a description in Chinese Medicine involving the loss of vital fluid Essence or Jing.  The quality of the myelin sheath is similar to the Chinese Medicine quality of Essence.  In Chinese Medicine the brain and spinal cord are understood to be an extension of the Kidney system, the storehouse of Essence.  Kidney yin and yang are the key factors in the regulation and balancing of yin, yang, qi, blood and all the body’s immune mechanisms.  Proper regulation of the normal immune response is achieved through balance.  Therefore the focus in treating the autoimmune aspect of MS in Chinese Medicine is to nourish the Kidney Essence and establish a balance in physical, emotional, mental and spiritual energy as well as in life style.

The most common Chinese Medical patterns seen in multiple sclerosis are:
Damp-Phlegm with Spleen Deficiency which manifests as numbness, feeling heaviness of the legs, tingling, dizziness and tiredness.
Liver and Kidney Deficiency
which manifests as progressive weakness of the legs, weak back and knees, dizziness, poor memory, blurred vision, hesitancy or urgency of urination.
Liver Yang Rising which manifests as stiffness of the legs, vertigo and vomiting.
Liver Wind which manifests as tremors, spasms and paraplegia.

ACUPUNCTURE, CRANIOSACRAL THERAPY, BOTANICALS AND NUTRIENTS IN  TREATING  MS  SYMPTOMS
Barbara and I believe that acupuncture, especially when it is combined with craniosacral therapy may help with MS related symptoms by releasing not only energy blockages in the meridians and energy centers but also restrictions in the fascia which surrounds muscles and organs as well as blood vessels and nerves.  The focus of these treatment strategies is to promote the flow of nutrients and energy throughout the body especially to the muscles, nervous system and immune system and encourage the balancing of these vital systems so that people with MS can lead a healthier life. The botanicals and nutrients work together to help enhance the vitality and life force, increase efficiency, restore harmony and rhythm, correct nutritional deficiencies and excesses, as well as remove toxins.

RECOMMENDED  FOODS
Eat only organically grown foods with no chemical treatments or additives, including eggs, fruits, gluten free grains, raw nuts and seeds, vegetables, soaked raw oats, sprouted wheat (if there is no gluten sensitivity), rice, raw goats milk, fresh wheat germ and GLA rich oils. (MS patients have a severe deficiency in various fatty acids, particularly linoleic acid).

Also recommended are tofu, tempeh, soy sprouts, soy milk, cabbage and cauliflower which are all rich lecithin sources. (Lecithin is often deficient in MS.)

Liver Yin tonics such as leafy green vegetables, mung beans, mung bean sprouts, millet, seaweeds, cereal grass concentrates, micro-algae, and in cases of severe deficiency gelatin or animal liver.
 
Cold-water fish – are rich in omega-3 oils which are important in maintaining normal nerve cell function and myelin production. They are incorporated into the myelin sheath where they may increase fluidity and improve neural transmission.
 
Maintain a low fat diet because a high fat diet impairs the conversion of linoleic acid to prostaglandin E1 (PGE1).  (PGE1 regulates brain function and nerve impulses, is required for proper functioning of the immune system, is a vasodilator, controls blood pressure and inhibits blood clotting.)
 
Eat plenty of raw sprouts and alfalfa, plus foods that contain lactic acid such as sauerkraut and dill pickles. Also good are drinks that contain lots of chlorophyll.
 
Drink at least eight 8 oz. glasses of quality water each day to prevent toxic buildup in the muscles.
 
Take a fiber supplement. Fiber is important for avoiding constipation.
 
Never consume saturated fats, processed oils, oils that have been subjected to heat (either in processing or in cooking), or oils that have been stored without refrigeration.

SWANK’S  DIETARY  PROTOCOL
Devised by Dr. Roy Swank, Professor of Neurology, Univ. of Oregon Medical School, this diet may help MS symptoms.  Swank’s diet recommends:
Fresh whole foods should be emphasized and animal foods (with the exception of fish) should be reduced, if not completely eliminated.
 
Fish should be eaten three or more times a week.
 
Saturated fat intake should be no more than 10 grams per day.
 
Daily intake of polyunsaturated oils should be 40-50 grams (margarine, shortening and hydrogenated oils are not allowed).
 
Normal amounts of protein are recommended.
 
Swank’s diet significantly reduces the platelet adhesiveness and aggregation which is observed in atherosclerotic processes as well as in MS.  Excessive platelet aggregation and micro-emboli are thought to result in damage to the blood-brain barrier, alterations in the micro-circulation of the brain and spinal cord and lack of oxygen to the brain. 
 
In addition to reducing platelet stickiness Swanks diet probably benefits MS in several other ways: 
1)   It would be expected to lower cholesterol. 
2)   Polyunsaturated oils appear to help prevent MS deterioration (cod-liver oil inhibits autoimmunity in experimental animals)
3)   Keeping the “bad” fatty acids low reduces their competition with the “good” ones such as omega-6 GLA and omega-3 ALA, EPA and DHA.

FOODS  TO  AVOID
Avoid saturated fats, cholesterol and alcohol because they lead to the production of PGE2 which promotes the inflammatory response and worsens MS symptoms.  Alcohol also interferes with unsaturated fatty acid conversion, increases the saturated-fat blood count and destroys various B vitamins.

Avoid red meat.  Animal source fats have a significant content of saturated fats; a low content of the anti-inflammatory omega-3 fatty acids DHA and EPA; and a high proportion of their omega-6 fatty acids are in the form of long-chain omega-6 arachidonic acid.  Arachidonic acid is a precursor to pro-inflammatory prostaglandins.  The delicate endothelial linings of the blood vessels are vulnerable to pro-inflammatory attack, and inflammation of blood vessels in the brain is characteristic of MS.  Plaques frequently arise around a vein or venule.  Omega-3 fatty acids help maintain anti-inflammatory balance in the circulation, while supporting myelination and nerve cell membrane renewal.
 
Avoid cow’s milk.  Cow’s milk contains only 1/5 the linoleic acid of human milk.  According to a study appearing in Lancet in 1974 people who were fed cow’s milk as children were found to be more susceptible to MS as adults than people who were breast-fed. 
 
Also avoid tobacco, chocolate, sugar, (eating sweets has been linked to increased MS risk), coffee, fried foods, highly seasoned foods, meat, refined foods, salt, processed, canned or frozen foods and nitrates (found in certain smoked sausages).  

Try avoiding gluten. In case you may be allergic to gluten you may wish to try eliminating gluten from your diet and see if it helps.

BOTANICAL AND NUTRITIONAL  SUPPORT
  • Antioxidants – Oxidative stress is a crucial factor in MS pathogenesis by ameliorating leukocyte migration, contributing to oligodendrocyte damage and axonal injury. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are created in the CNS of MS patients mainly by activated macrophages and microglia structures responsible for demyelinisation and axons disruption. Activated microglia secrete different inflammatory and oxidative stress mediators such as cytokines (TNF and IL- 1b and IL- 6) and chemokines (macrophage inflammatory protein MIP- 1a, monocyte chemoattractant protein, MCP- 1 and interferon (IFN) inducible protein IP- 10). The inflammatory state is promoted by that. MS in chronic stages is dominated by neurogenerative processes involving axon and neuron loss probably resulting from oxidative stress and excitotoxicity. Therefore, consideration of the treatment engaging antioxidants and dietary supplementation is needed. (Miller et al 2013)
Fruits highest in antioxidants include amla, bilberries (dried), black currants, wild strawberries, cranberries, dried apples, dried plums, dried apricots and prunes.  Grains highest in antioxidants are buckwheat, millet and barley.  Nuts high in antioxidants include walnuts, pecans and sunflower seeds. Beverages high in antioxidants include espresso, coffee and pomegranate juice. Spices highest in antioxidants include clove, peppermint, allspice, cinnamon, oregano, and thyme.  Artichokes are antioxidant rich vegetables. Fruits and vegetables in the medium antioxidant range are dried dates, dried mango, black and green olives, red cabbage, red beets, paprika, guava and plums. (Carlsen et al 2010) Other powerful antioxidants include alpha-lipoic acid, N-acetylcysteine, coenzyme Q10, vitamin C & vitamin E. 
  • CoQ10 – The present study suggests that CoQ10 supplements at a dose of 500 mg/day can decrease oxidative stress and increase antioxidant enzyme activity in patients with relapsing-remitting MS. (Sanoobar et al 2013) CoQ10 is needed for improved circulation and tissue oxygenation. It strengthens the immune system. Food sources include mackerel, salmon, sardines, beef, peanuts and spinach.
  • Curcumin is a polyphenolic compound isolated from the rhizome of the plant Curcuma longa that has traditionally been used for pain and wound-healing. Recent studies have shown that curcumin ameliorates multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel disease in human or animal models. Curcumin inhibits these autoimmune diseases by regulating inflammatory cytokines such as IL-1beta, IL-6, IL-12, TNF-alpha and IFN-gamma and associated JAK-STAT, AP-1, and NF-kappaB signaling pathways in immune cells. Although the beneficial effects of nutraceuticals are traditionally achieved through dietary consumption at low levels for long periods of time, the use of purified active compounds such as curcumin at higher doses for therapeutic purposes needs extreme caution. A precise understanding of effective dose, safe regiment, and mechanism of action is required for the use of curcumin in the treatment of human autoimmune diseases. (Bright JJ 2007)
  • DHEA (dehydroepiandrosterone) – Fatigue in progressive MS could be related to low serum levels of DHEA and DHEAS. Our results suggest that these hormones should be considered as biological markers of fatigue in MS patients and that hormone replacement may thus be tested as an option to treat fatigue in MS patients. (Tellez et al 2006)
  • Eicosapentaenoic acid (EPA) and docosahexanoicacid (DHA) – EPA greatly inhibits platelet aggregation and DHA is present in large concentrations in lipids in the brain. Supplementation may be helpful in areas where cold-water fish are not available as both EFA & DHA are found in cold-water fish oils.  A small clinical trial published by Cendrowski in Br J Clin Practice 1986;40: 365-367 with no patient control group suggested that omega-3 fatty acid supplements from fish oil might reduce MS exacerbations. 
  • Epigallocatechin-3-gallate (EGCG) exhibited neuroprotective effects by modulating neuroinflammation and attenuating neural damage. Quercetin, apple polyphenols, myricetin, and piceatannol have also activated SIRT1, thus exhibiting potential in MS treatment. Earlier studies have also shown  that flavonoids limit demyelination in MS suggesting their potential against neuro-inflammation and related disorders. Preclinical data has shown that polyphenols exhibit potential to block neural inflammation and damage by activation of SIRT1 pathway along with modulation of inflammatory cytokines. The potential of polyphenols on limiting demyelination makes them prospective therapeutics in age-related MS and amyotrophic lateral sclerosis (ALS). (Bhullar & Rupsainghe 2013)
  • Essential Fatty Acids (EFA) – The omega-6 EFA, linoleic acid, has an inhibitory effect on the inflammatory response and the omega-3 EFA, alpha-linolenic acid, has a greater effect on platelets (interferes with blood clotting) and is required for normal CNS composition. Both omega-3 and omega-6 EFAs are found in flaxseed oil.  A study published by Homa et al in J Neurol Neurosurg Psychiatr 1980;43:106-110 found abnormally low levels of linoleic acid in the red cells of 14% of their MS patients. Small clinical trials suggest a modest reduction in the severity and duration of relapses in patients with MS receiving PUFA supplements. (von Geldern & Mowry 2012)
  • Evening Primrose Oil – may be helpful in the event that there is a block in the conversion of linoleic acid to GLA (gamma-linolenic acid) as evening primrose oil has a high concentration of GLA. A non-controlled study done by Simpson et al published in New Zealand Med J 1985;98: 1053-1054 concluded that GLA from primrose oil improved peripheral blood flow characteristics and consequently, hand-grip strength.
  • Gamma-linolenic acid (GLA) – is produced in the healthy body from omega-6 EFAs and is also found in spirulina, borage seed oil, evening primrose oil and black currant seed oil. GLA is converted into PGE1 by the body.  PGE1 regulates brain function and nerve impulses, is required for proper functioning of the immune system, is a vasodilator, controls blood pressure and inhibits blood clotting. GLA contributes to anti-inflammatory balance by competing with the pro-inflammatory arachidonic acid.  Avoid non-steroidal anti-inflammatory agents such as aspirin, ibuprofen and indomethacin as they not only block the production of PGE2 but also PGE1.
  • Ginseng The purpose of this study was to evaluate the efficacy and safety of ginseng in the treatment of fatigue and the quality of life of multiple sclerosis (MS) patients. Of 60 patients who were enrolled in the study, 52 (86%) subjects completed the trial with good drug tolerance. Statistical analysis showed better effects for ginseng than the placebo as regards MFIS (p = 0.046) and MSQOL (p ≤ 0.0001) after 3 months. No serious adverse events were observed during follow-up. This study indicates that 3-month ginseng treatment can reduce fatigue and has a significant positive effect on quality of life. Ginseng is probably a good candidate for the relief of MS-related fatigue. Further studies are needed to shed light on the efficacy of ginseng in this field. (Etdemadifar et al 2013)
  • Oleanolic acidMultiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), are inflammatory demyelinating diseases that develop as a result of deregulated immune responses causing glial activation and destruction of CNS tissues. Oleanolic acid and erythrodiol are natural triterpenes that display strong anti-inflammatory and immunomodulatory activities. These triterpenes protected against EAE by restricting infiltration of inflammatory cells into the CNS and by preventing blood-brain barrier disruption. Triterpene-pretreated EAE-mice exhibited less leptin secretion, and switched cytokine production towards a Th2/regulatory profile, with lower levels of Th1 and Th17 cytokines and higher expression of Th2 cytokines in both serum and spinal cord. Triterpenes also affected the humoral response causing auto-antibody production inhibition. In vitro, triterpenes inhibited ERK and rS6 phosphorylation and reduced the proliferative response, phagocytic properties and synthesis of proinflammatory mediators induced by the addition of inflammatory stimuli to microglia. Both triterpenes restricted the development of the characteristic features of EAE. We envision these natural products as novel helpful tools for intervention in autoimmune and neurodegenerative diseases including multiple sclerosis. (Martin et al 2012)
  • Polyphenols are naturally occurring phytochemicals found in fruits and vegetables, exhibiting strong neuroprotective properties. Important dietary sources of polyphenols include apples, berries, cocoa, herbs, red wines, seeds, onions, and tea. Dietary polyphenols have also been implicated in prevention of oxidative damage and LDL oxidation. (Bhullar & Rupsainghe 2013)
  • Quercetin was found to control immune response via modulation of IL-1β and TNF-α and reduced the proliferation of peripheral blood mononuclear cells isolated from multiple sclerosis patients. (Bhullar & Rupsainghe 2013)
  • Resveratrol, a silent mating type information regulation 2 homolog1 (SIRT1) activator, has exhibited prevention of neural loss without immunosuppression in experimental autoimmune encephalomyelitis (EAE) model of MS. Pharmaceutical grade formulation of resveratrol SRT501 was found to attenuate neural damage in EAE through SIRT1 activation. Cell culture studies have also shown SIRT1-mediated neuroprotection by resveratrol. (Bhullar & Rupsainghe 2013)
  • Scutellaria baicalensis Georgi is one of the important medicinal herbs widely used for the treatment of various inflammatory diseases in Asia. Baicalin (BA) is a bioactive anti-inflammatory flavone found abundantly in Scutellaria baicalensis Georgi. To explore the therapeutic potential of BA, we examined the effects of systemic administration of the flavone (5 and 10 mg/kg, ip) on relapsing/remitting experimental autoimmune encephalomyelitis (EAE) induced by proteolipid protein 139-151 in SJL/J mice, an experimental model of multiple sclerosis. The results suggest that BA might be effective in the treatment of multiple sclerosis.(Zeng et al 2007)
  • Low vitamin B(12) levels and raised homocysteine levels  – A meta-analysis was conducted to assess the relationship between serum homocysteine, vitamin B(12), and folate levels in patients with multiple sclerosis (MS). Both  homocysteine and vitamin B(12) were statistically significant, but the standardized mean difference for folate was not. Patients with MS were found to have raised homocysteine levels but low B(12) levels, which might contribute to the pathogenesis of MS. (Zhu et al 2011) Vitamin B12 aids in cellular longevity and helps prevent nerve damage by maintaining the protective myelin sheaths. Use a lozenge or sublingual form. Food sources include: Brewer’s yeast, clams, eggs, herring, mackerel, dairy products, meat and fish; also dulse, kelp, kombu, nori, soybeans and soy products.
Hyperhomocysteinemia (elevated homocysteine) is associated with cognitive impairment in multiple sclerosis. The authors of this study concluded that plasma total homocysteine levels are increased in MS and that hyperhomocysteinemia is associated with cognitive impairment in this disease. (Russo et al 2008)  

  • Vitamin A – is an important antioxidant.  Oxidative stress is increased in MS.  Food sources include liver, fish liver oils, green and yellow fruits and vegetables, apricots, asparagus, beet greens, broccoli, cantaloupe, carrots, collards, dandelion greens, dulse, garlic, kale, mustard greens, papayas, peaches, pumpkin, red peppers, spirulina, spinach, sweet potatoes, Swiss chard, watercress and yellow squash.
  • Vitamin C – promotes production of the antiviral protein interferon in the body. It is also an antioxidant and immune stimulant.  Consuming foods rich in vitamin C has been correlated with decreased MS risk. Food sources include berries, citrus fruits, green vegetables, asparagus, avocados, broccoli, Brussel sprouts, cantaloupe, collards, kale, mangos, onions, papayas, green peas, persimmons, pineapple, spinach, strawberries and tomatoes.
  • Vitamin Dstatus has been shown to influence both the incidence and the course of MS. High vitamin D levels are probably protective against the development of MS, although the efficacy of vitamin D supplementation in slowing progression of MS remains to be established. (von Geldern & Mowry 2012) Vitamin D aids in calcium absorption.  Food sources include fish liver oils, fatty saltwater fish, eggs, dandelion greens, liver, sweet potatoes, salmon, tuna and vegetable oils.
  • Low Vitamin E and higher Homocysteine levels – We compared the blood levels of uric acid, folic acid, vitamins B12, A, and E, tHcy, CHL, HDL-cholesterol, and triglycerides in forty MS patients during a phase of clinical inactivity with those of eighty healthy controls, matched for age and sex. We found higher levels of tHcy (p = 0.032) and of HDL-cholesterol (p = 0.001) and lower levels of vitamin E (p = 0.001) and the ratio vitamin E/CHL (p = 0.001) in MS patients. (Sqlemi et al 2010) Vitamin E protects the nervous system, is important for circulation and is also a powerful antioxidant.  Food sources include cold pressed vegetable oils, dark green leafy vegetables, legumes, nuts, seeds and whole grains; also brown rice, dulse, eggs, kelp, flaxseed, oatmeal, cornmeal, soybeans, sweet potatoes, watercress, wheat and wheat germ.
  • Vitamin B1 (Thiamine) acts as a coenzyme participating in the complex process of glucose conversion into energy and is vital in certain metabolic reactions.  It is involved in the maintenance of the heart and nervous system, and acts as an antioxidant, protecting the body form the degenerative effects of aging.  Consumption of foods rich in thiamine is correlated with a decreased MS risk.  Food sources include brown rice, fish, legumes, peanuts, peas, poultry, rice bran, wheat germ and whole grains.
  • Vitamin B2 (Riboflavin) is necessary for cell respiration because it works with enzymes that take the oxygen from the cells.  It is part of a group of enzymes that are involved in the production of bodily energy, which utilizes carbohydrates, fats and proteins. Consumption of riboflavin rich foods is correlated with decreased MS risk. Food sources include cheese, egg yolks, fish, legumes, meat, milk, poultry, spinach, whole grains and yogurt; asparagus, avocados, broccoli, Brussels sprouts, currants, dandelion greens, dulse, kelp, leafy greens, mushrooms, molasses, nuts and watercress.
  • Vitamin B6 (Pyridoxine) – is required by the nervous system and is needed for normal brain function. It aids immune function and is involved in more bodily functions than almost any other single nutrient. Deficiency may cause MS in susceptible persons. Food sources include: brewer’s yeast, carrots, chicken, eggs, fish, peas, spinach, sunflower seeds, walnuts, and wheat germ.
  • Vitamin B complex – aids immune system function and maintains healthy nerves.
  • High copper and low zinc levels – The serum levels of zinc (Zn) and copper (Cu) were measured in sixty Iranian patients with MS and compared with sixty age-, gender- and socioeconomic status-matched healthy subjects without any neurological disorders as controls from the same geographical area. Significantly lower serum Zn and higher serum Cu levels were found in the MS patients compared with the controls (p < 0.0001 and p = 0.002, respectively). The serum Zn level of the secondary-progressive MS patients was significantly lower compared with the relapsing-remitting MS patients (p = 0.009). There was no significant difference between the serum Cu levels of the two subgroup of MS patients (p = 0.42). (Ghazavi et al 2012)
  • Sulfur – protects against toxic substances.  Garlic is an excellent source of sulfur.
  • Manganese – is needed for healthy nerves and a healthy immune system. It is an important mineral often deficient in people with MS.  Food sources include: avocados, nuts and seeds, seaweed and whole grains as well as in blueberries, egg yolks, legumes, dried peas, pineapples and green leafy vegetables.
  • Potassium – is needed for normal muscle function. Consuming foods rich in potassium has been correlated with decreased MS risk.  Food sources include: fish, fruit, legumes, poultry, vegetables and whole grains.  It is specifically found in apricots, avocados, bananas, blackstrap molasses, brewer’s yeast, brown rice, dates, dulse, figs, dried fruit, garlic nuts, potatoes, raisins, winter squash, torula yeast, wheat bran and yams.
  • Choline and Inositol – stimulate the central nervous system and aid in protecting the myelin sheaths from damage. Food sources of choline include: egg yolks, lecithin, legumes, soybeans and whole grain cereals.  Food sources of inositol include: brewer’s yeast, fruits, lecithin, legumes, unrefined molasses, raisins, vegetables and whole grains.  Caution:  The consumption of large amounts of caffeine may cause a shortage of inositol in the body.
  • L-glycine – aids in supporting the myelin sheaths. Glycine has been recommended for persons with MS since it counteracts aldehyde accumulation and has antispasmodic properties (daily dosage is about 3 grams per day).
  • Calcium – deficiency may create a predisposition to developing MS. Calcium is needed for prevention of muscle cramps, prevents bone loss associated with osteoporosis, helps to keep the skin healthy and aids in neuromuscular activity.  Foods high in calcium include kelp, cheddar cheese, collard leaves, kale, turnip greens, almonds, brewer’s yeast, parsley, dandelion greens, hazel nuts, Brazil nuts, watercress, goat’s milk, tofu, dried figs, buttermilk, sunflower seeds, yogurt, whole milk, olives, broccoli, clams and spinach. If supplementing use supplements consisting of calcium citrate and/or calcium malate. Use chelate form for best assimilation.  Caution: Calcium supplements should not be taken by persons with a history of kidney stones or kidney disease.
  • Magnesium – is needed for calcium absorption and for proper muscular coordination. A deficiency of magnesium interferes with the transmission of nerve and muscle impulses, causing irritability and nervousness. Food sources include dairy products, fish, meat, seafood, apples, apricots, avocados, bananas, brown rice, dulse, figs, garlic grapefruit, green leafy vegetables, kelp, lemons, peaches, soybeans, tofu, wheat and whole grains.
  • Valine, Isoleucine and Leucine – work together to protect muscle.
  • Lecithin (granules or capsules) – needed for normal brain function.
  • Acidophilus – helps to detoxify harmful substances, enhances absorption of nutrients and aids digestion.
  • Milk thistle – Numerous controlled studies in Germany have demonstrated that milk thistle can benefit the health of the liver. Conventional drug management of MS through interferon β-1a (Avonex) and glatiramer acetate (Copaxone) and most of the other injectable treatments tax the liver as can chronic use of medications such as Ibuprofen and Imodium. 
HERBAL  AND  NUTRITIONAL  SUPPLEMENT  SAFETY  ISSUES
On the question of enhancing immune system function with tonic herbs in MS: 
According to a review on herbal safety published in an article on the Rocky Mountain MS Center website, people with MS should be aware of individual herbs or mixtures of herbs that may activate the immune system.  The article asserts that since MS is characterized generally by excessive immune system activity, these herbs pose theoretical risks.  That these herbs may be immune-stimulating does not necessarily imply that they are “bad” for people with MS.  Instead, it means that there is a theoretical risk to be considered before using these herbs that are poorly studied in MS. 

The question of glutamine supplementation in MS: 
In an article by Subhuti Dharmananda on the dangers of excess glutamine in MS, he notes that in some neurological diseases, it is found that glutamate levels in the central nervous system become unusually high at sites of pathology.  In one of these processes that takes place glutamate is excreted by immune cells that take part in inflammatory processes, the result is high local concentrations at the neurons in progressive neurological diseases such as MS and ALS.  The excess glutamate at the neuron acts as a poison; at high enough levels, the nerves exposed to glutamate can be completely and permanently damaged, so that they are no longer capable of transmitting signals.  Thus, while glutamate is a major component of the body, and an essential part of the nervous system, high levels localized in the nerve cells can be quite toxic.
The role of glutamate in ALS and MS has raised the question as to whether persons with these diseases might have to be careful not to get high levels of either glutamine or glutamate via their diet and/or by taking glutamine supplements.  Until more is known about glutamine supplementation in relation to ALS and MS, it is recommended that patients who have these diseases limit their intake of supplemental glutamine.  One can avoid excessive intake of glutamate by minimizing ingestion of foods containing MSG and hydrolyzed vegetable protein, and by limiting the dosage of glutamine supplementation.  A modest glutamine supplement level of about 5-10 grams/day is likely to have some benefit in relation to muscle wasting, immune responsiveness, or intestinal disorders, without promoting increased glutamate levels in the blood. 

Use of Chinese herbs in the treatment of MS: 
 According to a study done by Xi and Yaohua entitled “Thirty-five cases of multiple sclerosis treated by traditional Chinese medical principles using differential diagnosis” published in the Chinese Journal of Integrated Traditional and Western Medicine1990; 10(3): 174-175 thirty patients received specific herbal decoctions over a period of 3-13 years and relapses were prevented except for two patients who each experienced only one minor exacerbation, each event following a viral infection (common cold).  Two of the cases were deemed basically cured after taking 45 – 68 doses, 15 were markedly improved and another 15 somewhat improved, most of them taking 20-40 doses.  Unfortunately this study was not a double-blind placebo controlled study and, therefore, such controlled studies will be needed to determine if, in fact, Chinese herbs are effective in treating MS.


LIFESTYLE RECOMMENDATIONS
  • Avoid stress and anxiety.  They often precipitate attacks of MS.
  • Avoid exposure to heat such as hot baths, showers, sunbathing and overly warm surroundings; avoid becoming overheated when working or exercising; and avoid exhaustion and viral infections. They all may trigger an attack or worsen symptoms.
  • Get regular exercise and keep mentally active.  These are extremely helpful in maintaining muscle function and bring about remission of symptoms. Exercises that increase body temperature can make the symptoms worse. Swimming is the best exercise. Stretching exercises are helpful.
  • When an exacerbation begins, take at least two days of complete bed rest. This can often stop a mild attack.
  • Maintain a strong immune system to avoid infections which often proceed the onset of MS.  Avoid being around persons who have viral infections.  Avoid getting chilled.  Treat all infections promptly.
  • Treatments to reduce Candida activity have been found to reduce the fatigue experienced by many people with MS.
  • Utilize practices that evoke spiritual rejuvenation such as meditation, yoga, qi gong, tai chi and prayer.
REFERENCES
Abbate. Skya, DOM, “The Management of Multiple Sclerosis with the Extraordinary Vessels”, Acupuncture Today, Dec. 2003 38-39
 
Balch, James F, M.D. & Phyllis A. Balch, C.N.C, Prescription for Nutritional Healing New York: Avery Publishing Group. 1997
 
Bensky, Dan & Randall Barolet, Chinese Herbal Medicine Formulas & Strategies, Seattle: Eastland Press, 1990
 
Berkow, Robert, MD, Editor, The Merck Manual, Rahway, NJ: Merck & Co., Inc., 1992
 
Blackstone, Margaret, The First Year – Multiple Sclerosis, New York: Marlowe & Co. 2003
 
Dharmananda, Subhuti, PhD, “Amino Acid Supplements I: Glutamine” Portland, OR: Institute for Traditional Medicine, Sept. 1997
 
Dharmananda, Subhuti, PhD, “Chinese Herbal Treatment for Multiple Sclerosis and other Flaccidity Syndromes, including Myasthenia Gravis and Amyotrophic Lateral Sclerosis” Portland, OR: Institute for Traditional Medicine, Nov. 1996
 
Dharmananda, Subhuti, PhD, “Evaluation of DHEA levels in Multiple Sclerosis” Portland, OR: Institute for Traditional Medicine, Sept. 1997
 
Dharmananda, Subhuti, PhD, “Modern Chinese Medical Methods for MS: Clinical Setting and Patient Reports” Portland, OR: Institute for Traditional Medicine, Sept. 1997
 
Dharmananda, Subhuti, PhD, “Preliminary Report on Second Year Study: Chinese Medical Treatment for Multiple Sclerosis” Portland, OR: Institute for Traditional Medicine, Oct. 1995
 
Dharmananda, Subhuti, PhD, “Report on Three Years of Clinical Study: Chinese Medical Treatment for Multiple Sclerosis” Portland, OR: Institute for Traditional Medicine, Oct. 1996
 
Harkness, Richard, Pharm., FASCP & Steven Bratman, M.D., Drug-Herb-Vitamin Interactions Bible, Rocklin, CA: Prima Publishing, 2000
 
Kidd, Parris M., PhD, “Multiple Sclerosis, An Autoimmune Inflammatory Disease: Prospects for its Integrative Management”, Alternative Medicine Review,
Dec. 2001, Vol 6, No. 6, 540-566
 
Kirschmann, Gayla, J, Kirschmann, John D, Nutrition Almanac, New York: McGraw- Hill, 1996
 
Kozovska, M.E., MD et al, “Interferon beta induces T-helper 2 immune deviation in MS”, Neurology, 1999;53:1692-1697
 
Jones, Cindy L.A., Ph.D., The Antibiotic Alternative, Rochester, VT: Healing Arts 2000
 
Lininger, Schuyler W., Jr., DC, The Natural Pharmacy, Rocklin, CA: Healthnotes, Inc. 1999
 
Maciocia, Giovanni, The Practice of Chinese Medicine, Edinburgh: Churchill Livingstone, 1994
 
Martino, G. et al, “Inflammation in multiple sclerosis: the good, the bad, and the complex”, Lancet Neurol 2002 Dec;1(8):499-509
 
Mindell, Earl, R.Ph, Ph.D., & Virginia Hopkins, Prescription Alternatives, New Canaan, CT: Keats Publ, 1998
 
Murray, Michael, N.D., & Joseph Pizzorno, N.D., Encyclopedia of Natural Medicine, Rocklin, CA: Prima Publishing, 1991
 
Pitchford, Paul, Healing with Whole Foods, Berkeley: North Atlantic Books, 1993
 
Rocky Mountain MS Center website www.MS-CAM.org “Traditional Chinese Medicine: Acupuncture, Asian Herbal Medicine and Asian Proprietary Medicine” Englewood, CO, 2003
 
Tortora, Gerard J, Grabowski, Sandra Reynolds. Principles of Anatomy and Physiology, New York: Harper Coffins, 1993
 
Vanderhaeghe, Lorna R. & Patrick J. D. Bouic, Ph.D., The Immune System Cure, New York: Kensington Publishing Co. 1999
 
Vickers, Edythe, N.D., L.Ac. and Subhuti Dharmananda, Ph.D., “Traditional Chinese Medicine and Multiple Sclerosis”, Portland, OR: Institute for Traditional Medicine, July 1996
 
Weil, Andrew, “Natural Help for Multiple Sclerosis” Self Healing, June 2000
Werbach, Melvyn R., MD, Nutritional Influences on Illness, Tarzana, CA Third Line Press, 1996


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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-475-1005.

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The Inner Dynamics and Energetics of Acupuncture

Compiled by John G. Connor, M.Ac., L.Ac. Edited by Barbara Connor, M.Ac., L.Ac.

TABLE OF CONTENTS
Introduction
Distinction Between the Gross, Subtle and Mental Worlds
Acupuncture Energetics and Craniosacral Dynamics
Similarities between Yoga-Based Energetics and Acupuncture Energetics
Health, Disease and Medicine
How to be a Good Practitioner
The Importance of Prayer
Physician Heal Thyself
Love and Pain
References

INTRODUCTION
More and more of us are realizing that modem medicine sometimes falls short of solving our health problems. One reason for this is because it is based on the concept that health solutions exist outside of us. So for example, if we have a pain, we’re advised to take a pill. If an organ causes problems, we may even be advised to have it removed.

The idea that illness or disease begins with an imbalance or restriction within us is given little credibility. Another of our cultural biases is that newer information and techniques are always better than older belief systems and techniques. Consequently, most people only know how to search outside themselves or look to modern science for answers to health issues. Ancient approaches to understanding disease and body healing often viewed illness from the perspective of the human spirit or the body’s life-force energy.

According to Dr. Richard Gerber these somewhat mystical viewpoints may now hold the key to understanding why people become ill and how they can regain their health.  Donna Eden in her book Energy Medicine believes that we are a “latticework of energies”.  She feels that the return of energy medicine, which is based on the energy systems that make up the subtle infrastructure of every body, is one of the most significant cultural developments of the day.

We are in a period which Meher Baba calls an Avataric period.  He says “such periods bring a new release of power, a new awakening of consciousness, a new experience of life – not merely for a few, but for all.  Qualities of energy and awareness, which had been used and enjoyed by only a few advanced souls, are made available for all humanity.  Life as a whole, is stepped up to a higher level of consciousness, is geared to a new rate of energy.  The transition from sensation to reason was one such step; the transition from reason to intuition will be another.”

Barbara, and I are discovering that more and more of our patients are longing for a deeper and more meaningful spiritual life.  We dedicate this article to the Divine Spark in them and in all of us. We hope this article may shed some light on how acupuncture energetics and craniosacral dynamics work synergistically and energetically together; and how, by applying the inner dynamics and energetics of acupuncture and craniosacral work, it can help our patients to regain control over their own healing processes and ultimately lead them to optimal health of body, mind and spirit.

DISTINCTION BETWEEN THE GROSS, SUBTLE & MENTAL WORLDS
Before we go into the dynamic relationship between acupuncture and the craniosacral system it is important to get a clear idea of what energy is in terms of the gross (physical), subtle and mental worlds. Meher Baba in his book God Speaks gives a very clear explanation and description of these three worlds.

Pictorial Representation of the Different Bodies
Firstly, he explains that the gross or physical sphere consists of numberless worlds, suns, moons, stars and in fact everything material from the crudest to the finest. Because we are gross conscious we are conscious only of the gross world and not of the subtle world or mental world.

Secondly, he emphasizes that the subtle sphere is the sphere of energy itself. And through its energy, its angels, and through man’s subtle-consciousness, while penetrating the gross sphere itself, it also penetrates infinite space with its suns, stars, planets and, in fact every thing and every being in all the worlds within the gross sphere. It is interesting to note that the unlimited diversity and intensity of subtle sights, sounds, feelings and powers have no parallel in the gross sphere, save energy which becomes limited within the bounds of the gross, and human consciousness which is surrounded by gross limitations.

The subtle world then is the domain of Infinite Energy. The infinite and unlimited power, which is an aspect of the infinite three-fold nature of God, when radiated from unbounded Infinity into the finite worlds of illusion, is translated into the finite and manifested in the domain of the subtle world in the form of the infinite energy of the subtle world.

As the poet Insha (1752-1818) expresses so eloquently:
What is it that doesn’t throb with the fire divine?
Every stone at its heart a spark of fire doth own,

And finally, Meher Baba explains that the mental sphere is the very abode of MIND itself, individual, collective and universal. The Mind pervades its own sphere as much as it does throughout the subtle and gross spheres. The sphere of the Mind includes everything relating to intellect, intuition, insight and illumination.

As the poet and master Kabir (1440-1518) says:
When the lower mind dies and thoughts come to an end
the man knows he is not the body.
My mind is pure as the real pearl
and in me only God resides!

In Avatar of the Age Meher Baba Manifesting Bhau Kalchuri explains that every individual limited mind has two sections – one is of thoughts and the other is of feelings. The thought-section of the mind is where the process of thinking occurs, and the feeling section is the heart, i.e., the seat of mind, where the process of thinking slows to the pure state of feeling.  The heart is the abode wherein the mind can slow down its activities and finally stop. The heart is called the “abode of God”  for herein the mind can finally stop and when the mind stops, God is realized.

As the poet, Mir Taqi Mir (1723-1810) says:
Everyone doth talk of heart, do you know what heart may be?
For those with discerning eyes, the heart presents a sight to see,
The tempest of its rising tides fills the space of earth and sky,
Seemingly a drop of blood, the heart, conceals a mighty sea.

Kalchuri further explains that because we are gross conscious we cannot experience the breath of prana which is in the subtle world and inspires the subtle conscious person with subtle powers within his own hands. However, we can experience the breezes of the subtle energy that come down to fill our gross conscious minds with inspiring words, images or melodies that echo through our poetry, songs and artistic images like shadows of the subtle powers. Thus gross conscious poets, musicians, writers and painters have inspiration but their inspiration comes down from the subtle world and is basically of the overwhelming force of inspiration that erupts throughout the entire subtle realm. Although it is said that no more than one percent divinity can be experienced in the gross world, the implications of our being able to experience even one percent divinity is enormous!

ACUPUNCTURE ENERGETICS AND CRANIOSACRAL THERAPY
Hugh Milne in the Heart of Listening observes that acupuncture and acupressure have addressed the energy field of the human head for four thousand years, as witnessed by Chinese records of acupuncture and “the art of listening.” He also notes that shiatsu has incorporated cranial work using visualization, pressure and “kime” (directed energy work) for almost a hundred years. In his book Craniosacral Biodynamics Franklyn Sills notes that in Chinese medicine the emphasis is on the balance of qi and the potency of jing in the body and that jing, or essence, is sensed to be an inherent ordering principle in the human body that is intimately related to its fluid systems. He goes on to point out that within the heart of all motion is a stillness that organizes. Stillness is at the heart of all polarities and polarity motions, such as the classic yin and yang polarities.

In Helen Dziemidko’s book The Complete Book of Energy Medicines she writes that in Traditional Chinese Medical theory life energy (qi) flows along invisible channels of energy known as meridians. Modern research suggests that the meridians lie at the interface between the etheric and physical bodies. It is at this level that Chinese medicine considers disease to arise. In our acupuncture treatments fine needles are inserted into the skin at specific points to affect the flow of this qi.  It is also speculated that the acupuncture points are located where two nadis or etheric channels cross.  

Acupuncturist and author Kiiko Matsumoto believes that the meridian systems lie in the superficial fascia and that the qi circulating within them is in fact the bioelectric energies associated with the connective tissue structures of the fascia.

The etheric body is defined as the innermost part of the body’s energy field. It is closely linked to the physical body and disturbances in it correspond to problems in the physical body. It can be likened to a blue-print of the physical body that forms a force field within which the physical body condenses.

Hugh Milne, in his book on visionary craniosacral work sees craniosacral work as a combination of sensitive hands-on body work with meditative use of the inner eye and inner ear. It draws techniques from osteopathy, energy work and Taoism. It is a way of “doing non-doing” honoring both the analytic understanding of how things happen and the intuitive perception of how things really are thereby allowing the soul to be touched and real healing to occur.

He feels that the brain cannot be in the right place in the head until the heart – the spiritual or energetic heart – is in the right place in the chest. And the heart cannot be in the right place if its energetic foundation, the sacrum, which is the home of the energy center known as swadisthana, the second chakra, is not in the right place in the pelvic girdle.
 
Milne believes that chakras, which are local condensations of qi, exert an equal, if not more powerful, effect upon the dense physical body than the meridian system does, He also feels that the hara (Dan Tian) and heart centers affect the position, field and movement of the cranial bones both directly and indirectly in the most decisive of ways. On a practical level Milne sees the ability to sense another person’s chakra system as a valuable diagnostic tool; and even if one wants to limit his or her work to a mechanical level of interaction when physically palpating the craniosacral rhythm, when one touches a person’s head what happens is alchemical.

Dr. John Upledger explains how he works craniosacrally in his book Your Inner Physician and You. He says that he uses the perception of very subtle energy activities in the body to focus on the source of abnormal energy patterns. 

The Sufi musician and mystic Hazrat Inayat Khan recognizes the relationship of rhythm and disease when he says “There is a rhythm of pulsation, the beating of the pulse in the head and in the heart; and whenever the rhythm of this beating is disturbed it causes illness because it disturbs the whole mechanism which is going on, the order of which depends upon the regularity of rhythm.”

SIMILARITIES BETWEEN YOGA-BASED ENERGETICS AND ACUPUNCTURE ENERGETICS

According to Rosalyn Bruyere the whole yogic chakra and energy system is electromagnetic. A chakra may be blocked wherein the energy flow is restricted. In any case, however, a chakra is always there, it is always spinning. Each chakra is both unique and potentially interactive with each other chakras. An auric or electromagnetic field is generated by the spinning of the chakras. As it spins each chakra produces its own electromagnetic field. This field then combines with fields generated by other chakras to produce the auric field. The seven major chakras of the Eastern yoga system are located along a central axis parallel to the spinal column of the physical body.

Like acupuncture points, yogic chakras are specialized energy centers throughout our bodies where a unique form of subtle environmental (life) energy is absorbed and distributed to our cells, organs and body tissues.

According to Dr. Richard Gerber each of the seven chakras is individually linked to small nerve bundles known as ganglia. Each ganglion is like a little brain center. It appears that each of the seven chakras (and their associated nerve centers) processes and “remembers” different emotional events and traumas that affect us throughout our lifetime.

In his book Meditation as Medicine Dr. Dharma Singh Khalsa explains that the chakras transmit ethereal energy to the physical body primarily by bringing energy to nerves and endocrine glands. Each chakra is located in the exact same area as a major nerve plexus, and an important endocrine gland. These nerve plexuses and endocrine glands are vitally important, because they enable ethereal energy to be transmitted to the physical plane.

Acupuncturist and author Jeremy Ross agrees that the human energy body or etheric body, permeates and surrounds the solid physical body. It is the sum of the energy fields or the individual cells, tissues and organs, acting in coordination and reflects the activity of the physical body, thoughts and emotions. As such, the energy centers, or chakras, represent central areas for the coordination of energy flows within the energy body. The main chakra energy centers are along the central vertical axis of the body, which is also coincidentally where the Governor and Conception channels traverse carrying qi up and down the vertical axis of the body. These two channels are also closely linked with the other Extra channels and with the Kidneys.

So during an acupuncture treatment we can consciously direct energy to a particular center. For example, the Head center can be accessed through the acupuncture point Yin Tang; the Heart center can be accessed through CV-17and the Body center can be accessed through CV-4 and so on. The acupuncture points and channels can therefore be seen as an interface between the physical and energy bodies, having aspects of each.

Each energy center has its own specific functions and pathologies, so that point combinations can be selected from the Governing Vessel or Conception Vessel points located over the affected energy centers. For example, the Throat center governs communication and the Heart center governs the flow of feelings in close relationships. Thus CV-23 and CV-17 can be combined for feelings of constriction and discomfort in the throat and chest, associated with stress within relationships.

The area around CV-4 (Gate to the Original Qi) and CV-6 (Ocean of Qi) is called the Dan Tian. This is the energy center of the body which is concerned with the storage and distribution of energy, both Qi and Jing (essence). CV-4 is used mainly to strengthen the storage aspect of the Dan Tian. CV-6 corresponds more to the distribution aspect of the Dan Tian.According to Japanese acupuncture theory the Dan Tian is the center from which the energies emanate; and virtually all pathologies are seen as stemming from stagnation of the basic qi.

Kiiko Matsumoto proposes that because the lower Dan Tian is located roughly where the Swadisthana Chakra is found in Indian energetic anatomy, it may share a relation to the sacral plexus and to a lesser degree the solar plexus with the Indian energetic concept.The relationship between acupuncture and yoga is described in a book entitled Moola Bandha.  In this book it is explained that the conception vessel (also called the Ren channel) and governor vessel (or the Du channel) of the Chinese and Japanese acupuncture systems, correspond to the arohan and awarohan pathways of kriya yoga.  Kriya yoga seems to have been known in China, for a system which possesses many similarities is mentioned in a scripture called the Tai Chin Hua Tzang Chih (The Secret of the Golden Flower). 

The conception and governor vessels run end to end to form an unbroken ellipse, and chi is visualized to travel in an anticlockwise direction beginning at GV-1 circulating the body and ending at CV-1 in the perineum.  Ren 1 is the meeting point of the conception and governor vessels and the site for moola bandha.  In acupuncture theory it is also known as a General Lo point through which any disequilibrium of yin and yang in the whole body (in particular the small intestines, heart, lungs, colon, bladder, kidneys, circulation and three heaters) can be rectified. The author goes on to conclude that Ren 1, by virtue of its connection with the governor vessel, is the seat of qi for the entire body in much the same way as the mooladhara chakra is the source of kundalini energy.

 In Acupuncture Today June 2001: Vol 2, No. 6 p.l9 it is reported that Dr. Binod Kumar Joshi and his two colleagues, Drs. Ram Lal Shah and Geeta Joshi have found new information showing that the roots of acupuncture come not from the Orient but from ayurveda, an Indian form of healing. They found evidence showing that marmas mentioned in an ancient treatise called the “Sushrit Samhita” correspond precisely with traditional acupuncture points used to treat the vital organs and that the dhamnis and siras mentioned in the treatise depict meridians and channels that aid in the flow of qi. This may help us better explain some of the similarities found in the energetic Indian chakra system with the qi and meridian energy system of Traditional Chinese Medicine.

Many of us have felt that the nadis of the Eastern yogic system are the same as the meridians which we talk about in Chinese Medicine.  So we were very happy to read the following from a conversation with the musician K. Sridhar:  “We use certain forms of music to raise the chakras (energy centers in the body).  Every human body has 72,000 nadis — or meridians as the Chinese call them — and they represent the sympathetic strings on an instrument, while the seven main notes represent the chakras.  So when we start playing a scale those sympathetic strings on the instrument or the 72,000 nadis in the body all start vibrating — even without being plucked.  Even if I keep the instrument away from me and start talking or making a noise the strings will vibrate.  So likewise, the 72,000 nadis are awakened by the sound.  Once you get control of this through a particular yogic posture or mantra chanting or meditation you will be able to control any form of desire.” (From the CD notes accompanying the CD of K. Sridhar (sarod) and K. Shivakumar (violin) (Shrinagar, 1989)

HEALTH, DISEASE AND MEDICINE
The first lesson in health according to Inayat Khan is the understanding that illness is nothing but disharmony and therefore the secret of health lies In harmony. In reality every disease means something is wrong with the rhythm. As the doctor says congestion is the root of diseases, so to a Sufi congestion means lack of rhythm.

He feels that disorder of the tone and irregularity in the rhythm are the principal causes of every illness. There is a certain tone which the breath vibrates throughout the body, through every channel of the body; and this tone is a particular tone, continually vibrating in every person. For example, if an instrument is not kept in proper tune, if it is knocked about by everyone who comes and handled by everyone, then it gets out of order. The body is the most sacred instrument and if it is kept in tune then it becomes a means of that harmony for which God created man.

The great Sufi poet and master Hafiz (1320-1390) has a unique perspective about being in tune. He says:
Ah! passing glad I’d be,
Could I but taste Thy favours soon;
Yet, after all, my grief for Thee
Doth keep my heart in tune.

Inayat Khan feels that the one and central cause of each disease and of all diseases is lack of movement. We see this all the time in our work when we deal with craniosacral restrictions and qi and blood stagnation. He feels that behind everything there is movement, vibration. If lack of movement and disharmony causes illness then movement and harmony can bring the cure. Our goal in all of our treatments is to bring movement and harmony wherever restrictions, stagnation or imbalance appear in the fascia or body. To do this we combine acupuncture, which works on the body energetically, with craniosacral therapy, which works on the body’s fascial network.

Franklyn Sills writes that stillness is the root of our being, and it is also the root of creativity.  It is a stillness that is alive and pregnant with potential manifestation.  Stillness expresses the potential for creativity, and through stillness one can begin to come into relationship to the deeper manifestations of Health within the human system.

Western medicine has its place, even drugs and surgery, when there is a need for them. But when drugs and surgery are used for little things that can be treated by other means, in the end one’s health gets out of hand and even drugs and surgery can’t help. From the spiritual point of view the best medicine would seems to be a pure diet, nourishing food, fresh air, regularity in action and repose, clearness of thought, pureness of feeling and confidence in the perfect Being with whom we are linked and Whose expression we are.

HOW TO BE A GOOD PRACTITIONER
One of the most uplifting and profound statements I have come across relating to the practice of medicine is by Meher Baba where he says “If you love your work you can do it with love, and anything that is done with love has perfect results. To be a good doctor, always have in mind that to you all patients, good or bad, big or small, are equal. Treat with as much care and interest a beggar as you would a millionaire, and in case you find you are not paid the price, you must not for a moment think of refusing.  It is simple and practical and yet a good many doctors don’t observe this simple rule. Only if a doctor realizes that One Infinite God is within all, then that doctor works like a saint!”   

Rumi (1207-1273) on the healing value of love writes:
Hail to thee, then, 0 Love, sweet madness!
Thou who healest all our infirmities!

According to Inayat Khan one of the greatest errors of this age is that activity has increased so much that there is little margin left in one’s everyday life for repose. Repose is the secret of all contemplation and meditation, the secret of getting in tune with that aspect of life which is the essence of all things. Avicenna (AD 908-1037), the great physician on whose discoveries medieval science was based, used to sit in meditation, and by intuition would write his prescriptions.

Inayat Khan gives great significance to the importance of breath and creating an atmosphere in healing.  When the breath is developed and purified the atmosphere that the healer’s breath creates, the very presence of the healer brings about a cure, for the whole atmosphere becomes charged with magnetism. All the other various manifestations of the magnetic current which come, for example, from the tips of the fingers or from the glance are indirect manifestations of the breath.

He feels that by directing the energy through the finger-tips and developing the magnetic power of the finger-tips one develops the power of healing. He emphasizes that the healer must from beginning to end hold the thought of a cure and of nothing else. The physical hands are needed to help the hands of the mind, and when the thought is directed from the mind through the hand its power becomes double and its expression fuller. The healer operates the power of the mind through his fingers in much the same way as a musician produces his feelings on the violin. It is not the placing of the finger on a certain place on the instrument, it is the feeling of the musician’s heart manifesting through his finger-tips that produces a living tone.

According to Inayat Khan to a healer there is no better means than the eyes to send his thought of healing; and there is no better means of receiving this thought in the patient than his eyes. 

Being a musician he believes that there is nothing that can thrill a man’s being as sound can. This explains why suggestion is much greater and more beneficial in healing than any other remedy. The healer, of course, must be sincere in his suggestions, because all the power lies in his sincerity. He must also be self-confident and a good man.

About the power of words Kabir says:
None knows there is no wealth like sweet words,
Diamonds can be bought, but the word is invaluable.

Inayat Khan observes that when a healer thinks he is healing, his power is as small as a drop but when he thinks God is healing then his power becomes as large as the ocean.

The Urdu poet Amir Ahmed Amir Meekai (1826-1900) says:
What need to consult physicians, considerate and kind?
Was he not a physician great, who caused this ache of mine?

According to Subhuti Dharmananda the spiritual aspects of healing involve what might be called right behavior. As the Taoists point out, right behavior is, in one sense, doing nothing. That is, much of human activity revolves around trying to be something or trying to get something, rather than allowing the fulfillment of one’s destiny to proceed, as mandated by heaven. Right behavior is doing that which is necessary and appropriate for the situation that has been presented, which one recognizes by having an open heart (therefore being able to listen correctly).

Lonny Jarret author of The Spirit of Traditional Chinese Medicine, writes that ideally, the patient’s transformation is initiated by the presence of the practitioner. This approach de-emphasizes acupuncture as a technology and places the responsibility of spiritual development and upright behavior on the practitioner.

THE IMPORTANCE OF PRAYER
Larry Dossey has been trying to convince health care professionals to view studies of prayer, etc. as legitimate evidence of a soul-like dimension of human experience that can result in miraculous or radical healing. He feels that if we are ever to understand the role of prayer in healing, and the relationship between spirituality and health, we shall have to grow more tolerant of ambiguity and mystery. We shall have to be willing to stand in the unknown.

He observes that the impulse to do when sick is understandable – to take the antibiotic with a cold’s first sniffles, to rush to surgery, and so on – and a certain amount of doing is always valuable and can even be lifesaving. But doing must also be supplemented by being – looking inward, examining focusing wondering asking.

Some studies on prayer showed that a simple “Thy will be done” approach was quantitatively more powerful than when specific results were held in mind. In many experiments, a simple attitude of prayerfulness–an all-pervading sense of holiness and a feeling of empathy, caring and compassion for the person or entity in need–seemed to set the stage for healing.

Experiments with people showed that prayer positively affected high blood pressure, wounds, heart attacks, headaches and anxiety. Remarkably, the effects of prayer did not depend on whether the praying person was in the presence of the person or organism being prayed for or not. Nothing seemed capable of stopping or blocking prayer.

 Larry Dossey does not pray for specific outcomes for his patients, rather he invokes the Absolute asking only that “Thy will be done” or “May the best possible outcome prevail” not specifying what “best” means.

 Bhau Kalchuri says that prayer should become the lighting of the lamp of love in our hearts. This will allow the lamp of love to perform the prayer of the Beloved. This lamp cannot be seen externally; it burns within to consume in its flame all of our bindings, freeing us, the lovers, to become united with the Beloved.

As Kabir says:
The ridiculous thing is that while in pain one remembers God
And not while he is comfortable.
If one remembers God all the time,
How can there be suffering and pain?
Misery is lessened and disappears ultimately by taking God’s Name.  
If one remembers God continually, he becomes One with Him!
0 Kabir! Real wealth is God realization and real pain is in being away from Him!

PHYSICIAN HEAL THYSELF
Inayat Khan reminds us that as health care practitioners we must first get our own rhythm right in order to be able to make our patient’s rhythm regular.

The Tao Te Ching states: The sage guides his people by putting himself last. Desiring nothing for himself he knows how to channel desires. And is it not because he wants nothing that he is able to achieve everything?

As Kalchuri says “The path of spiritual life has always been the path of desirelessness. This state of desirelessness is achieved through divine love. It is the fire of divine love that burns the roots of all desires.”

LOVE AND PAIN
Kalchuri beautifully explains to us that for a gross conscious person God is felt through the medium of pure love. Divine intoxication of God slows down the human mind. When a man is in a God-intoxicated state, he does not react to good or bad, natural or unnatural things, because his mind has slowed down sufficiently to see beyond these differences, he reacts only to the level of his own intoxication.

Mir Taqi Mir proclaims the glory of love in the following lines:
Love has organized this show, a director great is he,
Everything that lives and breathes, is by love conceived. Love the substance, love the shadow, real apparent, all that be, There he rules the world celestial, here controls the land and sea.
All pervasive in the world, active everywhere you see,Somewhere hid inside the heart, somewhere stands revealed.

Hafiz ties everything together so beautifully in the following couplet:
I have room within my heart for grief for Thee,
I make the pain itself my poor heart’s remedy!

REFERENCES
1) Anzar, Naosherwan, The Answer, Bombay: Glow Publications, 1972
2) Baba, Meher, Discourses, Myrtle Beach, SC Sheriar Press, 1987
3) Baba, Meher, God Speak, New York: Dodd, Mead & Co., 1970
4) Bruyere, Rosalyn L, Wheels of Light. New York: Simon & Schuster, 1994
5) Davis, F. Hadland, The Persian Mystics, Jalalu’D-Din Rumi, Lahore, Pakistan: Ashraf Press, 1973
6) Dharmananda, Subhuti, Ph.D., Essentials of Taoism, Portland; Institute for Traditional Medicine, May 1997
7) Dossey, Larry, M.D, Healing Words, New York: Harper San Francisco, 1993
8) Dziemidko, Helen E, MD, The Complete Book of Energy Medicines, Rochester, VT: Healing Arts Press, 1999
9) Eden, Donna, Energy Medicine, New York: Jeremy P. Tarcher/Putnam, 1999
10) Emery, Marcia, Ph.D., The Intuitive Healer, New York: St. Martin’s Griffin, 1999
11) Gerber, Richard, M.D., Vibrational Medicine for the 21st Century, New York: Eagle Brook, 2000
12) Gilkeson, Jim, Energy Healing, New York: Marlowe & Co., 2000
13) Goldman, Caren; Voorhees, Ted; “The Power of Prayer According to Larry Dossey, M.D., prayer may be as potent a medical procedure as antibiotics or surgery.”, Yoga Journal 06/30/1994; N.116;p.75-81
14) Jarrett, Lonny S., LAc., The Spirit of Traditional Medicine: the return to original nature. Traditional Acupuncture Society Journal (England) 1992; (12): 19-31
15) Kalchuri, Bhau, Avatar of the Age Meher Baba Manifesting. North Myrtle Beach, SC: Manifestation, Inc. 1985
16) Kanda, K.C, Mir Taqi Mir, Selected Poetry, New Delhi; Sterling Publishers, Pvt. Ltd, 1997
17) Kanda, K.C, Urdu Ghazals, An Anthology, New Delhi; Sterling Publishers, Pvt. Ltd., 1999
18) Khalsa, Dharma Singh, M.D., & Stauth, Cameron, Meditation as Medicine, New York: Pocket Books, 2001
19) Khan, Hazrat Inayat, The Sufi Message of Hazrat Inayat Khan, Volume 2, London: Barrie and Rockliff, 1960
20) Khan, Hazrat Inayat, The Sufi Message of Hazrat Inayat Khan, Volume 4, London: Barrie and Rockliff, 1961
21) Kwok, Man-Ho; Palmer, Martin & Ramsay, Jay, Tao Te Chin^ Shaftsbury, Dorset: Element Books Ltd., 1994
22) Matsumoto, Kiiko & Stephen Birch, Hara Diagnosis: Reflections on the Sea, Brookline, MA Paradigm Publications, 1988
23) Milne, Hugh, The Heart of Listening, A Visionary Approach to Craniosacral Work, Berkeley North Atlantic Books 1995
24) Ross, Jeremy, Acupuncture Point Combinations, Edinburgh: Churchill Livingstone, 1995 p 3-41
25) Siegel, Bernie S., M.D., Love, Medicine & Miracles,, New York: Harper & Row Publishers, 1986
26) Sills, Franklyn, Craniosacral Biodynamics, Berkeley: North Atlantic Books 2001
27) The Persia Society of London, Selections from the Rubaiyat & Odes of Hafiz, London: Stuart & Watkins, 1970
28) Upledger, John E., DO, O.M.M., Your Inner Physician and You, Berkeley North Atlantic Books, 1991
29) Workingboxwalla, Feram, Kabirji’s Couplets Unpublished manuscript
30) Buddhananda, Swami, Moola Bandha, The Master Key, New Delhi: Thompson Press (India) Ltd., 1996

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-475-1005.

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