This is an abridged version of Dr. André Saine’s article Homeopathic Treatment of the Multiple Sclerosis Patient. It was presented to the Second Annual Session of the Homeopathic Academy of Naturopathic Physicians, Portland, Oregon, April 25-26, 1987. I have removed some of the highly technical information since I can’t imagine any non-homeopath would really want to read it. I have also omitted the footnotes for reasons of space. Dr. Saine has treated hundreds of patients with MS since 1985, and many of our Hahnemannian colleagues have consistently obtained similar results. The complete article can be found on the Canadian Academy of Homeopathy’s website at www.homeopathy.ca.
Since the following paper was published 30 years ago, many exciting developments have been made regarding the vital role diet plays in the treatment of MS. Dr. John McDougall, building upon Dr. Roy Swank’s seminal work, consistently achieves remarkable results in treating patients with MS, as well as an impressive array of other auto-immune diseases. Please visit his website: www.drmcdougall.com.
Discussing cases with experienced homeopaths, I find a consensus that the great majority of patients diagnosed with MS respond well to homeopathic treatment. Such cases have been reported throughout the homeopathic literature as far back as 1862, shortly after MS was recognized as a precise syndrome. In the last two years [Ed. This paper was presented in 1987] over twenty cases diagnosed with MS have come under my care. It is difficult to precisely quantify and qualify the results obtained for a whole group without reviewing each case individually. However, attempting to give a broad summation I can report 50% excellent to very good results, 35% good to fair, and 15% poor to no results. From these figures, I have excluded six patients of the twenty originally seen as I was unable to personally follow them up. Three of these had been referred by other homeopaths only for the first consultation. By “excellent to very good results” are meant cases which demonstrated under pure homeopathic treatment dramatic changes in signs, symptoms and the course of their conditions, and in which there were unexpected uphill recoveries with rare exacerbations, mild if any. These include some early cases and advanced cases, but mostly chronic cases in the exacerbation-remission phase. In the “good to fair results” group, the changes are less dramatic but nonetheless remarkable, and exacerbations decrease in frequency, intensity and duration, but can still produce severe drawbacks. More patience and care must be paid by both the physician and the patient in such cases. In the “poor to no results” group are cases generally in the advanced progressive state, often bedridden, with almost total paralysis, or cases presenting defective illness. In some cases of this last group remarkable psychological and functional improvement are noted but with little or no improvement of the physical disability. These results are consistent with results reported by other homeopaths.
Because the inflammatory process of MS is reversible, as seen above, theoretically we can expect to stop the disease process in every case by neutralizing the predisposing and precipitating factors. The extent of recovery will depend on the capacity of the organism to repair areas of demyelination and possibly also areas with gliotic scaring. Clinically and practically speaking, the prognosis will depend on several factors which are learned through experience. I have observed the following factors as an aid to determine the prognosis:
The clarity of the case
The clearer the homeopathic case, the better the prognosis. When the totality of symptoms of both the disease and the patient correspond to one remedy, the simillimum, the prognosis is excellent. The prognosis is usually less good when the guiding symptoms lead to a remedy, the simile, that covers only a certain aspect of the case. The prognosis is very poor in defective illnesses.
The prognosis is better in the presence of clear and intense rare, peculiar and characteristic symptoms. Also, if the patient is very emotional, or there is a strong psychosomatic component in the onset or exacerbation of the disease, the prognosis is good. The prognosis is very good if the symptomatology is fluctuating because of the hypersensitivity of the patient to weather, climate, heat or cold, allergens, menstruation or other hormonal influences, etc. Similarly the prognosis is very good if there are present strong associated syndromes such as hypoglycemia, PMS, problems of circulation, sleep, appetite, moods and energy fluctuations, etc. On the other hand if there is a tendency to recurrent infections, such as flu, cold, sinusitis or urinary tract infections, the prognosis diminishes if these episodes are not controlled at once. Lastly, when the patient presents with eye symptoms and problems of vision, the prognosis is very good. With advanced cases of ascending paresthesia and paralysis the prognosis is poor. This may be partly explained by assuming that the longer the nerve pathway affected the more extensive is the damage and the less reversible it is.
The severity of the damage
The more extensive the organic change, the poorer the prognosis. If a symptom has been present without any improvement for a prolonged period (two years or more) it is usually irreversible. A recent onset favours a better prognosis.
The course of the disease
The more benign the course, the better the prognosis. Also, the remitting-exacerbating course favours a better prognosis. When the patient has reached the progressive state the prognosis is less favourable.
- Response to the indicated remedy: The better the first response to the first prescription, the better the prognosis for the rest of treatment. The prognosis is very unfavourable when the patient responds little or not at all to the simillimum. It is not unusual to have a patient responding very well to the remedy for six to nine months, then reaching a plateau and little response follows. When the case stalls in such a way little progress can be expected for months afterwards.
- Level of vitality: The more vital the patient the better is the response. Usually, the younger patient, the greater is the vitality and the better the prognosis. A state of sudden exhaustion does not influence the outcome but a state of chronic depression makes the prognosis unfavourable.
- Lifestyle: The better the patient’s lifestyle, or the greater the ability to adopt a healthy lifestyle, and subsequently the adoption of such lifestyle the better the prognosis.
- Compliance: The better the patient’s compliance with the treatment plan and lifestyle changes, the better the prognosis. On the other hand the prognosis is less favourable when the patient lives at great distance, or has poor understanding or is doubtful of the treatment plan.
Seasons and climate
The prognosis is usually more favourable when the treatment is administered between April and October and less favourable from November to March. Dry weather conditions will improve the prognosis, while cold wet weather and rapid change from warm to cold and vice versa during the winter months will greatly enhance the possibility of acute infections and ipso facto the occurrence of exacerbations.
The skill of the physician in applying appropriate homeopathic treatment is a crucial factor for the long term recovery of the patient. This is especially true regarding the ability of the physician to rapidly manage the patient during a period of crisis. The greater the experience of the physician in managing homeopathically and hygienically the MS patient the better the prognosis.
C: Case Management
1 – A thorough case history
A thorough case history is the first requirement in developing the basic understanding needed to guide even the most difficult patient to recovery. The most traumatic events in the MS patient’s life are usually important keys, especially the ones immediately preceding the time of onset and of exacerbations of the symptoms. Past medical history can also be very important, especially regarding occurrences and reactions to infectious such as colds, flus, urinary tract infections, etc. Recurrent illnesses and associated syndromes such as migraines, hypoglycemia, dysmenorrhea, PMS, etc, must be carefully noted as they often provide important leaders.
2 – Examination of the patient
The rubrics obtained by strictly observing the patient provide often more than half of the guiding symptoms in a case. Over and above this, a good physical and neurological exam of the MS patient will provide many objective signs that are extremely helpful in evaluating the response of the patient to the treatment and in important prognostic clues. The most important tests are examination of the deep tendon reflexes, the plantar reflex, the presence of clonus and nystagmus, the gait (especially when challenged by having the patient to walk heel-to-toe or on the heels, etc), the sensations, especially the sense of vibration and finally the fundus of the eyes.
3 – Case analysis
What are the most important symptoms on which we should base our prescription? The answer is simple. It is as old as Hahnemann. In Aphorism 258 of the Organon we read: “the only medicinal disease agent meriting attention and preference in any case of disease is always the one that is most similar to the totality of the characteristic symptoms and no petty bias should interfere with this serious choice.” To properly distinguish the characteristic symptoms from the common symptoms in the MS patient the homeopath must first have a good knowledge of pathology. Second he must complement this knowledge with learning from clinical experience in the homeopathic treatment of such MS cases as described below:
- Symptoms that are leaders in certain remedies but are common symptoms of MS are not helpful to find the simillimum.
- Common symptoms of the disease that have proved to be guides to the remedy are numbness of the face, nose and tongue, especially when unilateral. The great majority of MS patients are aggravated by heat. The most aggravating type of heat becomes characteristic. Burning sensations are found commonly in the MS patient, but the location is characteristic.
- Lastly we have the true characteristic symptoms of the disease. These rare, unusual and peculiar symptoms which are the result of the patient’s idiosyncrasies have been found to be the most important leaders for prescribing.
4 – Education of the patient
Education is the first duty of the physician. At the time of the first visit the patient must not only be educated on homeopathy and its possibilities but must also be provided with all the necessary instructions for proper homeopathic treatment. Care must be taken that the patient knows to immediately contact the physician at the first sign of a relapse or at the beginning of an infection, especially during the winter months.
Next the patient must be advised to adopt a lifestyle that is conducive to good health. This aspect of treatment may be the most important for enhancing the patient’s long-term recovery, but is the most difficult for the patient to achieve. First the patient must get sufficient rest and sleep. It is crucial for the MS patient not to get depleted by overstimulation, overworking, over exercise, or missing sleep—as from partying, for example. Rest must be balanced with adequate amounts of exercise. Russell, a professor emeritus of clinical neurology at Oxford, has observed that athletes in full training were virtually protected from developing MS but become more vulnerable two or three years after abandoning their training. In the early 1960s he developed a rest-exercise program (REP). He followed 69 patients for 15 years or more and found that there was no relapse or exacerbation as long as the REP was well conducted. The patients were able to virtually arrest MS just by adopting a disciplined program of rest and exercise. The REP of Professor Russell consists essentially of 2-3 periods a day of 5-10 minutes of building up to quite violent aerobic exercise, followed by a period of lying down in complete relaxation for 10-20 minutes.
Good diet will also play an important role in the long-term recovery of the MS patient. The patient must avoid all foods he is intolerant of and abstain as much as possible from processed foods, especially sugars, grain flour and alcohol, and stimulating foods such as tea and coffee. The patient should adopt a diet which is individualized to his needs. A diet low in animal products and high in unprocessed grains, vegetables, fruits, nuts and seeds is preferable in many cases. Such a diet is supported by findings of scientific studies investigating diet and dietary supplementation in the MS patient. Swank found that 95% of patients diagnosed with MS and with minimum neurological involvement suffered no further disability if in the first year of appearance of symptoms they adopted a diet low in animal fat.
It is important that the MS patient avoid contact with toxic chemicals and fumes and choose an environment as free from pollution as possible. Many patients have reported the onset or exacerbation of symptoms after exposure to these agents.
Regarding the removal of mercury amalgams from the teeth, great care must be taken. Homeopaths have reported toxicity from these amalgams since their first use around 1840. In my experience, some MS patients have experienced great relief while others have suffered severe drawbacks from removing the amalgams. The sudden removal of these amalgams at the time the patient’s resistance is low can precipitate a severe exacerbation. I recommend the more vulnerable patients have their amalgams removed at a time of greater resistance by a competent dentist using all possible precautions to minimize trauma and further intoxication. Each dental session should be kept to less than 90 minutes and at only one tooth should be worked on to better evaluate the strain caused by the removal.
5 – Supportive approaches
- Stress reduction is crucial. This can achieved through inner changes and through changing of one’s lifestyle. Priorities should be established and goals should be set. The patient is encouraged to live a life which is more in harmony with their needs. Exercise including yoga, arts such as music, painting or dancing and meditation are encouraged.
- Hydrotherapy in the hands of the trained physician is an ideal treatment to enhance the oxygenation and circulation of blood, to increase the oxidation and elimination of toxins, and to assist in the restoration of nervous equilibrium. Alternating applications to the spine and cold friction rubs would well complement constitutional treatment for both the acute and the chronic states of MS.
- Electrotherapy has also proved to be very useful in stabilizing the MS patient. Bioccular transcerebral iontophoresis has shown remarkable results in most patients with MS in decreasing the accumulated scar tissue in the CNS and restoring normal nervous equilibrium. Ultra-violet and infra-red light can be applied daily especially during the winter months. The infra-red light seems more beneficial when applied to the palms of the hands and the soles of the feet 5-20 minutes daily.
- Acupuncture has shown in non-control studies interesting results. Further research is needed to better evaluate this ancient art in the treatment of the MS patient.
6 – Management of acute infections
Acute respiratory tract infections such as sinusitis, colds and flus and acute urinary tract infections must be dealt with immediately with homeopathy and hygienic measures. These are critical times. If they are not attended soon enough the patient may experience a relapse of MS symptoms. Taking the remedy for the chronic state will often not prevent a relapse. If the acute condition is dissimilar to the chronic one and an acute remedy is prescribed the patient will recover quicker and this may prevent a relapse. In certain cases the chronic MS condition still relapses in spite of a quick recovery of the acute condition. The adoption of hygienic measures at such times may make the difference between a severe exacerbation and a good recovery. Rest is a must during a period of acute infection. Hydrotherapy applications will also be very useful in the hands of a knowledgeable physician.
7 – Prophylaxis
The prophylactic use of remedies must be individualized in each case depending on various factors such as the degree of exposure, sensitivity of the patient, past history of acute conditions, etc.
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