Hi John (thanks again) ,  and other friends,
 
An article published in the Parkinson Magazine,  two years ago but it is still
up to date.
 
Kees
 
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Public interest in alternative methods of treatment has been growing over
the years.  Since Parkinson patients, according to the latest developments
in orthodox medicine, are bound to take a variety of different medicines for
the rest of their lives, their interest in non medical therapies is
understandably high. It must be stated that it is rare that all symptoms
can be improved in the course of the illness. Therefore the search for
additional non-medical methods without side-effects is, especially useful for
the chronically ill; and in the wake of this, the Aertzlicher Beiratoften
receives inquiries about the status of specific alternative methods of
treatment. To date it has hardly been possible to give any reliable answers,
since in most cases weare about the findings of empirical medicine which have
not passed any scientific test. In the following article some alternative
treatment will be introduced and discussed regarding their possible use in
the treatment of Parkinson's Disease. We shall start with traditional Chinese
medicine
 
Tradionanul Chinese Medicine.
Most people in our part of the world associate acupuncture with Traditional
Chinese Medicine [TCM). However acupuncture represents only 20-30 percent of
the entirespectrum of TCM. At the centre of the Chinese art of healing is
medicinal-therapy, whichtakes the form of teas, individually prepared for
each patient (decoction).In addition to this, other supportive measures are
being undertaken to strenghten the lifeenergy, such as massage tehniques
(Tuina massage) and general exercises for breathing and movement
(e.g.Qi-Gong).
 
Historical Development
Under the obvious influence of the two dominant philosophical schools of
Taoism and Confucianism, TCM has developed over more than l000 years into a
unified system. The system of thinking in analogies goes back to Taoism.
Taoism demands a very precise observation of nature and applies some of the
interrelating concepts that are found here to all levels of being, e.g. the
human being or the entire cosmos. Confucianism, on the other hand, puts the
emphasis more on the rational aspect and social contacts between people.
The most important source of TCM is the book "The Inner Classic of the
Yellow Pince" that was compiled in the third century B.C. and still has to
be read by today's sudents of TCM. The book has been constantly change and
extended, e.g. by the "Classic of Acupuncture and Moxibution-Treatment" in
about 300 A.D.
 
In the beginning, medical knowledge was treated almost as an esoteric lore
which was directly passed on from master to disciple. However, when the
art of printing was introduced about 500 years earlier than in Europe, the
spread of knowledge increased, but at the same time an obvious weakening in
the art of healing took place. Many physicians merely acquired a certain
"theoretical knowledge from books" without actually having gained many years
of the experience for themselves. Further more, magic practices were added,
with the result that the decline of TCM started in about 1000 A.D. Also,
Western medicine gained the upper hand in China owing to its clearly
spectacular successes infighting infectious diseases. It was only in the
middle of this century that a new discussion about Western as well
as traditional Chinese medicine began. Even during Mao Tse Tung's rule only
Western medicine was promoted. At the moment, Western medicine and TCM are
considered equal. Students of medicine can choose between the two schools.
Both courses take about six Years. The same choice is also given to the
patients when seeking treatment.Occasionally, doctors of the two schools
share a practice so that supplementary treatment becomes possible.
 
The Chinese Concept of illness
Western and Chinese attitudes towards illness are completely different.
Within the framework of this article only a rough outline of the Chinese
point of view can  be attempted. In Chinese thinking the individual is part
of the cosmos which itself is embedded between the sky and the earth. The
generally applicable laws of being canbe applied to this individual.
According to Chinese Philosophy this means that the human being is part of
the life-energy "Qi" which is constantly flowing through him. Since all forms
of being are polar, this energy is polar too; i.e. it is composed of two
opposing parts. The polarity is symbolized at all levels by the symbols Yin
and Yang.This pair of concepts describes all sorts of polarities and
phenomenon at all spheres of lifeare related to it: for example, the sky and
the day reflect the Yang-principle and the earthand the night the Yin
principle. In the field of medicine, Yang represents the "non-material"
whereas Yin stands for everything organic. Consequently, all active functions
of the body such as movement, digestion, sweating, emotions etc. are
allocated to the Yang aspect but the individual organs to the Yin aspect. A
moral valuation of positive and negative, however, is not offered by this
pair of opposites, because the polesare value-free. The life-energy "Qi"
flows through the human body in five so called "functional areas" which
represent the load-bearing columns of the entire medical system. The names
of these functional areas are allocated to specific organs, e.g. "heart" or
"liver". But they by no means denote their anatomical counterparts as we know
them. The names of the organs express the sum of different symptoms. 2000
years ago these names were used because of pure observation of the phenomena
rather than as a result of, anatomical fact.
 
The Chinese doctor's skill consist of realising in which functional area
the life energy is being disrupted and where the flow is beginning to flag.
He hardly needs any technical equipment to make a diagnosis: in most cases, a
very detailed case history, the thorough of examination of the tongue and a
precise check of the pulse are sufficient.
 
Drug therapy
Over many thousands of years about 3000 plants were observed and documented
with regard to their effect on the human being. The results take all parts of
the plant into account, such as the root, blossom, leaf etc. In so doing, the
effect shown is allocated to one of the five functional areas previously
mentioned. Usually the remedies administrated as tea and are produced by
means of slow boiling (decoction). This preparation takes several hours.
Afterwards the tea is also drunk within a period of several hours. An average
tea contains ten different components, occasionally including mineral or
animal elements. As the preparation of each tea is very individual, a
medicine in the form of a tablet is hardly possible. Only a few "standard
mixtures" are obtainable as tablets. Otherwise, even today, a mixture of
herbs is prepared for each patient individually. On the one hand, this is
time consuming, but on the other hand, it is ensured that the symptoms of
each individual patient are considered.  Owing to a lack of detailed
knowledge of our native flora, Chinese doctors who practise in Germany
prescribe healing herbs from China which are shipped to Europe. Consequently,
these teas tend to be expensive.
 
Acupuncture
Acupuncture means "prickling and burning" as both needle therapy and heat
treatment are combined. The needles are either heated by red light or by
moxibution. In the case of the latter ,Moxawool (mugwort) is put on the
needle and lit. Afterwards the needle has to smoulder some milli-metres
above the flame. For traditional Chinese acupuncture needles are used. In
Germany, however, it is becoming increasingly common for laser beams to
be applied. No consensus has yet been reached on the extent to which both
methods are identical. Chinese colleagues, on the one hand, seem reserved
when expressing their views on the laser therapy, since they do not have
much experience with this technique. German colleagues, on the other hand,
tend to regard the laser therapy as having an identical or equal result. The
advantage of the use of laser beams is that the risk of infection can be ruled
out. The theoretical basis for the effects of acupuncture has always been
unclear although more and more doctors can become convinced of the effects.
The "channels of energy" which have been recorded in China for thousands of
years and along which the"Qi-stream" flows gas not yet found ananatomic
equivalent. There are, however, hints that an increased distribution of
certain body substances -like serotonin and peptide-exists at these
acupuncture points. This assumption might lead to an explanation of the
effects on different forms of pain. On the whole, the question of finding
the points of acupuncture comes about a result of experience. By means of the
injections,the "Qi-energy" which has come to a stand still, is supposed to
flow again. Also, energy from well-supplied functional areas can be usefully
diverted to other areas. To do so, an experienced acupuncturist only needs a
few needles. Otherwise, in most cases the treatment has to be carried out
for several weeks. The main reasons for the use of acupuncture are different
forms of pain such as migraine, phantom-pains, shingles, HWS- and
LWS-syndrome. Also, asthma, allergies, sleeping disorders and other disorders
are said to respond, whereas pathological changes of organs can not be
reversed.
 
Tuina-massage
This special type of massage is to a large degree unknown in Germany. But
since an increasing number of Chinese doctors come to Germany, this method of
treatment will also be disseminated here. Tuina-massage is very suitable for
all forms of rheumatic complaints. The therapist works his way forward layer
by layer: from the skin to the muscular system to the bones and the joints.
Every layer is massaged and loosened up intensively. A treatment takes 40-50
minutes.
 
Qi -Gong
Qi-Gong is the name given to working with "Qi", that is the energy of life.
It is a breathing therapy in combination with therapeutic exercises and has a
meditative character. Qi-Gong can be used in many different ways. Probably
the most common variation is a programme consisting of 18 exercises which is
supposed to keep "Qi" in cyclical motion. These exercises are natural and
relaxing and can easily be practised by elderly people. In addition, there
are specific exercises which maybe used under medical supervision. Here, the
transfer of energy or the building up ofenergy in special functional areas
can be achieved. These exercises are far more complicated and need the
guidance of a trained teacher. Besides, a mainly meditative Qi-Gong is used
which is similar to modified relaxation through self-hypnosis.
 
 
TCM and Parkinson-therapy.
The main emphasis of Chinese medicine is put on the prevention of illnesses
and the remedying of functional disorder. Obvious oganic changes cannot
be influenced. As regards the Parkinson syndrome it must be understood right
from the start that the previously mentioned methods can only be employed as
a supplement to the therapy.
 
There may be cases of sleeping disorders in various forms, increased
sweating and probably also some disor-der of the bladder and the bowel.
Furthermore, pains of arheumatic nature, which might be increased the
Parkinson symptoms, may experience some improvement.
 
At the moment, tests are being carried out in the Paracelsus-Elena-Clinic as
to whether itis possible to improve the already the quality of speech with
acupuncture treatment. Sofar, definite results are not available. In
China, too, the Parkinson therapy concentrates on the Western medicinal
complemtreatment, especially the therapy with L-Dopa. Regarding the
concept of TCM, acupuncture and some therapeutical exercises might
be transferable to the West. It seems unlikely,  however, that drug therapy
would be transferable. On the one-hand for an im the one hand, it is
elaborate and not practicable to get hold of the plants and to prepare them
for use. On the other hand, there is a lot to be said in favour of the fact
that this therapy achieves the best results in the cultural area where it was
developed. Just the taste of the Chinese "decoction" is barely palatable
for Western patients; and according to Chinese thinking, the patient should
enjoy the tea in order for it to work.
 
Already this minor aspect points out the enormous differences between the
cultural areas and their respective approaches to medicine.
Nonetheless, it makes sense to try a complementary view, especially when
there are very different approaches to diseases. In the course of this, the
creative reworking of some techniquesical might arise, e.g. laser acupuncture
instead of the traditional use of needles.Both the use of laser acupuncture
for an improvement of speech, as well as the influence of different autonomic
functions by means of acupuncture are being researched at the
Paracelsus-Elena-Clinic. As soon as results become available, they will be
made public to the patients.
 
Resource : Parkinson Magazine, Summer 1993, issue number 1
written by Dr. Gudrun Ulm, Kassel, Germany