Dear Colleagues,

I would like to devote this month's newsletter to some "news" - a report on a recent neural therapy conference in Guayaquil, Ecuador. 

(Feb. 2010 Vol 5).

As stated here before, South America has become the place to watch when it comes to neural therapy.  It is widely taught and practiced; literature and books are being published (in Spanish); and large educational meetings are held.  This particular one was convened with only one month's notice. Over 80 physicians attended, some flying in from Costa Rica, Columbia and Argentina - such is the interest in neural therapy!

What made the meeting special was the meeting of minds from the English and Spanish speaking worlds of neural therapy.  Of course both schools of thought can be traced back to the Huneke brothers of Germany.  But it became apparent to me that these traditions have developed somewhat differently in North and South America.  For example, the most experienced neural therapists in Latin America are using the original Huneke formula ("Impletol")of procaine 2% + caffeine 0.25% for injections. In North America, plain procaine ˝% or less, appears to be the standard.

Dr Fernando Pinto of Quito delivered a lecture on the rationale for the inclusion of caffeine, using historical, scientific and philosophical arguments.  However it was pointed out that Latin Americans continue to discuss the advantages and disadvantages of different formulations to this day.

Some of the neural therapy being conducted is (by North American standards) quite heroic - following in the footsteps of the early pioneers described in Dosch's textbook.  Dr Cardenas, also of Quito, is treating Parkinson's disease by injecting (among other sites) carotid and vertebral arteries.  A before-and-after video clip of a patient with severe Parkinson's gait was impressive.

I have found that in general the South Americans that I have met have little knowledge of osteopathy, a related discipline that shares many ideas with neural therapy.  However Dr Eduardo Granja presented an interesting lecture on the use of Chapman points as entry spots for neural therapy into the autonomic nervous system.  (Chapman was an American osteopathic physician, famous for his description of skin points that relate to internal organ function.)

One other interesting area of contrast was methods of testing for interference fields.  Even though George Goodheart DC had a direct influence on the development of Latin American neural therapy, the preferred method of testing appears to be Omura's bi-digital O-ring test.  In North America the most popular method is autonomic response testing, a variant of Applied Kinesiology developed by Dietrich Klinghardt and Louisa Williams.

Dr Carlos Chiriboga lectured on common interference fields associated with orthopaedic conditions.  Many of these relate to acupuncture points.  I was particularly intrigued by his observation that de Quervain's tenosynovitis is often caused by large bowel interference fields.

Charles Crosby DO of Orlando spoke on scalar energetics and demonstrated his invention, the Tenscam device.  I lectured on "Three Ways of looking at interference fields" and "Toxicities Affecting Neural Therapy". 

There is no doubt in my mind that the South American neural therapists' knowledge and experience of neural therapy is much deeper than ours in North America.  After all, neural therapy was brought to South America in the 1960's by Julio César Payan and Germán Duque, who had both studied directly under the Huneke brothers. It was 20 years later that Dietrich Klinghardt brought neural therapy to North America.

However, I believe that North Americans have something to offer South Americans in neural therapy.  One is the rich tradition of autonomic nervous system knowledge that comes from osteopathy.  Another is expertise in "functional medicine", the metabolic, nutritional, immunological and other factors that so influence the effectiveness of neural therapy.  The modern neural therapist needs these skills!

I have not yet touched on another related area of medicine where South Americans and North Americans have much to teach each other.  That is the world of "energetics".  Perhaps that will come in another newsletter!

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Letters: (in response to last month's newsletter on prolotherapy and neural therapy) 

Dr. Kidd,

I've enjoyed reading your Neural Therapy in Practice for several years now.  I'm still a significant novice in neural therapy, but more interested recently with the addition of an acupuncturist to my office.  He practices a Japanese style acupuncture.  He worked with a prolotherapy doctor who is very experienced with neural therapy.   We have co-treated several patients with neural and acupuncture.  He encourages the use of homeopathic injection and feels the procaine is not necessarily needed.  Have you used homeopathic injections such as Guna products?

Also, you may be interested in the work of John Lyftogt, MD from Christchurch New Zealand.  He has become involved with both Hackett-Hemwall and AAOM.  He has developed a technique of injection using only D5W injected subcutaneously along cutaneous nerves.  He has read extensively on the process of neurogenic inflammation mediated by C-fibers.  He believes there is a specific effect of dextrose on TRPV1 receptors; these receptors are implicated in chronic pain/spinal sensitization.  Using his technique, I have seen severe low back pain immediately blocked by injection of D5W alone; no caine of any kind used.  It can be rather remarkable and has made me rethink those patients that respond immediately to Prolotherapy as you described in this month's article.

Thanks for all your work!

Brad

Brad Fullerton, MD, FAAPMR 

Dear Brad,

To answer your question about use of homeopathics in neural therapy, yes, I do use them.  I rarely inject anymore, but when I did, I sometimes mixed homeopathics with the procaine.  I never tried injecting homeopathics by themselves.  Now I use the Tenscam device; hold the homeopathic over the target and direct the Tenscam's energy through the vial. It works as well or better than with procaine injections.

Dear Dr. Kidd

Your case report was very interesting.

In these kinds of situations one should look into the whole spine from the very beginning. There are counter blockages also that have to be removed. Then the pain will go away from both ends. In this case there must have been quite a bit of blockage in the lower spine and involvement of spinal nerves and the ANS.

From the acupuncture perspective the Du Mai channel was also involved. I had a very interesting case during 9/11 when the stocks went down and this patient developed eczema in the tail bone region (the start of the Du Mai channel). The patient was in the financial business and got emotionally upset. I gave an eczema remedy which successfully treated the tail bone region but instead the eczema showed up at the nose.  This made clear to me the spinal/ emotional/ neurological issues. I gave a nerve formula and the eczema cleared.

Checking for emotional blockage is important too. Pain causes lots of emotional concerns. The person should have been given some nutritional supplements, nerve tonics etc.

Still learning medicine every day.

Thank you

Ranvir Pahwa