Parkinson’s disease is recognized as a multisystem multi-neurotransmitter dysfunction disorder. Oxidative stress has been implicated in playing an important role in pathogenesis of disease.1,2 biomarker driven evidence suggest that PD is a complex disease that could present with non-dopaminergic syndrome . Treatment of PD remains underpinned by levodopa and dopamine replacement therapy .Although DRT and in particular levodopa has ability to improve the motor symptom but motor complication and other non-dopaminergic symptoms still be devil for the treatment strategies of PD. To prevent the motor complication and aid the non-dopaminergic symptoms we can use principles of homoeopathy along with therapeutics to help the Parkinson’s patients .
Parkinsonism, double complex disease, reportorial analysis, antioxidant activity, homoeopathic therapeutics.
CLINICAL PRESENTATION AND HOMEOPATHIC PERSPECTIVE
Parkinson’s disease, a disorder of basal ganglia (degeneration of nigrostriatal tract) results in disturbance of movement and posture without significant paralysis and also known as movement disorder. Besides the nigrostriatal tract, PD also affects other parts of brain like olfactory centre, lower brain stem, thalamus and cerebral cortex. The earliest Parkinsonian signs such as bradykinesia, < gait disturbances, rigidity and tremors are observed clinically. Other non motor symptoms and cognitive disturbances are also present in PD such as constipation , frequency of micturition , nocturia , orthostatic hypotension, undefined muscle pain , depression , anxiety ,sleep disturbances, etc. Levodopa therapy still considered one of the most effective treatment , that only provides a transient relief of the motor impairments caused by the disease by replacing the lost DA and does not address the basis of disease as well the other non-motor symptoms of disease. Therefore one promising approach for the treatment of disease is the use of homoeopathic drugs to promote the survival of dopaminergic neurons and also aid the cognitive disturbances ,sleep disturbances, anxiety, etc.
HOMEOPATHIC PRINCIPLES PERSPECTIVE
According to Hahnemann’s Organon aphorism number 44,Parkinson’s can be a double complex disease and can be managed Successfully with Hahnemann’s teachings given in aphorism 46.
Two diseases similar to each other can neither (as is asserted of dissimilar disease in I) repel one another, nor (as has been shown of dissimilar disease in II) suspend on another, so that the old one shall return after the new one has run its course; and just as little can two similar disease (as has been demonstrated in III respecting dissimilar affections) exist beside each other in the same organism, or together form a double complex disease.
SOME CLINICAL RUBRICS FROM DIFFERENT SOURCES
SYMPTOM RUBRICS (MURPHY) RUBRICS (KENT) RUBRICS (BBCR)
Constipation Rectum, Constipation, in general Rectum, Constipation (inactivity) Stool, Constipation
Frequent Micturition Bladder, Urination, Frequent Bladder, Urination, Frequent Micturition, Frequent
Nocturia Bladder, Urination, Frequent, Night Bladder Urination, Frequent, Night Micturition, Nightly
Depression Mind Depression, Sadness Mind, Despair Mind, Depression
Anxiety Mind, Anxiety gen Mind, Anxiety gen Mind, Anxiety-agony
Tremors Nerves, Trembling, motion amel. Gen, trembling, Externally/ Internally Sensation
nervous and nervous
Rigidity Muscles, Rigid Gen,Tension, Muscles Sensations & Complaints –
Bradykinesia Gen-Motion, difficult Gen-Rising/Walking, amel. Agg & Amel-Motion At
the beginning amel. or
rest after agg.
Murphy: Diseases: Paralysis-agitans.
Clarke: Paralysis agitans.
Boericke: Nervous system: Paralysis-Type – agitans
Commonly prescribed medicines according to symptom presentation
RHUS TOXICODENDRON: Hahnemann commented on the power of rhus in curing of paralysis of lower extremities , and here it has proved exceedingly useful. Paralysis caused by nervous fevers .There is much stiffness in the limbs, a dragging gait and it suits particularly chronic case.
CAUSTICUM: This remedy also has paralysis from exposure to the cold of winter. Facial paralysis caused by dry cold weather. Cowperthwaite published a large number of cases of facial paralysis cured with Causticum 30. It also has paralysis of single parts, face, tongue, pharynx etc. Other evidences of its paretic conditions are found in the aphonia and in weakness of sphincter vesicae.
GELSEMIUM: Complete motor paralysis , rather functional than organic in origin . Paralysis of ocular muscles , ptosis; the speech is thick from paretic condition of tongue . Paralysis from emotions . Aphonia paralysis of the larynx .
PLUMBUM METALLICUM: Paralysis , with atrophy, is the watch word of Plumbum. Wrist drop, paralysis of extensors, paralysis due to sclerosis or fatty degeneration . Heavy tongue , constipation , paralysis after apoplexy with pale dry cold skin . Tremors followed by paralysis. Paralysis agitans.
PHOSPHORUS: It has also proved useful in paralysis from fatty degeneration of the nerve cells , and in such cases the symptoms will point to it. Dr. Arnulphy thinks phosphorus is homoeopathic to all forms of paralysis due to degenerative processes and specially from a drain on the sexual system.
ZINCUM METALLICUM: Lameness , weakness , trembling and twitching of various muscles. Feet in continued motion ; cannot keep still . convulsion with pale face Transverse pain esp. in upper extremities. soles of feet sensitive .nervous motion of feet when asleep .
TARENTULA HISPANICA: Weakness of legs, trembling of limbs, twitching and jerking, yawning with uneasiness of legs. Must move them constantly. Extraordinary contraction and movements .
ARGENTUM NITRICUM: Trembling with general debility. Paralysis with mental and abdominal symptoms. Rigidity in calves , walks and stands unsteadily esp. when unobserved .urine passes unconsciously day and night .
Tips and tricks for living with Parkinson’s that go beyond medications
Speech and swallowing: Parkinson’s generally has consequences for all motor functions including speech and swallowing which both can become soft and slow. Usually problem with speech and swallowing occur in the later stages of disease but other experience changes in speaking and eating or drinking in an earlier stages.
Anti-Parkinson medication does it work but generally does not develop normal speech. However exercise help to regain intelligible speech. The best tip is to find a skilled speech therapist but otherwise some tricks for both people with Parkinson and their care giver.
Constipation: Constipation is considered as pre-motor symptom of Parkinson’s that affects the majority of people with Parkinson’s and can start more than a decade before diagnosis. Sluggish bowel affect mood, appetite, nutrient uptake, levodopa availability and affects the intestinal microbiome. To combat with constipation along with medication we should suggest fibre rich diet, nutritive supplements appropriate water intake etc.
CLINICAL EXPERIENCE WITH PARKINSON’S
Clinical experience gathered from practicing physicians suggests that Homeopathy can improve some of the symptoms of Parkinson’s in some people, for example:
⦁ Argentum nitricum – For ataxia (loss of muscle co-ordination), trembling, awkwardness and Anxiety
⦁ Gelsemium – Speech deficits
⦁ Causticum – For restless legs
⦁ Cuprum – For muscle cramps
⦁ Mercurius vivus – For easing Parkinson’s that is worse at night, and for panic attacks
⦁ Zincum metallicum – For restlessness and depression
Integrated approach along with our potentized medicines may not cure the incurable PD but lessen the complications and progress the malady along with the Dopamine Replacement therapy .Counselling and Rehabilitation social Therapy play a very important role in managing this disorder. One should take caution in withdrawing the patient off the Dopamine Replacement Therapy while treating the patient homeopathically.
API Textbook of Medicine
International Journal of Homeopathic Science
Journal Of Parkinson’s Disease, NY
Repertories-Kent’s Repertory, Clinical Repertory by Dr Robin Murphy and BBCR
ABOUT THE AUTHORS
Compiled by Dr Monika Devgan Kathuria and Ankita Jain (Final Year Student Dr B.R. Sur College)
(Dr Monika Kathuria is am MD (Repertory) in Homeopathy with a Gold medal to her credit. She has over 24 yrs of Experience in Clinical Homeopathy and has Taught in various Institutes at Undergraduate and Post graduate level. She has been teaching Clinical Research /Practice of Medicine, Surgery and Repertory since 2009)
(Ankita Jain is a very sincere and diligent Final Year student of Dr B. R. Sur Homeopathic Medical College and Hospital)
Homoeopathic Perspective With Rubrics Analysis From Different Repertories On Clinical Presentation Of Parkinson’s Disease