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Parkinson’s Disease

Dr. K. Y. Iyer

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Ayurvedic Treatment (Chikitsa)
Ayurvedic treatment for this condition centers around the treatment of vata disturbance. Oleation and fomentation form the basis of the constitutional treatment. Oleation through massage (abhyanga) and enema (basti) are indicated as well as the ingestion of oils. Naturally, jathargni must be strong enough to support such a heavy regimen. If the patient exhibits significant ama and is strong enough, gentle purification procedures should be administered first. Oils medicated with ashwagandha (withania somnifera) and bala (sida cordifolia) are commonly used to pacify vata and build ojas. They are known to be rejuvenative with a strong nourishing action on the nervous system.

The herb atmagupta (Mucuna Pruriens - also known as Kappikacchu) has received a lot of attention historically and again in recent years. A study in 1978, published in the journal, Neurology (india), showed its effectiveness on 23 patients diagnosed with Parkinson’s disease. This study used only the powdered seed of the plant. In 1990, Manyam published the results of his study in the Journal Movement Disorders in which he found that Mucuna Pruriens contains Levodopamine or L -dopa within its seeds. This confirmed the 1937 study by Damodaram and Ramaswamy published in the journal, Biochemistry. L-dopa is the precursor of dopamine, the neurotransmitter which is absent or decreased in Parkinson’s disease. The findings of these studies were confirmed at the Southern Illinois University, School of Medicine published research which was performed in the department of biology at the University of Groningen, the Netherlands. A controlled trial using a derivative Mucuna Pruriens called HP 200 was found to be effective in treating Parkinson’s disease.

Ayurveda teaches that a holistic treatment regimen offers the greatest chance of success with Parkinson’s patients. In addition to using Mucuna Pruiens (V-PK ++, sweet/bitter/cool/sweet), vata must be pacified at its site of origin in the colon, site of overflow in the rasa dhatu and at its site of relocation in the majja dhatu. Apana vayu disturbance may be treated with moist laxatives such as psyllium (Plantago Psyllium), flaxeed (Linum Usitatissimum), or the traditional formula, triphala. Vyana vayu in the rasa or licorice (Glycyrrhiza Glabra). And, prana in the majja dhatu may be treated with mucuna pruriens, along with supportive herbs such as Ashwagandha (Withania Somnifera). If vata has also entered the mamsa dhatu causing rigidity, herbs which are muscle relaxers and nervine sedatives may be of value. Jatamansi (Nardostachys Jatamansi) and Shank Pushpi (Canscora Dicussata) may be used. If vata has entered the manovaha srota and depression is present, Gotu Kola (Hydrocotyle Asiatica) and Saint John’s Wort (Hypericum Perforatum) are examples of herbs which can be added to formulas or used separately.

A vata pacifying diet and proper dietary habits are essential to long term success. Additional vata pacifying regimens including daily oil massage (applied by the patient or practitioner) and sensory therapies complete the treatment regimen. Finally, a supportive environment should be created which is not overly stimulating. Meditation and yogic practices are the cornerstone of all holistic ayurvedic programs, as they cultivate a sattvic mind and teach the patient how to manage their internal energies. This is essential for good health. When pitta is vitiated in addition to the primary vata disturbance, care should be taken that treatment and lifestyle do not overheat the mind or body. Herbs such as Gotu Kola (VPK-, bitter-cool-sweet) which are cool and tonify the mind and nervous system may be added to any formula and are essential if there is a distrubance of sadhaka pitta (symptoms of sadhaka pitta vitiation: Anger, overly critical, intense). Another good herb to add to the formula for a pitta-vitiated individual is Gaducci (Tinospora Cordifolia), and excellent bitter, nervine tonic and pitta rasayana.

Discussion
Ayurvedic regimens have a lot to offer patients with Parkinson’s disease. While the pharmocological actions of specific herbs such as Atmagupta (Mucuna Pruriens) are being found useful, complete treatment requires proper lifestyle and daily regiments which pacify the patients vikruti (imbalance) and in the long term, those which are in harmony with the patients constitution.

What is the prognosis?
PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time.  Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and other symptoms are more troublesome.  No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person.

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