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Neural Therapy: Course C
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| Dr Dietrich Klinghardt, MD PhD
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Course outline:
In this course all Neural Therapy injection procedures (NT)
and diagnostic principles of Autonomic Response Testing (ART)
will be briefly reviewed. Advanced Neural Therapy is defined
by
1. Using the most advanced injection techniques
2. Using all the important diagnostic techniques:
- history taking and observation
- traditional medical, orthopedic and neurological exam
- lab work and imaging techniques
- autonomic response testing
- knowledge and intuition
Because of the time restrictions of a 3-day course, the demonstrations
will be mostly related to 1. And 2d and 2e. During the lectures
all aspects of advanced NT will be addressed.
Only through the use of ART as a non-invasive rapid and reliable
diagnostic test significant progress has occurred in the way
NT procedures are used today. Significant discoveries were
possible, that have already significantly influenced thinking
and research in the medical field both in Germany and the
US (ie the prevalence and medical impact of heavy metal toxicity,
the prevalence and incidence of unresolved psychological trauma
leading to medical illness later in life etc. Therefore I
believe, that every advanced NT practitioner should also be
knowledgeable of and capable to perform the basic diagnostic
ART tests in order to be able to
- select the most appropriate Injection procedure(s) or
other type of intervention
- select the most appropriate medication
- monitor needle depth and accurate placement of needle
tip
- determine completeness/end of treatment
- monitor immediate changes, such as displacement/mobilization
of toxins
- monitor and treat (with Applied Psycho-Neurobiology)
unresolved psycho-emotional conflicts that are brought to
the surface as a result of the injection
- determine treatment priorities, sequence, best time-interval
till next appointment, other beneficial adjunctive treatments
By using ART in conjunction with NT procedures, NT has become
an extremely safe and effective treatment system, that is
suitable as significant adjunctive tool in the treatment of
all known illnesses.
If NT is used without the support of ART, the practitioner
should limit the use of NT to the procedures , quite narrow
indications and medications recommended in the handouts of
NT A and B.
All NT procedures and all of ART can be safely learned by
every practitioner. I recommend however, to take the NT and
ART courses several times, since the material is very complex
and every detail matters.
A board certification program is currently being developed
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The second part of this course is dedicated to introduce
and discuss new developments in NT and related sciences both
in the US and Europe. Much progress has been made in understanding
the true cause of infections in the jaw bone and NICO lesions
by the leading German toxicologist, Dr med Max Daunderer.
Intraosseous NT offers a unique fairly non-invasive approach
to these conditions. The discoverer of this method, Ara Elmajian
DDS and Dough Phillips, DDS two of the most gifted dental
physicians of our time, will discuss their experience with
this method. Much progress has also been made in the issue
of dental material bio-compatibility (research from the Karolinska
Institute in Stockholm and Dr Lehman in Germany will be presented).
I will give a detailed overview of our current knowledge in
the area of heavy metal toxicity, solvent toxicity and toxicity
from other sources with the focus on simple and effective
solutions.
Throughout this program volunteers from the audience will
be examined and treated, applying the state-of- the-art principles.
Since the function of the nervous system is to a large degree
dependent on the nutritional status of the person, we will
take a fresh look at our biochemistry and offer some spectacularly
simple yet effective and innovative ways to optimize a person's
biochemical health. Pearls regarding the treatment of specific
illnesses will be given throughout the course.
NT: THE BASIC PHILOSOPHIE
In the early part of this century there were 2 basic theories
of illness:
1. Virchow's Cell Theory ( in this country this theory is
incorrectly believed to come from Pasteur)Each cell can be
looked at as a uni-cellular organism, that responds and reacts
primarily as if it was alone. Toxins, bacteria and other invaders
interact with these individuals that become sick if their
defenses break down. Illness is the breakdown of a larger
number of these individual cells.
2. Ricker's "Relationspathologie" ( Pathology of Related
Structures) G.Ricker (his book: Relationspathologie, Springer
Verlag, Berlin, 1924) demonstrated in arduous and lengthy
microscopy sessions, that the pathogenic stimulus which is
necessary for conversion of a healthy group of cells into
a pathological tissue does not act on the cell or the cell
wall but on the sympathetic nerve fiber (which in turn regulates
a majority of the functions of the cell wall). All cells of
the organism are in close proximity and regulated by the terminal
fibers of the sympathetics. Ricker demonstrated, that virtually
all types of known stimuli (mechanical, thermal, electro-magnetic,
chemical -including neurotransmitters, hormones, toxins, microorganisms)lead
to a change in frequency and amplitude of action -potentials
in the afferent sympathetic neuron. This research has only
recently been made available since the opening of the iron
curtain (University of Magdeburg, Germany), even though the
Am.Academy of Neural Therapy has stated this for years based
on clinical observation. The stimulus has no lasting effect,
when the organism can detox the area or abolish the stimulus
in some other way (or when a medical intervention accomplishes
this). However, when the organism does not succeed the sympathetic
nervous system will be chronically aroused and react chronically.
Ricker was able to prove every aspect of this thesis in the
experiment using alive animals.
More recent developments:
Ricker's work has been continued in more recent years by
Pischinger and later H.Heine, resulting in the "ground-system
theory" - stressing the importance of not only the terminal
sympathetic fibers but also the adjacent structures in the
interstitial inter-cellular space, such as proteoglycans,
glycoproteins, conducting proteins called "connectins" and
others. Heine was the firs to demonstrate with electron-microscopy
the entrapment of mercury and other toxic metals in these
web-like structures of the extra-cellular space. When the
excretory detoxifying organs are overloaded (kidneys, liver,
lungs, skin) the ground-system is used as an intermediate
storage for toxic waste. From here it can go 3 ways:
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| 1. |
be absorbed by a process called pinocytosis
into the autonomic nerve endings . From here toxins travel either
centrally to the spinal chord and up to the brain or peripherally
to the autonomic nerve ending , such as those in muscle spindles,
nociceptors, walls of blood vessels and lymphatics with most
common effect of sensitizing these structures ("trigger points"
are found in muscle around sensitized muscle spindles) |
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| 2. |
be absorbed into the venules and lymphatics
in the area, transported into the large veins, from there distributed
into the lungs, kidneys ,brain and other tissues. The toxins
that reach the kidneys or liver may be successfully excreted
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| 3. |
toxins may be absorbed into the cell. This
happens for 3 reasons: |
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the storage facility is full and overflowing
(common in folks with amalgam fillings) |
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the cell wall is incompetent (fatty
acid malnutrition, damage from solvents etc.) |
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the ionic channels for this particular
toxin are open and there is an osmotic gradient ( less
toxin concentration inside the cell compared to the outside).
This happens typically, when the particular toxin is given
in a homeopathic dose. Example: someone has a high concentration
of mercury in the extracellular space, but is still reasonably
clean inside the cells. If homeopathic mercury is given
(merc.sol., merc.cyanatus, merc.corr. etc.), the cell
wall typically opens up and mercury ions can now move
into the cell, immobilizing the mitochondria or even passing
the barrier into the nucleus creating gene alterations
with all those consequences . |
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The Neural Therapy injection:
Ricker demonstrated, that when the sympathetics are stimulated
strongly, their peripheral effect is in general vasoconstrictive.
Is the stimulation gentle, their peripheral effect is vasodilating.
It is only accepted fairly recently, that vasodilatation is
a active process (does not merely reflect inactivity of the
sympathetics) and mediated by the same sympathetics, that
are responsible for vasoconstriction. The secreted neuropeptides
differ according to the strength and nature of the stimulus.
It is generally accepted now, that the commercially available
local anesthetics are sodium channel blockers, which would
explain some of their effect. This theory does not explain
the NT effect which clearly outlasts the action-time of the
anesthetic injected. Other theories that have never been refuted
must be considered:
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| 1. |
The axonal transport inhibition theory (Klinghardt):
Lidocain reversibly inhibits the axonal transport of neuropeptides
and other substances up and down the axon of the injected nerve.
Since only c-fibers (pain-nerves) and autonomic nerve fibers
are unmyelinated, the main effect of the LA would be on these
fibers. It is now well understood, that in chronic pain various
vicious cycles exist. One of them is the appearance of noxious
excitatory neurotransmitters in the periphery, which sensitize
nociceptors and create tissue damage. Interrupting the axonal
transport of these substances, i.e. substance P etc., would
be beneficial. Lidocain has been shown to reversibly block axonal
transport for 3 days, even though it's sodium channel blocking
properties last only for 1 hour. Procaine appears to have the
same effect. |
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The acetylcholine theory: in vitro acetylcholine
competes with local anesthetic for receptor sites on nerve |
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Competition of other chemical messengers
with local anesthetic: ATP and procaine/lidocaine have an antagonistic
effect. Lidocaine uncouples oxidative phosphorylation, reducing
intra-axonal supply of ATP. However, though axonal transport
is slowed, ATP levels are not reduced, if typical clinical doses
are used. There are also interactions with certain amino-acids,
urea and thiamin. |
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Metabolic poison theory: in brain mitochondria
the electron transport was inhibited at the NADH dehydrogenase
level (1 study). Oxygen uptake of brain slices was suppressed
in rank order of potency. |
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Decrease of oxygen-consumption theory (Klinghardt):
studies have demonstrated decrease of oxygen uptake in a blocked,
formerly active nerve. This could indicate, that blocking a
nerve that is oxygen-starved (for example in compression syndromes),
would allow the nerve to not only exist but maybe even recover
in an oxygen starved environment |
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The Calcium -channel blocker theory: both
Calcium and Sodium have a rather impressive local anesthetic
effect on smooth muscle. In smooth muscle contractility is regulated
by Calcium channels. Local anesthetics have an excellent Calcium-channel
blocking relaxing effect in these structures, such as bowel
wall, aortic wall, vein and uterus. High tissue levels of Calcium
interfere or compete with local anesthetic action. Calcium itself
binds unselectively to the external nerve membrane surface repelling
other cations (such as Sodium, toxic metals etc.). |
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Membrane expansion theory: Local anesthetics
cause the cell membrane to swell 3 - 5%, enough to reduce channel
permeability ( i.e.sodium channels), to decrease responsiveness
of gating proteins to electrical field charges and create disarrangement
of the membrane framework ( this very mechanism allows the LA
to diffuse through the membrane and attach to the internal axoplasmic
membrane surface, where the sodium channel inhibition occurs.
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The voltage profile theory: the local anesthetic
cation raises the transmembrane voltage profile. This makes
it more difficult for nearby local current circuits to draw
the membrane potential down to firing level. |
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Surface repulsion theory: The local anesthetics
cationic tail protrudes from the membrane surface and repels
like-charged cations such as sodium (therefore the sodium influx
necessary for firing of the nerve membrane is prevented) |
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The phospholipid theory: phospholipids in
the cell membrane are essential for the membrane to be excitable.
Local anesthetic bonding to phospholipid membrane components
is well documented. The local anesthetic cation end forms an
electrostatic complex with the phospholipids, that anchors the
lipoprotein gating structures, hindering voltage-dependent rotational
or shifting movements that normally would open the channel to
ion traffic. It moves the membrane towards its non-conducting
closed state. |
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The Procaine-nutrient theory: Procaine breaks
down rapidly after entering the tissue into diethyl-amino ethanol
and paba. Both nutrients have stabilizing effects on nerves
and are considered metabolic food for the nerve. |
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There are other theories. There are many local anesthetics.
Our choice is to use preservative free - yet clean - procaine
or normal saline for most injections. Lidocaine has been shown
to have a metabolite that is highly carcinogenic (Scientific
American May 1994). Marcaine causes muscle necrosis and severe
hypotension, when injected intravenously. Using ART, most
the time saline or procaine test, occasionally lidocaine or
carbocaine. It is always best to inject, what tests.
The above theories relate to the local anesthetic action
at the molecular level and their understanding has mostly
academic value only. Below listed are the functional aspects,
of what local anesthetics do in the alive organism:
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Detoxification: Local anesthetics
detoxify tissues ( the urine excretion of i.e. mercury can increase
dramatically after L.A. injection). The typical treatment in
this category is the injection of an autonomic ganglion (the
most common storage site for toxic metals) |
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Drug Uptake Enhancement: L.A. injection
(especially segmental therapy and scar injections) leads to
increased blood supply and trans-membrane transport of medication,
nutrients and toxins in all tissues, that belong to the same
autonomic segment (usually the tissues underneath the injected
skin area). Responsible for this effect is the cutaneo-visceral
reflex, which has been first described by the British physician
Sir Henry Head at the end of the last century ("Head Zones").
The most common treatment in this category is segmental therapy.
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Ends Abnormal Signaling : L.A. injection
normalizes traumatized tissues. Abnormal afferent neuronal signals,
which typically arise in these tissues, are often lastingly
stopped. The most well known NT phenomenon in this category
is the scar-injection . |
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Brings up old Unresolved Psycho-Emotional
Trauma: LA injection often activates repressed memories,
which have been stored in the subconscious mind. These can now
be processed appropriately. |
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There are other effects, which have been
observed by experienced practitioners |
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The Superficial Injection Procedures
Segmental therapy and the scar injections are the workhorse
and backbone of all good NT treatment and often underutilized
by many experienced practitioners. Segmental therapy allows
for the delivery of specific remedies, medical drugs and antidotes,
which can be delivered specifically to the involved segment
and all structures, that belong to this segment.
Scars are a problem unless proven otherwise. All scars on
any patient should be injected at least once. If there is
improvement, the injections should be repeated until there
is no more improvement.
A special application of the superficial injection procedure
is the injection of acupuncture points. Acupuncture treats
the perivascular sympathetic plexi and sympathetic as well
as parasympathetic nerve fibers. These are the only structures
in the body, that can translate the signal from a needle prick
into afferent action-potentials. Acupuncture points do not
really exist: they are locations of high autonomic nerve fiber
density, usually along blood and lymphatic vessels (research:
Schnorrenberger, Germany). The injection of body, ear, scalp,
intra-oral, tongue and other acu-points can be very effective
in regulating the autonomic nervous system. The advantage
over traditional acupuncture is, that appropriate medications
can be delivered into the acu-point, which often enhances
the effect dramatically.
The superficial injection procedures are covered in the NTA
manual.
The Deep Injections
Autonomic ganglia become toxic and stay toxic for long periods
of time. The ganglion injection is the fastest way to detox
the ganglion. The electro-bloc and infrared laser are also
acceptable for this purpose.
The most common antidotes injected are:
1. DMPS (against mercury, arsenic, copper , lead and tin)
2. Desferoxamine (against iron deposits - pituitary!)
3. DMSO (against toxic solvents, thioether, mercaptan, dioxin,
formaldehyde etc.)
4. Dilutions of the toxic substance itself ("isopathic remedies",
"nosodes")
5. Bacterial, fungal and viral antidotes (Sanum remedies
, ozone, H2O2, etc.)
6. Diluted "allopathic"medications, such as Benadryl, Demerol,
antibiotics (Mesotherapy)
7. Nutrients (B-vitamins, Magnesium etc.)
8. If you don't know, what to inject, but you know where,
inject preservative free procaine
The deep injection procedures are covered in the NTB manual
with only a few exceptions.
The most important of these procedures, which has not been
described in detail yet, is the caudal epidural injection.
The following pages are taken from the "Textbook of Orthopaedic
Medicine Vol. 1", by my wonderful teacher, the late Dr.James
Cyriax (Bailliere Tindall, 35 Red Lion Square, London WCIR
4SG).
I have done well over 3000 of these injections to date without
any significant problems. Cyriax performed over 40 000 in
his days.
In Neural Therapy the technique used is the same. However,
the spectrum of indications is broadened and less LA is injected
per treatment (between 2 and 10 cc only).
Indications:
- Intractable back pain/ Sciatica
- Chronic prostatitis
- Pelvic pain/dysparunia/pre-and perimenstrual problems/endometriosis
- Menopausal problems
- Hormonal problems
- Hemorrhoids
- Problems after childbirth (postpartum depression, chron.pain
syndromes etc.)
- Post-myelogram pain syndromes
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The sinuvertebral nerve blocks will be discussed and demonstrated
in the course.
To treat low back pain, a few clinical pearls:
1. Acute discogenic low back pain:
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Klinghardt cocktail every other day, until out of acute
phase. Then maybe 2times/week, once/week or less until resolved.
Also works often well in elderly friendly obese folks (EFOF)
with red cheeks and multiple joint pains, always including
the low back.
1 ampoule colchicine (2cc, 1mg), 1 ampoule Traumeel (2cc)
6 cc preservative free procaine
This mix (10cc)is injected with a 25 G butterfly slowly
over 2-3 min i.v.
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somewhat better than at worst time. |
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Caudal epidural with 50 cc 0.5% preservative free procaine.
I use 10 cc syringes with a 25G 2" needle. I change the
syringes cleanly with a hemostat.
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sacro-iliac joints: prolotherapy injections |
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| 4. Arachnoiditis: segmental therapy
with Traumeel and Zeel. Epidurals with procaine and Traumeel. |
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Sinuvertebral nerve blocks with 9cc 0.5%procaine and 1cc
DMSO. Usually up to 4 of these in 1 session (never epidural
and sinuvert.block in the same session
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5. Sciatica: Sinuvertebral nerve block with DMSO( see above).
Caudal epidural. Injection through the sacral foramina ( 5
cc of 0.5% procaine per level. I never do more than 1 level
on either side per session)
Coccygeal ganglion block. Trigger point injections - piriformis,
psoas)
Most back problems are the red light that goes on when a
distal interference field is active and untreated.
Most common:
- Wisdom tooth and retromolar space
- Kidney(s)
- Prostate/Frankenhauser Plexus (inferior hypogastric plexus)
- Unresolved Psycho-Emotional conflict
- Abdominal scar
- Parasites in the colon (especially coecum-area)
- Stasis in the gallbladder
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