Written by Adena Harford, December 2011
What is the conventional understanding of Multiple Sclerosis? What is the cause?
Multiple Sclerosis (MS) is a disease that affects the central nervous system (CNS). MS manifests when the myelin sheath created by the oligodendrocyte cells (cells which support neurons) along the axon of a neuron is damaged. MS can only effect oligodendrocytes, not Schwann cells. This means MS only effects the central nervous system not the peripheral nervous system. A damaged area along the axon is called an ‘MS plaque.’ When the myelin sheath is damaged, depolarization is slowed down or even stopped along the axon, and nervous system impulses can not be transmitted correctly. The demyelination occurs in different places throughout the body in different patients, and symptoms often come in episodes called ‘attacks.’ Often symptoms can improve partially or completely, but then they may reoccur later in another attack.
The exact cause of MS is not understood. It is categorized as an auto-immune disorder which means that the body seems to be attacking your own tissues. The immune system begins to break down its myelin producing cells, called oligodendrocytes. Your risk of developing the disease seems to be genetic, and may also be related to environmental factors, like in which climate you live. One study shows that MS attacks in a group of people seemed to occur most often in March in the northern hemisphere. MS is more common in women than in men.
The symptoms of MS can be quite different depending on the patient because MS can affect any part of the nervous system. These symptoms are seen only during ‘attacks.’ Though some damage can be permanent, most commonly they improve over time. Most commonly seen signs and signals are numbness, tingling or pain, weakness in the limbs or partial paralysis, tremors, loss of fine motor skills, blurred vision or slurred speech. Often it is difficult to diagnose MS because the signs and symptoms are similar to other neurological diseases. Patients often need to get an MRI to look for lesions in the bran or spinal chord, have a spinal tap or blood tests to detect inflammation, or sometimes MS is diagnosed because there is no other explanation for a patient’s symptoms.
How is Multiple Sclerosis treated with Conventional Medicine?
As of today, there is no cure for recurrent attacks of MS, but drugs are used to lessen the frequency and intensity of the attacks. These drugs often repress or modify the way the patient’s immune system functions. Some treatments aim to ease the symptoms of MS, focusing for example on decreasing pain, fatigue, numbness or tingling. The drugs vary in their use and function depending on symptoms of which part of the nervous system is affected.
What is the Ayurvedic understanding of Multiple Sclerosis? What is the cause?
The CNS most closely correlates with what is known as the majja dhatu in Ayurvedic anatomy and physiology. Majja literally means marrow, like bone marrow, but its actions imply that it functions like the nerve tissue in the body (dhatu = tissue.) Ayurveda is not as concerned with labeling a disorder, but finding and treating the underlying cause of the disease, and in doing so pacifying the symptoms. MS is a deterioration of the nerve tissue, the majja dhatu.
First, it is important to understand the foundations of Ayurvedic medicine. Ayurveda looks at the entire universe as being made up of five elements: Space, Air, Fire, Water and Earth, which manifest as three energies, the doshas of Vata (Space and Air), Pitta (Fire and Water), and Kapha (Water and Earth.) Myelin is white matter, and a form of kapha called in Ayurveda tarpaka kapha, correlates with the definition of white matter. Vata can be understood as the opposite of Kapha. Its qualities are dry, rough, cold and mobile, opposite those of the tarpaka kapha. Vata dosha is often responsible for deterioration, and in this case seen as the cause for the deterioration of the tarpaka kapha, or myelin sheathe. The sanskrit term that may best define MS is Vata Vikara Dhatukshayajanya; a Vata disease which causes gradual deterioration of the tissues. In this case, majja, or nerve tissue. Symptoms of a Vata imbalance are symptoms which are seen in MS: heightened sensitivity, numbness, tingling, fatigue, fear, worry, anxiety, depression, insomnia, pain, tremors, headaches, spastic movements, constipation, dry or rough skin, cold body parts.
The cause of MS according to Ayurveda look similar to what Western Medicine has discovered but with different terminology. MS could be caused by a build up of ama in the tissues. Ama literally means undigested food. When a person’s agni, or metabolic fire is not strong due to various factors, the food ingested is not properly digested or assimilated and this toxin, ama, is formed. Ama can also be formed when emotions or other sensory impressions are not ‘digested’ properly. Ama can circulate through the body and affect a weakened tissue or organ.
Stress, both physical and mental, aggravate Vata, the elements of Air and Space. When Vata is aggravated, the qualities of dryness, roughness, cold, and mobility increase. When lesser imbalances are not corrected (earlier stages of disease) they simply increase and can manifest into a complicated disease.
Ayurveda also understands MS as an immune disorder. Ojas is a term used to understand immunity. It is literally a refined substance in the body that is the essence of the bodily tissues. If the tissues are not healthy (due to dosha vitiation, poor nutrition, ama, etc) Ojas will be of poor quality or quantity and will not be useful in helping the body combat disease.
According to Ayurvedic pathology, MS is a fully manifested disease which is in the last stages of the disease process, truly involving all of the tissues, not only the nervous system. A person may get MS as opposed to another disease because due to genetics or past injury, the nervous system is weaker than the other tissues, and the disease happens to manifests there. This is known as the term kavaigunya, literally translated as ‘defective space.’
How could Multiple Sclerosis be treated using Ayurvedic Medicine?
According the the National MS Society, 75% of MS suffers use some form of CAM medicine alongside conventional treatments. Ayurveda employs a ‘like increases like’ philosophy in regards to treatment. Ayurvedic treatments include meditation, yoga, massage and other body work, the use of herbs and dietary changes. In general, Ayurvedic treatments are relatively low-risk and of moderate cost, though as of now most health care providers do not cover treatments.
Ayurveda is considered a holistic medicine. Holistic systems believe that a human being is more than just a body, that psychological, physical and spiritual concerns must be addressed for healing methods to be the most effective. This can also be understood in the way that it is not enough simply to treat the symptoms, one must treat or remove the cause. To find the most success with Ayurvedic treatment a client must make a long-term commitment to their healing. This may be one reason that patient often opts to simply take a drug rather than work hard at changing other aspects of their life.
According to the symptoms, Vata dosha is part of the underlying cause. The main treatment is to address the Vata Dosha. A person’s job, family life, diet, etc may be a part of this vitiation, so a very in-depth client intake would be done by a practitioner before making any recommendations.
Dietary changes to pacify Vata would include avoiding foods which cold, rough, subtle, light and dry qualities, and favoring foods that are warm, moist/oily, and grounding. Tastes that aggravate Vata are pungent, bitter and astringent, and favorable are sweet, sour and salty. Ayurveda always recommends a diet full of whole foods, and suggests avoiding leftovers, frozen, or processed food.
Specific body treatments could include Abhyanga, basti or shirodhara. Abhyanga (also called Snehana) is a specific Aurvedic massage that utilizes oils infused with special herbs. The quality of the oil directly counters the qualities of Vata dosha. The massage also increases circulation and the movement of toxins to the GI tract where they can be expelled. The herbs and oil nourish the tissues and help repair. Basti is an enema treatment in which oils and herbal teas are utilized. It is one of the best modes of treatment for pacifying Vata imbalances. Shirodhara is an ancient Ayurvedic technique used to balance the mind and nourish the nervous system. It involves warm oil poured on the forehead of the patient, performed by a specially trained therapist. An Ayurvedic practitioner would suggest a certain regimen of this body work depending on the patient’s needs.
Yogic techniques including meditation and pranayama, particularly alternate nostril breathing and ujjayi breathing, should be employed to calm Vata in the nervous system and bring tranquility to the mind. Herbs and various herbal combinations are suggested according to need. Some well-known Ayurvedic herbs that balance Vata are Ashwagandha, Bala, Brahmi and Yogaraj Guggulu.
A combination of all these modalities would be utilized for the most success in treating MS patients.
Resources:
Books:
Bowling, Allen C. Alternative Medicine and Multiple Sclerosis. Pp. 43-44. New York: Demos, 2001. Print.
Frawley, David. Ayurvedic Healing: a Comprehensive Guide. 2nd ed. Pp 303-306. Twin Lakes, Wisc.: Lotus, 2000. Print.
Websites:
Halpburn, Dr. Marc. “The Seven Dhatus Part VI: The Majja Dhatu: A Closer Look.” California College of Ayurveda. California College of Ayurveda. Web. 5 Dec. 2011. <http://www.ayurvedacollege.com/articles/drhalpern/Majja%20Dhatu>.
Kelkar, Dr. Rucha. “Multiple Sclerosis in Ayurveda.” Ayurbliss: The Natural Way of Healing and Rejuvenation through Ayurveda. Web. 06 Dec. 2011. <http://www.ayurbliss.com/articles.html>.
“Multiple Sclerosis.” Nervous System Diseases. Web. 06 Dec. 2011. <http://www.nervous-system-diseases.com/multiple-sclerosis.html>.
National MS Society. National MS Society. Web. 07 Dec. 2011. <http://www.nationalmssociety.org/>.
Articles (Online):
Iuliano, G. “Multiple Sclerosis: Long Time Modifications of Seasonal Differences in the Frequency of Clinical Attacks.” Pubmed.gov. Web. 07 Dec. 2011. <http://www.ncbi.nlm.nih.gov/pubmed/22143944>.
Olsen, SA. “A Review of Complementary and Alternative Medicine (CAM) by People with Multiple Sclerosis.” John Wiley & Sons, Ltd (2009). Pubmed.gov. Web. 07 Dec. 2011. <http://www.ncbi.nlm.nih.gov/pubmed/19222053>.
Yadav, Vijayshree. “Complementary and Alternative Medicine for the Treatment of Multiple Sclerosis.” Pubmed.gov. Web. 07 Dec. 2011.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901236/>.
Salamonsen, Anita. “Understanding Unexpected Courses of Multiple Sclerosis among Patients Using Complementary and Alternative Medicine: A Travel from Recipient to Explorer.” Pubmed.gov. Web. 07 Dec. 2011. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900149/?tool=pubmed>.