18 Luohan Hands Qigong

Discover all of the famous 18 Luohan Hands qigong set. If you could only practice one set of qigong exercises for the rest of your life, you'd be well served by the 18 Luohans.



The 4 Primary Skills

Techniques are great, but skills are more important for getting results. You'll learn all 4 of the primary skills of qigong: 
1. Discovering the Qi, 
2. Circulating the Qi, 
3. Aligning the Qi, and 
4. Gathering the Qi.

THE HANDS OF THE 18 LUOHAN: Technical Description of the Movements

MEDITATION POSTURE OR WU CHI

TECHNICAL & TEACHING POINTS
“Wu Chi” translates as the great void or emptiness, the one not manifested or the one without limits. This position it encompasses all the other positions. Within it, all principles of the remaining postures may be discovered.

Begin by feeling the soles of the feet touching the earth. Like the roots of a tree, the Yin aspect, the feet become the roots of the posture. Visualize roots extending through the feet to create solidity while at the same time extend the head upwards to the sky, developing the Yang aspect of the posture. Like the saying, “The higher you want to go into heaven, the deeper your roots have to be.” Many people on the spiritual path develop only the aerial aspect and forget the earth element.  Balance between these two forces, Yin and Yang, earth and heaven is essential for overall health and well-being.

The body must be very straight and the spine erect. The chin is slightly downward to straighten the neck and release tension from the back of the neck.  The arms hang loose and relaxed, drop the shoulders and relax so that the chest is concave and the back is rounded and convex. There is no tension as if very heavy suitcases have just been set down. Relax the groin, the buttocks and the lower back completely. The knees are straight and relaxed, not locked.

The base of the each foot is like a tri-pod with three points of support necessary to bear the weight of the body. These points are: the ball of the foot at the heel, the ball behind the big toe, and the ball behind the little toes. Lean forward a little in this position, feeling the full sole of the foot connecting, not the edges, neither the inside nor outside edge, but the whole foot resting on those three points.

Trained practitioners may hold this meditative posture for an extended period of time however beginners should start holding for less time and build up their ability to stand longer.

This posture is used to center and gather Qi in the low Dan Tien; to center the mind in the low Dan Tien; to discover the center of gravity in the body; and to calm the Shen or the spirit.

When the whole body is relaxed and the spine and the bones are aligned energy will flow in a very natural way.  There should not be a “boiled spaghetti” feeling, too limp and without backbone, in the body. The Chinese say, “Bones straight, tendons relaxed” meaning the bone structure should be kept straight while in a relaxed state. This ensures that blood and energy will flow freely. For example, using a hose to water the garden when the hose is bent or crooked will not allow water to flow through. In the same way, if the body is bent, the blood and Qi will not flow. Many injuries (in the lower back and neck, etc.) would be avoided by proper spine alignment. The meditation posture acts as a preventive tool to address many of the muscular and skeletal disorders due incorrect posture.

The front side is called the Yin side, while the whole back is the Yang side. As the palms are turned forward a statement of openness, with nothing to hide, like an open book is being made.

This posture transmits the quality of truthfulness and embodies cultivating honesty within ourselves and to certain principles in our lives.  Notice the accompanying phrase, “I keep my body straight and always tell the truth.” In India it is said that the person who never lies and has always spoken the truth speaks words that are so strong that, no matter what is said, they will always become a reality. 


YIN-YANG/SUN-MOON PALM

TECHNICAL & TEACHING POINTS

The position is a stretch up and a stretch down at the same time.  The upper hand is facing the sky and the lower hand is facing the earth. The fingers of the upper hand are pointed toward the inside of the body and the fingers of the lower hand are pointed to the buttocks. The legs are straight, the neck relaxed and the lower Dan Tien anchors the posture. This is a very good posture to stretch the tendons and ligaments in the arms and shoulders.

Throughout the 18 Luohan stretching is emphasized to balance Yin and Yang in the body and to create blood and energy flow. According to traditional Chinese medicine, disease stems from an imbalance in the flow of these two energies in the body. Each completed stretch emphasizes Yang while the release to a fully relaxed position emphasizes Yin. The stretch must always be accompanied by a state of relaxation with attention paid to body structure to avoid injury.

BEYOND TECHNIQUE 
This posture balances the spiritual or lofty and the realistic or grounded element with the hands, one reaching for the sky and the other reaching for the earth to create harmony with the Tao. Note the saying, “I will shine like the sun but I will be humble like the moon” acknowledging the self-assurance and internal power like the sun within everyone as well as the humble quality of the moon, not being arrogant or misdirecting the power within. The opportunity to act according to any given situation is cultivated whether in a more Yang manner, or more Yin manner.


TOPPLE MOUNTAIN RANGE WITH PALMS

TECHNICAL & TEACHING POINTS
In the DING JI MA, most of the weight is on the front leg, and there is a rotation of the hip. The knee should not go over the toe of the front leg. The back leg is completely straight, with the back foot at a 45 degree angle and the hip of the back leg rotated in.
Continue the rotation up the spine through the waist and spinal column making the spine flexible and stretching all the muscles, tendons and ligaments of the back.

If the left leg is forward, the opposite arm is forward and the fingers are facing up while the fingers of the back hand are pointed to the side. The upper torso, from the hip and the waist, are completely turned so there is a straight line from the front hand through both shoulders to the back hand.

Both wrists are stretched to a 90 degree angle in the WILLOW LEAF PALM.
Medically this exercise helps to stretch the back leg, strengthen the front leg, rotate the hip joints and increase flexibility.

BEYOND TECHNIQUE 

This posture illustrates the dragon pushing apart a mountain range. It strengthens the mind and the SHEN through a state of deep and powerful determination and concentration by focusing the eyes like the laser eyes of a dragon. Go beyond the physical stretch into a mental stretch; stretch the mind to expand the energy even more.

BLACK TIGER PUSHES THE MOUNTAIN
(click here to see the posture)

TECHNICAL & TEACHING POINTS
When stretching the palms forward there should be a tremendous extension, which stretches the back, and massages the kidney area.
This exercise is very good for lumbago, sciatica and strengthening the kidneys.

BEYOND TECHNIQUE
In Chinese medicine the tiger is related to the bones and kidneys, and this posture helps to strengthen both as well as the bone marrow.  Once the physical limit of the push is achieved the consciousness expands beyond the physical body and reaches out more with the mind. “With joy and self-confidence I will overcome any obstacle” is the phrase emphasizing the human value. Harnessing the power of the whole universe, one is able to overcome anything, never giving up, learning from mistakes and never accepting failure. This too is reflected in the natural Yin and Yang cycle; life is a learning process and there is always an up and a down. Learn to see life not as simply good or bad, but as containing many experiences and opportunities from which to learn and grow stronger. 

WHITE CRANE SPREADS ITS WINGS

TECHNICAL & TEACHING POINTS

The practitioner raises his hands, which are in crane’s beak formation, above his head, while breathing in. The practitioner simultaneously stands on his toes.
The entire posture should resemble a large and graceful bird, poised to leap into flight.

BEYOND TECHNIQUE 
Notice the phrase, “I open my mind and my heart and I am free as a bird.” This emphasizes the control that we as individuals have over the mind and emotions, and that actually we are the ones to control whether we are happy or not.


CHILD WORSHIPING BUDDHA TO THE  SKY

TECHNICAL & TEACHING POINTS 
All the muscles of the upper body, through the arms, shoulders and back receive a good stretch.
Being on the toes develops the muscles in the lower legs, and will improve agility. These muscles allow for quick movement. Refer to the colloquialism, “being on the ball” or literally on the ball of the foot, fast, ready and stable.

BEYOND TECHNIQUE
Notice the phrase, “I can reach any goal; there are no limits”. Understanding to discard any beliefs of limitations in personal possibility and potential is physically emphasized in this posture. Success is a manifestation of the inner life. Confucius said, “If it takes him ten times, it takes me one hundred. If it takes him one hundred times, it takes me one thousand. If it takes him one thousand times it takes me ten thousand times, and thus the not skillful can becomes skillful.” The Luohan is a GONG; meaning a skill that is developed through practice and time. If desire, perseverance and attitude are positively cultivated any goal may be reached.









CHILD WORSHIPPING BUDDHA 

TECHNICAL & TEACHING POINTS
The legs are straight but not locked and the elbows are out from of the body with space under the armpits. The hands are pressing together touching at the base and through the fingers, but inside of the palms there is a hollow area creating a connection between the two LAO GONG (Pericardium 8) points.

The fingertips are pointing to the upper DAN TIEN or “the upper field of elixir” located between the eyebrows. The upper DAN TIEN is related to SHEN or SPIRIT.  The lower DAN TIEN is also the seed of the JING or ESSENCE QI of the kidneys. The middle DAN TIEN, centered between the nipples is related to QI, to the breath and to the emotions. These three are called the “three treasures” of man: the JING, or the essence, the QI, the energy and breath, and the SHEN, the spirit.

BEYOND TECHNIQUE
This position helps to illustrate how body positions affect the mind, the emotions and thoughts. Feelings of deep silence, humility, and gratitude are palpable in this posture, and help to connect the practitioner to the TAO. It is often said, “the TAO that can be explained in language is not the real TAO,” so it is important for the practitioner to develop sensitivity to how the physical movements affect them on deeper levels.

Within the 18 Luohan a relationship to silence and peace may be discovered. A great deal of energy is expended through talking. Silence helps conserve energy and is a great healer.







THE EMPEROR HOLDS UP THE TOWER

TECHNICAL & TEACHING POINTS
Stretch the palms, facing up to heaven with the middle fingers touching. Once stretched fully, relax the upper gate and lean back a little bit or as much as is comfortable.
The legs are straight and the Yin side of the body, particularly the stomach muscles as well as the Yang side, the spine and the back, are stretched.

BEYOND TECHNIQUE
This is a powerful archetypal position; the emperor is so strong that he can hold up a tower. In studying the phrase, “Honesty gives me strength and everybody trusts me,” the theme of strength and the ability to stand one’s ground through honest interactions is continued. Honesty helps develop greater strength in word and action by being guided by higher moral values. Honesty establishes the pillars of happiness, health and peace.





VENERATING THE ORIGIN

TECHNICAL & TEACHING POINTS
The posture is done as though being pulled in both directions through the front and back hand.
Keep the back straight and the eyes forward, looking far to the horizon.

BEYOND TECHNIQUE
Venerating the Origin refers to reflecting on and honoring ones own source, home, family, traditions, and experiences. There are two ways of learning through experience: to learn from the mistakes and experiences of other people or, the hard way, to always learn through personal experience. Learning from others by listening, being receptive, carefully observing, and respecting the lessons and opinions that are given, even if, in the moment they do not seem correct, is a path to honoring and respecting one’s origin.





THE SNAKE COMES OUT OF THE CAVE

TECHNICAL & TEACHING POINTS
Unlike the other DING JI MA postures, this has the back leg bent and the front leg completely straight. Both hips are turned to the front, so that they are parallel to the direction of the front leg as well as the whole torso. The elbow should be perpendicular to the sky and the opposite fingers touching the shoulder. The other forearm should be touching the kidneys.
“Venerating the Origin” and “The Snake comes out of the Cave” are done in sequence. This undulating movement helps to simulate a snake and support the flow of energy. Learning to move in this very biodynamic way helps to avoid injury and conserves energy by using minimal effort.
Bodhidharma believed that there were things to be learned from observing the snake. In nature he saw that the snake was very relaxed, and very fluid, like water. At the same time it can become very hard and powerful, like a boa constrictor or python. The strength of the snake is like the power of water flowing through a hose: the mass of water is confined to a very small space, and so the force of the water is more powerful. In this context, a very soft thing like water is strong, and it is the same with the power of energy. The relationship between softness and strength and the energy of the snake represents QI and the ability of energy to flow freely through the body.

BEYOND TECHNIQUE
The associated phrase, “I always do my duties and obligations with care” illustrates the value of always doing things to the best of your ability.
Each movement should be performed as perfectly as possible given that moment and time. In order to fully experience the health, energetic and spiritual benefits, the techniques should be performed exactly as they are taught; the benefits are proportional to the correct technique. However, this does not mean that one should trapped by perfection. My grandfather used to say, “Perfection is the enemy of getting things done.” At the same time it is important to strive to cultivate something in life in which one may excel, whether it is qigong, painting, playing the piano, being a good doctor, a scientist or a computer expert. Developing mastery in one’s life leads to greater joy and peace, as well as benefiting our health. Accordingly, medical science is now confirming that people who enjoy what they are doing live longer and healthier lives.





OPEN THE BOW TO SHOOT THE VULTURE

TECHNICAL & TEACHING POINTS
The DING JI MA position must be correctly executed, turning through the hips as much as possible, then through low, middle and upper back.
The front hand is stretched all the way forward in a hollow fist and the back hand pulls back strongly with a hollow fist. Both of the little fingers are facing up towards the sky as the pull is completed.

BEYOND TECHNIQUE
The human value illustrated in the saying, “I choose a good objective and I concentrate all my attention to reach it” emphasizes the merit of wholly choosing a worthwhile path, goal, or objective and then applying concentration and perseverance. The ability to clearly focus one’s attention on a goal allows the essence of the subject to be fully realized.

In every exercise of the form, absolute concentration on the physical technique, the breath, the body sensations, and the intent is essential. Mastering these skills in the form then permeate into any daily activity and support the pursuit of health, peace, wisdom and happiness through persistent self-development. Embedded deeply within traditional Chinese culture, including the martial arts and techniques for self-defense, is the pursuit of self-development. For example, in archery, the emphasis is not necessarily on always hitting the bull’s-eye, but to develop the ability of the archer to become one with shooting an arrow, and to feel that the arrow is a part of them. If the archer is able to feel at one with the arrow, the level of concentration and presence within the moment will be so deep as to go beyond the physical act of archery into the realm of a spiritual development. In not worrying about the target, only focusing on the moment, and allowing nature to take its course, one will have arrived at the complete realization of whatever it is that is being done.

THE POWERFUL TIGER STRETCHES ITS BACK

TECHNICAL & TEACHING POINTS
This position emphasizes the importance of circles in the practice of Qigong. The energy of the circle allows for relaxation, the ability to gather energy and to allow that energy to flow smoothly. Note the circularity in the posture all the way through the spine, from the heel to the head; the circle between the arms, within the hands and also in the back. The line between the two hands resembles the line the separates the Yin from the Yang in the Yin/Yang symbol.
This is a strong exercise to strengthen the back muscles, the legs and hips and well as stretch the spine. Keeping the spine healthy and flexible will help keep the body young. Stretching is a powerful tool to keep the body healthy and young because it not only facilitates the movement of blood and energy to every part of the body but also dredges the energy channels of blockages in the process.

BEYOND TECHNIQUE
The human value emphasized is “I help others and I have the power of the tiger.” With honest compassion and caring, not attempting to maintain power over anyone or anything, one can be generous to all and begin to see the web of connection between all living creatures. There is a very beautiful saying, “You cannot pick a flower without affecting a star,” so deep is the connection that ties us all together.

GOLDEN COCK STANDS ON ONE LEG

TECHNICAL & TEACHING POINTS
This powerful position begins a series of one-legged postures. In the leg that is raised, the foot is completely extended while the other leg is slightly bent. Feel all the way to the tip of the foot.
The upper body is virtually the same as the movement “Open the bow to shoot a vulture”. The arm that is up should also stretch forward in order to get the rotation of the spine. The back hand pulling back is in the hollow fist position.
Drop the shoulders and drop the weight to the DAN TIEN. Strive to fully stretch but maintain the relaxation, so that only the minimal muscles needed to execute the movements are used.

BEYOND TECHNIQUE
The rising YANG energy of this posture, like the rooster greeting the rising sun is associated with the phrase “I smile and I am happy when I wake up.” Starting off each day from the first thought upon waking with a smile and a positive thought helps achieve happiness and peace in each and every day.

There is a saying, “All the faces in the world are mirrors.” It is up to you to decide what face you decide to show the world.

A few minutes of Qigong every morning, whether only 5 minutes or 30 sets the attitude to be carried into life. The transition from the world of unconsciousness into the physical world is aided by stretching and gathering energy, and by allowing the body time to wake up and get the energy flowing. Just like animals in nature, as they get up, they stretch a little bit, they move, they keep on stretching and moving a little bit and then slowly they begin to walk.

The Chinese say that the five wheels (or ways) in life to stay healthy and happy are:
1) to walk with the spine erect,
2) to have beautiful projects in your mind and to plan beautiful things,
3) to listen to music to enhance the life experience,
4) to walk in nature, enjoy and be one with nature,
5) and to smile.

There is scientific evidence that endorphins and other beneficial hormones are secreted when people are happy and laughing. This reiterates the relationship between the body, mind and emotions. It is difficult to feel sad when smiling. When looking for a problem a problem will be found. When looking for solution a solution will be found. Start with a positive attitude and the end result will be positive.

COMMON MISTAKES TO AVOID


WHITE TIGER LOOKS DOWN THE ROAD

TECHNICAL & TEACHING POINTS 
In the first aspect of this movement, the body leans back in the direction of the arms and though technically difficult to do, eventually the leg and trunk are in nearly a straight line.

In the second and third parts of this position the hands are held in a tiger claw with the wrists flexed. The leg that is raised is kept straight and the foot pointed.

There is tremendous rotation of the spine; movement of the hip joint and hip area; and movement of the internal organs.

BEYOND TECHNIQUE 
The name of the movement calls attention to the importance of developing skills in observation and attentiveness. It is tremendously useful to see the reality of situations that others don’t normally see. Encourage improvement not only in observation but also in every other sense to its fullest while simultaneously improving the capacity for deep concentration. The ability to see detail and become one with it allows us to penetrate to its essence. Then one will experience not only with the eyes, but also feel, understand and begin to know with the whole body.
Wisdom is likewise gained by paying attention to the elements. For example, the nature of water is very adaptable to its environment. It does not fight, but rather yields, nurtures, remains soft and because of that is powerful and strong. It is the one drop of water, that drop by drop, penetrates the rock. By observing the earth, the structure, stability and strength of the mountain is understood. The power and energy of fire to get things done with passion is recognizable; and from air the free and ethereal sense that not being tied down is learned.

The seasons, winter, spring, summer, and autumn, instruct in the cyclical and changing ways of living, thinking, dressing, eating throughout the year so as to harmonize with the season and create well-being. So the human value expressed in the saying, “I take care of nature” might be better understood as “I take care and harmonize and learn from nature.” As one delves deeper into silence, into these exercises and into introspection, an understand of this in a natural way, not from intellectual discourse, but from a living experience will manifest. Much of this wisdom is already innate.

Everyone agreed. And this is how it has been since that time. Man is always searching for happiness without knowing that happiness is within himself.

WHITE CRANE STRETCHES

TECHNICAL & TEACHING POINTS
This is a balancing posture with the two hands held in a cranes beak—fingers held together with, the tips of the fingers facing each other, the wrist flexed, and the arms outstretched.

One of the legs is stretched back and toe is pointed. The leg is turned so that the buttocks are facing to the back rather than up due to the rotation of the hip. Look forward and focus the awareness to the forward hand as well as back to the tip of the toe. The arms and leg that are in a straight line.

BEYOND TECHNIQUE
A crane stretching to fly brings to mind the migration of the birds. In order to migrate the birds must inherit all the knowledge they need to travel such long distances. They know how and where to fly innately and follow their natural course. The phrase “With perseverance and effort I reach what I want,” sums up the formula for success in life and, just like the birds, if one puts all of ones effort into reaching a destination, any goal will be reached.

This position provides an opportunity to put that perseverance into play. At the beginning it seems to be very difficult. Over time, improvement in the posture will develop. Often when students begin this posture, they are worried and say that it is very difficult to do. Yes, these positions are very difficult to do but I tell them, “You know difficult and easy, it just really doesn’t matter. These are words that I don’t even deal with. We must do things and so we do them.” The real question is whether it is worth doing, or not worth doing? If the movement is not thought of or interpreted as easy or hard, but worth doing, then, instead of conquering it in one day, it slowly and gradually unfolds over time. Patience is required to understand that things done well take time.

 KICK WITH THE HEEL

TECHNICAL & TEACHING POINTS
Feel the heel of the foot and the toe straight up. The opposite foot and hand are forward based on the rotation through the upper body.
The back should be kept straight, and the weighted leg may be kept bent or straight, which is more difficult.

BEYOND TECHNIQUE
In this exercise you develop stability and balance to maintain well-being and happiness. This is evident in the phrase, “I keep my balance to be happy.” Learning the way to harmoniously bring together duty and pleasure, work and fun is the most exquisite balance, and is the way to lasting and true happiness.

FAST KICK

TECHNICAL & TEACHING POINTS
The “Fast Kick”, is the only movement that is done quickly in the whole sequence. This exercise is used for coordination, stretching of the legs, loosening of the arms and a continued connection to the DAN TIEN.

It stresses elasticity and the flexibility of the joints and the legs while keeping balance and keeping the lower foot fully connected to the ground.

BEYOND TECHNIQUE
The phrase and associated human value refers to “Fast outside, calm inside.” This is means by which to move through life; allowing for the ability to move quickly without losing one’s stability or center while maintaining a sense of peace and calm. The Chinese say, “Stillness in movement, movement in stillness.” This is a very healthy attitude because energy is conserved. My first teacher said, “We should be like a hurricane in certain emotions and in certain times of our daily life. We act fast like the hurricane where the outside is moving very fast, but the inside is very calm.” The same teacher also said, “Go through life like a fish in a fish tank. The fish swims around very slowly in the fish tank, calmly without wasting energy but if you put a hand in there they are capable of moving very quickly. And then they return to peaceful, calm movement.”

In the Luohan, the movements are learned in a very calm and elegant way, but are capable of moving very fast as well. The ability to move quickly is related to the flow of blood and energy. While observing a cat it is obvious that it is not always moving but it stretches from time to time, allowing energy to flow, keeping the joints warm and lubricated and the muscles toned. When the cat decides to hunt it proceeds slowly and calmly with tremendous intention in the eyes, and it is ready to jump in a second.

TURN THE BODY WITH TWISTED STEPS

TECHNICAL & TEACHING POINTS
The entire sole of one foot is on the floor and the other foot connects with the ball of the foot. The both feet point forward and the weight is on both legs.

The hips should rotate so that they are oriented to the back with the body kept straight and the shoulders relaxed.

BEYOND TECHNIQUE
The phrase notes, “I am flexible and I adapt to different situations.” Adapting with flexibility to any given moment or situation and to act accordingly will improve the quality of life. Water is a perfect example of the ability to adapt, with the least effort, moving around until it reaches its goal and returns to the sea. Those who are very rigid and structured suffer without finding solutions to problems. In the Orient, it is said, “One of the first lessons we must learn is that there are many rules and laws to be learned and the most important one is that there is no strategy, there are no rules and one should be able to change very quickly.” As the different cycles of life are experienced many values, desires, and goals modify and must be changed accordingly. There is a saying from an Indian poet, “Do not cry because the sun has set, because the tears will not let you see the beauty of the stars.” The inability to change because of need and attachment does not allow for the possibilities of a new situation. Perhaps this new situation is much better. Learning to let go shows faith in nature and the willingness to take full advantage of all the possibilities that are offered.

LUOHAN DRIES HIS GOWN IN THE SUN

TECHNICAL & TEACHING POINTS
This is performed with the feet parallel and the arms relaxed while stretched out to the sides. The hips thrust forward while the legs are kept straight. The torso bends backwards, with the neck, the upper gate, relaxed and the arms hang like a piece of cloth.
This is a very powerful extension and flexion of the spine. As in all the other movements of the form, be sure that it is done carefully.

SWORD FINGERS

TECHNICAL & TEACHING POINTS
The last posture is done in a HORSE STANCE position in which the legs and the feet are parallel to each other facing the front. The knees are extended out as if being held open by a piece of wood, which helps to strengthen the muscles on the inside of the leg.
This position strengthens and opens the hip and is a very stable position related to the structure and power of the earth element.
The index and middle finger are put together while holding the ring and little finger with the thumb. The sword fingers are extended out to each side as if touching objects very far away, while extending the concentration and consciousness equally far away. It should have a very dignified, powerful and solid feeling.

BEYOND TECHNIQUE
The phrase, “I am courageous and guided by justice and honor” highlights the human value in this posture. Throughout the course of life many situations will demand courage, and the belief that courage is inherent will generate the power to overcome any obstacle. Actions, guided by a clear sense of justice and treating others as we would like to be treated, will reinforce our sense of honor and will provide peace and health.

In the last pages of the coloring book, a Luohan walks away during a full moon and it says “And Luohan continued his way observing, listening, meditating; trying to learn something new every day.” Life is the school and the learning process with each day provides an opportunity to learn to be better people, to be more peaceful and wise, to be more loving, more just, more honorable, because that is what will bring deep, true and lasting happiness. Observe oneself first, the feelings, emotions, thoughts, actions, and words and meditate on those. Mindfully observe others, and nature, and meditate on that to discover peace, health and happiness.


At the end it says “And it is said that Luohan is on the search of another grand adventure” indicating that there is always more to come in this very beautiful adventure that is life.

What is peripheral neuropathy?

An estimated 20 million people in the United States have some form of peripheral neuropathy, a condition that develops as a result of damage to the peripheral nervous system — the vast communications network that transmits information between the central nervous system (the brain and spinal cord) and every other part of the body. (Neuropathy means nerve disease or damage.) Symptoms can range from numbness or tingling, to pricking sensations (paresthesia), or muscle weakness. Areas of the body may become abnormally sensitive leading to an exaggeratedly intense or distorted experience of touch (allodynia). In such cases, pain may occur in response to a stimulus that does not normally provoke pain. Severe symptoms may include burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Damage to nerves that supply internal organs may impair digestion, sweating, sexual function, and urination. In the most extreme cases, breathing may become difficult, or organ failure may occur.

Peripheral nerves send sensory information back to the brain and spinal cord, such as a message that the feet are cold. Peripheral nerves also carry signals from the brain and spinal cord to the muscles to generate movement. Damage to the peripheral nervous system interferes with these vital connections. Like static on a telephone line, peripheral neuropathy distorts and sometimes interrupts messages between the brain and spinal cord and the rest of the body.

Peripheral neuropathies can present in a variety of forms and follow different patterns. Symptoms may be experienced over a period of days, weeks, or years. They can be acute or chronic. In acute neuropathies such as Guillain-Barré syndrome (in which the body’s immune system attacks part of the peripheral nervous system and impairs sending and receiving nerve signals), symptoms appear suddenly, progress rapidly, and resolve slowly as damaged nerves heal. In chronic forms, symptoms begin subtly and progress slowly. Some people may have periods of relief followed by relapse. Others may reach a plateau stage where symptoms stay the same for many months or years. Many chronic neuropathies worsen over time. Although neuropathy may be painful and potentially debilitating, very few forms are fatal.

In diabetic neuropathy, one of the most common forms of peripheral neuropathy, nerve damage occurs in an ascending pattern. The first nerve fibers to malfunction are the ones that travel the furthest from the brain and the spinal cord. Pain and numbness often are felt symmetrically in both feet followed by a gradual progression up both legs. Later, the fingers, hands, and arms may become affected.

How are the peripheral neuropathies classified?

More than 100 types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. In general, peripheral neuropathies are classified according to the type of damage to the nerves. Some forms of neuropathy involve damage to only one nerve and are called mononeuropathies. More frequently however, multiple nerves are affected, called polyneuropathy.

Some peripheral neuropathies are due to damage to the axons (the long, threadlike portion of the nerve cell), while others are due to damage to the myelin sheath, the fatty protein that coats and insulates the axon. Peripheral neuropathies may also be caused by a combination of both axonal damage and demyelination. Electrodiagnostic studies can help healthcare providers determine the type of damage involved.

What are the symptoms of peripheral nerve damage?

Symptoms vary depending on whether motor, sensory, or autonomic nerves are damaged. Motor nerves control voluntary movement of muscles such as those used for walking, grasping things, or talking. Sensory nerves transmit information such as the feeling of a light touch or the pain from a cut. Autonomic nerves control organ activities that are regulated automatically such as breathing, digesting food, and heart and gland functions. Some neuropathies may affect all three types of nerves; others primarily affect one or two types. Doctors may use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe the types of nerves involved in an individual’s condition.

Motor nerve damage is most commonly associated with muscle weakness. Other symptoms may include painful cramps and fasciculations (uncontrolled muscle twitching visible under the skin), muscle atrophy (severe shrinkage of muscle size), and decreased reflexes.

Sensory nerve damage causes a variety of symptoms because sensory nerves have a broad range of functions. Larger sensory fibers enclosed in myelin register vibration, light touch, and position sense. Damage to large sensory fibers impairs touch, resulting in a general decrease in sensation. Since this is felt most in the hands and feet, people may feel as if they are wearing gloves and stockings even when they are not. This damage to larger sensory fibers may contribute to the loss of reflexes. Loss of position sense often makes people unable to coordinate complex movements like walking or fastening buttons, or to maintain their balance when their eyes are shut.

Smaller sensory fibers without myelin sheaths transmit pain and temperature sensations. Damage to these fibers can interfere with the ability to feel pain or changes in temperature. People may fail to sense that they have been injured from a cut or that a wound is becoming infected. Others may not detect pain that warns of impending heart attack or other acute conditions. Loss of pain sensation is a particularly serious problem for people with diabetes, contributing to the high rate of lower limb amputations among this population.

Neuropathic pain is a common, often difficult to control symptom of sensory nerve damage and can seriously affect emotional well-being and overall quality of life. Often worse at night, neuropathic pain seriously disrupts sleep and adds to the emotional burden of sensory nerve damage. Neuropathic pain can often be associated with an oversensitization of pain receptors in the skin, so that people feel severe pain (allodynia) from stimuli that are normally painless. For example, some may experience pain from bed sheets draped lightly over the body. Over many years, sensory neuropathy may lead to changes in the skin, hair, as well as to joint and bone damage. Unrecognized injuries due to poor sensation contribute to these changes, so it is important for people with neuropathy to inspect numb areas for injury or damage.

Autonomic nerve damage symptoms are diverse since the parasympathetic and sympathetic nerves of the peripheral nervous system control nearly every organ in the body. Common symptoms of autonomic nerve damage include an inability to sweat normally, which may lead to heat intolerance; a loss of bladder control; and an inability to control muscles that expand or contract blood vessels to regulate blood pressure. A drop in blood pressure when a person moves suddenly from a seated to a standing position (a condition known as postural or orthostatic hypotension) may result in dizziness, lightheadedness, or fainting. Irregular heartbeats may also occur.

Gastrointestinal symptoms may accompany autonomic neuropathy. Malfunction of nerves controlling intestinal muscle contractions can lead to diarrhea, constipation, or incontinence. Many people also have problems eating or swallowing if autonomic nerves controlling these functions are affected.

What causes peripheral neuropathy?

Peripheral neuropathy may be either inherited or acquired through disease processes or trauma. In many cases, however, a specific cause cannot be identified. Doctors usually refer to neuropathies with no known cause as idiopathic.

Causes of acquired peripheral neuropathy include:

Physical injury (trauma) is the most common cause of acquired nerve injury.

• Injury or sudden trauma, such as from automobile accidents, falls, sports-related activities, and surgical procedures can cause nerves to be partially or completely severed, crushed, compressed, or stretched, sometimes so forcefully that they are partially or completely detached from the spinal cord. Less severe traumas also can cause serious nerve damage. Broken or dislocated bones can exert damaging pressure on neighboring nerves.

• Repetitive stress frequently leads to entrapment neuropathies, a form of compression injury. Cumulative damage can result from repetitive, awkward, and/or forceful activities that require movement of any group of joints for prolonged periods. The resulting irritation may cause ligaments, tendons, and muscles to become inflamed and swollen, constricting the narrow passageways through which some nerves pass. Ulnar neuropathy and carpal tunnel syndrome are examples of the most common types of neuropathy from trapped or compressed nerves at the elbow or wrist.

Diseases or disorders and their related processes (such as inflammation) can be associated with peripheral neuropathy.

• Metabolic and endocrine disorders impair the body’s ability to transform nutrients into energy and process waste products, and this can lead to nerve damage. Diabetes mellitus, characterized by chronically high blood glucose levels, is a leading cause of peripheral neuropathy in the United States. About 60 percent to 70 percent of people with diabetes have mild to severe forms of nervous system damage that can affect sensory, motor, and autonomic nerves and present with varied symptoms. Some metabolic liver diseases also lead to neuropathies as a result of chemical imbalances. Endocrine disorders that lead to hormonal imbalances can disturb normal metabolic processes and cause neuropathies. For example, an underproduction of thyroid hormones slows metabolism, leading to fluid retention and swollen tissues that can exert pressure on peripheral nerves. Overproduction of growth hormone can lead to acromegaly, a condition characterized by the abnormal enlargement of many parts of the skeleton, including the joints. Nerves running through these affected joints often become entrapped, causing pain.

• Small vessel disease can decrease oxygen supply to the peripheral nerves and lead to serious nerve tissue damage. Diabetes frequently leads to impaired blood flow to nerves. Various forms of vasculitis (blood vessel inflammation) frequently cause vessel walls to harden, thicken, and develop scar tissue, decreasing their diameter and impeding blood flow. Vasculitis is an example of nerve damage called mononeuritis multiplex or multifocal mononeuropathy, in which isolated nerves in two or more areas are damaged.

• Autoimmune diseases, in which the immune system attacks the body’s own tissues, can lead to nerve damage. Sjogren’s syndrome, lupus, and rheumatoid arthritis are among the autoimmune diseases that can be associated with peripheral neuropathy. When the tissue surrounding nerves becomes inflamed, the inflammation can spread directly into nerve fibers. Over time, these chronic autoimmune conditions can destroy joints, organs, and connective tissues, making nerve fibers more vulnerable to compression injuries and entrapment. Chronic conditions may alternate between remission and relapse. Acute inflammatory demyelinating neuropathy, better known as Guillain- Barré syndrome, can damage motor, sensory, and autonomic nerve fibers. Most people recover from this autoimmune syndrome although severe cases can be life threatening. Chronic inflammatory demyelinating polyneuropathy (CIDP) usually damages sensory and motor nerves, leaving autonomic nerves intact. Multifocal motor neuropathy is a form of inflammatory neuropathy that affects motor nerves exclusively. It may be chronic or acute.

• Kidney disorders may cause neuropathies. Kidney dysfunction can lead to abnormally high amounts of toxic substances in the blood that can damage nerve tissue. A majority of indviduals who require dialysis because of kidney failure develop polyneuropathy.

• Cancers can infiltrate nerve fibers or exert damaging compression forces on nerve fibers. Tumors also can arise directly from nerve tissue cells. Paraneoplastic syndromes, a group of rare degenerative disorders that are triggered by a person’s immune system response to a cancerous tumor, also can indirectly cause widespread nerve damage. Toxicity from the chemotherapeutic agents and radiation used to treat cancer also can cause peripheral neuropathy. An estimated 30 to 40 percent of people who undergo chemotherapy develop peripheral neuropathy and it is a leading reason why people with cancer stop chemotherapy early. The severity of chemotherapyinduced peripheral neuropathy (CIPN) varies from person to person. In some cases people may be able to ease their symptoms by lowering their chemotherapy dose or by stopping it temporarily. In others, CIPN may persist long after stopping chemotherapy.

• Neuromas are benign tumors that are caused by an overgrowth of nerve tissue that develops after a penetrating injury that severs nerve fibers. Neuromas are often associated with intense pain and sometimes they engulf neighboring nerves, leading to further damage and even greater pain. Neuroma formation can be one element of a more widespread neuropathic pain condition called complex regional pain syndrome or reflex sympathetic dystrophy syndrome, which can be caused by traumatic injuries or surgical trauma. Widespread polyneuropathy is often associated with neurofibromatosis, a genetic disorder in which multiple benign tumors grow on nerve tissue.

• Infections can cause peripheral neuropathy. Viruses and bacteria that can attack nerve tissues include herpes varicellazoster (shingles), Epstein-Barr virus, West Nile virus, cytomegalovirus, and herpes simplex members of the large family of human herpes viruses. These viruses can severely damage sensory nerves, causing attacks of sharp, lightning-like pain. Postherpetic neuralgia is long-lasting, particularly intense pain that often occurs after an attack of shingles. Lyme disease, diphtheria, and leprosy are bacterial diseases characterized by extensive peripheral nerve damage. Diphtheria and leprosy are rare in the United States, but the incidence of Lyme disease is on the rise. 

 
The tick-borne infection can involve a wide range of neuropathic disorders, including a rapidly developing, painful polyneuropathy, often within a few weeks of being infected. West Nile virus is spread by mosquitoes and is associated with a severe motor neuropathy. The inflammation triggered by infection sometimes results in various forms of inflammatory neuropathies that develop quickly or slowly.

The human immunodeficiency virus (HIV) that causes AIDS is associated with several different forms of neuropathy, depending on the nerves affected and the specific stage of active immunodeficiency disease. A rapidly progressive, painful polyneuropathy affecting the feet and hands can be the first clinically apparent symptom of HIV infection. An estimated 30 percent of people who are HIV positive develop peripheral neuropathy; 20 percent develop distal neuropathic pain.

Exposure to toxins may damage nerves and cause peripheral neuropathy.

• Medication toxicity can be caused by many agents in addition to those for fighting cancer. Other agents that commonly cause peripheral neuropathy as a side effect include those used to fight infection such as antiretroviral agents for treating HIV. In addition, anticonvulsant agents and some heart and blood pressure medications can commonly cause peripheral neuropathy. In most cases, the neuropathy resolves when these medications are discontinued or dosages are adjusted.

• Environmental or industrial toxins such as lead, mercury, and arsenic can cause peripheral neuropathy. In addition, certain insecticides and solvents have also been known to cause neuropathies.
• Heavy alcohol consumption is a common cause of peripheral neuropathy. Damage to the nerves associated with long-term alcohol abuse may not be reversible when a person stops drinking alcohol, however, doing so may provide some symptom relief and prevent further damage. Chronic alcohol abuse also frequently leads to nutritional deficiencies (including B12, thiamine, and folate) that contribute to the development of peripheral neuropathy.

Genetic mutations can either be inherited or arise de novo, meaning they are completely new mutations to an individual and are not passed along by either parent. Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood.

Advances in genetic testing in the last decade have led to significant strides in the ability to identify the genetic causes underlying peripheral neuropathies. For example, several genes have been found to play a role in different types of Charcot-Marie-Tooth, a group of disorders that are among the most common forms of inherited peripheral neuropathies. These neuropathies result from mutations in genes responsible for maintaining the health of the myelin sheath as well as the axons themselves. Key characteristics of Charcot- Marie-Tooth disorders include extreme weakening and wasting of muscles in the lower legs and feet, gait abnormalities, loss of tendon reflexes, and numbness in the lower limbs.

How is peripheral neuropathy diagnosed?

The symptoms of peripheral neuropathy are highly variable. A thorough neurological examination is required to sort out the cause of the symptoms and involves taking an extensive medical history (covering symptoms, work environment, social habits, exposure to toxins, alcohol use, risk of HIV or other infectious diseases, and family history of neurological diseases). In addition, tests are usually performed to identify the cause of the neuropathy as well as the extent and type of nerve damage.

A physical examination and various tests may reveal the presence of a systemic disease causing the nerve damage. Tests of muscle strength, as well as evidence of cramps or fasciculations, indicate motor fiber involvement. Evaluation of the person’s ability to sense vibration, light touch, body position, temperature, and pain reveals any sensory nerve damage and may indicate whether small or large sensory nerve fibers are affected.

Blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity. An examination of cerebrospinal fluid that surrounds the brain and spinal cord can reveal abnormal antibodies associated with some immune-mediated neuropathies. More specialized tests may reveal other blood or cardiovascular diseases, connective tissue disorders, or malignancies. Genetic tests are becoming available for a number of the inherited neuropathies.

Based on the results of the neurological exam, physical exam, patient history, and any previous screening or testing, the following additional tests may be ordered to help determine the nature and extent of the neuropathy:

• Nerve conduction velocity (NCV) tests can measure the degree of damage in large nerve fibers, revealing whether symptoms are caused by degeneration of the myelin sheath or the axon. The myelin covering is responsible for the very fast speed of nerve conduction. During this test, a probe electrically stimulates a nerve fiber, which responds by generating its own electrical impulse. An electrode placed further along the nerve’s pathway measures the speed of impulse transmission along the axon. Slow transmission rates and impulse blockage tend to indicate damage to the myelin sheath, while a reduction in the strength of impulses at normal speeds is a sign of axonal degeneration.
• Electromyography (EMG) involves inserting a fine needle into a muscle to record electrical activity when muscles are at rest and when they contract. EMG tests detect abnormal electrical activity in motor neuropathy and can help differentiate between muscle and nerve disorders.

• Magnetic resonance imaging (MRI) can show muscle quality and size, detect fatty replacement of muscle tissue, and can help rule out tumors, herniated discs, or other abnormalities that may be causing the neuropathy.

• Nerve biopsy involves removing and examining a sample of nerve tissue, most often from the lower leg. Although this test can provide valuable information about the degree of nerve damage, it is an invasive procedure that is difficult to perform and may itself cause neuropathic side effects.

• Skin biopsy is a test in which doctors remove a thin skin sample and examine nerve fiber endings. This test offers some unique advantages over NCV tests and nerve biopsy. Unlike NCV, it can reveal damage present in smaller fibers; in contrast to conventional nerve biopsy, skin biopsy is less invasive, has fewer side effects, and is easier to perform.

What treatments are available?

Address underlying conditions

The first step in treating peripheral neuropathy is to address any contributing causes such as infection, toxin exposure, medication-related toxicity, vitamin deficiencies, hormonal deficiencies, autoimmune disorders, or compression that can lead to neuropathy. Peripheral nerves have the ability to regenerate axons, as long as the nerve cell itself has not died, which may lead to functional recovery over time. Correcting an underlying condition often can result in the neuropathy resolving on its own as the nerves recover or regenerate.

The adoption of healthy lifestyle habits such as maintaining optimal weight, avoiding exposure to toxins, exercising, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption can reduce the effects of peripheral neuropathy. Exercise can reduce cramps, improve muscle strength, and prevent muscle wasting. Various dietary strategies can improve gastrointestinal symptoms. Timely treatment of injuries can help prevent permanent damage. Smoking cessation is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Self-care skills such as meticulous foot care and careful wound treatment in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and improve quality of life. Such changes often create conditions that encourage nerve regeneration.

Systemic diseases frequently require more complex treatments. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.

Inflammatory and autoimmune conditions leading to neuropathy can be controlled in several ways. Immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine may be beneficial. Plasmapheresis — a procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the body — can help reduce inflammation or suppress immune system activity. Large intravenously administered doses of immunoglobulins (antibodies that alter the immune system, and agents such as rituximab that target specific inflammatory cells) also can suppress abnormal immune system activity.

Symptom Management

Neuropathic pain, or pain caused by the injury to a nerve or nerves, is often difficult to control. Mild pain may sometimes be alleviated by over-the-counter analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). More chronic and discomforting pain may need to be addressed through the care of a physician. Medications that are used for chronic neuropathic pain fall under several classes of drugs: antidepressants, anticonvulsant medications, antiarrythmic medications, and narcotic agents. The antidepressant and anticonvulsant medications modulate pain through their mechanism of action on the peripheral nerves, spinal cord, or brain and tend to be the most effective types of medications to control neuropathic pain. Antidepressant medications include tricyclic antidepressants such as amitriptyline or newer serotonin-norepinephrine reuptake inhibitors such as duloxetine hydrochloride or venlafaxine. Anticonvulsant medications that are frequently used include gabapentin, pregabalin, topiramate, and carbamazepine, although other medications used for treating epilepsy may also be useful. Mexiletine is an anti-arrythmic medication that may be used for treatment of chronic painful neuropathies.

For pain that does not respond to the previously described medications, the addition of narcotic agents may be considered. Because the use of prescription obtained pain relievers that contain opioids can lead to dependence and addiction, their use is recommended only after other means of controlling the pain have failed. One of the newest narcotic medications approved for the treatment of diabetic neuropathy is tapentadol, a drug with both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant.

Topically administered medications are another option for neuropathic pain. Two agents are topical lidocaine, an anesthetic agent, and capsaicin, a substance found in hot peppers that modifies peripheral pain receptors. Topical agents are generally most appropriate for localized chronic pain such as herpes zoster neuralgia (shingles) pain. Their usefulness for treating diffuse chronic diabetic neuropathy is more limited.

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive intervention used for pain relief in a range of conditions, and a number of studies have described its use for neuropathic pain. The therapy involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, TENS has been shown in some studies to improve peripheral neuropathy symptoms associated with diabetes.

Other complementary approaches may provide additional support and pain relief. For example, mechanical aids such as hand or foot braces can help reduce pain and physical disability by compensating for muscle weakness or alleviating nerve compression. Orthopedic shoes can improve gait disturbances and help prevent foot injuries in people with a loss of pain sensation. Acupuncture, massage, and herbal medications also are considered in the treatment of neuropathic pain.

Surgical intervention can be considered for some types of neuropathies. Injuries to a single nerve caused by focal compression such as at the carpal tunnel of the wrist, or other entrapment neuropathies, may respond well to surgery that releases the nerve from the tissues compressing it. Some surgical procedures reduce pain by destroying the nerve; this approach is appropriate only for pain caused by a single nerve and when other forms of treatment have failed to provide relief. Peripheral neuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not amenable to surgical intervention.

What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

NINDS-funded research on neuropathy ranges from clinical studies of the genetics and natural history of hereditary neuropathies to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Other efforts are focused on understanding how immune system dysfunction contributes to peripheral nerve damage. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies.

Specific genetic mutations have been identified for some of the known hereditary neuropathies. NINDS therefore supports studies to identify other genetic defects that may play roles in causing or modifying the course of disease. The Inherited Neuropathies Consortium, focused on Charcot-Marie-Tooth neuropathies, seeks to better characterize the natural history of several different forms and to identify genes that modify clinical features in these disorders. Better knowledge of genetic causes may help identify people who are at high risk for developing peripheral neuropathy before symptoms appear. Understanding the role of genetic mutations may also lead to the development of gene therapies that prevent or reduce cumulative nerve damage. In addition, advances from genetics research inform studies to understand disease mechanisms. For example, scientists are using animal models to study how inflammation and nerve damage result from mutations in the Autoimmune Regulator (AIRE) gene, the cause of chronic inflammatory demyelinating polyneuropathy (CIDP) in some people.

Several NINDS-funded studies aim to determine why nerve axons degenerate in different types of peripheral neuropathies. Rapid communication between the peripheral nervous system and the central nervous system depends on myelination, a process through which special cells called Schwann cells create an insulating sheath around axons. Research has shown that Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy.
One promising area of research focuses on a class of molecules called neurotrophic factors. These substances, produced naturally by the body, protect neurons from injury and enhance their survival. Neurotrophic factors also help maintain normal function in mature nerve cells, and some stimulate axon regeneration. Several NINDS-supported studies seek to learn more about the effects of these powerful chemicals on the peripheral nervous system.

Another area of research aims to better understand inflammatory peripheral neuropathies, such as Guillain-Barre syndrome (GBS), in which the body’s immune system attacks peripheral nerves, damaging myelin and impairing signal conduction along affected nerves. NINDS-funded researchers are investigating the mechanisms by which the body’s immune system stops recognizing peripheral nerves as “self” and starts attacking them. GBS is usually preceded by a microbial infection, some as common as food poisoning or the flu, and researchers hypothesize that antibodies generated by the immune system to fight bacteria also attack nervous system proteins. Studies to test this hypothesis may lead to treatments that prevent these antibodies from damaging nerves. As a different strategy, researchers are studying the blood-nerve barrier in inflammatory nervous system disorders and developing ways to reduce the movement of immune cells from the bloodstream into nerve tissue, which may reduce inflammation, demyelination and nerve injury.

Transcranial magnetic stimulation (TMS), which uses a coil either held above or placed on the scalp that delivers electromagnetic pulses to activate electrical currents in general or specific parts of the brain, has shown some analgesic effect in treating various pain conditions. Current studies are examining the effectiveness of TMS in treating peripheral and chronic neuropathies.

In addition to efforts to treat or prevent underlying nerve damage, other NINDSsupported studies are informing new strategies for relieving neuropathic pain. Researchers are investigating the pathways that carry pain signals to the brain and are working to identify substances that will block this signaling.
 

Chapter 11- DYING OF THIRST

Chapter 11- DYING OF THIRST

Clean water for drinking, bathing, and growing food is one of the most precious commodities on the planet. You constantly read in the news about how we're running out of oil and energy—how
these resources can only last another 20-30 years. But the simple fact is, that's 20-30 years longer than we have for water. Already, in many parts of the world, lack of clean water is the biggest problem facing huge numbers of people[1]. Just to hazard a guess, in the next 50 years, more wars will be fought over water than oil.

  Why is water so important? Quite simply, it's essential for life. And the sad fact is...most people just don't get enough. The vast majority of people living in the industrial world (even where
water is abundant) are dehydrated.

      Quantity

   In advanced societies, thinking that tea, coffee, alcohol, soda pop, or other forms of manufactured beverages are desirable substitutes for the purely natural water needs of the daily "stressed" body is a common, but potentially deadly, mistake.[2]

[1 China is currently running a water deficit equivalent to seven times the water usage of the entire state of California.
In the next few years, that deficit will triple. Already, the Yellow River, one of the most important rivers in China, is so low in water that it failed to reach the ocean on 226 days in 1997.]


[2 Batmanghelidj, F., Your Body's Many Cries for Water, Falls Church: Global Health Solutions, Inc., 1995.]

Water is the solvent in our bodies, and as such, it regulates all the functions of our bodies, including the action of all the solids dissolved in the water. In fact, every function of the body is
monitored and pegged to the efficient flow of water. Think for a moment of just a few of the functions that water regulates in our bodies:
>The movement of blood

>The transport of nutrients into our cells

>The movement of waste out of our cells

>The flow of lymph fluid

>The movement of nerve impulses through our nerves

>The movement of hormones throughout our bodies

>The functioning of our brains

   If we were to become dehydrated, all of these functions (and a thousand more) would be impaired. Unfortunately, that's exactly what happens for the vast majority of us. Over time, as we
become increasingly dehydrated, our thirst mechanism gradually fails,[1] which leads to even more dehydration. Symptoms of chronic dehydration include allergies, asthma, chronic pains, constipation, acidosis, dry skin, and the shrinking of internal organs and thinning of skin associated with aging—to name just a few.

   We need to consume between 64 and 96 ounces of pure water a day. Pure, fresh (not bottled or canned) fruit and vegetable juices may be substituted for some of this quantity—as may limited
quantities of non-diuretic herbal teas (without sugar). In general, however, pure water is the key.

     Quality

   When you look at the big picture, state and federal authorities have done a remarkable job in providing "clean" water for the country as a whole. Water-borne epidemics such as cholera are almost unheard of in the United States. On the other hand, acknowledging what has been accomplished does not mean that we should close our eyes to the problems that exist.

  Keep in mind that the MCLs (maximum contamination levels) that water districts so proudly adhere to merely represent a compromise standard designed to be econonomically feasible for water districts to meet. They in no way come close to the safety standards established by the US government's Safe Water Drinking Act.

  On average, drinking water in the United States currently contains over 2,100 toxic chemicals that are known to cause cancer, cell mutation, and nervous disorders. This is not particularly surprising
considering that there are close to 100,000 chemicals now in everyday use—with over 1,000 new ones being added each year. In fact, according to the EPA, US industries generatesome 79 million pounds of toxic waste each year that is not disposed of properly.
What is probably more surprising to most people, though, is the fact that, according to the EPA, 53 million Americans unknowingly drink tap water that is polluted by feces, radiation, or ....

[1 Even when our thirst mechanism is functioning properly, it's not a reliable indicator of dehydration since "thirst" is one of the last symptoms of dehydration to manifest.]

.... other contaminants. Also according to the EPA, some 45 million people drink water contaminated with the parasite cryptosporidium that killed more than 100 people in Milwaukee in 1993. Or that
over half of all Americans drink water that has been used at least once before.[1]

   According to an ABC News Special, US industries generate some 88 million pounds of toxic waste a year, 90% of which the EPA estimates is improperly disposed of, whcih makes its way into our water supplies. With close to 100,000 chemicals now in use and with the introduction of 1,000 new ones each year, it's impossible for treatment plants to keep up. Each year, at least 400,000 cases of illness can be attributed to contaminated water.

   With all due respect for the great job that all of the water departments in all of the states and cities do, you still don't want to be drinking tap water. It may not kill you immediately, but as sure
as the sun rises in the morning, it will compromise your health over time. The bottom line is that you need to drink filtered (or distilled water). Tap water, well water, and bottled water[2] are all suspect.

  Chlorine

  Chlorine is the primary disinfectant used to purify drinking water. Let me make it absolutely clear that I am not advocating eliminating chlorine from the purification process. That would be
stupid. Chlorination controls many water-borne diseases, including typhoid fever, cholera, and dysentery. When chlorination was stopped in Peru, for instance, there was a cholera epidemic of
300,000 cases.

However, it should be understood that:

> Chlorine is one of the most toxic substances known. It does everything from drying your skin and destroying your hair to wiping out the beneficial bacteria in your colon.

> And the byproducts of chlorination (such as chloroform, dichloro acedic acid, and MX), which are found in drinking water, are all proven carcinogens.

> According to the US Council on Environmental Quality, the cancer risk among people drinking chlorinated water is 93% higher than among those whose water does not contain chlorine. There is a higher incidence of cancer of the esophagus, rectum,breast, and larynx and a higher incidence of Hodgkin’s disease among those drinking chlorinated water.

> Chlorine has been strongly implicated as a major factor in the onset of atherosclerosis and its resulting heart attacks and strokes.

> By the same mechanisms that chlorine narrows blood vessels that feed the heart, it also narrows the blood vessels that feed the brain. Consequently, chlorine has been implicated as a major factor in the onset of senility.

[1 You probably shouldn't think about this particular statistic too long if you have any tendency toward a weak stomach.]

[2 Yes, if you're on the road and you're thirsty, picking up some bottled water at a 7-11 is a better alternative than drinking from the water fountain or buying some coffee or soda.]

There's no question but that the use of chlorine in drinking water has helped stopped the spread of many virulent water-borne diseases. On the other hand, there's also no question but that
chlorine in our drinking water presents us with serious long-term health implications. The bottom line on chlorine is that it pretty much needs to remain part of the city water purification  process. That means that you need to remove it from your water at your house.

      Fluoride

  At the risk of being accused of being a Luddite, let's take a look at the use of fluoride in our drinking water.

  Exactly what is water fluoridation? In fact, all water contains some fluoride. Fluoridation is
the process of adjusting the level of fluoride in the water supply to theoretically protect against
tooth decay. This concentration varies from 0.7 to 1.2 parts per million (ppm). While it is true that
"organic" fluoride itself is present naturally in soil, water, plants and many foods,[1] the "industrial"fluoride used in water fluoridation is a toxic waste product.[2]

  Does it work? Now that's a question of more than some debate. There's no question that since fluoridation began, the incidence of dental caries has gone down significantly in the United States.
Score one for water fluoridation! But hold on a second. It's gone down throughout the country—even in states that don't fluoridate their water! In fact, there is no good statistical evidence that fluoride (either in your water or your toothpaste) makes one iota of difference in terms of dental health.[3]  All of the improvement in dental health that we have seen in the United States can easily be attributed to better dental hygiene (brushing and flossing), not fluoridation.

  Which brings us to the key question: Is it safe?

  Well, to be fair, community water fluoridation is supported by the U.S. Public Health Service,[4]the American Dental Association,[5]
 the American Medical Association,[6] the American Heart Association, the American Cancer Society, and the National Academy of Sciences. On the other hand, the devastating, toxic effects of fluoride are well documented by mainstream organizations such as: 

>Numerous articles have appeared in the New England Journal of Medicine and the Journal of the American Medical Association challenging the safety of fluoridation. 

>National Institute of Environmental and Health Sciences has shown that fluoride
causes cancer.

>Scientists at the Environmental Protection Agency have come out against fluoridation because they have confirmed that it does not reduce tooth decay and that there is clear evidence that fluoride causes cancer.

>The Pasteur Institute in France, and the Nobel Institute in Sweden have caused fluoride to be banned in France and Sweden respectively because the health risks from using fluoride far out-way any possible benefit.


>Fluoridation is also banned in Finland, Holland, Chile, and Japan among others.

[1 Tea, for example, is an extremly high source of fluoride (even when made with unfluoridated water).]

[2 American industry loves water fluoridation. Instead of having to pay for the disposal of a toxic waste product, they now get paid by cities by selling them this same toxic waste. It's probably no surprise then that the industries producing fluoride byproducts are some of the biggest proponents (and backers) of water fluoridation.]

[3 In fact, as New Zealand's former chief dental-health officer, Jon Colquhon, a one-time proponent of fluoridation, said, "When any unfluoridated area is compared with a fluoridated area with a similar income level, the percentage of children who are free of dental decay is consistently higher in the unfluoridated area."]

[4 While at the same time, curiously, pushing for a reduction in our daily fluoride intake. Maybe you can explain that to me.]

[5 It's worth noting that the American Dental Association is on the horns of a dilemma. To admit that promoting the use of fluoride was a mistake would open up the floodgates of litigation.]

[6 While at the same time repeatedly publishing articles in their magazine proving the dangers of fluoride. No one ever said this has to make sense.]

Fluoride is a potent toxin[1] that accumulates (about 50% a day for adults and 75% a day for children) in the body. Each exposure stays in your body and adds to the accumulated levels. And that's the key. We are constantly being exposed to high levels of fluoride other than in our water. It is in our toothpaste.[2] It is sprayed on our food.[3] It is present in pharmaceutical drugs ranging from birth control pills to antibiotics. It is in soda pop, which is manufactured from fluoridated water. Once you look at the scope of the problem, you realize that there is no way in the world to determine what your flouride intake is, but it's far higher than is healthy.

  Health problems associated with fluoride include:

>Destruction of the immune system

>Up to a 39% increase in various cancers—with an astounding 80% increase in rectal cancer

>Genetic changes both in sperm and other cells

>Dramatic increase in heart-related deaths

>Brittle bones[4]

>Chronic fatigue

>Gastrointestinal disturbances

[1 Fluoride is used as a pesticide particularly for roaches, ants, and rats.]

[2 Note: fluoride toothpaste can double the level of fluoride in the blood within five minutes of being used—just from the amount absorbed through the cheeks and gums.]

[3 Apples and grapes are particularly high in fluoride for this reason.]

[4 One of the claims for fluoride is that it helps builds bones. That claim is so deliberately misrepresentative of the truth that it borders on the criminal. Yes, while it is true that there are studies that confirm that fluoride builds thicker bones, it is gross misrepresentation to cite those studies without also mentioning that fluoride makes bones more brittle. And, in fact, there are numerous studies that have appeared in the Journal of the American Medical
Association that show a significant increase in hip fractures in areas with fluoridated water. In addition, The New England Journal of Medicine reported that fluoride treatment of osteoporosis patients resulted in higher hip fracture rates.]

>Increase in Infant Mortality

>Skin rashes after bathing

>Miscarriages

>Dizziness

>Vision problems—including blindness

>Not to mention mottled teeth

   Also, it is well established that fluoride is an extremely potent enzyme inhibitor.

  The bottom line is what freakin right does anyone have to force such a potentially toxic substance into your drinking water[1] for no proven benefit.[2]

  Oh yes, I almost forgot, the aluminum/fluoride connection. New research has revealed that fluoride in drinking water makes the aluminum that we ingest more bioavailable. In the presence of fluoride, more aluminum crosses the blood-brain barrier and is deposited in the brain. As was reported in Brain Research, Vol.7 84:98, the combination of aluminum and fluoride causes the
same pathological changes in brain tissue that are found in Alzheimer's patients. Now don't misunderstand, I'm not saying that aluminum/fluoride is the cause of Alzheimer's. That would be premature. All I'm saying is that it might be prudent to limit your exposure until we know more one way or the other. Remember, even O.J. was found innocent in the end.

    Bathing

  As it turns out, it's not enough just to worry about the water you drink. The water you bathe and shower with is equally, if not more, important.

  You absorb more chlorine through your skin in a 15 minute hot shower[3] than you do by drinking 8 glasses of that same water throughout the day. (So much for that nice safe feeling you had drinking only bottled water.)

    Just for fun, stop by your local swimming pool supply store and pick up a chlorine test kit. Fill a glass with some of your local tap water and test it with your kit. The water will change color according to how much chlorine there is in the water. Now fill up another glass with water from the tap. This time, soak your hand in the water for 60 seconds before testing. Notice how the water shows no chlorine. In just 60 seconds you absorbed all of the chlorine in the water into your body through your hand. The absorption factor is that dramatic. (Note: the younger you are, the more absorbent your skin tends to be. And women should take special note; breast tissue is the most absorbent tissue in the body. Soak your breast in the same water, and it will clean out all of the chlorine in just 20 seconds.)

[1 At least with toothpaste, you have a choice to buy a non-fluoride brand]

[2 There are now at least 10 studies that prove as fluoride intake goes up, so does tooth decay!]

[3 Actually, when you shower, you absorb more chlorine through your lungs in the form of vapor (produced by the small droplets of hot water) than you do even through your skin.]

The trick is, if you want to protect your skin (and your body as well), you've got to mount a defense at the surface of the epidermis. Once a substance gets past this tough outer layer of dead skin cells, it generally has a much easier time passing through the living area of the epidermis and then into the body.

     Bioavailability

  Although all water consists of the same basic H20 molecules, water nevertheless varies according to how these molecules bond together to form "water molecule groups." To put it simply,
it is in the size of these groupings that water differs. The smaller the groupings, the more bioavailable the water is—the more easily it is able to pass through cell walls, to circulate through your body as a whole.

   What holds water molecules together in clusters is surface tension. This is what you see when you wash your car and the water beads up in droplets on the hood. When washing your car, you use detergent to break that surface tension—which makes the water wetter and better able to clean. Obviously, you can't use detergent to "improve" the bioavailability of your drinking water.

  But you can use magnetics. Magnetizing your drinking water breaks its surface tension, making it wetter and more useable by your body. In addition, there's a strong secondary benefit. Applying
a magnetic field to water raises its pH. This is of vital importance as we will see in the next chapter.

      General Recommendations

> You need to treat the water that comes into your house to remove the chlorine, fluoride, chemical residues, heavy metals, bacteria, parasites, etc. in your water. And you need to remove all of these toxins not only at the tap where you drink, but also where you bathe and shower. So how do you do it? You really only have 4 choices.

  Get a system for the entire house that treats the water where it enters your house.

  This is obviously the most expensive way to answer the problem, but if you actually get a good system that removes all of the toxins, it's the best way to go.

   There's no question that a good water distiller will provide the "cleanest" water you can get, but you need to be sure it incorporates a charcoal filter, since toxins like chlorine vaporize and recondense along with the water you're trying to clean.

- There's one other question to consider. Distilled water, by definition, has no mineral content. For years there has been much debate as to whether that's good or bad. "Distillerites" claim that demineralized water is more natural—like rain water and glacier water—and that minerals in the water end up in your joints. The argument against distillers is that most animals drink water that has had contact with the ground and acquired a high mineral content. Prime examples are the high mineral water of the Hunzas and the coral calcium water of the islands off of Okinawa—two areas renowned for the age and health of their inhabitants. As for me, I don't think it matters, provided that if you drink distilled water, you make sure that your diet and supplements provide an abundant supply of minerals.[1]
   And as for the question of mineral-laden water leading to joint deposits, studies have proven that the calcium which deposits in joints comes from inside the body—leached from your own
bones because of too much acid in your diet.


[1 Understand, because it is devoid of minerals, distilled water is bioelectrically dead.]

   Reverse osmosis units produce a good quality drinking water. The problem I have with them is that they waste a huge amount of water—many gallons of waste for each gallon of usable water. I'm not really sure that's justifiable nowadays with the looming water shortage we face.

   A good water filter is probably your best bet, but keep in mind that it will cost you more than $29.95 or even $100. To find one that will truly remove ALL of the bad stuff, while leaving in the beneficial minerals, you will need to pay $250-$300.

> Drink 8-12 glasses of pure water a day. (To follow the water-cure-protocol formula, see below) 

> When possible, use glass to hold your water, not plastic. Absolutely avoid drinking water that has a strong plastic smell or taste.

> Apply a magnetic field to your water for at least 20 minutes (depending on how large your bottle is).

> If you're not using a central home purification system, remember to get a good shower filter to remove the chlorine from the water you shower in. Understand that the filter is on the shower, not the bath. The bath water (unless you fill the tub from the shower) will still be toxic.

(To follow Water-Cure protocol formula: Drink at least 10% of your own daily water-quota (31.42 ml multiply by your present body weight(kg), every 90 minutes. Use 1/4 teaspoon of sea-salt in your daily diet, for every 1250 ml water drank.)