A conversation with Doctor Pablo Koval

A conversation with Doctor Pablo Koval

Dear Colleagues:

In last month's newsletter I reported a case of a woman with chronic cardiac arrhythmias, unresponsive to medical treatment, who responded to neural therapy of her T6 vertebra.  I was pleased to receive an email from Dr. Pablo Koval of Argentina  commenting on the case. In my opinion, Dr. Koval is one of the deepest contemporary thinkers about neural therapy (newsletter July 2013) and his book "Neural therapy and self-organization" is a must-read for all serious neural therapists.  His ideas draw extensively from Speransky's work and places it in the modern world of cybernetics and Chaos theory.  Dr. Koval is also unique (as far as I know) in his application of Speransky's ideas of the nervous system's tonic (signaling) and trophic (nourishing) functions.  This concept becomes part of the correspondence below which he has kindly allowed me to share with you.

Dr. Koval:

"I would like to ask you if the somatic dysfunction of the T6 vertebra (asymmetry and restricted motion) and arcing was the cause or the consequence? Do you have a panoramic dental Xray from the patient?"

Editor (me): 
I believe the T6 somatic dysfunction was the cause and not the consequence of the arrhythmia for two reasons:

  • the response to treatment
  • "Arcing" indicates an "energy cyst", i.e. an accumulation of chaotic (or dissonant) energy. This is a concept described by the late John Upledger DO in his book "Craniosacral Therapy".  Usually arcing results from trauma, but it can also occur at sites of inflammation or other sources of irritation. The intensity of the arcing is usually proportional to the amount of force absorbed by the organism, so the energy cyst can be conceived of in classical physical terms as potential energy - like a loaded spring. The center of the arc does not usually coincide with somatic dysfunctions but in this case it did. Usually somatic dysfunctions result from arcing.  Most interference fields do not arc either, or the arcing is so subtle that I cannot feel it.

I did not ask for a panoramic X-ray from this patient, but did check her teeth energetically i.e. by autonomic response testing. Her teeth were for the most part healthy. 

Dr Koval: 
I don't know about arcing but I think that a somatic dysfunction must come from something else. Yes, the patient had two accidents, but the trophic system had time to repair it. Why didn't that happen? 

A somatic dysfunction is like a trigger point - there must be energetic chaos there also. But usually its maintenance over time is a consequence of an interference field that interferes with trophic function. 

In my experience dental-oral problems explain 70% of interference fields. (age 18 = wisdom tooth)

I think that it is necessary to wait for the evolution of the patient.

Editor (me): 
Your question is thought-provoking (about why the trophic system did not repair the somatic dysfunction).  I think that the reason no healing took place was that there was no "pathology" (in the classical sense). Somatic dysfunctions, like trigger points are not pathological entities, but rather dysfunctions.  (I use the analogy of "software problems" vs. "hardware problems".  Hardware problems need to be healed; software problems need to be reset or re-programmed.)  Similarly, foci (centers) of arcing are accumulations of chaotic energy that the organism must adjust to. They do not provoke an inflammatory response (at least not directly) and therefore cannot be "healed". But they may cause somatic dysfunction nearby or remotely as the organism accommodates an energy imbalance. 

Somatic dysfunctions occur for a number of reasons. I see them as being focal de-compensations of the neuromuscular system. Most do not cause symptoms; somatic dysfunctions can be found in most " healthy" people.    In a typical patient with musculoskeletal pain, a skilled osteopathic physician can find half a dozen or even a dozen somatic dysfunctions. Most are not clinically important and are called "secondary". One or perhaps two or three are "primary".  When these are treated the secondary ones generally self-correct. A skilled osteopath knows how to detect the primary ones and treats only these.

Primary somatic dysfunctions usually are the result of trauma, and require only manipulation to be treated successfully. For example a patient may have chronic headaches resulting from a fall on a buttock.  The headache is probably coming from a secondary somatic dysfunction in the upper cervical spine, but the primary somatic dysfunction is likely a shear of the sacroiliac joint. Treatment of the upper cervical spine may give temporary relief of the headaches, but only treatment of the sacroiliac joint will cure him or her.  

I have long felt that somatic dysfunction can be considered to be a type of interference field. http://ostemed-dr.contentdm.oclc.org/cdm/fullbrowser/collection/myfirst/id/8711/rv/singleitem

Somatic dysfunctions may also be secondary to visceral disturbances - so-called viscerosomatic disturbances. A common region for this to occur is in the lower thoracic spine, where backache, when it occurs is usually secondary to a stomach or lower esophageal disturbance.  Manipulative treatment of the thoracic spine somatic dysfunction will not be successful until the stomach or esophagus is treated. This should be familiar territory for neural therapists who know that visceral disturbances are often interference fields and can be treated with neural therapy. e.g. The patient with mid backache may respond to neural therapy of the stomach. 

And then there are somatic dysfunctions secondary to classical interference fields -scars, teeth, autonomic ganglia or other foci of nervous system irritation. This is where osteopathy and neural therapy intertwine. You are correct to suspect the T6 somatic dysfunction could be secondary to a wisdom tooth interference field because it, like the heart, sits on the same meridian.  And the patient's symptoms began in her teens, without any other precipitating cause in her history. 

Yes, we will have to wait for the evolution of the patient.  I am sure she will return if her cardiac symptoms resume, but she has now been symptom-free for about six months. 

This has been a long answer to a short question, but I hope that it will clarify some of the confusion around this subject. Perhaps we can talk about it some more in Bogota. 

Dr Koval: 
This a very good ping-pong exercise!

I do not differentiate between trophic and tonic. Both functions go together.  For trophism to work well a good tonic function is needed and for tone to work well a good trophic function is required. Actually health problems are tonic-trophic in nature. Some are more tonic and others more trophic, but all are tonic-trophic. For sure, trigger points are more dystonic than dystrophic, but they also respond to interference field treatment.

My question (why the trophic repairing function didn't do its work?) could have been stated: why did the tonic-trophic repair function not work?

With regard to this patient, the question in my mind is: when was the starting point? If it was at 18, the accidents had not yet occurred and the date matches with the wisdom teeth. Maybe she has no wisdom teeth at all, but the scars can save information.

The problem treating the consequence instead of the cause is that, the original problem can manifest itself with a different disease (progressive vicariation).

I don't know for sure which incident is the cause of the process. Probably you are correct but your case stimulated my interest.

Editor (me): 
I learn something from Dr Koval every time I hear him speak or read his writing.  I will close our discussion here, but no doubt it will continue at the conference in Bogota, where we both will be speaking.

The Neural Therapy in Practice newsletter was intended as a complement to Dr. Kidd's book, Neural Therapy: Applied Neurophysiology and Other Topics, which is still available for sale through Amazon.