Before reading this chapter please start with the chapters:
First Concepts.
WOB is Optimal

Parkinson’s disease (PD) is a neurological syndrome resulting from a damage (necrosis) of the basal ganglia (substantia nigra) in the brain, initiating a deficiency of the neurotransmitter dopamine. It may be  manifested by the following symptoms:
1. Rigidity and  stiffness of muscles, which  increases during movement. It is often responsible for a mask-like expression of the face.
2. Tremor
3. Slowness of movement (bradykinesia), characterized by a delay in initiating movements,
4. Poor balance (postural instability) particularly  when  patient moves abruptly.
5. Walking problems - decreased arm swing; short, shuffling steps, and sudden freezing spells (inability to take the next step).

Dopamine is a neurotransmitter which assists in the effective transmission of electrochemical signals from one nerve cell (neuron) to another.

Treatment directives of PD illustrate some major flaws of medical reasoning. .Accordingly,  PD is  initiated by a shortage of dopamine, and ought therefore be treated by dopamine replacement, with an analog called levodopa.  Unfortunately, with time this treatment fails. Levodopa is the most potent anti-PD drug available. . However, its long-term use  often leads to complications later in the disease, most importantly dyskinesia, or uncontrolled movements. To minimize the damage medicine advises to substitute levodopa by other drugs, as PD progresses. Yet their side effects are even more dangerous. By this,  medicine’s wisdom is exhausted.

Specific and nonspecific treatment

There are other ways to help the patient, which may be even more effective than levodopa. Medicine does not regard them as genuine treatments, since they are nonspecific. In order to treat a patient rationally, one has first to specify the molecular (genetic) aberration which caused the disease. Then devise a drug which will repair this aberration, or replace it, if it is a gene. This procedure is regarded by medicine as a rational, or specific treatment. Everything else is nonspecific, which received other names like, patient management, palliation, or placebo.  Nonspecific treatment is supposed to be less effective, and medicine passes it on to its 'non-rational' rival, known as Alternative Medicine. In order to emphasize its rational superiority medicine calls it now Complementary Alternative Medicine (CAM).

In PD this kind of reasoning fails. The name of the game is to delay the use of levodopa, which can be achieved only with nonspecific treatment.


First we ought to turn our attention to patients with mild disease. Most PD patients are rigid, yet not all have tremor, poor balance or walking problems. What is their secret? Patients who somehow know how to manage their disease receive here the Yogi suffix. A PD-Yogi knows how to live with PD in peace, and may not require levodopa.

Further reading:
Medical significance of the Cancer-Yogi metaphor

Acute PD

Medicine promotes the impression that with the destruction of basal ganglia  dopamine production can only decline, which may not be so. We may expect two kinds of PD. An acute, and a chronic. The first starts with a localized hemorrhage in  basal ganglia which destroys cells (necrosis), and initiates an acute dopamine shortage. Necrosis stimulates  cell formation, which replenishes the missing molecule. When prescribing dopamine we ought to realize that it might affect cell regeneration. Since WOB is optimal it will replenish dopamine to the required level, however  if some dopamine is supplied by us, WOB will produce less, not only dopamine, but nerve cells as well. Dopamine shortage stimulates cell production as well as cell formation, and vice versa.

This is true for any hormone replacement therapy (HRT), like estrogen in post menopausal women.  Following menopause, WOB produces less estrogen, and in order to feel better, women take estrogen pills, which has its price . Now that WOB gets estrogen from outside, it suppresses the formation of its own estrogen, and eliminates some estrogen producing cells which become redundant. External hormone supply  makes the woman completely dependent on external  estrogen. The same may happen also in PD and the physician has to find a compromise between the patient’s (mind) demand to improve his condition and the harmful effect of the external substance on cell formation.

Chronic PD

The outcome of an  ongoing damage of dopamine producing cells depends on the balance between cell formation and destruction. Cell death (necrosis) is a powerful stimulus of cell formation, and  WOB continually produces new nerve cells. Since birth rate is smaller than death rate, the population of dopamine producing cells declines. Yet this shortage is relative. It depends on patient's demands. When he (mind) sleeps, PD symptoms nearly disappear. Now dopamine production suffices to cover WOB needs  otherwise it would complain, and make the sleeping patient suffer.

Mind as Janus

Since mind functions as interface between WOB and the outside world, it acts as the ancient god Janus. Facing the inward it listens to WOB messages and responds with its own demands. Facing the outside, it listens among other to society and its biased attitude toward the PD patient. We ought therefore distinguish between two kind of PD. WOB-PD and Mind-PD.

WOB-PD is manifested by dopamine deficiency, its actual impact depends on the mind.. Hitherto patient (mind) was used to perform any task as soon as he decided to. Now it takes time to initiate and complete it. Haste increases tremor, and promotes loss of balance during walking, which disturbs the patient. Then comes the society with its prejudice. Patient suffers, and tends to depression. All this is regarded here as Mind-PD. In order to recover form Mind-PD patient has to change his attitude to life and society. Levodopa might help for a while, yet soon initiates dyskinesia and patient is more miserable.


When getting PD patient ought to realize that  his/her life has changed and she/he has to start a new life which may be as pleasant as his/her former one. His/her mission is to become a PD-Yogi. First she ought to reprogram her world view to 'slow is chic'. Then  turn to some time honored techniques like meditation and Yoga . Both teach how to maintain correct posture and movement, and how to relax, and so  require less dopamine. In this sense Yoga and meditation are more effective in treating WOB-PD than specific therapy. They are ideal for slowing down disease progression.

Meditation is particularly useful in treating Mind-PD. It switches off the mind and ignores the negative impact of society.  Actually this is exactly what Buddhism teaches.  Since all this is regarded by medicine as unimportant, and even ridiculous, PD-Yogi has to trot this way by himself. He has to search for new ways how to help himself. Sport as means to make muscles  and their nerves function with  less dopamine. Slow dancing. Massage for softening rigidity. Adequate diet. In short, PD-Yogi learns how to enjoy life. In between he might interlace some levodopa tablets, like when facing important tasks and events. However he should not take them daily and carelessly.

Chinese Mind-Body Exercises.

Ancient Chinese martial arts help improve balance, strength and body awareness. Two approaches seem applicable to PD : Tai Chi, and Chi Gong. The first is described as meditation in movement using controlled breathing combined with a slow and precise flow of body postures.  Chi Gong, is described as meditation in stillness during which participants learn to better control their movements through directed visualization (imagery), meditation and controlled breathing.

Unlike meditation, these techniques are not without risk. PD results from a deficiency of one or more resources, which requires  a slowing down activity. Over zealous exercise might deepen the deficiency.  These methods require a close supervision by a Tai Chi master and an open minded physician, which ought to determine  the  optimal dose of each exercise for each patient.

Activity is a message to WOB with two meanings: On one hand  it stimulates WOB to produce more dopamine, while on the other it may overpower WOB and worsen PD. Close inspection of WOB response may indicate how to proceed.

Since resources become scarce, one may design methods for distributing them in a new way. PD is a disease of the entire kinetic apparatus. Suppose that it would be possible to direct resources mainly  to cortical areas representing facial muscles, and less to legs? This might be achieved with modified Tai Chi, and Chi Gong exercises.

Unfortunately many patients give up and gradually deteriorate.

Further reading
Cancer and Meditation

Free will

PD illustrates the meaning of free will. The decision to raise my hand is a signal to WOB that I (mind) expect its assistance. Mind is unaware of how WOB raises the hand. Previously we distinguished between WOB-memory and Mind-memory. . While Mind remembers that it can raise the hand, WOB remembers how to raise the hand. Free will means that mind convinces WOB to carry out our will .In PD  WOB fails to cooperate. Yet free will prevails and mind has to search for new ways in order to make WOB cooperative. This is the mission of PD-Yogi, to find new ways to support his free will. It is like when a healthy individual decides to become a rope-dancer. A new way of life, with  a new challenge.

Further reading
Parkinson's Disease- An in depth analysis

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Parkinson’s disease (PD) and music

Oliver Sacks – a psychiatrist described a patient who was a piano player and had to stop playing after getting PD. Later on she could play only one piece by Chopin. Whenever she played it her rigidity faded away only to return after she stopped playing. The same happened even if she imagined this particular piece.

Rigidity may be alleviated with rhythmic music. During rigidity both antagonistic muscles are excited. Rhythmic music resolves the simultaneous excitation of muscle antagonists.

YouTube: A rigid PD patient started a music player and was able to dance at the music. When the music stopped he became rigid again.