The "Bulgarian treatment" for Parkinsonism
At the beginning of the 20th century, few avenues remained unexplored in the effort to identify an approach which might at least ameliorate the neurological sequelae of encephalitis epidemica (~1915-1925), particularly the especially common parkinsinoid syndrome. Amongst the more successful--and colorful--approaches was the "Bulgarian treatment", which became popular in Western Europe in the mid-1930s and remained a significant component of antiparkinsonian therapy until the advent of L-DOPA in the 1960s. Originally conceived in the early 1920s by Ivan Raev, a Bulgarian herbal healer, as a complete program which included phytotherapeutic, dietetic and psychotherapeutic components and promoted in a semi-mystical light, the method was brought to Italy in the 1930s, largely as the result of familial connections between the Bulgarian and Italian royal houses. Here the treatment was scientifically examined in clinics established by Queen Elena for this purpose, the essential component ultimately being identified as being the administration of a belladonna root extract. From here the method spread to Germany, other European countries and the United Staes. After a number of controversies regarding the chemical basis of the therapy and the relative merits of belladonna root from Bulgarian and other sources, standardized root extracts (such as "Homburg 680") became the standard means of application in Europe, while defined combinations of the tropane alkaloids presumed to underlie its efficacy (such as "Rabellon") were more popular in English-speaking countries. Both forms of the treatment were ultimately displaced in the 1950s by synthetic anticholinergic agents, as a result of which interest in the factors responsible for the superiority of the Bulgarian method to other solanaceous plant-based therapies waned.
Session XIII -- Movement Disorders
Montreal, Quebec, Canada