THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINEVolume 5, Number 6, 1999, pp. 543-552Mary Ann Liebert, Inc.
Neural Therapy in the Treatment of Multiple Sclerosis
ROBIN GORDON GIBSON, M.B.Ch.B., L.M.S.S.A., F.R.G.P., D.C.H., B.D.S., RF.Hom. andSHEILA LILIAN MARJORY GIBSON, M.D., B.Sc, M.F.Hom.
ABSTRACT
Objective: To assess the therapeutic potential of neural therapy, a modified form of acupunc-ture, in multiple sclerosis. I
Design: A pilot study followed by a double-blind, placebo-controlled randomized study.Setting: The Glasgow Homoeopathic Hospital, Glasgow, Scotland.Patients: An unselected group of 61 new patients referred to the Glasgow Homoeopathic Hos-
pital, suffering from any type of multiple sclerosis, who fulfilled the criteria of Schumacher andhad a Disability Status Score (DSS) or Expanded Disability Status Score (EDSS) grade of 1-7.
Intervention: Neural therapy, which is the injection of small amounts of local anesthetic with-out adrenaline, into specific trigger points in the ankles and around the greatest circumferenceof the skull.
Main Outcome Measures: Improvements in the Kurtzke scales and the DSS or HDSS assess-ments.
Results: Sixty-five percent (65%) of the patients in the pilot study {n = 40) and seventy-sixpercent (76%) of the patients in the double-blind trial (n ^ 21) benefitted from this treatment asassessed by Kurtzke scale improvements. On long-term follow-up of 2.0 to 3.5 years, more than50% of the patients continued to show improved Kurtzke scale ratings. Improvements could berapid. No toxic side effects were noted when injections were administered at a frequency of onceor twice weekly or less.
Conclusions: Neural therapy is an effective, nontoxic and inexpensive treatment for multiplesclerosis that can confer both immediate and long-term benefits.
INTRODUCTION the capacity of any particular regime to affectthe clinical course has been disappointing (Pat-
Multiple sclerosis (MS) is a common neu- zold et al., 1982; Noseworthy et al., 1991; Yud-rological disease currently affecting kin et al., 1991; Silberberg, 1992; Compston,
about 50,000 people in the United Kingdom. 1996). Hyperbaric oxygen, while initially ap-The cause is unknown, although viruses, au- pearing as promising (Fischer et al, 1983;toimmune disease, and genetic susceptibility Davidson, 1983, 1984) has not proved helpfulhave all been suggested as possible etiologic (Barnes et al, 1985; Neiman et al., 1985; Wilesfactors (Davison, 1982; McKhann, 1982). It is et al, 1986) and cyclophosphamide (Nosewor-also a disease for which, as yet, there is no spe- thy et al, 1991), plasma exchange (Noseworthycific treatment and despite many clinical trials, et al, 1991), azathiaprine (Patzold et al, 1982;
The Glasgow Homoeopathic Hospital, Glasgow, Scotland. i
543
544 GIBSON AND GIBSON
Yudkin et al, 1991), copolymer 1 (Wolinsky,1995), and interferon-^-lb (IFNB Study Group,1995; O'Connor, 1996; Richards, 1996) havebeen equally disappointing.
Seventeen years ago, an Austrian colleague.Dr. Andreas Pfretschner from Grobming, whowas visiting our hospital introduced us toneural therapy, a technique that had been inuse in Germany and Austria since 1928 (Dosch,1984). This treatment uses small quantities oflocal anesthetic injected into specific areas ofthe body, principally old scars and areas thatcorrespond to acupuncture points. Accordingto Dosch, neural therapy either "supplies en-ergy" to damaged tissues or "removes energyblockages," thereby helping to eliminate pre-viously acquired lesions and promote thebody's self-healing mechanisms (Fig. 1; Dosch,1974).
MS is not one of the conditions normallytreated by the European practitioners of neuraltherapy. However, the case of a 32 year old pa-tient admitted to hospital with MS demon-strated that it might have a place. The patienthad sustained a fracture of the right calcaneuswhen he was 15 years old that was so painfulthat for 3 years he could scarcely walk. He de-veloped ataxia at the age of 26 and a diagnosisof MS was made. The patient was walking withdifficulty using elbow crutches, was ataxic, andboth lower limbs were spastic.
Because the patient's right heel was still ten-der, the proposition that in neural therapy thelocal anesthetic restores cell membrane poten-tials thus enhancing cellular repair (Dosch,
1974, 1984), was applied and the painful areainjected. Although treatment was given for lo-cal pain only, the following day, the spasticityof the right leg was markedly reduced. Areasaround the left calcaneus were therefore alsoinjected and a similar improvement in tone inthe left leg was seen.
After two additional patients with MS weresimilarly treated with beneficial results, it wasdecided to conduct a pilot study of neural ther-apy in MS. In addition to injections into the an-kles (Fig. 2), injections were made around thegreatest circumference of the head (Fig. 3), astandard neural therapy technique for correct-ing balance (Dosch, 1984). It proved sufficientto administer one injection to each side of theankle, just distal to the malleoli.
This article describes a pilot study and a sub-sequent double-blind trial that were carried outbetween 1982 and 1984.
PILOT STUDY: METHODS
Patients
Forty (40) patients, aged 20-61 years, mean41.2 years, with proven MS as defined by Schu-macher et al. (1965) took part in the study. Theywere the next 40 consecutive patients with MSreferred by their general practitioners to theGlasgow Homoeopathic Hospital. All patientshad already been seen in other hospitals andthe diagnosis had been made prior to referral.All were pursuing a downhill course when first
Local anesthetic-t-290 mv.
Normal cellMembrane charge+90 mv = polarized
Permanentlydepolarized cellMembrane charge0 mv.
Hyper polarized cell= anesthesia.
After 20 minutesmembrane charge+90 mv = repolarized.
FIG. 1. The effect of local anesthetic on cell membrane potential (Dosch, 1974).
NEURAL THERAPY IN MULTIPLE SCLEROSIS
BladderMeridian
K i d n e yMeridi
545
67
Lateral Medial
FIG. 2. Injection sites around the heel.
seen, as determined by the Kurtzke assess-ments (Kurtzke, 1965). Duration of the diseaseranged from 6 months to 32 years, with a meanof 11.5 years. Seventeen (17) of the patientswere male and twenty-three (23) were female.
Twenty-three (23) of the patients sufferedfrom primary progressive MS, three (3) hadchronic stable MS and fourteen (14) had re-lapsing remitting MS. Twenty-eight (28) wereambulatory and twelve (12) were confined towheelchairs (Disability Status Score [DSS]grade 7 or more; Table 1).
Treatment
Treatment was given to all patients. This con-sisted of injections of local anesthetic (1% lig-nocaine [lidocaine] hydrochloride withoutadrenaline) into the medial and lateral aspectsof the calcaneus, in the regions of the acupunc-ture points Kidney 6 and Bladder 62 (Fig. 1; 2.5mL into each ankle point with the needle adja-cent to the periosteum) using a 5 mL dispos-able syringe and a microlance no. 14 needle.These points were chosen on the basis of the
JFIG. 3. Injection sites around the greatest diameter of the skull.
546 GIBSON AND GIBSON
TABLE 1. DATA FOR THE FIRST 40 MULTIPLE SCLEROSIS PATIENTS TREATED
TotalMaleFemale
Type of multiple sclerosisPrimary progressiveChronic stableRelapsing remitting
Type of improvementObjective improvementSubjective improvement onlyImprovement in DSSRapid response
^Two patients later regressed.DSS, Disability Status Score.
Ambulatory
281513
142
12
233
1322
Wheelchair
122
10
912
37»22
Total
401723
233
14
26101524
serendipitous discovery that injections in theseareas relieved spasticity and muscle dysfunc-tion. Their use is therefore empirical. Injectionswere also made around the greatest circumfer-ence of the head (0.1 mL at 5-cm intervals, againwith the needle adjacent to the periosteum; Fig.3) using a 2-mL disposable syringe and a mi-crolance no. 18 needle, 14 or 15 points in all.These are standard neural therapy points fortreating ataxia and vertigo. Their use in multi-ple sclerosis appears to have beneficial effectson locomotor function. The total dose did notnormally exceed 12 mL. One series of injectionswas given at the beginning of therapy, and wasrepeated as required depending on the pa-tient's progress. It was discovered early in thestudy that repeated injections while the patientwas still improving could reverse a previouslyencouraging response. Injections were there-fore not repeated unless there was no responseto treatment, or an initial response was notmaintained.
Assessments
Neurologic examination based on theKurtzke assessments (Kurtzke, 1965) weremade prior to treatment and at regular inter-vals thereafter (mean time 3 weeks). Visualfunction assessments were not made. Videorecordings were made to demonstrate motorfunction and ataxia before and after treat-ment.
RESULTS
Objective scale improvements were ob-tained in 26 of the patients (65%) while sub-jective improvements were reported by anadditional 10 patients, 2 of whom deterio-rated again 2 weeks and 6 months later, re-spectively. Improvements in the DSS wereobtained in 15 of the 40 patients (37.5%).These results are summarized in Table 1. Inall but 2 patients in whom an objective im-provement was obtained, a positive reactionwas noted within minutes of the first seriesof injections. In the other 2 no reaction wasseen for several days.
Nine (9) of the twenty-three (23) patientswith primary progressive MS (39.1%) im-proved their DSS rating, while 5 of 14 patientswith relapsing remitting disease (35.7%), and 1of 3 with chronic stable disease (33.3%) im-proved their DSS rating.
The improvement rate was better in the am-bulatory patients than in those confined to awheelchair (46.4% and 25%, respectively).There were more women than men in thewheelchair group (Table 1). If improvements inthe ambulatory group only are considered,there was little difference in response betweenmen and women. The improvements asrecorded by the video films correlated wellwith the improvements as assessed by theKurtzke scales.
NEURAL THERAPY IN MULTIPLE SCLEROSIS
DOUBLE-BLIND TRIAL: METHODS
Patients
This was a randomized, placebo-controlleddouble-blind trial in which 21 patients tookpart. They were an unselected group of the next21 multiple sclerosis patients to fulfil the crite-ria of Schumacher et al. (1965) to be referred tothe Glasgow Homoeopathic Hospital. All hadbeen diagnosed in the neurological depart-ments of other hospitals. There were 12 femaleand 9 male patients, 18 of whom were ambu-latory while 3 required a wheelchair. Agesranged from 25 to 53 years with a mean age of40.5 years. Twelve showed a primary progres-sive course, 2 a secondary progressive course,4 a relapsing remitting course, and 3 a chronicstable course. AU the patients were in a stableor slowly deteriorating condition on entry tothe trial and were hospitalized for the 2-weektrial period only for the purposes of the trial.
Treatment
The treatment was similar to that used in thepilot study, i.e., injection around the greatestcircumference of the skull, and into the anklesjust distal to the internal and external malleoli.The active treatment was 1% lignocaine hy-drochloride without adrenaline, and theplacebo was 0.9% saline.
The code was devised and held by a doctorwho prepared the injections but otherwise tookno part in the trial. Neither the two doctors con-ducting the trial, nor the patients, knew whichinjections were active and which were placebo.The patients were not informed that the injec-tions might be local anesthetic and thereforedid not know what to expect in terms of effects.Care was taken to make no suggestion thatthere might be any change in local sensationand any reference to this was ignored. The ma-jority of the patients (76%) had impaired sen-sation in their feet and legs. The anesthetic ef-fect wears off quickly and in the case of theskull injections could be assumed to be an ef-fect of injecting around the skull.
Because the pilot study had indicated that re-sponse could be rapid and that excessive rep-etition of the active injections could be coun-terproductive, the trial was conducted over a
547
TABLE 2. PRETREATMENT COMPARISON OF THETWENTY-ONE PATIENTS IN GROUPS A^ AND B^
AgeSex ratioDuration of diseaseDiagnosis confirmedRequiring wheelchairPrevious steroidsCurrent drugs
SteroidsOthers
Mean EDSSType of multiple sclerosis
Primary progressiveSecondary progressiveRelapsing remittingChronic stable
Group A11 patients
41.6 years5M:6F
9.2 years1124
1 ,4 '4.6
7121
Group BW patients
39,9 years4M:6F
12.1 years1015
224.2
5122
EDSS, Expanded Disability Status Score.^See text for description of Groups A and B.
period of 2 weeks. A regime was adopted inwhich patients received two injections perweek. In the first week, they were randomlygiven either two lignocaine hydrochloride in-jections (group A) or two saline injections(group B), and in the second week all receivedtwo lignocaine injections, but it was not knownwho changed treatment. This protocol kept thenumber of active and placebo injections to aminimum, avoided masking placebo injectionswith previously given active injections andgave all the patients the chance of the activetherapy.
With the exception of the visual assessments,neurological examinations based on theKurtzke assessments and the EDSS (Kurtzke,1983) were carried out on ail patients beforetreatment, after 1 week and after 2 weeks. Theresults of the examinations were scored as forthe pilot study with the exception that the ex-panded disability status scores were used. EachKurtzke scale is divided into a number ofgrades that vary with the function being as-sessed (Table 3). Video assessments wererecorded before treatment and after each set ofinjections. These were assessed independentlyby two other practitioners.
After the two trial weeks, the patients werefollowed up as outpatients 2 weeks later, andthen at monthly intervals. The code was notbroken until all patients had been treated for atleast 1 month. i
548 GIBSON AND GIBSON
TABLE 3. TOTAL KURTZKE SCALE GRADE IMPROVEMENTS FOR THE SEVEN FUNCTIONS
TESTED AND THE EDSS IN GROUPS A AND B AT THE END OF WEEK 1 AND WEEK 2
FunctionMental and cerebralBrain stemPyramidalCerebellarSensoryBowel and bladderOther functions
EDSSTotal
Grades0-50-50-60-50-60-50-1
O-IO
Group .
Week 1
2037835
432
Week 2
518
121166
655
Group
Week 1
0000010
01
Week 2
3154165
530
EDSS, Expanded Disability Status Score,^See text for explanation of Groups A and B.
The differences between the groups were with 30 in the same group in the second week,analysed by the Marm-Whitney U test and the The corresponding improvements in group AWikoxon signed ranks test (Siegel, 1956). were 32 Kurtzke scale grade improvements in
Ethical approval was obtained from the eth- the first week and an additional 23 (total 55) byical committee of the Greater Glasgow Health the end of the second week (Table 3). The dif-Board. ferences between groups A and B at the end of
week 1 are statistically significant {p < 0.01) asare those between group B at the end of week
RESULTS 1 and the same group on active treatment at theend of week 2 {p < 0.01). There was no signif-
There were 11 patients in group A and 10 in icant difference between Group A at the end ofgroup B. Nine of the 21 patients had previously week 1 and Group B at the end of week 2, af-had steroids and 3 were still on steroids on en- ter both groups had had 1 week of active treat-try to the trial. Six others were on nonsteroidal ment. While group A improved further aftermedication, analgesics, muscle relaxants, and the second week, the improvements were notin one case, antibiotics for recurrent urinary in- statistically significantly better than those ob-fections. The pretreatment comparison of the tained in the first week. The greatest improve-21 patients in groups A and B is shown in Table ments occurred rapidly in the first few days of2. Despite these treatments, the patients' con- treatment.ditions were stable or were deteriorating, on Three patients in group A improved theirentry to the trial. EDSS rating by 1-2 points after 1 week, 1 im-
At the end of the first week of treatment, 8 proved further after week 2, and 1 other patientof 11 patients in group A and 1 of 10 in group improved only after week 2. Therefore 4 of theB had improved in one or more function; at the 11 patients in group A improved their HDSSend of the second week, when all the patients rating by 1-2 points. Three patients in Grouphad had active treatment, 10 in group A and 6 B improved their EDSS rating after a treatmentin group B had improved in one or more func- of 1 week by 1-3 points.tion. Thus, at the end of the 2-week trial period. The blind ratings of the video records by the16 of 21 patients had responded to treatment, two independent colleagues were in complete15 while receiving active injections and 1 while agreement with the results as assessed by theon placebo. Five patients did not show any re- Kurtzke functional scales,sponse in any functional system. The improvements obtained in the various
There was 1 Kurtzke scale grade improve- functions in the 21 patients in the double-blindment in group B in the first week compared trial and the 40 patients in the pilot study are
NEURAL THERAPY IN MULTIPLE SCLEROSIS 549
compared in Table 4. The improvement ratesin the two trials are similar.
LONG-TERM FOLLOW-UP
Overall, of the 61 patients in the two studies,42 (69%) improved. Twenty-two (22) patients(36%) obtained DSS or EDSS rating improve-ments, the rest having functional grade im-provements only. They were followed up forperiods of 2.0 to 3.5 years with injections beingadministered according to clinical need. Overthis period 6 patients deteriorated, leaving anoverall long-term improvement in 36 (59%),with 18 (29%) improved on the DSS or EDSSratings. Improvement rates were similar in allforms of multiple sclerosis.
RESULTS OF OVERTREATMENT
While no toxic effects were observed usingneural therapy, it is possible to overtreat, withuntoward effects. Two patients who were seenearly in the pilot study experienced increasedspasticity of the muscles. In one case, this wasreversed by discontinuing therapy and the pa-
tient then continued to improve. In the othercase, however, the increased spasticity was notreversed. Whether this was occasioned by theneural therapy or was the result of the naturalprogression of the disease could not be ascer-tained.
It is therefore recommended that once im-provement is obtained, further treatment is notgiven unless the patient shows signs of relapse.If there has been no improvement after threesets of injections, it is unlikely that the patientwill respond to this therapeutic approach. Nor-mally injections are given in the heels only onthe second and subsequent visits. Injectionsaround the skull are not repeated unless bal-ance has deteriorated markedly.
DISCUSSION
The results of the preliminary study were en-couraging and were confirmed by the double-blind trial. Neural therapy was more effectivethan hyperbaric oxygen in all parameters ex-cept nystagmus (Davidson, 1983,1984; Fischeret al., 1983; Barnes et al., 1985; Nieman et al.,1985; Wiles et al., 1986). In contradistinction tohyperbaric oxygen, neural therapy could act
TABLE 4. COMPARISON OF NUMBER OV PATIENTS IMPROVING IN THE
PILOT STUDY AND ;N THE DOUBLE-BLIND STUDY ArrEK 2 WEEKS
Pilot study
40 patientsNumber of patients
could improve improved
FunctionMental and cerebralBrain stemPyramidalCerebellarSensoryBowel and bladderOther funtions
DSS/EDSS
Overall improvementall patients
Ambulatory patientsDSS/EDSS 0-6
The grades for each functionDSS, Disability Status Score;
28173838303431
40
40
28
are the
113
10226
1115
15
26
23
same as for Table 3EDSS, Expanded Disability
whopercentage
39.317.626.357.920.032.448.4
37.5
65
82.1
Status Score.
Double-blind study
21 patientsNumber of patients who
could improve improved
14112120161521
21
21
19
72
1012$8
10
7
16
percentage
50.018.247.660.037.553.347.6
33.4
76.0
84.2
550 GIBSON AND GIBSON
rapidly, with effects being seen in many caseswithin minutes of the injections. It is thereforeoften possible to predict which cases are likelyto respond. The length of time for which im-provement is maintained varies considerablyfrom patient to patient, ranging from a fewdays to weeks, months, or even longer. In gen-eral, each subsequent improvement lastslonger than the previous one.
Trials with cyclophosphamide, (Noseworthyet al., 1991), azathiaprine, (Patzold et al., 1982;Yudkin et al., 1991), copolymer 1 (Wolinsky,1995) and interferon-/3-lb (IFNB Study, 1995;Richards, 1996; O'Connor, 1996) have as theirmain outcome measures reduction in relapserate and prevention of further deterioration.Functional improvements were not reported. Itis therefore difficult to compare these studiesdirectly with the present one in which outcomemeasure was improvement in the individualKurtzke scales and DSS or EDSS ratings, withconcomitant improvements in patient function.Because neural therapy can produce statisti-cally significant improvements in function inthe seven systems assessed and in theDSS/EDSS ratings, and because relapses can betreated as they occur, there would appear to beno advantage of treatm.ent drug over neuraltherapy. The long-term outcome of patientstreated with neural therapy appears to com-pare favourably with that of these conventionaltreatments. Interferon-/3 Ib and copolymer 1were assessed in patients with relapsing re-mitting multiple sclerosis only, whereas neuraltherapy benefitted patients with all types ofmultiple sclerosis. Neural therapy is not asso-ciated with toxic side effects, which can be aproblem with cyclophosphamide and azathi-aprine, is well tolerated by patients, and is in-expensive. Neural therapy, therefore, has thepotential to offer significant therapeutic bene-fits safely to a large number of patients. Long-term improvements (2.0-3.5 years) were main-tained in over 50%.
POSTULATED MECHANISMS
It is interesting that the patient who showedan objective improvement while receivingplacebo did so in bladder function. The injec-
tion site below the external malleolus is nearthe acupuncture point Bladder 62 that, in clas-sic acupuncture, is used for treating earlyweakness of the lower limbs and bladder dys-function. Any injection into this point mayhave a weak acupuncture effect and may ex-plain this patient's improvement on placebo inweek 1. However, the substantially improvedeffect with lignocaine indicates that somethingmore than simple needling of the point is op-erating in neural therapy.
The double-blind trial confirmed the rapideffect of neural therapy on the symptoms ofmultiple sclerosis. Work by Davis and Schauf(1981) and Schauf and Davis (1981) has shownthat changes in temperature and ionic concen-tration can have a rapid effect on the conduc-tion velocity of demyelinated nerve fibers andon their ability to transmit nerve impulses. It ispossible that neural therapy acts by restoringconduction capacity in demyelinated but oth-erwise intact axons and the efficacy of the treat-ment in any given patient may depend on theproportion of axons in this state. According toDosch (1974) lignocaine acts by repolarizingand stabilizing depolarized cells (Fig. 1). If thisis so, then one possible action of neural ther-apy would be in line with the observations ofSchauf and Davis (1981) and could explain whythe effect can be surprisingly rapid.
Individual response patterns vary and treat-ment must be tailored to each patient. Neuraltherapy was more effective in the ambulatorypatients than in those already confined to awheelchair. This observation is again in linewith the findings of Schauf and Davis (1981),because the more severely affected the patient,the less likely are any of the axons to be intact.
Neural therapy is inexpensive, quick, andeasy to administer, does not require expensiveapparatus, and is apparently free from side ef-fects provided that patients are not overtreated.No infection or significant bleeding has beenobserved. Repeated injections may, in the longterm, cause mild scarring that might reverse thebenefit, although European experience doesnot substantiate this, nor has it been noted inover 300 patients who have now been fol-lowed-up for 12 years or more in our clinics.
The possible relationships between neuraltherapy and acupuncture deserve further
NEURAL THERAPY IN MULTIPLE SCLEROSIS
study. Some of the points used in this work arenear classic acupuncture points. Modem ideasabout acupuncture suggest that it too may actby affecting electrical charges on cell mem-branes and so may act similarly to neural ther-apy. Further studies with neural therapy in re-lation to acupuncture points may lead to agreater accuracy in the siting of injections andto the possibility of the rapid reversal of the ef-fects of overtreatment.
In the light of recent problems in the UnitedKingdom with regard to National Health Ser-vice government funding of treatments formultiple sclerosis, neural therapy has the ad-vantage of being a cheaper alternative to inter-feron-/3 lb and copolymer 1. While not a curefor multiple sclerosis, it has the ability to im-prove function in about 60% of multiple scle-rosis patients, to maintain their ability to work,and in some cases has enabled a return to work.
The time taken to administer a series of in-jections is not great, 5 to 10 minutes, and al-though a degree of skill is required, most doc-tors can be trained to use the methodsdescribed here in two to three teaching ses-sions. It is important, however, to bear in mindthe possibility of overtreatment, an aspect thatcannot be too strongly emphasised.
Although this work was carried out between1982 and 1984 and produced significantly bet-ter results than any other therapies available atthe time, we delayed publication until we hadthe opportunity of assessing the long-term(12+ years) results of this innovative approachto multiple sclerosis. Because this long-term as-sessment has confirmed the positive benefits ofneural therapy in over 300 patients and hasshown that these benefits have been main-tained in the majority of the patients, and be-cause orthodox approaches to multiple sclero-sis still do not offer significantly greaterbenefits, we are now in a position to publishthis intriguing study.
ACKNOWLEDGMENTS
The authors would like to thank Dr. AndreasPfretschner for introducing them to neuraltherapy; Drs. David Reilly and Brian Kennedyfor their assistance in holding the code, prepar-
ing the injections, and assessing the videorecords; Dr. Harper Gilmour for statistical ad-vice, and the late Dr. James McGregor for tech-nical advice.
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Address reprint requests to:Robin Gordon Gibson, M.B.Gh.B. LM.S.S.A.,
F.R.G.P., D.G.H., B.D.S., F.F.Hom.354 Albert DriveGlasgow G41 5P}
Scotland, United Kingdom
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