While working on different articles for this site I could not avoid such condition as lethargy. Moreover, I was lucky to observe typical case of lethargy and use an approach I developed called RANC to treat the patient who was sleeping for 3 months.

It happened in 2007. I had been working as a neurologist in Krasnodar city clinic №14 for three years. After appointment I usually visit my patients at home. One day the pediatrician of our polyclinic came to me and asked to visit a young man who was in a strange condition, as if in brain coma. There were no time for discussion, she left an address and went away. After work I went to a patient. Patient's mother met me and we came to a room where he was. The young man was laying in the bed with closed eyes as though he was sleeping. It was 4 or 5 p.m. Mother told me that on the previous day morning he set off to find work, after a few hours returned nervous, agitated and went to sleep without mentioning a word. Told only that somebody laughed at or dressed down him. She told me that her son is very sensitive and react to unfairness.

Before I started working in polyclinic I had been working in ER, there were different cases. First of all I explained mother about alcohol and drugs because there were no traumas that could cause coma. it turns up that her son Vitaliy even does not smoke because he is religious. I tried to come into contact, stir him up although nothing helped, neither words, nor pain from the touch of neurological hammer. Pupils of eyes were responding to light, but he was rolling his eyes. Reflexes, arterial pressure, pulse are all normal. Muscle tone is regular for a relaxed, asleep man. On the whole, he was making an impression of a man who was pretending though his reaction to pain from a needle and pinches was almost absent. I have seen people in hysterics, they reminds his condition but they, as a rule, come into contact and are concerned about their state. And despite the claim that they don't feel legs, they react to pain. Vitaliy didn't reacted to rather considerable pain. I did understood that it is not come but I couldn't think about lethargy. I had never seen this seeing the exceptional rareness. Moreover, mother concealed the fact that her son had been in this condition not for a day, but for three months. That is why I decided that it is a peculiar hysterics. Remembering permanent positive effect from injections to interscapular area which I give to patients in coma and hysterics, I decided to carry out a procedure. Furthermore, it relieves a headache and a patient was complaining about it, according to his mother.

I explained Svetlana(Vitaliy's mother) that I want to give injections in interscapular area which help him. Despite obvious anxiety, she agreed about this simple procedure considering that I as a doctor know what I was doing and would do no harm. We turned him on the stomach, I probed trapezius muscles that were in some places tense. Usually these tensed area are so sore that people cry out when slightly touch it. But he was not responding and it puzzled me because it is impossible to bear this pain and conceal feelings. Although he was not reacting. I don't remember exactly how many injections I gave, somewhere about ten in the each side. A person who experienced this(I experienced this on myself lots of times until I was sure that it is safe) knows that even though pain is short, it is still specific. So people can't hide their feelings when they experience it. I can't say that his state changed right away but I could noticed that he felt something. When blood stops in places of injections we turned him to back and let him alone. I always sympathize my patients when giving injections. When the procedure finishes I feel physical relief. Even though the intentions are good, I hurt people. I didn't expect miracle because knew from my experience that positive changes, after strokes for example, happen sometimes in several days. Of course, I never suspected lethargy, otherwise I would insist on hospitalization. Vitaliy still were laying in bed. I checked blood pressure, pulse, whiche were normal, gave recommendations and went away.

After two or three days Svetlana came to my office when I had an appointment, told in a few words that he is feeling better and asked me to visit them again. I came to their home on the same day. Vitaliy was laying in his room but it was a completely normal person. I talked to him. He seemed to be a reserved and shy person. Never complained though when I started asking questions he confirmed that felt week and even fell down after taking a bathroom. He didn't look exhausted because has a athletic build. He complained about a headache and I suggested to give more injections. He agreed without persuasion and enthusiasm. I could see that he was trying to restrain himself from moaning. Since I was giving no more than 10 injections, and I give one in a second, the procedure was finished very soon. Everything was normal and weakness is the thing that all ill people have. So I wished him fast recovery and said goodbye. After a few days I visited their apartment by his mother request. Svetlana asked me to have a look at her younger son, who was 14 at that moment, about his headaches. When I came, Vitaliy wasn't there, went out to deal with his affairs. I examined his brother, carried out a procedure, about 20 injections. Then Svetlana and I had a talk and she confessed that Vitaliy was "sleeping" for 3 months. I can't say that I was astonished but surprised for sure. Since he wasn't at home, I couldn't get details from him. I was surprised at another thing, why mother kept him at home and never came to a hospital. But since she is religious, I referred it to ideology. Besides, she said that not long ago her mother died and attitude towards hospitals was negative. Her logic was understandable, her son was just sleeping, not talking and look healthy and possibly soon would be fine. When it was lasting for 3 month she became anxious. Then I understood that it had been lethargy. I wasn't astonished because by that time I had more reasons to be astonished observing the miraculous result of patients who suffered epilepsy, was in the process of recovery after stroke and also patient with Parkinson's syndrome got after treating with my approach. We talked for a while and said goodbye. I have seen Svetlana only once or twice at her friend's house where I was treating a patient and Vitaliy only once in policlynic, he was queuing to take fluorography. We couldn't have a talk. Now, when I understand how the approach is working and have seen many peopled who miraculously recovered for 13 years and regard it as a rule, it is strange to watch TV and hear from doctors about incurable and causeless diseases. Lethargy as a state, connected with the decline of reticular formation activity because of the stress, is, in my opinion, insignificant disease. It is so not only because lethargy is rare, but also the damage is so small that can be easily eliminated. That is why we should be surprised not by the fact that people spend years in this state, but by the fact that nobody sees the link between simple definitions in encyclopedia.
I don't think that I'm the only one who is trying to find logical answers to questions about causal relationships between phenomenons using available information. There are no functions or phenomenons without a material object. If we put aside discussions about the human soul, the rest phenomenons of our mind and vital activity are certainly bound to some structures of the body or brain, which controls the body.

There is lots of information or at least enough to not think that lethargy is a mysterious disease and causes are not known. Is it education really creates hard file system where analysis and interchange even between two nearby files I impossible? The world conspiracy theory I refuse. Then how should we explain a role of the brain which links external, internal environment with regulatory systems and called reticular formation(or UPWARD ACTIVATING SYSTEM) and leads if damaged in experiment to suppression of conscious and sleep. Everybody knows that when we bring a cotton pad wetted with sal ammonia to a nose(or influense through trigeminal nerve), it activates and brings back consciousness. Does the stimulation of structure, created for brain activation through another nerve of brain stem, seem like a trick?

I don't understand people who solve all the questions with the help of one theory, which explains the origin of life, dinosaurs death and the mystery of crop cycles. There are other persistent people who really think that they will save the world and turn to other people with this idea. Believe and all your problems will be solved. In practice, many other factors appear and prevent dream from coming true.

Having the considerable life experience we cautiously accept new ideas not because of the fear, we don't want waste our time. And at the same time we want to believe in miracles.

Lethargy state, a person can be in this state from several hours to several days, have some features:

1. Lethargy could be due to severe stress.
2. A person seems as if he is sleeping, laying with closed eyes, don't react to external stimuli.
3. Depending on the extent of suppressed living functions a person can look like sleeping or even dead man. If a person is inhibited but not sleeping, such states are not lethargy and refer to other diseases.
4. It is common for a lethargic sleep to safe memories about happening events, i.e. a person is not sleeping in the full sense but and just motionless(a lack dopamine?)
5. In this state a person can in one way or another eat, which is not common for a sleep.

After telling the main causes of lethargy it is strange to read that the cause of this disease is unknown for science. If some brain divisions become damaged as a result of trauma or intoxication, we can observe certain symptoms. Although it isn't fantastic that the occurrence of these symptoms happen without organic damage of the brain and can't happen without the fact that these brain divisions don't stop functions. We forget that brain cells can be in a state of parabiosis. Sustenance of life without performing other functions is common for parabiosis. In fact, from the point of functional activity these cells don't differ from dead cells. We have to only wonder why gastritis with low acidity occurred due to stress doesn't amaze but heart stop and football player death during the match does. Probably, the matter is in consequences.

In every article I am trying to share the simple thought. Almost every disorders of nervous system caused by internal or external factors(caused by stress of not threat of life, but of a human conclusions) can be influenced through the reticular formation of the brain. To easy to believe, but it is true. I remind once more about the stimulation on the reticular formation by bringing to nose a cotton pad wetted with sal ammonia. "Awaking" effect from irritation of insignificant area of nasal mucosa can be explained by stimulation of reticular formation through trigeminal nerve, which cores, as well as reticular formation cores, are laid in the brain stem. This stimulation approach is limited by the impossibility to apply the greater influence without the risk of damage. We can get to the brain stem and through the reticular formation get to all stem, cortex, subcortex brain centers and spinal cord by only one place. This place is trapezius muscles that control the accessory nerve which is linked tightly with the reticular formation.

It give perfect results that I have been observing for 13 years and completely safe. I'm used to it and consider it as a norm. What are the perspectives of RANC treatment approach? They surely exists. It is just necessary to make brain scanning with the help of Functional Tomography and find out which areas of trapezius muscles are linked to brain structures, create a map in order to avoid trial and error method when we have to make observation for years.

Under the control of scanning and laboratory data we should define the intensity, frequency and precise periodicity to gain positive results for certain diseases.

Optimal process of hyperstimulation when treating disorders in inner organs and pain in a body has to be checked. We have to determine accurately when it is better to influence through the spinal cord by muscles hyperstimulation, i.e. bottom-up. And when it is better to go up-bottom influencing firstly on relicular formation and then on segmental structures of spinal cord.

I simply couldn't not to write the article about suck rare disease which I saw and treated with my approach. Moreover, I was observed another case related also to lethargy almost at the same time. It described in article "Chronic brain iscemia". As for Vilaliy, he moved to another city and I don't any contacts. But one day I met Svetlana and she agreed to shot video where she told what had happened. Only then I found out other details. I was very surprised when discovered that Vitaliy when we first met suffered from schizophrenia. Once or twice a year exacerbation happened, he had headaches, insomnia, lost control over himself and started vagabonding. I never expected that my procedures will help him but according to his mother it did help. And only after the row of family scandals he became ill again.

Now Vitalliy is in Omsk in specialized psychiatric facility.

The end of this story is tragic. The only positive thing in it is that schizophrenia, that I had never seen before, in my opinion, is similar to lethargy, Parkinson's disease and brain ischemia. The effectiveness of RANC approach would be no lower than for these diseases. Anyway, there are no theoretical objections and the Svetlana evidence about a year remission is another confirmation.

neurologist A.A.Ponomarenko