Apoplexy & CVA
Apoplexy is the unconsciousness or paralysis associated with CVA (Cerebo-vascular Accident), or Stroke. A vessel in the brain ruptures causing bleeding. This deprives that part of the brain of Blood and oxygen, causing a loss of function of the parts associated. Some may experience Hemiplegia (paralysis of half the body), or paralysis of a part, such as an arm or leg. Loss of speech is relatively common, and sometimes the mind is confused or memory may be lost.Wind is traditionally associated with Stroke, and in this form it is associated with Hypertension which predisposes to Stroke.
An acute CVA requires emergency care in a hospital. Therefore, as practitioners we will usually see the after-effects of the Stroke. Treatment usually includes a combination of the following:
- Move the Blood, Clear Stasis–Blood stasis is to be cleared with Medicines such as Frankincense, Saffron, Notoginseng San Qi, Earthworm
- Settle Wind, Regulate Qi–regulate the flow of Qi with medicines such as Peony, Gastrodia Tian Ma, Calamus, Cyperus, Clove
- Open the Orifices–use aromatics to stimulate the Brain such as Musk, Camphor, Storax, Clove
- Open the Channels–medicines which penetrate the fine capillaries, Clove, Camphor, Saffron
- Clear Excess of Heat, Phlegm, Damp etc–clear any excess, such as Coptis Huang Lian or Rhubarb to clear Heat; Agaric, Poria or Gum Ammoniac to clear Phlegm and Damp;
- Tonify Deficiency–tonify the deficiency. Walnuts and Pine nuts are good to strengthen the Brain; Ginseng and Astragalus tonify Qi; Peony and Dang Gui nourish Blood. Peony and Mistletoe are highly regarded in the Western tradition and form an important tonic combination for this and related diseases.
As always, the choice of herbs depends on the individual. In general, compounds which combine several suitable categories from the above would be used. In all cases, moving the Blood and clearing stasis is necessary, as is settling Wind and regulating Qi. The main differentiation is in identifying a Heat or Cold pattern. If there is Phlegm (which may be present in either Heat or Cold types) medicines to resolve Phlegm are added. In severe deficiency marked by weakness and lassitude with a weak pulse, tonics are added.
In cases where necessary medicines couldn’t be administered, suitable herbs or compounds were dissolved in brandy and given slowly be mouth. Strong aromatics can be used to stimulate the senses. Cupping with bleeding on the shoulders and base of the neck (C7) are good. Points on the head such as the nose tip, mid eyebrows, forehead vein etc. can be bled if there is excess or blood stasis.
Most used Tibetan Formulas for Apoplexy Sequelae:
A study of Tibetan Medicine use in Apoplectic Sequelae at a Hospital of Tibetan Medicine (in Naqu) showed the following three formulas to be predominately used out of 479 patients:
1. Aloeswood 20 (338 cases)
2. Wish-fulfilling Jewel (322 cases)
3. Pearl 70 Pills (315 cases)
See also
Wind Diseases
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Western Tradition Simples
Formulas 1. Sagapen taken in doses of 1 dram with wine. 2. Bryopny root taken in doses of 1 dram for a year. 3. Peach kernels steeped in Pennyroyal water and drunk 4. Rosemary, Angelica, Vervain, Calendula 5. Peony, Mistletoe, Amber, Saffron 6. Hyssop, Sage, Rosemary, Nutmeg (as a tincture) 7. Betony, Marjoram, Vervain, Sage 8. Bay leaf, Hyssop, Sage, Betony, Camomile, Calamint. Marjoram; decoct in equal parts of water and wine, then dip cloths in and apply warm to the head. 9. Euphorbium mixed with oil and applied to the nape of the neck. Borage Water Violet Water Decoction for Apoplexy (Countess of Kent) Decoction of Sarsaparilla Against Apoplexy (Bonet) Decoction to Warm the Head Syrup for Apoplexy of Arnold de Villa Nova Syrup of Stoechas (Judeus) Syrup of Stoechas (Fernelius) Syrup of Earthworms Compound Syrup of Peony Oxymel of Squill Tincture for Apoplexy Tincture of Lemon Thyme Tincture of Mastic Tincture of Myrrh Tincture of Amber Tincture of Juniper Compound Apoplectic Tincture Rosemary Wine Wormwood Wine Wine for Apoplexy Apoplectic Powder of Crato Powder Against Apoplexy Powder Against Apoplexy 1 (Zwelfer) Powder Against Apoplexy 2 (Zwelfer) Powder Against Apoplexy (Wirtenberg) Powder for Apoplexy (Wirtenberg) Restorative of Nicholas (Pleres Arconticon) (Nicholas) Pills of Sarah (Unani) Pills for Apoplexy of (Arnold de Villa Nova) Wonderful Confection for Cold Nerve Diseases Aloeswood 20 (A gar nyi shu) (Tibetan) Triphala Electuary for Epilepsy (Itrifal Zabeeb) Supreme 25 (Bla med nyer lnga) Pearl 25 (Mu tig nyer lnga) (Tibetan) Zha Chong 13 Pill (Mongolian Medicine) Loss of Speech from Apoplexy Saxifrage roots chewed Euphorbium Peach kernels Mistletoe (worn around the neck) Spirit of Lavender held in the mouth To Purge Electuary of Dates (Diaphoenicum) (Mesue) Arabian Pills (Nicholas) Foetid Pills Greater (Mesue) Pills of Agaric (Mesue) Pills of Fumitory (Avicenna) Pills of Lapis Lazuli 1 (Mesue) To Strengthen Powder of Musk Sweet (Diamoschu Dulce) (Mesue) Electuary of Calamus (Diacorum) (Mesue) |
TCM Classification Simples
Phlegm & Heat Obstructing the Orifices Fever, irritability, delirium, deep red tongue, rapid pulse An Gong Niu Huang Wan Zhi Bao Dan Shi Xiang Fan Sheng Wan Liver Wind & Heat Fever, irritability, headache, restlessness, dizziness, vertigo, spasms and twitches, loss of consciousness, red tongue and rapid pulse Tian Ma Gou Teng Yin Ling Jiao Gou Teng Tang Qu Feng Zhi Bao Dan Pearl 25 (Mu tig nyer lnga) (Tibetan Medicine) Blood Stasis with Deficiency Hemiplegia, deviation of mouth, aphasia, loss of speech, excess saliva, weakness of lower limbs, incontinence, always tired, purplish color of the lips, tongue and nail beds Tao Hong Si Wu Tang Bu Yang Huan Wu Tang Yin Deficiency with Wind Severe lack of energy, very weak pulse with crimson tongue. Severe lack of energy, very weak pulse with crimson tongue Da Ding Feng Zhu Zhen Gan Xi Feng Tang Deficiency with Heat and Phlegm Obstruction Aphasia, stiffness of the Tongue, weak legs, paralysis, dry mouth, thirst Di Huang Yin Zi Cold, Wind & Phlegm Obstructing Channels with Blood Stagnation Sequela of Stroke, weak limbs, paralysis with numbness, heaviness, pale tongue with white tongue coating, soft and weak pulse Xiao Huo Luo Dan Tong Qiao Huo Xue Tang |
Special Formula
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POWDER OF FRANKINCENSE Peony Orris 3 drams ea. Frankincense 1.5 drams Calcined Deer horn Mistletoe Saffon 1 dram ea. Sugar Penids 2 oz. Dose: 0.5–1 scruple POWDER AGAINST APOPLEXY Amber Deer horn burnt Aloeswood Peony root ½ oz. each Citron peel 1 dram Pearled Sugar 3 oz. Cinnamon oil 60 drops Powder; add Ambergris ½ scruple, Musk 5 grains. Chronic Headache, Vertigo, Apoplexy, Infantile Epilepsy Dose: ½ dram–2 scruples. ANTI-APOPLECTIC POWDER Doronicum 1 oz. Sweet Costus Aloeswood Cardamon 3 drams ea. Cubeb Coriander Annis 2 drams ea. Nutmeg White Amber, of each ½ oz. ea. Clove 1 ½ drams Citron seed 1 scruple Distilled Cinnamon oil 1 scruple Apoplexy, Epilepsy, Vertigo. Dose: 1 scruple–½ dram, or 2 scruples. APOPLECTIC WATER (SENNERTUS) Lavender flowers Cubebs Cinnamon Mace Nutmegs Galangal Mistletoe Peony Steep sufficient Lily of the Valley flowers in 6 lbs. rhenish wine, then distill. Add the above in powder to the distillate and infuse 2 weeks, then distil again. Dose: 1 spoonful TINCTURE FOR APOPLEXY Sage Hyssop 1 ½ handfuls ea. Rosemary 3 handfuls Nutmeg 1 ½ oz. Alcohol ½ pound. |
NAO XUE SHU LIQUID Astragalus Huang Qi Leech (Shui Zhi) Calamus Shi Chang Pu Achyranthis Huai Niu Xi Paeonia Mu Dan Pi Rhubarb (Da Huang) Ligusticum Chuan Xiong This is used for Aphasia due to stroke with good effect. (See research here). It also has a protective effect on hypertensive hemorrhage. (See research here) |