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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
  • 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 such as Ginseng should be used.

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. 

See also
Wind Diseases


Western Tradition

Simples
Peony
Calamus
Angelica
Betony
Rosemary
Saffron
Amber

Mistletoe
Indian Spikenard
Calendula
Vervain

Sage
Frankincense
Earthworm


Formulas
1. Rosemary, Angelica, Vervain, Calendula
2. Peony, Mistletoe, Amber, Saffron
3. Hyssop, Sage, Rosemary, Nutmeg (as a tincture)
4. Betony, Marjoram, Vervain, Sage
5. 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.

Decoction for Apoplexy (Countess of Kent)
Decoction of Sarsaparilla Against Apoplexy (Bonet)

Decoction to Warm the Head
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
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 for Apoplexy of (Arnold de Villa Nova)
Pills of Crato

Wonderful Confection for Cold Nerve Diseases
Triphala Electuary for Epilepsy (Itrifal Zabeeb)

Stronger
Apoplectic Powder of Crato
Pearl 25 (Mu tig nyer lnga) (Tibetan Medicine)




TCM Classification

Simples
Pinellia Ban Xia
Paeonia Bai Shao
Ligusticum Chuan Xiong
Scutellaria Huang Qin
Safflower (Hong Hua)

Leech (Shui Zhi)
Arisaema Tian Nan Xing
Paeonia Mu Dan Pi
Angelica Dang Gui
Gastrodia Tian Ma
Peach kernel (Tao Ren)

Musk (She Xiang)

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

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


Special Formula

1. 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

2. 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.

3. 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.


4. 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

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)

Research
1. An Analysis of the Combination Frequencies of Constituent Medicinal Herbs in Prescriptions for the Treatment of Stroke in Korean Medicine: Determination of a Group of Candidate Prescriptions for Universal Use

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