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Dr.rams cva

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  • It is one of the best presentation.... the therapeutics explained here is the new way of explaining Homoeopathic therapeutics. The author took pains taking effort to explain it in a clear and easily understandable way... thank you Doctor.
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  • 1. CEREBROVASCULAR ACCIDENTS <Brain Attack>HOMOEOPATHIC ANALYTICAL APPROACH Dr.K.Ram Kumar M.D(Hom) Senior Medical Officer Directorate of AYUSH Govt of NCT of Delhi.
  • 2. CEREBROVASCULAR ACCIDENTS STROKE(APOPLEXY) The rapid onset of focal neurological deficit, resulting from diseases of the Cerebral vasculature and its contents.
  • 3. Diseases of the Cerebral blood vessels are the third most common cause of death next to Ischaemic Heart Disease and Cancer. Cerebrovascular disease can cause death and disability by; Ischemia from occlusion of blood vessels (producing Cerebral Ischaemia and Infarction.) Or Hemorrhage through their rupture.
  • 4. GENERAL CLASSIFICATION Ischaemic variety; Cerebral Thrombosis Cerebral Embolism Hemorrhagic variety; Ruptured Aneurysm in the young Hypertensive Cerebral hemorrhage in the elderly Lacunar infarcts are deep, small multiple wedge-shaped cerebral infarcts.
  • 5. RISK FACTORS MAJOR RISKS Arterial Hypertension Diabetes mellitus Smoking Hyperlipidaemia Polycythaemia, sickle cell anemia Thrombocythaemia Heart failure, Atrial fibrillation, Infective endocarditis MINOR RISKS High alcohol intake Positive family history Oral Contraceptives Trauma
  • 6. CLINICAL CLASSIFICATION Complete, if the focal neurological deficit is persistent and not worsening. Transient (TIA) if the focal neurological deficit recovers within 24 hours. Evolving if the focal neurological deficit continues to worsen after about 6 hours from onset.
  • 7. HOMOEOPATHIC THERAPEUTICAL APPROACH
  • 8. THE GOALS OF THERAPY TO AVOID DEVELOPMENTOF CEREBRAL INFARCTION AND IF, PRESENT ALREADY TO PREVENT ITS PROGRSSION OR RECCURENCE
  • 9. THERAPEUTICS Based on; Mode of onset of the disease & Aetiology Anatomical Site Of lesions Stage of the disease
  • 10. COMMONLY INDICATED REMEDIES ACONITE ARNICA AGARICUS ALUMINA AURUM BARYTA-C BARYTA-M BELLADONA BOTHROPS CALC-C CALC-F CAUSTICUM COCCULUS CROT-HOR CROT-CASC GELSEMIUM GLONOINE IPECAC LACHESIS NUX-VOM NUX-MOS OPIUM PHOSPHORUS PLUMBUM VERAT-VIR ZINCUM
  • 11. MODE OF ONSET & AETIOLOGY RAPID ONSET STROKE CEREBRAL THROMBOSIS a) Atherosclerosis – Baryta-c, Baryta-m, Agar, Calc-f, Lach, Phos, Phos-ac, Anac, Plb,etc in elderly people—Lachesis in obese persons--- Capsicum b) Arteriosclerosis-Arnica, Aurum-iod, Baryta-c, Tabac, Plb, Kali-iod, Sumbul, Polyg-avia c) Syphilitic Arteritis-Calc, Kali-iod, Nat-iod, Lach.
  • 12. CEREBRAL HEMORRHAGE Bothrops, Bell, Cocculus, Gels, Ipecac, Lach, Opium,Hammelis, Crot-hor,Vipera,Sangui., Hypertension - Nat-M, Glon, Lach, Baryta-Mur, Verat-vir Ruptured Aneurysm--Baryta, Carb-v, Lach, Lyco, Digi, Plb. Capillary---Calc-f, Fl-acid, Tuber
  • 13. CEREBRAL HEMORRHAGE Head Injury: Arnica, Nat-s, Hell, Mille, Allium-c, Hyper,Cicuta Leading to Hematoma-Ars,Apis, Kalmia. Bleeding disorders: Ars, Phos, Crot-h, Nat-sil, Hamm, Lach, Adren Purpura – Arn, Sulph-ac, Bovista, Led Leukemia – Ars, Nat-ars, Nat-sul, Pic-ac, X-Ray,Benzeneum.
  • 14.    CEREBRAL EMBOLISM: Crat, Naja, Lach, Spongia, Stroph, Spig, Kalm, Kali-c, Crot-hor, Calc-f  HYPERTENSIVE ENCEPHALOPATHY: Nat-m, Lach, Baryta-m, Glon,Asterias rub.    SUB-ARACHNOID HAEMORRHAGEGelsemium DEPRESSED SKULL FRACTURES: Ruta, Ledum, Symphytum
  • 15. SLOW ONSET STROKE SPACE OCCUPYING LESIONS      Cerebral tumours:---kali-brom, Zinc-m, Phos, Plb-iod Plb-m, Calc,Conium.      Cerebral abscess:--- Arn, Crot-h, Iodum, Lach, Opium,Vipera, Pyrog.     Chronic Sub-dural haematoma:---Apis, Ars, Kalmia, Arnica, Calc-f, Nat-s, Sil.     INTERNAL CAROTID ARTERY OCCLUSION Hyos, Chen-a, Baryta-m, Syphilinum.
  • 16. REMEDIES ACCORDING TO STAGE OF THE DISEASE Remedies to Prevent the attack; Acon, Amyl, Bell, Apis, Hyos, Opium, Verat-v, Nux-m, Gels, Glon. In chronic cases--Aurum, Calc, Ferrum, Phos, Spongia, Sulph. Remedies During the attack; Acon, Arnica, Bell, Cocculus, Conium, Gels, Hyos, Glon, Lauroc,Lach, Nux-v, Opium. Remedies for Remote changes; Anac, Causticum, Cuprum, Plumbum, Zincum.
  • 17. ANATOMICAL SITE OF LESIONS
  • 18. KALI.BROM,HYOS BARYTA.M,CHEN-A ARN,CAUST,HYOS GELS AUR,STRAM, MUR-A,GELS,SEPIA,
  • 19. FEATURES IN DIFFERENT ARTERIAL TERRITORIES AND RELEVANT DRUGS: MAIN BRANCH INTERNA L CAROTID BRANCH MIDDLE CEREBR AL (MCA) AREAS OF SUPPLY CLINICAL FEATURES Most of the motor & sensory areas, Internalcapsule , speech & auditory areas. Hemi paresis (face& HYOS(deaf arm leg) ness), Hemianesthesia, CHEN-A Dysphasia,dysarthri (aphasia), aHemianopia rarely. BARYTA-M (lt.Hemiple&aphasia) ANTERIO Motor areas R esp. for legs. CEREBR AL (ACA) Hemiparesis (leg arm & face) Incontinence urine & stool. DRUGS ARNICA CAUST HYOS
  • 20. POSTERIO Mid brain R Visual area CEREBRAL Thalamus (PCA) VERTEBR- Cerebellum BASILAR Labyrinthine Pons Medulla Amnesia(memory loss) Homonymus Hemianopia Cortical blindness Sensory loss to all modalities,Thalamic pain (spontaneous burning pain) Vertigo, Dizziness, Ataxia, Dysarthria, Diplopia, Nystagmus, Facial weakness / numbness, Bilateral sensory symptoms, Loss of conciousness, Dysphagia, Occipital headache. AURUM STRAM MUR-ACID (numbness+ aphasia) GELS SEPIA PONTINE Hemorrhage Contra lateral Hemiplegia, Deep coma, Hyper pyrexia, PIN-POINT pupils OPIUM
  • 21. THERAPEUTICS IN GENERAL
  • 22. ARNICA -H/o- Head injury -Left-sided paralysis -- Involuntary evacuations from bladder and bowels --pulse full,strong, stertorus breathing --Arnica 30,for dissolving blood clots
  • 23. OPIUM •-Ruputure of vessels & consequent symptoms of extravasation of blood into the cerebral subatance leading to; •-One- sided paralysis, with stertorus breathing , •-Jaw dropped •-Pin-Point pupils •-Tetanic rigidity of the body •-Face mottled, purple or hot, hot sweat. •-In Drunkards, followed well by Nux-vom •-Opium follows Bell in apoplexy.
  • 24. GLONOINE  Indicated in the high arterial tension and co-existing kidney disease(Asterias)  Monoplegia ( affecting one arm or leg) Stertorus breathing Coma Intense heat Shiny skin & Cold extremities
  • 25. PLUMBUM MET •-Apoplexy ,stupor, when Opium is sufficiently similar to remove the cerebral congestion which always surrounds the apoplectic clot, Plumbum may follow. (kent) -Cerebral Tumours and Cerebral Sclerosis -Paralytic weakness of Oneside of the body -Paralysis of muscles (lt.sided)—atrophy -Violent pain in the Paralysed parts & Hyperesthesia of normal side.
  • 26. GELSEMIUM In Sub-arachnoid haemorrhage •-Nervous affections of Cigar makers •-Threatened & actual apoplectic seizure •-The symptoms are Stupor General paralysis Headache,nausea Dilated pupils Twitching of the single muscles •-Dizziness, drowsiness, dullness & trembling
  • 27. CAUSTICUM • Indicated not for congestion, exudation but for the Remote symptoms, when, after absorption of the effused blood has taken place, there still remains paralysis of the opposite side of the body. • Right-sided paralysis • Paralysis of Single parts • Incontinence (Hyos) • Contracture of the affected parts.
  • 28. COCCULUS It affects the voluntary muscles rather than the intellectual power. Face red & hot Eyes closed, with the balls constantly rolling Pupils dilated Breathing with out noise Left or Right extremities paralysed; after night watching & exhaustion. CROTOLUS- HOR Cerebral Haemorrhage -- Bleeding disorders Right –sided paralysis
  • 29. LAUROCERASUS Apoplexy when it occurs suddenly without prodromal; Patient falls suddenly into a comatose state out of which he cannot be aroused; Cold moist skin Convulsion of the muscles of the face.
  • 30. LACHESIS • After Liquor, Emotion • Left-sided paralysis • Cannot bear anything around neck • When Conscious talks abruptly HYOSCYAMUS • Falls with a scream • Involuntary defecation & urination • Inability to swallow • Twitching, jerking of all muscles of body
  • 31. ANACARDIUM • Loss of Memory • In After-effects of Cerebro Vascular Accidents   BARYTA-CARB • In old people • Drunkards • Behaves Childish . AURUM-MET • Paralysis of tongue, speech imperfect • Stammering • Mental function unimpaired
  • 32. NUX-VOMICA • Paralysis of lower jaw,lower limb • Retention of urine • Constipation • In drunkards, followed by Opium. ZINCUM-MET • Senses are affected after attack • Fidgety feeling in feet, must move them constantly
  • 33. ACONITE • From fright  • Fear, Anxiety, restless • Dry & hot skin BELLADONA • Red bloated face • Headache > by warmth • Dilated Pupil • Loss of sight , smell, speech VERATRUM VIRIDE • Nausea & Vomiting • Quick bounding pulse • Thick speech • Red streaked down the middle of tongue.
  • 34. FEW SNAP SHOTS
  • 35. Hemiplegia with Aphasia -- Bothrops, Cench Rt.Hemiplegia with Aphasia -- Bothrops, Cantharis, Chen-a Lt.Hemiplegia with Aphasia -- Baryta-mur Lt. Hemiplegia after hemorrhage – Curare Lt.upper limb(monoplegia) – Ars.alb For Lacunar Strokes – Caust, Curare, Plum-met
  • 36. Aphasia due to Embolism of Middle cerebral artery : Kali-brom Apoplexy followed by idiocy – Helleborus Apoplexy in drunkards -- Opium, Nux-vom, Sepia. when coma fails to yield to Opium – Apis.mel Apoplexy after excitement --Stannum APOPLEXY: due to Sudden fright                 – Acon, Opium Excessive joy - Coff, Opium Suppression of menses – Nux-v, Puls Disappointed love - Phos
  • 37.      ALLEN.H.C, Key Notes and Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica with Bowel Nosodes, New Delhi, B.Jain Publishers Pvt. Ltd., 8 th Reprint Edition 1996 BOERICKE, WILLIAM , A Manual of Homoeopathic Materia Medica and Repertory, New Delhi, B.Jain Publishers Pvt. Ltd., Reprint Edition 1996. CLARKE.J.H. A Dictionary of Practical Materia medica, (Vol.I, II, III), New Delhi, B.Jain Publishers Pvt. Ltd., New Issue with additions, Reprint 2000.  CLARKE.J.H, A Clinical Repertory to the Dictionary of Materia Medica, New Delhi, B.Jain Publishers Pvt. Ltd., Reprint Edition 2001 COWPERTHWAITE.A.C. A Text Book of Materia Medica and Therapeutics (Characteristic, Analytical and Comparative), New Delhi, B.Jain Publishers, 13th Reprint Edition 2001.  FARRINGTON.E.A. Clinical Materia Medica, New Delhi, B.Jain Publishers Pvt. Ltd., Reprint 4 th Edition 2002.  KENT.J.T, Lectures on Homoeopathic Philosophy , New Delhi, B.Jain Publishers Pvt. Ltd., Reprint Edition 1997.  KENT.J.T, Repertory of Homoeopathic Materia Medica , New Delhi, B.Jain Publishers Pvt. Ltd., 6 th Edition.  KENT.J.T, Lectures on Homoeopathic Materia Medica , B.Jain Publishers Pvt. Ltd., Reprint Edition   LILIENTHAL, SAMUEL, Homoeopathic Therapeutics, Calcutta, Sett Dey & Co., Reprinted Edition 1969.  OXFORD, Text Book of Medicine,davidsons and harrisons etc   MURPHY ROBIN’s, Homoeopathic Medical Repertory, New Delhi, Published by Indian Books and Periodical Syndicate, 1st Indian Edition, 1994. Other relevant Websites and homoeoathic softwares.etc…
  • 38.  The effort made in this work is not merely to arrive at any conclusion regarding the scope of homoeopathic doctrine over cerebro vascular diseases alone. It is also to infuse interest into the future researches in homoeopathy confined to various remedies belonging to the materia medica to show a delicate focus in the study of individual clinical conditions. in doing such works in future a better understanding of the armamentarium of homoeopathic materia medica will be obtained.these efforts correspondingly will ensure  A better understanding of the hidden symptoms in our vast materia medica could be explored.  . A better approach in several clinical conditions by which, the therapeutic value of Homoeopathic materia medica gets enriched.