[Zeit-Online: Richard Friebe]
Gefäße unter Stress
Bluthochdruck, in der medizinischen Fachsprache als arterielle Hypertonie bezeichnet, gilt neben Diabetes und Übergewicht als größte Epidemie der Gegenwart. Er ist nachweislich eine Hauptursache für Herzinfarkte, Schlaganfälle und chronische Nierenerkrankungen und spielt bei vielen weiteren Leiden eine Rolle. Leider bleibt er oft unbemerkt: Schätzungen besagen, dass mehr als ein Drittel der Betroffenen nichts von dem Blutdruckproblem weiß.
Wie hoch ist zu hoch?
Der Blutdruck wird stets in zwei Werten angegeben, man sagt "125 zu 90". Der höhere Wert entspricht dem systolischen Druck, der in der Anspannungsphase des Herzmuskels in den Gefäßen herrscht, und der niedrigere dem diastolischen Druck während der Entspannungsphase des Herzens. Die Deutsche Gesellschaft für Kardiologie betrachtet Werte von weniger als 120 zu 80 als optimal, bis 139 zu 89 sind sie normal bis hochnormal. Bei Werten über 140 zu 90 liegt offiziell ein Bluthochdruck vor. Das ist in Deutschland auch die Grenze, ab der Ärzte eine Behandlung einleiten. Manchmal reicht dafür eine Änderung des Lebensstils aus, oft verschreibt der Arzt aber auch Medikamente.
Die richtige Diagnose
Bevor man über eine Behandlung nachdenkt, muss eine verlässliche Diagnose vorliegen. Eine ein- oder zweimalige Messung beim Hausarzt reicht dafür in der Regel nicht aus. Inzwischen
gilt eine Langzeitblutdruckmessung als beste Methode, also ein 24-stündiges Blutdruckmonitoring mit einem Gerät, das Patienten mit nach Hause nehmen können. Wenn danach ein Bluthochdruck diagnostiziert wird, sollte der Arzt weitere Untersuchungen veranlassen, um mögliche Ursachen wie eine gestörte Schilddrüsenfunktion auszuschließen und nach vielleicht bereits bestehenden Organschäden zu suchen.
Senken ohne Medikamente
Vor allem Betroffene mit einem leicht ausgeprägtem Bluthochdruck können diesen mit einer konsequenten Umstellung des Lebensstils senken, ohne auf pharmazeutische Hilfe zurückzugreifen. Übergewichtige sollten versuchen, langsam und nachhaltig abzunehmen. Dabei helfen zwei weitere Strategien, die auch nicht übergewichtigen Patienten empfohlen werden: regelmäßige sportliche Betätigung und ausgewogene Ernährung. Wer als Hochdruckpatient sehr viel Salz konsumiert, sollte dies reduzieren. Alkohol sollten Menschen mit Hypertonie nur moderat trinken, Zigaretten am besten gar nicht rauchen. Wer unter Stress leidet, sollte versuchen diesen zu verringern oder den Umgang damit positiver zu gestalten. Genug Nachtschlaf scheint ebenfalls wichtig zu sein.
Behandeln mit Medikamenten
Wenn eine Änderung des Lebensstils nicht ausreicht, steht eine ganze Reihe pharmazeutischer Blutdrucksenker zur Verfügung. Dazu gehören zum Beispiel ACE-Hemmer, Betablocker und
entwässernde Medikamente. Der Arzt verordnet sie als Einzelpräparat oder in Kombinationen. Eine optimale Medikamentenauswahl und Einstellung des Blutdrucks ist jedoch nicht trivial.
Sie erfordert häufige Kontrollen und hängt oft davon ab, dass der Patient diese aktiv einfordert.
Nr. 30 Ch-k-sulf. + Nr. 1 Calc-f. + Nr. 15 Kali-i. morgens, mittags und abends, 4 Wochen lang, 4 Wochen pausieren und die Therapie wiederholen.
It is very important that one should always treat hypertension not as a disease but as an individual who suffers from hypertension. The classical Hahnemannian method is always the golden rule
to follow. Hypertension in homoeopathic practice can be seen in two ways, either you are invited to treat acute crisis of hypertension for which I was lucky to have tremendous experience
or one has to treat hypertension chronically where lot of allopathic drugs have been given and patient is not responding to increasing doses of the drugs or having side effects of the drug and hence
he has come for homoeopathic consultations.
Unfortunately in our homoeopathic profession majority of the homoeopathic practitioners allow anti-hypertensive drugs with homoeopathy only that they themselves take anti hypertensive drugs
for their own hypertension, I know a homoeopath who owns a large collection of homoeopathic medicines but for his own hypertension he prefers allopathic drugs!!!!!
This is not right as allopathic drugs not only interfere with the action of the homoeopathic remedies but also produce an Edito artificial layer of drug on the vital force there by reducing the susceptibility of the patients. Sooner or later one has to taper off the dose so that an ideal cure is achieved.
Miasmatically if one looks at hypertension, it can be classified as psoric when the hypertension is purely due to an anxiety, nervousness or fear; such hypertensions do not need treatment, simple
assurance or removing the circumstances from the patient’s life can bring back the condition to normal, however if the situation persists for a prolong period then one needs an antipsoric remedy.
The same hypertension becomes sycotic when there are arteriosclerotic changes in the blood vessels bigger or smaller and also there will be an increase in the level of low density lipoproteins.
This low density lipoproteins are the main lipoproteins that thickens the arterial.
Syphilitic hypertension comes when the arteries are hard like a cord and fragile so that they are prone to rupture or may get totally obstructed producing different type of cerebro vascular disease.
The hypertensions I commonly see in my practice are syco-syphilitic in nature where you see collection of cholesterol deposits in artery with tendency to produce apoplexy.
Psoric hypertensions are seen by me but not so common.
Many times the person who suffers from hypertension is quite asymptomatic and hence he will not give you many symptoms, the best bet in to treat such hypertension constitutionally depending heavily on his pre disposition and disposition, which includes his past, family history, his physical and mental makeup and finally his general symptoms.
Never try to reduce the allopathic medicine all of a sudden as it may produce severe aggravation. The method that I follow is that reduce 1/3rd of the dose in the first 3 months and 2/3rd the dose
in the next 6 months and later on just totally stop the dose. Blood pressure need not be monitor everyday but should be monitor with the same instrument and at the same time once in 15 days
to know the effect of the homoeopathic remedies.
Never tell the patient to buy an instrument and measure it in the house because this will make him measure his blood pressure every few hours which is very bad. Many psoric or nervous individuals
keep an instrument in the house, you should always discourage such practices as it damages and hampers the homoeopathic treatment. The biggest failure in homoeopathy to treat hypertension is
that the homoeopaths are not able to find the right medicine which the patient requires and hence the medicine given to the patient never brings the blood pressure under control. Another cause
of failure is to consider hypertension as local malady and treat it with drugs like Crataegus oxyacantha or Rauwolfia serpentine, physicians who are in practice for more than 20 years I have seen
are doing this!!!!!
It is not good to take the rubric
GENERALS - HYPERTENSION from the repertory when you are treating a case of hypertension because this will only bring common remedies which usually will not cure the case.
This is an interesting case of a man who was 65 years old, he came to me with two complaints, 1st complaint was bunions on his feet and 2nd complaint was fluctuating hypertension.
Here fluctuating hypertension means that for some days his blood pressure will be quite controlled with allopathic medicines and for some days his blood pressure suddenly shoots up, he has vertigo
because of that and it remains for few days and then again comes back to its original position.
He was on calcium channel blockers i.e. Calcigard retard one tab two times a day and he was on Lortazan phosphate 50 mg one tab 2x daily. So totally he used to take two types of anti-hypertensive
i.e. four tablets a day but even with that his blood pressure used to fluctuate.
He was a retired bank executive, retired from a very high post; he had a strong family history of heart attack, hypertensions and cerebro-vascular accident. He was a graduate from England later did
his accountancy examinations in India and from a very young age he was successful, competitive, strong leadership qualities, egoistic, a good organizer and a good performer. By the time he reached 40 years he be comes second in the rank in hisbank and at the age 48 he becomes the chairman of the bank. He was known for his discipline, he had an eccentric nature and hence people were afraid to approach him because sometime the response will be good and encouraging but sometimes the response will be too insulting and humiliating.
His wife mentions that he does not believe much in medicine and he takes medicine only out of a fear that he may have a heart attack or a stroke.
He will always argue and quarrel with anybody and everybody if things do not go his way.
With vertigo he will always has to lie down with his eyes open, if he closes eyes his vertigo becomes worse. For years together he complains of ringing noise in the ear this happened when he was
swimming one day when he was also suffering from common cold, also noises aggravate whenever he has cold and catarrh of upper respiratory tract.
He also gets nausea which is better by eating.
He is chronically a constipated person, stool is always soft. He has a bad bunion on his feet near the toes; he repeatedly gets it operated or scrubbed but it keeps on growing. They are extremely painful and as a result he gets severe cramps in the feet.
His main concern was his bunions and not his hypertension when he consulted me but when I offered him that homoeopathy treats the person as a whole and your hypertension will be controlled
with the same medicine that I will use for bunions.
He wanted to challenge the effect of homoeopathy, he says “I have never taken homoeopathy in my whole life and this will be a big challenge for me”.
When I examined him his blood pressure was 160 systolic and 98 diastolic. His skin was wrinkled; his pulse was very strong and large, thumping on my fingers.
His wife said that he also suffers from rheumatism but there are no modalities.
I tried various remedies: Ferr-met. Lyc. Sulph. and Lach., the first 4 months I could not control his hypertension as well as bunion because the remedy that I selected was wrong.
Ferr-met. selected because he was competitive, quarrelsome, closing the eyes produces the vertigo, ringing in the ears, nausea better by eating, cramps in the feet, rheumatic pain and a strong pulse. But unfortunately Ferrum did not help the patient.
Then I went to Lycopodium because he was very egoistic, competitive, quarrelsome, constipation with soft stool, and it is a very important remedy for bunions on the feet, rheumatic pain and
a strong pulse. Lycopodium did not help the patient.
Then I went to Sulphur because it shares many common symptoms with Lycopodium.
Finally Lachesis was given because he had a tendency to refuse to take the medicine. Lachesis patients specially chronic ones do not have faith in medicine because they always feel that all the
medicines will do more harm to them so they avoid taking medicines. You may refer to the rubric ‘MIND – REFUSING - medicine; to take the’ and you will see Lachesis inside.
But unfortunately Lachesis also in different potencies did not help.
What is most important thing in this whole case is his egocentric nature, e.g. he always felt that he is intelligent, successful and knowledgeable, his eccentric nature, his nature to refuse the
medicine, as I mentioned earlier he only wants to take the medicine out of fear and not out of his need.
I restudied his case from Encylopedia Homoeopathica and I saw that Veratrum viride also covered many non hypertensive symptoms i.e. the chronic picture. I had in the past never used this drug
as constitutional remedy. I started with Veratrum viride 30C in this case and I went all the way up to 50M in next one year, I advised him not to cut his bunion or scrap it or not to put some local medicines on this but allow the bunion to heal from internally.
I also asked him not to take any laxatives for his constipation, I advised him not to even regularly measure his blood pressure but come to my clinic once in 15 days just to measure it.
He followed the rule very religiously and within nine months I could chop out his Calcigard retard totally and his bunion became 50% less. In the next 6 months I decreased his Lortazan phosphate
to half the dose that is 50 mg instead of 100 mg
and I asked him to continue this another 6 months. His vertigo was much better there was no episode for last one year of any hypertension crisis, in fact at the end of 14 month of homoeopathic treatment his blood pressure was in the range of 140 and 145 instead of 160 systolic and the diastolic blood pressure was in the range of 88 to 94. It never went to 98; this was a very good sign.
His ringing in the ears which was his oldest symptom ever since he was 30 years old was coming less frequently, his nausea totally disappeared and the last prescription of Veratrum viride that he received was Veratrum viride 50M one dose every week. I never asked him to do any other therapy along with homoeopathy because I wanted to see the effect of homoeopathic medicine in this particular case.
As you know Veratrum viride comes from the natural order of botanical family Melanthaceae. This plant is extremely similar to its sister plant Veratrum album, basically this plant contains an
alkaloid known as Jervin and Veratroidine and they are very strong cardiac sedatives acting directly on the heart or the nerves that supply the heart. It reduces the force of the heart beat and there
by reduces the blood pressure. I have used this very successfully in pneumonia, pleurisy, and rheumatism but the most important condition where I have used it mostly on the constitutional
basis in the cases of chronic hypertension or in cases of acute cerebro-vascular accident.
The most important thing is the concomitant of nausea, vomiting and congestion, if you find these three things in a case of stroke or in a case of an infraction or in a case of any cardiac complication
including hypertensive crisis then Veratrum viride is the drug of choice. Like that you can use many remedies like Belladonna, Ferr-met. Gels. Glon. Hell. Lach. Meli. Phos. Sanguinaria for an acute stroke but this concomitant of nausea, vomiting and congestion is peculiar to Verat-v. only.
Another most important thing is the prostration along with a dry or moist or white or yellow tongue. In acute situation the Veratrum viride patient may be either confused or stupefied but in a chronic situation the patient can resemble an egoistic person or domineering or dictatorial person who feels that he has an infinite knowledge or he is a great person, he has lot of knowledge and people should obey and respect him.
They are very thirsty like Veratrum album but many times drinking brings on excessive vomiting.
Another very useful indication that I would like to share with you is the pulse which usually very strong, the heart beat is very loud and the whole arterial system is in a state of excitement.
The next case is of a 55 years old woman; she had married and has two elder daughters and one elder son.
She was a painter and housewife. Her husband was a businessman. She had 3 major problems 1st unstable hypertension, 2nd alcoholism with early cirrhosis of liver and 3rd glaucoma.
These were her 3 main complaints; she was already on allopathic medication for all the above complaints excepting alcoholism for which she was taking no drugs. She comes to my clinic expecting
some miraculous drug to stabilize her blood pressure.
She was on beta blockers and she was also on the drug Verapamil 1 tablet 2x daily. She says that her doctor’s plans to change this drug as her liver functions are getting deteriorated.
Verapamil is calcium channel blocker and it works by relaxing the muscle of the heart and blood vessels. She wanted a substitute in homoeopathy for that I said we do not have any substitutes
like that but we can treat your constitution as a whole for all the above problems.
She comes from Gujarat, her childhood was very peaceful, her father used to own farms and lands, there was no problem, and the upbringing was secured safe and full of luxury. At a very early age
of 21 she gets married after marriage she stays within a big family where lot of responsibilities come to her she was not accustomed and not experienced to live her life in this way, and hence she
took time to adjust. By the time she was adjusting she gets pregnant and she gets added responsibility and she now just cannot cope anymore.
This is the time when the hypertension starts in her life and this was the same time when alcoholism also starts, she starts drinking alcohol to give her courage and support.
Her husband was extremely busy businessman, they had everything that money could buy but their life was full of stress managing such a large joint family of 30 members living in large bungalow.
The relationship with husband was good but the husband was busy and hence she could not discuss many things with her husband which she wanted to;
her problems her grief her anxieties. She is an extremely nervous person but she has a bad anger, she can speak anything rudely on the face of the person immediately.
Her biggest mental shock came early in her life when the husband was diagnosed with the myocardial infarction this came as a shock, she suddenly realizes that what will happen to her if he dies!!!
As she does not have that kind of capacity to run his business. Also after being diagnosed with hypertension she was always worried about her health that she will die soon because nobody gets cured
She was always in an excitable and quarrelsome state, she has an argumentative nature, she would love to fight, and was very obstinate in her views.
When the pressure goes above 180 systolic and 100 diastolic she develops a dull ache in the occipital region that surrounds the whole head gradually or get the pain in the occiput ext. forehead and the eyes; and at that time she has to lie down, she cannot do any household work at that time and she needs to rest.
After the husband’s sickness they decide to stay separately but once she stayed separately she does not maintain much relation with the relatives of the husband. She has a weakness of the memory especially for the names.
This was the time when she develops glaucoma for which she is putting Timoptol eye drops. Because of her abnormal liver function she has a constant sensation of vomiting and nausea with a sour taste immediately after eating.
She is a known case of gastro-esophageal reflux for which she takes antacids.
When she lies down in the bed she gets cramps in the calf muscles and the feet become cold so she needs to cover her feet a lot with blanket. But in general she is a hot patient and she likes cold air she likes cold air from the wind she likes cold air from the winters she likes cold air from the aircondition she needs a lot of cold air.
She has a desire for sweets and a strong aversion to meat. She was a Muslim and hence aversion to meat was a characteristic because the Muslims are basically me at eaters.
This was the history available to me when I first saw her in my clinic. The cardiologist was worried that if she does not stop this tablet and goes to a higher generation of the antihypertensive drug
she will invite problem. The cardiologist wanted her to take the tablet Telmisartan.
When I examined her I saw her face quite suffering; The sides of the tongue was red, her blood pressure was 165/98 mmHg.
To me she was very friendly and nice but her son and daughter who accompanied her in my clinic (son was medical doctor) said that our mother is very rude, she can speak anything on anybody’s
face if she is angry she does not care and these days she lives with the fear that she will die because she already has an abnormal liver function test with high liver enzymes and the cardiogram
changes shows ischemia.
I studied her case and I gave her a remedy Anacardium because there was alcoholism, there was nervous excitement, her obstinate nature, wants to fight, weakness for memory, dull pain in the head, sensation of nausea and vomiting constantly, hot patient and desire for sweets. I put her on Anacardium but that did not give her any relief so the next prescription I gave her was Opium.
Opium I prescribed basically because of the shock that she got after her husband’s infarction, with history of alcoholism, nervous excitement, obstinacy, heaviness of the occiput, glaucoma, the
sides of the tongue are red, constant nausea sensation, hot patient with aversion to meat and desire for sweets.
I tried different potencies but it never helped. This time I was thinking of a remedy which has a mental shock with alcoholism with excitement but with strong fear of impending death, a person who
is quite different to her relatives with heaviness in the occiput that extends anteriorly the sensation of nausea and vomiting with cramps in the calves (in bed) and the coldness of the feet in the bed.
This time I prescribed her Sec. 30, I asked her to see me after a month, I gave her 3x daily from the 5 cup method.
She responded very beautifully to Sec. after a month she said there was a marked change in all her complaints including the cramps nausea, heartburn, the sour taste, there was no episode of
hypertensive crisis, in fact she says twice she got her blood pressure measured and the blood pressure was quite good, it came in the range of 150 and the diastolic was in the range of 95.
I said - good that we never went to a higher generation of antihypertensive drug i.e. Tab Telmisartan and we will now try to reduce your dose of Verapamil by half and go to Sec. 200 for next 2
Again for next 2 months I saw that there was more control in blood pressure, headache and the cramps. I talked a lot with her and she said - for the first time my anxiety levels have gone down,
my excitement levels have gone down and now I drink alcohol occasionally or on a social occasion otherwise normally before starting homoeopathy I used to drink alcohol 3 times a week.
I continued Sec. for 3 more months there by reducing the dose of Verapamil to ¼. When I totally stopped Verapamil after 6 months I went to Sec. 1M and I told her to take 1M one dose every single day, later on I tapered off Sec. from once daily to 2x a week. Her liver function test especially the GGTP which was in the range of 150 or 160 or 180 almost came down to below100, her SGPT which was in the range of 120 or 150 came down to 60 with homoeopathy, her gastro-esophageal reflux was much better, the taste was normal, she was more friendly and less angry, and there was
an overall improvement in her condition.
Sec. as you know basically a fungus, it’s a nosode? which is prepared from the ergot.
It has been used by me in my practice in different conditions; mostly I used it in gynecological conditions, neurosis and cardiovascular disorders. What I see here is the great restlessness almost
like Arsenic album and they are quite abusive, rude and insulting to others, this is very important aspect. They may be having a good heart but at that particular time when they are angry they can
insult you a lot. They are always having a fear that they will die because of their disease condition.
They are very hot, externally they may feel very cold but from with in they are very hot. They crave for cold drinks, ice, acidic drinks, sour drinks, they crave for sweets, sugar but the same time they
have a strong aversion to chocolate. They are usually worse in a warm room and they do not like much covering. They have a history of alcoholism which is very strong in them.
I have also found Sec. useful in chronic cases of vertigo.
Hypertension and Homoeopathic Management
By the term blood pressure people are inclined to think of a serious disease of modern civilization. Due to modern stressful life hypertension has become the “silent killer”. In certain pathological states the BP rises above the normal figure, sometimes reaching such heights as to become a source of imminent danger to life. This raised BP is not a disease by itself, but a sign or manifestation of a pathological process. It is a measurable external index of an internal malady. The rise of BP is a conservative or compensatory process by which adequate circulation of blood is maintained in the tissues, in-spite of increase resistance or obstruction to the flow of blood. If the BP would fail to rise while the obstruction to the flow of blood is increasing, the inevitable result would be death from failure of circulation.
High BP, which is also known as hypertension, seems to be more common in modern times. It cannot be denied that modern civilization has brought in its wake a great deal of adverse factors tending to raise BP. Intensive struggle
for existence associated with continual anxiety, greed, ambition, artificial methods of living, want of faith in religion, intemperance, irregular hours, adulterated and unwholesome food and many vices peculiar to modern civilization
do play an important part in its causation. Moreover, with the discovery of the sphygmomanometer, the detection of raised BP has become an easy affair and therefore, more cases are brought to the notice of the profession today
Treating hypertension with anti hypertensive’s and sedatives appeals to the logic of the common-medical practitioner. They are taught that those cases of hypertension with no detectable cause may be treated as “essential hypertension”, which in layman’s language is hypertension of unknown cause. The followers of modern medicine use anti-hypertensives and sedative drugs to save the patient from a possible, probable or rather certain catastrophe that would take place if they were left alone. These antihypertensive drugs in the long run may prove unhelpful if not actually harmful. Undetectable causes of essential hypertension can be overcome by treating the sick individual as a whole according to the laws of Homoeopathy, not by treating him in parts.
An elevated arterial pressure is called hypertension and is the most important public health problem in developed countries. It is a common, asymptomatic, readily detectable, usually easily treatable ailment that often leads to lethal complications if left untreated. The prevalence of hypertension depends on both the racial composition of the population studied and the criteria used to define the condition. In a suburban population study, nearly one-fifth of individuals have blood pressure >160/95mmhg, while almost one-half have pressures >140/90mmhg. In females the prevalence is closely related to age, with a substantial increase occurring after age 50. This increase is presumably related to the hormonal changes of menopause. The ratio of hypertension frequency in women versus men increases from 0.6 to 0.7 at age 30 to 1.1 to1.2 at age 65.
Understanding of the etiology of hypertension is far from complete but there seems to be a strong familial and genetic predisposition and a number of modifiable predisposing factors have also been identified. Several studies have demonstrated the influences of:
Rapid heart rate.
Blood pressure is defined as the product of cardiac output and peripheral resistance (PR).Hypertension is therefore said to be caused by increased cardiac output and/or increased PR. Each of these primary factors is determined
by a complex series of interactions. Increased cardiac output, though involved in the initiation of hypertension, does not persist. The typical hemodynamic finding in established hypertension is an elevated PR and normal cardiac output. It is also suspected that heredity plays a role as a background to most of these abnormalities, along with varying contributions of three environmental factors: sodium, stress and obesity.
Factors involved in increased cardiac output:
1. Increased circulating fluid volume
Excess sodium intake and sodium sensitivity: Excess sodium intake can cause hypertension by increasing fluid volume and preload, thus increasing cardiac output.
Renal sodium retention-excessive sodium retention by the kidney has also been proposed as an important factor.
Sympathetic nervous over activity- the sympathetic nervous system (SNS) directly or indirectly dictates the state of cardiac output and systemic vascular resistance.
Thus, excessive activity of SNS may increase the blood pressure.
2. Increased peripheral resistance,
The final common feature of established hypertension is a raised peripheral resistance, which can be associated with both functional constriction and structural vascular remodeling and hypertrophy.
3. Other pathogenetic factors-
Insulin resistance and hyperinsulinaemia are often associated with hypertension.
4. Contributing factors ,
A variety of factors, such as foetal environment, plasma calcium, intake of calcium and parathyroid hormone, deficiency of potassium or magnesium, alcohol and physical inactivity are considered to be the contributing factors in susceptible individuals.
• Blurred vision
• Chest pain
• Difficult breathing
History of diabetes, asthma, heart disease, gout, drinking, smoking, self-medication or use of oral contraceptives should also be brought to the notice of the doctor.
In the beginning hypertension is labile, but in due course, it becomes established hypertension. The complications are more common in higher blood pressures. The accompanying arteriosclerosis may be the reason for cardiovascular diseases in uncontrolled hypertension; Ischemic heart diseases like angina pectoris, myocardial infarction or congestive heart failure. 50% of patients die, 33% get cerebral strokes, 15% get renal failure. Renal failure is more common
in hypertension with diabetes as the patients suffer from proteinuria, which is an evidence of nephropathy.
The complications are classified:
1. Hypertensive complications;
• Malignant hypertension
• Congestive cardiac failure
• Aortic dissection and aneurysm
• Cerebral hemorrhages and infarctions
2. Atherosclerotic complications;
• Ischemic heart diseases like angina pectoris and myocardial infractions
• Sudden death
• Cerebral thrombotic strokes
• Peripheral vascular diseases
Homoeopathy considers health as a state indicating harmonious functioning of the life force. Disease is a deviation from health, which develops when the life force is unable to overcome obstructions to its smooth functioning.
It can be seen as the total response of the organism to adverse environmental factors, internal or external, conditioned by constitutional factors, inherited or acquired. This stands true for all diseases, including essential hypertension.
A closer examination of the modern concepts of health and disease accepted in the medical world today shows that they are coming closer to the homoeopathic model. Perhaps nothing epitomizes this better than the etiological concepts of essential hypertension, which is seen as a product of “constitutional” and environmental factors.
Notwithstanding these similarities, there remain for the most part significant differences in the concept of disease in both systems. The essence of this difference is contained in the Hahnemannian statement: “there are no diseases, but sick people”. Perhaps a more eloquent exposition is given by Dr. Kent in his lecture on “the sick”. He says “the allopath thinks that the house in which the man lives, which is being torn down, expresses all there is in sickness.
In other words, tissue changes are all there is to the sick man. But homoeopathy perceives that there is something prior to the results. It is the man who is sick and has to be restored to health, not his body, not his tissues”. Thus in the case of essential hypertension, homoeopathy focuses on the patient with the hypertension, rather than on the hypertension itself. The totality of various characteristic signs and symptoms exhibited by this patient leads the homoeopath to the similar remedy. The similar remedy relieves the totality of symptoms and with it the symptoms of an elevated blood pressure.
The homoeopathic management of essential hypertension like all other disease conditions is based on the principle of similia. Being a chronic disease, it requires constitutional, anti-miasmatic treatment. It is the totality of symptoms which guides the homoeopath to the indicated remedy. In the search for the similar remedy, homoeopathy lays emphasis on the individuality of the patient
in aphorism 153 of the Organon. Hahnemann makes it clear that it is the peculiar, characteristic and individualizing symptoms and not the common symptoms that denote the similimum. Hahnemann also stressed the prime importance of the mental symptoms in all physical disorders. He said that the mental disposition and emotional reactions are to be particularly noted as they often determine the remedy selection. This will apply naturally to cases of essential hypertension where psychological factors play a significant part in the causation of illness. While treating diseases with multiple miasmatic influences like essential hypertension, it is also important that the remedy selected correspond to the dominant miasm. This is very often found to be the psoric miasm. Afterwards, the dormant syphilitic or sycotic miasm, as the case may be, manifests itself and may call for appropriate changes in remedy.
Below are some remedies often used in managing hypertension:
Acon..: Tachycardia. Affections of the heart with pain in left shoulder. Stitching pain in chest. Palpitation, with anxiety, fainting, and tingling in fingers. Pulse full, hard, tense and bounding; sometimes intermits. Temporal and carotid arteries felt when sitting. Great fear, anxiety and worry accompany every ailment. Fears death but believes that he will soon die; predicts the day. Fears the future, a crowd, crossing the street. Restless with fullness, heaviness in head. Vertigo < on rising and shaking head.
Adon.: Mitral and aortic regurgitation. Chronic aortitis. Fatty heart pericarditis. Rheumatic endocarditis. Precordial pain, palpitation and dyspnoea. Marked venous engorgement. Cardiac asthma. Fatty heart. Myocarditis, irregular cardiac action, constriction and vertigo with irregular and rapid pulse.
Adren.: Indicated in high arterial blood pressure. Roaring in the ears due to high blood pressure. Palpitations and Tachycardia. In the crude form, it causes constriction of the peripheral arterioles resulting in a rise in blood pressure.
All-s.: Pain in the left side of chest with dark urine. Darting pain in the chest which prevents sleep. Bounding of the heart. It suits people who eat a great deal more than they drink. In the mental sphere there is anxiety and impatience. Fears he will not recover; that he will not be able to bear any medicine, fear of being poisoned. It is suited to fleshy people and those used to a high standard
of living. Weeping during sleep. Swelling of breast, sensitive to touch.
<: change of temperature/open air (chest complaints); Reading, walking (pains in limbs). >: sitting in a bent position;
Ant-t.. Shortness of breath. Difficult respiration. Rattling of mucus in the chest. Visible and anxious palpitation of the heart, sometimes during an evacuation. Palpitation with loose stool. Pulse – hard, quick and small or weak, quick and trembling, small thread like, imperceptible. Fits of vertigo with sparking before the eyes and dizziness when walking. <: on sitting down/when seated/on rising from a seat/sitting bent forward; >: sitting erect/from eructations;
Anxious about the future. Excessively peevish and quarrelsome. Consequences of anger and vexation. Suicidal mania.
Apis.: Oppression in the chest, shortness of breath (ascending), inability to remain in a warm room. Dull, aching pain on the left side of the chest, near the middle of the sternum, with sensation of fullness and short breath. Burning, stinging pain throughout chest. Marked edema. Sudden pain just below the heart, ext. chest r. with suffocation. Very feeble action of the heart, violent pulsations, shaking the entire body, intermittent beats. Region of heart sensitive
to least pressure; rasping sounds of systole and diastole unmistakably audible. Depression, feels as if about to die. Dread of death; sensation as if he could not breath again. Aversion to tight things. Prostration leading to fainting.
Great debility. Oedematous swellings.
Apoc-c.: Depression in the heart’s action, controls dropsical effusions and produces diuresis. Low arterial tension. Fluttering, darting pains, prostrated feeling in the cardiac region. Quick, sharp, catching pain in the heart with palpitations. Pulse slow, labored, irregular, intermittent, at times feeble and slow. Pulse quick, feeble when moved. Fainting on moving the head. Heart action scarcely perceptible. Oedema of feet, ankles and legs. Swelling in every
part of the body; cardiac dropsies, pulsating jugulars and general cyanosis. There is aggravation on walking in the morning. Many of the symptoms are aggravated after sleep. Patient is bewildered, nervous low spirited.
Dry tongue, immoderate thirst; but water disagrees, causing pain and is immediately thrown out. Cannot tolerate food or drink, which is immediately ejected. Excretions are diminished, especially urine and sweat.
Aur-met.: Syphilitic affections of the heart. Hypertension due to valvular lesions and arteriosclerosis. Sensation as if the heart stops beating for two or three seconds, followed by a tumultuous rebound. Paroxysms of suffocation, with constrictive oppression of the chest and bluish discolors of the face. Continuous aching in the left side of the chest. Incisive pain, and obtuse shootings near the sternum. Sensation of great weight on the chest; on the sternum. Difficulty in respiration at night. Walking in the open air, require deep breathing. Pain in the region of the heart ext. left arm to fingers. When walking, the heart seems to shake as if it were loose. Sensation as if the heart stood still. Great sensitivity to cold. Melancholy, hopelessness, profound depression, tendency to suicide and longing for death are marked. Aggravation from emotions. Complaints after grief, fright, anger, disappointed love, contradiction, reserved displeasure. Suited to sanguine people with black hair and dark eyes, olive brown complexion and light haired scrofulous people.
Bar-m.: Indicated in arteriosclerosis with a high systolic pressure and a comparatively low diastolic pressure with cerebral and cardiac symptoms. Hypertension and vascular degeneration (aged and mentally-physically dwarfed people).
White blood corpuscles increased. Great weakness, which necessitates lying down. Swelling of hands and feet. Loss of appetite. Stools white, hard like stones. Great anxiety, with gastralgia, nausea and retching. Palpitations, heart beats irregularly. Pulse is scarcely perceptible. Periodical attacks of convulsions. Mania with increase of sexual desire.
Bell.: Violent of attacks and suddenness of onset. Oppression of the chest in the morning. Cannot breathe in the room, > in the open air. Violent palpitations which are sometimes felt in the head. Palpitation of the heart when ascending. Trembling of the heart, with anxiety and oppressive pain. Neuralgic pains come and go suddenly. Throbbing throughout the body. Melancholy, with grief, hypochondriacal humour, moral dejection, and discouragement. Desire to die and inclination for suicide. Sleepy but cannot sleep. Sweat on covered part only. Belladonna is suited to the bilious, lymphatic temperament. Light hair and complexion, blue eyes.
Carb-a.: High blood pressure with obstinate occipital headaches. Great sensitiveness to open, cold dry air. Palpitation of the heart, in the morning and in the evening and when singing in a public place. Panting respiration. Atheroma
and aneurism. Numbness of all the limbs. Hard and painful swelling of the glands. Weak digestion. <: eating/lying on the side/after shaving/from slight touch/from lifting. >: lying hand on part/rubbing the eyes;
Con.: Difficult gait, trembling, sudden loss of strength while walking, painful stiffness of legs. Great debility in the morning in bed. Weakness of body and mind, trembling, and palpitation. Indicated in Arterio-sclerosis. Excitement causes mental depression. Depressed, timid, averse to society and afraid of being alone. No inclination for business or study, takes no interest in anything. Vertigo when lying down, and when turning over in bed, when turning head sidewise, worse shaking head, headache, stupefying, with nausea and vomiting.
Dig.: Pulse weak, irregular and abnormally slow. Weakness and dilatation of the myocardium. Cardiac muscle failure. It stimulates the heart muscles and increases the force of systole. Hypertrophy with dilation. Auricular fibrillation. Heart block and other organic diseases of the heart. Least movement causes violent palpitations, mitral disease leads to an irregular heart. Sensation as if heart suddenly stopped. Cardiac dropsy. Audible palpitations. Oppression
of chest with cyanosis.
Gels.: Indicated in the heaviness in the middle of the chest especially in the afternoon. Extreme and alarming difficulty in breathing; extreme restlessness from threatened suffocation. Stitches in the chest and region of the heart.
Weak, slow pulse of old age. Irregular heart beat, palpitation. Feeling as if heart would stop beating if she did not move about. Pain in the heart when rising from a seat. Pulse frequent, soft, weak, almost imperceptible. Excessive irritability of mind and body. It is adapted to children and young people of nervous, hysterical temperament, to irritable, sensitive, excitable people. Dread of being alone. It has great muscular weakness and tired feeling. Dizziness, dullness and drowsiness with all complaints. General depression from heat of the sun with thirstlessness.
Glon.: Sudden and violent irregularities of the circulation. Palpitation with dyspnoea. Cannot go uphill. Any exertion brings on a rush of blood to the heart and a fainting spell. Violent action of the heart, distinct pulsations all over
the body. Sharp pain in the heart. Severe stitches from the heart, extending into the back. Purring noise in the region of heart when lying, pulse intermittent. Sensation as if the heart would rise to the throat. Pains are bursting, throbbing, pulsative, piercing, stabbing, gnawing. Laboured breathing of the heart with oppression and fluttering. Vertigo < stooping/moving head/in open air; Great weakness and prostration. Fear as if something unpleasant would happen to him. Cannot bear heat around the head, cannot walk in the sun, must walk in the shade or carry an umbrella; cannot bear heat from a stove; great vertigo on assuming an upright posture, on rising from bed or from a seat. Great sensitiveness to the least jar. Aversion to bright light.
Ign.: High blood pressure due to emotions, disappointed love and/or grief. Fluttering of the muscles of chest. Throbbing cardiac hyperaesthesia. Anxious feeling in precordia. Difficult respiration, as if there is some weight on the chest, shortness of breath when walking. Feeling of suffocation on running. Palpitation of the heart at night. Strong disposition to be frightened. Sadness and concentrated sorrow with sighing. Loves solitude.
Kalm.: Shooting through chest above heart into shoulder-blade; pain in left arm. Stitches below breast. Indicated in angina pectoris aggr- from every motion. Vertigo is aggr on stooping; on looking down; on rising from a seat. Palpitation < bending forward and by mental effort. Fluttering of heart. Palpitation, with anxiety. Suppressed breathing, with faint feeling and dyspnoea. Severe pain in cardiac region. Pulse- slow, weak, irregular, remarkably slow;
40-80. Numbness of the left arm. Arms feel weak, scarcely perceptible. Limbs cold. Gouty and rheumatic metastasis of heart. Indicated in tachycardia, sharp pains take away breath. Dyspnoea and pressure from epigastrium towards the heart. Paroxysms of anguish around the heart.
Lach.: < walking up, sleeps into aggravated restlessness cannot bear tight clothes. As soon as he falls asleep, breathing stops. It is particularly suitable to those with a melancholic disposition. Women who “have never been well
since the change of life”. Debilitated, weakened people. People who cannot stand the sun and who are aggravated in summers. Tremors of the tongue, frantic loquacity. Insane jealousy. Vertigo and pale face. Unquenchable thirst desires: oysters, wine, coffee. The heart feels too large - cramp like pain in precordia. Palpitation with numbness down the arm. Must have open air; <: standing/stooping/motion. Shortness of breath, after a meal and on walking. Pressure on chest as if from on weight. Stitches in the left side of chest, with difficult breathing. Irregularity of beats. Fainting and giddiness. Complaints chiefly during climacteric period sensation as if the heart is hanging by a thread.
Nat-m.: It reduces blood pressure in patients who have a craving for salt and who worry a lot. Suppressed anger. The patient wants to be alone and any attempt to console, irritates beyond endurance. Wants to be alone to cry. Very inclined to weep and be excited, tears with laughter. It is a great heart remedy. Fluttering palpitation with faint feeling, < lying down. Pains in chest dyspnoes on ascending stairs and shortness of breath. Lancinating pains in chest
and sides of chest, with impeded respiration. Anxious and violent palpitation of the heart at every movement of body, Tachycardia pulse intermits on lying down. General dropsies and oedema due to salt retention. The throbbing headache has its analogue in palpitation of the heart. It is suited to cachectic persons, old people, teething children, anaemic, chlorotic people with catarrhal troubles and emaciated people.
Plb-met.: Cardiac weakness. Cramp like constriction of peripheral arteries causes hypertension. Hypertrophy and dilation of the left ventricles. High blood pressure + constipation and timidity. Complexion is waxy, pallid, greasy or shiny looking. Excessive and rapid emaciation. Loss of appetite with violent thirst. Pressure on chest, especially when breathing deeply or laughing. Pulse rapid, jerky, weak. Great anguish and uneasiness with sighs. Anxiety with restlessness and yawning. Weariness of life. Depression, wants to lie down. Throbbing in the entire body after slight exertion. <: at night/exertion/excitement/from motion/drinking; >: hard pressure and from rubbing;
Rauw.: This drug has come to the fore only recently and has started receiving laurels in cases of high blood pressure in its various degrees of intensity and acuteness. It has been credited with quickly softening the action of the heart, thereby normalizing the circulation, dissipating the violent congestion of head and heart, thus tending to bring the blood pressure down, even from a frightening level. The violent congestion and bursting throbbing headache quickly subside; hemorrhages from nose or somewhere else stop quickly, giddiness vanishes, normal sleep is restored and the patient soon feels tranquility. The drug has not yet been proven upon the healthy but is being used clinically.
Term-a.: A great remedy for heart maladies. Highly effective in cases of high blood pressure with vertigo, palpitation and a sense of mental and physical exhaustion. It is a good remedy for diseases of the heart, both organic and functional, angina pectoris, weakness and pain in the heart.
Thuj.: High blood pressure (+ poor arterial wall). Personal and parental history shows coronary thrombosis. Cramp in the heart. Palpitations audible with nausea. Stitches in the region of the heart. Pulse slow and weak in the morning,
in the evening accelerated and full. Swelling of veins. Patient is anxious, apprehensions about the future. Music causes him to weep. Talks hastily, very depressed, sad, irritable. Aversion to life. <: 3 h and 15 h./cold damp air/after vaccination/ excessive tea; >: rest/drawing up the limbs/warmth/in open air;
Verat-v.: Induces fall of both systolic and diastolic blood pressure. Auricular fibrillation. Valvular heart disease. Beating of pulses throughout the body especially in the right thigh. Pricking pains in the region of the heart with headache. Burning under the sternum. Dull, hot, aching pain in the heart. Slow action of heart. Palpitation and dyspnoea. Faintness and biliousness; when rising from a lying position, from sudden motion. Pulse: slow, soft and weak, irregular, intermittent; suddenly increases and gradually decreases below normal. Full blooded, plethoric persons with depression and prostration and great fear of death, fears of being poisoned.
Visc.: Feeling of suffocation when lying on the left side. Stertorous breathing. Spasmodic cough. Arterial hypertension with valvular insufficiency. Unable to rest in a reclining position. Oedematous swelling of the extremities. Teeth chatter. Eyes sleepy, difficult to open, lids heavy. Bowels obstinately constipated. Urine milky-white after standing. Palpitation during coitus. Heart gives a throb and then a pause. Pulse small, quick and very irregular, slow, full and bounding. Low tension due to dilated blood vessels.
Used a Homoeopathic Complex in the treatment of primary Hypertension in adult males over a six week period and proved to be effective.
The complex was composed of Crat. Rauw. Lach. Nat-m. and Verat. Alle C 6.
[Fernanda Abrao, Brasil]
R.S.: "Hypertension is the result of astral hyperexcitability at the level of the rhythmic system". In German, this pathology is called hypertonie, that is, exacerbated or intensified tonus. We know cramping as a constrictive action of the astral body on the muscles acting from outside as if a hand were gripping them. To understand "hypertonus", imagine this exacerbated astral tonus going deeper, as if it were generating exaggerated tonus at the level of the rhythmic, or cardiovascular, system. Here we see that this astral activity does not act from outside as it does in the case of a cramp.
It is not my intention to diminish the importance of the pathophysiology of hypertension. The comparison with a cramp is used only to get us closer to the constrictive, tension element of the astral process - something which is almost mechanical in the case of a cramp.
We find the causes of this astral tension of the rhythmic system in psychic disorders, moral tremors which affect the human being as a creature of soul and spirit. A simple and instructive example of the effects that a threat can cause to our feeling life is fright. When someone is startled, a feeling of abandonment arises, as if presence of mind abandons them. In other words, the activities of the Ego and the astral body move out of harmonious relationship with the physical-etheric body. These four bodies balance harmoniously in our rhythmic system. The consciousness of our Ego dwells in our cardiovascular system. If fright overcomes us, our capacity to react is impaired; the "shield" of the Ego and the astral body does not fully protect us. As a result, fear can invade us.
R.S.: Disorders of the rhythmic system are important in human beings between the 2nd and 3rd seven-year periods as a cause of hypertension. The 2nd seven-year period of life is the solar phase, which is essentially a rhythmic one when the child suffers very little illness.
Dr. Holtzapfel: The aesthetic and artistic experience of the world and the experience of beauty have their roots in this period. The child perceives everything around it through its most genuine feeling; we can state unequivocally that this feeling is an organ through which the child receives the world and through which he goes out to meet it. In this way, traumas of the soul from different sources will disturb the above-mentioned attitude of soul, and the soul will absorb these elements during the process of structuring the personality.
It is as if the activities of the Ego and the astral body are attempting to settle on the base of the physical-etheric body, whose node of confluence is at the cardiovascular level, but does not succeed
in doing so properly. Traumas are like frights in installments which cause the Ego and the astral body to hover, thus making it difficult for them to fit into the lower bodies like a hand in a glove.
The attempt to incarnate occurs more from outside, irregularly, in the cardiovascular system, generating an increased tonus, hypertonus, or hypertension.
R.S.: In a talk on the heart:
The human heart is a center where the cosmic forces and karmic activation are interlaced. From the age of seven up to the beginning of puberty/adolescence the individual etheric heart is born, originating from the cosmic spheres of influence (fixed stars, zodiac, planets). Together with this process there is a penetration of the astral elements (which were formerly outside) into all the physical organs; and it is as if the heart is the central point of this interiorization. These astral elements consist of karmic elements developed during the prenatal life. And it is in the heart that this clash between the cosmic-etheric forces and the karmic-astral forces takes place. The ego joins this process in sympathy from the astral body, inscribing in the astral body its aims and ideas based on which man carries out his actions... Indeed, here there is complete union of the karma with the laws of the cosmos... After death, the etheric body, upon dissolving in the starry cosmos, hands over to the universe, as it were, everything that was created by karma on earth.
This is an incomplete account of the lecture designed to illustrate the importance of the cardiovascular system in the deeper context of the existence of a human being.
Dr. Mees: Dealing with the heart, asks us to consider the muscular continuity of the heart-aorta-arteries. Since the heart is the stage on which the "dramas of the soul" are enacted, it is possible for a tensional process to materialize in the arterial system. He also reminds us that it is not only the heart that beats but the entire arterial system.
Dr. Walther Buehler: “Der Leib als Instrument der Seele in Gesundheit und Krankheit describes the heart as the "perceptive" organ of the arterial circulation”; it is the latter which really beats, leading the heart to beat with it.
Hypertension and Sclerosis
R.S. and Ita Wegman: In the seventh clinical case of the Fundamentals of Therapy it is stated that the excess astral activity not absorbed by the physical and etheric bodies causes sclerosis.
Later in the book, they state "...the excess of activity of the astral body also increases the activity of the Ego, which is manifested as a rise in blood pressure." The correlation between sclerosis and hypertension is very common (when deposits are observed on the walls of the arteries). An excess of activity of the soul/spirit can be seen as the basic cause of sclerosis; but it is interesting to note that the degenerative element can be attributed to the astral activity whereas the Ego would be the harmonizing element of this process - if it were in control. Here, however, the astral element causes degradation, irregularity, constriction or hardening, which can lead to hypertension, to more obvious metabolic disorders such as atherosclerosis or arteriosclerosis, or to less obvious ones.
In the same book, they refer to the medicine Scleron: "In sclerosis, the organization of the Ego becomes very weak; it does not do enough breaking down. As a result, the breaking down takes place only by means of the astral body..." From this we see that both in sclerosis and in hypertension there is a predominance of the irregular astral activity, poorly controlled by the healthy activity of the Ego. The effect of Scleron is precisely to give priority to the activity of the Ego over the astral body; it is to fortify and intensify the activity of the Ego in the therapeutic sense, attempting to dissolve the hardening or constrictive tendency of the astral body.
When the activity of the kidneys and adrenal glands is increased, the resulting plethora can, in turn, lead to cardiovascular disorders and sclerosis. The pyknic constitution and the choleric temperament have this tendency.
People with a weak kidney radiation tend to have low blood pressure and a melancholic temperament of the longilineous type.
R.S.: "The hypertensive patient is a hypotensive person up against life." I think that, especially in the above case, this definition is perfect if we remember that this type of person generally has little vital energy, which affects the will, especially in the case of a low kidney radiation.
Some very interesting research was recently performed by means of a microneurogram in which the stimuli of the sympathetic (peripheral) nervous system on the arteries related to hypertension was observed. The initial conclusion was that the hyperactivity of this system (due to stress, emotions, intellectual activity, etc.) caused arterial constriction, even going so far as to constrict minor blood vessels. It further concluded that in hypertensive patients the number of nervous stimuli remained high, even in the absence of triggering factors.
From this, it is not difficult to understand the previously-mentioned aspects if we consider the increased astral activity acting "from outside", causing contraction in the arterial system through the channel with which it has most affinity - that is to say, the nervous system.
Common name: chayote, vegetable pear
The possible therapeutic indications for this plant in the treatment of hypertension are manifold. It has been studied and is used in Brazilian folk medicine as an anti-hypertensive.
The plant itself has some interesting characteristics. It is a creeper with green leaves the size of a human hand or larger, gripping tendrils, small yellow or white flowers and a green fruit the size and shape of a pear. The chayote is intensely green, including its fruit, typical of the purest plant forces. This green is the element of water, of cold. The green fruit is edible. When the fruit ripens, however, it becomes yellowish and fibrous with small external spines and becomes inedible. The chayote's yellow or white flower is tiny, even timid looking. Here, in the flower, the vital etheric forces are hardly modified at all through astral intervention. Witness the chayote's tiny flower on the one side and its watery, expansive fruit on the other. Therapeutically, the leaves or tendrils are used as an infusion or the boiled fruit, either separately or in combination.
Pigs fed the chayote fruit suffer from reduced sexual potency or even impotence for a period of time. The relationship between the astral body and sexual activity, in humans as well as in animals, is well known. The more vitality a being has, the more energy it can potentially devote to a vigorous sex life. This excess vitality, which is healthy in animals, becomes pathological in human beings. The plethoric, hypertensive patient is the one that might benefit by treatment with chayote. Chayote would counter this excess vitality which "spills out through the pores." Will chayote work in other forms of hypertension? Possibly. At present, I am acquiring further clinical experience with it.