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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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

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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

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Special Formula

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