Homeopathic Management of Hypertension

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 homeopathic practice can be seen in two ways, either you are invited to treat an acute crisis of hypertension for which I was lucky to have tremendous experience or one has to treat the chronic hypertension where lots of allopathic drugs have been given and the patient is not responding to the increasing doses of the drugs or having the side effects of the drugs and hence has come for the homeopathic consultation.

Unfortunately in our homeopathic profession, the majority of the homeopathic practitioners allow anti-hypertensive drugs with homeopathy as they themselves take anti hypertensive drugs for their own hypertension! I know a homeopath who owns a large company of homeopathic medicines but for his own hypertension he prefers the allopathic drugs! This is not right because the allopathic drugs not only interfere with the action of the homeopathic remedies but can also produce an artificial layer of the drugs upon the vital force thereby 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 it is purely due to anxiety, nervousness or fear. Such hypertension does not require any treatment. Simple assurance or removing the aggravating circumstances from the patient’s life can bring the condition back to normal. However if the situation persists for a prolonged period, one needs an antipsoric remedy.

The same hypertension becomes sycotic when there are arteriosclerotic changes in the blood vessels, whether bigger or smaller, and there is an increase in the level of low density lipoproteins. These low density lipoproteins are the main lipoproteins that thicken the arteries.

Syphilitic hypertension occurs when the arteries are hard like a cord and so fragile that they are prone to rupture or may get totally obstructed, producing different types of cerebrovascular diseases.

The hypertension that I commonly see in my practice is syco-syphilitic in nature where you see a collection of cholesterol deposits in the arteries with a tendency to produce apoplexy. Psoric hypertension is seen but it is not so common. Many times a person who suffers from hypertension is quite asymptomatic and will not give you many symptoms. The best bet is to treat such hypertension constitutionally depending heavily upon his pre-disposition and disposition, which includes his past and family history, physical and mental makeup and the general symptoms.

Never try to reduce the allopathic medicines all of a sudden as it may produce severe aggravation. The method that I follow is to reduce 1/3rd of the dose in the first three months and 2/3rd of the dose in the next 6 months and later on to stop the dose. The blood pressure need not be monitored everyday; instead it should be monitored with the same instrument and at the same time once every fifteen days to know the effect of the homeopathic remedy. Never tell the patient to buy an instrument and measure the blood pressure in the house because this will make him measure his blood pressure every few hours which is bad. Many psoric or nervous individuals keep an instrument in the house; you should always discourage such practices as it damages and hampers the homeopathic treatment.

The biggest failure in homeopathy to treat hypertension is that the homeopaths 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 a local malady and treat it with the drugs like Crataegus oxyacantha or Rauwolfia serpentina.

Presentation

This is an interesting case of a man, 65 years old, who came to me with two complaints. The first complaint was bunions on his feet and the second complaint was fluctuating hypertension. For some days, the blood pressure would be quite controlled with the allopathic medicines and some days it would suddenly shoot up, he would get vertigo and then again it would come back to its original position.

Medicinal History

He was on calcium channel blockers i.e. Calcigard retard one tab twice a day and Lortazan phosphate 50 mg one tab twice a day. So, in total, he was taking two types of anti-hypertensives i.e. four tablets a day but inspite of them, the blood pressure used to fluctuate.

Life History

He was a retired bank executive, retired from a very high post. He was a graduate from England. Later on, he did his accountancy examinations in India. He had a strong family history of heart attack, hypertension and cerebrovascular accidents. From a very young age, he was successful and competitive with strong leadership qualities, egoistic, a good organizer and a good performer. By the time he reached 40, he had obtained second rank in his bank and at the age 48, he became the chairman of the bank. He was known for his disciplines. He had an eccentric nature. The people were afraid of approaching him because sometime the response would be good and encouraging but other times, it would be insulting and humiliating.

His wife mentioned, ‘He does not believe much in the medicines and takes them only out of fear that he may have a heart attack or a stroke. He always argues and quarrels with anybody and everybody if things do not go his way. With vertigo, he will always have to lie down with his eyes open. If he closes the eyes the vertigo becomes worse. For years, he complains of a ringing noise in the ear. This happened when he was swimming one day and he was suffering from common cold. Noises aggravate whenever he has cold and catarrh of the upper respiratory tract. He gets nausea which is better by eating. He is a chronically constipated person. The stools are 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. It is extremely painful and as a result he gets severe cramps in the feet’.

His main concern was his bunions and not his hypertension.  But I told him that homeopathy treats the person as a whole and the hypertension would be controlled with the same medicine that I use for the bunions. He wanted to challenge the effect of homeopathy. He said that he had never taken homeopathic medicine in his whole life and this would be a big challenge for him.

Examination

When I examined him, the blood pressure was 160/98 mm Hg. His skin was wrinkled. The pulse was very strong and large, thumping on my fingers.

escription

I tried various remedies like Ferrum metallicum, Lycopodium, Sulphur and Lachesis for the first 4 months but I could not control the hypertension as well as the bunion because the remedies that I selected were wrong.

Ferrum metallicum was selected because he was competitive and quarrelsome; closing of the eyes produced 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 tried Lycopodium as he was very egoistic, competitive, quarrelsome, had constipation with soft stool and it is a very important remedy for bunions on the feet, rheumatic pain and a strong pulse. But even Lycopodium did not help the patient.

Then I tried Sulphur because it shares many common symptoms with Lycopodium. Finally Lachesis was given because of a tendency to refuse to take the medicine. Lachesis patients especially chronic ones do not have faith in the medicines because they feel that all the medicines will do more harm and they avoid taking medicines. You may refer to the rubric ‘MIND-REFUSING-medicine; to take the’ and you will see Lachesis there. Unfortunately Lachesis did not help even in different potencies.

I restudied the case from Encylopedia Homoeopathica and I found that Veratrum viride also covered many of the non hypertensive symptoms i.e. the chronic picture. I had never used this drug as a constitutional remedy. I started with Veratrum viride 30C in this case and I went all the way up to 50M in one year. I advised him not to cut his bunion, not to scrap it or not to put some local medicines on this but allow it to heal from internally. I also asked him not to take any laxatives for his constipation. I advised him not to measure his blood pressure regularly but come to my clinic once every 15 days to measure it.

He followed the rules religiously and within nine months I could stop the Calcigard retard totally and his bunion also reduced to 50 % of the original size. In the next 6 months I decreased his Lortazan phosphate to half the dose i.e. 50 mg instead of 100 mg and I asked him to continue this for another 6 months. The vertigo was much better. There was no episode of any hypertension crisis for the last one year. In fact, at the end of 14 months of homeopathic treatment, his systolic blood pressure was in the range of 140-145mm Hg instead of 160 mm Hg and the diastolic blood pressure was in the range of 88-94 mm Hg. It never went to 98 and this was a very good sign. The ringing in the ears which was the oldest symptom ever since he was 30 years old was still present.  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 homeopathy because I wanted to see the effect of homeopathic medicine in this particular case.

About Veratrum Viridae

Veratrum viride belongs to the ‘Melanthaceae’ family. 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 and the nerves that supply the heart. It reduces the force of the heart beat and thereby reduces the blood pressure.

The most important thing is the concomitant of nausea, vomiting and congestion. If you find these three things in a case of stroke, infraction or any cardiac complication including hypertensive crisis, Veratrum viride is a drug of choice.

Another most important thing is prostration along with a dry or moist or white

Presentation

The next case is of a 55 year old woman who had three children. She was a painter and a housewife. Her husband was a businessman. She came to me with three major problems. The first was unstable hypertension, second was alcoholism with early cirrhosis of liver and third was glaucoma. She was already on allopathic medications for all the above complaints except alcoholism for which she was taking no drugs. She was taking beta blockers and the drug ‘Verapamil’ one tablet twice a day. She said that her doctor had planned to change this drug as her liver functions were getting deteriorated.

She came from Gujarat. Her childhood was very peaceful. Her father used to own farms and land. The upbringing was secure, safe and full of luxuries. At the early age of 21, she got married in a big family where there were lots of responsibilities. She was not accustomed to live her life in this way and she took time to adjust. By the time she was trying to adjust in her new family, she got pregnant which added more responsibilities and now she could not cope up. This was the time she suffered from hypertension and started drinking alcohol to give her courage and support.

She had a good relationship with her husband but he was so busy that she could not discuss anything with him. She was an extremely nervous person but she was so angry that she spoke rudely to anyone’s face.

The biggest mental shock came early in her life when her husband was diagnosed with myocardial infarction and she suddenly realized what would happen to her if he died! Also after being diagnosed with hypertension she was always worried about her health and thought she would die soon because nobody was cured of hypertension.

She was always in an excitable and quarrelsome state. She was very argumentative in nature. She loved to fight and was very obstinate in her views. When the blood pressure would go above 180/100, she would develop a dull ache in the occipital region that gradually surrounded the whole head or she would get pain in the occiput which would extend to the forehead and eyes. At that time, she had to lie down, could not do any household work and needed rest. After the husband’s sickness, they decided to stay separately and she did not maintain much relation with the relatives of the husband. She had a weakness of the memory especially for names.

This was the time when she developed glaucoma for which she was putting ‘Timoptol’ eye drops in her eyes. Because of her abnormal liver function she had a constant sensation of vomiting with a sour taste immediately after eating. It was a known case of gastro-oesophageal reflux for which she used to take antacids. When she lay down in bed, she would get cramps in the calf muscles and the feet would become so cold that she had to cover them with a blanket. But in general, she was a hot patient and she liked cold air. She had a desire for sweets and a strong aversion to meat. She was a Muslim and hence aversion to meat was characteristic because the Muslims are basically meat eaters.

When I examined her, I saw in her face that she was suffering. The sides of the tongue were red and the blood pressure was 165/98 mmHg.

To me she was very friendly and nice but her son and daughter, who accompanied her to my clinic, said that she was very rude. She could speak anything to anybody’s face if she got angry. She lived with a fear that she would die because she already had an abnormal liver function test with high liver enzymes and the cardiogram changes showed ischaemia.

Prescription

I studied her case and I gave her the remedy ‘Anacardium’ on the basis of following symptoms:

I put her on Anacardium but it did not give her any relief and the next prescription was Opium.

Opium was prescribed because of the shock that she got after her husband’s infarction with a history of alcoholism, nervous excitement, obstinacy, heaviness of the occiput, glaucoma, red sides of the tongue, constant nausea, a hot patient with an aversion to meat and desire for sweets. I tried it in different potencies but it never helped.

This time I was thinking of a remedy which covered mental shock with alcoholism and excitement but with a strong fear of impending death, a person who was quite different to her relatives with heaviness in the occiput that extended anteriorly, nausea and vomiting with cramps in the calves especially in bed and the coldness of the feet in the bed. This time I prescribed ‘Secale cor’ in 30 potency, 3 times a day from 5 cup method. I asked her to come back after a month. She responded beautifully to the medicine. After a month, she told that there was a marked change in all her complaints including the cramps, nausea, heartburn and sour taste. There was no episode of hypertensive crisis. In fact, she got her blood pressure measured and it was in the range of 150/95. I reduced the dose of ‘Verapamil’ to half and prescribed Secale cor 200 for next 2 months.

Again after 2 months, I saw that there was more control in the blood pressure, headache and cramps. She told that for the first time her anxiety and excitement levels had gone down and she took alcohol only occasionally. I continued Secale cor for three more months thereby reducing the dose of ‘Verapamil’ to one fourth.

When I totally stopped ‘Verapamil’ after 6 months, I prescribed Secale cor 1M one dose every day.  Later on I tapered off the dose from once daily to two times a week. The liver function test especially the GGTP which was in the range of 150 -180 came down to below 100 and the SGPT which was in the range of 120 -150 came down to 60, the gastro-oesophageal reflux was much better, the taste was normal, she was more friendly and less angry and there was an overall improvement in her condition.

About Secale cor

Secale cor as we know is basically a fungus. It is a nosode which is prepared from ergot. It has been used by me in my practice in different conditions like gynaecological conditions, neurosis and cardiovascular disorders.

What I saw here was the great restlessness almost like Arsenic album and the abusive, rude and insulting behaviour which is a very important aspect. They may have a good heart but they can insult you when they are angry. They always have a fear that they will die because of their disease condition. Externally, they may feel very cold but from within they are very hot. They crave cold drinks, ice, acidic and sour drinks, sweets and sugar but the same time, they have a strong aversion to chocolates. They are worse in a warm room and they do not like much covering. They have a strong history of alcoholism.